Beware the "false positive" stress test

4. March 2007 William Davis (11)
There's a widely-known (among cardiologists) problem with nuclear stress tests. It's called the "false positive." (Nuclear stress tests are known as stress Cardiolites, stress thalliums, stress Myoviews, persantine stress tests, adenosine stress tests)

Stress tests, nuclear and otherwise, are helpful for identifying areas of poor blood flow. If an area of poor blood flow is detected and the area is substantial, then there may be greater risk of heart attack and other undesirable events in the relatively near future.

What "false positive" means is a stress test that shows an abnormality but it's not true--it is falsely abnormal. There are a number of reasons why this can happen. The problem is that this phenomenon is very common. Up to 20% of nuclear stress tests are false positives.

There are indeed situations where there may an abnormality and it is not clear whether it is true or false. This may lead to a justifiable heart catheterization or CT coronary angiogram. But, given the extraordinary number of false positives, there's a lot of gray in interpreting these tests. Hospital staff, in fact, call nuclear medicine "unclear" medicine. It's common knowledge that you can often see just about anything you want to see on a nuclear image of the heart. Abnormalities in the bottom of the heart, the "inferior" wall, are especially common due to the overlap of the diaphragm with the heart muscle, yielding the appearance of reduced blood flow. Defects in the front of the heart heart are common in females with large breasts for the same reasons.

The problem: The uncertainty inherent in nuclear stress tests opens the door to the unscrupulous or lazy practitioner. Any blip, tick, or imperfection on the nuclear images serve as carte blanche to drag you into the hospital for procedures.

This abusive practice is, in my experience, shockingly common for two reasons: 1) It pays better to do heart catheterizations, and 2) Defensive medicine.

What's the disincentive? Only doing the right thing and maintaining a clear conscience. Slim reasons for many of my colleagues--and a lot less money.

If you are without symptoms and feel fine, and a nuclear stress test is advised by your doctor, followed by a discussion of an abnormality, insist on a discussion of exactly what is abnormal, just how abnormal, and what the alternatives might be. If you receive unsatisfactory or incomplete answers despite your best effort, it's time for another opinion.

Don't neglect your magnesium

3. March 2007 William Davis (3)
Magnesium is kind of boring. So most people don't pay too much attention to it.

Magnesium can be important, however. I saw an interesting phenomenon recently. A type I diabetic patient of mine (that is, an adult who developed diabetes as a child), Mitch, was experiencing wide swings in blood sugar: low low's and very high high's (300-400 mg/dl). Mitch's magnesium was only marginally low at 2.0 mEq/L. (Ranges for normal magnesium blood levels are usually 1.3–2.1 mEq/L or 0.65–1.05 mmol/L.) Note that Mitch's blood levels fall within "normal." I do not agree with these "normal" ranges. I shoot for 2.1 to 2.4 mEq/L, which I think is the truly normal range.

In addition to eating plenty of raw nuts and green vegetables, Mitch began supplementing magnesium with magnesium citrate, 200 mg twice a day (our preferred supplement form). He reported that the wide swings in blood sugar were nearly eliminated.

Mitch's dramatic benefit is just a great illustration of how magnesium can help control blood sugar metabolism. A type I diabetic is more sensitive to the effects, but anyone with type II (adult) diabetes, metabolic syndrome, or just a slightly high blood sugar could benefit from magnesium supplementation.

There's a number of ways to accomplish getting sufficient magnesium in your daily regimen. Track Your Plaque members, Be sure to read:


Your water may be killing you at
http://www.cureality.com/library/fl_03-002magnesium.asp

Magnesium: Water to the rescue! at http://www.cureality.com/library/fl_03-010magnesium2.asp

Third heart scan a charm

1. March 2007 William Davis (0)
It struck me recently that, for many people, it's not the second but the third heart scan that more commonly shows a reduction in score.

I think this is because many people's reaction to their first heart scan is "This can't be. There's no way my arteries have that much plaque." They then follow a half-hearted program to correct their patterns.

When the second heart scan shows a significantly higher score, that really catches their attention. This is when they finally buckle down and give it their all.

Only the occasional person will, after the first heart scan, seize full control and take their program very seriously. These tend to be highly motivated people.

Don't feel too bad if your second heart scan score shows an increase. Look at it for what it represents: feedback on the adequacy of your program.

Metabolic syndrome--cured

27. February 2007 William Davis (0)
Peter started out at age 59 at 248 lbs, standing 6 ft tall (BMI = 33.6!).

Along with his weight, Peter had the entire panel of phenemena of the so-called "metabolic syndrome", or pre-diabetes:

--Triglycerides 238 mg/dl and associated with extremes of excess VLDL and IDL
--High blood pressure
--Blood sugar 115 mg/dl
--High c-reactive protein
--Small LDL particles 99% of total LDL

Interestingly, Peter's HDL was a surprisingly favorable 58 mg/dl (HDL is usually low in this syndrome). However, when broken down by size, he had nearly zero large, healthy HDL (sometimes called HDL2b). Though total HDL was favorable, most of it was simply ineffective.

Peter eliminated snacks and processed foods, particularly bread; increased his reliance on healthy oils and lean proteins; incorporated soy protein; increased vegetables. He added 30 minutes of a rapid walk on a treadmill every day. He added vitamin D to achieve a blood level of 50 ng/dml. He added a magnesium supplement.

Peter has lost 31 lbs. in the last year. Weight 207 lbs., BMI 28.1 (desirable <25). Blood sugar: 96 mg/dl; triglycerides: 56 mg/dl; HDL 71 mg/dl with 35% in the large fraction; small LDL 45% of total. Not perfect, but a damn site better.

Control of metabolic syndrome is an achievable goal for over 90% of people, just with these simple efforts. We haven't yet had a chance to assess the effect on the progression or regression of Peter's heart scan score, but he has, at the very least, spared himself a future of diabetes and all its complications.

Heart Scan Curiosities #6

27. February 2007 William Davis (0)















This is a "slice" from a normal heart scan in a 58 year old woman. Heart scan score zero. Look at the lungs, the dark areas left and right of the heart in the center. The lungs are also normal. Black represents normal density, healthy lung tissue. The white streaking is just normal lung blood vessels. This person doesn't smoke.


















This woman smokes a pack of cigarettes a day and has done so for 45 years ("45 pack-years"). She had a surprisingly low heart scan score (at age 64) of only 71, despite the smoking. However, look at this woman's lungs. It's a little tough to make out, since the computer graphics loses some of the resolution. But you can see the near absence of lung tissue on both sides. This is an advanced phase of the destructive lung disease, emphysema, from smoking. Even if she quit smoking today, the destroyed lung tissue never grows back. She literally has huge gaps or holes in her lungs where lung tissue used to be.

Smoking is among the most destructive, terrible things you can do to your body, short of swallowing strychnine or jumping off a building. Stay as far the heck away from cigarettes as you possibly can. If you are exposed to "secondary" smoke, insist that the person never smoke in your presence. It's not the smell that destroys your lungs or causes coronary plaque (though it is indeed foul), it's the actual smoke.

Should you become a vegetarian?

24. February 2007 William Davis (0)
Do you need to become a vegetarian in order to reduce your heart scan score?

No. Plain and simple. We’ve had many non-vegetarians drop their scores.

That said, are there still advantages to following a vegetarian diet, or some variation on the vegetarian theme?

Yes, there are. Let’s put aside the moral or religious arguments in favor of not eating animals—the need to eliminate killing animals for food, elimination of suffering common in modern livestock practices, Kosher considerations, etc. (Not that there aren’t real arguments here. Our focus for this conversation is not, however, the moral dilemma, but the health argument.)

Some of the most unhealthy people I’ve ever met, mostly males, are proud carnivores who boast of their prodigious capacities to eat meat. Unfortunately, it’s hard to tease out the ill-effects of excessive meat eating, since these same men also tend to be substantially overweight, smoke, drink excessively, and fail to get exercise unless their job is physically demanding. You know the type.

What advantages does a vegetarian obtain? A number of studies have suggested that the reduced saturated fat, reduced exposure to parasites, as well as reduced exposure to the antibiotics and hormones now used routinely in livestock-raising practices, do indeed provide benefits to the vegetarian. Thus, vegetarians tend to be substantially thinner, experience less bowel cancer, have less diabetes and heart disease, and live longer.

(If you are interested in reading or seeing more about just how inhumane modern livestock practices are, take a look at the video, "Meet Your Meat" at meat.org. Be sure not to view this after dinner.)

Of course, some of the disadvantages of eating animal products diminish when free-range livestock are eaten, i.e., livestock not raised in the inhumane cramped, filthy conditions of livestock factories, but in the open, grazing or rooting freely. These animals tend to have different fat compositions and taste different.

The advantages of vegetarianism, however, have blurred in recent years, since many so-called vegetarians have failed to maintain the distinction between naturally-occurring foods and processed foods. So, Ritz Crackers, Oreo cookies, whole wheat bread, and Raisin Bran fit into a vegetarian program, but they’re awful for your health. I’ll occasionally meet a self-proclaimed vegetarian who looks every bit as unhealthy as a conventionally eating American, that is, overweight, pre-diabetic person with a developing heart scan score.

So it is not necessary to be vegetarian to reduce your score. You might consider vegetarianism for other reasons, such as moral considerations, or to reduce your risk for cancer. But it is not necessary to drop your heart scan score. A non-processed food diet? Now that's is worth giving serious consideration.

Let's make it a lot easier

24. February 2007 William Davis (0)
The American Heart Association just released a new set of consensus guidelines on heart disease prevention in women: Evidence-Based Guidelines for Cardiovascular Disease Prevention in Women: 2007 Update

For those of you following the Heart Scan Blog and the Track Your Plaque program, there will be little new in the guidelines. In fact, you'll wonder if the date on the front of the report should be 1987, rather than 2007. Did you know that you should exercise and eat healthy?

Take a look at the list of risk factors for coronary vascular disease (CVD) listed in the report:

Major risk factors for CVD, including:
Cigarette smoking
Poor diet
Physical inactivity
Obesity, especially central adiposity
Family history of premature CVD (CVD at <55>

Progress: You'll notice that buried inside the list is "Evidence of subclinical vascular disease (e.g., coronary calcification)". Just a few short years ago that wouldn't have even been included.

The Track Your Plaque contention is that, for the great majority of women, this list could be shortened to one item: coronary calcification. As time goes on, the people who argue and draft these guidelines will come to the realization that coronary calcification is the disease--it's not a risk for the disease, a predictor of the disease. Coronary calcification is the disease itself. The other items on the list recede way into the background when you know whether or not coronary atherosclerosis is present, i.e., you know your heart scan score (of coronary calcium).

The report goes to say such things as taking a little bit of fish oil is a good idea, maintaining a normal blood pressure is desirable. . . yada yada yada. You've heard this all before.

A major part of the treatment guidelines are devoted to LDL cholesterol reduction with statin agents. You shouldn't be surprised. It's amazing what $22 billion dollars in revenues will buy.

A closing paragraph reads:

'Population-wide strategies are necessary to combat the
pandemic of CVD in women, because individually tailored
interventions alone are likely insufficient to maximally prevent
and control CVD. Public policy as an intervention to
reduce gender-based disparities in CVD preventive care and
improve cardiovascular outcomes among women must become
an integral strategy to reduce the global burden of
CVD.'

Say that again? If you understood that bit of gobbledygook, you're a lot smarter than me.

Don't look to the American Heart Association report for any new ideas. It reminds me of the politician who reminds everybody of what a devoted family man he is: It has nothing to do with his policies. It just makes him look good. If compared to prior report, the 2007 report does indeed represent progress--but just oh so little.

No wonder nobody talks about real prevention

23. February 2007 William Davis (0)
Take a look at this eye-opening statement taken from a well-written NY Times article about Dr. Arthur Agatston, the South Beach Diet and now South Beach Heart Program books:


'We have made major improvements in prevention,” Dr. Gregg W. Stone, the director of cardiovascular research at Columbia University, says. “But it’s difficult. It takes frequent visits, a close relationship between a physician and a patient and a very committed patient.'

Which is exactly the atmosphere Dr. Agatston’s practice tries to create. Nurses there give patients specific cholesterol goals to meet and help them deal with the side effects of the drugs they are taking. A nutritionist, Marie Almon, meets with patients frequently enough to discuss real-life issues like how to stick to a high-fiber Mediterranean diet even on a cruise or a business trip.

There is only one problem with this shining example of a medical practice: it is losing money.


From NY Times, January 24, 2007. What’s a Pound of Prevention Really Worth? (Find the full text at http://www.nytimes.com/2007/01/24/business/24leonhardt.html?ex=1172379600&en=4268a738e82857da&ei=5070.)

It gets at one of the fundamental reasons why your cardiologist will probably never talk to you about an intense approach to prevention: it doesn't pay. Because John Q. Cardiologist focuses, instead, on how to increase procedural volume, train how to put in the next best defibrillator, etc., there is little consciousness about preventive issues. Just the simple matter of taking fish oil causes their eyes to glaze over.

That's why the Track Your Plaque program exists: it is a portal for the kind of information you cannot get. Of course, you could read all the scientific studies, attempt years of trial and error, and try to gain a sense of how to do this yourself. Or you could follow this program. We are proud to not worry about generating procedural profits. We ar unbiased by drug or medical device money. We say exactly what we mean.

By the way, we are on a current push to really "beef-up" our online discussions via real-time chat. Long-term, we'd like to be able to offer chat with our staff many hours every day. Be patient. It will happen, but not today.

HDL and vitamin D

22. February 2007 William Davis (5)
I know of no published reports on this question, but I've now seen numerous people experience significant jumps in HDL with raising blood vitamin D to 25-OH-vitamin D3.

Last week, for example, I had a man who had struggled with raising HDL from a starting level of 28 mg/dl. On niacin, exercise, weight loss, fish oil, red wine, and cilostazol (a prescription agent that I use occasionally that raises HDL), his HDL rose to 41 mg/dl--better, but hardly to our goal.

I added vitamin D, 4000 units, and raised his 25-OH-vitamin D3 level from 22 ng/ml to 53 ng/ml. Next HDL: 73 mg/dl! Small LDL improves along with a rise in HDL.

Not everybody's response is this dramatic. I see more typical rises of 5 to 10 mg/dl every day. I'm uncertain of why the response is inconsistent, though people who begin with lower vitamin D levels seem to experience a larger HDL increase. I wonder if the partial normalization of insulin and glucose responses is at work, or some anti-inflammatory effect.

Vitamin D provides so many other benefits, as well as HDL-raising. I hope you've gone to the effort to have your blood level checked to determine your replacement need. If not, now's the time. February represents your nadir (lowest point) for 25-OH-vitamin D3 blood levels.

Even more Michael Pollan

20. February 2007 William Davis (0)
"Eat food. Not too much. Mostly plants.

That, more or less, is the short answer to the supposedly incredibly complicated and confusing question of what we humans should eat in order to be maximally healthy. I hate to give away the game right here at the beginning of a long essay, and I confess that I’m tempted to complicate matters in the interest of keeping things going for a few thousand more words. I’ll try to resist but will go ahead and add a couple more details to flesh out the advice. Like: A little meat won’t kill you, though it’s better approached as a side dish than as a main. And you’re much better off eating whole fresh foods than processed food products. That’s what I mean by the recommendation to eat “food.” Once, food was all you could eat, but today there are lots of other edible foodlike substances in the supermarket. These novel products of food science often come in packages festooned with health claims, which brings me to a related rule of thumb: if you’re concerned about your health, you should probably avoid food products that make health claims. Why? Because a health claim on a food product is a good indication that it’s not really food, and food is what you want to eat."

Michael Pollan, author of my latest favorite book, The Omnivore's Dilemma, wrote a wonderful piece for the New York Times entitled "Unhappy Meals". You can find the full text at http://www.nytimes.com/2007/01/28/magazine/28nutritionism.t.html?ex=1172120400&en=a78c20f4da0cdc7b&ei=5070. (Another favorite read of mine, The Fanatic Cook's Blog at , alerted me to Pollan's article. Incidentally, take a look at the Fanatic Cook's latest posts--very entertaining and informative. She's got incisive insight into foods as well as a great sense of humor.)

Pollan goes on to say that...

"...typical real food has more trouble competing under the rules of nutritionism, if only because something like a banana or an avocado can’t easily change its nutritional stripes (though rest assured the genetic engineers are hard at work on the problem). So far, at least, you can’t put oat bran in a banana. So depending on the reigning nutritional orthodoxy, the avocado might be either a high-fat food to be avoided (Old Think) or a food high in monounsaturated fat to be embraced (New Think). The fate of each whole food rises and falls with every change in the nutritional weather, while the processed foods are simply reformulated. That’s why when the Atkins mania hit the food industry, bread and pasta were given a quick redesign (dialing back the carbs; boosting the protein), while the poor unreconstructed potatoes and carrots were left out in the cold.

Of course it’s also a lot easier to slap a health claim on a box of sugary cereal than on a potato or carrot, with the perverse result that the most healthful foods in the supermarket sit there quietly in the produce section, silent as stroke victims, while a few aisles over, the Cocoa Puffs and Lucky Charms are screaming about their newfound whole-grain goodness."

Not everything Pollan says is new, but he says it so eloquently and cleverly that he's worth reading. If you haven't yet read Omnivore's Dilemma, or just want a condensed version of the book, the New York Times piece is a great piece of the world according to Michael Pollan.
Have some more

Have some more

7. April 2011 William Davis (37)
Wheat, via exorphin effects, is an appetite stimulant. Eat a whole wheat bagel or bran muffin, you want another. You also want more of other foods. You also want something to eat every two hours due to widely-swinging insulin-glucose responses: blood sugar high followed by a sharp downturn that triggers a powerful impulse to eat (thus the cravings for a snack at 9 and 11 a.m. after a 7 a.m. breakfast).

If wheat is a stimulant of appetite, then removing it should yield reduced appetite and reduced calorie intake. That is precisely what happens.

When wheat products are removed from the diet--without calorie restriction, without counting fat or carbohydrate grams, no exercise program, no cleansing regimen, no skipping meals . . . nothing--calorie intake drops 350 to 400 calories per day. This calorie figure remains curiously consistent across multiple studies in which wheat was eliminated.

400 calories per day results in 21 lbs lost over 6 months, based just on calories. (3500 calories per pound lost.) That is what happens in wheat elimination diets: 21-26 lbs lost over 6 months.

Wheat is the processed food industry's nicotine, a means of ensuring repeat food purchases. It's also low-cost (subsidized by the U.S. government), high-yield, an ingredient that even has its very own withdrawal syndrome should you miss a "hit."
Tags :

Comments (37) -

  • Steve

    4/7/2011 2:49:30 PM |

    The reduced appetite after wheat withdrawal is exactly what I'm experiencing. A very low carbs (and so very low wheat) diet is the first diet that I can stay on because I don't get hunger pangs. I'm down about 20 lbs. (10%) since finding this blog and going wheat-less.

  • Anonymous

    4/7/2011 3:31:35 PM |

    Hmmm... I've been wheat free (grain-free, actually) for almost 3 weeks now. I started off being mildly hungry all the time, and that has faded. I wonder if that's what you're talking about there!! Terrific!

    Keep the articles coming... love them.

    Diana

  • Steve

    4/7/2011 4:16:45 PM |

    I started just before Christmas. The first week or so was unpleasant ... hungry, groggy ... wheat withdrawal. The "no hunger pangs" showed up after that and made it possible for me to stay on this diet. It's the first time I've been able to consistently lose weight.

  • Real Food RD

    4/7/2011 4:44:52 PM |

    When I first went off wheat it took a good 3-4 weeks for the withdrawl to stop.  During that time I was ravenously hungry and ate constantly.  I know my body was just hoping I'd eventually eat some bread.  I gained probably 10 pounds, but it came back off (I don't have any other weight to lose).

    Was that a study you are referencing or clinical experience?  Would love to have more details.

  • Might-o'chondri-AL

    4/7/2011 5:08:06 PM |

    Biblical wheat and remote regional "landrace" wheat strains are not the same as tetra-ploid wheat we're sold. Tetraploid varieties have been grown for less than 500 years; and di-ploid varieties around for 500 to 1,000 years.

  • Megaera

    4/7/2011 5:23:28 PM |

    Look, I'm glad that this works for some/lots of people - but I've been doing this since before Christmas, 4 months now, and I haven't lost a pound.  My status is a good deal worse in a number of subtle and not-so-subtle respects, and frankly nothing of substance has actually improved in any way.  Recommendations of iodine supplementation were an unqualified disaster.  And I effectively have nowhere to go, now -- I'm stuck with this mode, because I have every reason to believe that going back to grain in any degree will yield uncontrollable weight gain.  I'm really not trying to be negative, but the point  has to be made, amid all the rosy predictions of magic pounds disappearing (that's just calories-in-calories-out which is supposed to be BS, according to the new Received Wisdom, no?) that this regimen doesn't work for everyone.

  • ChicagoGirl1

    4/7/2011 6:06:43 PM |

    How is wheat different from just carbs in general? Don't they all create this problem?

  • brec

    4/7/2011 7:09:57 PM |

    "...has its very own withdrawal syndrome should you miss a 'hit.'"

    If you follow the link, you'll see that this unqualified statement is based on self-selected (Dr. Davis's blog commenters) anecdotal evidence.

  • Anonymous

    4/7/2011 7:42:27 PM |

    brec:

    If you keep following those links back, you'll eventually land here:

    http://www.jbc.org/content/254/7/2446.full.pdf+html

  • Dani

    4/7/2011 8:25:31 PM |

    I agree. I can't stop once i start eating crackers or croissants.

    In your opinion, do other grains like corn and rice have the same effect?

  • Gene K

    4/7/2011 9:44:27 PM |

    @Megaera

    I used to eat a lot of bread. For the first four months of my grain-free and carbs-from-veggie-only life and policing my blood sugar I gained about 10lbs. My NMR profile got significantly worse, too. Dr Davis checked my APOE and it was type 4, so he told me to limit fats and changed my medications. In addition, I stopped being a vegetarian and increased the amount of lean proteins in my diet. I also changed my exercise routine according to slow-burn. Four months later - 14 lbs have been lost and NMR profile improved drastically.

    I am saying it, because there is a happy path of losing weight when you stop eating wheat, but certain people may need to make an additional effort. So you need to look further.

  • Might-o'chondri-AL

    4/7/2011 10:03:45 PM |

    Japanese children (290) aged 5 - 18 had MRI of brain to see if breakfast centered on white bread vs. white rice differ. The study adjusted for confounding factors.

    The older white rice breakfasters showed a larger grey matter in relation to cranium volume; in some brain areas white bread eaters had more grey matter.In the youngest there was not a statistical differenece in grey matter volume between the groups.

    Rice breakfasters' MRI showed more grey matter in left superior temporal gyrus, left inferior temporal gyrus,right pre-central gyrus, left superior caudate  nuclei and the bilateral caudate nuclei. Caudate volume is associated with a subset of verbal IQ ( POI component); the rice breakfasters had higher POI scoring. And in addition they had higher IQ than the bread group; IQ is associated with prefrontal and orbito-facial corteces and the cingulate gyrus.

    Bread breakfasters MRI showed more grey matter in the postcentral gyrus, right precentral gyrus, right fronto- parietal orbit, and bilateral orbito-frontal corteces. Their MRI showed more white matter in
    the right pre-frontal gyrus  and post-central guyrus; otherwise the two diets showed no white matter % differences between the groups.

  • Just Joan

    4/8/2011 1:00:06 AM |

    My experience has been exactly like Steve's. Since going completely wheat-free (as well as ditching the sugar and most fruit), I'm down 15 lbs. and still losing. The best part of all is that my hypoglycemia symptoms have completely disappeared, my energy is through the roof, and I no longer get uncontrollable hunger pangs.

  • Dr. William Davis

    4/8/2011 1:01:57 AM |

    As Steve and 1st Anonymous point out, this approach can work for many, if not most, people with extravagant weight loss and health benefits.

    However, as the frustration expressed by Meg suggests, there may be confounding factors. As Gene points out, apo E4, for instance, can modify the response. But this was not the focus of the post.

    This is a blog. Each post makes a point. Don't mistake this for a one-on-one healthcare encounter.

  • Dr. William Davis

    4/8/2011 1:03:27 AM |

    Hi, Real Food-

    I was referring to the collective experience demonstrated in gluten-elimination diets in celiac patients.

    I will summarize this literature in my upcoming book from Rodale, Wheat Belly.

  • mongander

    4/8/2011 1:32:32 AM |

    I've relented and switched from oats to swallowing about 1 oz of chia seed for breakfast.  The rest of the day I mainly rely on cabbage/veggie soup (no starches)...snack on roasted peanuts & boiled eggs.  Am losing weight.

  • Frank Hagan

    4/8/2011 2:01:10 AM |

    Dr. Davis - I posted today about leptin resistance, and how high triglyceride levels have been implicated in stopping leptin from its normal "hunger stopping" function. Have you seen a dramatic decrease in triglycerides from those that simply refrain from wheat, without intentionally counting other carbs?

  • WheatlessX

    4/8/2011 2:23:20 AM |

    A few months ago, I read a post on this blog which suggested getting a BG meter in order to see what effect things like wheat had on BG. The results of my first meal (whole wheat pasta with red sauce, broccoli, and whole wheat toast) showed 183 at 1hr PP and 149 at 2hr! What was really surprising to me, however, was that despite the 2 hour number being as high as it was, I was still very hungry.

    Based on this and subsequent tests, along with increased awareness of satiety, I've made some pretty significant changes in the types of foods I eat. Mostly, I've cut back on all the grains (even "whole grain") and added fats (I no longer believe the "low fat" recommendations).

    The result is that in about 3 months I've lost roughly 15 lbs. (mostly in my belly), despite having no sense of being deprived. It doesn't hurt that my lipids have improved, as well (TC, LDL and trigs all lower).

    I had been skeptical of Dr. Davis's claims about wheat at first, but I am now convinced that for me at least, wheat is not my friend.

  • Anonymous

    4/8/2011 3:33:36 AM |

    What if that happens to me with prety much every thing. I want another almond, another egg, another piece of cheese, another wine, more chocolatte, another sushi, a bit more of meat....

  • David Evans

    4/8/2011 8:16:16 AM |

    I started to cut down on my bread intake about 3 years ago and am now almost completely grain free (apart from accidental consumption). I have lost over 50lb and feel like a diifferent person.

    One of the biggest bonuses of cutting wheat from my diet is the improvement in my mood and temperament. I used to be quite a moody and slightly unpredictable type of personality, but now everything is calm and serene.

    Quite a few scientific papers show a connection between schizophrenia and cereal intake. http://healthydietsandscience.blogspot.com/search/label/Cereals%20and%20Schizophrenia

    This may help to explain the improvement in my personality.

  • Anonymous

    4/8/2011 11:10:35 AM |

    I've been mostly wheat-free for over a year, and have lost exactly zero pounds. I still don't eat it, since I believe there are a lot of benefits to leaving it out (all my blood-work #'s were fine before, but improved a bit more after awhile of high-fat/low carb). The biggest improvement I've seen is in my mood -- no more depression. However, I'm still 100 lbs overweight. Frown

  • CarbSane

    4/8/2011 12:27:43 PM |

    When wheat products are removed from the diet--without calorie restriction, without counting fat or carbohydrate grams, no exercise program, no cleansing regimen, no skipping meals . . . nothing--calorie intake drops 350 to 400 calories per day. This calorie figure remains curiously consistent across multiple studies in which wheat was eliminated.


    I would be interested in one study demonstrating that just cutting wheat from the diet resulted in 350-400 cal/day spontaneous reductions in intake.  Preferably controlled for protein content by substituting other carbs for normal wheat content.  

    The VLC diet studies don't count as too many variables are changed there to attribute most, if even any, of the decreased intake to reductions in wheat intake.

    If wheat is addictive, and whole wheat supposedly contains more addictive substances, why don't people gravitate towards whole wheat pasta and bread and binge on
    those?

  • Eric

    4/8/2011 3:12:46 PM |

    CarbSane-

    You stated "The VLC diet studies don't count as too many variables are changed there to attribute most, if even any, of the decreased intake to reductions in wheat intake."

    Same could be said for the studies that cholesterol and fat are the sole reasons for our obesity, diabetes, heart disease, etc- yes?

    I also don't buy your suggestion that people don't binge on whole wheat containing foods as I've seen it countless times at bagel shops, healthy Asian noodle bowl places, pizzerias, etc. People trying to eat "Healthy" often over indulge on "healthy" pizzas, bagels, breads and pasts all while thinking they are doing eating exactly what the AHA recommends. Something that is more than likely silently killing them.

    I've done all this before and all it got me was a plethora of trips to a cardiologist, anxiety, depression, bloating and countless Rx pills that did absolutely nothing. And I'm not an unhealthy guy by any means.

    You may feel Dr. Davis' posts are all anecdotal and that's fine. His new Track Your Plaque book has all the evidence and studies I need to support his claims and it was the anecdotal evidence that he posts that spoke volumes to me. It was the first place I found that explained exactly what I was going thru (30 years old, extremely hypertensive, depressed, slightly overweight and angry with atherosclerosis that seriously a 30 year old should not be suffering from). From that point on I've read his book, followed his plan and have replaced all my worthless Rx's for a daily dose of VD3, Omega3 and steer clear of "Healthy" grains... and I couldn't be happier.

    Of course this is my own "anecdotal" experience, that four of my previous cardiologists couldn't achieve...

  • Steve

    4/8/2011 4:01:05 PM |

    In posts above I didn’t make clear that I am actively “dieting” as in “trying to lose weight”.

    My diet: Two Atkins shakes for breakfast with vitamins and two more for lunch. An Atkins shake for snacks, as needed. Dinner is a leafy greens salad with vinaigrette and maybe nuts, peppers, tomatoes, cheese, minced garlic plus a meat portion and sometimes a low-carb vegetable. A 30 minute after-dinner walk with my dog most  evenings. A 15 minute walk/run some mornings before my weigh-in.

    I believe the only reason I can stay on this tough diet is the “no hunger pangs” effect that I get with very-low-carbs. For example, I can have the Atkins shakes for breakfast and easily go until lunch with no cravings. To accelerate weight loss, I can even skip breakfast – no hunger pangs means I can go from dinner to lunch without cravings – I’m hungry but I can do it – I’ve done it every day this week.

    I’m about 5’8”. I found this blog on Dec. 17th and I weighed 204 lbs. On Jan. 29th I weighed 189. Today, April 8th, I weighed in at 179.8! I hadn’t been in the 190s in years. The 180s? The 170s? They were just dreams to me.

    I have gone off the diet; typically after multiple social events in a row. Example -- alumni social Thursday eve, extended-family dinner at a restaurant Friday eve, sports event Saturday, why-not-keep-eating Sunday. Then, I want to keep losing weight so I get back on the diet. I go through wheat-withdrawal again but now I know it’s just a temporary phase and that helps me get through it. It takes about 10 days to get back to where I was and then I keep dieting.

    Disclaimers – On a tough diet like this I am weaker than normal but I can function and I put up with it because, after my initial success, I see this works & I want to lose the weight. I have a desk job so I can probably better handle the reduced energy levels than someone with a more active job. My family is supportive and we eat dinners that work with the diet. So I have intangible factors helping me.

    One definition of hack is “a clever solution to a tricky problem”. To me, very-low-carbs is an empowering “hack” of my metabolism that lets me control my weight. Hallelujah!

  • Might-o'chondri-AL

    4/8/2011 5:01:12 PM |

    A single variety of modern tetra-ploid wheat has 100s of different gluten proteins. This equates to 10s of thousands of variations of peptide sequences one can ingest from wheat.

    The molecules formed depend on how trans-amin-dation (cross linking proteins) binds the free residues of glutamine. This potential bond is genetic for each strain of wheat, since involves the positioning of Carbon terminals (located on any of those peptides, as a proline residue). Tetra-ploid wheat has many unique proline residues that cross-link (ex: alpha gliadin) in a way that can resist our digestion.

    Plasticity is a term used to describe the human brains ongoing adaptability. The nerve axons are in a outer (extra-cellular) matrix of gluco-proteins; this includes the proteo-glycan chondroitin sulfate ( glycan = poly-saccharides & oligo-saccharides; hence "glyc-").

    Chondroitin sulfate's residue (wing) of N-acetyl-galactos-amine provide a place for lectins to bind to (ex: lectins most infamous  trans-amididation incarnation is the gliadin molecule, a type of glyco-protein). Thus different glyco-proteins, with unique derivative glycos-amino-glycan molecular chains are going to affect brain neurons differently.

    Anti-bodies for uOR (natural opiod receptor)detected in circulation are indicative of a reaction to some lectin. This means a lectin is binding to the uOR; Doc calls this an "exorphin effect" with one end result being appetite stimulation.

    Neo-striata cells in the brain work off of input from the cortex; the neo-striatum has a part called the matrix (note: here matrix is a brain structure & not to be confused with terms like extra-cellular matrix) and another part called the striosome. The matrix neo-striata gets input from the pre-frontal brain and senori-motor regions; while the striosome input is from pre-limbic, infra-limbic and pre-motor corteces.

    The matrix neo-striata neuro-chemistry is  integral to behavior involved in self-initiated action, goal directed behavior, sensory integration and motor programs. During post-natal (growing child) brain development the striosome neo-striatum cells have a high degree of involvement with glyco-proteins; which may partly explain the Japan school children brain development differences due to breakfast of rice vs. bread (detailed above).

  • CarbSane

    4/8/2011 6:29:24 PM |

    @Eric, I agree.  Don't know where I've claimed such.  Dr. Davis made a claim (and he preceded that with "When wheat products are removed from the diet--without calorie restriction, without counting fat or carbohydrate grams, no exercise program, no cleansing regimen, no skipping meals . . . nothing-").  Study?  One?  

    I'm just asking for a study that demonstrates this claim.  I don't refute that a good many people could benefit from avoiding wheat.

  • Eric

    4/8/2011 7:59:13 PM |

    My apologies CarbSane, I didn't mean for reply to come across as combative.

    Dr. Davis may have a study that he can refer you to.

    But it is a well known fact that foods that trigger a surge in blood sugar and after-meal crashing also lead to increased hunger more frequently.

    Foods that lead to the surge are carbs in (either healthy or processed) grain or sugar form.

    Sometimes all the anecdotal evidence should stand above the biased studies attempting to maintain the status quo. Just my .02

  • Nick

    4/9/2011 4:38:03 AM |

    I reduced my CHO intake about three years ago and lost about 8 pounds in the first three months.  At about the three month point, I removed wheat and all other grains from my diet.  I have lost no additional weight since I gave up wheat.  

    I would say that I have not reduced my caloric intake by 400 calories a day.

  • CarbSane

    4/9/2011 11:09:24 AM |

    @Eric, no apology necessary, I didn't take your post as combative at all.  I just find Dr.Davis making sensationalistic claims a matter of routine lately.  I do a lot of literature searching and I've not, to my memory, ever come across one study that just looked at eliminating wheat and intake.  I'd be curious to see the results of such a study done in a well controlled manner.

  • Dr. William Davis

    4/9/2011 4:36:30 PM |

    In response to several commenters:

    Citing studies in which calorie intake is reduced by strictly eliminating wheat while not imposing any other restrictions does not necessarily mean that this is the most healthy way to eat.

    In other words, if I eliminate wheat but replace lost calories with corn chips, jelly beans, and Coca Cola, then of course I will not lose weight nor obtain health benefits beyond elimination of gluten and other undesirable ingredients in wheat.

    A better approach would be to 1) eliminate wheat, then 2) reduce carbohydrates, especially cornstarch, oats, and sugar, then 3) eat other whole healthy foods.

    My point is that, sans wheat, the drive for consumption is diminished for many, though not all, people.

  • Might-o'chondri-AL

    4/9/2011 4:55:03 PM |

    MRI of adult brain while eating shows a response according to an individuals BMI variation. I had this as a well composed comment at WholeHealthSource, but can't retrace it; so, roughly, from my notes now.  

    High BMI individuals have more brain activity in the left posterior insula, supramarginal gyrus, para-central lobule and the cerebellum's uvula/declive/tonsil structures. Cerebellum response involves how one likes the looks/smell of food; more blood flowing in the cerebellum coincides with increased appetite.

    Low BMI individuals have more brain activity in the anterior insula, posterior hypothalamus, amygdala, thalamus, pons and mid-brain structures.

    The Vagus nerve (dorsal) leads from our "gut" up into the pons sub-nucleus of our brains dorsal raphe. In obese individuals this link shuts down when eating. Contrary to the obese, this link is open in lean individuals when they (non-obese) are eating.

    The Pons, which inputs into most of the other brain structures, shows more functioning with slower eating. In addition, stuffing with excess food in a meal slows the pons interaction with the brain.

    The Amygdala, part of our limbic system, sets the emotional response to things ingested. It gets plenty of neuro-signals from the gut, and is implicated in binge eating.

    The Posterior Insula recieves input from both the amygdala and hypothalamus (regulator of amount we ingest). In obese individuals both the posterior and middle insula trigger (on)into action when they see the meal; as contrasted to normal BMI individuals, where these brain structures remain unaffected when they (non-obese) see a meal.  

    In obese individuals there is comparatively more dopamine activity in the neurological circuits of the hypothalamus, amygdala, mid-brain and thalamus (arousal response). So, all in all, it seems quite possible Doc's nemesis (tetra-ploid wheat's molecules) can play antagonistic roles in the brain.

  • CarbSane

    4/9/2011 5:37:21 PM |

    But Dr. Davis, you said there are multiple studies demonstrating a similar drop in caloric intake from eliminating wheat "without calorie restriction, without counting fat or carbohydrate grams, no exercise program, no cleansing regimen, no skipping meals . . . nothing-"

    Are you walking that back?  Or do such studies exist.

  • Might-o'chondri-AL

    4/10/2011 12:39:51 AM |

    Hi CarbSane,
    Doc's rant is about the "undesireable ingredients"
    in modern wheat. If would you forgive me for sounding like a know-it-all, then, my comments show some brain responses that go beyond "x" number of calories, "x" amount of carbohydrates, "x" level of exercise and "x" amount of meals.

    It is modern wheat's assorted agglutin fractions, the way they bind glycans (like chitotriose, Beta-1-4-linked N-acetyl glucosamine) and how they cleave off "rogue" metabolites that has an effect on the brain cells. These metabolites have to get inside the brain cells cytoplasm by trans-duction; they are not ions.

    These "undesireable" cleaved metabolites have exposed glucosamine (GlcNAc) wings (residues) that bind to GLcNAc receptors on the cell; this fosters their trans-duction (carrying) past the cell membrane and any intervening endothelial (blood vessel wall) barriers.

    The "undesireable" metabolite then out binds Lysosome C; thus normal lysosomal "housekeeping" endo-cytosis (engulfing) action is inhibited from destroying (ie: no opportunity to hydrolyse apart bonds in the metabolite) that metabolite. This gives the metabolite the time to act like a Heat Shock Protein (ie: it has
    physically blocked that brain cell's usual heat shock protein ever since it locked onto that cell's GluNAc receptor); and thus, that "undesireable" metabolite can ferry (translocate) it's glycan/peptide right to the Endoplasmic Reticulum inside of that brain cell.

    Once the endoplasmic reticulum
    (in a brain cell) recieves an
    "undesireable" peptide/glycan complex it (endoplasmic reticulum) is not able to do a
    "normal" job with it; which job is to properly fold (ratchet into explicit configurations) the normal proteins the  brain cell passes to it (endoplasmic reticulum). Any alternate fold in a protein means it (protein)will react differently in the cascades it participates in.

    How this translates into each of the physical alterations in specific brain structures that I mentioned is beyond my understanding. This comment is to explain one of the ways those
    changes can get initiated in human brain cells by modern wheat; and also, to show our schooling on calories/carbs/ exercise/meals/cleansing misdirect us Doc insists he sees clinical results.

  • Onschedule

    4/10/2011 6:23:53 AM |

    @Might,

    I have enjoyed many of your comments; you have a keen talent in selecting and presenting information which dovetails nicely with Dr. Davis's blog entries. I found this one particularly fascinating.

    Thanks!

  • rcdyoga

    5/6/2011 3:22:45 AM |

    Here is my wheat story. I have been "mostly" avoiding wheat for 3 years and when finally being diagnosed with Hashimoto's decided to go completely wheat free. My doctor suggested a gluten challenge for a definitive diagnoses of celiac or gluten intolerance.  Unfortunately, I agreed. Six weeks into the 3 month challenge I quit due to problems that began during the gluten challenge (joint pain, severe digestive distress, insomnia, adhesive capsulitis, nightsweats). Unfortunately the gluten caused some damage and I developed new food intolerances to dairy and nightshades, which have not resolved in 7 months of being grain free.

  • Yvonne

    8/2/2011 10:42:30 AM |

    Sorry this reply comes so late! I hope you see it. May I suggest that you try magnesium oil? It's a mixture of mag chloride and water that you apply to your skin. You may be mag deficient and, if so, that could explain why you're not losing weight.

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