Apo E4 and sterols: Lethal combination?

11. February 2011 William Davis (24)
Phytosterols, or just "sterols" to its friends and neighbors, are a group of cholesterol-like compounds that are abundant in the plant world. Lately, however, sterols have proliferated in the processed food supply, thanks to the observation that sterols reduce LDL cholesterol when ingested by humans.

This must mean that sterols are good for you.

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

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

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

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

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

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

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

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

Glucomania

8. February 2011 William Davis (52)
As I suggested in a previous Heart Scan Blog post, a glucose meter is your best tool to:

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

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

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

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

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

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

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

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

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

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

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

It works. Plain and simple.

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

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

Diarrhea, runny noses, and rage: Poll results

6. February 2011 William Davis (19)
Here are the results of the week-long poll asking the question:

Have you experienced a wheat re-exposure syndrome?
Yes, undesirable gastrointestinal effects 223 (41%)
Yes, asthma or sinus problems 51 (9%)

Yes, joint pains and/or swelling 85 (15%)

Yes, emotional or other nervous system effects 59 (10%)
No, nothing, nada  107 (19%)

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


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

Second most common: joint pains and/or swelling.

Third: asthma or sinus congestion.

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

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

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




Sassy said:

Reflux -- starts a day later and goes for up to a week. And Bloat:2-5 inches on my waistline in a day, lasting up to three. Miserable. And why, having experienced this once, have I done it often enough to verify the connection with certainty? I am working on that one.
Anonymous said:
Wheat increased hunger with even with only a small amount. Crackers in soup was enough to set it off.

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

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

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

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

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

I get red rashes around my neck sometimes right away and sometimes up to a day or later and sometimes get bad diarrhea. 
I think it can be almost dangerous to cut things like gluten and sugar suddenly out of the diet without being very serious about keeping them out. I have found it very hard to cut out wheat without binging on it later after 4 or 5 days. I don't believe that my symptoms are just psychological either.
I was also diagnosed with ADHD as a young kid and then rediagnosed with adult ADHD by 3 different doctors. I also have bouts of mania at times too. I am considering trying to go completely gluten/refined carbohydrate free to see if it helps with the symptoms and gives me some relief.

I have never been tested for celiac or gluten intolerance but I would like to be. I think it would help explain to my girlfriend, family and friends why I can't go out and eat pizza or have a beer or ice cream. Right now they all think I'm a hypochondriac. At times I have experienced an intense fatigue the next day like I can't wake up and also sharp pains in my body and headaches.
Anonymous said:
I ditched wheat a year ago after my wife was diagnosed celiac. I immediately experienced a number of health improvements (blood lipids, sleep, allergies, etc.).

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

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

And then I read your post!

Anne said:
Depression, agitation and brain fog if I get glutened. Some times this comes with abdominal pain and a rash on my back - I think it is dose dependent. Cross contamination with wheat is a big issue when eating out. Needless to say, I eat out infrequently and then try to stick with the restaurants that are the most aware of gluten issues.
Terrence said:
Several weeks ago, I started Robb Wolf's 30 day challenge.

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

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

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

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

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

John said:
I suffered from Ankylosing Spondylitis, Iritis, Plantar Fasciits, etc for a number of years. I restricted carbs, especially wheat and I've been symptom free for the past two years now.
Lori said:
I found wheat to be one of the worst things for giving me gas bloating and acid reflux, and I'd had sinus and nasal congestion my whole life. When I ate that cookie, it just re-introduced old problems. I can occasionally eat a gluten-free, grainy goody at my party place without any side effects. I also have a little sprouted rice protein powder every day.

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

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

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

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

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

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

Steve said:
Interesting that I should sit down, turn on my computer and find your poll. Having gone several weeks, maybe months, avoiding gluten, I took my daughter and her boyfriend out to eat because my wife has been working late at the office lately. Although I was thinking I would just eat my steak and chicken, I succumbed to the temptation of eating about a dozen greasy, breaded shrimp that my daughter and her boyfriend ordered. It's 1:39am and I still do not feel sleepy. My left nostril is completely blocked, my stomach feels bloated, really, really full and I've been burping. In your poll I checked sinus problems but could have chose gastrointestinal or nervous problems just as well. 
A few weeks ago my daughter brought home a pizza and, once again, despite my knowing that I shouldn't, I ate a couple of pieces. I was sick for two days. The pain in what I think was my transverse colon was so bad I thought I might have to go to ther emergency room. Before I ate the pizza I had never gone grain-free that long before. I did this after reading Robb Wolf's book. 
I AM CONVINCED. No more wheat for me! Please, Lord, give me strength.
LV said:
What don't I experience! I typically avoid wheat (and gluten for that matter) as I'm pretty sure it makes me sick, but when I slip (or someone else slips me some) I end up with massive amounts of joint swelling and tenderness, diarhea, cramping, gas, bloating and brain fog. I'm absolutely miserable. Just that alone is enough to keep me off gluten. I have RA, so if I have repeated exposures I'll have a flare which SUCKS!

The perfect Frankengrain

4. February 2011 William Davis (25)
Pretend I'm a mad food scientist. I'd like to create a food that:

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

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

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

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

Diabetes: A study in aging

3. February 2011 William Davis (0)
Diabetics experience long-term health difficulties, including atherosclerosis/heart attacks, peripheral vascular disease, hypertension, cataracts, kidney disease, neuropathies, male erectile dysfunction, osteoarthritis, and colorectal cancer. They also die, on average, 10 years earlier than non-diabetics.

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

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

To put HbA1c values into perspective:

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

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

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

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

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

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

Fish oil: The natural triglyceride form is better

2. February 2011 William Davis (43)
If you have a choice, the triglyceride form of fish oil is preferable. The triglyceride form, i.e., 3 omega-3 fatty acids on a glycerol "backbone," is the form found in the body of fish that protects them from cold temperatures (i.e., they remain liquid at low ambient temperatures).

Most fish oils on the market are the ethyl ester form. This means that the omega-3 fatty acids have been removed from the glycerol backbone; the fatty acids are then reacted with ethanol to form the ethyl ester.

If the form is not specified on your fish oil bottle, it is likely ethyl ester, since the triglyceride form is more costly to process and most manufacturers therefore boast about it. Also, prescription Lovaza--nearly 20 times more costly than the most expensive fish oil triglyceride liquid on a milligram for milligram basis--is the ethyl ester form. That's not even factoring in reduced absorption of ethyl esters compared to triglyceride forms. Remember: FDA approval is not necessarily a stamp of superiority. It just means somebody had the money and ambition to pursue FDA approval. Period.

Taking any kind of fish oil, provided it is not overly oxidized (and thereby yields a smelly fish odor), is better than taking none at all. All fish oil will reduce triglycerides, accelerate clearance of postprandial (after-eating) lipoprotein byproducts of a meal (via activation of lipoprotein lipase), enhance endothelial responsiveness, reduce small LDL particles, and provide a physical stabilizing effect on atherosclerotic plaque.

But if you desire enhanced absorption and potentially lower dose to achieve equivalent RBC omega-3 levels, then triglyceride forms are better.

Here are cut-and-pasted abstracts of two of the studies comparing forms of fish oil.

Bioavailability of marine n-3 fatty acid formulations.

Dyerberg J, Madsen P, Moller JM et al. 
Department of Human Nutrition, Faculty of Life Sciences, University of Copenhagen, Copenhagen, Denmark.

Abstract

The use of marine n-3 polyunsaturated fatty acids (n-3 PUFA) as supplements has prompted the development of concentrated formulations to overcome compliance problems. The present study compares three concentrated preparations - ethyl esters, free fatty acids and re-esterified triglycerides - with placebo oil in a double-blinded design, and with fish body oil and cod liver oil in single-blinded arms. Seventy-two volunteers were given approximately 3.3g of eicosapentaenoic acid (EPA) plus docosahexaenoic acid (DHA) daily for 2 weeks. Increases in absolute amounts of EPA and DHA in fasting serum triglycerides, cholesterol esters and phospholipids were examined. Bioavailability of EPA+DHA from re-esterified triglycerides was superior (124%) compared with natural fish oil, whereas the bioavailability from ethyl esters was inferior (73%). Free fatty acid bioavailability (91%) did not differ significantly from natural triglycerides. The stereochemistry of fatty acid in acylglycerols did not influence the bioavailability of EPA and DHA.
(Full text of the Dyerberg et al study made available at the Nordic Naturals website here.)



Eur J Clin Nutr 2010 Nov 10. 

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

Neubronner J, Schuchardt JP, Kressel G et al. 
Institute of Food Science and Human Nutrition, Leibniz Universität Hannover, Am Kleinen Felde 30, Hannover, Germany.

Abstract

There is a debate currently about whether different chemical forms of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are absorbed in an identical way. The objective of this study was to investigate the response of the omega-3 index, the percentage of EPA+DHA in red blood cell membranes, to supplementation with two different omega-3 fatty acid (n-3 FA) formulations in humans. The study was conducted as a double-blinded placebo-controlled trial. A total of 150 volunteers was randomly assigned to one of the three groups: (1) fish oil concentrate with EPA+DHA (1.01?g+0.67?g) given as reesterified triacylglycerides (rTAG group); (2) corn oil (placebo group) or (3) fish oil concentrate with EPA+DHA (1.01?g+0.67?g) given as ethyl ester (EE group). Volunteers consumed four gelatine-coated soft capsules daily over a period of six months. The omega-3 index was determined at baseline (t(0)) after three months (t(3)) and at the end of the intervention period (t(6)). The omega-3 index increased significantly in both groups treated with n-3 FAs from baseline to t(3) and t(6) (P < 0.001). The omega-3 index increased to a greater extent in the rTAG group than in the EE group (t(3): 186 versus 161% (P < 0.001); t(6): 197 versus 171% (P < 0.01)). Conclusion: A six-month supplementation of identical doses of EPA+DHA led to a faster and higher increase in the omega-3 index when consumed as triacylglycerides than when consumed as ethyl esters.

Diarrhea, asthma, arthritis--What is your wheat re-exposure syndrome?

30. January 2011 William Davis (52)
Have you experienced a wheat re-exposure syndrome?

As I recently discussed, gastrointestinal distress--cramps, gas, diarrhea--is the most common "syndrome" that results from re-exposure to wheat after a period of elimination.

Others experience asthma, sinus congestion and infections, mental "fogginess" and difficulty concentrating, or joint pains and/or overt swelling.

Still others say there is no such thing.

Let's take a poll and find out what readers say.

Marathoners, triathletes, and heart disease

30. January 2011 William Davis (0)
Curious thing: People with lipoprotein(a) gravitate towards elite levels of exercise.

I tell my lipoprotein(a) patients that, if they want to see a lot of other people with lipoprotein(a), go to a marathon or triathlon.

This effect applies more to males than to females, just as the fascination with numbers seems to be confined to men, too. That's why I've posted in past about the "prototypical" lipoprotein(a) male.

I believe this is a big part, perhaps the only, reason why there seems to be a modest increased risk for cardiovascular events despite high exercise levels in marathoners. It has nothing to do with the exercise itself; it has to do with the kind of people who choose to exercise at this level.

The best fish oil

29. January 2011 William Davis (30)
The best fish oils available are the liquid forms. Contrary to many people's expectations, the best liquid fish oils have no fishy odor or taste.

I use a lot of liquid fish oils because of the higher doses we use in the Track Your Plaque program, as well as our strategy of high-dose fish oil to reduce lipoprotein(a). Women, in particular, don't like taking the oodles of capsules required to achieve the higher doses we need. So the ladies really like the liquid forms.

The best liquid fish oils are non-fishy, highly-concentrated, and come in the better absorbed triglyceride form. Many capsules, including prescription Lovaza, are the less well-absorbed ethyl ester form. Several studies, such as this one, have now demonstrated that the naturally-occurring triglyceride form yields higher blood (RBC) levels of omega-3 fatty acids, likely due to more efficient digestion via pancreatic lipase.

While there are many good forms of fish oil and only a few bad, these are the best of the best:

Pharmax
The Pharmax Finest Pure Fish Oil with Essential Oil of Orange contains 1800 mg EPA + DHA per teaspoon. This is the preparation I've been taking.

Nordic Naturals
The Nordic Naturals lemon-flavored ProOmega Liquid contains 2752 mg EPA + DHA per teaspoon, the most concentrated of any fish oil I've seen.

(This list is not exclusive. These are just two brands I've used extensively with good results.)

These highly-concentrated, triglyceride forms are more expensive, due to their concentrated nature. 1 teaspoon Pharmax fish oil, for example, provides an equivalent quantity of omega-3 fatty acids as 6 standard fish oil capsules on a milligram for milligram basis, but more like 8 to 9 capsules when absorption efficiency is factored in. The triglyceride form is also more laborious to manufacture. On our Track Your Plaque Marketplace, our Pharmax 500 ml runs $58.95 list. (500 ml provides 100 teaspoons or 600-capsule equivalent.)

Note that, minus the protection of the capsule, liquid fish oils will oxidize if not refrigerated. So be sure to keep your liquid fish oil in the fridge.
Fasting with green tea

Fasting with green tea

1. June 2011 William Davis (34)
I've been playing around with brief (18-24 hour) fasts with the use of green tea. Of the several variations on fasting, such as juice "fasts,"  I've been most impressed with the green tea experience.

While the weight loss effects of daily green tea consumption are modest, there seems to be a specific satiety effect that has now been demonstrated in multiple studies, such as this and this. In other words, green tea, through an uncertain mechanism, reduces hunger. The effect is not just due to volume, since the effect cannot be reproduced with hot water alone.

I therefore wondered whether green tea might be a useful beverage to consume during a fast, as it might take the "edge" off of hunger. While hunger during a fast in the wheat-free is far less than wheat-consuming humans, there is indeed an occasional twinge of hunger felt.

So I tried it, brewing a fresh 6-8 oz cup evert two hours or so. I brewed a pot in the morning while at home, followed by brewing single cups using my tea infuser at the office. Whenever I began to experience a hunger pang, I brewed another cup and sipped it. I was pleasantly surprised that hunger was considerably reduced. I sailed through my last 18 hours, for instance, effortlessly. The process was actually quite pleasant.

I brew loose Chinese bancha, sencha, and chunmee teas and Japanese gyokuro tea. Gyokuro is my favorite, but also the most expensive. Bancha is more affordable and I've used that most frequently.

If anyone else gives this a try, please report back your experience.
Tags :

Comments (34) -

  • Phyllis

    6/1/2011 12:04:50 AM |

    I would like to know if this works with iced green tea as well. I used a method of one meal per day to loose 50+ pounds. I found it pretty easy, all in all, but have regained about 20 now and need to get back on it. I think I will give iced green tea a try! (I'm not crazy about hot green tea, but like it fine iced)

  • preserve

    6/1/2011 12:09:56 AM |

    I use tea as a method of extending eating intervals.  It works well.  I'm sure a lot of it has to do with the "upper" effect.  Ie.  uppers reduce appetite as a result of blocked sensory.

    I find fasting and sensory blocking to be counter-productive.

  • Geoffrey Levens, L.Ac.

    6/1/2011 12:33:19 AM |

    May be other effects but caffeine and it's cousin theobromine in the tea are pretty reliable appetite suppressants.  But isn't getting jacked up (even if only a little) a bit counter productive to some of the potential benefits of fasting?  The idea is to rest your physiology while catabolism is in full swing. Activating the sympathetic nervous system so you don't have to experience the sensations you don't like during the early stages of fasting does not seem to me to really promote that.

  • fredt

    6/1/2011 1:09:29 AM |

    Yes, green tea reduces my hunger; I just use Tetley in the bag. Some of the greens do not have a satiating effect on me, nor do any of the black teas. Coffee increases hunger for me. Bullion cubes or OXO packets also help. I make a 1.5 l thermos, and suck on that until its done. Some days 3 or 4 of them in a day. I think I have more hunger than most people, but I am down 55 kgs, 2 to 4 years ago and have been down for 2 years.

    The other thing that helps me is chew-able Vitamin C, a couple of 500s any time I feel hungry. It seems to raise BG, possible due to BG sparing, as it is required for far oxidation, or inside cell far transport, depending on who is explaining. Two 500's raise my BG form 4.0 to 5.3 -- OK US 72 to 95.
    I am off wheat mostly; occasionally Clam chowder, sausages, and a few crackers for low BG issues. One cracker raises BG 1.5 at 15 mins.

    Thanks for the one hour BG idea. Some of my higher protein meals were a problem, like 280 Calories of canned salmon ran my BG to 9.0 (OK 162). And my doctor says I an not diabetic but my a.m. BG sure is erratic, 4.0 to 6.2 this week.

  • Sharon

    6/1/2011 2:22:06 AM |

    Hey Phyllis, I'm with you. I have been drinking 4 cups green tea made with tea bags and then chilled and have noticed that I'm not as hungry but didn't really connect it with the tea itself. I need to lose 50 lbs and I like the idea of one meal a day.

  • Scott P.

    6/1/2011 2:24:11 AM |

    Green tea, or any tea actually, makes me a little ill on an empty stomach.  Not sure but believe it is the tannins.  I also was consuming a lot of green/white tea while fasting and I just felt really acidic and my face got red splotches, which seems to coincide with acidity.  I know the net result is supposed to be alkaline for green/white tea but that has not been my experience.  Recently, I've been adding a tablespoon of apple cider vinager to a cup of warm water.  Went a fairly easy 18 hours today but did break down and had four or five macadamia nuts around 12 hours in.

  • MAS

    6/1/2011 2:44:37 AM |

    I absolutely drink green and lightly oxidized oolongs during my fasts.   It curbs the hunger and provides focus.  Been doing it for 2.5 years.

  • Dr. William Davis

    6/1/2011 2:49:43 AM |

    After millennia of human starvation, to think that we still have tons to learn about fasting used for health purposes!

    Phyllis--While I've not tried it personally, nor do I know of any formal data, I expect that iced green tea--provided it is real brewed green tea, and not the bottled variety--should work every bit as well.

  • Dianne - TPSW

    6/1/2011 1:28:40 PM |

    I am unable to drink green tea at all on an empty stomach, I will absolutely throw up if I do.  I end up with pullovertothesideoftheroadI'mgoingtopukeyesseriously!".   I actually threw up all over my suit once which was really special.  Green tea with food often makes me queasy as well.  I am allergic to oak so I think there may be a tannin connection as some heavy oak wines are problematic for me.

  • Anne

    6/1/2011 4:46:28 PM |

    I am making today a fast day. I have been drinking a mix of green and white tea but it is decaffeinated.  How often should one fast?

  • Jonathan Carey

    6/1/2011 5:58:30 PM |

    For those who get dizzy on green tea, try puerh tea.  It is a fermented green tea that is also much lower in caffeine and it taste much better than green.  It is the equivalent of drinking an aged red wine over 2 buck chuck.

  • JLL

    6/2/2011 11:27:49 AM |

    This question has been around for quite some time,  but no one seems to know the answer for certain.

    Theoretically at least, consuming antioxidants during fasting could be detrimental to autophagy (removing "junk" cells), since antioxidants might suppress the stress response from fasting. This is why some studies show antioxidants and exercise are a bad combination -- you *want* some stress to happen so that the body can adapt to it.

    Then again, there is the theory that small amounts of antioxidants actually work through the same mechanism as fasting and exercise -- hormesis. In which case fasting + antioxidants might complement each other. But that's just speculation.

    What we do know from studies is that green tea seems to increase weight loss, for example when combined with calorie restriction (and thus should apply to fasting):

    http://inhumanexperiment.blogspot.com/2009/04/green-tea-increases-weight-loss-during.html

    And when combined with exercise:

    http://inhumanexperiment.blogspot.com/2009/03/green-tea-extract-increases-insulin.html
    http://inhumanexperiment.blogspot.com/2009/02/green-tea-extract-enhances-abdominal.html

    And when combined with capsaicin (from chilli pepper), it reduces the feeling of hunger and thus calorie intake:

    http://inhumanexperiment.blogspot.com/2009/04/green-tea-and-capsaicin-reduce-hunger.html

    So all in all, whatever the mechanism is, if you're fasting just for the sake of losing weight, I'd say green tea is a pretty good bet.

    - JLL

  • Paul Lee

    6/2/2011 12:21:31 PM |

    Would depend on the length of fasts, but the East Stop East method advocates two fasts per week.  My fasts are now usually shorter, as they kind of trained me to stop grazing. I usually don't bother with breakfast now. The more you eat, the more you want to eat sometimes.

  • nina

    6/2/2011 8:10:00 PM |

    I'm subscribed to your blog, but since  you changed format the posts haven't been showing up in my mail box.  I tried to re-subscribe, but am told I'm already subscribed.  How do I get back in the loop?

    Nina

  • Dr. William Davis

    6/3/2011 1:31:00 AM |

    Anyone not receiving email versions of this blog:

    I wonder if the shift over to the new platform caused a few glitches. My blog IT help is out of commission temporarily. Therefore, please sign up again at the top.

    Sorry about that.

  • Dr. Mary Taylor, PT, DPT

    6/3/2011 6:41:41 PM |

    Yes, I completely agree with you! I went 90% wheat and sugar free from November 2010 to February 2011 and lost a whopping 2 pounds. It wasn't until I went to 95% or more wheat free that I was able to start losing weight. I am now 100% wheat free and I have lost 36.2 pounds in 15 weeks. I have also been able to significantly cut my caloric intake to 500-700 calories per day (sometimes less than 500) using iced jasmine green tea. I truly believe that a diet that is lower in calories is better for health. I typically drink 6-8 glasses a day and I really enjoy it. It helps immensely with any hunger I may have and completely satisfies my sense to eat. I use any of the varieties available in tea bag (Numi, Two Leaves and a Bud, Stash, and Mighty Leaf are my favorites). I typically choose whatever's on sale. I also drink a full glass every morning prior to eating and that also seems to stimulate my colon which is a bonus as well when consuming such low caloric counts.

    On a cholesterol and BG level, my family genetics are something that should be studied. While I started my diet at 234.8# on 2/15/2011 (I'm 5'3" and 47 y/o female) my total cholesterol was 167 and my HDL was 54. My 102 y/o grandmother however, has a total cholesterol of 155 and an HDL of 115! My 76 y/o mother also has the same great results but her HDL is "only" 109. Neither of them are on any medication for cholesterol and both of them eat a diet fully based on things we berate on this blog (cookies, bread, ice cream, fried foods, etc). Neither are overweight either. I'm eager to see what my levels become when I reach my goal weight. Maybe I can surpass that HDL of 115!

  • nina

    6/3/2011 9:39:20 PM |

    I tried that before I posted and it tells me I'm already subscribed.

    Nina

  • Ron Saunders

    6/5/2011 8:06:56 AM |

    About 15 years ago I went on a fast and had only water.  The fast lasted for 10 days.  No green tea.  Just water.  After 18 hours, I completely lost any hunger.  Meanwhile I continued to cook meals for my family.  I also continued to go to work every day.

    The experience seemed wonderful.  I had been suffering badly from asthma, and all symptoms disappeared!  I could have kept going forever without eating.  However, after 10 days I started to have problems with urination.  I began excreting small, hard pellets.

    I went to the doctor, and he exploded.  "You bloody fool!" he said.  I had altered the ketone content of my blood.

    So I started eating again.  My first meal was brown rice (no salt).  It was the most beautiful meal I ever had.  Gradually I returned to normal eating.  Gradually I returned to my asthma symptoms. Gradually all meals started tasting the same.

    Did I lose weight?  I'm not sure, as my ketone problem overshadowed all else.  Did I need green tea or anything else to curb my appetite?  No, plain water (not even distilled or bottled water, but tap water) was good enough. Do I recommend fasting?  In moderation.  10 days is far too long.

  • Gabriella Kadar

    6/6/2011 3:20:06 AM |

    Is the fluoride content of any tea (Camellia sinensis) not an issue?  Data on ppm fluoride vary but they all appear to be quite high and much higher than water fluoridation levels.

  • David

    6/7/2011 8:37:20 PM |

    Try Jasmine Tea which is green tea with Jasmine flowers.  Much tastier.
    I don't like plain green tea myself, but I love Jasmine tea.

  • Renfrew

    6/8/2011 8:08:38 AM |

    There is only one problem with green tea: Pesticides.
    Most green tea is imported from India or China because it is the cheapest. On testing, a serious amount of pesticides, fungicides, microcides is found regularly. I wonder if this diminishes the health aspect of green tea.
    I used to buy organic green tea from Japan but after Fukushima that option is also out.
    Still, certified organic is the only option left, I suppose.
    Renfrew

  • nina

    6/8/2011 8:04:07 PM |

    Just tried again and I get the same message 'You're already subscribed'.  Pity that Feedburner no longer delivers to me.

    Nina

  • GaryR

    6/9/2011 9:43:01 AM |

    Started IF HFLC diet three months ago. 30 lbs lost and A1c down to
    5.1 !! (was 6.7 ) . Curiously I have been drinking green tea during the daily 18 hour fasts and hunger is a rare occurance,  hunger pains last only a few seconds. The tea helps,  body and mind trained to not think about food until
    nightly free for all. Thank you, Dr. Davis and contributors>

  • majkinetor

    6/9/2011 1:37:31 PM |

    2 Gabriella

    Flouride IS an issue with green tea. There are known cases of flourde poisoning with excessive green tea drinking - woman drinking equivalent of 20-30 green tea cups per day. This isn't something to worry about on regular usage but if you do it on IF with reduced nutrient input and more frequently to reduce appetite it can become a problem.

    White tea has lower content of fluoride as it is harvested when plant is still young. It is much more expensive but overall better then green tea due to less processing and lower fluoride content.

    Coffee works for me absolutely amazing in reducing hunger. To some people, however, it works the opposite way. My friend develops hand tremor, nervousness, and heat. The same thing she got from the green tea but not other teas. Caffeine might be problematic for some I guess, or maybe tannin. We are currently in the process of isolation of such substance.

    To reduce appetite, I found the following valuable:
    - Garlic, fresh, in tomato juice (parsley can be included to block the smell). The capsule doesn't work.
    - High intensity exercise, short bursts of 15-20 minutes will shut down digestive engine and you will not be able to eat for hour at least.
    - Marijuana restriction - its usage during fat loss might be problematic due to activation of CB1/anandamide system.
    - Periodic IF can learn body to handle prolonged food abstinence. I find that 16-24 hours fast is enough.
    - Almonds, 10-15g, are cool, especially if you tend to go crazy before sleep - its mostly fat which doesn't rise insulin during night. 2g CHO, 3.5g MUFA, 1g PUFA, 2g P is enough to make your hunger go down at least a bit and still keep your insulin down.
    - Water

    I would suggest extensive supplementation during IF - especially Vit C (at least 2g as frequent as possible), Mg, Iodine, Selenium, Idebenon.

  • Sifter

    6/10/2011 4:13:39 AM |

    Drs. Davis or Taylor (or anyone else) have you noticed any issues with accumulated caffeine intake from multiple cups of Green Tea throughout the day?

  • Cate

    6/12/2011 8:22:10 PM |

    Dr. Davis, I hadn't heard about the dangers of pesticide use relating to green tea (as mentioned by Renfew, above)...is this a viable concern?  Since green tea is loaded with antioxidants, do the benefits outweigh the risks in this case?

    I have been drinking about two to three cups of Tazo Zen Green Tea for quite awhile now (hot, as well as chilled), and enjoy it very much.  It does seem to curb cravings quite well.  I also notice increased energy without the edgy side effects that coffee sometimes causes.  Before Tazo, I was not a big fan of the taste of green tea, but the Zen blend also contains lemon verbena, spearmint leaves and lemongrass, which enhances the flavor and makes it quite delicious--providing an "aromatherapy experience" along with the tea consumption.  Smile

  • Evolutionarily

    6/21/2011 7:28:23 AM |

    Thank you for your informative comment JLL!

  • azzy

    6/27/2011 12:15:19 PM |

    me too!i keep hearing about green tea for fasting, so i took it on day 2 i think and was detoxing to fast cos i took it on a empty stomach....:/

  • Logan

    9/15/2011 7:56:34 PM |

    I drink the Tazo Zen Green Tea from Starbucks. I prefer this green tea over any others, however I have noticed extreme dizziness when I drink this tea. Has anyone experienced this? I even bought the tea bags to brew at home, I do not add any sweetener and love the taste. I occasionally drink black tea or soda and do not get the same dizzy feeling, therefore I believe it is not caffeine causing me to feel dizzy it's just green tea. Any suggestions or comments? I like the benefits of green tea but not sure it's worth the dizziness.

  • Dr. William Davis

    9/16/2011 2:36:08 AM |

    Wacky. No, I'm not sure why this happens.

    Perhaps its some mixture or proportion of the theaflavins or other components. There are hundreds of green tea preparations available. It might be worth finding a happy alternative.

  • Wendy Rahilly

    11/25/2011 3:50:05 PM |

    I have been using green tea for years in weight loss.  You are right, it is not a "speedy" remedy and you will only recognize small affects it has, however, it does work.  On average, it is said that you can burn anywhere from 70 to 80 calories a day drinking green tea.  This is assuming you are drinking at least 3 to 4 cups daily.  It should be combined with water and a healthy diet and exercise.

  • Dr. H

    10/27/2012 11:38:52 AM |

    About the dizziness, I had severe vertigo in the middle of the night, i.e. at 3 am (my blood pressure was 130/100 pr 90), and the day and the night before sleeping, I consumed 4 mugs of green tea. The vertigo was associated with vomiting (which relieved the vertigo for a while). The vertigo lasted till the next day (vomited 4x). The green tea was a gift from a friend who came back from China-loose dried leaves. After that episode, I think I can't make myself to drink green tea again.

  • Jennifer

    2/20/2013 7:12:45 AM |

    I sometimes do a morning 'flush' of green tea, up to 4 freshly brewed mugfuls, with the addition of a squeeze of fresh lemon, which complements the taste and gives extra benefits, vitamin c and supporting detoxification.

    I recently saw a BBC documentary which demonstrated an optimal brew time of 7 minutes for maximum anti-oxidant release.

    Also, the cooled teabags are an excellent beauty treatment for the eye area, squeeze excess moisture and relax for a few minutes.

    Am reluctant to extend beyond midday due to stimulating effect of caffeine, how about switching to other teas that deliver other useful benefits? Ginger, fennel, liquorice come to mind.

    Blessings of health

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