Wheat brain

Among the most common effects of wheat are those on the brain.

Consume wheat and susceptible individuals will experience a subtle euphoria. Others experience mental cloudiness or sleepiness. (This is what I personally get.)

It gets worse. Children with ADHD and autism have difficulty concentrating on a task and have behavioral outbursts after a cookie. Schizophrenics experience paranoid delusions, auditory hallucinations, and worsening of social detachment. People with bipolar disorder can have the manic phase triggered by a breadcrumb. All these effects are blocked by administering drugs that block the brain's opiate receptors. (This is why, by the way, a drug company is planning to release an oral agent, naltrexone, formerly administered to heroin addicts to help control addiction, for weight loss: block the euphoric effect, take away the temptation, lose weight.)

Here is Heart Scan Blog reader, Nicole's, mental fog story:

I have been grain-free (no gluten free grains either) for quite a long time (about a year and a half). Earlier this week, I decided to try white bread and pasta. The experiment only lasted two days. I had horrible terminal insomnia both nights, causing me on the second night to wake up at 2:30 am unable to get back to sleep at all. I felt drugged and in a mind-fog all the next day and even dozed off a few times! Luckily I had the day off work.

I had very bad forgetfulness also. I forgot that I left my bag and groceries at work, so I had to go back for them. Then I had to use my husband's keys to get in because I thought my keys were in my bag, but it turns out they were in my pocket. Then I got my bag, set the alarm, locked the door and then realized I forgot my groceries. So I had to re-open the door, unset the alarm, and go back for the groceries. Then I locked the door, forgetting to set the alarm, so I had to unlock it, open up and set the alarm. It was just ridiculous, I am NEVER like that!

In addition to the insomnia and forgetfulness, I also had horrible anxiety and paranoia, almost to the point of panic. Which I NEVER have, I am usually very easy-going, even-tempered, and worry-free. But this was horrible, I really was quite paranoid and anxious about everything. Weird!

And the worst, was that in just two days of eating wheat, I gained 4 lbs and 2% bodyfat!! It's two days wheat-free now, and it's finally going back down, but wow. Just two days of wheat-eating caused that much weight and fat gain!

Anyway, I've learned my lesson and will continue to avoid grains (including gluten free grains) entirely.


Eat more "healthy whole grains"? Modern dwarf Triticum aestivum, perverted even further by agricultural geneticists and modern agribusiness, subsidized by the U.S. government to permit $5 pizza, is better than any terrorist plot to discombobulate the health and performance of the American people.

The Westman Diet

Dr. Eric Westman has been a vocal proponent of carbohydrate restriction to gain control over diabetes, as have Drs. Richard Bernstein, Mary Vernon, Richard Feinman, and Jeff Volek.

Several studies over the years have demonstrated that reductions in carbohydrate content of the diet yield reductions in weight and HbA1c (glycated hemoglobin, a reflection of average blood glucose over the preceding 60-90 days).

Among the more important recent clinical studies is a small experience from Duke University's Dr. Eric Westman. In this study, obese type 2 diabetics reduced carbohydrate intake to 20 grams per day or less: no wheat, oats, cornstarch, or sugars. Participants ate nuts, cheese, meats, eggs, and non-starchy vegetables.

After 6 months, average weight loss was 24.4 lbs, BMI was reduced from 37.8 to 34.4. At the end of the study, 95% of participants on this severe carbohydrate restriction reduced or eliminated their diabetes medications.

That was only after 6 months. Note that the ending BMI was still quite well into the obese range. Imagine what another 6-12 months would do, or achieving BMI somewhere closer to ideal.

Curiously, this idea of severe low-carbohydrate restriction to cure or minimize diabetes is not new. Sir William Osler, one of the founders of Johns Hopkins Hospital and author of the longstanding authoritative text, Principles and Practice of Medicine, advocated an diet identical to Dr. Westman's diet. So did Dr. Frederick Banting, discoverer of the pancreatic extract, insulin, to treat childhood diabetics. Before insulin, Banting and his colleagues at the University of Toronto used carbohydrate elimination (less than 10 g per day) to prolong the lives of children with diabetes.

This lesson was also learned many times during war time, when staples like bread were unavailable. The Siege of Paris in 1870 yielded cures for diabetes in many (or at least they stopped passing urine that tasted--yes, tasted--sweet and attracted flies), only to have it recur after the siege was over.

These are lessons we will have to relearn. As long as the American Diabetes Association and most physicians continue to advocate a diet of reduced fat, increased carbohydrate that includes plenty of "healthy whole grains," diabetics will continue to be diabetics, taking their insulin and multiple medications while developing neuropathy (nervous system degeneration), nephropathy (kidney disease and failure), atherosclerosis and heart attack, cataracts, and die 8 to 10 years earlier than non-diabetics.

All the while, we've had the combined wisdom from antiquity onwards: Carbohydrates cause diabetes; elimination of carbohydrates cures diabetes.

(This applies, of course, only to adult overweight type 2 diabetics, not type 1 or some of the other variants.)

Handy dandy carb index

There are a number of ways to gauge your dietary carbohydrate exposure and its physiologic consequences.

One of my favorite ways is to do fingerstick blood sugars for a one-hour postprandial glucose. I like this because it provides real-time feedback on the glucose consequences of your last meal. This can pinpoint problem areas in your diet.

Another way is to measure small LDL particles. Because small LDL particles are created through a cascade that begins with carbohydrate consumption, measuring them provides an index of both carbohydrate exposure and sensitivity. Drawback: Getting access to the test.

For many people, the most practical and widely available gauge of carbohydrate intake and sensitivity is your hemoglobin A1c, or HbA1c.

HbA1c reflects the previous 60 to 90 days blood sugar fluctuations, since hemoglobin is irreversibly glycated by blood glucose. (Glycation is also the phenomenon responsible for formation of cataracts from glycation of lens proteins, kidney disease, arthritis from glycation of cartilage proteins, atherosclerosis from LDL glycation and components of the arterial wall, and many other conditions.)

HbA1c of a primitive hunter-gatherer foraging for leaves, roots, berries, and hunting for elk, ibex, wild boar, reptiles, and fish: 4.5% or less.

HbA1c of an average American: 5.2% (In the population I see, however, it is typically 5.6%, with many 6.0% and higher.)

HbA1c of diabetics: 6.5% or greater.

Don't be falsely reassured by not having a HbA1c that meets "official" criteria for diabetes. A HbA1c of 5.8%, for example, means that many of the complications suffered by diabetics--kidney disease, heightened risk for atherosclerosis, osteoarthritis, cataracts--are experienced at nearly the same rate as diabetics.

With our wheat-free, cornstarch-free, sugar-free diet, we have been aiming to reduce HbA1c to 4.8% or less, much as if you spent your days tracking wild boar.

Battery acid and oatmeal

Ever notice the warnings on your car's battery? "Danger: Sulfuric acid. Protective eyewear advised. Serious injury possible."

Sulfuric acid is among the most powerful and potentially harmful acids known. Get even a dilute quantity in your eyes and you will suffer serious burns and possibly loss of eyesight. Ingest it and you can sustain fatal injury to the mouth and esophagus. Sulfuric acid's potent tendency to react with other compounds is one of the reasons that it is used in industrial processes like petroleum refining. Sulfuric acid is also a component of the harsh atmosphere of Venus.

Know what food is the most potent source of sulfuric acid in the body? Oats.

Yes: Oatmeal, oat bran, and foods made from oats (you know what breakfast cereal I'm talking about) are the most potent sources of sulfuric acid in the human diet.

Why is this important? In the transition made by humans from net-alkaline hunter-gatherer diet to net-acid modern overloaded-with-grains diet, oats tip the scales heavily towards a drop in pH, i.e., more acidic.

The more acidic your diet, the more likely it is you develop osteoporosis and other bone diseases, oxalate kidney stones, and possibly other diseases.

Here's one reference for this effect.

What'll it be: Olive oil or bread?

We frequently discuss the advisability of consuming fats, carbohydrates, and various types within each category.

But what's the worst of all? Combining fats with carbohydrates.

Putting aside the wheat-is-worst form of carbohydrate issue and treating bread as a prototypical carbohydrate, let's play out a typical scenario, a make-believe feeding study in which a theoretical person is fed specific foods.

John is our test person, a 40-year old, 5 ft 10 inch, 210 lb, BMI 27.7 (roughly the mean for the U.S.) He starts with an average American diet of approximately 55% carbohydrates and 30% fat. Starting lipoproteins (NMR):

LDL particle number 1800 nmol/L
Small LDL 923 nmol/L


(The LDL particle number of 1800 nmol/L translates to measured LDL cholesterol of 180 mg/dl, i.e., drop last digit or divide by 10.)

Also, calculated LDL cholesterol is 167 mg/dl (yes, underestimating "true" measured LDL), HDL 42 mg/dl, triglycerides 170 mg/dl.

We feed him a diet increased in carbohydrates and reduced in fat, especially saturated fat, with more breakfast cereals, breads and other wheat products, pasta, fruit juices and fruit, and potatoes. After four weeks:

LDL particle number 2200 nmol/L
Small LDL 1378 nmol/L

Note that LDL particle number has increased by 400 nmol/L due entirely to the increase in small LDL particles triggered by carbohydrate consumption. Lipids show calculated LDL cholesterol 159 mg/dl--yes, a decrease, HDL 40 mg/dl, triglycerides 189 mg/dl. (At this point, if John's primary care doctor saw these numbers, he would congratulate John on reducing his LDL cholesterol and/or suggest a fibrate drug to reduce triglycerides.)

John takes a rest for four weeks during which his lipoproteins revert back to their starting values. We then repeat the process, this time replacing most carbohydrate calories with fats, weighed heavily in favor of saturated fats like fatty red meats, butter and other full-fat dairy products. After four weeks:

LDL particle number 2400 nmol/L


Let's

Chocolate peanut butter cup smoothie

Here's a simple recipe for chocolate peanut butter cup smoothie.

The coconut milk, nut butter, and flaxseed make this smoothie exceptionally filling. If you are a fan of cocoa flavonoids for reducing blood pressure, then this provides a wallop. Approximately 10% of cocoa by weight consists of the various cocoa flavonoids, like procyanidins (polymers of catechin and epicatechin) and quercetin, the components like responsible for many of the health benefits of cocoa.


Ingredients:
1/2 cup coconut milk
1 cup unsweetened almond milk
2 tablespoons cocoa powder (without alkali)
2 tablespoons shredded coconut (unsweetened)
1 tablespoon ground flaxseed
1 teaspoon almond extract
1 1/2 tablespoons natural peanut, almond, or sunflower seed butter
Non-nutritive sweetener to taste (stevia, Truvia, sucralose, xylitol, erythritol)
4 ice cubes

Combine ingredients in blender. Blend and serve.

If you plan to set any of the smoothie aside, then leave out the flaxseed, as it absorbs water and will expand and solidify if left to stand.

For an easy variation, try adding vanilla extract or 1/4 cup of sugar-free (sucralose) vanilla or coconut syrup from Torani or DaVinci and leave out the added sweetener.

The compromise I draw here is the use of non-nutritive sweeteners. Beware that they can increase appetite, since they likely trigger insulin release. However, this smoothie is so filling that I don't believe you will experience this effect with this recipe.

Letter from the insurance company

Claudia got this letter from her health insurance company:

Dear Ms. ------,

Based on a recent review of your cholesterol panel of January 12, 2011, we feel that you should strongly consider speaking to your doctor about cholesterol treatment.

Reducing cholesterol values to healthy levels has been shown to reduce heart attack risk . . .


Okay. So the health insurer wants Claudia to take a cholesterol drug in the hopes that it will reduce their exposure to the costs for her future heart catheterization, angioplasty and stent, or bypass surgery. This is understandable, given the extraordinary costs of such hospital services, typically running from $40,000 for a several hour-long outpatient catheterization procedure, to as much as $200,000 for a several day long stay for coronary bypass surgery.

So what's the problem?

Here are Claudia's most recent lipid values:

LDL cholesterol 196 mg/dl
HDL 88 mg/dl
Triglycerides 37 mg/dl
Total cholesterol 291 mg/dl

By the criteria followed by her health insurer, both total and LDL cholesterol are much too high. Note, of course, that LDL cholesterol was a calculated value, not measured.

Here are Claudia's lipoproteins, drawn simultaneously with her lipids:

LDL particle number 898 nmol/L
Small LDL particle number less than 90 nmol/L (Values less than 90 are not reported by Liposcience)

LDL particle number is, by far and away, the best measure of LDL particles, an actual count of particles, rather than a guesstimate of LDL particles gauged by measuring cholesterol in the low-density fraction of lipoproteins (i.e., LDL cholesterol). It is also measured and is highly reproducible.

To convert LDL particle number in nmol/L to an LDL cholesterol-like value in mg/dl, divide by ten (or just drop the last digit).

Claudia's measured LDL is therefore 89 mg/dl--54% lower than the crude calculated LDL suggests.

This is because virtually all of Claudia's LDL particles are large, with little or no small. This situation throws off the crude assumptions built into the LDL calculation, making it appear that she has very high LDL cholesterol.

Do you think that Big Pharma advertises this phenomenon?

Healthy smoothies

I've now seen several people who have either caused themselves to be diabetic or to have other phenomena associated with excessive consumption of carbohydrates, all by innocently indulging in a carbohydrate-packed smoothie every morning.

Kay, for instance, has a smoothie of a half-pint blueberries, a banana, a scoop of whey, low-fat yogurt, a cup of milk every morning. The rest of her diet was fairly healthy: salads with oil-based dressing for lunch, salmon and asparagus for dinner, only an occasional carbohydrate indulgence outside of her morning smoothie ritual. Yet she had a HbA1c (a reflection of prior 60 to 90 days average blood sugar) at the near-diabetic range of 5.9%.

The mistake most people make when making smoothies is relying too heavily on carbohydrates like fruit. A smoothie like the one made by Kay can easily top 50, 60, or 70 grams carbohydrates per serving, more than sufficient to send blood sugars up to 150 mg/dl or more.

So what can you put in your smoothie and not send you over the edge to diabetes, small LDL, and all the other undesirable phenomena of excessive carbohydrates? Here's a list:

--coconut milk, unsweetened almond milk. Less desirable: milk, full-fat soymilk
--ground flaxseed
--oils: flaxseed oil, coconut oil (melted), extra-light olive oil, walnut oil
--dried coconut
--extracts: vanilla, almond, coconut, cherry, hazelnut
--spices: cinnamon, nutmeg, ginger
--herbs: mint leaves, cilantro
--cocoa powder (unsweetened)
--nut or seed butters (peanut butter, almond butter, sunflower seed butter)
--tofu
--exotic ingredients (ingredients you wouldn't expect in a smoothie): spinach, kale, cucumber

How do you sweeten a smoothie? This is what trips up most people. If you resort to fruit like bananas, pineapple, or apple, you will readily send your blood sugar skyward. Honey, agave syrup, and sugar, of course, all increase blood sugar and/or have the adverse effects of fructose. Be careful of yogurt, also, for similar reasons.

Therefore, to sweeten your smoothie, consider:

--Small servings of berries, e.g., 8-10 blueberries, 2 strawberries, a few wedges of apple, half a kiwi
--Non-nutritive sweeteners like stevia, Truvia, sucralose, xylitol, erythritol. Also, sugar-free (sucralose-based) syrups like those from DaVinci and Torani are useful. (Just be aware that non-nutritive sweeteners can increase appetite--use sparingly.)

Also, note that, if you have divorced yourself from wheat, cornstarch, and sugars, your desire for sweet should be much reduced. Foods other people find just right will taste sickeningly sweet to you. You might therefore find that foods like peanut butter or coconut milk have a mild natural sweetness; added sweetness is only minimally necessary.

Coming next: I'll share a smoothie recipe or two of mine. Anyone want to share a recipe?

Insulin secretagogue

Dairy products have the peculiar property of triggering pancreatic release of insulin. The research group at Lund University in Sweden have contributed the most to documenting this phenomenon:




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

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

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

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

Good news: The effect is least with cheese.

Be gluten-free without "gluten-free"

While I've discussed this before, it is such a confusing issue that I'd like to discuss it again.

I advocate wheat elimination because consumption of products made from modern dwarf Triticum aestivum:

--Triggers formation of extravagant quantities of small LDL and LDL particle number (or apoprotein B)
--Triggers inflammatory phenomena like c-reactive protein, increases leptin resistance, and reduction of the protective adipocytokine, adiponectin.
--Encourages accumulation of deep visceral fat ("wheat belly") that is inflammatory and causes resistance to insulin
--Increases blood sugar more than nearly all other foods--higher than a Milky Way bar, higher than a Snickers bar, higher than table sugar.
--Is being linked to a growing number of immune-mediated diseases, including celiac disease (quadrupled over past 50 years), type 1 diabetes in children, and cerebellar ataxia and peripheral neuropathies.

This last group of wheat-related phenomena are primarily due to gluten, the collection of 50+ proteins found in each wheat plant. For this reason, people diagnosed with celiac disease are advised to eliminate gluten from wheat and other sources (barley, rye, triticale, bulgur) and to eat gluten-free foods.

Gluten-free has therefore come to be viewed as wheat-free and problem-free. It ain't so.

Among the few foods that increase blood glucose higher than wheat: cornstarch, rice starch, potato starch, and tapioca starch--Yup: the ingredients commonly used to replace wheat in gluten-free foods. They are also flagrant triggers of the small LDL pattern, along with increased triglycerides, reduced HDL, increased visceral fat, increased blood pressure. In short, gluten-free foods lack the immune and brain effects of wheat gluten, but still make you fat, hypertensive, and diabetic.

I tell patients to view gluten-free foods like jelly beans: Gluten-free pancakes, muffins, breads, etc. are indulgences, not healthy replacements for wheat. It's okay to have a few jelly beans now and then. But they should not be part of a frequent or daily routine. Same with gluten-free foods.
Eat triglycerides

Eat triglycerides

Dietary fats, from olive oil to cocoa butter to beef tallow, are made of triglycerides.

Triglycerides are simply three ("tri-") fatty acids attached to a glycerol backbone. Glycerol is a simple 3-carbon molecule that readily binds fatty acids. Fatty acids, of course, can be saturated, polyunsaturated, and monounsaturated.

Once ingested, the action of the pancreatic enzyme, pancreatic lipase, along with bile acids secreted by the gallbladder, remove triglycerides from glycerol. Triglycerides pass through the intestinal wall and are "repackaged" into large complex triglyceride-rich (about 90% triglycerides) molecules called chylomicrons, which then pass into the lymphatic system, then to the bloodstream. The liver takes up chylomicrons, removes triglycerides which are then repackaged into triglyceride-rich very low-density lipoproteins (VLDL).

So eating triglycerides increases blood levels of triglycerides, repackaged as chylomicrons and VLDL.

Many physicians are frightened of dietary triglycerides, i.e, fats, for fear it will increase blood levels of triglycerides. It's true: Consuming triglycerides does indeed increase blood levels of triglycerides--but only a little bit. Following a fat-rich meal of, say, a 3-egg omelet with 2 tablespoons of olive oil and 2 oz whole milk mozzarella cheese (total 55 grams triglycerides), blood triglycerides will increase modestly. A typical response would be an increase from 60 mg/dl to 80 mg/dl--an increase, but quite small.

Counterintuitively, it's the foods that convert to triglycerides in the liver that send triglycerides up, not 20 mg/dl, but 200, 400, or 1000 mg/dl or more. What foods convert to triglycerides in the liver? Carbohydrates.

After swallowing a piece of multigrain bread, for instance, carbohydrates are released by salivary and gastric amylase, yielding glucose molecules. Glucose is rapidly absorbed through the intestinal tract and into the liver. The liver is magnificently efficient at storing carbohydrate calories by converting them to the body's principal currency of energy, triglycerides, via the process of de novo lipogenesis, the alchemy of converting glucose into triglycerides for storage. The effect is not immediate; it may require many hours for the liver to do its thing, increasing blood triglycerides many hours after the carbohydrate meal.

This explains why people who follow low-fat diets typically have high triglyceride levels--despite limited ingestion of triglycerides. When I cut my calories from fat to 10% or less--a very strict low-fat diet--my triglycerides are 350 mg/dl. When I slash my carbohydrates to 40-50 grams per day but ingest unlimited triglycerides like olive oil, raw nuts, whole milk cheese, fish oil and fish, etc., my triglycerides are 50 mg/dl.

Don't be afraid of triglycerides. But be very careful with the foods that convert to triglycerides: carbohydrates.

 

 

 

 

 

 

 

Comments (31) -

  • Kurt

    6/8/2011 2:51:47 AM |

    There must be genetic variations, though, as my triglycerides have measured between 78 and 90 on every test since 1993. For the past two years, I've been eating a 20% fat diet (with about 50% carbs), and on my latest VAP test, my triglycerides were 78. The diet, by the way, lowered my LDL 30%.

  • Ian Goldsmid

    6/8/2011 2:55:47 AM |

    Dr. Davis

    Could you please clarify:

    If I have one slice of gluten free mixed grain /seed toast - and very liberally heap Organic Coconut Oil & Almond Butter on it - am I still going to get the exaggerated carbohydrate to triglyceride conversion effect from the toast?

    Thanks, IJG

  • Gene K

    6/8/2011 3:28:45 AM |

    Dr Davis,

    How much TG-rich foods is it safe for APOE 4 people to consume? Will this amount depend on their fasting TG? Will it be per meal or a day's total?

    Thank you.

  • Markus Damian

    6/8/2011 7:16:16 AM |

    I think this article is excatly on target- I ate a low-fat, high-carb vegetarian diet for years, and at one point my measured triglyceride levels were > 300. After I started omitting most refined carbs from my diet (and upping my fat/protein intake correspondingly), my last reading has been 88. So, for me at least, dietary intake of triglycerides is not substantially related to blood levels.

  • Markus D

    6/8/2011 7:32:02 AM |

    ... having said that, there is something which I don't quite understand. Given that virtually the entire human population is on a high-carb feast, it must be that some of us react differently to high-carb diet than others, otherwise everyone would have elevated triglyc levels, right? My mother, who is certainly genetically quite close to me, eats a high-carb, low-fat diet, and her triglyceride levels are normal ...  Many thanks, M.

  • Might-o'chondri-AL

    6/9/2011 12:18:07 AM |

    EPA (eicosa-pentaenoic fatty acid)  an omega-3  poly-unsaturated fatty acid reduces the amount of glucose that is made into tri-glycerides ("trigs") , thus decreasing de-novo lipo-genesis put out by the liver.  When I added daily concentrated fish oil  with 1,500 mg EPA & 750 mg DHA to my moderate carb diet my NMR  tested measurement of trigs went from 90 mg/dL down to 42 mg trigs/dL (tests  were 4 months apart).  

    EPA also increases the amount of insulin related glucose transporters inside skeletal muscle cells, which allays insulin resistance;  it (EPA) induces the skeletal muscles to "burn" more glucose for ATP energy  in oxidative phosphorylation , which decreases irritating lactate output that contributes to body "aches".  Insulin in circulation can then also work as a co-fact0r with EPA,  together they go on to increase functional  leptin  levels  (leptin = anti-appetite);  thus  we get less impulse to "graze"   between meals on  carbs that make  trigs.

  • carb sane

    6/9/2011 11:57:11 AM |

    Actually, it has been established that DNL is NOT a major source of fatty acids in VLDL.

    http://carbsanity.blogspot.com/2011/05/where-do-triglycerides-come-from-part-i.html

  • majkinetor

    6/9/2011 1:49:40 PM |

    Actually, its around 20%

    http://ajpendo.physiology.org/content/286/4/E577.full

  • majkinetor

    6/9/2011 1:49:59 PM |

    Nice. I didn't know that. Thats pretty big amount of EPA/DHA, it is therapeutic amount often used for COX-2 inhibition.

    Can you tell more about the dosage ? Did you try smaller dose ? Is it fish oil or fish capsule or simply fish ? What are you thoughts about potential problems with PUFA and oxidation in regard to fish oil ?

  • carb sane

    6/9/2011 5:05:24 PM |

    Firstly, that's not about VLDL.  Secondly, that means around 80% comes from dietary fat.    Did you read my link?

  • Might-0'chondri-AL

    6/9/2011 6:15:27 PM |

    Hi majkinetor,
    I only went from no fish oil supplementation as an experiment to taking 1 tsp of Natural Factor's "pharmaceutical grade"  (  concentrated Canadian product's total fish oil=4,400 mg.  with 2,630 Omega 3 fatty acids of which 1,500 = EPA & 750 = DHA)  taken, as free  poured liquid along with morning food and evening food in 1/2 tsp measuring spoon slurps. Intake  of liquid oil was at the same time ate carbs , and carb intake was similar for when had 1st measured trigs when wasn't supplementing with fish oil  .  

    I personally don't think PUFA oxidation is an issue in diets that have lots of substrate for gut bacteria to make short chain 4 carbon fatty acid butyrate. It (butyrate) up-regulates many distinct  GST (glutathione S-transferase) genes;  these go on to tackle multiple lipid peroxidation by-products  (ex:  activity neutralizes 4-hydroxy- nonenal &  trans-alk-enals/dienals ),  while  micro-somal GST promotes the glutathione conjugation to electro-philes  which then can act to decrease lipid hydro-peroxide activity.

  • majkinetor

    6/10/2011 7:25:50 AM |

    Ah, sorry, I missread your post.

  • majkinetor

    6/10/2011 7:30:08 AM |

    Secondly, that means around 80% comes from dietary fat
    Not at all.
    80% from dietary fat AND cho.

  • Jimmy

    6/10/2011 11:11:24 AM |

    Might: Do you live in Canada?
    Jim

  • Helen

    6/10/2011 11:25:24 AM |

    M-Al,

    I used to take fish oil, but now that I'm measuring my glucose daily, I find that even a small dose immediately raises my fasting glucose 10-15mg, and somewhat worsens my post-prandial readings.  My own observation is in keeping a study that showed that prediabetic women's glucose control was worsened by a fish oil supplement.  (I don't have the link handy.)  Can you explain?

    I have the same troubles with modest supplements of vitamin C and niacin, though I'm sure for different reasons.  I find it interesting, and I don't mean that in any coded way, that two of Dr. Davis' recommended supplements  (fish oil and niacin) impair glucose control in me and in some studies.  I am wondering if this might explain in part his advice to shun carbs.  In the context of those supplements, carbs are not well tolerated.

  • Dr. William Davis

    6/10/2011 12:12:00 PM |

    Several commenters make the point that there is genetic variation in susceptibility to triglyceride intake and carbohydrate intake.

    Absolutely. Two people on the same diet can have wildly different results. Part of this is attributable to apo E genotype, apo C genotype, lipoprotein lipase and hepatic lipase genotypes, among others. Body weight and previous eating habits will also enter the equation. However, in most people increased triglyceride intake does not result in substantial increase in serum triglycerides.

  • Might-o'chondri-AL

    6/10/2011 9:59:19 PM |

    Hi Helen,
    I've heard some respond as you mention;  I wonder if they were all overweight during the data collection period, as pre-diabetic could imply.  In your circumstances (ie: blood glucose goes up with supplements)  it would be instructive to know if  you've a tendency for excess weight.

    My own niacin use went from none to 3x per day of 500 mg.  niacin taken with meals;   my own 2011 NMR lipid tests done 4 months apart were as follows.  Without any niacin fasting NMR cholesterol test results:  LDL = 139,  HDL=45,  total number of LDL particles  = 1,676,  with the number of small LDL particles  = 1,021 nmol/dL .  As for NMR cholesterol test with 1,500 mg daily total  niacin :  LDL = 100, HDL = 64,  total number of LDL particles = 976 , with the number of small LDL particles = nmol/dL.

    The nice plunge in small LDL doesn't seem to be due to a massive restriction of carbs;  in fact,  both my  HbA1c  and fasting serum glucose test result ciphers  went up slightly after I had  instituted niacin &  EPA/DHA fish oil  (started both at same time).   Incidentally,  I've never had  weight gain problems  and unintentionally lost 10 pounds I didn't intend to  since started taking the fish oil;  losing so much small LDL was more than thought possible and maybe wasn't 100% due to the niacin  (also daily  added  6,000 IU vitamin D3 from none, taken as 2,000 IU  with each meal).

    So,  before you decide that niacin & EPA/DHA supplements driving up your post-prandial glucose is positively detrimental it might be good to have your own baseline data (ie:  NMR for cholesterol & HbA1c for accretion of  blood sugar) .  If you are in the USA you can get a valid blood draw order in ANY state at all and the emailed results by using  cheapest online arrangement from summitcountymedicalsociety.prepaidlab.com ;  their doctor orders the blood test for you and,  of course, I have no financial interest in this .

  • Might-o'chondri-AL

    6/10/2011 10:04:42 PM |

    edit,
    see 2nd paragraph's last sentence to Helen above, missing number in last set of data is for number of small LDL nmol/dL and should be 96 (ninety-six) ... in other words  that data shows that with niacin the  small LDL  "plunged" to 96 from being 1,021 nmol/dL without niacin supplementation.

  • Helen

    6/11/2011 5:27:07 AM |

    Hi M-Al,

    I'm different from a lot of visitors to this blog in that I have never had cholesterol problems.  I don't remember my exact numbers but my HDL and LDL split has been deemed "ideal," and my triglycerides range from 44-48, with total cholesterol being about 157.  

    My current BMI is 20 or less (haven't checked the charts lately) and my highest ever was 25, about a year ago.  Generally, I've been in the 23 range.  So, no, I don't have a propensity to weight gain.  On the other hand, I'm borderline diabetic.  Last year, at my highest BMI, my A1C was 6.4.  On low-carb, it slowly got down to 6.0, and my last test, on low-fat, was also 6.0, although according to my meter readings, taken at least three times a day, it should be 5.3.  I'm definitely right on the border with the diabetes, though have pushed it back some over the past year.  My blood sugar *sometimes* shoots to 200 or over within the first hour of eating (a "diabetic" number, though my endocrinologist says it has to be 200 at two hours to be considered clinical diabetes), but it quickly goes down again.  My liver seems to pump out a lot of glucose.  I tend to have a fasting glucose between 109 and 125.  Sometimes it gets as low as 99.  On low-carb, it ranged from 125 to 145, and was 160 a few times.  

    Needless to say, my biggest concern is my glucose level.  Metformin didn't help, low-carb didn't help much (and definitely made my tolerance for any amount of carbs next to zero - I once went to 198 on a carrot and half an orange, but I don't anymore.  It also gave me heart palpitations, worsened my insomnia, and greatly impaired my exercise tolerance), and I wonder if I'm just stuck with what I've got at this point.  Not that I'm throwing in the towel.  Fortunately, my cholesterol profile has  been ideal, my resting heart rate and blood pressure are low-normal, and my weight is okay without a struggle.  But I'm getting aches and pains in my joints and think the fish oil could help there.

  • Peter

    6/11/2011 1:32:44 PM |

    Dr. Davis, at one point you were concerned that you were eating too many nuts
    because your ratio of omega 3 and 6 was off.  What is your current thinking about the trade-offs?

  • Might-o'chondri-AL

    6/11/2011 10:02:26 PM |

    Hi Helen,
    lost 2 replies, says server error ... sorry

  • Might-o'chondri-AL

    6/11/2011 10:14:46 PM |

    Hmm Helen,
    Sounds like epigenetic or good old genetic polymorphism ... appears that Hexokinase II (HK II) is NOT staying inside skeletal muscle mitochondria and glucose-6-phosphate (G-6-P) is working to keep HK II in cell cytosol in a loop,  whereby HK II engenders glycogen output and instigates lots of G-6-P ... that cell has own glucose from glycogen so GLUT 4 (glucose transporters) move too far away to pick up blood glucose  ... liver glycogen  for it's part involves HK IV (glucokinase) and G-6-P too, but may not be root of  your syndrome ... too slow a rate of G-6-P degradation and /or too many carbon or nitrogen terminals on HK II would allow G-6-P to yank HK II  into metabolism cranking out glycogen ...  hey - twice wrote this already.

  • Might-o'chondri-AL

    6/12/2011 12:49:42 AM |

    Helen, Hi-
    Metaformin probably did not work for you because it functions to increase glucose uptake by provoking anaerobic glycolysis to create additional glucose demand;   you may already be doing plenty  of anaerobic glycolysis  as a consequence of your extra ordinary local glycogen synthesis.  The carbon from glucose with anaerobic glycolysis engenders a lot of lactate being produced; your aching joints and body pain syndrome fit the profile of excessive lactate in circulation.

    There is no easy way to determine what phase of the G-6-P dynamic with Hexokinase forms is not working normally, if even involved.  When we wean to real food our skeletal muscles start to run glucose metabolism with HK II and GLUT 4,  rather than the HK I and GLUT 1  we started with;  this change over occurs when we  starts to relatively "burn" both carbs and fats  and skeletal muscles develop  their insulin sensitivity.

    I am not  a clinician, and you have your personal physician to guide you; if I had a distorted  HK II  and G-6-P pattern ( that was unresponsive to low carbs)  I would try to end run it,  and not have skeletal muscle cells utilizing glucose to stop ratcheting up G-6-P and short out the negative feedback loop . I'd  significantly increase my consumption of  dietary fat in the explicit form of unheated virgin coconut oil  and fatty fish (for the EPA/DHA);  if taking EPA causes  blood sugar to rise it is probably because the EPA is driving skeletal muscles to "burn" fat , and thus skeletal muscles are using less of the HK II glycogen  which itself then used even less blood glucose as substrate  (ie: EPA  reduces blood glucose commonly used so glucose level in blood measures higher if cell metabolism aberrant  in the manner like I surmise).

  • Might-o'chondri-AL

    6/12/2011 4:28:39 AM |

    Hi Jim,
    Am not  residing in Canada.

  • majkinetor

    6/12/2011 7:04:12 AM |

    Vitamin C can give falsely higher values when measuring bunch of markers, most notably glucose. Its because it is so similar with glucose (very similar net formula, the same transporters in the body - GLUT, its made from glucose in animals etc...)

    About oil, it can only slow down carb absorption and let the body tolerate better. Did you experiment with other fish oil manufacturers ? Perhaps something in the product apart from fish oil makes you feel that way. For instance, ascorbyl palmitate is typical antioxidant used (along with Vitamin E) so this can be responsible for false higher reading.

  • majkinetor

    6/12/2011 7:22:27 AM |

    Helen, did you try megadosing with Vitamin C (~10g per day as frequent as you can). Vitamin C influences beta cells in the pancreas and deficiency is common in diabetes. Scorbutic guinea pigs show defects in insulin metabolism in vitro. Higher glucose levels compete with C for transporter. Add chromium if you didn't. Daily exercise will surely help. Since low carb made your glucose problem worst (most probable is higher hepatic insulin resistance that is consequence of low carb diet) you might try to return some safe starches back (for instance potato or rice) and keep CHO between 50 and 75 g per day.  Ashes and pains in the joint might be consequence of your too low carb diet since carbs are used for joint functions. Carbs are also used for intestinal mucus which so on very low carb you might have some micronutrient deficiencies.

  • Dee

    6/13/2011 7:47:05 PM |

    Have you tried adding D-ribose to your mix of supplements?  It has helped with my muscle aches from exercise.

  • Kris - Health Blog

    6/14/2011 7:52:50 AM |

    It seems that a lot of doctors would do well by going back a few years in time and re-reading Biochem 101.

  • Jim Anderson

    6/14/2011 7:05:22 PM |

    My wife and I have both been following a low-carb eating plan.  For me, that has meant increased fat consumption from the start.  I have felt full and satisfied after meals, and can go longer without feeling hungry.  I have also lost weight steadily.  My wife, however, has had a harder time of it.   She claims that is because women just have a harder time losing weight than men do.  That's true, I guess, in general, but I have also noticed that she seems to be avoiding fat a lot more than I do.  (Well, I don't avoid it at all!)  So she gets hungrier more often.  It is very difficult to overcome years and years of anti-dietary fat propaganda!

  • Joe Lindley

    6/30/2011 2:04:03 PM |

    Yes!  Thanks for the complete explanation of the fats vs. carbs impact.  I'm successfully on a low carb diet now after quitting Atkins years ago because my wife was worried I'd keep over from a heart attack.  With the right information out there now that dietary fat won't hurt you, people can stick to a low carb diet and get enough satiety (food satisfaction) with fats in the diet to stay on a diet.  It's truly been a disaster that the nutrition authorities shooed us away from dietary fats starting in the 1970s.  It's taken decades to get the word out that dietary fats are OK.  I published a nostalgic post on this about how Barney Fife got it right back in 1963:  http://bit.ly/m5eAhE

  • James Roberts

    7/30/2011 12:59:43 AM |

    Great post, great site.  I made my way to focusing on triglycerides by starting with Lipitor.  I had some bad though serious side effects (mostly insomnia),  so I dropped it and worked really hard on reducing fat intake.  That pretty much worked, but surprise (to me)... triglycerides went way up.  Now that I've also worked on cutting empty calories my levels are down to borderline.  Once you make it to a genuinely healthy diet everything seems to work out Wink
    cheers,
    James

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