Thanks for the knowledge sharing...it helps to be healthy.

Here is a link showing the atherogenicity in mice of different saturated fats in diets with 1% cholesterol. Look at page 1416 of the free full report that can be downloaded here:

http://www.ncbi.nlm.nih.gov/pubmed/8409772

On the opposite you can see bread not being atherogenic in baboons here:

http://www.ajcn.org/cgi/content/abstract/33/8/1869

By the way you can notice the effect of 0.1% cholesterol at the end of the article = 1 gm cholesterol per kg of food = 5 egg yolks.

Does it look a lot ? "There is evidence from animal experiments showing that if atherogenic dietary factors are reduced to levels comparable to man's intake, the same vessel changes occur as with higher levels, but more slowly."

Download the free full report here:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1938976/

In this report you can also see butter to be highly atherogenic to swine without additional cholesterol to their diet.

What about rice?  Does it also increase small LDL particles?

@x.ds: Humans aren't C57BL/6J mice (susceptible to diet-induced fatty streak lesions), baboons or pigs.

@x.ds

The strain of mice in the first study are predisposed to diet-induced obesity, type 2 diabetes, and atherosclerosis.

Likewise, here's an interesting quote from the last paper based on a porcine model: "Whenever there are three
animals from the same litter, they are divided equally among the three groups (ie, "control", "butter", & "egg yolk" groups)  In the present experiment, this occurred once. These three pigs had the most aortic atherosclerosis in their respective groups. The control pig with the most atherosclerosis was the brother of the pigs with the most disease fed egg and butter."  

The group of pigs with the highest rate of atherosclerosis was the egg yolk group - yet at most we see a vanishingly positive relationship, if any, in a large number of human epidemiological studies of moderate egg consumption and heart disease (too many to list here - many are recent and easy to locate, though).  Do we even have grounds to formulate a hypothesis of egg induced atherogenesis based on human observational studies? I don't know, really - though a casual glance suggests, "no".

Looking forward to reading the other study you pointed us to when I get the time.

x.ds:

Often times these animal studies don't translate well when applied to humans.

Also, like Dr. Davis pointed out in his blog, most (LDL) cholesterol lowering research doesn't use advanced lipoprotein testing like NMR so the data is misleading to say the least.

x.ds:

It would be nice for a change to see experiments on other than herbivorous (mice) or mostly vegetarian animals (both pigs and baboons on the wild).

Bobber--

While all carbohydrates increase small LDL, the effect of wheat is the most extravagant.

I generally agree with those who deny the universal applicability of experimental results in mice and rats to men. However, I do so with this one caveat; there is one fact I cannot deny: Many women are convinced that most men are rats.

Doc, does this mean that I ca sorta log my particle size by getting my apoB checked in quarterly labs? I'll never be able to convince primary to do the outright particle size test...yet (working on that). Thnx.

I admit I do not understand VLDL-C. What I would really like to find is a simple range scale. Mine shows up VLDL-C..7  Non HDL ..70
I do not know if that is good or bad. Is there such a chart showing like,  1 good ... 100 bad ??
LP(a) shows up by itself and I understand that because there is a range showing bad ..over 30.
Any help understanding appreciated

LynP -

Bypass your doctor and order your own NMR test. PrivateMDlabs has it for $79.99, minus a 15% discount.

http://www.privatemdlabs.com/lab_tests.php?view=search_results&show=865&category=2&search=nmr#865

Dr. Davis,

I honestly think you are doing God's work and have learned to appreciate the value of heart scans through your site.  However, it still bugs me that so many people in Asia can live off of large quantities of white rice with minimal atherosclerosis.  For instance, this study shows that American Whites have much higher atherosclerosis than Japanese despite the Japanese having much higher LDL-cholesterol, blood pressure, fasting glucose, and smoking rates:

http://ije.oxfordjournals.org/cgi/content/full/34/1/173


This other study (below) tries to explain this difference based on the Japanese consumption of fish. However, if you look at the data, those Americans who consume the most fish oil consume about as much fish oil as those Japanese that consume the least fish oil, and yet between these comparable groups in terms of fish consumption, the Japanese still have vastly lower atherosclerosis on heart scans.  And the Japanese American group consumes more fish than the White American group and has more coronary calcium.

http://content.onlinejacc.org/cgi/content/full/52/6/417


And here is another study showing much lower CAC in Japanese than in Japanese-Hawaiians even after controlling for a bunch of risk factors including fish intake:

http://aje.oxfordjournals.org/cgi/content/full/166/11/1280


Although in this other study looking at only at Americans, the incidence of CAC appears to be similar to that in Japanese - so maybe there was something unusual about the US samples in the other studies?

http://content.onlinejacc.org/cgi/content/full/49/20/2013

Dr. Davis,
What is your opinion of the LP-Pla2 test for arterial plaque?  If you've used the test, do any elements of your program reduce levels of this enzyme?

However, the effect will not be fully evident if you just look at the crude conventional calculated (Friedewald) LDL cholesterol. This is because restricting carbohydrates not only reduces small LDL, it also increases LDL particle size. This make the calculated Friedewald go up, or it blunts its decrease. Conventional calculated LDL will therefore either underestimate or even conceal the real LDL-reducing effect.

I wonder if people such as the Kitavans (and other pacific islanders), Hadza in Africa and many other traditional civilizations who survive on sources of carbohydrates like tubers, yams etc walk around with blood sugar  monitoring devices?

Another great and helpful post on blood sugar!
As an overweight, out of shape diabetic, I'm working on this--my blog, http://transformation-transformative.blogspot.com/, is my way of keeping myself honest and tracking my progress.
My thanks for your work!

Always great information!  So you are saying that for the normal healthy person, a target of 40-50 carbs a day is the max we should take in to avoid inflammation and they host of issues that go along with it?  I ask b/c if you eat enough veggies and fruit, even without sugar or wheat, it is easy to push over the 40-50 carbs.  Just wanted to make sure I understand so I can tune in my numbers.  Thank you for all of your work!

Hyper-glycemia is able to increase the levels of matrix metallo-proteinase 9 (MMP 9), an endo-peptidase enzyme implicated in alterations of blood vessels'   walls.  It is thought to play a role in aortic aneurisms; and, since MMP 9 is made in plaque, it is also implicated in ruptures of plaque. There is a notable increase in MMP levels in individuals with  familial hyper-cholesterol and diabetics.

Diabetics have elevated urine & blood levels of MMP 9;  but also above normal levels of  it's  inhibitor  (tissue inhibitor metallo-proteinase, or TIMP). The theory is that these conflicting markers indicate there is an ongoing paradigm, in which  vascular exterior cell matrix (ECM) remodeling is aggravated, by the influence of hyper-glycemia, and this is being opposed by a body response, which tries to keep vascular walls from getting so misshapen they lose function. (To be clear this is not necessarily a narrowing of the inside of the small blood vessels; more a case where, when measured across, it is wider. And then too this is not directly causing any worsening of systolic pressure.)

Since nothing is simple know that both too much MMP and too much of it's inhibitor TIMP are not desirable. On one hand if there is too much TIMP (ie: low MMP) then the ECM can become more fibrous from excess collagen allowed into that vessels matrix; so normal amounts of MMP is desireable. While in another context it is suggested that the way advanced glycation end products (AGE) increases oxidative stress contributes to more MMP 9; and then the high levels of vascular adhesion molecules (VAM 1),  that are notably induced by AGEs,  get to cause more monocyte adhesion to the MMP enzyme prepped vascular endothelium.

I wonder how folks who follow insane diets like Dr. Furhman's Eat to Live manage to keep their blood sugars down? According to his web site, they do manage to doso, and they keep their HDL up and their triglycerides down. There's something going on there but I'm not sure quite what it is. The diet avoids meat and fat, but it also avoids sugar and grains as well. They apparently eat a lot of beans.
Anyway, anyone could get the same results or better without avoiding meat like it's the devil, but that's another story.

The lactose content of yogurt varies a lot depending on how long it's allowed to ferment. Most people don't like sour yogurt, so most commercial yogurt producers stop the fermentation when it's still pretty sweet, even without added sweetener. The sourer the yogurt, the less milk sugar remaining. So differences in BGs after eating yogurt might stem from the level of fermentation as well as from individual differences in blood sugar control and allergies.

Not everyone goes up to 140 after meals, even very carby ones. If you look at this chart carefully, you can see that although many people go over 160 after a carby breakfast, some start below 70 and only go up to about 90 after breakfast.

http://www.diabetes-symposium.org/index.php?menu=view&source=topics&sourceid=16&chart=17&id=322

Some people on diabetes lists have tested spouses, and many say they never go above 90, although with hearsay reports like this it's not always clear when they were testing. Nondiabetics can go up to 160 after a carby meal and be back to below 100 in an hour or two.

One person who had tested diabetic and then lost about 100 pounds said that after the weight loss, he never went over 100 unless he really stuffed himself, and then I think he only went up to slightly over 100.

@ mito: my husband had a major hemorrhagic stroke 10 years ago - he was not a diabetic and his cholesterol was routinely around 150 - he was a SAD eater.

@ mcfreddy: same with the 'starch based' McDougall diet. (high carb, no added fat, no animal or dairy,  just heavy on veggies, fruits, beans, lots of sweet potatoes and potatoes - and grains as tolerated). After the initial adjustment period the majority of followers have normal stats all around.
This whole carb thing just isn't black and white - unfortunately.

Hi rhc,
Would you mind telling how old  your husband was when he had his hemorrhagic stroke ?

A fasted homeostatic blood sugar level equals around1 teaspoon of sugar out of the 1000 teaspoons of blood in your body.  When analyzing food labels & tracking your carb intake the formula to remember is the 1-5-20 rule, meaning 1 teaspoon of sugar equals 5 grams which equals 20 calories.  For optimum health an honest dietitian, nutritionist or doctor will advise keeping TOTAL carb (sugar) intake to around 10 to 12 teaspoons a day MAX, others will say 10 to 12 or 15  total ADDED sugars per day.  12 teaspoons X 5 grams per equals only 60 grams & times 20 calories per teaspoon equals just 240 calories. So yes it's not much, but considering the damage done to the body by glucose from carbs, & since ALL carbs reduce to glucose, less is better.

He was 60 - doing ok but with major right side empairment remaining and only takes one medication for blood pressure.

Hi rhc,
You realize I discussed above an  aortic aneurism; this is not in the brain. As for hemorrhagic stroke there is a risk  condition one can be born with,  relatively rare to be sure, called arterio-venous malfunction; while the common sub-arachnoid hemorrhage can be either looming likewise since birth or as a rupture associated with advancing age.
Sounds like you might be alluding to an intra-cerebral hemorrhage of some artery inside the brain. These are usually ascribed to hyper-tension's affect on brain artery.

For George Zachary ... this was blocked by Server several times when tried to send you over on Doc's 2nd post  back (ie: "The Exception to Low Carb); if anyone wants to copy and paste it there for him that would be nice.  
  
PCSK9 "non sense"mutations that lower circulating LDL cholesterol:
2% of African Americans get 40% less LDL from  these 2 in 80% of those having these:
(a) PCSK9 variant 426C G encoding Y142X (ie: tyrosine at position 142 replaced by stop codon)
(b) PCSK9 variant 2037CA encoding C679X (ie: cysteine at position 679 replaced by stop codon)

3% of Caucasian Americans get 15 to 21% less LDL from:
(a) PCSK9 sequence variant 137GT encoding R46L (ie: arginine at position 46 replaced with leucine)

PCSK9 alleles that both can give 28% less LDL:
(a) PCSK9 9142X allele in 0.8% of African Americans
(b) PCSK9 9679X allele in 1.8% of African Americans

PCSK9 9646L allele gives 15% less LDL in:
(a) 3 % of Caucasian Americans
(b) 0.7% of African Americans

xxxxxxxxxxxx

One crucial difference exists between the modern American and other populations: We have been incredibly overexposed to processed carbohydrates since birth, from teething crackers, to Lucky Charms and Scooter Pies, to pizza and beer, to "healthy whole grains."

We now arrive at later adulthood with beaten up, tired, beta cell-exhausted pancreases that make us unable to deal with the continuing flow of modern processed carbohydrates.

I am assuming you are directing your comments at sedentary unfit people.  Anyone who works  physically or trains as I do (I run and do heavy weight training), could not survive and train on those sorts of amounts of carbs.  If I go below about 200g/day for any length of time my ability to train drops off markedly.

Hi, Aileen--

Yes, indeed. This advice is definitely not intended for people who engage in high levels of endurance training. My wife, for instance, in training for an Iron Man competition, needs to supplement carbohydrates during her training sessions, such as a 112-mile bike trip.

Dr. Davis, thank you really so much. Very interesting article. I believe it is also not just a a matter of the right source of carbohydrate and carb counting but also the right food combining. But what is a person has to do a lot of intelletual work? For example,  when I have to solve a lot or complicated mathematical tasks and make serious projects involving higher mathematics I just cannot do without much carbs, much more than most of my familiy members. Otherwise, it feels like the brain gets dry. On the other hand, physical  workouts never make me really hungry. IS that ok?

I do agree sandra but please explain  I have to solve a lot or complicated mathematical tasks and make serious projects involving higher mathematics I just cannot do without much carbs

Hi, Sandra--

Only people who rely on carbs need them for cerebral work.

I wonder if something to boost acetylcholine might work better? There are a number of neat supplements you can use to achieve this, such as acetyl-L-carnitine.

I suggest Piracetam.

I think it is important to keep the good cholesterol foods intact in your diet.  Fruit has been getting a bad rap lately for sugar, but it is a totally different type of sugar for the body.   Apples were one of my staples when I dropped my cholesterol by 15% and weight by 45 lbs. after receiving a high cholesterol reading.    I also picked out many other good foods that contained healthy or good carbs.  Check out these other important plaque and cholesterol fighters.

www.cholesterolgoodfoods.net