Fat Head: Tom Naughton's manifesto for low-carb eating

12. March 2010 William Davis (16)
I just got back from Jimmy Moore's low-carb cruise to the Bahamas.

Among the many interesting people I met on the cruise was the creator of the documentary film, Fat Head, Tom Naughton.

Tom brings both creative insights into low-carbohydrate eating as well as humor. Low-carb eating can be a pretty contentious issue, but Tom made it fun. He will make you laugh about many of the odd notions we have about diet.

Among the best parts of Fat Head is Tom's portrayal of the effects of carbohydrates on insulin and fat metabolism:






Fat Head joins the ranks of films like Food, Inc, that make nutrition information entertaining. For anyone interested in a unvarnished look at diet, weight loss, along with a few laughs along the way, Tom Naughton's Fat Head is worth viewing.

Oatmeal: Good or bad?

11. March 2010 William Davis (67)

You've heard it before: oatmeal reduces cholesterol. Oatmeal producers have obtained permission from the FDA to use a cholesterol-reducing claim. The American Heart Association provides a (paid) endorsement of Quaker Oats.

I've lost count of the times I've asked someone whether they ate a healthy breakfast and the answer was "Sure. I had oatmeal."

Is this true? Is oatmeal heart healthy because it reduces LDL cholesterol?

I don't think so. Try this: Have a serving of slow-cooked (e.g., steel-cut, Irish, etc.) oatmeal. Most people will consume oatmeal with skim or 1% milk and some dried or fresh fruit. Wait an hour, then check your blood sugar.

If you are not diabetic and have a fasting blood sugar in the "normal" range (<100 mg/dl), you will typically have a 1-hour blood glucose of 150-180 mg/dl--very high. If you have mildly increased fasting blood sugars between 100 and 126 mg/dl, postprandial (after-eating) blood sugars will easily exceed 180 mg/dl. If you have diabetes, hold onto your hat because, even if you take medications, blood sugar one hour after oatmeal will usually be between 200 and 300 mg/dl.

This is because oatmeal is converted rapidly to sugar, and a lot of it. Even if you were to repeat the experiment with no dried or fresh fruit, you will still witness high blood sugars in these ranges. Do like some people and pile on the raisins, dried cranberries, or brown sugar, and you will see blood sugars go even higher.

Blood sugars this high, experienced repetitively, will damage the delicate insulin-producing beta cells of your pancreas (glucose toxicity). It also glycates proteins of the eyes and vascular walls. The blood glucose effects of oatmeal really don't differ much from a large Snickers bar or bowl of jelly beans.

If you are like most people, you too will show high blood sugars after oatmeal. It's easy to find out . . . check your postprandial blood sugar.

In past, I recommended oat products, specifically oat bran, to reduce LDL, especially small LDL. I've changed my mind: I now no longer recommend any oat product due to its blood sugar-increasing effects.

Better choices: eggs, ground flaxseed as a hot cereal, cheese (the one dairy product that does not excessively trigger insulin), raw nuts, salads, leftovers from last evening's dinner.

Mustard: Super health food?

6. March 2010 William Davis (32)
Could mustard--yes, the yellow condiment you smear on hot dogs--be a super heart healthy food in disguise?

Consider that mustard contains:

Vinegar

Turmeric

No appreciable sugar


The vinegar slows gastric emptying, resulting in slower absorption of any carbohydrates and a reduced glucose area-under-the-curve. Of the little fats contained (about 3 grams per 1/4 cup), most are desirable monounsaturates. Mustards are relatively rich in selenium, with 20 mcg per 1/4 cup, helpful for protection against cancer and thyroid disease, and magnesium, 31 mg per 1/4 cup.

Turmeric is added to most mustards. One of the constituents of turmeric, curcumin, the substance that confers the bright yellow color, has been a focus of interest for its anti-inflammatory effects. Curcumin has been documented to reduce activity of the inflammatory enzymes cyclooxygenase-2 (COX-2), lipoxygenase, and reduce activity of inflammatory signal molecules, tumor necrosis factor-alpha (TNF-a), interleukin (IL)-1,2,6,8, and 12, and monocyte chemoattractant protein (MCP). Curcumin also has been shown to reduce LDL oxidation, a potentially important step in atherosclerotic plaque formation. Turmeric is used as a tea by Okinawans. (Hmmmm . . . )

Turmeric content of mustard can vary, of course. Likewise, sugar content. Look for mustards that are not sweetened, so avoid honey mustard in particular. Look for hot, brown, horseradish, Dijon, etc. If there is a downside to mustard, it's sodium content, though the 709 mg per 1/4 cup should only be a problem for those who are sodium-sensitive (African Americans, in particular).

So perhaps mustard isn't exactly a super health food. But it may have some bona fide health effects and should be used generously especially if you are concerned about blood sugar and inflammatory phenomena.

Exercise and blood sugar

5. March 2010 William Davis (30)
There is no doubt that exercise yields benefits across a spectrum of health: reduced blood pressure,  reduced inflammation, reduced blood coagulation, better weight control, stronger bones, less depression, reduced risk for heart attack.

Exercise also influences blood sugar. Diabetics understand this best: Exercise reduces blood sugar 20, 30, 50 or more milligrams. A starting blood sugar, for instance, of 160 mg/dl can be reduced to 80 mg/dl by jogging or riding a bicycle. (I recently had brunch at an Indian restaurant with my family. Blood sugar one-hour postprandial: 134 mg/dl. I was sleepy and foggy. I got on my stationary bike and pedalled at a moderate clip for 60 minutes. Blood sugar: 90 mg/dl.)

Could the reduction of blood sugar with exercise be THE reason that exercise and physical activity provide such substantial benefits?

Think about it. Reduced blood sugar:

1) Reduces risk for future cardiovascular events.
2) Reduces glycation of proteins, i.e., reduced glucose binding to proteins like the ones in artery walls and the lenses of your eyes.
3) Reduces blood coagulation
4) Reduces endothelial dysfunction (abnormal artery constriction that leads to atherosclerosis)

This might explain why it doesn't require high levels of aerobic activity to derive benefit from exercise, since even modest efforts (e.g., a 15-minute walk after eating) reduce blood sugar substantially.

The incredible 33-year, 18,000-participant Whitehall study tells us that a postprandial (after-eating) blood sugar of an impossibly-difficult 83 mg/dl is required to erase the excess cardiovascular risk of blood sugar. Could this simply be telling us that physical activity or exercise is required to suppress blood sugars to these low levels?

It makes me wonder if an index of the adequacy of exercise is your post-exercise blood glucose.

The most important weight loss tool

4. March 2010 William Davis (15)

Question: What is the most effective tool available to help you lose weight? 


A pedometer (walk 10,000 steps, etc.)?

A treadmill? 




A bicycle?






No. None of the above. 

The most important tool you can use to achieve weight loss is your glucose monitor:



Timing of blood sugars

3. March 2010 William Davis (5)
Because different foods generate different blood sugar (glucose) responses, the timing of your blood sugar is an important factor to consider.

This question has come up a number of times. Commenters have asked whether the one-hour postprandial glucose is timed with the start of the meal or the conclusion of the meal.

In my view, if we simply ignored all aspects of meal composition, then blood glucose should be obtained one hour after the conclusion of a meal. This is because most mixed meals (i.e., mixed in composition among proteins, fats, and carbohydrates) yield peak blood glucose levels at 60-90 minutes after consumption. Timing blood glucose to 60 minutes after the conclusion of a meal puts the sample right about at the peak.

But this is an oversimplification. For instance, here is the blood glucose behavior after so-called "complex" carbohydrates wheat bread, rye bread, rye made with beta glucan, and whole wheat pasta (50 grams carbohydrates each) in slender, healthy volunteers, mean age 29 years:


From Juntunen et al 2002

Note that blood glucose peaks at 35 minutes postprandial. (To convert glucose in mmol/L to mg/dl, multiple by 18. Thus, whole wheat bread increased blood glucose from 94 mg/dl to 122 mg/dl. Also note the lower peak glucose for pasta, but sustained higher glucose levels hours later.)

In another study, older (mean age 64 years), overweight (BMI 27.9) females with diabetes were given 50 grams carbohydrate, 50 grams carbohydrate with olive oil, or 50 grams carbohydrate with butter:


From Thomsen et al 2003. Control meal of soup plus 50 g carbohydrates ({blacktriangledown}), the control meal plus 80 g olive oil ({circ}), and the control meal plus 100 g butter (•).

In this experience, note that postprandial glucose peaks 60-120 minutes after the meals (consumed within 10 minutes), delayed more when either oil is included. Blood glucose started at 144 mg/dl and peaked as high as 230 mg/dl with carbohydrates only; peaks were reduced (along with AUC) when oil was included. (Note the differential effect, olive oil vs. butter.)

These two sets of observations give you a range of blood glucose behavior. One side lesson: Carbohydrates should never consumed by themselves, else you will pay with a high blood sugar (not to mention the hypoglycemic response later for many).

Psssst . . . There's sugar in there

1. March 2010 William Davis (13)
You non-diabetics who check your postprandial blood sugars already know: There are hidden sources of sugar in so many foods.

By now, everybody should know that foods like breakfast cereals, breads, bagels, pretzels, and crackers cause blood sugar to skyrocket after you eat them. But sometimes you eat something you thought was safe only to find you're showing blood sugars of 120, 130, 150+ mg/dl.

Where can you find such "stealth" sources of sugars that can screw up your postprandial blood sugars, small LDL, inflammation, blood pressure, and cause you to grow visceral fat? Here's a few:

Balsamic vinaigrette
Many commercially-prepared balsamic vinaigrettes, especially the "light" varieties, have 3 or more grams carbohydrates per tablespoon. Generous use of a sugar-added vinaigrette can therefore provide 12+ grams carbs. (Some, like Emeril's and Wish Bone, also contain high-fructose corn syrup.)

Hamburgers
I learned this lesson the hard way by taking my blood sugar after having a hamburger, turkey burger, or vegetarian burger (without bun): blood sugar would go way up. The effect is due to bread crumbs added to the meat or soy.

Tomato soup
If it were just tomatoes, it would still be somewhat high in sugars. But commercially-prepared tomato soup often contains added high-fructose corn syrup, sucrose, and wheat flour, bringing sugar totals to 12 to 20+ grams per half-cup. A typical 2-cup bowl of tomato soup can have upwards of 80 grams of sugar.

Granola
Sure, granola contains a lot of fiber. But most granolas come packed with sugars in various forms. One cup of Kellogg's Low-fat Granola with Raisins contains an incredible 72 grams (net) carbohydrates, of which 25 grams are sugar.


Given modern appetites and serving sizes, you can see that it is very easy to get carried away and, before you know it, get exposed to extraordinary amounts of sugar and carbohydrates eating foods you thought were healthy.

And don't be fooled by claims of "natural" sugar. Sugar is sugar--Just check your blood sugar and you'll see. So raw cane sugar, beet sugar, and brown sugar have the same impact as white table sugar. Honey, maple syrup, and agave? They're worse (due to fructose).

How low should blood sugar be?

28. February 2010 William Davis (0)
What should your blood sugar (glucose) be after eating?

Take a look at the data from the Whitehall study reported in 2006. The Whitehall Study stands apart from other studies in that it was very large (over 18,000 participants) who were observed for an unusually long time (33 years). All participants were administered a 50 gram glucose "challenge" at the start with glucose levels checked after the glucose challenge.

Here's what they found:




From Brunner et al 2006.
Chocolate peanut butter cup smoothie

Chocolate peanut butter cup smoothie

19. March 2011 William Davis (18)
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.
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Comments (18) -

  • Anonymous

    3/18/2011 11:28:11 PM |

    This is very good - just mixed up a large glass full (minus the flaxseed).  And, that's my question, do you use finely ground flax seed?  I also tossed in a fist-full of blueberries - should be able to tolerate them well; I just had a very intense resistance training session

    I'd love to see more recipes for some ideas.  I disagree with those who wrote in on the earlier post, characterizing smoothies as "not real food."  I'm a big fan for time-challenged mornings and post-workout nourishment.

    Bill

  • praguestepchild

    3/19/2011 12:11:34 AM |

    I can't believe you passed up a perfectly good opportunity to embed a cheesy 80's Reese's commercial in this post.

    http://www.youtube.com/watch?v=DJLDF6qZUX0

  • Dr. William Davis

    3/19/2011 1:36:19 PM |

    Anon--

    Yes, I used a finely-ground flaxseed.

    The berries are a great idea, provided quantity is small.

  • Kathryn

    3/19/2011 6:33:41 PM |

    Just a cautionary note -

    Sucralose/Splenda can have severe reactions.

    I seem to respond/react to things severely.  Sucralose has caused both allergic reaction (swollen mucus membranes) and severe migraine for me.  In fact, as a frequent migraine sufferer (tho much less now that i've removed gluten and sulfites), the migraine i got from sucralose was by far the worst i've ever had.  

    Personally, i am of the belief that if it effects me so strongly, it is probably not good for anyone, but the damage it does is much less pronounced in other people.

    I stick to stevia for a no-calorie sweetener.

  • Geoffrey Levens

    3/19/2011 8:43:16 PM |

    http://jstevens.wordpress.com/2008/02/20/how-sucralose-aka-splenda-is-made-and-why-you-want-to-avoid-it/

    "How Sucralose (aka Splenda) Is Made And Why You Want To Avoid It

    ...I wanted to comment on Splenda.  Splenda, also known as sucralose, was created accidentally when some chemists were trying to produce an insecticide.  Here is the process by which they produce the formula sold in stores:

    “1.  Sucrose is tritylated with trityl chloride in the presence of dimethylformamide and 4-methylmorpholine, and the tritylated sucrose is then acetylated with acetic anhydride.

    2.  The resulting sucrose molecule TRISPA is chlorinated with hydrogen chlorine in the presence of tolulene.

    3.  The resulting 4-PAS is heated in the presence of methyl isobutyl ketone and acetic acid.

    4.  The resulting 6-PAS is chlorinated with thionyl chloride in the presence of toluene and benzyltriethylammonium chloride.

    5.  The resulting TOSPA is treated with methanol in the presence of sodium methoxide to produce sucralose.”  (Note that methanol, wood alcohol aka paint remover,  is one of the questionable ingredients in aspartame.)

    In addition, the bags and packets of Splenda commercially available are not pure sucralose.  They also contain bulking agents.  All artificial sweeteners use bulking agents.  Do you know what they use?  Sugar.  Dextrose, sucrose, and maltodextrin.  (Maltodextrin is corn syrup solids composed primarily from fructose and glucose in a starch form.)   All sweetener packets are at least 96 percent sugar.  Splenda is 99% sugar.

    The packets are labelled calorie free as a result of manipulating a loophole in the food labeling laws.  The product can be described as sugar free if a serving contains less than 5 grams of sugar, and calorie free if a serving is less than 5 calories.  So they set the serving size on bags at .5 grams  and the packets contain a serving of 1 gram.  A one gram packet contains 4 calories.   This can be confirmed on the manufacturer’s website in the FAQ section:  â€œLike many no and low calorie sweeteners, each serving of SPLENDA® No Calorie Sweetener contains a very small amount of common food ingredients, e.g., dextrose and/or maltodextrin, for volume. Because the amount of these ingredients is so small, SPLENDA® No Calorie Sweetener still has an insignificant calorie value per serving and meets FDA’s standards for “no calorie” sweeteners. “

    To make matters worse, when sucralose was shown to not raise blood sugars, it was the pure substance that was tested, not the mixture that is sold to the public.  Dextrose, sucrose, and/or maltodextrin are definitely going to raise a diabetic’s blood sugar.  There is also a great deal of evidence that artificial sweeteners actually cause an increase in appetite, causing people who consume them to take in more calories than they would otherwise.

    Stevia, on the other hand, lowers blood sugar, making it a much better choice.  If you have tried stevia in the past and did not like the flavor, you might want to try another brand. ..."

  • Brandon Nolte

    3/19/2011 10:38:51 PM |

    If your looking for a more nutritious "sweetner" you should try adding half a cup of coconut water. Delicious!

    Ps. I love your blog. Keep up the great work!

  • bob412

    3/19/2011 11:34:59 PM |

    Tapioca starch in the almond milk, but not enough to hurt you.

  • Dr. John

    3/20/2011 2:49:18 AM |

    I enjoy your blog. You have a good thread about the hazards of hyperglycemia.
    However, this recipe is not one I would recommend to patients attempting to reverse metabolic syndrome, T2D, or IR.
    Their main concern is the inflammation caused by the above listed disorders. The omega 6 content of the peanut butter, sunflower seed, and to an extent, almond butter would exacerbate the inflammation mitigated by the hyperglycemia.
    In addition, sugar alcohols (xylitol, erythritol) tend to cause GI upset (gas, diarrhea). Also the hazards of Sucralose are intuitively obvious....it contains chlorine molecules....commonly found in many household cleaners, and of course used in WWI as a pulmonary choking agent.
    I would only use macadamia nuts/nut butter, and Stevia to sweeten.
    Dr. John

  • Dr. William Davis

    3/20/2011 1:28:28 PM |

    Thanks, Dr. John.

    I hear you on the sucralose issue. I've actually been having positive experiences with stevia, xylitol, and erythritol. The important thing is that people have some good choices nowadays, unlike 20 years ago when we had saccharine . . . period.

    There is no question that mannitol and sorbitol have greater potential for both GI distress (diarrhea) as well as increases in blood glucose, so these are clearly on the no-no list (unless you need a quick laxative).

  • Gabriella Kadar

    3/20/2011 7:23:42 PM |

    Sucralose is not metabolized.  Most of it is excreted unchanged in the feces.  A small percentage is absorbed and excreted unchanged in urine.  

    Sodium in food is more of a concern for a person who experiences migraine headaches.  Over-activity of muscles activated by the Trigeminal nerve due to airway resistance secondary to water retention is a greater concern.  Various factors are present both anatomically and physiologically in people who experience migraine.  The only way to determine if sucralose is actually the cause of a migraine is to consume sucralose on its own.

    What concerns me is what happens to the sucralose in the environment.  The addition of a chlorine atom, (not a molecule, Dr. John) results in a molecule which cannot be metabolized by bacteria.  If environmental degradation is possible, then sucralose excreted by human beings is not an issue.  But if it persists in the environment, then it is a pollutant.

  • Anonymous

    3/21/2011 3:22:42 AM |

    I am practically a fruitarian, so much of what I like would be off limits.
    Is there an article here on what IS recommended?

  • Dr. John

    3/21/2011 3:29:27 PM |

    Yes, atoms, not molecules...ie. precisely 3 atoms of chlorine/molecule of sucrose...

    An interesting thing about this selective halogenation of sucrose, is the fact that sucralose (being 600 times as sweet as sucrose), increases the HbA1c numbers in my patients. This demonstrates a lessening of diabetic control. Thus, hemoglobin gets glycated and fasting blood sugar increases....with the attendant hyperglycemia issues as mentioned, and this excellent blog site.

    For this reason I do not recommend sucralose for diabetics nor anyone wanting to keep blood sugar levels within normal limits. The current cost and future costs for diabetes will cripple our healthcare structure. Here are ADA numbers:

    $174 billion: Total costs of diagnosed diabetes in the United States in 2007
    $116 billion for direct medical costs
    $58 billion for indirect costs (disability, work loss, premature mortality)

    Dr. John

  • Gabriella Kadar

    3/22/2011 1:42:51 AM |

    Dr. John, is it possible that other factors contribute to higher H1ac levels in your type 2 diabetic patients?  

    Since sucrolose is not metabolically active and does not act as a laxative, then there could be other endocrinological and neurological reasons for higher glucose levels.

    Here's an abstract on sucralose and Type 2 diabetes:

    Grotz VL, Henry RR, McGill JB, Prince MJ, Shamoon H, Trout JR, Pi-Sunyer FX. Lack of effect of sucralose on glucose homeostasis in subjects with type 2 diabetes. J Am Diet Assoc. 2003 Dec;103(12):1607-12.

    OBJECTIVE: To investigate the effect of 3-months' daily administration of high doses of sucralose, a non-nutritive sweetener, on glycemic control in subjects with type 2 diabetes. DESIGN: A multicenter, double-blind, placebo-controlled, randomized study, consisting of a 6-week screening phase, a 13-week test phase, and a 4-week follow-up phase. SUBJECTS/SETTING: Subjects with type 2 diabetes (age range 31 to 70 years) entered the test phase of this study; 128 subjects completed the study. The subjects were recruited from 5 medical centers across the United States and were, on average, obese. INTERVENTION: Subjects were randomly assigned to receive either placebo (cellulose) capsules (n=69) or 667 mg encapsulated sucralose (n=67) daily for the 13-week test phase. All subjects blindly received placebo capsules during the last 4 weeks of the screening phase and for the entire 4-week follow-up phase. MAIN OUTCOME MEASURES: Glycated hemoglobin (HbA1c), fasting plasma glucose, and fasting serum C-peptide were measured approximately every 2 weeks to evaluate blood glucose homeostasis. Data were analyzed by analysis of variance using repeated measures. RESULTS: There were no significant differences between the sucralose and placebo groups in HbA1c, fasting plasma glucose, or fasting serum C-peptide changes from baseline. There were no clinically meaningful differences between the groups in any safety measure. CONCLUSIONS: This study demonstrated that, similar to cellulose, sucralose consumption for 3 months at doses of 7.5 mg/kg/day, which is approximately three times the estimated maximum intake, had no effect on glucose homeostasis in individuals with type 2 diabetes. Additionally, this study showed that sucralose was as well-tolerated by the study subjects as was the placebo.

    PMID: 14647086 [PubMed - indexed for MEDLINE]

    Now, I can understand how sugar alcohols taken in large quantities might have some effect on blood sugar because they are laxative and increase gut motility and cause discofort or pain, both of which will spike blood sugar values. the liver dumps glucose into the bloodstream when the body is under stress like this.  And of course, the pancreas reacts very sluggishly to endogenous glucose.

    I think type 2 diabetics should have routine sleep study screening to determine whether breathing issues during sleep may be upramping the sympathetic nervous system and causing high sugar levels during sleep. We can't just help these people improve their life quality by looking at only one parameter.

    They need otolaryngological evaluation for anything from deviated nasal septa to chronic allergies, enlarged adenoids and tonsils.  The size of their jaws, how they function and tongue posture also factors in.

    Not to mention, anyone with pulmonary issues would have increased effort on breathing...asthma, pulmonary hypertension etc.  The existance of chronic pain and anxiety conditions also influence how the body produces its own glucose.  

    Patient's require a multi-disciplinary workup to determine the multiple factors that result in the development of type 2 diabetes.  It's not merely diet because these people have an awfully hard time changing their diets without having other problems addressed.

  • Anonymous

    3/24/2011 7:01:46 PM |

    Excellent! Dr. Davis, you have had many posts of what not to eat but very few on what we should eat. Taking something out of our diet means we have to replace it with something. This post seems to be in the right spirit. I am going to try this soon. Now if only you can post a similar substitute for Keva Juice's Oreo Speedwagon smoothie! Yes, I know they are hazardous to your health but they are wickedly good!

    -- Boris

  • Dr. John

    3/25/2011 5:50:15 AM |

    I'm not totally convinced why sucralose, a chloro-carbon, similar to DDT and PCBs, would elevate the HgA1c levels. My guess would be a neurological response to an ingested poison. Sucralose does kill intestinal beneficial bacteria...lactobacillus, bifidobacteria, and bacteroides...of varying amounts of 37-67%...and the enteric nervous system would react by elevating cortisol/adrenaline/glucagon: while at the same time not delaying gastric emptying.
    Body perception is stress....glycation of RBCs result, with CVD and sudden cardiac death.

    Studies that use diabetic, and obese subjects in the assessment of A1c elevation are biased from the start. These individuals have already lost glycemic control and as a result would not have normal A1c levels to begin with...let alone studying their response 13 weeks later.

    McNeil Nutritionals, maker of SPLENDA® Brand products, stated it has provided the American Diabetes Association (ADA) with a sponsorship to support the Association's efforts to fund research, information and advocacy programs on behalf of people with diabetes.
    And McNeil Nuts. are owned by Johnson and Johnson, who are large contributors to the ADA...the journal of the previously listed biased study showing the sucralose doesn't affect A1c levels...in spite of the fact in clinical results showing the opposite.

    Anything, sucrose or sucralose, that elevates A1c levels is cardio-lethal...and is best avoided.

  • reikime

    4/2/2011 5:07:29 PM |

    Dr. D,
    Do you use regular coconut milk or the lite? Does it make a difference, except calorically?

    Thanks!

    Jeanne

  • Anonymous

    4/8/2011 1:09:56 AM |

    I am allergic to the artificial sweeteners. Thought I could tolerate sucralose but it just took a little time for a reaction. My mouth and throat became inflamed and I had sore bumps all over the inside of my throat and back of my mouth after about a week.

    I don't like stevia or the other natural no calorie sweeteners either...they just don't taste sweet to me or have odd flavors.

    But I found something.  It is not calorie free, but it has low glycemic index and tastes just like sugar.  It is "Organic Blue Agave". What are a few calories in exchange for some actual taste.

    I bought it at Costco.

  • Geoffrey Levens

    4/8/2011 1:30:13 AM |

    ""Organic Blue Agave". What are a few calories in exchange for some actual taste."

    High fructose corn syrup (HFCS) is about 55% fructose and cause inflammation, insulin resistance, and elevates triglycerides.  Agave syrup is often 70% or higher (possibly as high as 90%) fructose!  Marketing scam...

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We got the drug industry we deserve

We got the drug industry we deserve

14. October 2011 William Davis (6)
A biting commentary on just who is writing treatment guidelines for diabetes and cardiovascular disease was published in the British Medical Journal, summarized in theHeart.org's HeartWire here.

"About half the experts serving on the committees that wrote national clinical guidelines for diabetes and hyperlipidemia over the past decade had potential financial conflicts of interest (COI), and about 4% had conflicts that were not disclosed.

"Five of the guidelines did not include a declaration of the panel members' conflicts of interest, but 138 of the 288 panel members (48%) reported conflicts of interest at the time of the publication of the guideline. Eight reported more than one conflict. Of those who declared conflicts, 93% reported receiving honoraria, speaker's fees, and/or other kinds of payments or stock ownership from drug manufacturers with an interest in diabetes or hyperlipidemia, and 7% reported receiving only research funding. Six panelists who declared conflicts were chairs of their committee.

"Of the 73 panelists who had a chance to declare a conflict of interest but declared none, eight had undeclared COI that the researchers identified by searching other sources. Among the 77 panel members who did not have an opportunity to publicly declare COI in the guidelines documents, four were found to have COI."

The closing quote by Dr. Edwin Gale of the UK is priceless:
"Legislation will not change the situation, for the smart money is always one step ahead. What is needed is a change of culture in which serving two masters becomes as socially unacceptable as smoking a cigarette. Until then, the drug industry will continue to model its behavior on that of its consumers, and we will continue to get the drug industry we deserve."

It's like having Kellogg's tell us what to each for breakfast, or Toyota telling us what car to drive. The sway of the drug industry is huge. Even to this day, I observe colleagues kowtow to the sexy sales rep hawking her wares. But that's the least of it. Far worse, even the "experts" who we had trusted to have objectively reviewed the evidence to help the practitioner on Main Street appears to be little more than a hired lackey for Big Pharma, hoping for that extra few hundred thousand dollars.
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Comments (6) -

  • Jim Purdy

    10/14/2011 1:36:03 AM |

    I am not a fan of any drugs, and as a result, I change primary care physician regularly, usually after two visits.
    ON THE FIRST VISIT, I explain to the new doctor that I do not, and will not, take prescription medications. I explain that the only reason I am in their office is to get orders for lab work, so that I can review the results and make my own decisions about lifestyle changes, especially diet. The doctor then calls me" non-compliant" and prints numerous computer-generated prescriptions anyway. Obviously, it is the doctor who is non-compliant, since I have already said I do not want drugs.
    ON THE SECOND VISIT, the doctor asks, "Have you been taking your medications as ordered?" When I tell the doctor again, as I did at the first visit, that I do not take medications, the doctor says, "You're crazy and suicidal." I then find the next doctor, and the cycle starts over.
    As I see things, I have two choices when I feel ill:
    1. I could attack my body with some bizarre BigPharma chemicals that our ancestors' bodies have never dealt with in millions of years of evolution (Oxycodone, hydrocodone? Really? Are doctors nuts?).
    2. Or I could get out of the way and let my body heal itself as has been done over many millions of years of evolution. All I want to do is support that process by making sure to give my body the proper nutrition in the form of the appropriate whole foods.

  • Dr. William Davis

    10/14/2011 3:40:23 AM |

    Wow, Jim. Creepy.

    Don't despair: I'm confident that you will eventually find a healthcare practitioner who will act as your advocate, not a provider of drugs. It may take, unfortunately, going through quite a few practitioners before you come on such a person.

  • Suze

    10/19/2011 1:44:46 AM |

    Great post. I am starting to think there are two kinds of people - those who seek drugs and those who run from them. LOL.
    Among other occupations, I am an OR nurse. I have been wined and dined by the best reps ever, to buy their wares for surgery. It's all about the money.The drug companies have a lot to lose if we all quit taking their meds. Which is exactly what I want to do. I do not want to be a slave to a diagnosis and accompanying pill bottle. I want to be freeeeee.
    This is not to say there is a time and place for medicine. There IS. But not for every sniffle.

  • Jeanne

    10/20/2011 11:44:20 AM |

    Boy Suze, I can relate!  I'm a nurse as well and spent lots of years in NICU, but a change to chemical dependancy/psych was eye opening and downright disgusting in the amount of meds handed out.

    I used to ask patients if they were hungry when dispensing a 6oz. Cup FULL of various pills before breakfast!
    Couldn't take it and quit. Couldn't be a party to pharm management over real therapy.  I also take as few pills as possible, especially antibiotics.

  • N

    11/30/2011 6:36:01 PM |

    Hi Doc,

    I just visited my parents, and my mom shared her recent blood work with me.
    Her cholesterol was a mere 210, and her doc (general practitioner), put her on a statin !!!
    I told her about your blog a bit and particle size, but of course she's hesitant since her doctor obviously has more credibility than me.

    Outside of eating better, what next steps should I advise her to take?  She agreed to request a cholesterol particle size test (is there an official name for this?).

  • Dr. William Davis

    12/1/2011 4:22:01 AM |

    Yes, N: Lipoprotein testing, such as NMR Lipoprofile or Atherotech VAP.

    It really shouldn't be that tough, but we are battling the incredible ignorance in the primary care community who is spread too thin to master any one area.

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