Rerun: To let low-carb right, you must check POSTPRANDIAL blood sugars

2. April 2010 William Davis (12)
Checking postprandial (after-eating) blood sugars yields extraordinary advantage in creating better diets for many people.

This idea has proven so powerful that I am running a previous Heart Scan Blog post on this practice to bring any newcomers up-to-date on this powerful way to improve diet, lose weight, reduce small LDL, reduce triglycerides, and reduce blood pressure.



To get low-carb right, you need to check blood sugars

Reducing your carbohydrate exposure, particularly to wheat, cornstarch, and sucrose (table sugar), helps with weight loss; reduction of triglycerides, small LDL, and c-reactive protein; increases HDL; reduces blood pressure. There should be no remaining doubt on these effects.

However, I am going to propose that you cannot truly get your low-carb diet right without checking blood sugars. Let me explain.

Carbohydrates are the dominant driver of blood sugar (glucose) after eating. But it's clear that we also obtain some wonderfully healthy nutrients from carbohydrate sources: Think anthocyanins from blueberries and pomegranates, vitamin C from citrus, and soluble fiber from beans. There are many good things in carbohydrate foods.

How do we weigh the need to reduce carbohydrates with their benefits?

Blood sugar after eating ("postprandial") is the best index of carbohydrate metabolism we have (not fasting blood sugar). It also provides an indirect gauge of small LDL. Checking your blood sugar (glucose) has become an easy and relatively inexpensive tool that just about anybody can incorporate into health habits. More often than not, it can also provide you with some unexpected insights about your response to diet.

If you’re not a diabetic, why bother checking blood sugar? New studies have documented the increased likelihood of cardiovascular events with increased postprandial blood sugars well below the ranges regarded as diabetic. A blood sugar level of 140 mg/dl after a meal carries 30-60% increased (relative) risk for heart attack and other events. The increase in risk begins at even lower levels, perhaps 110 mg/dl or lower after-eating.

We use a one-hour after eating blood sugar to gauge the effects of a meal. If, for instance, your dinner of baked chicken, asparagus brushed with olive oil, sauteed mushrooms, mashed potatoes, and a piece of Italian bread yields a one-hour blood sugar of 155 mg/dl, you know that something is wrong. (This is far more common than most people think.)

Doing this myself, I have been shocked at the times I've had an unexpectedly high blood sugar from seemingly "safe' foods, or when a store- or restaurant-bought meal had some concealed source of sugar or carbohydrate. (I recently had a restaurant meal of a turkey burger with cheese, mixed salad with balsamic vinegar dressing, along with a few bites of my wife's veggie omelet. Blood sugar one hour later: 127 mg/dl. I believe sugar added to the salad dressing was the culprit.)

You can now purchase your own blood glucose monitor at stores like Walmart and Walgreens for $10-20. You will also need to purchase the fingerstick lancets and test strips; the test strips are the most costly part of the picture, usually running $0.50 to $1.00 per test strip. But since people without diabetes check their blood sugar only occasionally, the cost of the test strips is, over time, modest. I've had several devices over the years, but my current favorite for ease-of-use is the LifeScan OneTouch UltraMini that cost me $18.99 at Walgreens.

Checking after-meal blood sugars is, in my view, a powerful means of managing diet when reducing carbohydrate exposure is your goal. It provides immediate feedback on the carbohydrate aspect of your diet, allowing you to adjust and tweak carbohydrate intake to your individual metabolism.

LDL glycation

1. April 2010 William Davis (11)
The proteins of the body are subject to the process of glycation, modification of protein structures by glucose (blood sugar). In the last Heart Scan Blog post, I discussed how glycated hemoglobin, available as a common test called HbA1c, can serve as a reflection of protein glycation (though it does not indicate actual Advanced Glycation End-products, or AGEs, just a surrogate indicator).

There is one very important protein that is subject to glycation: Apoprotein B.

Apoprotein B, or Apo B, is the principal protein of VLDL and LDL particles. Because there is one Apo B molecule per VLDL or LDL particle, Apo B can serve as a virtual VLDL/LDL particle count. The higher the Apo B, the greater the number of VLDL and LDL particles.

Because Apo B is a protein, it too is subject to the process of glycation. The interesting thing about the glycation of Apo B is that its "glycatability" depends on LDL particle size: The smaller the LDL particle, the more glycation-prone the Apo B contained within.

Younis et al have documented an extraordinary variation in glycatability between large and small LDL, with small LDL showing an 8-fold increased potential.

Think about it: Carbohydrates in the diet, such as wheat products and sugars, trigger formation of small LDL particles. Small LDL particles are then more glycation-prone by up to a factor of 8. Interestingly, HbA1c is tightly correlated with glycation of Apo B. Diabetics with high HbA1c, in particular, have the greatest quantity of glycated Apo B. They are also the group most likely to develop coronary atherosclerosis, as well as other consequences of excessive AGEs.

No matter how you spin it, the story of carbohydrates is getting uglier and uglier. Carbohydrates, such as those in your whole grain bagel, drive small LDL up, while making them prone to a glycating process that makes them more likely to contribute to formation of coronary atherosclerotic plaque.

High HbA1c: You're getting older . . . faster

28. March 2010 William Davis (16)
Over the years, we all accumulate Advanced Glycation End-products, or AGEs.

AGEs are part of aging; they are part of human disease. AGEs are the result of modification of proteins by glucose. AGEs form the basis for many disease conditions.

Accumulated AGEs have been associated with aging, dementia, cataracts, osteoporosis, deafness, cancer, and atherosclerosis. Most of the complications of diabetes have been attributable to AGEs.

There's one readily available method to assess your recent AGE status: HbA1c.

Hemoglobin is the oxygen-carrying protein of red blood cells. Like other proteins, hemoglobin becomes glycated in the presence of glucose. Hemoglobin glycation increases linearly with glucose: The higher the serum or tissue glucose level, the more glycation of hemoglobin develops. Glycated hemoglobin is available as the common test, HbA1c.

Ideal HbA1c is 4.5% or less, i.e., 4.5% of hemoglobin molecules are glycated. Diabetics typically have HbA1c 7.0% or greater, not uncommonly greater than 10%.

In other words, repetitive and sustained high blood glucose leads to greater hemoglobin glycation, higher HbA1c, and indicates greater glycation of proteins in nerve cells, the lens of your eye, proteins lining arteries, and apoprotein B in LDL cholesterol particles.

If AGEs accumulate as a sign of aging, and high blood sugars lead to greater degrees of glycation, it only follows that higher HbA1c marks a tendency for accelerated aging and disease.

Indeed, that is what plays out in real life. People with diabetes, for instance, have kidney failure, heart disease, stroke, cataracts, etc. at a much higher rate than people without diabetes. People with pre-diabetes likewise.

The higher your HbA1c, the greater the degree of glycation of other proteins beyond hemoglobin, the faster you are aging and subject to all the phenomena that accompany aging. So that blood glucose of 175 mg/dl you experience after oatmeal is not a good idea. 

The lesson: Keep HbA1c really low. First, slash carbohydrates, the only foods that substantially increase blood glucose. Second, maintain ideal weight, since normal insulin responsiveness requires normal body weight. Third, stay physically active, since exercise and physical activity exerts a powerful glucose-reducing effect. Fourth, consider use of glucose-reducing supplements, an issue for another day.

While HbA1c cannot indicate cumulative AGE status, it can reflect your recent (preceding 60 to 90 days) exposure to this age-accelerating thing called glucose.

If your doctor refuses to accommodate your request for a HbA1c test, you can perform your own fingerstick test.

Slash carbs . . . What happens?

26. March 2010 William Davis (20)
Cut the carbohydrates in your diet and what sorts of results can you expect?

Carbohydrate reduction results in:

Reduced small LDL--This effect is profound. Carbohydrates increase small LDL; reduction of carbohydrates reduce small LDL. People are often confused by this because the effect will not be evident in the crude, calculated (Friedewald) LDL that your doctor provides.

Increased HDL--The HDL-increasing effect of carbohydrate reduction may require 1-2 years. In fact, in the first 2 months, HDL will drop, only to be followed by a slow, gradual increase. This is the reason why, in a number of low-carb diet studies, HDL was shown to be reduced.--Had the timeline been longer, HDL would show a significant increase.

Decreased triglycerides--Like reduction of small LDL, the effect is substantial. Triglyceride reductions of several hundred milligrams are not at all uncommon. In people with familial hypertriglyceridemia with triglyceride levels in the thousands of milligrams per deciliter, triglyceride levels will plummet with carbohydrate restriction. (Ironically, conventional treatment for familial hypertriglyceridemia is fat restriction, a practice that can reduce triglycerides modestly in these people, but not anywhere near as effectively as carbohydrate restriction.) Triglyceride reduction is crucial, because triglycerides are required by the process to make small LDL--less triglycerides, less small LDL.

Decreased inflammation--This will be reflected in the crude surface marker, c-reactive protein--Yes, the test that the drug industry has tried to convince you to take statins drugs to reduce. In my view, it is an absurd notion that you need to take a drug like Crestor to reduce risk associated with increased CRP. If you want to reduce CRP to the floor, eliminate wheat and other junk carbohydrates. (You should also add vitamin D, another potent CRP-reducing strategy.)

Reduced blood pressure--Like HDL, blood pressure will respond over an extended period of months to years, not days or weeks. The blood pressure reduction will be proportion to the amount of reduction in your "wheat belly."

Reduced blood sugar--Whether you watch fasting blood sugar, postprandial (after-meal) blood sugars, or HbA1c, you will witness dramatic reductions by eliminating or reducing the foods that generate the high blood sugar responses in the first place. Diabetics, in particular, will see the biggest reductions, despite the fact that the American Diabetes Association persists in advising diabetics to eat all the carbohydrates they want. Reductions in postprandial (after-eating) blood sugars, in particular, will reduce the process of LDL glycation, the modification of LDL particles by glucose that makes them more plaque-causing.


You may notice that the above list corresponds to the list of common plagues targeted by the pharmaceutical industry: blood pressure, diabetes (diabetes being the growth industry of the 21st century), high cholesterol. In other words, high-carbohydrate, low-fat foods from the food industry create the list of problems; the pharmaceutical industry steps in to treat the consequences.

In the Track Your Plaque approach, we focus specifically on elimination of wheat, cornstarch, and sugars, the most offensive among the carbohydrates. The need to avoid other carbohydrates, e.g., barley, oats, quinoa, spelt, etc., depends on individual carbohydrate sensitivty, though I tend to suggest minimal exposure.

Normal fasting glucose with high HbA1c

23. March 2010 William Davis (24)
Jonathan's fasting glucose: 85 mg/dl
His HbA1c: 6.7%

Jonathan's high HbA1c reflects blood glucose fluctuations over the preceding 60-90 days and can be used to calculate an estimated average glucose (eAG) with the following equation:

eAG = 28.7 X A1c – 46.7

(For glucose in mmol/L, the equation is eAG = 1.59 × A1C - 2.59)

Jonathan's HbA1c therefore equates to an eAG of 145.59 mg/dl--yet his fasting glucose value is 85 mg/dl. 

This is a common situation: Normal fasting glucose, high HbA1c. It comes from high postprandial glucose values, high values after meals. 

It suggests that, despite having normal glucose while fasting, Jonathan experiences high postprandial glucose values after many or most of his meals. After a breakfast of oatmeal, for instance, he likely has a blood glucose of 150 mg/dl or greater. After breakfast cereal, blood glucose likely exceeds 180 mg/dl. With two slices of whole wheat bread, glucose likewise likely runs 150-180 mg/dl. 

The best measure of all is a postprandial glucose one hour after the completion of a meal, a measure you can easily obtain yourself with a home glucose meter. Second best: fasting glucose with HbA1c.

Gain control over this phenomenon and you 1) reduce fasting blood sugar, 2) reduce expression of small LDL particles, and 3) lose weight.  

Can you handle fat?

21. March 2010 William Davis (19)
No question: Low-carbohydrate diets generate improved postprandial lipoprotein responses.

Here's a graph from one of Jeff Volek's great studies:



Participants followed a low-carb diet of less than 50 g per day carbohydrate ("ketogenic") with 61% fat.   The curves were generated by administering a 123 g fat challenge with triglyceride levels assessed postprandially. The solid line represents the postprandial response at the start; dotted line after the 6-week low-carb effort.

Note that:

1) The postprandial triglyceride (area-under-the-curve) response was reduced by 29% in the low-carb diet.  That's a good thing.

2) The large fat challenge generated high triglycerides of greater than 160 mg/dl even in the low-carb group. That's a bad thing. 

In other words, low-carb improves postprandial responses substantially--but postprandial phenomena still occur. Postprandial triglycerides of 88 mg/dl or greater are associated with greater heart attack risk because they signify the presence of greater quantities of atherogenic (plaque-causing) postprandial lipoproteins.

A full discussion of these phenomena can be found in the Track Your Plaque Special Report, Postprandial Responses: The Storm After the Quiet!, part of a 3-part series on postprandial phenomena.

Statin stupid

19. March 2010 William Davis (0)
If we followed the lead of the pharmaceutical industry and my cardiology colleagues, we would all subscribe to the "statins for all" philosophy. There is now $2 billion of clinical "research" to back up this "evidence-based" practice.

I do not endorse this "statins for all" philosophy. I believe it is a product of the raw profiteering of the pharmaceutical industry, who are adept at recruiting physicians to their cause.

But lost in the confusion of tainted studies and over-the-top media saturation is the fact that there are small groups of people who likely do obtain benefit from statin drugs. They would certainly benefit from better informed scrutiny of their lipoprotein and metabolic abnormalities. But treatment may involve statins.

This is entirely distinct from the "statins for all" argument, the simpleminded rule that primary care physicians and cardiologist are told to follow.

Groups who may indeed benefit from statin therapy include:

Homozygous or heterozygous familial hypercholesterolemia--Lacking a receptor for LDL particles, LDL piles up to very high levels in these people. LDLs of 300+ are common and lead to heart disease and stroke at relatively young ages.

Combined mixed hyperlipidemia--Among the one or more genetic defects underlying this condition involves excessive production of apoprotein B and VLDL particles. This leads to high risk for heart disease.

People unable to follow a diet to correct their lipid disorder--I have 80+-year old patients, for instance, who say, "I've eaten this way for 82 years. I'm not going to change now!" In the absence of diet and other efforts (e.g., omega-3 fatty acids from fish oil), drugs may be the answer.

In other words, of the $27 billion annual bill for statin drugs, perhaps a tiny fraction is truly necessary. The majority of people taking statin drugs would not really need them if they had the real answers. But don't let that confuse us: There are some people who do indeed benefit.

Butter and insulin

19. March 2010 William Davis (83)
In a previous post, Atkins Diet: Common Errors, I commented on butter's unusual ability to provoke insulin responses. I offer this as a possible reason why, after a period of effective weight loss on a low-carbohydrate program, inclusion of some foods, such as butter, will trigger weight gain or stall weight loss efforts.

This develops because of butter's insulin-triggering effect, doubling or tripling insulin responses (postprandial area-under-the-curve). If insulin is triggered, fat gain follows.

Here's one such study documenting this effect: Distinctive postprandial modulation of ß cell function and insulin sensitivity by dietary fats: monounsaturated compared with saturated fatty acids

López et al 2008


From Lopez et al 2008. Mean (± SD) plasma glucose, insulin, triglyceride, and free fatty acid (FFA) concentrations during glucose and triglyceride tolerance test meal (GTTTM) with no fat (control), enriched in monounsaturated fatty acids (MUFAs) from refined olive oil (ROO meal), with added butter, with a mixture of vegetable and fish oils (VEFO) or with high-palmitic sunflower oil (HPSO). N = 14.

The postprandial (after-eating) area-under-the-curve is substantially greater when butter is included in the mixed composition meal. This effect is not unique to butter, but is shared by most other dairy products.

Fat, in general, does not make you fat. But butter makes you fat.

Vitamin D as a cardiovascular risk factor gains ground

18. March 2010 William Davis (0)
If you were reading The Heart Scan Blog back in 2007, or read my Life Extension article on vitamin D deficiency as a cardiovascular risk factor, you already knew that vitamin D deficiency is rampant and adds to cardiovascular risk.

Results of a study from the Intermountain Medical Center Heart Institute in Utah bolster the concept that vitamin D deficiency is a cardiovascular risk factor, vitamin D normalization/supplementation reduces cardiovascular risk.

Science Daily reported:

For the first study, researchers followed two groups of patients for an average of one year each. In the first study group, over 9,400 patients, mostly female, reported low initial vitamin D levels, and had at least one follow up exam during that time period. Researchers found that 47 percent of the patients who increased their levels of vitamin D between the two visits showed a reduced risk for cardiovascular disease.


In the second study, researchers placed over 31,000 patients into three categories based on their levels of vitamin D. The patients in each category who increased their vitamin D levels to 43 nanograms per milliliter of blood or higher had lower rates of death, diabetes, cardiovascular disease, myocardial infarction, heart failure, high blood pressure, depression, and kidney failure. Currently, a level of 30 nanograms per milliliter is considered "normal."


Over the past 4 years, people in our program have been enjoying the extravagant benefits of vitamin D restoration. Cardiovascular benefits are becoming better documented and the bone health, cancer-preventing, insulin-normalizing, mood-adjusting, and anti-inflammatory effects likewise.

Atkins Diet: Common errors

18. March 2010 William Davis (74)
No doubt: The diet approach advocated by the late Dr. Robert Atkins was a heck of a lot closer to an ideal diet than the knuckleheaded advice emitting from the USDA, American Heart Association, American Diabetes Association, and the Surgeon General's office.

But having just spent a week with Atkins low-carbers, here are some common errors that I see many make, errors that I believe have long-term health consequences, including impairment of weight loss.

Excessive consumption of animal products--Non-restriction of fat often leads to over-reliance on animal products. Higher intakes of red meats (heme proteins?) have been strongly associated with increased risk for colon and other gastrointestinal tract cancers. It is not a fat issue; it is an animal product issue. We should consume less meat, more vegetables and other plant-sourced foods.

Consumption of cured meats--Cured, processed meats, such as sausage, hot dogs, salami, bologna, and bacon, have a color fixative called sodium nitrite, an additive that has been confidently linked to gastrointestinal cancers. Risk is likely dose-dependent: The more you ingest, the greater the long-term risk.

Overconsumption of dairy products--Dairy products, especially milk, yogurt, cottage cheese, and butter, are potent insulinotropic foods, i.e., foods that trigger insulin release. There can be up to a tripling of insulin (area-under-the-curve) levels. This is not good in a world populated with tired, overworked pancreases, exhausted from a lifetime of high-carbohydrate eating.

Too many calories--While I agree that "a calorie is a calorie" and "calories in, calories out" are faulty concepts, I have anecdotally observed that long-time low-carbers often trend towards unlimited consumption of food, a phenomenon that seems to result in weight gain, especially in the sedentary. I wonder if this is a reflection of the insulinotropic action of dairy products and other proteins, compounded by the poor insulin responsiveness that develops with lack of physical activity. Factor into this conversation that lower calorie intake extends life, probably substantially (Sirt-2 activation and related phenomena, a la resveratrol). If lower calorie intake extends life, unlimited calorie intake likely shortens life.

Please don't hear this as low-carb bashing--it is not. It is a call to improve diets and not stumble into common traps that can impair heart health, weight loss, and longevity.
I eliminated wheat . . . and I didn't lose weight!

I eliminated wheat . . . and I didn't lose weight!

19. October 2011 William Davis (33)
Elimination of wheat is a wonderfully effective way to lose weight. Because saying goodbye to wheat means removing the gliadin protein of wheat, the protein degraded to brain-active exorphins that stimulate appetite, calorie consumption is reduced, on average, 400 calories per day. It also means eliminating this source of high blood sugar and high blood insulin and the 90-minutes cycles of highs and lows that cause a cyclic need to eat more at the inevitable low. It means that the high blood sugar and insulin phenomena that trigger accumulation of visceral fat are now turned off. It may possibly also mean that wheat lectins no longer block the leptin receptor, undoing leptin resistance and allowing weight loss to proceed. And weight loss usually results effortlessly and rapidly.

But not always. Why? Why are there people who, even after eliminating this appetite-stimulating, insulin-triggering, leptin-blocking food, still cannot lose weight? Or stall after an initial few pounds?

There are a list of reasons, but here are the biggies:

1) Too many carbohydrates--What if I eliminate wheat but replace those calories with gluten-free breads, muffins, and cookies? Then I've switched one glucose-insulin triggering food for another. This is among the reasons I condemn gluten-free foods made with rice starch, cornstarch, tapioca starch, and potato starch. Or perhaps there's too many potatoes, rices, and oats in your diet. While not as harmful as wheat, they still provoke phenomena that cause weight loss to stall. So cutting carbohydrates may become necessary, e.g., no more than 12-14 grams per meal.

2) Fructose--Fructose has become ubiquitous and has even assumed some healthy-appearing forms. "Organic agave nectar" is, by far, the worst, followed by maple syrup, honey, high-fructose corn syrup, sucrose,and fruit--yes, in that order. They are all sources of fructose that causes insulin resistance, visceral fat accumulation or persistency, prolongation of clearing postprandial (after-meal) lipoproteins that antagonize insulin, and glycation. Lose the fructose sources--as much of it as possible. (Fruit should be eaten in very small portions.) Watch for stealth sources like low-fat salad dressings--you shouldn't be limiting your fat anyway!

3) Thyroid dysfunction--A real biggie. Number one cause to consider for thyroid dysfunction: iodine deficiency. Yes, it's coming back in all its glory, just like the early 20th century before iodized salt made it to market shelves. Now, people are cutting back on iodized salt. Guess what's coming back? Iodine deficiency and even goiters. Yes, goiters, the disfiguring growths on the neck that you thought you'd only see in National Geographic pictures of malnourished native Africans. Number two: Exposure to factors that block the thyroid. This may include wheat, but certainly includes perchlorate residues (synthetic fertilizer residues) on produce, pesticides, herbicides, polyfluorooctanoic acid residues from non-stick cookware, polybrominated diphenyl ethers (flame retardants), and on and on. If you are iodine-deficient, it can even include goitrogenic iodine-blocking foods like broccoli, cauliflower, and soy. Thyroid status therefore needs to be assessed.

4) Cortisol--Not so much excess cortisol as disruptions of circadian rhythm. Cortisol should surge in the morning, part of the process to arouse you from sleep, then decline to lower levels in the evening to allow normal recuperative sleep. But this natural circadian cycling is lost in many people represented, for instance, as a flip-flopping of the pattern with low levels in the morning (with morning fatigue) and high levels at bedtime (with insomnia), which can result in stalled weight loss or weight gain. Cortisol status therefore needs to be assessed, best accomplished with salivary cortisol assessment.

5) Leptin resistance--People who are overweight develop an inappropriate resistance to the hormone, leptin, which can present difficulty in losing weight. This can be a substantial issue and is not always easy to overcome. It might mean assessing leptin levels or it might mean taking some steps to overcome leptin resistance.

Okay, that's a lot. Next: More on how to know when thyroid dysfunction is to blame.
Tags :

Comments (33) -

  • Jay

    10/19/2011 2:37:59 AM |

    I tend to gain weight when I work a lot of night shifts at the hospital.  My sleep/wake pattern gets very messed up and I turn to extra carbs to fight off fatigue.  Working rotating shifts must take a toll on health.

  • JO

    10/19/2011 4:06:28 AM |

    Well I am living proof that 4 and 5 exist. Very low carb diet ( 10 g a day ) for 3 months and less than 2kg weight loss. My Leptin is 32 ( norm is 8 here ).

    So how do I sort out Cortisol and Leptin ??

  • Fat Guy Weight Loss

    10/19/2011 5:18:50 AM |

    Surprised to see high-fructose corn syrup so far down on the list....don't really consume any of those but enlighting still.

  • Helena

    10/19/2011 11:31:04 AM |

    Could it be as easy as these people might actually need to cut down on something else instead... I am most often in favor or cutting wheat in diets but if you look at blood type there is actually some grains that are good for some people with a certain blood type. Type A is one of the group that could possibly be seeing nothing when they stop eating wheat and continue to eat other things that is not good for them, such as red meat. Off course there could be other issues too, just what you are saying in your post, but I think it could mention that blood type do play a role in what your body can do with the food you give it...

  • Howard

    10/19/2011 4:03:12 PM |

    I eliminated wheat in 1999. Lost 100 lbs and my arthritis, but stalled out at about 50 lbs over goal.

    I have been "tweaking" lately. I already take an iodine supplement (didn't appear to make any difference, although my low morning body temperature isn't as low).

    I'm guessing that all those trans-fats damaged my metabolism. Or maybe it was a combination of trans fat, HFCS, and wheat.

    My latest experiment for breaking the nearly decade-long stall is IF, combined with Fred-Hahn style slow-burn twice a week. That appears to be working, at least in the short term.

    I am interested in the Leptin resistance idea, and especially in ways to fix it if that is the problem.

  • Howard

    10/19/2011 4:05:18 PM |

    @Helena: "eat other things that is not good for them, such as red meat. "

    Nutritional ignorance abounds. You are confusing red meat with fuzzy gray-green meat. The latter is not good for you, but the former is.

  • Dr. William Davis

    10/19/2011 4:27:09 PM |

    Yes, it does, Jay.

    The sooner you can escape this unnatural sleep-wake pattern, the sooner you can regain better health.

  • Dr. William Davis

    10/19/2011 4:27:44 PM |

    Let's cover in a future post, Jo. There's no quick answer.

  • Dr. William Davis

    10/19/2011 4:29:20 PM |

    Hi, Howard--

    Let's cover the leptin question in future.

    I do love the Slow Burn idea, too, a way to make substantial gains with a minimum of effort.

  • Bertil

    10/19/2011 6:12:25 PM |

    Dr Davis,

    Do you have some references for the term "best" as in "best accomplished with salivary cortisol assessment"?

  • michael

    10/20/2011 2:20:38 AM |

    I  would prefer this comment to be private:

    It seems that maybe excessive alcohol consumption might be a factor in not losing weight after cutting out wheat.  I am wondering why you don't talk  frankly and directly about alcohol consumption when you talk about the patients you have helped.  You do say moderate consumption is  better, but you do not go into any detail about what overcunsumption is and what it does, or what advice you give to those who are drinking too much when you help them.  You have given vivid examples of people whose lives have been saved by the avoidance of wheat, but is that really the whole story?  My guess is that at least 10% of the people who are reading your blog or who have bought your book are drinking alcohol to excess.  What advice would you give that 10% ?  I applaud you for your diligent efforts to help people recover their health, and I would encourage you to consider those people who might still be outside your scope of interest.

  • oc

    10/20/2011 11:51:02 AM |

    Hi Dr. Davis:
    If one has an abnormal salivary cortisol or is leptin resistant, what steps must be undertaken to overcome each of these?  Thanks.

  • Susan

    10/20/2011 1:35:08 PM |

    I have not eaten wheat, (or any grains) for over a year. I do not eat sweets except occasionally fruit like berries. (When peaches were in season last summer I could not resist.) I have been able to stop gaining weight, but losing weight is elusive. I have Hasimoto's disease. My TSH is around 1 with 45 mg Armour Thyroid, but my T3 and T4 are in the lower range of normal. I do take about 750 mcg  iodine, Standard Process Thytrophin PMG (which is supposed to help with the autoimmunity) and a product called Sea Vegetables Plus which has sea vegetables, L-Tyrosine and Bioperine . Are there any other ways to optimize thyroid function?

  • Clark

    10/21/2011 9:27:42 AM |

    I've long eliminated all of what you list from my diet and reaped benefits. I'm very lean but for a very small handle around my mid-section -- I'll call it my 'fruit belly' as fruit is the one indulgence I refuse to give up.

    I live in a region with fresh fruit stands on almost every corner and I eat it aplenty. I think there are a few pleasures in life worth a little weight gain (if it causes any in me at all). And certainly there must be some benefits to a diet full of many different types of fresh fruit.

  • Dr. William Davis

    10/21/2011 2:50:33 PM |

    Hi, Oc--
    Great topics for future discussions!

  • Dr. William Davis

    10/21/2011 2:51:45 PM |

    I hear you, Michael.

    I suppose that I am guilty of not saying the obvious, at times, such as smoking causes heart disease over-consumption of alcohol, e.g., more than 3 drinks per day, is unhealthy for a long list of reasons. Thanks for the reminder.

  • Dr. William Davis

    10/21/2011 2:54:14 PM |

    None that I know about, Susan. In fact, I am skeptical that ANY iof the "thyroid support" supplements available do anything at all.

    Iodine works, no question. Selenium might work in Hashimoto's thyroiditis. Beyond this, I know of nothing that makes the thyroid work better, including tyrosine. Giving your thyroid tyrosine is like putting more gas in your gastank: It won't make the car go any faster.

  • Dr. William Davis

    10/21/2011 2:55:20 PM |

    Just beware of glycation, Clark.

    Gauge glycation by your HbA1c. I regard anything above 5.0% as an undesirable level of glycation.

  • Peter Andrews

    10/21/2011 3:00:56 PM |

    This is a comment about a statement in the first chapter of Wheat Belly but I did not know how where to send it to.

    You have repeated the oft statedidea' that humans share 99% of their genes with chimpanzees. The correct number is closer to 95% if you take into account insertions and deletions. The 99% was an early estimate based on older technology and has been superseded. See http://www.ncbi.nlm.nih.gov/pmc/articles/PMC129726/ "Divergence between samples of chimpanzee and human DNA sequences is 5%, counting indels"

  • Kenneth

    10/21/2011 3:55:11 PM |

    How big of an effect can borderline hypothyroidism have on lipid profiles? I've been fighting high triglycerides and low HDL (and presumably small LDL) all my life.  Even on a gram of niacin, lots of fish oil and topped up vitamin d, I'm running 300ish on TG and 33-35 HDL. I'm not obese or even overweight by more than perhaps 5 pounds. Even when I'm a fanatic about exercise and low carb, the best I've ever done was 160 TG. As much as I hate the idea, I'm ready to throw in the towel and resort to Tricor and/or a statin. I've been on testosterone replacement for over two years (I'm 41), and I may have my thyroid evaluated as we make adjustments to that. I don't think I'm big-time hypothyroid, but if its running a little slow, can fixing that have a marked impact on lipids?Is whole extract usually/always better than synthroid?

  • MGCC

    10/21/2011 7:24:39 PM |

    Or another possible reason - I had already sharply reduced carbohydrate intake for several months, and hit a stable plateau of just over 250 lbs (tall and muscular guy, but still 30 lbs too fat).  Going off all wheat six weeks ago hasn't helped break below that weight.  I've never been symptomatic for coeliac or other auto-immune reactions from wheat so for me it was just a tightening of my carb intake.  Activity levels pretty high - regular gym work, some running & walking, outdoors for soccer coaching.  But stuck above 250.

  • MGCC

    10/21/2011 7:25:32 PM |

    I admire  your way with words, and I imagine you're a very good looking man as well.

  • MGCC

    10/21/2011 7:26:14 PM |

    Aw shucks.  But lots of people say that.

  • Dr. William Davis

    10/22/2011 12:58:01 PM |

    Hi, Kenneth--

    Thyroid can exert a BIG effect on lipids. The worse the hypothyroidism, the bigger the effect.

    And, if thyroid replacement is necessary, the extracts are nearly always better than T4 alone as Synthroid.

  • Sandra Brigham

    10/22/2011 7:21:56 PM |

    Dr. Davis, I'm one of those who gained doing Archevore (eliminated all grains, legumes, sugar, seed oils but kept whole cream, cheese and butter).. In 10 mths I'd lost inches everywhere but start gaining wt the last couple mths. On your blog you suggested that I might have a thyroid issue. I bought myself a glass thermometer and did basal temp checks 3 mornings in a row at same time before rising - 96.9, 97.1 and 97.1. I understand the normal range is 97.4-98.2.  My average of 97 indicates hypothyroid right? If most people don't see symptom resolutions using thyroid meds, is there any reason for me to get tested?

    I also concurrently gave up all dairy and substituted coconut milk. I am happy to say I am now seeing a wt loss of 1/2 - 1 lb a day this week! I have even been able to up my carbs from VLC (25) to moderate (60-100) with no adverse effects!  While I had given up milk, I really did not think cream, butter or cheese was holding me back. Boy was I wrong! The joint achiness is also now gone!

  • Dr. William Davis

    10/23/2011 11:48:14 PM |

    Hi, Sandra--

    Normal temperature if taken orally immediately upon awakening is 97.3 F. So your temperatures are marginally low. Worth watching over time.

    That's great with the dairy products. While I've included limited dairy products in the diet I advocate, there are undoubtedly people like you with exceptional sensitivities.

  • Henk Poley

    10/25/2011 2:51:50 PM |

    Please make sure you still have a good calcium source. Most western people are very vitamin D deficient, especially during the winter. Which means you don't take up all the calcium from the food. So keep an eye on your 25(OH)D3 level, and calcium intake.

  • Henk Poley

    10/25/2011 3:08:07 PM |

    You should check your 25(OH)D3 and B12 levels to make your sleep more effective: http://www.youtube.com/view_play_list?p=35D93D52577FB34C

    And if you are not a night owl, don't work nightshifts..

  • Tee

    10/28/2011 11:28:43 AM |

    Dr. Davis
    This gentleman, Dr. Kruse, is all the rage at Marks Daily Apple site. I'm curious about your thoughts on his Lipten Reset approach.
    Here is a link to his bog, and his Leptin Prescription.
    http://jackkruse.com/my-leptin-prescription/
    Thank you.

  • Dr. William Davis

    10/29/2011 10:52:00 PM |

    Dr. Kruse's advice is very reasonable. One modest difference: I tend to rely on an even lower carbohydrate intake, e.g., 10-12 grams per meal, while trying to regain control over metabolic distortions.

  • Tee

    10/30/2011 3:41:40 AM |

    Thanks Dr. What are your thoughts on eating 50 gr. of protein within a half hour of waking up?  I'm never hungry till after11 AM.

  • Chris

    5/6/2012 5:33:37 AM |

    Interesting Blog. I've read this far, and I see over and over again one theory that has me a bit baffled, which is fruit. Hi carb to be sure, but the 80/10/10 diet by Dr. Graham suggests that fat is the culprit that drives up blood sugar.  My blood sugar has been very stable on a strict fruit/veggie diet. I'm curious what your take would be with regards to small LDL particles on a strict fruit and veggie regimen?

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