In search of wheat: Einkorn and blood sugar

There are three basic aspects of wheat's adverse health effects: immune activation (e.g., celiac disease), neurologic implications (e.g., schizophrenia and ADHD), and blood sugar effects.

Among the questions I'd like answered is whether ancient wheat, such as the einkorn grain I obtained from Eli Rogosa, triggers blood sugar like modern wheat.

So I conducted a simple experiment on myself. On an empty stomach, I ate 4 oz of einkorn bread. On another occasion I ate 4 oz of bread that dietitian, Margaret Pfeiffer, made with whole wheat flour bought at the grocery store. Both flours were finely ground and nothing was added beyond water, yeast, olive oil, and a touch of salt.

Here's what happened:

Einkorn wheat bread:

Blood sugar pre: 84 mg/dl
Blood sugar 1-hour post: 110 mg/dl

Conventional wheat bread
Blood sugar pre: 84 mg/dl
Blood sugar 1-hour post: 167 mg/dl

The difference shocked me. I expected a difference between the two, but not that much.

After the conventional wheat, I also felt weird: a little queasy, some acid in the back of my throat, a little spacey. I biked for an hour solid to reduce my blood sugar back to its starting level.

I'm awaiting the experiences of others, but I'm tantalized by the possibility that, while einkorn is still a source of carbohydrates, perhaps it is one of an entirely different variety than modern Triticum aestivum wheat. The striking difference in blood sugar effects make me wonder if einkorn eaten in small quantities can keep us below the Advanced Glycation End-Product threshold.

Comments (32) -

  • Jim Purdy

    6/14/2010 12:21:36 AM |

    Doctor Davis, for those of us who aren't inclined to bake our own bread, but who still like sandwiches, are there any commercially available breads (or bread substitutes) that you would recommend?

    Jim Purdy
    The 50 Best Health Blogs

  • Anne

    6/14/2010 3:19:39 AM |

    Did you check your blood sugar at 2 hours? There are times when my BG spike is later than 1 hour.

    Very interested in hearing about everyone's experience.

  • D.M.

    6/14/2010 5:43:36 AM |

    Interesting, but assuming that the einkorn bread contained the same amount of carbohydrate as conventional bread (if it contained less, then this effect is hardly magical) then one would expect a similar effect on blood sugars ultimately. Perhaps einkorn bread simply left you with higher blood sugars at three hours?

  • David M Gordon

    6/14/2010 11:35:16 AM |

    What do you think of displacing wheat in favor of coconut? The following text is a blurb for a cookbook (of all things!)...

    "Are you allergic to wheat or sensitive to gluten? Perhaps you avoid wheat because you are concerned about your weight and need to cut down on carbohydrates. If so, the solution for you is coconut flour.

    "Coconut flour is a delicious, healthy alternative to wheat. It is high in fiber, low in digestible carbohydrate, and a good source of protein. It contains no gluten so it is ideal for those with celiac disease.

    "Coconut flour can be used to make a variety of delicious baked goods, snacks, desserts, and main dishes. It is the only flour used in most of the recipes in this book. These recipes are so delicious that you won't be able to tell that they aren't made with wheat. If you like foods such as German chocolate cake, apple pie, blueberry muffins, cheese crackers, and chicken pot pie, but don't want the wheat; you will love the recipes in this book! These recipes are designed with your health in mind. Every recipe is completely free of wheat, gluten, soy, trans fats, and artificial sweeteners. Coconut is naturally low in carbohydrate and recipes include both regular and reduced sugar versions. Coconut flour pres many health benefits. It can improve digestion, help regulate blood sugar, protect against diabetes, help prevent heart disease and cancer, and aid in weight loss."

  • Jenny

    6/14/2010 12:12:46 PM |

    Dr. Davis,

    Unfortunately, all your test showed is that the einkorn digests more slowly than the other wheat. You might have seen the same result with a sourdough white bread.

    A more reliable test would have tested at 1.5 and 2 hours, but because you have normal insulin production you would have to have measured insulin to see what was really happening.

    All carb would have eventually been digested, and it takes the same amount of insulin to process it. While it's good to avoid blood sugar spikes if a person is insulin resistant the einkorn will provoke a large though slower insulin release.

    This is the problem with the whole idea of the glycemic index. If the problem is insulin, the SPEED with which it is secreted really is a red herring.

  • Anonymous

    6/14/2010 12:30:28 PM |

    What about the blood sugar level after 2 hr? 3? 4? Could it be that, like pasta, the einkorn bread gives a steady medium-high blood sugar for 3-4 hours, while normal wheat gives a spike yet quickly falls down to base level?

  • Martin Levac

    6/14/2010 12:45:29 PM |

    In my opinion, the AGE threshold is ketosis. In ketosis and there's little to no AGE production, out of ketosis and there is AGE production. Then there's the bit about ketones directly stimulating junk protein aka AGEs recycling and it becomes obvious what the threshold really is.

  • Dr. William Davis

    6/14/2010 1:14:48 PM |

    Excellent points about the delayed blood sugar response with einkorn.

    Yes, indeed. It would have to generate a longer blood glucose curve, as DM suggests, it is still a carbohydrate, though I did not specifically test this.

  • Dr. William Davis

    6/14/2010 1:15:32 PM |


    I wasn't aware of using coconut flour in place of wheat flour. Interesting!

    Have you tried it?

  • Martin Levac

    6/14/2010 1:26:26 PM |

    I'm with Jenny about the insulin thing. If we only know BG numbers, we still don't know whether it's because there's more carbs in einkorn or if it digests more slowly or something else. We must know how much insulin it takes to bring BG to those numbers.

    Incidentally, ketosis (and therefore AGE production and clearing) is also a function of how much insulin is flowing, not a function of how much blood glucose there is. So I guess you'll have to measure insulin to know what's what.

  • David M Gordon

    6/14/2010 1:26:26 PM |

    No, I have yet to try coconut flour. In an odd moment of serendipity, I received a scanned copy of the cookbook concurrent with your post.

    Odd, because for some health reason I do not recall (not allergy, though) I had strayed away from coconut everything. But things change.

    So I will share the cookbook with my wife, and request, nicely, we try a recipe or two. We attempt to go wheat-free this week, so I will wait out this test before trying, and then report back.

    PS: I receive the results of my lab tests this afternoon. I sure hope the many changes I put into place several months ago on your suggestions changed my numbers for the better!

  • Emily

    6/14/2010 1:41:04 PM |

    coconut flour/fiber isn't truly low in carbs, it has 8 grams carbs/ 2 Tablespoon sized serving. 5 grams of that is fiber, which according to some carb-counters, isn't counted as a true carb.

    also coconut flour bread tastes absolutely nothing like wheat bread.  i dont think i could convince a wheat lover that coconut flour bread was the way to go.

  • k

    6/14/2010 1:55:59 PM |

    Reminds me of Dr. Bernstein, when testing his blood sugar after eating various brands of crackers. He did find one that did not spike blood sugar levels - GG Scandinavian Crispbread, made from unprocessed wheat bran. I tried them and liken it to eating a wood shingle (ok, I imagine that is exactly what a wood shingle would taste like). He tries substituting it as bread in a couple of recipes. This struck me as almost sad; our craving and addiction to starch/sugar is mind blowing.

  • LeenaS

    6/14/2010 5:52:49 PM |

    Dear Dr Davis,

    Since you are experimenting, would you consider the option of making your own regular wheat bread the way you made the eikorn bread?

    Ready-milled whole wheat flour bought from a store differs dramaticlly from freshly milled flour, both enzymatically and in fatty acid quality. Only with freshly milled flour one has a chance to digest non-degraded Pufas (present in all grains).


  • jandro

    6/14/2010 6:03:48 PM |

    Very interesting. I wonder if they both had the same caloric density. If eikorn has lower calories it would show a lower glucose response. I wonder what your reaction to something like a sweet potato is. I stay away from grains as they don't agree will with me.

    About coconut flour, I have used it before for making pancakes. I really like it but I LOVE coconut in general, someone who doesn't like coconut might feel differently about it. An advantage to other nut flours is that it's low in O6.

  • Tony

    6/14/2010 6:37:42 PM |

    The Many Uses of Coconut Flour:

  • Marnae

    6/14/2010 8:04:58 PM |

    Yeast needs sugar to work properly--just a little sugar or honey would have made the bread rise much better. No sense using yeast if there's no sugar for it to eat.

  • DogwoodTree05

    6/14/2010 10:20:24 PM |

    Coconut flour is okay for brownies, bar cookies, and pancakes.  It would never yield an edible bread.  Gluten-free baked goods are unsatisfactory, IMO.  They have a somewhat crumbly texture, not spongy like wheat.  I have tried coconut, almond, and other gluten-free flours, including grain-based ones sold commercially.  Nothing can replace the spongy texture that wheat gives baked goods.  Save for the occasional bar cookie or pancake made with coconut or almond flour, I've given up eating flour-based products.

  • Michael

    6/14/2010 10:31:18 PM |

    Coconut flour is okay for some recipes but functionally speaking it certainly is not a substitute for sandwich bread.

    While it is not a grain I still had a weird feeling after eating it. I think it shares the same need as all flour to be fresh milled and used immediately, or fresh milled and then soaked or fermented in some way.

  • Dr. William Davis

    6/15/2010 2:10:09 AM |

    Hi, Leena--

    Actually, the whole wheat (not einkorn) bread was made from flour that was freshly ground. I shudder to think what might have happened had it been store-bought flour.

  • Cheryl

    6/15/2010 2:53:50 AM |

    Dr. Davis,

    I wonder if you'll try this experiment again, this time with a CGM and periodic draws to find out what your insulin level was.

    This experiment, to a more casual reader, provides too much hope (to a person with diabetes) that they can eat bread and still have optimal glucose levels.

    Diabetes has been documented in the ancient world it may be that a 'treat' wouldn't harm someone once, but a regular and consistent 'treat' becomes a habit. Poor habits are what precipitate diseases like Type 2 diabetes, yes?

  • Hans Keer

    6/15/2010 5:40:33 AM |

    Funny experiment, but as stated by other commenters, it does not say much. And as you have said before yourself: "The best thing is to avoid grain consumption". Some dangers of grains:

  • Alfredo E.

    6/15/2010 4:56:40 PM |

    Dr. Davis, you wrote: “After the conventional wheat, I also felt weird: a little queasy, some acid in the back of my throat, a little spacey. I biked for an hour solid to reduce my blood sugar back to its starting level”

    I am very interested to know how biking reduced your blood sugar after one hour. Do you have some ideas as how exercise can actually reduce blood sugar?

    In my case, I am pre diabetic and after one hour of intense exercise my blood sugar is very similar to before exercise, above 100's. Nevertheless, after some meals, it could come down to 80’s, how could that be explained?

    Best wishes,
    Alfredo E.

  • shutchings

    6/17/2010 7:21:21 AM |

    Where can you buy bread made from freshly ground wheat?!

  • rmarie

    6/17/2010 7:18:18 PM |

    I'm prediabetic too and I've discovered a quick and convenient way to lower my BG: I do 50-60 jumping jacks and if it's very high I'll add 20 pushups. It takes about 5 minutes and lowers my BG anywhere from 20 to 40 points in half an hour or so.

    The glucose in your body is reduced quickly because anaerobic exercise like that requires a lot of energy and it takes that in the form of glucose. So it's not an artifical lowering of BG like through medication. The body just uses up available glucose more quickly.

    Some may worry that such a large BG drop might make them hypoglycemic but I have never had that happen to me even before I was doing this. I'm not on any medication.

    Maybe Dr. Davis can elaborate on this a little more. We don't always have time or circumstance to go bike riding to lower our BG and for me this is a convenient alternative.

  • Carrie

    6/23/2010 12:03:26 AM |

    Dr. Davis-
    A friend of mine who is new to GF eating mentioned that her husband's blood pressure has stabilized rather quickly after eliminating wheat. I googled "GF for heart health", and was delighted to discover your blog.    

    My family eats grain free, and the only flour I use is coconut flour.  I recommend Bruce Fife's book "Cooking with Coconut Flour" as a jumping off point, because it explains how the properties of coconut flour make it unique to cook and bake with.  You NEED many more eggs than in a traditional bread recipe because that is what gives it a light airy texture, and you also need lots of fats to ensure it is moist.  I really don't do any cakes, cookies, etc because we try and stay low-carb, but the coconut flour has been great for breakfast, because neither my baby or I can eat eggs plain (wish I could, but they make me gag, he does too).  

    Coconut Flour Crepes:
    2 eggs
    2 TBSP melted butter or coconut oil (if you use coconut oil, the eggs need to be room temp or it will clump up)
    Add 2 TBSP of sifted coconut flour and mix again until smooth.  
    Finally thin the mixture with about 1/3 cup of water and/or coconut milk
    (I use frozen from Asian market, not canned, and dilute it 50/50 with water and a drop of vanilla Stevia)

    cook crepes in pan brushed with ample coconut oil.  They are great with just butter.

  • David M Gordon

    6/23/2010 2:24:17 AM |

    Dr Davis,

    The book Carrie mentions, Cooking with Coconut Flour, is the one I mentioned last week. I have the entire book as a 2Mb pdf file, and am happy to share with anyone interested.

  • Kris

    6/28/2010 9:43:44 AM |

    Doctor Davis

    i think we are missing a very vital step here that is of fermenting wheat dough (making sourdough wheat). That is THE traditional style of consuming wheat everyday around the world.

    The process is neatly captured under subheading Europe:Sourdough Bread.

    That is how entire Indian subcontinent consumes wheat. That is approximately 2 billion people, not counting europe!

    I will really look forward to seeing how sourdough wheat plays out in these tests as that is the staple food for the vast majority day in and day out.

  • Ginger

    8/1/2010 8:09:31 PM |

    Great interview with einkorn wheat producer Etienne Mabille that may interest some of you: (you will have to use an online translation tool if you don't read french)

  • Chris Masterjohn

    9/16/2010 2:42:21 AM |

    Hi Dr. Davis,

    Interesting post.  I just received my shipment of einkorn today.  I'll be performing a more sophisticated version of your experiment on myself beginning next week and I'll let you know the results.  Just have to get a blood sugar-o-meter first.


  • susan

    8/29/2012 4:32:22 PM |

    David M Gordon,
    is it still possible to get a copy of the coconut flour book?

  • Mark Richardson

    5/6/2014 4:19:47 PM |

    Tested my wife's BG before she ate a bowl of glutten free cereal 90. 1 hour latter was 308. I sure got her attention!

"Friday is my bad day"

"Friday is my bad day"

At the start, Ted had a ton of small LDL particles. His starting (NMR) lipoprotien values:

LDL particle number: 2644 nmol/L

Small LDL: 2301 nmol/L

In other words, approximately 85% of all LDL particles were abnormally small. I showed Ted how to use diet to markedly reduce small LDL particles, including elimination of wheat, limiting other carbohydrates, and even counting carbohydrates to keep the quantity no higher than 15 grams per meal ("net" carbs).

Ted comes back 6 months later, having lost 14 pounds in the process (and now with weight stabilized). Another round of lipoproteins show:

LDL particle number: 1532 nmol/L

Small LDL: 799 nmol/L

Better, but not perfect. small LDL persists, representing nearly 50% of total LDL particle number.

So I quiz Ted about his diet. "Gee, I really stick to this diet. I have nothing made of wheat, no sugars. I count my carbs and I almost never go higher . . . except on Fridays."

"What happens on Friday?" I asked.

"That's when I'm bad. Not really bad. Maybe just a couple of slices of pizza. Or I'll go out for a big custard cone or something. That wouldn't do it, would it?"

That's the explanation. Your liver is well-equipped to recognize normal, large LDL particles. Large LDL particles therefore "live" for only a couple of days in the bloodstream. But the human liver does not recognize the peculiar configuration of small LDL particles, so it lets them pass--over and over and over again. The result: Once triggered by, say two slices of pizza, small LDL particles persist for 5 days, sometimes longer.

So Ted's one "bad" day per week is enough to allow a substantial quantity of small LDL particles to persist. While a fat indulgence (if there is such a thing) pushes large LDL up, the effect is relatively short-lived. Have a carbohydrate indulgence, on the other hand, and small LDL particles persist for up to a week. It means that Ted's one "bad" day per week is enough to allow his small LDL particles to persist at this level, preventing him from gaining full control over coronary plaque.

It also means that, if you have blood drawn for lipoprotein analysis but had a carbohydrate goodie within the previous week, small LDL particles may be exaggeratedly high.

Comments (29) -

  • yuma

    11/19/2011 4:45:34 PM |

    This is scary! One bad day sets you back a week.
    I limit my carbohydrates (zero grains, no more than 25 grams of sugar) to no more than 100 per day. How low should I go?

  • Jeff

    11/19/2011 8:44:09 PM |

    Dr. Davis, I think we need some clarification on "carbohydrates" -such as which sub-group, sugars (of which there are also sub-groups), starches (more sub-groups), and fiber (more sub groups) need limits. Obviously, sugars are of top concern, with starches following close behind. But arent some of the fiber carbohydrates desirable?

  • Jeff

    11/19/2011 8:45:36 PM |

    I think your website clock is off by twelve hours.....

  • Mary Titus

    11/19/2011 10:58:44 PM |

    How would this affect triglycerides, Dr. Davis.

  • Might-o'chondri-AL

    11/20/2011 4:24:33 AM |

    Hi All-
    Got server error where this belongs, so...about lamestream media hype of vitamin D & fibrilation here is the study's own press release - they only worry about D over 100ng/ml.
    Quote:  "... Dr. Bunch and his colleagues examined blood tests from 132,000 patients in the Intermountain Healthcare database.Patients did not have any known history of atrial fibrillation, and all had previously received a vitamin D assessment as part of their routine care. Patients were then placed into categories to compare levels of vitamin D: low (less than 20 nanograms per decilter), low/normal (21-40 ng/dl), normal (41-80 ng/dl), high/normal (81-100 ng/dl), and excess (more than 100).Patients with vitamin D levels in the normal range were compared with other groups to assess their risk of developing atrial fibrillation.
    In patients with low, low-normal, normal and high-normal levels of vitamin D there was no increased risk of atrial fibrillation.  However, in those with excess levels of vitamin D there was a significant increased risk of atrial fibrillation.  Atrial fibrillation risk was two and a half times greater in patients with excess levels of vitamin D compared to those with normal levels."

  • Teresa

    11/20/2011 2:42:29 PM |

    Thanks for bringing that up, Al.  I had heard of the study, but hadn't gotten around to looking it up.  

    Two and a half times higher risk of atrial fibrillation may not be as much of an increase as it sounds.  It depends on how many people were in the group, and what the real numbers are.  I found this on WebMD:

    The risk of a-fib in those with normal levels of vit D was 1.4%.  With high levels, it was 3.8%.  It isn't that much of a difference, and not as significant as it would be if the risk went from say 10% to 25%.  It is also not as significant if the group number is very small, but we don't have that information.  

    I also found this note on a case study in which a-fib stopped after starting vit D.  Go figure.

  • Dr. William Davis

    11/20/2011 3:53:11 PM |

    Triglycerides tend to go up, Mary, though not with the same magnitude as small LDL particles.

  • Dr. William Davis

    11/20/2011 3:57:27 PM |

    Hi, Jeff--

    The problem with the fiber is that it comes with digestible carbohydrate. It means that a slice of white Wonder bread triggers small LDL, but so does a cup of quinoa, millet, or buckwheat, all fiber-rich grains.

    Got to be careful: We can't fall for the same logic that has fooled generations of nutritionists: If something bad for you is replaced by something less bad and there is apparent benefit, lots of the less bad thing is good for you.

  • Dr. William Davis

    11/20/2011 3:58:35 PM |

    Wow, that's a lot, Yuma.

    It varies with individual carbohydrate sensitivity, but most people tolerate 15 grams per meal well without postprandial rises in blood glucose or triggering of small LDL.

  • STG

    11/20/2011 4:26:57 PM |

    Dr. Davis:
    It amazes me how some nutritionists  (e.g., ADA or AHA  based) and diet book writers encourage people to cheat on their diets without considering the health impacts. Clearly a mixed message when one is told to make changes, but then told that they can ignore the dietary changes once a week or on special occasions or holidays.

  • Dr Matti Tolonen

    11/21/2011 11:44:07 AM |

    Hi doc, are you sure you have the right units (nmol/l)? Hwere in  Europe, the target for LDL is less than 3 mmol/l which would equal to 3000 µg/l (not nmol/l).

  • Dr. William Davis

    11/21/2011 1:39:01 PM |

    Hi, STG--

    Yes, it is amazing. I have done so many lipoprotein panels (tens of thousands) that I see patterns that a casual observer would not see. This is a substantial, though underappreciated, effect.

  • Jim

    11/21/2011 2:11:19 PM |

    Great post Doc! That really brings the message home.

  • Jeff

    11/21/2011 3:43:08 PM |

    Actually, I am questioning how much do we ned to be concerned about the carbohydrate content of things like green peppers or onions? Flax seed has a nearly all-fiber carb content, doesn't it? What's a safe daily target for total carbohydrate intake, and how should we do the math, if any?

  • Kent

    11/21/2011 4:18:48 PM |

    Knowing that high postprandial glucose levels cause an increase in small ldl particles. And we know that carbohydrates, especially wheat, significantly raise post prandial glucose levels. Would it make sense that Ted could cheat on Fridays with a carb load and still drop his particle score just by exercising after being bad if it kept his glucose levels from spiking?

  • Renfrew

    11/21/2011 10:19:10 PM |

    exercising after "cheating" (eating carbs) MAY work, especially for people who still have enough residual beta cells left in their pancreas and not much insulin resistance. But often exercise is counterproductive because the exercise raises cortisol levels which in turn release blood sugar from the liver. This can only be determined by tight blood sugar measuring (pre/post exercise).

  • Dr. William Davis

    11/22/2011 3:16:41 AM |

    Hi, Jeff--

    It varies, but most people can do well with around 15 grams carbohydrate grams ("net" carbs, meaning total carbs minus fiber) per meal.

  • Dr. William Davis

    11/22/2011 3:17:26 AM |

    This has never been studied, Kent, but I suspect that exercising will only partially blunt the effect, not eliminate it.

  • steve

    11/23/2011 2:36:27 AM |

    Dr Davis:
    Where do you come out regarding the "safe starch" debate on the Jimmy Moore website?

  • Lindas

    11/23/2011 2:47:10 AM |

    Can anyone (or Dr. Davis)  tell me what they include in their 15 gr. carb meals?  how many carbs per day total,,,,SNACKS ETC? does this cause ketosis?  I've been trying to eat right,  however, at 8:30 PM my blood sugar was 112. is that bad or ok?  I'm a 61 year old woman. my calcium score 4/11 was 206. thank you

  • Dr. William Davis

    11/25/2011 2:13:48 PM |

    Sorry, Steve, I'm not familiar with that term.

    If you are referring to amylose, the form of carbohydrate that is less efficiently digested, it will boil down to blood sugar consequences of a specific amylose-containing food.

  • Dr. William Davis

    11/25/2011 2:15:10 PM |

    Hi, Lindas--

    I aim for blood sugar to stay below 100 mg/dl--all the time, including after meals.

    Ketosis can occur, though usually not. Eat vegetables, nuts and nut meals, oils, olives, avocados, meats, cheese. Plenty to eat without wheat and limited carbs.

  • Chris Buck

    11/26/2011 5:09:38 AM |

    Can I add vegetables does not include potatoes, corn, and rice - just to be clear.

  • Dr. William Davis

    11/27/2011 2:16:38 PM |

    Yes, correct. They will trigger small LDL if consumed in anything but the smallest portion size (e.g., more than 1/2 cup).

  • steve

    11/28/2011 6:18:55 PM |

    Dr Davis:
    The "safe starch" discussion is related to rice and potatoes being "safe starch" according to the writers of the Perfect Health Diet, The Jaminets.

    1/2 cup serving per meal X3 = 1.5 cups per day.  If three meals consumed in a day and zero at one meal could you eat 1 cup at one meal, and 1/2 cup at another and still be ok from an overall perspective?
    Are you advocating zero rice, potatoes as well as wheat and other starches?
    How is the level of acceptable maximum small LDL?
    Which would you find more acceptable for a person with CAD with normal weight, thryroid, D?
    LDL 2200
    small 200
    HDL 69
    The above with no statins; or
    LDL 650
    small <90
    HDL 60
    The above with statins
    Both with virtually zero starch
    Is zero starch healthy?  Will zero starch induce thyroid issues?
    Meat, chesse, fish, veggie diet healthy ok for those who cannot eat nuts?

    Wheat Belly sound advice; I have recommended it to several who have  gotten the book

  • STG

    11/29/2011 3:19:21 AM |

    Dr. Davis:
    What population develops small LDL--your patients, anyone who eats carbohydrates, individuals with defective glucose metabolism (e.g., prediabetic, diabetic, insulin resistant)?

  • Dr. William Davis

    12/1/2011 4:22:34 AM |

    Yes and yes. It is truly ubiquitous with few modern people escaping it.

  • Dr. William Davis

    12/1/2011 4:27:04 AM |

    Hi, Steve--

    The triggering of small LDL tends to be dependent on the contents of a single meal. It does not necessarily mean zero carbohydrates, but staying below the threshold for provocation, which can be approximated by checking a 1-hour postprandial glucose: If any rise above the pre-prandial level is seen, then there is potential for provoking small LDL.

    There is no confident answer to which is better. But, given the apo E4-driven or other abnormal metabolic pattern with the LDL particle number of 2200, I would opt for statin, much as I hate to say it.

  • Amos

    12/7/2011 7:25:33 AM |

    I'm not familiar with American blood sugar levels....what on earth would it mean to keep blood sugar under 100, in Canadian terms?  (I've been given a target of 4-7 before meals, and 7-9 after meals....)