Wheat-free and still fat

Readers of The Heart Scan Blog know that I preach a diet that contains foods with low glycemic index to control weight, raise HDL, and reduce triglycerides, blood sugar, and small LDL.

A crucial aspect of a low glycemic index approach is to sharply reduce, preferably eliminate, wheat products.

I pick on wheat specifically because it has come to dominate the American diet. Look at the shelves in the supermarket: aisle after aisle of processed wheat products. The bread shelves alone in some of the grocery stores in my neighborhood are 40 feet long, six shelves high. There's also breakfast cereals, granola products, cookies, cakes, baking products, pretzels, crackers, pasta, and on and on.

Wheat products like these are tasty and they're addicting--literally. Test animals given processed wheat will eat more and gain more weight. Wheat fails to trigger satiety. So laboratory mice--and you and I--eat and eat, because eating wheat stimulates appetite, creates a hunger for more wheat, and a vicious cycle ensues. Eliminating wheat, on the other hand, results in dramatic drop in appetite, substantial weight loss, followed by correction of the metabolic disruptions it created.


A quick Google search for "gluten-free" turns up a startling array of wheat-free, gluten-free, yet high glycemic index products. The breakfast cereal pictured, for instance, can do as much damage as most wheat containing products--though it won't cause gluten enteropathy (also known as "celiac disease").




The product shown contains:

Brown rice flakes, rice bran, evaporated cane juice, brown rice syrup, raisins, cinnamon, gum arabic, vanilla, molasses, ground flaxseed, rosemary extract.

A 1/2-cup serving contains:
Total Carbohydrate 31g
Dietary Fiber 5g
Sugars 8g


And I'll bet that most people eat a lot more than a half-cup serving.

But you and I are not laboratory mice. If deprived of wheat, many people will then seek out processed rice products (rice cakes, Rice Krispies), processed cornstarch or cornmeal products (tacos, cornbread, many processed foods using these products for texture or thickness), or other products labeled "gluten-free."

Going wheat-free for our purposes is not about avoiding the gluten in wheat. It is about seizing control of appetite, eliminating a food that disrupts insulin responses, reduces HDL, raises triglycerides, and creates small LDL particles. But this applies to processed corn, rice, and other high glycemic index foods, as well.

So, occasionally, someone will declare, "I've eliminated wheat! Now I only eat rice, corn, and I've discovered all the gluten-free alternatives!"

Unfortunately, they've traded one evil for another. So it's not just about wheat. It's really about reducing or minimizing foods that mess up metabolic responses and lead to coronary plaque growth. Wheat is the biggest culprit and so I focus on it. However, you could easily transfer far less popular rice and corn products into center stage and allow them to wreak all the health damage of wheat.

Going wheat-free for our atherosclerotic plaque-control purposes is not the same as going gluten-free. So be careful of the distinction.


Wheat-free gummi bears:


Contents:
Organic dehydrated cane juice, organic corn malt syrup, organic juice concentrates (may contain organic apple, organic apricot, organic aronia, organic carrot, organic cranberry, organic elderberry, organic lemon or organic red beet), organic spinach powder, organic apple pectin, citric acid, natural fruit flavors.

Virtually pure sugar--yet wheat-free.



Wheat-free rice bread


Ingredients:
White rice flour, water, honey, soy oil, natural gum, salt, yeast, natural gum














Copyright 2008 William Davis, MD

Comments (14) -

  • Anne

    2/15/2008 8:59:00 AM |

    Two years ago when I discovered I was intolerant to them, rather than go "wheat free" I went "grain free", I cut out all the grains. I don't miss grains at all, and doing a test with my blood glucose meter after a piece of bread was final confirmation of how bad they are ! When we go to friends for a meal it's so much easier to say I don't eat any grains at all than to say I'm intolerant to this one or that one or to gluten. Dh has also virtually cut out grains but it's obviously an addiction because he can't completely cut them out and has the occasional rice cake :-( You can tell grains are a cheap way of feeding people though as our food bill has gone up a lot since I stopped eating them and replaced them with lots of fresh veggies. I didn't know how much it would help my HDL, that's nice to know...mine is 2.4 (93).

    Anne

  • Anonymous

    2/15/2008 11:23:00 AM |

    Celiacs today are lucky, depending on how you look at it.  There are just so many ready made foods for them to choose from these days.  Additionally food manufactures now label if their food has wheat in it - some even volunteer to label if gluten is present!  There is a health food grocery store a few blocks from our place and one whole isle is dedicated to only gluten free foods!!  I'm jealous because I used to have a grumpy gut 20 to 15 or so years ago and different doctors would suggest I try eating gluten free.  Back then plain old Quaker rice cakes was about as tasty as it got when it came to a quick meal.

    Thanks for the wonderful blog Dr Davis.  I enjoy e-mailing it out to friends and family.  As I tell them, your blog wittings are too good to keep to myself.  Received two e-mails yesterday from others wanting to learn more about TYP.  Primrose

  • Anne

    2/15/2008 12:36:00 PM |

    I have non-celiac gluten sensitivity. I have to eliminate gluten 100% in order to feel well. I found out very quickly, if I want feel my best, I must avoid all the processed gluten free(GF) foods too.

    As more and more people get diagnosed with celiac disease/gluten sensitivity, more and more processed GF products are showing up on the grocery shelves. You are right to point out that a GF diet is not always a healthy diet. That is a common misconception. Yesterday I spoke with a doctor who said she was going to eat GF in order to lose weight. When I told her Snickers and Coke were GF, she was surprised.

    By sticking with whole foods and eliminating all grains, I regained my health.
    Anne

  • Anonymous

    2/15/2008 3:08:00 PM |

    I am in complete agreement with your stance that refined/processed sources of wheat should be avoided. But are moderate glycemic load whole grain foods such as bulgur wheat, kasha, brown rice, and 100% whole wheat bread, which are important sources of fiber and B vitamins, truly "evil"  when CONSUMED in moderation? I may be somewhat unusual because I do not need to lose weight or decrease my blood sugar (or, for that matter, reduce TG's or raise HDL) but I have the "dreaded combination" of genetically induced Lp(a) and small LDL. Do I actually have to feel that I am "doing damage" to myself by eating a few whole grain products a few times a week?

  • Anonymous

    2/15/2008 4:58:00 PM |

    So where does a highly processed product like Bran Buds (wheat bran, sugar, psyllium seed husk, oat fiber, high fructose corn syrup... uh oh!) come out?  Lots people eat this one for a fiber boost, but is it really just another Frankenstein food, masquerading as "healthy"?

    1/3 cup serving has 70 cals., 1 gm fat; 200 mgs. sodium; 300mgs. potassium; 24 gms. carbs of which 8 gms are sugars; 13 gms fiber, of which 3 gms are soluble and 10 gms are insoluble fiber; 2 gms protein

    I may have answered my own question.

    Thanks for the great blogs, Dr. Davis.

    madcook
    Cypress, TX

  • Anonymous

    2/15/2008 5:20:00 PM |

    I've been reading about coconut flour, which is supposedly lower on the glycemic scale, and is high in fiber -- according to the sites promoting coconut flour.

    Do you think baked items made from 100% coconut flour would be ok for blood sugars, and not causing increases in LDL and triglycerides, if eaten in moderation?

    Glycemic Index of Coconut Flour Products in Normal and Diabetic Subjects

    S

  • Zute

    2/15/2008 5:31:00 PM |

    I always thought you picked on wheat because of something in particular about wheat.  However, I have found that all grains definitely play havoc with my blood sugar and ultimately lead me to getting fat(ter) and unhealthier.  

    Since I've gone "Paleo" and eliminated all grains and dairy products I found a lot of strange health issues that I can trace directly to removing them from my diet (and their subsequent reappearance when I add them back) disappeared like:

    Terrible IBS (wheat)
    Low blood sugar feelings (grains)
    Brain fog and memory problems (wheat)
    Insomnia maybe lack of D3 (wheat)
    Arthritis (wheat)
    Sinus problems (dairy)
    Muscle spasms (dairy)
    Acne (dairy)
    Constipation (dairy)

    Anyway, wheat is the worst for me but the other grains are right behind it.

  • Ross

    2/15/2008 11:41:00 PM |

    Absolutely correct in my experience.  My body composition didn't start to change until I cut out grains and starchy vegetables entirely (except for one weekly cheat meal).

    Wheat may be the worst of the bunch, but it's the carbs within the wheat that are really the problem, and those carbs are found in lots of places.

    One thing that's really suprised me are how many "low-carb" foods are also low-fat.  What's left?  I don't want a high-protein diet, I want a high-fat diet with fats from natural animal and vegetable sources.  It's frustrating that it's so difficult to find healthy food in the grocery store these days.  I'm really looking forward to the day when the era of "low-fat = healthy" is broadly regarded as an embarassing lapse of judgement by an entire culture.

  • Mike

    2/15/2008 11:59:00 PM |

    But the Gummi Bears are Organic! They must be healthy. I'm wondering if I can get some organic arsenic.

  • Cindy Moore

    2/16/2008 2:01:00 AM |

    Many low carbers eliminate all grains, not just wheat. There certainly isn't any reason why we should be eating grains!

    Personally I think wheat, corn and soy should all be eliminated....and one or more is in almost every processed food in some way.

  • Anonymous

    2/17/2008 7:40:00 PM |

    No one explicitly mentioned oats.   I try not to eat many grains, but I do feel better with a bowl of Scottish oatmeal for breakfast and it is mostly soluble fiber which is good for your digestion.  I'm really not much of an "egg person" and get really tired of them everyday.

    Noreen

  • migraineur

    2/18/2008 10:30:00 PM |

    I just tell people I'm allergic to grains.  Since most desserts also have flour in them, that covers me on 95% of anything people might try to serve me as a main dish or dessert.  The last 5% would be potatoes or legumes, and those are usually served as a side dish, so I can just avoid them.

  • Anna

    2/19/2008 4:08:00 AM |

    With rare exceptions, we don't eat grains very often at our house anymore.  I still do get some sprouted wheat bread for my son, but I have to freeze it because he eats it so slowly.  I do add some very small amounts of quinoa to stews and soups, or sprout it to add to salads, but even that is minimal.

    Another commenter mentioned coconut flour.  Last year I started baking again, using recipes from a coconut flour cookbook (Fife).  Be aware, that without gluten, 100% coconut flour (as opposed to a flour blend) requires a lot of binder, usually eggs, or else the item will fall apart.   I also have to watch my blood sugar with a low carb diet, and if consumed sensibly, low sugar coconut flour  cookies fit in well.

  • Anonymous

    2/22/2008 12:08:00 PM |

    @ Anna re: Coconut flour

    Thanks for the feedback about coconut flour; I''m going to give it a try for the occasional baked goods replacement.

    I was aware that without gluten, extra binder would be needed. I originally thought about what the celiacs use, guar or xanthum, but Gluten A Go Go has been using ground flax or chia as her binder for her celiac baked goods. So I'll play around with those too.

    S

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The Perfect Carnivore

The Perfect Carnivore

People who carry the gene for lipoprotein(a), Lp(a), tend to be:

--Intelligent--The bell curve of IQ is shifted rightward by a substantial margin.
--Athletic--With unusual capacity for long-endurance effort, thus the many marathoners, triathletes, and long-distance bikers with Lp(a).
--Tolerant to dehydration
--Tolerant to starvation
--Resistant to tropical infections

In other words, people with Lp(a) have an evolutionary survival advantage. More than other people, they make clever, capable hunters who can run for hours to chase down prey, not requiring food or water, and less likely to succumb to the infections of the wild. In a primitive setting, people with Lp(a) are survivors. Evolution has likely served to select Lp(a) people for their superior survival characteristics.

But wait a minute: Isn't Lp(a) a risk for heart attack and stroke? Don't we call Lp(a) "the most aggressive known cause for heart disease and stroke that nobody gives a damn about"?

Yes. So what allows this evolutionary advantage for survival to become a survival disadvantage?

Carbohydrates, especially those from grains and sugars. Let me explain.

More so than other people, Lp(a) people express the small LDL pattern readily when they consume carbohydrates such as those from "healthy whole grains." Recall that the gene for Lp(a) is really the gene for apoprotein(a), the protein that, once produced by the liver and released into the bloodstream, binds to an available LDL particle to create the combination Lp(a) molecule. If the LDL particle component of Lp(a) is small, it confers greater atherogenicity (greater plaque-causing potential). Thus, carbohydrate consumption makes Lp(a) a more aggressive cause for atherosclerotic plaque. The situation can be made worse by exposure to vegetable oils, such as those from sunflower or corn, which increases production of apo(a).

Also, more than other people, Lp(a) people tend to show diabetic tendencies with consumption of carbohydrates. Eat "healthy whole grains," for instance, or if a marathoner carb-loads, he/she will show diabetic-range blood sugars. I have seen long-distance runners or triathletes, for instance, have a 6 ounce container of sugary yogurt and have blood sugars of 200 mg/dl or higher. The extreme exercise provides no protection from the diabetic potential.

Because carbohydrates are so destructive to the Lp(a) type, it means that people with this pattern do best by 1) absolutely minimizing exposure to carbohydrates and vegetable oils, ideally grain-free and sugar-free, and 2) rely on a diet rich in fats and proteins.

The perfect diet for the Lp(a) type? It would be a diet of feasting on the spoils of the hunt, devouring the wild boar captured and slaughtered and eating the snout, hindquarters, spleen, kidneys, heart, and bone marrow, then eating mushrooms, leaves, nuts, coconut, berries, small rodents, reptiles, fish, birds, and insects when the hunt is unproductive.

Capable hunter, survivor, consumer of muscle and organ meats: I call people with Lp(a) "The Perfect Carnivores."

Comments (19) -

  • BuckarooBanzai

    10/2/2012 7:07:35 PM |

    Then I suppose I am the imperfect carnivore-tendency towards high Lp(a) which is recently under control but also apoE3/4 which suggests limiting fat (or is it just saturated fat?).  Limit carbs...no, limit saturated fat.  OK, so that leaves lean meat, avocadoes, nuts and non-starchy veggies, right?

  • Dr. Davis

    10/3/2012 1:40:11 AM |

    Not necessarily, Buckaroo.

    The apo E4 introduces a trait of highly variable fat-sensitivity.

    Perhaps this is something worth discussing in future.

  • Ulrik

    10/3/2012 3:20:49 PM |

    I'll second a request for your opinions on what to do when you're ApoE ε3/ε4 or ε4/ε4! This is very interesting, but just the beginnings of personalized medicine.

  • Anand Natrajan

    10/3/2012 6:54:13 PM |

    Dr. Davis,
    I have extremely elevated Lp(a) (190 mg/dL) that hasn't budged despite 2 g niacin  and  4 g  fish oil daily.  I am seem to fit several of your descriptors, i.e. thin, premature CHD at. 47, LDL that is resistant to lowering beyond 85 mg/dL despite statin and niacin therapy, borderline fasting glucose etc. Always been very physically active and that hasn't changed despite one stent.

    However, I am not and don't want be to be a carnivore. Any other options?
    Thank you.

    Anand

  • Bob

    10/3/2012 7:16:40 PM |

    What level of Lp(a) do we need to be concerned about?

  • BuckarooBanzai

    10/3/2012 9:43:10 PM |

    I would welcome a more in-depth discussion of the role of fat sensitivity in apoE4.  I've not been able to find anything remotely like a consensus on PubMed, and The Perfect Gene Diet which addresses was a big disappointment.

  • Susan

    10/4/2012 1:30:46 AM |

    Well, I just got my Lab Results back and I am the lucky carrier of Lp(a) as well as Apo E3/4 and probable FH or FDB. LDL-C Direct 205, HDL-C 95, Triglycerides 52, LDL-P1969, LP(a) Mass 64, LP(a) Cholesterol 13. I have been wheat free, sugar-free, low carb, high fat for about 3 years. Looks like I will have to make some changes, but feel uncertain because high fat is what has really helped me lose weight. Without the fat, I have cravings. Higher carbs are no good for me. Would coconut oil perhaps lead to better results?

  • Yet Another Kim

    10/4/2012 6:38:19 PM |

    Hmm, I've recently learned I have lipoprotein(a). I am definitely not an endurance athlete (I adore sports where I can go hard for a minute and then recover), but the rest of the sketched profile fits.

    I'm not sure how I feel about your assertions wrt carb tolerance as it applies to me, though. If I eat by preference with no effort to restrict, I get on average 100g carb/day (a bit less if there are no social demands), but higher or lower levels of carbohydrate don't seem to make too much difference in my blood glucose readings (or mood or ability to lose weight). I have had some wild effects from medication, though: the Mirena IUD (levonorgestrel) in particular caused a crazy post-prandial rollercoaster and elevated fasting glucose for a couple of months until I pulled the plug.

  • Gene K

    10/6/2012 1:21:32 PM |

    I am ApoE 3/4, and I have followed this issue closely. You may find some useful advice on Dr. Kruse's Optimal Living site, especially in his EpiPaleo diet - http://jackkruse.com/brain-gut-6-epi-paleo-rx/.

  • Haley Joel

    10/9/2012 10:14:20 AM |

    Hi Susan,

    Instead of coconut oil i would rather suggest to have some high calorie food, because oil makes you increase of cholesterol not fat , having high calorie food like cereals will also help in have some energy in the body

  • Celeste

    10/12/2012 7:51:31 PM |

    Dr. Davis,

    I am working on bringing my husband's Lp(a) 14 and apoB 109 down.  His current pattern is A/B smack in the middle.  What confuses me is saturated fat. How is this good for bringing down your numbers (assuming your not apoe4) when it is also highly inflammatory.  Perhaps this is in the book but it hasn't arrived yet.
    Thanks.

    Celeste

  • Rick

    10/16/2012 10:46:29 AM |

    Look at this article on kidney failure in sugar cane workers...horribly fascinating.

    http://openchannel.nbcnews.com/_news/2012/10/16/13866856-mystery-kidney-disease-decimates-central-america-sugarcane-workers?lite

  • Gene K

    10/21/2012 2:47:14 AM |

    It is hard to believe that regular readers of this blog will consider cereal in their diets.

  • Stephanie

    10/26/2012 2:36:07 PM |

    I just got my first VAP test results back and my Lp(a) is 12 mg/dL.  I probably fit your description pretty well, except I have no idea if I get diabetic if I eat lots of grains.  I used to be semi-vegan but I was a marathoner at the time.  I do know that back then I would get very hungry every 2 hours and I would gain weight pretty easily if I stopped doing so much cardio.  My LDL has gone up (116 now, pattern A, was 94 a year ago) since going paleo 1.5 years ago, but my HDL is also up (95, was 85) and my trigs are down (55 now, was 65).

    Thanks for the info!  I'll keep my carbs low as I can while keeping my energy up.  I know if I don't eat some starches I start to feel pretty awful, especially during certain times of the month.  I guess I should start using a glucometer!

  • RFM

    1/4/2013 4:15:47 PM |

    Dr. Davis,

    My VAP test showed that I have an Lp(a) of 12 on a normal scale of 1-10.  A specific Lp(a) blood test showed that I have an Lp(a) of 250 mg/dL.  Do you see such discrepancies often?  How can both tests possibly be right?

    Thanks.

  • Richard

    2/3/2013 8:33:08 PM |

    Kinda disliked that the text encourages confirmation bias, but had a private test for lp(a) anyway ($50, pretty cheap info).  It was predictably, very high, which matched up to the NMRLipo derived suspicions I had, big numbers were all awesome, with a bajillion ldl-p and very near diabetic a1c & insulin resistant! lol.

    Needless to say, sugar and refined grains are now mostly deleted.    Keeping a <10% cap on carbs for now; not sure I can manage a smaller cap, but we'll know if that change was sufficient in a couple more months.

    If someone needs a reason why lp(a) and associates would be evolutionarily advantageous?   On a distance hunt, away from village support, quick repair is better than good repair; and a downed hunter may not have much meat, but will have some body fat, and will have dried fruit.   Sugar+injury+gobs of sticky things in the blood, good nuff to be back in the game quickly (if painfully).    No one cares if their hunters die at 55 instead of 75.

    nb... objectively measured, I fit your stated tendency characteristics exactly.   I'd kinda like to live past 55 though.

  • Mar

    8/19/2013 7:58:22 PM |

    Hi Dr. Davis,
    My husband has very high Lp(a) at 30 years old. We are trying to get on the right diet to help him so he can live a long life and not die of a heart attack at a young age like his mother, uncle and both grandfathers. You seem to be very knowledgeable in regards to Lp(a) levels in cardiac patients. His doctor is not and we are currently doing the Caldwell Esselstyn diet (plant-based, low-fat) to reverse plaque build-up. Reading your blog suggests to me that we are on the wrong track. Can you please point me to the research papers from which you derive your specific conclusion that high Lp(a) carriers should be carnivorous?
    I would greatly appreciate any help!
    Thank you so much,
    Mar

  • R Shaffner

    11/20/2013 10:20:28 PM |

    How about eggs, dairy and fish?

    And be sure to take low-dose aspirin, which has been shown to "abolish" the incremental risk of having Lp(a).

  • R Shaffner

    11/20/2013 10:27:45 PM |

    Dr. Davis,

    I've had high Lp(a) readings in the past.  I've lost 35 pounds and dropped 4 meds, by eating low-carb, high-fat.  It's a now a lifestyle for me, not a temporary diet.  And I get plenty of fish oil, so I'll see what your recommendations do for my Lp(a).

    I'm curious what you think of this study:  http://www.atherosclerosis-journal.com/article/S0021-9150(08)00522-4/abstract .  For the women in this study, the incremental Lp(a) risk was from having a minor allele in the LPA genotype, and for those women in this large study, low-dose aspirin eliminated that incremental risk.

    I've been taking daily aspirin too, but now I think I know how it helps.

    Thanks for all you do!

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