I'm finishing a jar of "dry" (not oil suspended) Vitamin D3 capsules and taking them with enteric coated fish oil. Might the enteric coating prevent the fish oil from helping the "dry" D3 absorption?

Really interesting post. I think I'm sensitive to wheat, but can't seem to stop eating it right now. Once I gave it up for about two months and lost 20 pounds. I should probably try to eliminate it again. Thanks for the insight.

Interesting.  I have just the opposite experience though.  My very rare (maybe once every 6 months or so) consumption of wheat causes no obvious symptoms whatsoever though I have in the past had severe sinus allergy response to wheat/gluten

When I first went gluten-free, I was not as careful as I am now and had several incidences of acute joint pain (with incredible heat) upon exposure to minute amounts of gluten.  The last time I knowingly ate gluten (crumbs from a crouton on a salad) I woke up the next day with the most intense back pain I have ever had.  My usual response to gluten is in the form of migraines. This pain was definitely not muscle pain but neurological with squeezing pains from my spine to the front.  That was the last time I had any gluten - I am extremely careful now and I have been GF 3 years and feel so much better.   I think gluten is a poison, plain and simple, and everyone would be better off not consuming it in any way.

I'm one of the lucky ones.  I caved during the silly season and stole a couple of my sisters' delicious homemade double chocolate cookies.  Alas, no mad dashes to the procelean apparatus.

Wheat breeding sounds to be at fault for the way it's protein folds into an antigen trigger for a lot of people. Granny gave me jam with bread, pie and sugar cookies which didn't provoke malaise, but that was older breed of wheat.  

Now-a-days professional diet advice is to avoid sugar, substitue sweetener. So, many don't get that sugar binding to  the gluten protein fragments. For people with metabolic syndrome adding back in sugar doesn't make sense; they can't use it to "goop-up" the gluten. Cutting out the wheat for them solves the dilema.

Gluten are metabolized into opioids. Both the digestive system and the immune system have lots of neurons AFAIK. Is a nice system to protect the brain, I would guess. Evolution and natures way to say: Don't eat that, it'll mess you up.

Why diarrhea with wheat rechallenge etc.?
Perhaps because your bacterial intestinal flora has changed since wheat/grain elimination.

I have suffered from gastroparesis for 20+ years. Some medication has helped, but nothing has worked better than a carb/wheat free diet. If I avoid them my digestion seems fine. One cookie and within a few hours the rumbling and belching begins . . .

There's this Ethiopian restaurant here in LA. They serve a flat bread called Injera.

I must have it once or twice a year, I tell you, I must! Even though it causes sores in my mouth by the next morning. It never did that when I was eating wheat regularly. Now that I've given up wheat, BAM! Sores!

Otherwise, I'm a sore-free, wheat-free good boy the rest of the year.

Dr. Davis,

Great post.  I believe I have experienced exactly what you described.  I gave up drinking beer (my only grain) last summer and recent grain encounters led to stomach pain and quick trips to the bathroom.  One time I felt really sick for hours.

There are never a shortage of reasons to avoid grains.

@ Anonymous,
I did some work in Ethiopia in 1970 & ate a lot of Injera;
fermented Teff grain with a soaking phase. This increases the % of Arginine amino acids in Injera. People with cold sores are often agravated by arginine foods. Your sensitive mouth tissue is probably reacting to the high level of arginine. (Your individual sensitivity would likely extend to Indian Idli, soaked/fermented rice with dhall bean puff; it's bio-converted a lot of arginine too.)

For those of us that are cutting way back on wheat in our diets, but not eliminating it - what are our best options?  I'm finding heirloom wheat flour available on the internet.  And here's an interesting article I found on Heirloom wheats:
'Are Heirloom Wheat Varieties the Next Big Baking Trend?"
http://www.seriouseats.com/2010/01/is-heirloom-wheat-the-next-big-baking-trend-jim-lahey.html

And what about Kamut?  Any comments?  Here's a write-up on it - it has some very nice features.
http://www.suite101.com/content/kamut-ancient-grain-in-modern-times-a89648

I try to avoid wheat all the time.

However, I found one bread here, that is made without Flour but uses wheat sprouts instead. The recipe is made by Russian academic scientist.
You have some English language info at

http://www.zernohleb.ru/health_eng.html

What do you think about it ?

Thx

My digestion was always lousy (but I didn't know it) until I cut out wheat.

Now if I reintroduce the reaction varies depending on the form of poison. Pasta is worst, sending the gi tract into the red zone for a week, plus migraines and sinus.

other forms (cookies, pizza) the reaction is less volcanic, but still noticeable. The baseline reaction is the sensation that the lining of my stomach has been scrubbed with a brillo pad, and sometimes joint and back pain, with a touch of sinus fun.

All this I used to think of as"normal".

Anyone have any success with enzyme products (like "Gluten Ease“) to help deal with occasional exposure?

"The majority of people who experience a wheat re-exposure syndrome will have diarrhea and cramps..."

This seems to say that of those who DO have symptoms ("experience a ... syndrome"), a majority will have diarrhea and cramps and a minority will have other symptoms.  But what proportion experience any symptoms?  Like Geoffrey above, I don't.

Wow... that just happened to me.  But only after being wheat free for like a week.  I was experimenting with a gluten free paleo diet but went out with some friends to the mall to see a movie.  I drank one beer ate 4 slices of pizza and a big cookie.  I ended up screaming at a friend over a stupid comment, nothing serious, but I felt SO angry .  Something that is not usual for me.  Then that night I woke up in the middle of the night with stomach pain and diarrhea.  
This was after just 1 week with no wheat.

I forgot to add that I had bad headaches just 30 minutes or so after eating the pizza slices too..

Don't you think this could also have something to do with the 1 in 133 statistic for celiac disease? Alot more are gluten intolerant and on down the spectrum to gluten sensitive.  

That adds up to a whole lot of people out there who are on the continuum of mere sensitivity --->celiac

That's me in a nutshell. Re-exposed to wheat and it was two days of unspeakable nastiness... I lapsed into this silliness as an experiment with the 4HB which necessitates a weekly wild day. It was wild alright...

Great post. I would love it if someone could explain the mechanism by which this re-exposure horror happens.

Since cutting out gluten, even tiny exposures have sent my stomach into paroxysms of pain. This is accompanied by nausea and an all over sick feeling, like I have been poisoned.

My bloods tested negative for coeliac though so I don't understand why I have such a bad reaction.

I am one of those people prone to headaches, migraine and colds. Usually, my first recourse is White Flower Embrocation (embrocation.50webs.com), also called White Flower Oil

It all falls in line with obesity being another marker for an overall metabolic condition, not being the *cause* of the metabolic condition.  

The biggest disservice the medical establishment has done is ignore the evidence of this and continue to prescribe a diet that just makes it all worse and worse.

I'm glad you're spreading the good word!

Hi Dr Davis,

Another cracking post. It reminds me distinctly of a long discussion on Dr Bernstein's site as to whether weight loss to ideal weight is needed to normalise blood sugars in a type 2 diabetic. You appear to be looking at another aspect of the metabolic syndrome, IHD. And it appears to be quite obvious that weight loss, per se, is irrelevant to both IHD and normoglycaemia, PROVIDED you normalise the problems described as the metabolic syndrome.

Furnham and fasting is equally interesting. One has to ask; what happens during fasting? A full water fast to might be expected to give up to a kilo of weight loss each week perhaps? I've never tried this, but would guess this is reasonable. With flat-line basal glucose and insulin levels. That's just under 150g/d of weight loss, of which perhaps at least 100g/d is body fat. Mostly palmitic acid with some palmitoleic thrown in.

The fat does not just evaporate. This is what a person's metabolism runs on during fasting. Mostly saturated fat. And fasting is excellent for plaque reversal, we're told. And I believe it.

The question to me is, what would happen if you replaced that lost fat, by mouth, with similar fat (palmitic and palmitoleic, ie lard) to produce weight stability? Would you continue reversal without fasting? Perhaps throwing in 50g/d high quality protein to stop muscle loss.

Obviously anyone on a low fat diet, needing to maintain weight stability, requires a high carbohydrate intake with its associated and inevitable post prandial hyper-insulinaemia. No insulin, no glucose uptake. We need calories to live. 1000kcal of lettuce needs insulin for every molecule of glucose it releases. Once a low fat vegan has lost their palmitic acid based excess weight, they'll be right back on to glucose based metabolism.

Fasting is fat fueled. It works for reversal. Whether from your adipocytes or your plate, it's the same palmitic acid.

Peter

Hi, Peter-

Interesting thoughts.

It makes me wonder again whether there are ways to accelerate the process of plaque reversal. While we typically achieve it in a 12-18 month long timeline, could it be achieved in a less than 4 week period? Could we do so by using specific nutrient manipulations during fasting?

I don't know, but I'm hoping that we can inch towards some insight towards this process.

It's pretty strange seeing you promoting a Vegan doc...flies in the face of much of what you've been talking about.  And water-only fasts are tremendously muscle-wasting.

I'm not promoting anybody.

I am entertaining interesting concepts from people who provide unique or differing views.

Coronary disease is potentially a life-threatening disease. If I need to sacrifice some recoverable muscle mass in order to substantially control or reverse it, then it's a small price to pay.

Anonymous,

If I could just clarify my own opinion:

A vegan on a water fast, after the first 2 days, is living on animal fat and animal protein. Their own. They will obviously die if they continue, although possibly without arteriosclerosis (makes you think of Pritkin). Supplying that same person with 150g of lard and 9 whole eggs (biologically eggs are the highest value protein according to the WHO) per day will provide the same metabolic conditions as fasting without the fasting, weight loss or muscle loss. The question then is whether this will continue the rapid reversal of arteriosclerosis. That is open to debate, and no doubt we all will have our opinions. I invite the use of logic. I've said before, I visit here as Dr Davis is open to ideas which do not necessarily tally with his own. That's good.

Peter

Dr. Davis,

I'm not a doctor or a scientist so what do I know?  nothing...  And I'm probably not going to restate Peter's argument very well.

But it seems to me that in the rethinking of diet that you're engaged in, partially triggered by the Taubes book, you're going to need to address this argument that Peter makes.  I had never heard that argument before but I can't think of an escape from the logic of it, namely:

1) during fasts, plaque regresses, 2) during fasts, body fat (which Peter says is mostly saturated fat) is used to provide energy, but 3)  how could plaque regress if a metabolism running on saturated fat was harmful to that regression process?

It would be very interesting to hear what Dr. Fuhrman thinks about this too.

Hi, WC--

I don't have a pat answer for you, but I think the conversation opens up some very fascinating avenues for further thought and exploration.

Of course, fatty acids do not just enter and exit cells passively depending on concentration gradients, but do so under the control and influence of a number of factors.

Nonetheless, I think we are onto something, this idea of "enhanced fasting" to achieve accelerated reversal. Hmmmm....

Just a thought, don'T know if its related or not....When people stalled out on weight loss Atkins suggested a fat FasT for 4 or so days eating macadamina nuts,olives, egg salad with whole fat mayo,even a few T OF OLIVE OIL.It seemed to reboot the metabolism...don't know about plague reversal but it stopped hunger and people started to lose again, he said not too do this until the plateau was a month long, I cant recall exact time frames.
Its so contrary to what we have been led to beleive but if I knew it would reverse my plague I would do it, but would have to see how to balance BG, maybe have to go off glucopaghe while doing it and monitor lots.

Several on Bernsteins site fast alot in the week to regain control of bg.

I read your new special report at  Track Your Plaque that is an interview with Dr. Fuhrman on fasting and had some thoughts.

I confess that my head is still spinning by the argument that Peter has made in his comments to this post.

When I first read Peter's argument, it reminded me more than anything else of the first paragraph of Gary Taubes' NYT Magazine article a few years back when he described the irony that would be many doctors standing naked in Times Square moment:

Dr. Fuhrman, an ardent vegan, promotes fasting as a helpful solution for reducing plaque without realizing and surely without understanding that the reason the solution works is because it amounts to increased animal fat consumption.

I have to say that I'm completely unimpressed by any explanation or theory Dr. Fuhrman's put forward, either in his first book or in his interview with you, about WHY fasting works to regress plaque or at least reduce angina symptoms.

Am I missing something and he actually can and does explain why it works?

Peter, on the other hand, has put a theory on the table about why it works that could be tested, right?  Or has it already been tested?

If and when the moment comes when a lot of doctors are standing naked in Times Square, I'm going to be there with a camera.  lol

As always Dr. D, thanks for the post and for attracting some great minds who make posts that are fascinating reads.

To my knowledge, formal clinical research on the effects of fasting (i.e., controlled "starvation") are woefully limited. I know of no studies that examine the effects of specific nutrient feeding to fasting or starving subjects. But it would be fascinating.

The other aspect in common between fasting and a very low-carb diet are the ketones. It might be that the ketones are responsible for a bettering of heart condition as it is most efficient fuel we can use.

There is a difference though between them, one is catabolic the other is anabolic, so they may not be exactly equivalent.

Just some random thoughts.

What an interesting idea!

Excellent point

Yasiwaya points out that ketosis restores the mitochiondrial function lost in insulin resistance, best quote:

"The ability of a physiologic ratio of ketone bodies to correct most of the metabolic defects of acute insulin deficiency suggests therapeutic roles for these natural substrates during periods of impaired cardiac performance and in insulin-resistant states"

Some of the other papers by this author, available in full text by hitting "related links" suggest a deep in depth knowledge, but they're way beyond me.

For those of us who long ago abandoned the cholesterol hypothesis, hyperinsulinaemia and insulin resistance are the driving forces of IHD. The Yudkin/Stout camp. Ketosis appears to side step insulin resistance, be that in the myocardium or the cells of the arterial media. I would wholely agree this is a useful step in IHD and may well be where the benefits come from.

Peter

I have to admit that I hadn't thought of ketosis as a process with its own health consequences, just as a consequence itself. This may be worth investigating!

Dr Davis,  been meaning to mention, I've been informed that the company Vassol Inc, there web sight is http://www.vassolinc.com/, has succeeded in being able to scan the "moving" heart with an MRI machine.  I was told that the company is now working with the NIH in conducting further studies.  Thought you might find interesting as I imagine an MRI would be helpful with wanting to check quick progress on patients.

Yeah but...

Why use BMI? Why not use body fat directly instead?

Peter, I would use butter, ghee, or beef fat instead of lard (2-4% PUFA vs 12%). You're wrong that eating a high lard diet would be the same as fasting. On a fast, you don't eat a gram of PUFAs. 150g of lard has 18g of PUFAs. 150g of beef tallow has 3 to 4.5 grams, or 1/4 to 1/6 as much as lard. Ruminant animals are best. Also, eggs are unnecessary. You can eat fat from meat, butter, and some organ meats every now and then. The eggs have more than PUFAs than beef and butter fat. To really reproduce the fasting state, I would keep the PUFAs as low as possible (3-4g).

Fasting induces autophagy, a process that recycles cellular structures that range in size from proteins to organelles. It's central to many processes of biological repair.

Research in autophagy is growing very fast, and must be relevant here.

(BTW, niacin and other antilipolytic agents also induce autophagy.)