Dr. Davis: This is incredibly encouraging, especially since it occurred in an 81 year old man, whose biological repair systems would be expected to be somewhat slow, in the short span of a year. I hope you will tell us what he did.

Hi, Rich--

Please watch for the upcoming Track Your Plaque newsletter for February and we will detail his entire program.

...and no-one on a low-carb diet will eat those.  There are much better alternatives.  No story here.

May as well have put pasta on the list.

Yes looking at it like that you realise how a diet based on starchy veg, grains and fruits (not to mention all the processed cereals and refined sugars) can add up to one hell of a lot of carbs! No wonder we're such a sickly species.

Dr. Davis: Where to you get adequate carbs when you are running long distances, including the marathon distance?

Would like to see what Dr. Davis' opinion is about coconuts and their products.

It the picture in the head of the blog and there no single post about it!

There are those who seek to achieve a no carb diet - see this forum for details: http://forum.zeroinginonhealth.com/

Here is a forum that talks about achieving zero carb - http://forum.zeroinginonhealth.com/

...and those 30 grams of carbs would mean you were on a very low carb diet indeed.  As a percentage of 2,000 calories, it would be 6%.  The other 94% would have to come from protein and fat.  Since too much protein taxes the kidneys and will turn to glucose if needed, your only choice in this very low carb scenario would be to go ~ 80% fat.

Just clarifying that this is the intent of the 30g example.

Are these total carbs or net carbs? My understanding is that carbs that are fiber aren't digested.

This is quite a bit of food, too.

To answer bobby's question, you don't!  I routinely run 50K events and just ran the San Francisco Marathon on very-low carb, pre-race, during the race, and post-race.  If you're adapted to a low-carb diet and fat-burning, you don't need carbs at all for fueling muscle activity.  In fact running fat-fueled gives you more stable long-lasting energy, no highs and lows, no bonking, and you can go much longer on no added fuel at all.

David

I would think the opened coconut is not dissimilar in representing plaque build up in our vessels.

Funny though, because I believe coconut is beneficial in many ways. I started cooking with it recently due to its high tolerance to heat, my perspective change in saturated fats and exploration of Indian foods.

BTW, I have cut out wheat, rarely eat corn starches and keep sugar usually in the single digits g/day while eating 70% of the items posted in Dr. Davis' on my low carb regimen. Some of the benefits so far are 40+ pounds lost and a decrease in BP. Systolic is now normal (reducing the resting pressure is a bit more challenging). Looking forward to what the next two months bring . . . .

Bobby and Drs. Cynthia and David-

I have seen the gamut of carbohydrate needs with elite levels of endurance exercise, from those who need to use a glucose source, such as bananas or Goo with exercise, to those who need nothing but water.

There seems to be individual variation in glucose needs during extreme endurance exercise, though needs clearly diminish the longer you follow a low-carbohydrate restriction.

Think of how hunter gatherers of eons ago ran tens of miles on empty stomachs.

Well, when you eat a no-carb diet you avoid those low-carb foods. Instead, you only eat food containg no (or very close to zero) carbs: meat, fish, egg, clarified butter (ghee), and coconut oil.

If you are liberal, you may add ordinary butter and some cheese. Giving you no more than 1-2 grams of carbs per day.

Here you can find Swedish guy, Michel Blomgren, that eats almost no carbs, and train hard: http://translate.google.com/translate?u=http://michelblomgren.blogspot.com/p/vad-jag-ater.html&sl=sv&tl=en

There's a body builder at my gym who's in his 60s, and he's been eating a very low carb diet for 15+ years. While his musculature is great, his skin looks saggy and old. It makes me wonder if his skin might look better if he'd had greater intake of Vit C (for collagen) and other phytonutrients (antioxidants).

I have a friend who is a recognized authority on sports medicine.  He's generally opposed to all processed foods, especially high fructose drinks but endorses the consumption of such drinks during extreme aerobic competitive exercise saying they give a huge quick boost in energy.

"Think of how hunter gatherers of eons ago ran tens of miles on empty stomachs."

I find it difficult to use such examples as good/valid reference points. In my opinion there is s big difference between running by choice and running because you have to for survival.

Belfast Biker is way off the mark - those all legit foods to eat - veggies some fermented diary (cheese), small amounts of seeds and nuts- Pasta is not even close to being sensible for that list.

Dublin pjnoir.

My understanding is there's an obligate requirement for sugar in the Krebs cycle.  If the body runs low on stored carbs it makes its own through gluconeogenesis. But that means catabolising muscle tissue.  In 50 and 100 mile races I eat all the potatoes and sugary sweets available at the aid stations but for daily diet I stick with low carb.  For my Sunday long runs I often run out of glycogen.  At that point my pace falls from 9 to 12mph.

kevin

HOW HEALTHY IS IT TO BE IN CONSTANT KETOSIs though?? There are no long term studies, no hunter gatherer was ever in constant ketosis. he/she was in and out. i understand low carb for glucose problems but it seems to be managing te problem not fixing it. eventually a low carb diet leads to a VLC diet leads to a ZC diet like the crazy people at zeroing in on health. the more you drop your carbs the more insulin resistance you force upon yourself.

Just eat real food, and real fat

about coconut stuff...IMO unless your a kitavan person you dont really need it. does anyone know ANY existing data not supported or sponsored by the coconut industry? i dont think it is all it is cracked up to be. no one has been consuming it long enough, unless again you are a kitavan and also eating like 70% sweet potatos.

there arent coconuts over in africa where we originated

Carbohydrates are not an essential macronutrient. Fat and protein are. There was a study done on two men who ate nothing but meat for a year. The results may suprise some. See Nothing but meat for a year

Dr Davis

After starting fish oil and vitamin D3 and eliminating sugar/wheat/pasteurised milk my hunger seems to have ratcheted up! i wonder whats going on here? Is this normal?
There is no dearth of calories in the diet!

After starting fish oil and vitamin D3 and eliminating sugar/wheat/pasteurised milk my hunger seems to have ratcheted up! i wonder whats going on here? Is this normal?
There is no dearth of calories in the diet!

My weight has always been good and I work out (hard) regularly and have so for the last 30 years (I'm 53). My cholesterol is also good. I  didn't eat much processed food before but in the last 9 months have cut it out completely. No sugar, no white flour, no bread, less of all other grains and now I can't stop weight loss. I am below my desired weight and it keeps coming off. If I even walk too fast I lose weigh!! I tried adding more tubers with no luck. I added larger portions of quinoa...no help. I have now resorted to eating soaked brown rice which hasn't helped yet. I get roughly my bodyweight in protein per day. I am always hungry and I'm eating about every hour. I consume around 3000 calories per day. I'm 5'10 and went from my fighting weight of 183 to 168 as of this morning.  I need to get back to at least 173-175 but it won't happen unless I add back some more grains. I will now start increasing the portion sizes of the grains I'm eating but I am already up to close to 2 cups per serving!!! I have now added rice/quinoa to lunch meals also.

you can train athletically on a low carb diet.  our bodies are highly efficient.  if you don't give it sugar, it will make energy from stored fat.  (and we all have fat, even thin people.)  the best training i ever did and strongest i ever was involved a low carb (vegetable) and hi protein diet.  After a few weeks, your body produces fuel differently.  if you're used to gooing or sports liquid, your body will have to acclimate to training without it.  But one you do, you'll notice your lactic threshold will be higher and you'll bonk much less.  Cashews are great instead of the goo...

The USDA National Nutrient Database for Windows is a great little tool is you're very serious about restricting the total number of carbs eaten in a day.  Combine that with weighing your food, and you can get a very good idea of all the nutrients going into your body.

The aren't many studies showing the benefits of coconut oil.  However, in my case, adding coconut oil to me diet sent my HDL from 32 to 52.

good luck to those who try this no-carb diet.

http://www.diabetesdaily.com/edelman/2010/03/interview-dr-bernstein-on-low-carb-diets-treatments-politics.php

Dr Richard K. Berstein was interviewed on Mar 23 and was an eye opening regarding A1C and the incompetence of the mainstream medical community dealing with diabetics.  Author of many books for diabetics.

http://www.amazon.com/gp/entity/Richard-K.-Bernstein/B001IOBDVW?ie=UTF8&ref_=s9_simh_gw_p14_al1

Acceptable blood glucose levels of 250 and A1C levels of 7?  And not being accepted into diabetes clinics with A1C level less than 6.5  Criminal.

HbA1c is a measurement of early glycation products which correlates with serum AGE levels, but is not a measure of advanced glycation end-products. For example, one Japanese study of cognitive decline in diabetes found, "Serum AGE levels were significantly associated with the impairment of complex psychomotor skills independent of HbA1c."

You have written on the benefits of coffee.  While I share your love of coffee and believe coffee does not affect HbA1c, it clearly is one of the worst sources of AGEs.

Use a BG meter to check effect of meals/foods on BG peaks, as described in this thread:
http://www.imminst.org/forum/index.php?s=&showtopic=36724&view=findpost&p=373966

btw, the case of high A1C with normal fasting BG is often due to high rates of gluconeogenesis (glucose from protein) that keeps BGs high between meals, but drops by morning as all remaining protein gets digested overnight.  A high rate of gluconeogenesis is often characteristic of insulin resistance, and is what forces many to eventually need the help of drugs to control BGs (i.e., reducing carb intake may not be enough to keep BGs low, and you're stuck consuming a certain amount of protein).

Question: does this test measure just proteins reacted with glucose or also those reacted with fructose? I recall hearing somewhere that fructose was seven times as reactive.

Exactly right, Denny.

HbA1c can only provide an indirect indicator, and only a short-term one at that. However, it's better than no indicator at all.

" the case of high A1C with normal fasting BG is often due to high rates of gluconeogenesis (glucose from protein) that keeps BGs high between meals, but drops by morning as all remaining protein gets digested overnight."

Also, can result from too frequent eating.  By adding a couple light, between meal snacks to my 3 meals per day I jumped my A1c from 5.1 to 6 in a few months.  Won't do that again!

Dr. Davis,

Have you ever looked into the potential for substances like taurine, benfotiamine, pyridoxamine, carnosine?  I've seen passing mention of these as potential glycation inhibitors.

I've also seen sources that suggest that R-ALA and ALCAR can be of possible help in reducing glycation damage.

While the comment in your post seems to point a bit more to the latter, I realize that you mentioned that glucose-reducing supplements are a topic for another day. But perhaps this can add to the mix for a possible future post on those topics.

Doug Rafferty

I've now gone back and read all the recent blog posts about BGs made by Dr. Davis, and would like to point out several issues:

- first, it's great to see someone finally pushing BG measurements for non-diabetics; however, there's a lot to know about this, and I encourage others to read the imminst thread referred to in comment #3 above

- for low-carb dieters with insulin resistance, their average BG (and A1C) will usually be dominated by glucose produced from protein digestion (i.e., it's not just about carb intake)

- the most accurate and precise meter I've seen is AccuChek Aviva, where precision is mainly determined by strip quality, and crummy strips will cost you a lot more money and blood, since you'll need to make a lot of extra measurements (i.e., with crummy strips you may have to average 3 results to get an accurate number)

- disease risk rises exponentially with BG levels, which is why peaks matter most

- the time to your peak BG after meals depends on so many factors that you'll have to determine that yourself (i.e., don't assume 1 hour; mine is 30-60 minutes for most meals)

- exercise after meals can reduce your BGs to fasting levels, but they will soon rise again due to continued protein digestion (or even low-glycemic carb digestion); so the benefit of regular exercise is mainly in a general lowering of insulin resistance, and greater glucose uptake by muscle mass when at rest

Cinnamon - a simple recipe with a double punch.  Take a couple of cups of almonds and wet them.  Shake them in a bag with a couple of teaspoons of Ceylon Cinnamon.  Make sure you use Ceylon for best Blood Sugar results.

Preheat your oven to 350.  Spread the almonds on a cookie sheet.  Pop them in the oven and turn it off.  20 to 30 minutes later the Cinnamon will be dried to the almonds - let cool and enjoy.

What was it they were eating in the 20s and 30s to cause heart disease?  My grandfather died in 1934 of quote, acute indigestion.

With respect to weight loss and BG measurements, some of you may find my story encouraging:

- starting at 205 lbs, I lost about 20 pounds basing decisions mainly on carb counts and low glycemic index

- after getting a meter and eliminating foods causing high-post meal BGs (such as oatmeal!), I dropped another 10 pounds

- after fixing a testosterone deficiency (andropause), I dropped another 10 pounds

which puts me at about 165 and BMI near 22.  (All that was done over the course of about 5 years, but it took me that long to figure out this stuff!)

Oops! I forgot to mention I use a little Stevia with the Ceylon Cinnamon and almonds.  It also works great with walnuts.

Steve

To my above list, I'd like to add a few points about "grazing":

- from the plots in the blog, it appears that evidence of "stacking" comes mainly from excessive fructose consumption; my own experience with a TG meter does not show stacking of TGs when grazing on fat-rich mini-meals

- it's irrelevant whether grazing is "self-indulgent"; diet needn't be torture, and you're unlikely to stick with something you don't enjoy doing

- it's also irrelevant whether grazing is "unnatural", since the optimal diet (to reach, for example, age 100) is unlikely to be one followed by people who rarely lived beyond age 50; to reach extraordinary ages, you'll likely need to do extraordinary things (niacin? fish oil capsules? D3 capsules? etc.)

- peaks matter, and fewer meals means larger peaks (as well as increased acid reflux, esp. bad when large meals are consumed late in day)

imho, i don't think the data currently exists to prove the case one way or the other, and suspect that the optimal solution will turn out to be very person-specific

More thoughts on "stacking": If one spread one's consumption across 24 hours, then food would be being burned at exactly the same rate as it was being consumed, and no significant stacking would occur. Thus stacking results from compressing consumption into smaller time frames. In fact, the ultimate "stack" is formed by consuming a single meal per day (i.e., all the TG and BG is forced to pile up over a very short time frame).

The caveat to this is that it may be the case that larger TG and BG peaks create more efficient processing (i.e., ice cream is somehow better handled after a big meal than when consumed in isolation), or that the benifits from lows between meals outweigh all the highs during meals. But I remain skeptical that such stress (high peaks, high insulin, etc.) is ultimately a good thing (esp. since I've already taken the trouble to control acid reflux by spreading intake across the day).

But wouldn't be surprised either way. There's already a camp that believes that BG spikes are necessary for optimum bone formation, etc., so who knows?

I've found every article in this blog really interesting and helpful and everything seems to make a lot of sense.
But I still fail to see how it fits for people that don't want/need to loose weight.
Say a 190pound healthy athlete with a very active live.
How do you feed him without gazing, only two meals per day, 50g carbohidrates per day and 40g of fat per meal?
How would you feed Michael Phelps?

Dr. Davis,

In this latest post, you said "Fourth, consider use of glucose-reducing supplements, an issue for another day."

I would very much like to read your thoughts on these supplements and would look forward to a blog post on this topic.