Heroin, Oxycontin, and a whole wheat bagel

For a substantial proportion of people who remove wheat from their diet, there is a distinct and unpleasant withdrawal syndrome. Here are the comments of Heart Scan Blog reader, Scott, from Texas:

Hello Dr. Davis,

I've been experimenting with diet, converging upon a Paleo type diet, but I keep running into problems. I have isolated the problem to cutting out wheat.

Sugar, rice, fruit, corn, potatoes, etc. are relatively ok to add or remove from the diet, but cutting out wheat in particular brings on a moderate headache with heavy fatigue all day long. This resembles the wheat withdrawal symptoms I found on your blog. As I write this, I'm on day 8 of wheat-free. I consume a fair variety of meat and veggies each day with a moderate amount of white rice for carbs. Perhaps a bowl of corn flakes with milk and half a bar of dark chocolate a day. I've learned from experience over the past 5 months or so that none of these foods affect the withdrawal. It's purely wheat.

My question is, what is the range of times for withdrawal symptoms that you've heard from different people? Has there been anyone who never recovered from the wheat withdrawal symptoms even after many months?

It's very tough to get work done like this, and even though my body and head feel much healthier in general, my sinuses have cleared, don't have to take a big nap after I eat, etc., I don't want to go down a path where this is the way things are going to be forever.

People who have never experienced wheat withdrawal pooh-pooh the effect. But, for about 30% of people, wheat withdrawal is a real, palpable, and sometimes incapacitating experience.

Beyond removing an exceptionally digestible carbohydrate that yields blood sugar rises higher than nearly any other known food (due to the unique amylopectin structure of wheat-derived carbohydrate), wheat withdrawal is a form of opiate withdrawal, somewhat like stopping heroin, Oxycontin, and other opiates. Stop eating whole wheat toast for breakfast, whole grain sandwiches for lunch, or whole grain pasta for dinner, and the flow of exorphins, i.e., exogenous morphine-like compounds, stops. You experience dysphoria (sadness, unhappiness), mental "fog," inability to concentrate, fatigue, and decreased capacity to exercise. It is milder than withdrawal from prescription opiates. Unlike withdrawal from more powerful opiates like heroine, there are, thankfully, no seizures or hallucinations. There are also no deaths.

In my experience, most people get through with wheat withdrawal in about 5 days. An occasional person will struggle for as long as 4 weeks. Thankfully for Scott, I've never seen it last longer than 4 weeks. (Interestingly, people who survive the withdrawal syndrome are often prone to a peculiar re-exposure phenomenon that I will discuss in future, i.e., they get sick upon re-exposure.)

The modern dwarf mutant variant of Triticum aestivum (that our USDA urges us to eat more of) contains greater proportions of gluten proteins compared to wheat pre-1970; glutens are the source of wheat-derived exorphins.

Incidentally, a drug company should be releasing a drug in the next year that will contain naltrexone, an oral opiate blocking drug, for a weight loss indication. They claim it is a blocker of the "mesolimbic reward system." I say it's a blocker of wheat exorphins.

Erectile dysfunction (ED), previously known as "impotence," and coronary atherosclerotic plaque go hand in hand.

A recent study in men with advanced coronary disease showed that 93% experienced ED. The participants in the Track Your Plaque program, for the most part, do not have advanced coronary atherosclerosis, but have an earlier form detected by a CT heart scan.

What proportion of men with asymptomatic coronary plaque as measured by a CT heart scan have ED? Around 50%. In other words, it's not a rare occurrence.

The conversation about ED (and even its renaming from impotence) really gained momentum with the development of ED-drugs like Viagra and Cialis. The drugs are reasonably effective and safe. However, you will hear little about all the strategies that can either precede your need for these drugs and/or enhance your response to these drugs if the response is partial. That part of the conversation, of course, doesn't yield loads of drug company revenues.

One of the most helpful and specific nutritional supplements available that can partially restore the nitric oxide-deficiency of ED is l-arginine. L-arginine is the body's source of nitric oxide (NO), the master dilator (relaxing agent) for all arteries of the body. NO dilates penile arteries, it dilates coronary arteries. Lack of NO disables the penile capacity for erection and encourages growth of coronary atherosclerotic plaque. Track Your Plaque Members are already familiar with l-arginine as a facilitator of coronary plaque regression.

We will detail the supplements that you can use safely in your Track Your Plaque program to both enhance erectile function if you suffer ED, as well as impact positively on coronary health, in an upcoming and detailed Special Report on the www.cureality.com website.

"Treat the patient, not the test."

That is a common "pearl" of medical wisdom often passed on during medical training.

It refers to the fact that we should always view any laboratory or imaging test in the context of the live, human patient and not just treat any unexpected value that doesn't seem to make sense.

I raise this issue because it recently came up on a discussion on the Track Your Plaque Forum. A Member with a high heart scan score of around 1100 was advised by his doctor that it should be ignored, because he'd prefer to treat the patient, not the test. The patient is apparently slender, physically active, and entirely without symptoms, with favorable cholesterol values as well. The high heart scan score didn't seem to jive with the appearance of the patient, as viewed by this doctor.

This common phrase is meant to impart wisdom. It is a reminder that we treat real people, not just a jumble of laboratory values.

But the unspoken part of the equation is that judgment needs to be applied. A well looking person who shows an unexpected rise in white blood cell count could just have a screwy result, or could have leukemia. Liver tests (AST, ALT) that top 400 could represent a fluke, or dehydration incurred during a long workout, or hepatitis from a long ago blood transfusion.

Yes, treat the patient. But don't be an idiot and entirely dismiss the signficance of an unexpected laboratory or imaging test. A heart scan score of 1100 should be as readily dismissed as discovering a white blood cell count of 90,000 (normal is less than 12,000), or a 5 cm mass in the lung. The absence of symptoms or the failure of conventional risk factors to suggest causation is insufficient reason to dismiss the concrete findings of a test.

In this particular person, dismissing the significance of the heart scan finding by suggesting that the doctor should treat the patient, not the test, is tantamount to:

--Colossal ignorance
--Malpractice
--A certain sentencing of the hapless patient to future major heart procedures, heart attack or death (20-25% likelihood every year, or a virtual certainty over the next 5 years).

There is an ounce of wisdom in this old medical pearl. But there's also plenty of room for a knuckleheaded doctor to misconstrue and abuse its meaning for the sake of covering up his/her ignorance, laziness, or lack of caring.

The Paleo Solution: The Original Human Diet

I have to say: I'm impressed. If you would like insight into why a "Paleo" nutritional approach works on a biochemical level--why you lose weight, burn fat, and gain overall better health--then Robb's book is worth devoting a few hours to, of not a reread or two.

Robb has a particular knack for organizing and presenting information in a way that makes it immediately accessible. You will gain an appreciation for how far American nutritional habits have veered off course.

Because Robb brings expertise from his academic biochemistry background, as well as personal trainer and educator running a successful gym in northern California, NorCal Strength and Conditioning, he delivers a book packed with information that is extremely easy to convert to immediate action in health and exercise. He seems to anticipate all the little problems and objections that people come up with along the way, dealing with them in his characteristic lighthearted way, providing practical, rational solutions.

Robb's book nicely complements what Dr. Loren Cordain has written in his The Paleo Diet: Lose Weight and Get Healthy by Eating the Food You Were Designed to Eat and The Paleo Diet for Athletes: A Nutritional Formula for Peak Athletic Performance. (My wife is now reading The Paleo Diet for Athletes and loves it. I'm going to add Robb's book to her reading list for her to read next.)

If nutrition has you stumped, if the USDA food pyramid still sounds like a reasonable path, or if you just would like to understand nutrition a little bitter, especially its biochemical ins and outs, Robb's book is a wonderful place to start.

There's a fascinating and vigorous debate going on at the Heart.org website among Dr. Melissa Shirley-Walton, the recently publicized proponent of "a cath lab on every corner": Dr. William Blanchet, a physician in northern Colorado; and a Track Your Plaque Member who calls himself John Q. Public.

John Q. has been trying to educate the docs about the Track Your Plaque program. Unfortunately, Dr. Shirley-Walton essentially pooh-poohs his comments, preferring to lament her heavy work load. In her last post, when she discovered that John Q. was not a physician, she threatened to block his posts and delete all prior posts.

However, Dr. Blanchet has emerged as a champion of heart scanning, intensive lipid management, and lipoproteins, much similar to our program. In fact, many of Dr. Blanchet's comments were so similar to mine that John Q. asked me if it was really me! (It is definitely not.)

Here's a sampling of some of the discussion going on now:

Dr. Blanchett started out the discussion by saying:

Stent Insanity
I have no trouble agreeing with the argument that we have initiated the widespread use of DES without adequate study regarding outcomes. Shame on us.

That said, we are ingoring the DATA that shows that most heart attacks occur as a result of non-obstructing plaque and all the talk about which stent to use ignors the majority of individuals at risk. In addition, for a decade we have known that stenting does not improve net outcomes anyway.

What ever happened to effective primary prevention? We discarded EBT calcium imaging like moldy cabbage without even looking at the outcomes DATA. With direction provided by EBT calcium imaging and effective primary prevention, I have been able to reduce myocardial infarction by 90% in my very large Internal Medicine practice. Through effectively identifying patients at risk and measuring success or failure of treatment with serial EBT, I have made the argument as to which stent to use moot. No symptomatic angina and rare infracts equals little need for any stent.

Is anybody listening? Certainly not the cardiologists whose wealth and fortunes are based on nuclaer imaging, angiography and stenting.

Dr. Shirley-Walton, skeptical of Dr. Blanchet's claim of >90% reduction of heart attacks using a prevention program starting with a heart scan:

To rely soley upon a calcium score will deprive you of a lot of information that could be otherwise helpful in the management of your patients.

Without seeming sarcastic, I must refute : "of 6,000 patients I've seen 4 heart attacks in 3 years". Although I certainly hope your statistics are accurate, I will suggest the following:

You've not seen all of the heart attacks since up to 30% of all heart attacks are clinically silent. So unless you are echo'ing or nuclear testing all of these patients in close followup, you aren't certain of your stats.

Secondly, in order to attribute this success to your therapy, you would have to have nearly 100% compliance. In the general population, compliance is often less than 50% with any regimen in any given year of treatment. If you can tell us how you've achieved this level of compliance, we could all take a lesson.

Dr. Blanchett, commenting on his use of heart scanning as a primary care physician:

CAC [coronary artery calcium] is an inexpensive and low radiation exam to identify who is at increased risk for heart attacks.

A study of 222 non-diabetic patients admitted with their first MI found 75% of them did not qualify for cholesterol modifying therapy prior to their initial MI (JACC 2003:41 1475-9). In another study of 87,000 men with heart attacks, 62% had 0 or 1 major risk factors (Khot, et al. JAMA. 2003). Almost all individuals with 0 or 1 risk factor are Framingham "Low risk" and therefore will not qualify for cholesterol lowering therapies. (JAMA. 2001;285:2486-2497)

Risk factors alone are not sufficient. In my practice, of the last 4 patients who have died from heart attacks, none qualified for preventive therapies by NCEP guidelines.

Studies have shown that CAC by EBT provides an independent and incremental predictor of heart attack risk. (1. Kondos et al, Circulation 2003;107:2571-2176, 2. Am Heart J 141. 378-382, 2001, 3. St Francis Heart Study Journal of the American College of Cardiology July, 2005) The old saw that CAC simply reflects risk factors and age is just wrong.

Although CT angiography shows great promise to reduce unnecessary conventional angiography and is helpful in emergency room chest pain evaluation, I do not see CT angiography as a screening study in asymptomatic individuals. 10 times more radiation than EBT calcium imaging plus the risk of IV dye exposure makes CT angiography inconsistent with the principles of a screening test. Taken in the context of a primary care physician's evaluation of heart attack risk, EBT calcium imaging has great value.

Coronary calcium changes management by: 1. Identifying those at risk who do not show up with standard risk stratification (St Francis Heart Study: Journal of the American College of Cardiology July, 2005). 2. Motivating patients to be compliant with therapies (Atherosclerosis 2006; 185:394-399). 3. By measuring serial calcium, we can see who is and who is not responding to our initial treatment so that we can further refine our therapeutic goals (Atherosclerosis, 2004;24:1272).

When used in the primary care preventive setting, CAC imaging is indeed of great incremental value. In my practice, in improves my outcomes so greatly that it compels Melissa Walton-Shirley to question my veracity.

Dr. Melissa Walton-Shirley:

Ahhhhhh.......the aroma of profit making, I thought I smelled it. [Accusing Dr. Blanchett of referring patients for heart scans for personal profit.]

I will tell you that I was a little hurt when I was called "a typical cardiologist with a butcher block mentality" after my primary pci piece for med-gen Med was reviewed by the track your placque [sic] folks.

Though, it's clear that they misunderstood and thought I was cathing for dollars, instead my intention was to "push" for primary PCI for AMI, it left me seething until the blessing of a busy schedule and a forgetful post menopausal brain took its toll.
None the less, an honest open discussion is always welcome here but I would appreciate it if everyone would just divulge their affiliations up front so that the context of their opinions could be better understood.

I also insist that the compliance described by you William B. is rather astounding and a bit unbelieveable, however if it's accurate, you are to be congratulated.

Dr. Blanchett, in response to Dr. Shirley-Walton's statement that she relies on stress testing:

I think that the threshold of comfort you get from stress test stratification is different than what I consider acceptable. It is hard for me to tell a bereaved spouse that the departed did everything I suggested and still died from a MI. Coronary calcium imaging provides me the tool that I need.

Are you aware that there are a number of studies that show a dramatic increase in risk of MI in individuals with an annualized increase in calcified plaque burden of >14%? I consider this to be a valuable measure of inadequacy of medical management. A stress test does not become positive until we have catastrophically failed in medical management. Consequently, even in the patient with “high risk” stratification, one can justify a calcium score to establish a baseline to measure adequacy of primary prevention. Calcium scores by EBT cost about 1/5th the cost of a nuclear stress test and subject the patient to 1/10th the radiation of nuclear imaging and provides more precise information.

Regarding John Q, I do not think that non-medical prospective should be excluded from this blog. I think we as physicians benefit from hearing how the non-physician public views medicine. I have become much better at what I do by listening to my patients and learning from them.

Dr. Blanchett continues:

Yes, I have seen a dramatic reduction in coronary events. Of 6,000 active patients, 48% being Medicare age and over, I have seen 4 heart attacks over the last 3+ years. 2 in 85 year old diabetics undergoing cancer surgery, one in a 90 year old with known disease and one in a 69 year old with no risk factors, who was healthy, and had never benefited from a heart scan.

The problem with coronary disease is that we rely on risk factors. Khot et al in JAMA 2003 showed that of 87,000 men with heart attacks, 62% had 0 or 1 major risk factor prior to their MI. According to ATP-III, almost everyone with 0-1 risk facto is low risk and most are do not qualify for preventive treatment. EBT calcium imaging could have identify 98% of these individuals as being at risk before their heart attack and treatment could be initiated to prevent their MI.

Treating to NCEP cholesterol goals prevents 30-40% of heart attacks. Treating to a goal of coronary calcium stability prevents 90% of heart attacks. Where I went to school a 40% was an F. Why are we defending this result instead of striving to improve upon it? I am not making this up, look at Raggi's study in Ateriosclerosis, Thrombosis, and Vascular Biology 2004;24:1272, or Budoff Am J Card

Melissa, I strongly disagree with the assertion that the stress test is a great risk stratifier. Laukkanen et al JACC 2001 studied 1,769 asymptomatic men with stress tests. Although failing the stress test resulted in an increased risk of future heart attack, 83% of the total heart attacks over the next 10 years occurred in those men who passed the stress test.
Falk E, Shah PK, Fuster V Circulation 1995;92:657-671 demonstrated that 86% of heart attacks occur in vessels with less than 70% as the maximum obstruction. A vast majority of patients with less than 70% vessel obstruction will pass thier stress test.

William, regarding your question of owning or referring for EBT imaging, I would be amused if it were not insulting. The mistake that is often made is that EBT imaging is a wildly profitable technology. It is not nearly as profitable as nuclear stress imaging. Indeed there are few EBT centers in the country that are as profitable as any random cardiologists stress lab.

How can we justify not screening asymptomatic patients? Most heart attacks occur in patients with no prior symptoms and according to Steve Nissen, 150,000 Americans die each year from their first symptom of heart disease. My daughter is at this moment visiting with a friend who lost her father a few years ago to his first symptom of heart disease when she was 8 years old. That is not OK! We screen asymptomatic women for breast cancer risk. Women are 8 times more likely to die from heart disease than breast cancer. We do mass screening for colon cancer and we are over 10 times more likely to die from heart attacks than colon cancer. An EBT heart scan costs 1/8th the cost of a colonoscopy.

So what say we drop the sarcasm and look at this technology objectively. Read the literature, not just the editorial comments. This really does provide incredibly valuable information that saves lives.

Yes, a 90% reduction in heart attacks in my patients compared to the care I could provide 5 years ago when I was doing a lot of stress testing and referring for revascularization. Much better statistics than expected national or regional norms. I welcome your scrutiny.

John Q. Public jumps into the fray with:

Fascinating, isn't it, that there appear to be two doctors, William Blanchet in this forum and Dr. William Davis, FACC, of cureality.com that both claim to have dramatically reduced risk of heart attack among their patients and/or actual calcium plaque score regression and BOTH are ardent proponents of CT Calcium Scoring?

Despite Dr. Blanchet's persuasive arguments backed up with numerous scientific citations and John Q.'s support, I sense they had no effect whatsoever on Shirley-Walton's way of thinking.

Such are the deeply-entrenched habits of the cardiology community. It will be many years and impassioned pleas to see things in a different light before the wave of change seizes hold.

Tree
1/25/2011 1:50:08 PM |

Celiac disease is often noticed by people who go off wheat for health reasons, then when they try to eat it again, it makes them sick.

For the record, Corn Flakes contain barley malt which has the same protein, gliadin, as wheat. I have celiac and the "formula" is no wheat, barley or rye because they are so closely related and have the same "gluten" protein.

Martin Levac
1/25/2011 1:55:45 PM |

Isn't it interesting. They treat obesity by fixing the "mesolimbic reward system" because they believe eating too much "food" makes us fat. But then you say wheat isn't food, it's a drug.

Are we really eating too much "food"?

Emily Deans, M.D.
1/25/2011 2:15:16 PM |

A heroine is a very different concept than "heroin." And withdrawal from oxycontin or heroin is unlikely to cause hallucinations or seizures (Trainspotting babies on the ceiling notwithstanding) - though it is exceedingly unpleasant, it is not typically medically dangerous. Perhaps you are thinking withdrawal from alcohol, barbituates, or benzodiazepines, all of which can cause hallucination, seizures, or death if done without medical supervision.

Anonymous
1/25/2011 2:35:18 PM |

I have celiac and had similar problems when I first went off gluten. It took me about a month to stop reacting. I get quite ill whenever I accidentally am exposed to gluten, say at a restaurant. My symptoms are migraine and flue like aching in my joints, plus severe fatigue. None of my doctors thought I might have celiac by the way, because I am slightly overweight (BMI 25) and didn't have severe digestive symptoms, but there is recent research showing that many patients present with migraine as their only celiac symptom.

Dr. William Davis
1/25/2011 2:47:15 PM |

Oohh. Thanks for catching the typo, Dr. Deans. Fixed.

By the way, I've seen plenty of hallucinations and seizures with opiate withdrawal, as well as benzodiazepine withdrawal. Or, perhaps it was combination addictions that were at fault.

That, however, was not the point.

Emily Deans, M.D.
1/25/2011 3:11:53 PM |

I think the point was well-made - just didn't want anyone to fear that wheat withdrawal was medically dangerous (quite the opposite). I've had a few cases where I was able to stop night (carb - typically bread) binging with (off-label) use of naltrexone - pretty telling, I would say.

Dr. William Davis
1/25/2011 10:21:46 PM |

Dr. Deans--

I am VERY impressed you knew of this effect.

I have tried this, too, in people who are, despite their best effort, unable to resist temptation to consume this drug-disguised-as-food called wheat.

Anonymous
1/26/2011 12:24:48 AM |

My health improved dramatically after I stopped eating wheat, grains, and other carbs, I even had a cataract disappear. But it required nine months before I could adjust to the low carb way of eating. It's worth all the trouble, no more high blood pressure or diabetes medicine. Most of my arthritic pain is gone, I am able think more clearly. Lost 30 pounds. No more allergies or indigestion.
Thank you for writing this blog!

DK
1/26/2011 4:08:13 AM |

I was able to stop night (carb - typically bread) binging with (off-label) use of naltrexone - pretty telling, I would say.

Nothing at all particularly telling I would say. Other than telling that opioid receptors are part of the reward circuit. Which is obvious and not disputed by anyone. Naltrexone main use is in treatment of alcohol dependence. Using your logic ethanol is an agonist of opioid receptors. Which is self-evidently not true. The effects are indirect.

Might-o'chondri-AL
1/26/2011 5:30:17 PM |

Question here:

Is the "craving" for wheat due to psychoactive tri-peptides derived from wheat protein ? If that is the molecule that "dopes" our opiod receptors then decreasing levels of tri-peptides as the day progresses will make some look for their wheat "fix".

Naltrexone @50mg was FDA approved (1984) in 1984 opiod addition; to block receptors. I think the doctors here are referring to single evening doses of 3 to 4.5 mg.
for screened patients.

BWR
1/27/2011 3:08:46 AM |

Here's what I don't understand: Why is it that entire countries of people who eat bread by the basket, like Spain, have exceptionally low levels of heart disease? This is a sincere question. I want to do what's right for my heart, but it seems to me that a naturally occurring sample size of several million people is pretty compelling. What am I missing?

Anonymous
1/27/2011 8:25:08 AM |

Jack LaLane on sugar:

http://www.youtube.com/watch?v=LJVEPB_l8FU

Jonathan Byron
1/27/2011 1:56:02 PM |

Milk and dairy products are also a source of endorphin-like chemicals. Would it make sense to try to kick a wheat habit by temporarily drinking more milk?

Anonymous
1/27/2011 3:42:20 PM |

BWR

It is possible that Spanish bread is made from a much healthier wheat variety.

The devil is on the details.
From a HSB comment May 24, 2010
Here in France, Einhorn( Triticum monococcum) has been cultivated since the 9 th millennium BC in a small area of Haute Provence. It is called petit epeautre and it is truly delicious! It has very little gluten.
There is much regulation in the cultivation in order to protect the genetic purity of this ancient grain. Like wines it has a AOC (appelation d'origine controlee

Please note: Higher Mg and Lysine in einkorn

Modern wheat has had much of the Mg bred out
http://petitepeautre.com/nutritiona.html

Scandinavian Journal of Gastroenterology
http://www.einkorn.com/toxicity-of-einkorn-gluten/

Same for casein in milk where A1 milk can be a serious problem and the casein is similar to gluten
http://www.guernsey.net/~wgcf/PageMill_Resources/Acres_Woodford.pdf

Dr. William Davis
1/27/2011 4:37:27 PM |

Hi, BWR--

There are some unanswered questions with this thing called wheat. As the anonymous commenter pointed out, there may be differences in strains grown worldwide. While 99% of all wheat grown today are dwarf variants of Triticum aestivum, there are pockets of agricultural adherence to older cultivars.

revelo
1/27/2011 8:41:02 PM |

I am perfectly willing to believe than many people cannot tolerate wheat. But this obsession with villifying wheat discredits Dr Davis's very valuable promotion of regular heart scans and other diagnostics, as well as D3, Iodine and other supplements.

It isn't just the Spaniards. My own ancestors are a mix of French, German and English, and I don't seem to have any problems with wheat, rye, barley, to speak nothing of oats. Furthermore, I believe a heavy grain diet is precisely why I am able to keep my weight down and my test results good. I experimented with going to a somewhat more paleo diet recently and the result was to DECREASE my insulin sensitivity when I went back to eating oats. Now that I'm back to eating mostly oats, my insulin sensitivity has returned to normal. Worse, the paleo diet caused a surge in uncontrollable hunger. One particularly bad day, I ran through a dozen eggs, a pound of meat, another pound of nuts and all sorts of other food before my appetite finally settled down. I never had these uncontrollable appetite problems with my usual mostly oats diet, nor did I have problems when I used to eat mostly pasta (though I was younger then and had higher metabolism than now).

Appetite is the key. If a food sends appetite soaring, then it doesn't matter how healthy that food is by itself--it will make you fat and thereby reduce insulin sensitivity and thus destroy you in the end. Conversely, if a food depresses appetite, then assuming it isn't absolute poison (like arsenic), eating that food will allow you stay lean, and by staying lean you stay insulin-sensitive (assuming you also do some daily exercise), and that is the ultimate key to avoiding most health problems, from what I understand. For some people, wheat and oats may very well be the keys to appetite suppression, and it is thus a disservice to condemn these foods for everyone.

Anonymous
1/27/2011 10:47:13 PM |

what do you make of this new study citing adverse effects of a high fat diet?

http://www.ajcn.org/content/early/2011/01/26/ajcn.110.002758.abstract

Onschedule
1/28/2011 1:21:46 AM |

@revelo,

In his practice of Cardiology, Dr. Davis has apparently observed great results with a good number of his patients that choose to avoid wheat. Apparently, an impressive enough effect, in his opinion, to make the statements that he does. These observations, and the recommendations he makes based upon them, hardly "discredit" his professional advice.

It may be true, as you suggest, that not every single person will have a problem eating wheat, but a person's weight (or appetite) is not the only indicator of potential heart-health related issues. While wheat might not make everyone fat, it may still provoke immune response, inflammation, surge in blood glucose and triglycerides, etc.

Anecdotally, thanks to Dr. Davis' advice regarding wheat, my 68 year-old mother lost 15% of her bodyweight in four months, without exercise, and without any other change in her diet except to replace the pastas and breads with eggs, vegetables, and meats. She had always taken great pride in the "healthy" foods she ate, but over the past twenty years had very slowly gained weight and a bloated appearance. She started crying during our last visit because she is so happy to "recognize" herself again in the mirror, and is wearing clothes that haven't fit in over a decade. I stopped eating wheat one year ago. Since then, I've dropped from size 34 to 28 pants and get compliments weekly concerning how young I look; I feel great and lab results (blood tests, radiology) are unbelievably improved.

Wheat avoidance may not indeed be necessary for everyone; but, it's done wonders for *all* of those around me that have given it a good chance.

reikime
1/28/2011 3:53:27 AM |

Jonathan,
Subbing milk for the wheat wold NOT work as milk produces a morphine- like substance called caseomorph and wheat produces gliadimorphs. Two different types of exogenous morphines.

This is one of the rationales for the gluten free- casein free diet that seems to greatly help some children on the autistic spectrum. Sorry to be a spoilsport!

reikime
1/28/2011 3:55:31 AM |

oops! typo alert ...sorry
Subbing milk for the wheat would NOT work as milk...

Might-o'chondri-AL
1/28/2011 7:55:05 AM |

reikime,
thanks for the answer.

reikime
1/30/2011 12:39:45 AM |

You're welcome Might-.

Olive Kaiser
1/30/2011 3:13:16 AM |

Check out www.theglutensyndrome.net

I get folks who contact me from my site who have strange neurological symptoms when they either withdraw from gluten/wheat the first time or  flip flop on and off too much. I have a page on temporary adverse effects from going gluten free.

Our 23 year old nursing student daughter experienced a very strange neurological effect from a 6 week gluten challenge after being strictly gluten free for 6 months.  Ischemia/reperfusion injury is a possibility, and gluteomorphin withdrawal also.  Her story is on the site.  For sure she is very strictly gluten free now, and doing fine 6 years after the experience. http://glutensensitivity.net/cases.htm#ztop

In the book, "Mendel in the Kitchen, Nina Federoff, a strong proponent of GMO technology, relates how wheat was genetically altered by the 1950's by both x ray irradiation and chemical mutation, and the gluten levels were raised far above older varieties. The wheat today is not the same as our ancestors, at least not here in the States.

FYI, a new lab (www.Cyrexlabs.com)  has just opened 2 weeks ago with much more complete gluten syndrome testing.  They are testing many more antibodies than previous standard panels, and expected to turn up many more folks with gluten syndrome.  They also teach that gluten can damage multitudes of tissues by molecular mimicry between gluten related antibodies and look alike innocent tissues all over the body.  The villi, which have been the gold standard target tissue in the celiac community, are turning out to be just one of many possible sites of damage.

Many folks have gluten/wheat related antibodies, but their main target of autoimmune tissue damage is in places other than the villi, such as the heart, nerves, organs, joint lining, etc.  Villi as the target tissue is found in relatively a few folks, and that is the tissue damage that has gotten most of the attention.

Dr. Aristo Vojdani, PhD, Immunology, and others have accumulated a lot of research to support these theories, and they fit the gluten syndrome community like a glove.

Jonathan Byron
1/30/2011 3:39:54 AM |

>> "Subbing milk for the wheat wold NOT work as milk produces a morphine- like substance called caseomorph and wheat produces gliadimorphs. Two different types of exogenous morphines."

Right, but is the fundamental problem generally the morphine-like effect, or is it some other antigen specific to gliadins? My wife has hashimoto's thyroiditis, and the smallest trace of wheat, barley, or other gliadin grains quickly makes her miserable... she can feel her thyroid swell, she gets cold, she has other problems. Dairy does not have this effect. Since cutting out gluten from grains, her T3, T4, and TSH levels have returned to normal, while her anti-thyroid antibody level has dropped to very near normal.

I am willing to consider that with some conditions (like autism), both gluten and milk can be a problem. It is not clear to me that if gluten is a problem then milk must also always be a problem. If the casomorph proteins allows some people to quit wheat with fewer withdraw symptoms due to the substitution of endorphin-like molecules, that could be a good thing.

reikime
1/30/2011 10:37:28 PM |

Jonathan,

The issues your wife has with gliadin really dont seem related to the morphine like responses some people have with gluten and /or dairy.

Sure some people that have a wheat/gluten intolerance can ingest dairy just fine...that said, if the microvilli are damaged from wheat and not healed yet, you are much more likely to have a problem with dairy.
The tips of the villi are where lactase is produced.
Also, if one is subject to the effects of gliadiamorphins, IMHO one would likely be sensitive to caseomorphins, because the unhealed intesine is permeable.. ie leaky gut syndrome. This allows proteins into the bloodstream that would normally not be there. (and to wreak havoc)

Willing to say I may be wrong, though. Anyone?

I spend alot of time on celiac research issues, so naturally this is where my brain goes! lol

Dr Charles Parker
3/22/2011 1:02:56 PM |

Great to see that others have identified gluten as a potential pathogen/allergen that can significantly contribute to both mind and body deterioration through compromised immune dysfunction. I know you, Dr Davis, often think of the heart as the canary in the coal mine, and I see the brain as a canary partner showing first signs of impending acute deterioration.

This link will take you to a series of interviews I did with Dr Peter Osborne on similar issues as discussed in this posting:

http://www.youtube.com/watch?v=dJCZmNzkRNA&playnext=1&list=PLD61FCED98A4A5C66

Hope this helps encourage more discussion and awareness, and thanks for your excellent work!
cp

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Carlos
9/20/2010 10:24:56 PM |

Does he subscribe to Cordain's anti-saturated fat view of nutrition? That is one of the biggest issues I have with Cordain's take on paleolithic nutrition. The biggest problems with speculations on paleolithic nutrition is the extinction of the megafauna that were the basis of human global expansion. Fatty acids in modern deer doesn't tell us anything about fatty acids in mammoths, cave bears, and aurochs.

LInda Middlesworth
9/21/2010 2:46:19 AM |

It is so sad that Robb is making money off of telliing people to eat the same SAD (Standard American Diet) that is killing Americans. The SAD diet is the same diet to promote heart disease, diabetes, obesity, cancer, etc.
and all other chronic diseases that plague western countries. Only animal foods have cholesterol so stop eating them. Go Plant BASED! goveg.com

kellgy
9/21/2010 4:52:22 AM |

Dr. Davis, I'm not sure if you meant to, but the book you have linked is for Cordian's Paleo Diet not Wolf's Paleo Solution.

Here is Wolf's link: http://robbwolf.com/

I've been interested in studying the paleo diet for a little while now. Since I am following some of the principles on my low carb/sugar regimen, it can't be too much of a stretch. The health benefits are probably a great improvement over the SAD and vegetarian diets I have tried in the past.

Eating foods that readily provide nutrients for lean muscle mass development gives you a competitive edge on the health continuum.

Maybe I'll take a dive on the upcoming release.

Dr. William Davis
9/21/2010 1:53:50 PM |

Oops!

Thanks for catching that, Kellgy.

Anonymous
9/21/2010 2:27:42 PM |

How old is Robb? It says former research biochemist but he looks like he's 27?!! Guess that's what paleo does for ya.

Diane
9/21/2010 4:42:44 PM |

@Linda- Actually, consuming animal based foods isn't what the SAD diet means. SAD is more about processed foods (largely grain-based) which is what the Paleo diet does NOT promote consumption of. The reality is that Robb doesn't make money by telling people to go out and buy whole, real food. None of us who promote a whole-food diet benefit in the pocket from it.

A Paleo diet is actually largely plant based, though it clearly involves animal foods to a large degree. We eat TONS of plants.

If you knew anything about cholesterol, you'd know that eating it actually isn't killing us. Processed grains and sugar will go way farther to damaging our health than a hunk of pork belly any day.

Diane
9/21/2010 4:43:22 PM |

Oh, Robb is around 38, I think...

Sandy Sommer RKC
9/21/2010 7:03:33 PM |

Linda, You may want to check and then re-check your facts. Wolf's ideas are the antithesis of SAD. I'm 49 years old, 8.5% body fat, eat no grains at all...None.....Have very low blood pressure....great blood chemistry and unlimited energy.

Drew
9/21/2010 9:07:21 PM |

@ Linda, quality meat (grassfed, wild, etc) is not bad. Humans have been consuming meat for 2.5 million years. Hell, the Inuit have a diet that contains about 95%+ animal products, and they don't suffer from the level of chronic diseases we do. If you actually do your research on the subject, you'll see that meat is not the source of all our problems. "The Vegetarian Myth", written by a former vegan, is a very good book I hear.

Drew
9/21/2010 9:10:20 PM |

@ Carlos, actually, Cordain's stance on saturated fat has softened quite a bit. He is actually releasing a revised version of his book, The Paleo Diet, in which some of stuff on saturated fat is revised.

Robb Wolf tends to be saturated fat agnostic. He weighs the pros and cons in the book, and provides good info and research to back it up.

Dr. William Davis
9/21/2010 11:53:07 PM |

Drew said it well: Saturated fat varies in composition, depending on what mix of fatty acids it contains, e.g., stearic, lauric, and myristic.

It also matters whether saturated fat keeps the company of exogenously generated advanced glycation end-products.

Saturated fat, in and of itself, is not that bad. But it can keep the company of other things. In other words, saturated fat has served as a surrogate marker for these other things. Unfortunately, it means that, for years, the data have been distorted by these other measures.

Adolfo David
9/22/2010 1:51:49 AM |

Linda
Go meat-eating! And read please.

Cholesterol bad? What stupidity!

Vegetarians are so so ignorants...

Anne
9/23/2010 1:50:10 PM |

Just catching up with the posts since I've been on holiday. Just posted in the Fred Hahn bit as I've been doing Slow Burn for over three years now. I have also been following a Paleo diet for over four years ! Wow, two of the things that have been most influential for my health and well being you posted on Dr Davis ! Wish I could have taken part in discussions while I was away. Never mind...I couldn't agree more with both the Slow Burn weight lifting technique and the Paleo way of eating....they both help me with my health problems: osteoporosis, atypical type 2 diabetes (thin and not insulin resistant) and congenital heart valve defect.

Carlos
9/23/2010 5:05:07 PM |

Drew: I'll be keeping an eye out for the updated PaleoDiet. Thanks for the heads up.

Dean Deleo
9/24/2010 6:04:01 PM |

Vegetarians are silly.

That Paleo makes alot of sense

lala
10/18/2010 4:06:25 AM |

Thanks for your post and welcome to check: here
.

Anonymous
11/20/2007 1:32:00 AM |

I give thanks that the health of my heart does not rely upon the Melissa Shirley-Waltons of the world.

Anonymous
11/20/2007 3:37:00 AM |

Where exactly is this debate going on? I was unable to find a forum at that site, even though the site index. I did a search for the doctors' names, and came up blank.
Thanks,
S

Dr. Davis
11/20/2007 3:45:00 AM |

Just go to heart.org and the Forum is on the left navigation bar. You will have to sign in, presumably as a media representative.

Anonymous
11/20/2007 1:24:00 PM |

Looks like this "John Q Public" has emerged from the shadows over at the HeartCipher blog.

http://www.heartcipher.com/archives/42

Anonymous
11/20/2007 1:27:00 PM |

The link to the forum in question is:

http://www.theheart.org/viewForum.do

The thread title is:

"DES showdown: Serruys vs Virmani"

Paul Kelly - 95.1 WAYV
11/21/2007 5:23:00 PM |

Hi Dr. Davis (and everyone!) -

In talking with my family physician today about CT Heart Scans, she said she doesn't like them because of the level of radiation. She said she just read an article that said even one CT can increase your chances significantly for leukemia, cancer, etc. She's a believer that a comprehensive stress test can tell you what you need to know - i.e. if you have plaque, it's going to affect the results of your stress test and is therefore detectable that way. Is the level of radiation really something to be scared of?

Paul

Rich
11/21/2007 10:20:00 PM |

Dr. Davis recently wrote a blog piece titled "Are Cardiologists the Enemy?" that seems particularly relevant here.

-Rich

Anonymous
11/23/2007 3:48:00 PM |

Since it seemed like I had read John Q Public's writing style recently, I clicked on this blog's side links, and found JQP was most likely HeartCipher. I read through some of HeartCipher's recent posts and found the link to the forum, at theheart.org -- not heart.org as originally linked.

Dr. Davis, perhaps the link could be corrected in the blog post?

Many thanks to the anon commenter for the DIRECT link to the thread (too bad I didn't reread through the comments before sleuthing LOL)! Once I receive my confirmation letter from theheart.org I'll be able to read it.

S

Dr. Davis
11/23/2007 4:05:00 PM |

Yes, my mistake, now corrected. Thanks.

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