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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Red flags for lipoprotein(a)

Red flags for lipoprotein(a)



Lipoprotein(a), Lp(a), is an important cause for heart disease, heart attack, and coronary atherosclerotic plaque.

How do you know you have it?

Of course, it could be as simple as checking a blood level. But there are also a number of red flags for the presence of Lp(a), tell-tale signs that suggest it is present and contributing to the growth of coronary plaque.

I've seen so much of this pattern over the years that it's gotten so that I can pretty much pick out most of the people with Lp(a) just by either looking at them or by hearing their story. I do this simply by knowing what hints to look for.

Some of the red flags for Lp(a) include:

--High blood pressure in a slender person. Overweight is the overwhelmingly common reason for high blood pressure. However, inappropriate high blood pressure in a slender person can serve to tip you off that Lp(a) is present.

--HIgh LDL cholesterol poorly responsive to statin drugs. For instance, someone's LDL cholesterol of 190 mg/dl will be treated with Lipitor 40 mg, but drops to only 165 mg/dl, a very poor response. This can sometimes point towards Lp(a).

--Family clustering of heart disease in people before age 60. For instance, father with heart attack age 53, uncle with heart attack at age 55, aunt with heart attack age 59, etc. This clustering of risk, more often than not, signals Lp(a).

--Coronary disease or high heart scan score in the presence of relatively bland appearing lipids. For instance, LDL cholesterol 130 mg/dl, HDL 55 mg/dl, triglycerides 70 mg/dl on no medications or other efforts--figures ordinarily not associated with high likelihood of heart disease--yet heart disease is indeed present. This can mean that Lp(a) is the concealed culprit behind coronary atherosclerosis.

These red flags are not perfect. If you lack any of them, it doesn't necessarily rule out the possbility of having Lp(a). They simply serve as signs to suggest that Lp(a) may be lurking.

Once Lp(a) is identified, then the battle begins to gain control over this somewhat troublesome genetic pattern. Resourcesfulness and some ingenuity may be required. However, knowing that you have it shows you where to concentrate your efforts.

Comments (24) -

  • Anonymous

    1/17/2008 1:03:00 AM |

    I wish I knew more about exactly what Lp(a) will do that will cause me problems.  I have high Lp(a)(22 on my VAP test).

    I am 5'2" and weight 110.  I am a fitness professional -  healthy blood pressure level.

    My TC at it's worse was 226 with low Trig, high HDL, and high LDL (144).  My Dr wanted me to get the LDL down with drugs.  I chose the supplement path, and increased my fiber intake.

    My TC is now around 224, but my HDL is 86, and LDL 118.  My real LDL size pattern is A/B.  My HDL 2 & 3, and VLDL 3 are all in the desireable range.

    Oh - I do have a family history of heart disease (mother had strokes in her 60s).

    I had a heart scan - no measurable plaque found.  I'm 55 years old.

    That darn LpInnocent.  Should I be worried it's going to do something I'm not aware of?

    Bonnie

  • Dr. Davis

    1/17/2008 1:41:00 AM |

    Yes. You might have a Lp(a) variant that accounts more for carotid disease than coronary disease, judging from your mom's history. Also, you are still young. Some women will not fully express Lp(a) characteristics until their late 50s.

    All the principles we talk about for Lp(a) on the Track Your Plaque website still apply. Also, please see our upcoming report that summarizes unique strategies for Lp(a) treatment to be released in the next two weeks.

  • Anonymous

    1/17/2008 5:32:00 AM |

    If Bonnie thinks her LP(a) at 22 is high, I guess mine is high also at 24, but at least its a whole lot better than it was 18 months ago when it was 52.   I attribute the reduction to DMAE and NAC,thanks to your recomendations, Dr. Davis.

    Your list of possible examples of high LP(a) just doesn't include me.

    My BMI is 21.  I have relatively low blood pressure,95-110 over 70.  My age is 65.   Total Chol=190; LDL=110  HDL>65 and sometimes as high as 100.  Low Trigs < 70.

    No family history (mother still kicking at 95). Father died in hi 70's from pancreatic cancer with a very strong heart and lung system.  And yet I have had a really high LP(a)!!!

    I can't afford a CT scan, as much as I would like to get one, but I did have a lipoprotein breakdown which showed
    VLDL=25; LDL particle number 789 dense LDL IV=101 HDL Total=9066 and Buoyant HDL 2b=2528.  All  measured in (nmol/L).  My density was neither A nor B, but in an intermediate zone near the A border.

    My homocysteine is raised (12.26) probably because of the 750mg of Slo-Niacin I take, but I'm trading niacin's lipid enhancements for it.

    When my LP(a) was at 52, all blood work was similar to now, weight was the same, exercise, diet, everything was the same.   I don't understand why it was so high.   I was hoping your list would give me a clue, but I'm just not on it!!!

    Noreen

  • Anonymous

    1/17/2008 6:44:00 AM |

    Thanks.  My mom unfortunately led an extremely sedentary lifestyle, and didn't eat well or take care of herself.  I always assumed her strokes were a result of that.  I guess it was probably part of it, but not all of it.

    I did not know about Carotid disease - seems all I ever hear about is Heart Disease these days.

    I look forward to finding out more about the new approaches to dealing with Lp(a)!

    Bonnie

  • Dr. Davis

    1/17/2008 1:36:00 PM |

    Hi, Noreen-
    I'm curious about the DMAE. I've used it (unsuccessfully) for memory enhancement, but not to reduce Lp(a). What is the basis for this?

  • Anonymous

    1/17/2008 3:45:00 PM |

    Big Goof, Dr. D!!!  I was tired and didn't get up to check my supplements.  I'm taking 50mg of DHEA for lowering the LP(a)!!!

    Sorry, thats what I get for getting into this stuff so late at night!!!

    I'm still at a loss as why mine went so high (52)!!!   Especially with no family history of heart disease.

    Noreen

  • Anonymous

    1/17/2008 4:11:00 PM |

    Noreen - your post reminded me of something that I find curious.

    When I first had my Lp(a) tested it wsa a separate test from my Cholesterol test.  Results came back 59 wih a reference range of  0-29.  

    Next time it was measured it was part of a VAP test, and when I saw it at 22 I thought it had dropped (by some miracle Smile.  Then I noticed the reference range was different, and that the high end of the range was 10.  

    Different tests maybe?

    Bonnie

  • Anonymous

    1/17/2008 6:00:00 PM |

    Thanks Bonnie -- Yes, it was different labs, but the reference range was less than 30 on each one.   I did read somewhere that some labs use less than 20 as the normal range, but these two labs used < 30.

    This lab also did a nutrient profile and found that I was deficient in pantothenate, glutamine and glutathione.   I was already taking 500mg NAC, but they recommended 1000mg, so I'm now taking 1200mg of Jarrow Sustain NAC in hopes it will satisfy the glutathione deficiency and lower that LP(a) further.  

    I also started taking pantothenate to satisfy that and read that it can reduce LDL, so I'm hopefull there.   I upped the glutamine that I was already taking and switched to a powder form.

    Thanks,
    Noreen

  • Dr. Davis

    1/17/2008 7:41:00 PM |

    Hi, Noreen-
    Somebody, Mom or Dad, had to give you Lp(a), though the expression and consequences of Lp(a) can vary.

  • Anonymous

    1/17/2008 8:25:00 PM |

    Is it a dominant characteristic from just one parent or can it be a recessive one from both with neither having it?   I don't think my mom has ever been tested, but her doctor said her heart is still very strong at 95.    My paternal grandfather died of a massive heart attack at 78.  Before that he was hospitalized several times with fluid in his chest (cardio-myapthy) maybe?

    I was under the impression that if it were genetic that nothing will reduce it.  Is this wrong?   Mine did come down to 24 after taking the NAC and DHEA.   I'm really looking forward to reading that paper on lowering it too.  Thanks so much,
    Noreen

  • Bad_CRC

    1/17/2008 9:09:00 PM |

    Dr. Davis, just to clarify:

    1. Lp(a) is not like IDL, where having any measurable amount is abnormal, right?  Mine was 7 mg/dL, and I took this to mean that I don't "have Lp(a)."

    2. Also unlike IDL, small LDL, etc., it's purely hereditary and not a symptom of metabolic syndrome or similar, correct?  So if I don't have it at 30, I don't need to worry about developing it by 50?

    Thanks

  • Dr. Davis

    1/17/2008 10:26:00 PM |

    Lp(a) is genetic but blood levels are manipulable. But Mom or Dad HAD to give it to you, they just may not have fully expressed its consequences (which does happen occassionally, for not entirely clear reasons).

  • Dr. Davis

    1/17/2008 10:28:00 PM |

    Hi, Bad--
    Yes, correct on both counts.

  • Anonymous

    1/17/2008 10:33:00 PM |

    But Mom or Dad HAD to give it to you, they just may not have fully expressed its consequences (which does happen occassionally, for not entirely clear reasons).

    So Dr. Davis, are you saying that if you have this genetic marker, that it is inevitable that at some point down the line it will do bad things - no matter how good all of the rest of your risk factors are? (assuming there continues to be no reliable way to reduce it).

    Bonnie

  • Dr. Davis

    1/17/2008 10:54:00 PM |

    No, not inevitable, but darn close. It could be expressed as hearet disease, carotid disease, aneurysms, or just hypertension.

  • Anonymous

    1/18/2008 2:29:00 AM |

    Are there any major differences between  Lp(a) testing via a VAP test as compared to NMR?

    VAP seems to use a lower test range (over 10 being considered high). Does this mean their test is different than others, or simply they use a lower marker to differentiate between high and low? And would a Lp(a) test via VAP be as accurate as one from NMR, etc,?

    My VAP numbers for Lp(a) was pretty low, around 4-5, if I remember right. I just want to make sure this was an accurate test.

  • Dr. Davis

    1/18/2008 1:19:00 PM |

    There are several methodological differences among the various Lp(a) measures. For this reason, I advise everyone to always stick with the same laboratory. There may also be differences in the validity or accuracy. This is detailed in a full Special Report on the Track Your Plaque website.

  • Joan

    1/18/2008 8:54:00 PM |

    My Lp(a) score came back at 160--that's right--160!  I have a stent in one artery, obviously I have CAD.  I presently take Zocor 20 mg. and an Ace Inhibitor drug.  I can not take Niacin---what can I do?


       Joan

  • Anonymous

    1/19/2008 2:35:00 AM |

    Dr Davis,
    My Cardiologist has me on 1500mg Niacin which reduces LP(a)to around 30 and that seems to be about the lowest I can get it, as more Niacin gives me a rash. So He says we need to reduce LDL as low as possible by diet,exercise and possibly a low Statin dose. Reducing the amount of carriers, He says, will negate to a large degree, the risk of my high LP(a). Does this sound like sound treatment?   Thanks.....

  • Dr. Davis

    1/19/2008 5:06:00 AM |

    That sounds like a very solid approach to Lp(a). Congratulations to your doctor for being up to date in his thinking about Lp(a).

    Also, watch for an upcoming report on our Track Your Plaque website for a review of unique therapies for Lp(a).

  • Dr. Davis

    1/19/2008 5:13:00 AM |

    I'm afraid that's a bit too much to handle in a blog post.

    You are invited to read our Track Your Plaque Special Reports on Lp(a), including an upcoming review of unique therapies to be posted within the next two weeks.

  • Anonymous

    1/19/2008 5:40:00 AM |

    Also, watch for an upcoming report on our Track Your Plaque website for a review of unique therapies for Lp(a)

    Can you see me tapping my foot..... impatiently.....  

    Smile  
    (Just kidding)


    I hesitate to take Niacin because I have a tendency toward slightly high liver enzymes for some reason (possibly mild NAFLD since all other tests came back negative), and I've read Niacin can raise liver enzymes.  I look forward to hearing about other possibilities.

    Bonnie

  • Anonymous

    2/20/2008 6:50:00 PM |

    SO after all is said and done should a LP(a) redaing of 12 be of any concern? It is noted as "high" on my VAP test but it certainly is close to normal. All of my other readings on the VAP are normal.

    John

  • buy jeans

    11/3/2010 2:26:48 PM |

    These red flags are not perfect. If you lack any of them, it doesn't necessarily rule out the possbility of having Lp(a). They simply serve as signs to suggest that Lp(a) may be lurking.

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