Dr. Davis,
would you please explain, in layman's terms, why chiceking blood glucose can be so important for not only keeping track of blood sugar but for weight loss? I think I get it, but my mother, who was recently diagnosed as "pre-diabetic", says she is going to return the glucosometer she based bought upon my suggestion, as she is going to eat low-carb and track calories, etc.  Help me help my mom out!  Thanks so much,
emily

Dr Davis, thanks for the site.

There's a history of Diabetes in my family.
My dad and his father were both Diabetics and they both died of Pancreatic Cancer in later years.
They never watched any of their habits though.
My dad's doctor used to call him a "food and lifestyle" liar. Dad shrugged it off.. and kept on lying.

Yes, I know about the genetic odds here.
I do watch what I eat, Vit D3, no cigarettes and I exercise and live life.

I've never seen a conclusive study relating Diabetes and Pancreatic Cancer.
Any thoughts on that ?
I'm not Diabetic. FBG today of 89.
But I still watch myself and I have started to use a BG monitor to watch post-prandial numbers.
It's interesting how different foods affect everyones's BG differently.
I'm continually learning.
Thanks again for the site.

I'm new to all this but have a question if anyone is willing to indulge me an answer...

I frequently fall to sleep after lunch and/or after dinner, just "nod off" type of thing.  Is this a result of high BG and then the insulin response driving sugar low?

I am not diabetic and try to eat reasonable healthy meals, moderates amount of lean meat, vegetable and starch like rice or potato.  I wonder if I have insulin insensitivity...guess I need a meter. Thanks

Thanks for explaining why.

Could you maybe elaborate a little?

Carbs cause blood sugar to rise. Indulge in excess carbs, and you can walk, run and bike till you drop and not lose an ounce.

Awesome post Dr. Davis. I check my post-prandial BG constantly and have eliminated many so called low glycemic foods. ALso, nice simple explanation Lori.

@ Larry said...
I've never seen a conclusive study relating Diabetes and Pancreatic Cancer.
Any thoughts on that ?
It's not a straightforward connection, they are still arguing about it.
This abstract suggests  
the development of diabetes in subjects prone to pancreatic cancer could be a red flag for malignancy.

And this full text article
Is Type 2 Diabetes a Risk Factor for Pancreatic Cancer? explains why it's difficult to definitively identify type 2 diabetes mellitus as a risk factor for pancreatic cancer.

Worth pointing out for those with Diabetes who are concerned about the threat of Pancreatic cancer that Metformin monotherapy carried the lowest risk of cancer. However that was comparing medical diabetes treatments, so didn't include people using Dr Bernstein's or similar approaches to controlling diabetes through diet, exercise.

I found this paper Cancer as a metabolic disease worth studying. It's not specifically about pancreatic cancer. It makes the point that Reduced glucose availability will target aerobic glycolysis and the pentose phosphate shunt; pathways  required  for  the  survival  and  proliferation  of many  types  of  tumor  cells.
Maybe it isn't just the risk of heart disease that is reduced by lowering circulating  glucose levels.

@  Emily
Please try to persuade your mum the glucose meter is an essential tool to understand which foods really raise BG levels.
I thought, a bit like your mum, that because I followed a Low carb eating plan I wouldn't have a problem with high glucose.
Only after readingTo get low-carb right, you need to check blood sugars did I get a meter and start checking.
Despite eating almost exclusively low carb I was regularly spiking up to 199.8 ~ 11.1.
Adding into my diet a variety of things to slow gastric emptying has reduced the height of 1hr after meal spikes and I've now gone a week under 133.2 ~ 7.4 and the trend is towards lower numbers mostly under 108 ~ 6

I've not restricted my calorie intake nor am I able to exercise much but I have, unintentionally, lost weight. A month ago I was 168lbs and am now 163 lbs.

I went out and bought a glucose meter yesterday.  I bought the one Dr. Davis recommended, the OneTouch mini purchased at Walgreens.

In hindsight though, it turned out to be an expensive choice.  I had to buy the OneTouch test strips as well, and they are fairly pricey.

For anyone considering buying a glucometer, buy the Walgreen's version.  I think it had a mail-in rebate, cost a bit less than the one touch, and also, the generic Walgreen's test strips are half as much as the One Touch.

And thank you Dr. Davis for this great blog.

Consumer Reports magazine recommended the ReliOn Ultima and their strips. The meter is, like, $9 and the strips are very inexpensive (compared to "branded" ones). (I'm pre-diabetic.) I don't have any hesitation checking my b.g. anytime, because the strips are cheap.  (No insurance, I have to pay for all my supplies.)  If you have insurance but they limit your strips (as with my nephew, a Type 1), you can use the  cheap one to fill-in your testing.

From my research and experimentation, the Accuchek Aviva shown in picture is the most accurate and precise meter currently available.  Over the long run, an accurate and precise meter will save you money and a lot of trouble, versus one whose results are not as reliable, and which forces you to test more.

btw, most precision issues are due to the strips, and cheap strips will simply result in lots of unnecessary holes in your fingers if you're serious about knowing what's going on with BGs.

thanks

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I wish that I can have all those weight loss tool. I am sure if I have all those my weight loss program is going to be more effective.

I would just love to drink my tap water for necessary minerals but my city has deemed it necessary to forcefully medicate it's inhabitants by adding fluoride to it so I go to my local water store and get my drinking water.

I have hashi's so I must avoid flouride (except for having to bathe in the citywater)as much as possible.  Sometimes I get distilled and sometimes I get the reverse osmosis for my drinking water.  I add Himalayan 'sea' salt to the water to add back in the minerals but I really have no clue if that is adequatly providing the minerals my body needs so I also take vit/min supplement and additional magnesium(sometimes before going to bed - it seems to allow a more restful sleep and makes me calmer overall).

Some of the proponents of distilled water drinking say that absorption of minerals from water is negligible.  I don't know if there are any studies out there to prove if this is so.  My guess is that it would depend on the gut health of the individual.

I also give my pets the bottled water with the sea salt added to it.  they don't need no steenkin fluoridated tap water either.

Growing up we had well water and it was delicious.  I don't know if anyone ever tested the water for it's mineral content, though.  

Nancy

Most people would do well to take a vitamin/mineral supplement each day. It's simple to do, and relatively inexpensive. Relying on our diets to provide us with the right nutrients can leave out important ones.

Fortunately, I live in Hot Springs, Arkansas where I have free access to 140° thermal spring water, with 4.9 ppm Mg.  Don't know if that's sufficient but that's all I drink.

There are many types of magnesium available in vitamin stores. Which is the best type to buy? I am curious about absorption by the body and not including a lot of potentially unhealthy ingredients?.

Does Wheat actually contain the amount of magnesium claimed?
Evidence of decreasing mineral density in wheat grain over the last 160 years.
Is the magnesium in wheat absorbed ?
New data on the bioavailability of bread magnesium.
Is it possible the drive to include Whole grain into the diet is counterproductive and simply results in further magnesium depletion resulting in negative balances ?
Zinc, copper and magnesium absorption from a fibre-rich diet.

KRISPIN has some interesting suggestions regarding an appropriate magnesium intake

Magnesium oxide has been shown to be poorly absorbed, while magnesium aspartate releases aspartate, which *might* cause some excitotoxicity. Your best bet is probably magnesium citrate or malate.

Jeremy Fox,

Read the first comment from this post by Dr. Eades for what kind to buy:
Link

@Ares
Actually, no one should take a multi vitamin (= the shotgun approach) without talking to a knowledgable doctor and/or doing a lot of research.

And NO ONE should take a cheap generic multi. That's suicidal and I'm serious.
The evidence conclusively proves that generic multis (badly formulated, over-/underdosed, etc) are a waste of money at best and dangerous at worst. (1, 2)

There are two *vastly* superior approaches:
A. fix your diet (check nutrient intake using CRON-o-meter) and supplement whatever you are lacking (i.e. single nutrients).
B. take a well-formulated *low dose* multi á la AOR orthocore (although, it's too high in folic acid in my opinion)

(1) Cochrane Database Syst Rev. 2008 Apr 16;(2):CD007176.
Antioxidant supplements for prevention of mortality in healthy participants and patients with various diseases. Bjelakovic G, Nikolova D, Gluud LL, Simonetti RG, Gluud C.
(2) Multivitamin use and risk of cancer and cardiovascular disease in the Women's Health Initiative cohorts.
Neuhouser ML, Wassertheil-Smoller S, Thomson C, Aragaki A, Anderson GL, Manson JE, Patterson RE, Rohan TE, van Horn L, Shikany JM, Thomas A, LaCroix A, Prentice RL.

I'm curious what Dr. Davis recommends regarding magnesium intake and what specific form.

Magnesium glycinate (Albion), orotate or a taurate may be preferred. The Albion's have good absorption studies. And for orotate there is little bit of evidence is can reduce cholesterol (maybe), and some decent studies on improving heart health.

I enjoyed two books on magnesium, The Magnesium Factor and The Magnesium Miracle.  They complement each other well, as the first one is more about magnesium's role and the second has more practical info about supplementing.

We used to take magnesium oxide, but it is the magnesium salt with the lowest absorbability (only 4% I think), so the dose must be higher.  Consequently it also has more of a laxative effect than some other magnesium preparations.  We're taking a magnesium complex (oxide, aspartate, citrate, and taurate) or magnesium taurate now, though I do keep the magensium oxide around for the times when a mild laxative is useful (esp with travel).

The Magnesium Miracle frequently mentions magnesium oil (magnesium chloride?) which isn't really an oil, but feels like one when applied topically.  I haven't found it in local stores (no one has heard of it), but it is available online.  Has anyone used magnesium oil?

I have bought on line and used used Swanson's magnesium oil topically-5 short sprays on each arm prior to bedtime on a daily basis.  I have used about 40% of 8fluid ounces and I just got my blood test results.  normal range 1.5 to 2.5.  My result was slightly high at 2.7.  By applying it topically, you get full absorption.  Dr. T from "nephropal.blogspot.com put me on this system.

Congratulations Amy!

And here I thought that plaque was in your arteries for life... and then tonight I find this blog.

Amy (and Neal) give all of us inspiration to truly modify our lifestyle.

I'm also especially gratified that a woman now holds our record. I'm uncertain why, but the ladies have been shy and the men remain the dominant and vocal participants in our program. Speak up, ladies!

My first time to click through from the reader, so I love the new banner! Your first couple of paragraphs had me giggling, mostly at myself. But I'm not quite that bad, yet.

In addition to stopping sugar and high-glycemics because I had that borderline A1C a few months back (had to reschedule follow up appt because of jury duty), your harping wheat got me to at least slow it down enough to figure out it was causing my 'gut episodes'. So after an elimination diet, I've been feeling far less pain/bloating (exception peas, a new seemingly unconnected sensitivity). I didn't get a celiac blood test when I went back to GI since I'd been completely off wheat quite a while by that time.

And I've dropped 20 lbs since stopping the wheat!!  Yay, and THANKS for harping on wheat!!

But I still don't know if meat fat still needs to be trimmed as much since it seems it doesn't directly contribute to bad cholesterol. I could stand to lose more weight though LOL

S

great post for newbies, but you still  dodged:
I know about the flour and starch, now:
is there a ceiling for omega-3 fatty acid supplementation?
Here:
http://www.second-opinions.co.uk/fats_and_cancer.html
you can read how the fish oil was used to suppress the immune system after transplants or something, so should we treat fish oil just like sunflower oil?

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Same here. I lost about 55 pounds and my CRP, blood pressure, cholesterol, etc., dropped to optimal levels. Fruits, vegetables, occasional salmon, carefully chosen vitamins and supplements, and a daily brisk walk of at least 30 min. While this programs may seem like a considerable sacrifice, it beats the alternative: 100% sacrifice.

My father has been doing the TYP program with out following the low carb. diet.  He just got his test results yesterday and the #s differ little from the last test done.  It has him scratching his head.  After this he might finally follow the diet.  He is asking me lots of questions this morning.  The supplements and drugs were helpful, in particular his triglycerides and HDL have significantly changed for the better, but lots of work to be done still, specifically on lowering LDL, and it's fractions.

Regarding an upper limit for fish oil, I believe the cut-off (for most people) is considered around 3 grams/daily of Omega 3. Higher doses could theoretically lead to thinning of the blood (eskimos were prone to bleeding-brain type strokes) and immune suppression is another possibility. Even at 3 grams/daily, some immune suppression might be going on. And for some people with auto-immune disorders, that could be a good thing. Although for the general population... not so sure.

Maybe one day Dr. Davis could devote an article delving into fish oil a bit more? There is the ethyl ester vs. triglyceride form issue, which I don't recall seeing ever mentioned here. And although heavy metal toxicity isn't really an issue with most fish oils (in my opinion), oxidation is. Fish oil doesn't have to be rancid to have some oxidation, which could be unhealthy. And there is also immune suppression... and also the question of which omega 3 is of greater benefit, EPA or DHA. Lots of fishy stuff to look into.

OK - I need a lesson in Wheat & Cholesterol/Weight Gain/Health 101.

  What exactly is the problem with wheat, and why does it have a bad effect on cholesterol/weight?  Can someone point me to this basic information?  I assume it has nothing to do with the gluten in wheat (unless you have Celiac disease).

Thanks,
Bonnie

I find it very difficult to eliminate wheat.  It seems to be in so many things.  Can anyone tell me about breads without wheat, cereal without it and wheatless pasta.  I am Italian and it seems like missing pasta and breads in particular are really hard in our family.

I do know of spelt bread and we buy it.

I think that Dr. Davis does himself a disservice in this posting by claiming that it's wheat that is the big problem.  While wheat may well have antinutrients that sabotage our digestion, the big risk for everyone in eating wheat and wheat products is the starch (carbs).

Your body converts starches to simple sugars before being absorbed across your intestinal wall, which means that for the sake of your insulin levels (and your LDL particle sizes), wheat is as bad as a big glass of glucose syrup.  Not quite as bad as a glass of high fructose corn syrup since the fructose is converted directly to triglycerides by your liver, but bad enough.

In answer to the anonymous italian looking for wheat-free bread, cereal, and pasta alternatives: the real answer is to realize that these food categories are compromised because they come from grains.  

If you moderate your intake of these kinds of foods, they won't do very much harm to your metabolism.  But if you can bring yourself to completely eliminate them from your diet, you'll be even better off.

As for seeking lean meat: I do the exact opposite.  I've been buying suet (beef fat) and rendering tallow to make pemmican and other foods that are very rich and compact, calorie-wise.  These high-fat foods have been helping me lose and then maintain my weight very effectively (and they're tasty too!)  High fat foods make me full, not fat.

After a rather thorough reading of the science on saturated fat, I've personally concluded that saturated fat is harmless or beneficial.  Most of the older research that doesn't determine the precise composition of solid fats also doesn't discriminate between trans fats and naturally occurring saturated fats.  The balance of the research shows clear benefits to the various fatty acids found from fat sources as varied as coconut oil, palm oil, tallow (beef fat), lard (pork fat), butter, milk, etc.

Oh, and I'd only stay away from lowfat milk and lowfat milk products.  Whole milk causes a moderate increase in insulin (30GI) along with a parallel increase in glucagon (an antagonist of insulin) leading to nearly perfect digestion and allocation of sugars, fats, and proteins within our bodies.  Yes there are some sugars (mostly lactose), but the fats and proteins seem to be more than enough to balance things out.  Assuming you can tolerate the lactose and don't have serious damage to your intestines (celiac disease and crohn's disease would both qualify), milk is very nearly a perfect food (along with eggs).  IMHO, of course.

I pick on wheat specifically because, after obvious poor sugar-rich choices like candy and soft drinks, wheat constitutes 90% of the problem in the modern diet.

I am also not so ready to embrace unlimited saturated fats. I do not think we can dismiss the mounds of observations that have tied saturated fat consumption to heightened cancer risk, even in populations not exposed to trans fats nor to processed carbohydrates. Whether it is saturated fat specifically, or something that travels with saturated fat is not entirely clear, but unlimited saturated fat is, in my view, an invitation to adverse effects. This has also been well-documented in in vitro observations.

In any study I've read that comes out strongly against saturated fats as a category, there are significant problems, from failure to eliminate trans fats as a confounder to inaccurate data gathering (diet questionnaires, etc.) to completely inadequate sample size (17 samples with one worse outcome = conclusive?).  I misstated when I said that this was a problem of older studies.  This is a problem of modern studies as well, especially those most interested in finding problems with unprocessed foods and unprocessed fats.

The giant EPIC study currently going on is a perfect example of this.  They have no ability to discriminate between trans fats and saturated fats in their data, and yet various analyses based on early data have been quite willing to conclude that saturated fats are bad for you.  Science this shoddy should not only embarass the authors but the journals that let it slip by without effective criticism.

As for in-vitro studies, I've only seen one recent study that focused on this area, where it was claimed that safflower oil inhibited the anti-inflammatory effects of HDL less than coconut oil.  Except that the scientists forgot to isolate out one gigantic difference between the two oils: Vitamin E.  Which is present in safflower oil, and is not in coconut oil, and is already known to have multiple, significant anti-inflammatory effects.  The authors also failed to note that their flow-mediated dilation data strongly indicated regression to mean.  Despite these issues (and others), the authors were willing to suggest that oils from 15 different food types should be minimized in our diet solely based on the presence of saturated fatty acids in those oils.  These types of scientific failures would be funny if they weren't so common.

Dr. Davis, there's a lot of bad science on fats out there.  I know your time is precious and reading between the lines on studies is quite time consuming, but you already know to be careful what you accept at face value.  Please be willing to apply the same critical razor to dietary information that you already apply to cardiac information.  I think you'll come away with a much more charitable view towards saturated fats from whole food sources.

On the question of how to replace bread and pasta...

I'm Italian too and grew up on pasta.  The big secret to low-carbing is discovering the flavor is in the sauce, not the pasta!

I stirfry shredded cabbage as a base for cream-type sauces and stirfry shredded zucchini as a base for tomato-type sauces.  Both are yummy.

I make lasagna-in-a-bowl sometimes.  Mix some ricotta with chives, top with sauce and mozzarella and nuke.

Another option is soba noodles.  Many brands are made of both buckwheat and wheat, but some are all buckwheat.

I make an Italian sausage soup, heavy on the peppers, onions and garlic with loads of other veggies added too.  It's REALLY good stuff, you don't at all "miss" the pasta.

My primary anti-bread strategy is eating too much other food to miss it!  

Basically... think of how Subway serves the same stuff on top of a salad instead of a sub.  If you have a big plate of mixed greens,  tomatoes, cucumbers, onions, peppers and olives to go with your ham and cheese, you won't miss the bread much.

There's also the notion of doing lettuce as "bread" for a sandwich.  Roll-up the ham and cheese in a lettuce leaf (romaine holds up best).  

If you're trying to avoid *carbs* as opposed to wheat, there are low-carb tortillas, wraps and crispbreads that are mostly fiber that work as bread replacements too.  I'm a whole foods advocate so try to use these rarely myself.  

But when I really, really want a pizza, a low-carb tortilla topped with sauce, mozzarella, garlic and pepperoni bakes up like a thin crust pizza and satisfies the craving with minimal carbs.

You didn't ask, but the typical low-carb replacement for potatoes is cauliflower.  You cook it and mash it up with some sour cream or cream cheese or butter and maybe some chives or roasted garlic.  

Or grind raw cauliflower and "fry" patties of it into "hash browns".  

Add some whole florets and some mashed cauliflower to soups and stews to "thicken" like potatoes do.  I make an awesome clam chowder with cauliflower!

After over a decade of low-carbing, I am convinced the *real* secret to doing it in a satisfying manner is to get VERY creative with non-starchy vegetables.

Dr. Davis

How does one teaspoon a day opf Carlson's cod liver oil sound to you for good health?

Thanks