Doctor Davis, for those of us who aren't inclined to bake our own bread, but who still like sandwiches, are there any commercially available breads (or bread substitutes) that you would recommend?

Jim Purdy
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Did you check your blood sugar at 2 hours? There are times when my BG spike is later than 1 hour.

Very interested in hearing about everyone's experience.

Interesting, but assuming that the einkorn bread contained the same amount of carbohydrate as conventional bread (if it contained less, then this effect is hardly magical) then one would expect a similar effect on blood sugars ultimately. Perhaps einkorn bread simply left you with higher blood sugars at three hours?

What do you think of displacing wheat in favor of coconut? The following text is a blurb for a cookbook (of all things!)...

"Are you allergic to wheat or sensitive to gluten? Perhaps you avoid wheat because you are concerned about your weight and need to cut down on carbohydrates. If so, the solution for you is coconut flour.

"Coconut flour is a delicious, healthy alternative to wheat. It is high in fiber, low in digestible carbohydrate, and a good source of protein. It contains no gluten so it is ideal for those with celiac disease.

"Coconut flour can be used to make a variety of delicious baked goods, snacks, desserts, and main dishes. It is the only flour used in most of the recipes in this book. These recipes are so delicious that you won't be able to tell that they aren't made with wheat. If you like foods such as German chocolate cake, apple pie, blueberry muffins, cheese crackers, and chicken pot pie, but don't want the wheat; you will love the recipes in this book! These recipes are designed with your health in mind. Every recipe is completely free of wheat, gluten, soy, trans fats, and artificial sweeteners. Coconut is naturally low in carbohydrate and recipes include both regular and reduced sugar versions. Coconut flour pres many health benefits. It can improve digestion, help regulate blood sugar, protect against diabetes, help prevent heart disease and cancer, and aid in weight loss."

Dr. Davis,

Unfortunately, all your test showed is that the einkorn digests more slowly than the other wheat. You might have seen the same result with a sourdough white bread.

A more reliable test would have tested at 1.5 and 2 hours, but because you have normal insulin production you would have to have measured insulin to see what was really happening.

All carb would have eventually been digested, and it takes the same amount of insulin to process it. While it's good to avoid blood sugar spikes if a person is insulin resistant the einkorn will provoke a large though slower insulin release.

This is the problem with the whole idea of the glycemic index. If the problem is insulin, the SPEED with which it is secreted really is a red herring.

What about the blood sugar level after 2 hr? 3? 4? Could it be that, like pasta, the einkorn bread gives a steady medium-high blood sugar for 3-4 hours, while normal wheat gives a spike yet quickly falls down to base level?

In my opinion, the AGE threshold is ketosis. In ketosis and there's little to no AGE production, out of ketosis and there is AGE production. Then there's the bit about ketones directly stimulating junk protein aka AGEs recycling and it becomes obvious what the threshold really is.

Excellent points about the delayed blood sugar response with einkorn.

Yes, indeed. It would have to generate a longer blood glucose curve, as DM suggests, it is still a carbohydrate, though I did not specifically test this.

David--

I wasn't aware of using coconut flour in place of wheat flour. Interesting!

Have you tried it?

I'm with Jenny about the insulin thing. If we only know BG numbers, we still don't know whether it's because there's more carbs in einkorn or if it digests more slowly or something else. We must know how much insulin it takes to bring BG to those numbers.

Incidentally, ketosis (and therefore AGE production and clearing) is also a function of how much insulin is flowing, not a function of how much blood glucose there is. So I guess you'll have to measure insulin to know what's what.

No, I have yet to try coconut flour. In an odd moment of serendipity, I received a scanned copy of the cookbook concurrent with your post.

Odd, because for some health reason I do not recall (not allergy, though) I had strayed away from coconut everything. But things change.

So I will share the cookbook with my wife, and request, nicely, we try a recipe or two. We attempt to go wheat-free this week, so I will wait out this test before trying, and then report back.

PS: I receive the results of my lab tests this afternoon. I sure hope the many changes I put into place several months ago on your suggestions changed my numbers for the better!

coconut flour/fiber isn't truly low in carbs, it has 8 grams carbs/ 2 Tablespoon sized serving. 5 grams of that is fiber, which according to some carb-counters, isn't counted as a true carb.

also coconut flour bread tastes absolutely nothing like wheat bread.  i dont think i could convince a wheat lover that coconut flour bread was the way to go.

Reminds me of Dr. Bernstein, when testing his blood sugar after eating various brands of crackers. He did find one that did not spike blood sugar levels - GG Scandinavian Crispbread, made from unprocessed wheat bran. I tried them and liken it to eating a wood shingle (ok, I imagine that is exactly what a wood shingle would taste like). He tries substituting it as bread in a couple of recipes. This struck me as almost sad; our craving and addiction to starch/sugar is mind blowing.

Dear Dr Davis,

Since you are experimenting, would you consider the option of making your own regular wheat bread the way you made the eikorn bread?

Ready-milled whole wheat flour bought from a store differs dramaticlly from freshly milled flour, both enzymatically and in fatty acid quality. Only with freshly milled flour one has a chance to digest non-degraded Pufas (present in all grains).

Regards,
LeenaS

Very interesting. I wonder if they both had the same caloric density. If eikorn has lower calories it would show a lower glucose response. I wonder what your reaction to something like a sweet potato is. I stay away from grains as they don't agree will with me.

About coconut flour, I have used it before for making pancakes. I really like it but I LOVE coconut in general, someone who doesn't like coconut might feel differently about it. An advantage to other nut flours is that it's low in O6.

The Many Uses of Coconut Flour:

http://www.marksdailyapple.com/coconut-flour/

Yeast needs sugar to work properly--just a little sugar or honey would have made the bread rise much better. No sense using yeast if there's no sugar for it to eat.

Coconut flour is okay for brownies, bar cookies, and pancakes.  It would never yield an edible bread.  Gluten-free baked goods are unsatisfactory, IMO.  They have a somewhat crumbly texture, not spongy like wheat.  I have tried coconut, almond, and other gluten-free flours, including grain-based ones sold commercially.  Nothing can replace the spongy texture that wheat gives baked goods.  Save for the occasional bar cookie or pancake made with coconut or almond flour, I've given up eating flour-based products.

Coconut flour is okay for some recipes but functionally speaking it certainly is not a substitute for sandwich bread.

While it is not a grain I still had a weird feeling after eating it. I think it shares the same need as all flour to be fresh milled and used immediately, or fresh milled and then soaked or fermented in some way.

Hi, Leena--

Actually, the whole wheat (not einkorn) bread was made from flour that was freshly ground. I shudder to think what might have happened had it been store-bought flour.

Dr. Davis,

I wonder if you'll try this experiment again, this time with a CGM and periodic draws to find out what your insulin level was.

This experiment, to a more casual reader, provides too much hope (to a person with diabetes) that they can eat bread and still have optimal glucose levels.

Diabetes has been documented in the ancient world it may be that a 'treat' wouldn't harm someone once, but a regular and consistent 'treat' becomes a habit. Poor habits are what precipitate diseases like Type 2 diabetes, yes?

Funny experiment, but as stated by other commenters, it does not say much. And as you have said before yourself: "The best thing is to avoid grain consumption". Some dangers of grains: http://bit.ly/ckgK4E

Dr. Davis, you wrote: “After the conventional wheat, I also felt weird: a little queasy, some acid in the back of my throat, a little spacey. I biked for an hour solid to reduce my blood sugar back to its starting level”

I am very interested to know how biking reduced your blood sugar after one hour. Do you have some ideas as how exercise can actually reduce blood sugar?

In my case, I am pre diabetic and after one hour of intense exercise my blood sugar is very similar to before exercise, above 100's. Nevertheless, after some meals, it could come down to 80’s, how could that be explained?

Best wishes,
Alfredo E.

Where can you buy bread made from freshly ground wheat?!

@Alfredo
I'm prediabetic too and I've discovered a quick and convenient way to lower my BG: I do 50-60 jumping jacks and if it's very high I'll add 20 pushups. It takes about 5 minutes and lowers my BG anywhere from 20 to 40 points in half an hour or so.

The glucose in your body is reduced quickly because anaerobic exercise like that requires a lot of energy and it takes that in the form of glucose. So it's not an artifical lowering of BG like through medication. The body just uses up available glucose more quickly.

Some may worry that such a large BG drop might make them hypoglycemic but I have never had that happen to me even before I was doing this. I'm not on any medication.

Maybe Dr. Davis can elaborate on this a little more. We don't always have time or circumstance to go bike riding to lower our BG and for me this is a convenient alternative.

Dr. Davis-
A friend of mine who is new to GF eating mentioned that her husband's blood pressure has stabilized rather quickly after eliminating wheat. I googled "GF for heart health", and was delighted to discover your blog.    

My family eats grain free, and the only flour I use is coconut flour.  I recommend Bruce Fife's book "Cooking with Coconut Flour" as a jumping off point, because it explains how the properties of coconut flour make it unique to cook and bake with.  You NEED many more eggs than in a traditional bread recipe because that is what gives it a light airy texture, and you also need lots of fats to ensure it is moist.  I really don't do any cakes, cookies, etc because we try and stay low-carb, but the coconut flour has been great for breakfast, because neither my baby or I can eat eggs plain (wish I could, but they make me gag, he does too).  

Coconut Flour Crepes:
Mix
2 eggs
2 TBSP melted butter or coconut oil (if you use coconut oil, the eggs need to be room temp or it will clump up)
Add 2 TBSP of sifted coconut flour and mix again until smooth.  
Finally thin the mixture with about 1/3 cup of water and/or coconut milk
(I use frozen from Asian market, not canned, and dilute it 50/50 with water and a drop of vanilla Stevia)

cook crepes in pan brushed with ample coconut oil.  They are great with just butter.

Dr Davis,

The book Carrie mentions, Cooking with Coconut Flour, is the one I mentioned last week. I have the entire book as a 2Mb pdf file, and am happy to share with anyone interested.

Doctor Davis

i think we are missing a very vital step here that is of fermenting wheat dough (making sourdough wheat). That is THE traditional style of consuming wheat everyday around the world.

The process is neatly captured under subheading Europe:Sourdough Bread.

http://wholehealthsource.blogspot.com/search/label/gluten


That is how entire Indian subcontinent consumes wheat. That is approximately 2 billion people, not counting europe!

I will really look forward to seeing how sourdough wheat plays out in these tests as that is the staple food for the vast majority day in and day out.

Great interview with einkorn wheat producer Etienne Mabille that may interest some of you: http://www.satoriz.fr/les-entretiens/Le-Petit-Epeautre-de-Haute-Provence/article-sat-info-500-5.html (you will have to use an online translation tool if you don't read french)

Hi Dr. Davis,

Interesting post.  I just received my shipment of einkorn today.  I'll be performing a more sophisticated version of your experiment on myself beginning next week and I'll let you know the results.  Just have to get a blood sugar-o-meter first.

Chris

David M Gordon,
is it still possible to get a copy of the coconut flour book?
sue

Tested my wife's BG before she ate a bowl of glutten free cereal 90. 1 hour latter was 308. I sure got her attention!

This is all so true. What makes me even more mad is my Dad is on some cholesterol lowering drug and no matter how much evidence I show against it he does not believe that his doctor would not do what is best for him. Makes me sick when I think about it.

I am currently in a battle with my "preventative" cardiologist.  she just handed me a bunch of Crestor due to a very high Lp(a) and family history of heart disease.  I have gone round and round with her about statins and she was willing to go the Niacin route first.  I was convinced that would work but something very strange occurred.  I don't mind the Niacin flush at all and I did take with food, aspirin, the whole 9 yards.  After being on the Niaspan for 12 days, I suddenly broke out into horrible hives all over my body and now 3 weeks later I still have some lingering rash/hives on my arms.  My diet and exercise program couldn't be better - I walk 6 miles a day, yoga 3 times a week, eat whole foods only, drink lots of water and I am just not sure what to do next.  My Lp(a) number is 135 and my total cholesterol is 267 with a not so good "ratio".  If anybody has any suggestions or comments I would love to hear them!

Judy, make sure you take a close look at the hormones (estrogen, DHEA, thyroid, etc.), as these can influence Lp(a) to a pretty large degree.

High dose EPA/DHA from fish oil is also really important. Consider up to ~6,000 mg EPA + DHA daily.

Consume raw nuts and seeds. Almonds and ground flaxseed are great, and can help in dropping Lp(a).

L-carnitine can help in lowering Lp(a), at least by a little bit.

Not sure what you're including when you say your diet is made up of "whole foods." If this refers to things like "whole wheat," then that's problematic. Based on the research I've seen, those of us with Lp(a) (and yes, I am one of them too) are quite a bit more sensitive to the carbs. Eat carbs, and your Lp(a) goes up. Eat lower carbs, higher fat (particularly saturated), and your Lp(a) goes down. I would be loving on the coconut oil if I were you (and that's exactly what I do).

As for exercise, I would start changing it up. That's an awful lot of walking, and it's not going to create the hormonal response that you need. The real benefit is in the high intensity stuff. Short, vigorous sprints, squats, that sort of thing. Check out www.crossfit.com for some idea of what I'm talking about.

Judy,
I second what David says above--it sounds like good, solid advice.
I would add 3 things to the supplement category--Vitamin C (min 6000mgs/day) L-Lysine (min 6000mgs/day) and NAC, (min 1200mgs/day)
The Vitamin C and L-Lysine combination is I'm sure you know, the Pauling-Rath formula--it's been around a long time, many swear by it, but it's never been clinically double-blind tested.  The NAC, I recently learned, is possibly the most powerful natural Lp(a) inhibitor out there, for now, anyway.  I was so swayed by what I read about it, I purchased a couple of bottles of it to add to Pauling-Rath, since I, too, am sometimes irked by the Niacin flushes I begin experiencing as I get closer to the 500mg dose--and this is after weeks of slowly titrating the dose so that I may avoid that uncomfortable event.
Judy, also keep in mind, I've always read that 1)It's better for women to have higher cholesterol levels and 2) up until a few years ago, a cholesterol level of over 300 was considered high.  Now that '200' is the new '300', there seems to be quite a market for new prescriptions, nu?
Adam

The Pauling/Rath therapy is indeed intriguing. Before I discovered Dr. Davis and the TYP program, I thought that the Pauling therapy was the answer to heart disease.

I now believe and am convinced that there's more to it than that, and I think Dr. Davis has one of the best, most comprehensive programs for heart disease out there.

However, this is not really a criticism, and I remain convinced that there is value to the Pauling/Rath therapy. It makes so much sense, at least theoretically in terms of reducing Lp(a), and it has quite a bit of anecdotal evidence behind it (not to mention the research carried out by Rath, complete with CT scans). It seems like the experience of doctors using this therapy with their patients varies quite a bit, though. Some doctors swear by it, while others say it just doesn't work. It's only for this reason that I usually don't bring it up until I've brought other ideas to the front that I know are very effective.

I've got my dad on the Pauling therapy, along with these other things (basic TYP stuff), and we'll be getting his Lp(a) rechecked soon. Should be interesting to see how much it has come down, though I won't know which factor (niacin, diet, carnitine, fish oil, etc.) is creating the most change. I just decided to hit it with everything we've got.

Oh, and it's the same with the NAC. There are pockets of stunning success, but there's also worry about long term safety and the development of pulmonary hypertension. Is that a real danger? I don't know. I would guess not, personally, but at the same time I'd rather mention the "tried and true" methods first that have the most overall benefit.

I'm glad the Pauling therapy was brought up, here. I think it definitely should be looked into more, and people need to be aware of it as an option that many are having success with.

David

This may be of interest to those who may want to reduce the risk of venous thromboembolism (VTE) with a statin (Crestor):

http://www.usatoday.com/news/health/2009-03-29-statin-clots_N.htm

Statin Crestor lowers risk of deep-vein clots

"ORLANDO — (3/30/09) Researchers have shown for the first time that a potent cholesterol-lowering drug, Crestor, reduces the risk of deep vein thrombosis, or "economy-class syndrome," caused by potentially lethal blood clots that start in the veins and migrate to the lungs, sometimes after long flights.

The evidence, out today, is the latest to emerge from the landmark JUPITER trial, which showed that statin treatments can cut in half the risk of heart attacks and strokes even in people with normal cholesterol levels."

No other medicine has been shown to safely prevent these blood clots, which occur in at least 350,000 people a year and kill as many as 100,000 of them. The standard remedy once thrombosis has occurred is the drug warfarin, which, unlike statins, can promote bleeding.

Statins are "a remarkably benign therapy," says senior investigator Paul Ridker of Brigham and Women's Hospital in Boston. "The thing that's really exciting is that there is no bleeding risk."

Other studies have hinted that statins also reduce clot formation, but their power to prevent deep vein thrombosis was unknown. Ridker and his co-workers decided to use JUPITER to test the theory. A total of 17,802 people were randomly assigned to treatment and placebo groups. They were followed for nearly two years, on average.

Deep vein thrombosis occurred in 34 patients taking Crestor and 60 people who were taking placebos, indicating that treatment reduced the risk of clots by 43%. Ridker says he believes that other statins would also reduce the risk.


What I take from this;

The dose of Crestor in JUPITER was 20mg.  Paul Ridker said that this is a remarkably benign therapy?  I think not, given Dr. Davis' descriptions of intolerable side effects that will inevitably occur to the majority of people at this dosage.  I've never used Crestor, but I have used 10mg Zocor and developed mild myopathy in my legs after only three weeks, so I'll take his word that I would be a poor candidate.

I think the most interesting part of the press release is that JUPITER (like the other statin trials) in no way confirms what mechanism may be behind the reduced risk of VTE.  Could it be due to a lowering of vascular inflammation as indicated by a lower CRP?  That certainly makes sense.  It would be really great to get a definitive answer, since CRP can be effectively managed by other means than taking such a strong statin like Crestor.

AstraZeneca's press release of CRESTOR® REDUCED RISK OF BLOOD CLOTS IN THE VEINS (3/29/09):

http://www.prnewswire.com/mnr/astrazeneca/37394/

AstraZeneca’s (AZN.L)(AZN.N) powerful cholesterol drug Crestor cut the risk of dangerous blood clots in the vein by 43 percent in a large study, researchers said on Sunday.

After being on the Niaspan for 12 days, I suddenly broke out into horrible hives all over my body and now 3 weeks later I still have some lingering rash/hives on my arms.

Took it for a year or so, but now I need it again and my insurance wont pay for it and my other medicines are over $400.00 a month and they want $160.00 more for Crestor. We just can't do it.