Wow, these numbers are wild.  It'd be great to see where they are in six months, assuming a change in diet.

Did you see the WSJ article today?

"Giving Up Gluten to Lose Weight? Not So Fast"

The last sentence is priceless:

“Also, for dieters, going back to gluten after avoiding it can lead to stomach cramps, bloating, diarrhea and other symptoms, at least temporarily.”

If an egg had that effect on you, they'd do a recall.

http://online.wsj.com/article/SB10001424052748703846604575447413874799110.html

great post! would be cool if you could pipe the links to your posts into your twitter account as well (there are online services), so that it can easier be forwarded by followers of you.

The WSJ should give up the diet reporting and stick to what they (supposedly) know - financial news.  

There's giving up gluten and then there's giving up gluten but maintaining a high starch alternative grain  GF diet.   Of course replacing one starch with another won't result in weight loss if one is overweight.  It's even possible to gain weight on such a GF diet.    

Are people really silly enough to take diet advice from "creaky bones" Gwenyth Paltrow?

I watched the WSJ video.  It wasn't bad.  It was mainly ridiculing "gluten-free" imitation products.  The lady recommended eating natural foods that are gluten free.

I am completely baffled by some of the lipid panel numbers I see. She had 7 stents put in but there are many out there seemingly with no problems, with high numbers like that. Meanwhile I have eaten right and exercised seriously for the last 30 years, have never been overweight, always been in shape, had good lipid panel results but suffered a heart attack last year anyway. I just had bloodwork shortly before the attack and once again (as had been the case for years) I was told I was in perfect health. My triglycerides were good as was my CRP and my complete lipid panel. Actually any test I took ever, always produced good results. Even after my heart attack they couldn't get my heart rate up high enough in my stress test unless I ran longer and at the steepest incline. I'm still in great shape.....but I had a heart attack.  I never had a belly or bulge and still don't. 5'10" 169 lbs.  Go  figure.

My results after eight months: http://paleohacks.com/questions/9124/first-post-paleo-blood-work-results

After 8 months and -50lbs  I can safely say that the std American flour/sugar diet is complete bullshit.

I bet that poor woman has forgotten what it's like to feel good. She'll surely feel better with an improved diet. I wish her the best.

Re: WSJ article, I got a stomach ache that lasted two days the last time I ate a chocolate chip cookie made of wheat flour. That's some kind of "temporarily"!

Lipids after two years of high-fat, moderate-protein, very low-carb eating:
Total Cholesterol: 220, Triglycerides: 69,
HDL: 98,
LDL: 108.
I think I'll carry on that way.

After 7 stents and she still refuses to change her eating habits? I think that got my attention more than anything else in your report of this patient. I guess I am baffled on why people do not take charge of their health especially when expert advice is offered on a "silver platter".

Tommy,

Sorry to hear that.  I guess it goes to show nothing is a guarantee.  No matter what we do, the chance is always there.

Tommy, your case only goes to prove that cholesterol doesn't cause heart attacks.  
There is something else causing CVD.
Inflammation from Poly fat and grains seem the most plausible to me.

"Tommy, your case only goes to prove that cholesterol doesn't cause heart attacks.
There is something else causing CVD.
Inflammation from Poly fat and grains seem the most plausible to me."

I had my CRP checked and it was below 4 just before my HA. After taking care of myself for the last 30 years and always doing well in every aspect I really felt backed against the wall afterward. My numbers are very low now (pretty close to 60's across the board) but all of this is more complexed than just numbers.

Hi, Tuck--

That's great!

It reminds me of the USDA's request for public commentary on the food pyramid revision, prefaced by "We don't understand why, after we tell people to increase consumption of whole grains, they keep on gaining weight and becoming diabetic."

42--

Well said!

"eating right" and "taking care of myself" only tells me you were healthy by your standards or by the governments standards.  Most of the people I hear say "I eat healthy" means they eat lower fat but mostly trans fat when they do.

There has to be something causing your problem.  I would suspect what ever makes you extra hungry would be a possible cause.  Maybe it's too low cholesterol.  Agreed; very complicated.  Maybe it's just genetics.  Maybe there's something in the past 30 years that was not right but what?  A lot of maybes there.  Have you had a calcium score?

Tommy-

Do you have Lipoprotein(a)? You sound to me like a textbook Lp(a) case. Better get it checked and address it.

Trans fat? nooooooooo...lol.
No refined crap, no processed anything. Damn...I don't even eat ketchup(sugar)!! I consider AMA snobish about food intake. I had a conversation with a "heart healthy" dietitian from the hospital after my heart attack and she wanted me to have less than 50 g of fat per day (impossible). I told her I go by percentages of total calories consumed and explained it to her. She had no clue and didn't understand it in simplest terms. "Ok what if I wanted to consume more fat and just added non fat calories to my total intake....that would lower my percentage right? Uhhh....what? lol

@ David
I am thinking I may be LP(a) and I have been taking extra Vitamin D as well as a high dose of fish oil. Next cardiologist visit I will discuss Niacin as well as pattern B possibilities.

Tommy, what about stress and sleep?  Stress is a killer...

David, that is my suspicion. It's complicated because a lot of things happened at once at that time. Through July and August I was under stress from problems at work combined with personal family issues. In September i went on a cruise an ate up a storm as well as drank more than normal gaining 14 lbs. (my prior good blood labs gave me confidence ..ha ha ha.) Then I came home, worked out hard and lost all the weight in a week. Then my grand daughter got sick and I was very stressed out about it while my work issues were still mounting. In October I had an argument in the morning before leaving work (I had been switched to an overnight shift)and was stewing when I went to sleep. I woke up a few hours later having a heart attack. The rest is history.

Hi Dr. Davis.

These numbers are awful, but I think a point must be stressed regarding natural vs. industrial carbohydrate-rich foods. These numbers are not typical for normoglycemic folks who eat natural carbohydrate-rich foods.

Avoiding natural carbohydrate-rich foods in the absence of compromised glucose metabolism is unnecessary. Those foods do not “tire” the pancreas significantly more than protein-rich foods do.

Protein elicits an insulin response that is comparable to that of natural carbohydrate-rich foods, on a gram-adjusted basis (but significantly lower than that of refined carbohydrate-rich foods, like doughnuts and bagels).

http://healthcorrelator.blogspot.com/2010/04/insulin-responses-to-foods-rich-in.html

And nobody can live without protein. It is an essential nutrient. Usually protein does not lead to a measurable glucose response because glucagon is secreted together with insulin in response to ingestion of protein, preventing hypoglycemia.

I definitely get the whole low-carb thing, but I think you always use the extreme cases to make your point.  Even dietitians would not recommend that much starch.  In fact, many of the "top" dietitians limit starch quite drastically in their meal plans.  They are not as ignorant as you think.  However, because they have clinical experience (which I know you have too), they know that draconian, restrictive diets do not work.  Therefore, they work starches in the diet a bit, so people don't feel "deprived."  Still they choose "better" starch options like beans (OMG LECTINS!!!).

I do not believe for one second that the majority of people claiming to be eating according to the USDA guidelines are doing so within the correct caloric guidelines.  They are eating far too much and making terrible choices for starches to boot.  Portion control is tough obviously.  I think people who cannot master it may find low-carb useful because they eliminate starches/sugars outright and don't have to worry about serving sizes.  Plus, ketosis gives them a metabolic advantage allowing them to consume more calories and still lose weight.  It definitely is not an end all solution though.

Also, they don't bad mouth carbs in the press because people being people would start avoiding things like vegetables.

There is nothing inherently wrong with carbs.  We just have to eat them within reason.  Just like calcium for example.  Too much calcium is linked to heart attacks and prostate cancer.  But in moderate amounts, it is helpful.

Okay, I went my two weeks without wheat carbs. My results are purely non-scientific, but here goes. I lost 4 pounds, down to 156. I wasn't hungry at all. I didn't have any bread cravings like I thought I would. But I did have a hard time sleeping, for whatever reason.

After my two weeks I had angel hair pasta and a hamburger on a wheat roll. My stomach was slightly upset for a couple of days once I started eating wheat carbs again - probably just a coincidence though.

So I proved I could do it and I proved to myself that I wouldn't starve or go crazy without my bread. So, I think I'll be more careful about the wheat I put into my system. On the other hand, it looks like May needs to correct things and do it sooner than later.

Just goes to show ya. I'd *love* to weigh what Mary weighs - but it seems there is more involved that that. I just had an NMR test recently myself. Total LDL particle count was 2018. My doctor is freaked and says it's a horrible number. Every website I consult says it's a horrible number -though my small LDL is 212, only 10.6% of the total. But all the websites I consult say the total number is far more a risk factor than paticle size.

But what were the HDL and triglycerides of the people with high particle counts. High like Mary's? My own HDL (measured just last week) is 66 and my triglycerides 49.

But how do you get the particle number down? I've already been low-carb for four years, gluten-free for 18 months, avoid all sugars, take D3, magenesium, K2, 1500 mg niacin.

Might it go down if I can get my thyroid normalized? That's one issue I'm still trying to work through with my doctor. Sheesh, the older I get the harder it gets. So many things to consider I sometimes wonder how anyone manages to stay alive for a few weeks - let alone many years for most of us.

So for people with existing coronary artery issues and Small particle LDL is it true that increasing fat (especially saturated fat) only makes this worse? If you go low carb you need to also be low fat?
I read that "low fat" is bad for Pattern A but beneficial to pattern B.

Dr. Davis?

Increased Levels of 25 Hydroxyvitamin D and 1,25-Dihydroxyvitamin D After Rosuvastatin Treatment: A Novel Pleiotropic Effect of Statins?
So statins work their magic (in some way not yet identified)by  increasing vitamin d status and thus obtaining Vitamin D3's important pleiotropic effects that lead to reduced coronary artery disease mortality.

So is this an excuse to make everyone take a statin (that inevitably will have some side effects)to achieve higher vitamin d status or is there a simpler way of increasing vitamin d3 status that doesn't have (at the normal amounts people reading this forum can be expected to require)any nasty side effects?

I think we just need to Follow the Money, to see how this piece of research will be interpreted.

So tell us. How much is too much?

This is an excellent post.

But Doctor Dean Ornish points out that the same argument is made about mono-unsaturated fats being better than saturated fats, and people therefore eat lots of mono-unsaturated fats. He claims that logic is also badly flawed.

I used to be a big fan of Ornish, and I still am, but I do try to eat lots of mono-unsaturated fats from avocados, pecans, and walnuts.

One web doctor says eat no meat. Another, no fruit. Yet another, no dairy. Still another, no grains. So much disagreement tells me that dietary results are anecdotal. Simply opinions.

Some.

No wheat is necessary for a long diabetes-free, heart disease-free life.  Also, there appears to be very little real benefit to consuming wheat, so "some" is too much.

Now that the data which establishes the protective nature of many saturated fats (including animal fats and tropical oils), and the beneficial nature of fats in general, I think that we're on the cusp of discarding Ancel Keys's bizarrely misguided leadership on fats.  Next we need to decide as a country that the FDA (Department of Agriculture) probably isn't the right place to seek dietary advice.

As for Ornish, well, I simply say that he and I start from different premises.

Anonymous,

You are correct about one thing...if you spend enough time on the web you can find a physician or nutrition 'expert' that will support any diet you want to follow.  However, find me another physician that has tested the lipid profiles of thousands of patients, both during a grain based diet and following the elimination of grains, and still tells you to eat them.  

I can save you the time and aggravation, you're not going to find it.  The unfortunate truth is that most physicians you speak to know no more about nutrition than you do.

I followed the low fat high carbohydrate diet recommended by the medical establishment for 50 years.  I put on 80 pounds, developed diabetes type 2 which led me to chronic kidney disease stage 3 along with many other ailments too numerous to mention.  10 months ago I went on an evolutionary diet, high saturated fat and low carb supplementing with high dose vitamin D3, Omega 3 wild fish oil, vitamin K2 and kelp. I have lost 54 pounds, diabetes type 2 cured, my Trig/HDL ratio is now 2.53.  

This is not an opinion it's a fact.

Courageous doctors who are not afraid of ridicule are leading the way to a medical revolution and I am sorry to say that DR. Ornish is not one of them.

It's amazing that for fifty years I was in decline and now I am reversing my health issues.

This health revolution could could cut the cost of health insurance in half if only it would become the national recommendation.  WAKE UP AMERICA!!

Hi, Ted--

Excellent point.

It's as if every aspect of health can be best served by a drug, particularly statin drugs.

While statins like rosuvastatin may increase vitamin D in its various forms by a modest quantity, it is far better to simply supplement vitamin D.

Anon-

So should we just toss up our hands and give up?

Well, that's certainly what Big Food would like us to do--succumb to the tides of marketing and eat what tastes good.

I'll stay out of that line. I'd choose instead to pick the food philosophy that makes most sense. Humans did not evolve to consume pretzels, high-fructose corn syrup, and Cheerios.

This is the best blog ever for cardiovascular, thyroid, and other medical information!  Thank you Dr. Davis!  I respectfully disagree with the idea that complete elimination of whole grains is the BEST or ONLY way to bring about the beneficial health changes (weight loss, drastic improvement in lipid profile, blood sugar, blood pressure, etc).

"Too many whole grains are bad for your health.  Therefore, you must completely elimate whole grains from your diet."...seems like a faulty logic sequence to me.

How about just consuming reasonable portion sizes within the context of a truly balanced diet?  I would bet that few people you see in your clinic actually do this.  Therefore, how would you know if it worked just as well (or even better) than completely eliminating them?  It is certainly one way, but I don't believe it is the only way, and I do not know if it is the best, because I do not understand what exactly you replace the whole grains with.  I am wondering what the "ideal" day looks like as far as macronutrient breakdown and the actual foods eaten.  Would love to see a post about this!

I just received my latest blood test results and was delighted but not surprised to find my triglycerides down from 115 mg/dl to 66 mg/dl, because of your recommendation to supplement with high dose vitamin D3 and high dose omega 3 fish oil.  However, my other numbers have yet to improve very much. In a previous post August 9, 2007 you recommended oat bran to lower LDL to the 60 mg/dl range.  The problem is that I am hung up on the fact that oat bran is a grain product, and because I am totally wheat and grain free I hesitate to eat this.  Am I making a mountain out of a mole hill?  Also my HDL is stagnant at 42 mg/dl and will not budge.

Because of following your dietary recommendations my health has improved immensely.  Diabetes type 2 now cured and a 54 pound weight loss so far.  I will not give up until I get my HDL and LDL to mirror my excellent triglyceride numbers.

Thanks for your wonderful recommendations.  Keep up the good fight.

Dear Dr Davis,

Re the current questionnaire you have about going wheat free and what amount of weight a person lost, I  think you need another option for people who did not need to lose weight but still went wheat free. The questionnaire implies that people go wheat free to lose weight...not everyone does as not everyone is overweight to begin with.

Anne

Dr. Davis

Would you consider dedicating a post to your weekly diet (or even just a couple days)?  I hear the no grains, more mono fats, veggies and fruits thing but I have no idea how to put them together to make a meal since I'm so used to eating wheat products.  For instance, all I can think of for breakfast is eggs, eggs, and more eggs.  What other options are there?  Is dairy bad too?  Thanks!

Billye--

I ran the wheat-free poll as a reason to talk about why people fail to lose weight with wheat elimination, and a reason to talk about what grains fit well into a healthy diet. Coming soon.

DJ

I had diabetes type 2 for most of my adult life. Because of this, according to my Nephrologist, I became a chronic kidney disease stage 3 patient.  Dr. T.  "www.nephropal.com" also told me that millions of us are walking around with kidney disease and don't even know it.  He also said that if I had this program before I contracted CKD I probably would have avoided it. Ten months ago he put me on a wheat and grain free regimen and completely turned my life around.  I don't think that he would mind if I told you that he reads Dr. Davis religiously and believes they are simpatico. Because of this his practice is now based on nutrition coupled with a reduction or elimination of prescription medications including Staten's.  His plan is to be Wheat and grain free, low carb high saturated fat, supplementing with high dose vitamin D3, high dose fish oil, Super K2 and kelp caps.  These two
brave doctors along with many others who came before, are changing the face of how medicine is practiced today.  Yes, the primary offender is wheat.  Before this plan I could never report to you A1c numbers of 4.7, 4.8 and 5.0 over the last 6 months. I know no one who's life style allows them to lose weight permanently without any hunger what so ever.  The freedom of having complete control is overwhelming.  It took me fifty years to finally get it, I hope you don't waste as much time chasing fruitless diets that make you sicker and sicker. Please take advantage of the advise these great doctors provide and talk to your own physician about this plan.  By the way my kidney disease is not only under control, some of the markers are also reversing, miracle of all miracles. MY wish for you is only Good luck and great health.

I'm a zero carber and it's no big deal. You just eat meat and some eggs, maybe some cheese. Don't have to worry about anything else.

I eat about 1200 cals a day, I'm not hungry and I have no cravings. My lipids when doing low-carb were the envy of people half my age.

And I'm not going to stand around waiting for everyone to reach a consensus on what and how to eat. I've tried them all and this is what works for me. I listen to MY body. It tells me when I'm hungry and when to eat.

Dr. Davis, once again - I love your blog! I am a bit confused about the wheat and grain part. To lower cholesterol are we supposed to eliminate wheat or ALL grains?

I am now on a quest to get my nice belly down to a normal size, and eliminating all grains is on my list, including other actions off course.

Thank you again for a well written blog!

Zing!

Here's yet another take

http://www.paleonu.com/panu-weblog/2009/7/1/where-are-all-the-healthy-whole-grains.html

OK...so I'm new to all of this and have to ask what about those of us who start healthy (all the numbers look good), eat a balanced diet that included a reasonable balance of all sorts of food, and exercise regularly/aren't overweight.  On a very pragmatic level, I agree w/ Anne...suggestions for menus/meals, etc would be helpful...especially for those of us with teenage boys who eat like locusts regardless of what you fill them up with (protein, fat, grains, vegetables, fruit).  My personal opinion is that the #1 reason most folks in the US have a problem is that we simply eat TOO MUCH...there is food all around us.  Just eating less would probably solve a lot of our health problems.

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