Whoa, that's a lot of photos of spoons, hah.

I definitely get a worse effect from eating bread (historically, I don't anymore) than I have from eating table sugar (say in coffee or sprinkled on strawberries, neither of which I do anymore, either).

And... is sugar bad?

I can think of tastier options for consuming that much sugar, but only on my cheat days! -Kristie

Wrong. Table sugar is 50% fructose. Does bread starch break down to 50% fructose? Fructose and glucose are metabolized quite differently. The former only in the liver if I understand correctly.

What about bread made from sprouted grains -- e.g., Ezekiel Bread?  I understand there's still gluten in it, but this particular bread actually has a short, easily understandable ingredient list -- seems far better than the highly processed "whole wheat" bread out there.  Any thoughts?

Bread does not equal sugar. This is a too simplistic Doc, and you know it.

Of course we all know that bread starch does indeed break down as glucose in the body, but there is so much more to bread than just that. Of all people, in the entire blogosphere, I would expect this post from you the least. You know ALL about wheat and bread. You post more on wheat than any other blogger. Yet you say bread equals sugar. I know what you mean, for sure. I get it, but I would like to suggest to you that sometimes people seriously take you word for word, especially when you have a large following of daily readers that know you're a Doctor and maybe don't understand the differences. Then they are gonna run out and tell their friends and family that eating bread is just like eating sugar.

As another commenter mentioned, sugar is half fructose, and although the fructose is mostly bound to the glucose, some of it still definitely goes into your liver. A huge sugar overload is going to have drastically different effects on metabolism as a huge bread overload. Neither are good for you in any way. The bread comes with all kinds of problems that the sugar doesn't have. I'm not sure which is worse, but they're not equal to each other.

I think I just spurted out a bunch of insulin looking at those pics. ; )

Wow, take a chill-pill folks.

It states in the very first sentence that he is speaking in terms of carbohydrate content.

I don't believe for a second that the good doc's readers only read the headline and then run off making nutritional recommendations to their friends and family.

Thanks for another great post.

Thanks, Cary.

It never ceases to amaze that talking about food is like insulting your mother: virtual fist fights inevitably break out.

I was lumping wheat bread and gluten-free bread together. That is indeed misleading, because wheat-containing bread is far WORSE than sugar. The point I was trying to make, perhaps awkwardly, was that both wheat bread and gluten-free bread are, in effect, large carbohydrate loads. And I didn't insult your mother.

Although 2 slices of bread are generally equivalent to 30 g carbohydrate (although some are less and some are more), they are not necessarily equal to 6 tsp of sugar/2 tbsp of sugar.  The carbohydrate in bread is not all sugar.  Bread, especially whole grain bread has fiber which is an indigestible carbohydrate.  2 slices of whole grain bread have 4g of fiber generally, which you will not find in table sugar.  Additionally, this fiber helps to slow down the absorption of the carbohydrate or sugar in the bread.  Therefore, plain table sugar (just glucose + fructose) is far more easily digested than 2 slices of whole grain bread.  Therefore, from the pov that whole grain bread is not 100% composed of sugar nor is it digested in the same manner as sugar (in terms of their glycemic index/how long it takes for the sugar to enter the bloodstream), it seems incorrect to say that 2 slices of whole grain bread= 6 tsp of sugar.  I understand the logic of your reasoning in the sense that all digestible carbohydrate eventually breaks down into glucose, however, fiber (found in whole grain bread) does not and therefore its erroneous to say that they are equivalent to each other and may be misleading to individuals reading this article.

Was there no point to this post but to keep the blog going and selling stuff?  What is going on here?

What was that you said about my mother?

Did you look at a table of glycemic indexes? Most bread, including whole wheat bread, has approximately the same glycemic index as table sugar.

Reduced/absence of fructose makes the bread less toxic, but I'm guessing this post was written from the perspective of the resulting insulin response - in which case, referring to six teaspoons of sugar is accurate for comparison purposes.

I watched Nurse Jackie this week (or maybe last week?) and the head nurse was 'educating' overweight children.  She named a bunch of candy bars/candies and asked what they all had in common.  A child responded "Sugar?".  "Correct!" she replied.  She then told them that when she wants a snack, she eats "These" - then holds up a box of raisins.  Oh, and the children were all holding apples.

you've covered this general concept in many of your other posts about bread and/or wheat in general. everybody knows that bread is carb heavy. but a carb is a carb is a carb is simply not true. besides that, i think the nasty ingredients in most gluten free breads are far worse than the carbohydrate content of the starch.

We are just blind to many other foods when trying to avoid sugar to save us from diabetes.I think we must consult a specialist to formulate our diet which would be healthy and accurate.

If only it were true that "everyone" knows that bread is carb-heavy, or that starches convert to sugar, or even that fruits are carbs! I asked my brother to tell me what he eats in a typical day. "I don't eat a lot of carbs... For breakfast, two breakfast tacos on flour tortillas and a Sprite, for lunch I just eat an apple and another Sprite, and dinner is maybe chicken-fried [breaded] steak and some cornbread, or maybe mashed potatoes." I asked him if he thought soft drinks don't have carbs, and he said he thought clear sodas "don't count"--just colas have carbs. To say nothing of the flour, potatoes, corn, or fruit.

That's a more typical (mis)understanding of carbs than we want to think. And that's why I dont mind reading posts like this.

There are many ways to skin a cat, as the saying goes.  I, for one, appreciate Dr Davis attempts to get the message across by putting it out there in many different ways and using different analogies.  You never know which description will hit home with someone or at least make him stop and think.

Many times I've come across exactly what Annabel describes - so many people lack even a basic understanding of which foods are carbohydrate-rich.  I was astounded when my husband mentioned that he'd always thought fruits were not carbs (and he's a scientist!).   To him, carbs are starches, only - bread, pasta, maybe potatoes, etc...

I used to eat a lot of bread.  Now, none.  I don't have a problem passing up ordinary, store-bought, mass-produced loaves, but when I'm in a deli or restaurant with quality breads -- well, that's harder.  Still, I know I will get a lot hungrier a lot sooner if I eat the bread than if I don't, and so I don't.  It seems paradoxical that eating more food makes you hungrier sooner; knowing that is the key.

Doctor Davis:  It would be helpful to see a post of how you would construct a daily diet for heart health that minimizes the carbs.  There seems to be a full range of low carb alternatives ranging from Atkins like to Rosedale(high fat), etc.  Thanks,

When I first started following Dr. Davis and the TYP eating guidelines, I had a hard time giving up wheat - hell it's in everything!!!  Plus it's a hard addiction to break.  

Now that I'm wheat free thanks to Dr. Davis' recommendations you couldn't pay me any amount of money to go back.

The debate over glucose vs. fructose is interesting but the only thing that's really important is how I feel.

-s-

I used to be a wheat addict but no anymore.  I've had one wheat product in the last 6 months and since then have lost 30 pounds.  I've done nothing different in my diet or exercise program - just ditched the wheat.  The weight dropped off easily.  Dr. Davis rocks!!!

That is messed up
fresh apples are better for children.  All of us.  Everyone.

But, raisins are a better alternative to candy/packedged/processed food...even organic.  or hydroponic.  I say kids.  Eat the apple.

I stumbled across this blog quite a while ago and remain a casual reader of it.  What attracted my attention is how eliminating wheat was what I needed to do to get rid of my belly.  I have been sorely disappointed!  I am a 60 yo female, 5'7", weigh 132, small frame, have always been thin but started gaining weight around midsection in my 50s.  One year ago I gave up my daily glass of wine, and 8 months ago eliminated wheat from my diet.  That was hard!  I agree that I feel better and the hunger is not as intense, but I have long zero weight.  I walk briskly, as briskly as my bad knees allow (former jogger) every morning.  I eat fruit, yogurt and nuts for breakfast, a bowl of raw veggies for lunch (no dressing) and some protein and more veggies for dinner.  Will I ever lose this 5 to 7 pounds around my middle?  Thank you for letting me vent!

Marianne, you're still running on carbs instead of dietary fat. Most fruit and yogurt and sugar bombs. And without dressing or other fat, you won't absorb the vitamins A, D, E or K in your vegetables. Eliminating wheat is great--and I admire your dedication--but I don't see much fat or protein in your diet. Try adding a boiled egg or two and some dressing to your salad for lunch, some fatty fish or other fatty meat and buttered veg for dinner, and leftovers for breakfast. Give it a two-week trial.

I agree with Lori...not enough fat and protein, too many carbs.

You might enjoy reading Dr.(s) Eades book, "The 6 Week Cure For The Middle Aged Middle."  You should be able to get rid of those 5-7 pounds in a couple of weeks.  At your age, it may be mostly visceral fat, not subcutaneous fat, and visceral fat is far more worrisome to your overall health because it's connected to inflammation.

Joe

Another thing: various studies and a lot of anecdotal evidence have shown that aerobic exercise is ineffective for losing weight. IME, it's just as overrated for weight loss as whole grains are for health. Weight training is better for improving your physique and possibly improving insulin resistance. The Eadeses also wrote a book, along with Fred Hahn, called Slow Burn; Dr. Davis has some posts on this.

That doesn't give us any information about metabolic effects of the food.

Don't eat fruit.  Use some caffeine creme.  Have a cheat day.
When things get confusing, you have to log everything - you will be surprised, thats for sure.

Yes, that seems to be truth. I would go for high intensity training as fast twitch muscles drain glucose much faster then slow twitch muscle, plus, its much more doable given the modern time constraints.

There is a problem tho  - high probability for injury, with any type of exercise. Injury equals to even more sedentary life then before exercise.

In Marrianes case, I guess, however, that lots of effort needs to be devoted to solving menopausal hormonal disturbances which promote weight gain. This is, to my knowledge done with concentrating to food quality rather then quantity.  Supplementation is essential.

Lori, I don't think even weight training will rid her of her "middle-aged middle." Only a proper diet can do that (and pretty quickly, too), especially if it's all visceral fat, as is likely.

Weight training will give her a stronger mid-section, of course, but it'll mostly remain hidden under the fat.

Joe

Agreed--weight training won't get rid of fat, but it'll make you generally firmer.

One thing I really like about Fred Hahn's weight training method is that it's easy on the joints. In the doorknob squats, for instance, your feet are a little in front of your knees and you hold a door knob for support, making for a challenging exercise that doesn't hurt your knees.

Still, I don't think she could do enough ab work to get rid of her "middle-aged middle," which she claims is her remaining objective.

That's going to require a special diet, like the one the Eades recommend, for example.

By the way, the best ab workout, in my opinion, is sprinting. Spend a little less time walking or jogging, and a little more time sprinting (provided you're already in relatively good shape). I'm about to enter my 8th decade, and I'm still sprinting.

Works for me.

Joe

I disagree that wheat is worse than sugar, generally.  

Sure it's worse for celiacs, and others with gluten intolerance.  And sure it will raise worse than the equal "net carbs" of sugar since starch is a glucose polymer.

But sugar is half fructose which is a LOT of fructose.  And fructose is very bad for fatty liver, for diabetes, for triglycerdies, for adiposity, for everything...

On the other hand, this is sort of like arguing whether arsenic or cyanide is worse... doesn't really matter.

Hi, Jpatti--

This is a confusing issue. It is the reason why I wrote Wheat Belly that will be hitting bookstore shelves in early September, 2011.

I believe that, once you hear the entire rationale, you will agree that, not only is wheat worse than sugar, it is the most incredibly bad thing ever created by modern genetics and agribusiness and is responsible for more disease and suffering than any war ever waged.

I'm looking forward to your book.  I had heavy whole wheat bread (plus butter and jam) for breakfast for years thinking I was being health conscious (mostly because it was fibrous enough that I didn't snack till lunch).   How wrong I was!  Now that I've gotten educated on the metabolism of carbohydrates plus the dangers in wheat, I realize how unhealthy that was.

Nice post Bill. People really need to get this info into their heads.

Great meeting you  on the cruise!

Please could you provide links to the interventional controlled (not observational) studies that have shown a link between eating meat and cancer risk, that separate the effect from eating junk food, and the fact that vegetarians are more likely to eat healthily in general than meat eaters due to the widespread and incorrect belief that saturated fat is harmful to health.

Also, could you explain lack of cancer in traditional tribal societies with a high meat intake? You would need to do this before stating that meat intake necessarily increases cancer risk.

Hi doc,

Great blog. How do you explain the Inuit, Masaai, Komi (Siberia), Native American and similar cultural groups whose diets seemed to subsist primarily on animal products? ie. including my ancestors.

Perhaps its an emphasis on wild/grass-fed/raw dairy(or as close to) animal products as opposed to the grain-fed animal products which encompass the majority of the US that you need to be addressing?

Thanks.

Interesting point of view.  Can you please provide references to support your claims?

Great diet, and yes, it seems that we should talk about healthy eating instead of weight loss or diets. Anyway the purpose of any diet is to move your eating habits to new healthy level.

Thanks for sharing and possibility to comment! Welcome to visit Ideal Weight Blog to find some recipes and great articles! Thanks!

Just on the nitrate/nitrite subject: as far as I know nitrate is a naturally occurring compound and the human exposure to it is mostly through  consumption of vegetables, and to a lesser extent water and other foods...

http://www.efsa.europa.eu/en/scdocs/scdoc/689.htm

I would say there are 3 primary pitfalls of low-carb dieting:

1) Being too low in carbohydrates - being in ketosis is anti-metabolic and induces insulin resistance, and probably why Atkins suggested that his diet "tends to shut down the thyroid."  

2) Too much protein - this strains the thyroid as well, and encourages gluconeogenesis, which is also problematic - especially when in ketosis and insulin resistance is extreme.  

3) Extremely high in omega 6 polyunsaturated fat.  Eating a low carb diet with lots of pork fat, chicken skin, peanut butter, and nuts - the typical standbys of many low-carb dieters, provides an astronomical amount of omega 6.

By my best guesses, I was consuming 15+ grams of omega 6 while on a low-carb diet.  I've since cut that back to less than 3 grams per day and the change has been dramatic.  Of course the 400 grams of carbs per day helps too.

Dr. Davis,
Thank you for this post.  I'm certainly culpable of the "common errors" you mention.  I find that making daily decisions on what to eat difficult. I want to eat healthy and have some variety. Here's the question.  What do you eat?  What did you have for breakfast this morning?  What did you eat last night?  What do you keep in the fridge and on the counter to make following your dictates easier.
I don't want to over-think it but all this information is overwhelming.  I feel like a scientist and my body is the research subject.
Thank you for your blog.  I've learned a lot but need some direct guidance.
Sincerely,
Dana Law
San Diego, Ca

Why is "Calories in vs. calories out" a faulty concept?

Have you really read the meat leading to cancer literature carefully or do you just think it's like that? Others like Gary Taubes and Eades (who I really trust when it comes to research) have found no evidence that meat cause cancer.

On sodium nitrate, I totally agree. I get so mad when I'm walking in the grocery stores. All meat has sodium nitrate added. Grrr.

I share your thought about dairy. But do you really mean that butter triggers insulin spikes?

Most nitrite is form your own spit and originally ingested by eating vegetables.  

I believe the epidemiological studies (which also typically find fat to have bad associations...) have more to do with a lack of fruits/vegetables/polyphenols than anything that is bad about meat.  

Also, I don't think glycemic index or the insulinotropic nature of certain proteins matters one lick for people that are healthy.  I can eat a boiled potato for breakfast without my blood sugar breaking 100... I don't think diabetes is an overuse injury - more likely, it is cause by damage to the liver and then pancreas from PUFA and fructose overconsumption.  

I think Matt Stone is correct about the top three problems with Atkins.

If you're really concerned about your nitrite intake, watch your celery, arugula and spinach (and many other vegetables) consumption, too. Nitrites galore. Though it's not nitrites and nitrates in and of themselves that are linked to cancer, it's the nitrosamines that can form from them.

Sodium nitrite isn't primarily a colour fixative, it's a an anti-bacterial agent. Meats cured with sodium chloride only have to be done quite carefully to avoid botulism. Nitrite has been used since the 16th century to preserve meat. Modern cured meats also add sodium ascorbate, and ascorbates have been shown to inhibit nitrosation reactions and thus the nitroamine level in these cured meats is usually at undetecable levels.

Nitrites are produced in our mouths from bacterial reactions to the nitrates in food and water, and at least 70% of our dietary nitrite comes from this salivary nitrite (which came from our food and water). The nitrites and nitrates we then ingest are mostly either excreted fairly promptly or used to make nitric oxide. Human gastric secretions have a pH which isn't condusive to nitrosamine formation, and also include ascorbates which reduce nitrosamine formation, and keeping one's vitamin C at good levels will also have an effect. People with achlorhydria will obviously be more susceptible to nitrosamine formation. But interestingly, there are studies which now suggest that nitrite consumption is a good thing: http://www.ncbi.nlm.nih.gov/pubmed/20005970 - and branched-chain amino acids are also suggested as suppressing the effect of nitrosamines. However the amount of nitrosamines you get from smoking is definitely Not Good, and no amount of ascorbate will ameliorate it.

So, a good intake of nitrates and nitrites primarily through vegetables, some fruit, and some cured meat is good: the vegetables and fruit contain ascorbates as does your body, and most of hte meat should have it added also, minimising the formation of nitrosamines, leaving your body to get on with making use of the nitr*tes to make needed nitric oxide. (Oral nitric oxide/arginine supplements are rubbish though - the studies showing their benefit used intravenous/injected supplement.)

Personally, I'll take nitrites over botulism, thanks.

Hmmm, I've never been on a cruise, but if I did go on one, I'll bet I'd have to eat somewhat differently than I do at home, regardless of the carb count.  Between not having access to the pastured bison and wild game, raw dairy, "backyard" eggs, and organic CSA produce subscription, and so on that make up most of my family's daily diet, and no access to a kitchen, my meals on a cruise would hardly be representative of my usual diet.  

I'll bet LC cruisers are as prone to anyone when it comes to the excesses of endless supply of prepared foods on cruises, but I'm not sure we can assume that's the way they always eat.  Most people  eat somewhat differently on vacation, whether it's because they are on somewhat of a "diet vacation", or because they have to make the best of what's available.  When I was on vacation in Italy I had a gelato every day, but I certainly don't do that at home (it was a conscious decision to take a slight vacation from my diet and enjoy a local specialty for a limited time).  And I've been places where it was impossible to get eggs cooked in real butter instead of the ubiquitous "griddle grease" hydrogenated veggie oil, let alone pastured eggs and humanely produced bacon (seriously, we breakfasted at a tiny roadside diner outside Twenty-Nine Palms that had NO butter on the premises).  

And not all LC eaters are following an Atkin's diet plan, though I understand the Atkins label has become be a generic term for LC eating.  I've read an Atkins book (as well as at least a half dozen other LC diet books).  I eat LC (& GF now) but I've never followed specifically an Atkin's diet plan, nor do I describe myself as at Atkin's dieter.

I think the points you make point out that even on low carb, people can and do still rely on far too much industrial food.  It's convenient and it's everywhere (hard to avoid, esp when dining away from home).  Frankly, one of the reasons cruise vacations hold little appeal to me is the idea of having to nothing to eat all week but cr@p industrial food, no matter how talented the chefs may be at making it look and taste good.   I may be making a sweeping assumption, but somehow I don't imagine that cruise chefs are simmering their own bone broth stocks, curing charcuterie themselves, and making their own cheese (or even sourcing from small artisan vendors  very much).    I'd be extremely surprised if cruise ship food ingredients weren't offloaded from US Food tractor trailer trucks.  That's what I've seen at many land-based resorts.  When I travel,  as much as possible, I want to try the local traditional foods and specialties, prepared as authentically as possible.  That might mean eating more of something than usual (and less, too).

Isn't it also an Atkins diet error that low-carb eaters tend to be on a constant and frantic quest for processed fake food items that are pretend substitutes for the food that got them in trouble in the first place?  And many of them have made Jimmy Moore, a huge hawker of low-carb substitutes and a less-than-successful low-carber, their role model.  

I noticed on Swedish physician Dr. Andreas Eenfeldt's blog that his description of his experience on the cruise was that "[t]he big difference with Sweden is that many are fond of low-carb versions of traditional junk food, sugar, and so. Low carb cake, low carb icecream, low carb potato chips, diet sodas ... In my eyes seemed to just those participants who ate such did not have the same persuasive power of the diet. To put it nicely. Perhaps it was the roundest of them all, the man [Andrew DiMino -- Carbsmart.com?] who handed out the various "low carb" products that are advertising for his company. [Google translation]

People I know who have been totally unsuccessful on Atkins have gleefully loaded up on "substitutes" that probably have derailed them.  And the Atkins company that sells this crap will forever keep the Atkins mantra from the gaining the credibility it probably deserves.

also curious as to how butter could cause a rise in insulin. butter has even less/no carbs compared to cheese, and in previous posts you've said cheese doesnt cause blood sugar rises...

also many health food stores, grocery co-ops, and whole foods and trader joes sell either no nitrate-added or uncured deli meats and bacon. applegate and niman ranch are brands that sell these foods.

Bill you said:

"Excessive consumption of animal products--Non-restriction of fat often leads to over-reliance on animal products. Higher intakes of red meats (heme proteins?) have been strongly associated with increased risk for colon and other gastrointestinal tract cancers. It is not a fat issue; it is an animal product issue. We should consume less meat, more vegetables and other plant-sourced foods."

I don't think this is true Bill. As far as I'm aware, there is no good evidence to support protein as cancer causing. Dr. Eades has debunked this on his blog.

Andrew, scroll down and see the section on conservation of energy for why calories in vs out is faulty: http://entropyproduction.blogspot.com/2009/02/all-medical-science-is-wrong-within-95.html

Ditto what Tim said. My understanding is that it's the whey in dairy that is insulinogenic (tho it's a bit like the glycemic index ... it depends on when and what you eat it with).

Butter should not be as big a problem. One of my go-tos is ghee from grass-fed cows. The small amount of milk solids left in butter are removed when ghee is made.

If you cut out animal protein, dairy, and carbs, there's not much left to eat.

The protein sources favored by vegetarians, beans, rice, and grains, make blood sugar increase too much for people with diabetes.

One can not live on tofu and fat alone, and anyway some people say too much soy is not good.

I don't know why people have a prejudice against dairy. See this:

http://care.diabetesjournals.org/content/29/7/1579.full

If you have a diabetic tendency, it means your beta cells aren't producing enough insulin, so a food that helps them along is good.

Well said Dr. Davis!  We were certainly appreciative of your presence on the Low-Carb Cruise.  THANK YOU so much for all of your contributions...we need to get you back on the podcast later this year.

Too many calories on a high fat diet? Good luck keeping that up. I can't get 2000 most days. Too full.

Why were there traditional societies that used dairy as a staple yet were free of CVD and diabetes, including the super long lived people on the border of Eastern Europe and Central Asia?

Copy and paste the above argument for "eating too much meat."

Low carb may not be for everyone, but the biggest problem with some low carbers is probably too much n-6 from processed meat. Lots of nuts aren't that good for you either.

What is the alternative for animal protein? Soy, gluten,beans, nuts all cause other problems?

Please suggest some sample of improved Atkin diet.

Again Low carb is NOT zero carb. Many atkins folks don't really read the diet. I used atkins succesfully last year and eat more veggies then I ever did. It is not all about meqat meat meat or even high protein. And as much as I enjoy your blog- you still have a huge fear of fat. With Atkins I have improved my metabolic problems.

I've been concerned to learn, here and elsewhere, that dairy products are insulinogenic, particularly since I can't seem to manage a reasonable diet without a fair amount of them.  (Nuts don't do well with me, soy is a no-go, I can only eat so much meat, my family has egg-allergy issues, and the fish that is non-contaminated, sustainably caught, not-BPA-canned, not-fed omega-6 and dioxin-laced stuff in a disgusting fish farm, is wicked expensive and logistically impossible to get fresh for my family more than once a week....)

On the other hand, there are several dairy-reliant cultures that are quite long-lived and healthy, and dairy-consuming people in our own culture tend to be healthier than non-dairy eaters.  So maybe something mitigates the insulin question with dairy.  Just saying.

In the end, you have to eat something, and sometimes reading this blog I feel I can't eat anything.  Like Dana Law, I'd like a better picture of what an ideal, or at least acceptable, day's or week's diet would look like from your point of view.

I've followed Atkins for these last three years, losing 80lbs in the process, so am quite familiar with what's permitted and not.

Atkins did not recommend consuming any milk, nor was much yogurt or cottage cheese permitted. Hard cheese, cream cheese and heavy cream are allowed, but the Atkins diet permits less than 2-3 oz per day.

Butter is allowed liberally, but is 100% fat so can't be very insunlinotropic, if at all.

Because I raise dairy goats, until three years ago, I drank goat milk freel.  Now I never drink it, though I do have a glass of very sour kefir now and then, after the probiotics have cultured most of the lactose into lactic acid.  The kefir I drink is very tart. Most people don't like it that sour. lol

The "Atkins is High-Protein" myth is often bandied about by anti-low-carb groups. I track my daily intake on FitDay and it's usually about 15-18% protein, 65-70% fat, and 10-20% carbs... pretty much what Atkins recommended; even 20% protein is not especially high protein.

My carbs come mostly from eggs, green vegetables, heavy cream for coffee, berries and other LC fruit, and certain nuts and seeds, like flax.  Peanut butter is very carby, and not freely allowed in Atkins.

I recommend reading the old Atkins book to understand what his diet really contains. Read the 1972 version, as the newer books (after 1999) were changed by Atkins Nutritionals to allow low-carb junk food that they conveniently sell.

I don't want anybody to hear "don't eat meat" here.

I think that you should eat meat. I am a former vegetarian and I don't particularly like meat. Despite this, I do feel that humans are meant to be carnivorous. I just don't believe that piling your plate high with animal products several times per day is the ideal way to eat.

Dr. Davis, you sure it was "Atkins low-carbers" you were with?

"Excessive consumption of animal products"

At least with DANDR 2002, as you go up higher on the rungs, meat is replaced somewhat by veggies.  Personally, I eat around 200g of meat per day.  Of that, less than 90g is red meat (the rest is fish.)

"Consumption of cured meat"

I love bacon as much as the next guy, but in even Dr. Atkins stated in DANDR 20002 that one should "try to avoid meat and fish products cured with nitrates, which are known carcinogens."

As for dairy, it's not taboo but still has to be fitted into the carbs you are allowed per day.

This is the second blog post since the trip you have me scratching my head.  I hit your 60-60-60 markers using oat bran all the while being IGT and sporting an A1c of 4.8%.  (And before anyone asks, in DANDR 2002 Dr. Atkins mentions oat bran to bring down your cholesterol levels.)

Dr. Davis says:

"I just don't believe that piling your plate high with animal products several times per day is the ideal way to eat."

Try to do that for an extended period of time. I lasted about 2 weeks. Now I have a very small meaty breakfast, and a modest size meaty dinner, and I'm STUFFED. Been like this for years. Can't eat lunch-not hungry.

You prefer plant foods which is great, but you're not in a carnivore's shoes. From our perspective, what you say is rather silly because many of us actually worry about not getting enough calories! Fat is filling. I'm a 6ft, 165 lb male and I can barely get 2000 calories I feel so full.

Amen to Zach. I'm a PUFA-phobe, and if there's no grass-fed meat or butter in my diet, where am I going to get my fat?
Nuts? (PUFAs)
Soy? (Won't eat it unless it's fermented--like miso)
SUPER-skeptical about your claim regarding insulinotropic dairy. If it is so chronic disease-inducing, wouldn't the Swiss of the Loetschental Valley been prematurely "toes up in the dirt" of the emerald green countryside before Weston Price would have arrived to find out how spectacular their health was because of the dairy they consumed?

Brilliance abounds here: http://www.paleonu.com/panu-weblog/2010/3/18/sat-fat-or-pufa-which-one-do-you-fear.html

Hey, Gretchen,

Thanks for the link!  Good to know, and I was wondering about whether producing more insulin would be good or bad for me.  I had gestational diabetes, so I do have a diabetic tendency.  I'll keep eating my yogurt, then.

Helen

Here's a good take on the conventional "wisdom" of nitrates: http://junkfoodscience.blogspot.com/2008/07/does-banning-hotdogs-and-bacon-make.html

Matt:

"Being too low in carbohydrates - being in ketosis is anti-metabolic and induces insulin resistance, and probably why Atkins suggested that his diet 'tends to shut down the thyroid.'"

I generally find your thoughts to be spot-on, so there's no need to manipulate Atkins' quote to enhance your point.  What he said was that dieting in general tends to shut down the thyroid.

"[P]rolonged dieting [including ‘this one’] tends to shut down thyroid function."

Dr Davis -
Could you please post your "typical" breakfast, lunch, and dinner? I've been reading this blog for awhile (and it's great), and have read a lot of what NOT to eat, but haven't read much on what TO eat. What should our 3 square meals/day look like?

I knew that dairy was insulinotropic, but like Emily, I was surprised to see butter on the list as butter is mostly fat, and clarified butter entirely fat.  As I understand, it is protein-rich foods like beef, chicken, and fish, that provoke unexpectedly high insulin responses, so I thought it was either the sugars or the protein in dairy, not the fat, that spiked a rise in blood sugar.  Is butter really insulinotropic like other dairy products containing lactose sugars and proteins?

Another comment about dairy and weight gain:

I have noticed that melted cheese in particular - a warm, creamy fat with some carbs and protein - is highly palatable.  Full-fat yogurt, whipped cream, and guacamole are similarly irresistible.  I could not consume more than a couple tablespoons of olive oil yet have no trouble gobbling down a few slices of cheese melted onto a piece of chicken or beef.  I'm trying to shave off 5 more pounds to reach my goal, so I've given up all dairy except for clarified butter, which I use to saute veggies.  Will see if this works.

Most of the low-carbers on the cruise seemed to be overweight.  I don't know if some of them were just starting eating low carb.  I think this is what prompted Davis' post.  If you are still overweight doing low-carb - are you doing something wrong? Should slimness be a goal every low-carber can meet (apart from all the other health benefits)?

Hi, Fred!

We had some great conversations. I learned a lot from your "slow-burn" discussions and I've been applying them to my workouts.

Good to see you here! I will be detailing some of the fat/animal product/cancer discussions in future.

"I do feel that humans are meant to be carnivorous. I just don't believe that piling your plate high with animal products several times per day is the ideal way to eat."

I'm scratching my head trying to reconcile these two statements.

How about eating animal products to hunger once or twice a day?

Haggus--

Excellent point.

What Bob Atkins called "the Atkins Diet" was somewhat different from what is commonly practiced as "the Atkins Diet."

As time passes, I continue to marvel at how much he got right.

How high is "too high?" I say this not to be a smart aleck or to overlook the wisdom in "you'll know it when you see it," but this is a bit too vague to be of much use.

Clearly a largely plant-based diet supplemented with a decent amount of animal protein will trump loading up heavily on animal products to the exclusion of plant-based foods. But there's far too many vague generalizations being bandied about by so-called dietary experts these days and not a lot of concrete recommendations that can be tailored to fit a person's unique context.

-Bob Sutcliff

Wow. Echoing a few other commenters, I'd really like some guidelines on what a good diet would look like.

Jenny said: "I track my daily intake on FitDay and it's usually about 15-18% protein, 65-70% fat, and 10-20% carbs... pretty much what Atkins recommended...."

Whenever I read this sort of thing, I get confused. 15-18% of WHAT? the total calories? and if so then how do I translate that percentage into actual amounts (like grams or ounces?)

I'm sure most of you can straighten me out on this once and for all. Thanks!

Dr. Davis,

it would be great after such lengthy and detailed discussions about this topic to give us a typical sample food or meal list for a day of yours.
Looking forward to it.

Renfrew

Fred Hahn: I'm mixed up about your two posts here, "People need to get this into their heads" and "Not true."

I would also like to see a typical day in the life of Dr. Davis.

Anon-  Yes, they mean a % of total calories.  You can figure it this way:

1g Protein = 4 cals
1g Carb = 4 cals
1g Fat = 9 cals

So if a person eats 2000 cals/day and 18% was from protein, then that person ate approximately 360 cals of protein.  Divide 360 by 4 and you get 90 grams of protein.

I agree that there are many low carbers who follow their eating plan less than optimally. I see them posting on the low carb forums I follow. But as one who was also on the cruise, I don't think you can really equate cruise eating with what people eat on a normal day-to-day basis!

I had resolved to eat only "real food" on the cruise, as I almost always do at home, and I had resolved not to snack. And I was pretty good about my resolve. I didn't snack, ate only three meals a day, avoided the flour, sugar, even the sugar-free cheesecake and other things provided.

But did I eat exactly the way I would eat at home? No, I didn't. I undoubtedly ate more than I would have eaten at home, and probably certainly more protein sources than I would have eaten at home. The last night of the cruise I even broke down and had one of the sugar-free margaritas, and I had a half glass of red wine at the comedy show.

And I'm sure my PUFA intake was higher than I would normally like. We had no control over how foods were prepared in the kitchen after all, or very little.

But this was 5 days out of my life, not a lifetime of eating. I didn't gain any weight on the cruise and indeed have even hit a new low this week since being back. Overall I've lost more than 100 pounds.  

I'm not convinced of the meat/cancer link either - though too much protein raises my blood sugar so I don't normal OD on protein much. I was never a vegetarian but often thought I could have gone that way as I'm not all that crazy about meat. But now I have an "It's them or me" attitude and look for meats I  enjoy better - just not too much.

Apparently Matt Stone has challenged my son to try out a super-low-calorie, essentially fat-free diet, based on 1930s research by Evans and Strang, and I'm following his progress with interest. But at the moment it's not for me. I still love my butter and coconut oil.

But we are all so different, and what works for one may not work well for another. But I wonder how many low carbers eat at home the same way they ate on the cruise?

Well said Dr. Davis!

Jimmy this is not at all what you promote.  I am confused by your comment.

Dr. Davis, are you choosing to ignore all those who have asked you to defend your claims (and the great questions asked).  This is the first post I have ever read by you that makes me shake my head.  

Sally Sue

Anon said: "Whenever I read this sort of thing, I get confused. 15-18% of WHAT? the total calories? and if so then how do I translate that percentage into actual amounts (like grams or ounces?)"

Percentages of my daily food intake. I used percentages because everyone has a different calorie ceiling where we stop losing weight. The ceiling calorie limit usually changes as you lose weight; but the percentage of Protein, Fat and Carbohydrates should remain the same.

My daily calorie limit is now around 1500 calories; when I weighed 80 lbs more, it was closer to 2000 calories; and at 2000 calories back then I was losing 3-4 lbs a week.  Either way, the grams/oz of Potein/Fat/Carbs that I eat probably won't relate well to you; but percentages can and will.

By the way, I use a food-tracking program called FitDay, that calculates your food entries into P/F/C, and into grams/oz and percentages, and also gives daily vitamin/mineral counts as well as for individual foods.  It's really quite interesting to compare the nutrition counts of different foods; that way you can see what's really worth eating.  Meat contains a lot more than just protein... it has a lot of essential vitamins and minerals, actually.

FitDay is free online, but the purchased version is much more convenient; I paid $25 three years ago and consider the money well spent.

You should track your own food intake to see for yourself what percentages your current diet contains... you might be surprised. Food tracking, whether through FitDay or some other program, is the single most useful thing that helps keep me on track.

Red meat and intestinal cancer isn't strongly linked.  In fact, it seems to be dissolving under tougher scrutiny.

http://www.medicalnewstoday.com/articles/73040.php

"Recent studies published in the journal Cancer Science have disproved the common myth that consumption of red meat increases colorectal cancer  risk."

Eat for health, not for weight loss. I agree.

However, if, perchance, you believed that you ate for health, yet the same diet kept you fat, or God forbid kept you emaciated, would you really be eating for health then?

Re Anonymous and "percentages."  This drives me crazy too.  Without a total daily calorie count, percentages are meaningless.  So what if I eat "10%" carbs, if I am noshing on 6000 calories a day?

To answer your question: yes, you do have to do some simple math.  First, figure out the number of calories in the given percentage, using a hypothetical total daily caloric intake.  40% of 2,000 calories, for example, would be 800 calories.  A carb has roughly 4-5 calories per gram, so that would equate to around 200 grams of carbs.  Protein is similar.  Fat, on the other hand, has 9 calories per gram.  So those 800 calories would be slightly less than 90 grams of fat.

Once you start doing it, it gets easier.  Practice on food labels!

Anon - most food values are given as a % of calories.  For example if you are eating 2000 calories/day of which 70% is fat, then you're eating about 155 gms of fat per day (2000 x 0.70 = 1400/9 = 155 gms). Fat has about 9 calories/gm; carbs & protein each have about 4 calories/gm.

As for "...15 to 18% of what" that would depend on what you're eating.  Three ounces of white fish (raw) has about 16 gms of protein; 3 oz of beef chuck (raw) has about 28 gms of protein.

Beth:

That doesn't prove that calories in vs. calories out is faulty.  The calories in vs. calories out concept is simply the theory that you will lose weight if you eat below BMR, regardless of what foods you eat.  The Thermodynamics argument is misapplied to this concept, IMO.

Perhaps we are simply thinking of two different concepts.

Some highlighted words from the original post: overconsumption, excessive consumption, and too many calories. The point seems to be that a little rich food goes a long way. Oh, and don't eat food that causes cancer.

Sue said,"Most of the low-carbers on the cruise seemed to be overweight. I don't know if some of them were just starting eating low carb. I think this is what prompted Davis' post. If you are still overweight doing low-carb - are you doing something wrong? Should slimness be a goal every low-carber can meet (apart from all the other health benefits)?"

I was on the cruise and yes, many of the cruisers were overweight.  Some are just starting a low carb lifestyle, and some are not.  I personally have lost over 150 lbs on low carb and maintained that loss for nearly 2 years now.  I consider that a success, however, I am not thin by any means and am working on about 50 more lbs.  I took the advice from many of the speakers, Dr. Davis included, and have worked it into my daily routines.  As a registered nurse, I am aware of nutrition both mainstream and low carb.  I do my research.  I try to eat cleanly most of the time.  Life interferes sometimes, much as is does for anyone who is human and as I know it has for some of the individuals who were on the cruise.  I do believe individuals who are or have been morbidly obese are vastly different from your average American with 30 lbs to lose.  Everything happens on a grander scale.  We lose weight bigger and gain weight bigger.  All I know is I've lost 100+ lbs using the Standard American Diet--twice.  Within a year I gained it back--twice.  Finding a low carb diet has saved my life.  I eat in normal portion sizes, I maintain. Is it for everyone? No.  Is it the only way? No.  But it is one way that works for many people who really need it.  

Thanks Dr. Davis, for your presentation.  I truly enjoyed it.

"Higher intakes of red meats (heme proteins?) have been strongly associated with increased risk for colon and other gastrointestinal tract cancers."

Really? Strong association? If that's true, then how do you explain this?:
http://www.ajcn.org/cgi/content/abstract/ajcn.2008.26838v1

Hilary said:

"Really? Strong association? If that's true, then how do you explain this?:
http://www.ajcn.org/cgi/content/abstract/ajcn.2008.26838v1"

Hilary, I have not formed an opinion one way or the other on this issue yet, but the study you cite was "Supported in part by the Cattlemen's Beef Board, through the National Cattlemen's Beef Association, and the National Pork Board."

Re my question as to how to translate percentages of protein, fat and carbs into grams, I should've have asked my trusted friend "google" instead of taking up someone's time here. So please forgive me.

But Thanks! to those who responded. Your explanations were very helpful.

Meanwhile, I found a site which will do all that computation for me and thought I'd pass it on.
http://www.freedieting.com/tools/nutrient_calculator.htm

Hi I was on the cruise and thoroughly enjoyed it. Sue, Yes I am overweight according to my BMI of 29, I was on the cruise the first year by the second i was 20 pound lighter by the time I got on this years cruise since last year I have lost 54 pound. Yes I am still as you say overweight but I am doing something about it. Sorry I wasn't "normal" for this year but I will be for next year. Snacks were handed out but the message was clear that these are treats and a preferable treat than something high carb and sugar loaded. There were new people there and others who have been doing it a while and of those we are all less than when we started. We had some excellent speakers i.e. Dana Carpender who spends her life educating us how to make foods using our own ingredients she even said you can put weight on eating low carb as we still can make the wrong choices. We all have the same problem with food do we not but we are prepared to be educated by the fabulous speakers who went to help us and gave their time freely to pass on their knowledge.

A big big thank you to them and you Dr Davis

Ailsa who came one the cruise all the way from the UK.

I've been reading your blog for a couple years and really enjoy doing so. I think you've got it wrong on the Atkins diet, though. I don't know where you got your information and I'm pretty sure you didn't read the books. Milk and yogurt aren't on the "diet". Atkins also told you to not eat cured meats. As far as calories are concerned, Atkins also told people to not eat too much! So... I'm having a lot of difficulty with this article in particular & wanted to pipe up. I'll go back to readin' the rest of your blog now. Thanks for all your efforts in keeping this blog up and running. -- Mike

Dr. Davis, have greatly enjoyed your insights on this blog over the year. Have had your book for a couple of years. Have noticed great benefits from your vitamin D recommendations. When is your updated Track Your Plaque book coming out? I thought it was coming out toward the end of last year? Any ETA on it? Very interested in seeing your recommendations as it relates to diet? Typical recommended breakfasts, lunchs, and dinners?

George

This seems consistent with Ray Peat's advice as far as meat meat is concerned- he recommends balancing meat intake with gelatin so as to not get too much iron (hemeprotein afterall) as well as the fact that it has a less inflammatory amino acid profile (muscle is high in tryptophan and histidine wheras gelatin has no tryptophan and lots of glycine and proline...)

Also he mentions that he always drinks coffee when he eats red meat so as to block iron overload even more!

Of course he has no problems with milk, butter and cheese consumption but prefers the latter b/c curds have a better amino profile than whey.

Over the years, I've looked closely at the studies associating red meat with colorectal cancer, and it appears to be impossible from them to separate the effects of modern meat production practices from that of the meat. In other words, it is as likely as not that what's wrong with the red meat is what we put into it, and how it is grown, versus any attribute of the meat itself.

However, whatever the cause of the problem, it pays to at least limit consumption of red meat that you buy in a supermarket.

Hi Dr Davis,

Thanks for sharing your comments. I am a big Atkins Diet follower, and we all need to remind ourselves to keep the intake of "processed" meat & foods to a minimum. Vegetables are a good way to go! Thanks for providing us <a href ="http://atkinsdietinformation.blogspot.com>Atkins Diet</a> followers with such relevant and important information

Cheers,

John

I think it's bizarre to associate ANYONE'S eating habits on a cruise with what their day-to-day life is like.

My normal food would not be available on a cruise: homemade yogurt and kefir made from fresh raw whole milk mixed with berries, pastured eggs with dark yellow yolks cooked in pastured butter, pastured meat, fresh organic fruits and vegetables, homemade chocolate made with coconut oil, cocoa, almonds and stevia... I don't see a cruise line providing food like this.

So, I'd probably do sugar-free cheesecake too, or wind up overeating fresh fruit, just cause there'd not be any of my food there.

When I travel, I do Wendy's burgers using the lettuce as a bun if hitting a drive-through or really crappy salad bars with not much beyond iceberg lettuce.

Sometimes, you do the best you can with the circumstances... cause to eat really WELL, you pretty much need a kitchen.

This article contains huge inventory of knowledge and telling about the diet and what to eat or not.

healthty diet is important..nice article about diet

Thanks for sharing this very useful tips.

Really some truth to the fact that people from Mediterranean areas are seldom obese despite eating a very high fat diet? Did science get it all wrong before? Was there a national conspiracy to force people to eat boring, healthy foods? Thanks for your good suggestion.

Welcome to visit-
weight loss accelerator.
Cheap Calorad

I haven't eaten meat or dairy in long time. Humans don't need meat or dairy. I think meat is disgusting and I'm glad I don't have to eat it. I've seen meat-eaters B-12 deficient, so this shows eating meat doesn't necessarily make someone sufficient in B-12. Methylcobalamin B-12 works great. Eating red meat apparently increases colon and breast cancer risk. I think meat was meant to be an option, just like grains or legumes. Humans were designed to survive on many different things. Plant foods are affordable and bearable for me - meat is not.

Overconsumption of dairy products--Dairy products, especially milk, yogurt, cottage cheese, and butter, are potent insulinotropic foods, i.e., foods that trigger insulin release. There can be up to a tripling of insulin (area-under-the-curve) levels. This is not good in a world populated with tired, overworked pancreases, exhausted from a lifetime of high-carbohydrate eating.

hey guys,
you out there had some great conversations that help me learn a lot from your, atkins diet, "slow-burn" discussions, meat consumption and being vegetarian.

Nice exchange of great ideas, keep going guys and thanks Dr. Davis.

What do you make of this 'physiological insulin resistance' and its role in creeping weight gain on too low carb
http://www.lowcarbconversations.com/344/22-barbara-rose-dean-dwyer-paleo-guy-weston-price-gal-discuss-body-image-more/#comment-306963040

Hi, Lance--

I've not heard this argument before. If you've got the references for the studies showing this effect, I'd be happy to take a look.

In real life, I've not seen this play out. People who restrict carbs, lose visceral fat, drop HbA1c, glucose, and insulin. Maintaining the diet does not, over the years, allow recrudescence of the phenomena of insulin resistance.

Have you ever used a DexCom 7, like Tim Ferriss did for the 4 Hour Body book?

There is evidence that alcohol decreases the blood glucose rise, which may explain in part why moderate drinkers have lower risk of heart attacks. Have you found this to be true?

With all respects, Doctor Davis, but I am at a loss to understand your reasoning behind the suggestion of constructing a 2-hour curve with readings taken every 15 minutes. Invariably after eating, blood glucose level will rise and then fall over the two-hour period. I can control the severity of the "spike" by the type of food I consume. After eating however, I cannot control the shape of the curve without the intervention of medication or physical exercise. This is known. So what additional practical information is provided me from this exercise?
My regards, StanO

Hi! These are my readings using a 1-low carb meal-day approach during months.

day   hour mg/dL
02/15 11:17 74
02/15 12:57 83
02/15 13:53 79
exercise lifting weights
02/15 15:11 93
end of exercise
02/15 15:46 75
02/15 16:22 86
02/15 16:49 83
meal time

As you can see these are my pre-meal levels in a low carb diet, one meal a day approach eating nuts, yogurt, liver, meat, fish, especial atkins bread, butter, chicken, eggs etc..

Next day I change my normal low carb meal for a high carb meal (pasta with a bit of meat) with my morning sugar in these same levels. Lets the party begin.

02/16 13:20 finish pasta festival
02/16 13:29 114
02/16 13:42 103
02/16 13:57 125
02/16 14:06 127
02/16 14:12 137
02/16 14:23 119
02/16 14:36 126
02/16 14:48 130
02/16 15:03 123
02/16 15:15 106
02/16 15:30 112
02/16 15:46 111
02/16 16:11 107
02/16 16:22 105
02/16 16:47 114
02/16 17:21 121
02/16 17:32 120
02/16 18:07 113
02/16 18:21 125
02/16 18:50 110
02/16 19:42 114
02/16 20:21 130
02/16 21:29 112
02/16 23:37 119
time to bed. I also feel like shit.

Next day, do you think the party is over?

02/17 07:20 121 (no)
02/17 12:15  71 (finally, nearly 24 hours of high sugar levels!)
02/17 13:00  84
02/17 14:50  81
02/17 15:57  71
02/17 16:30  end meal (with a bit of wheat bread)
02/17 16:48  99
02/17 17:08 111
02/17 17:27  94
02/17 17:47  82
02/17 18:18  87
02/17 18:42  73
02/17 20:09  78
exercise (please, do not ask what type of exercise and how I can manage to check my sugar in that situation
02/17 21:31  98
02/17 22:01  97
end of exercise
02/17 23:15  88
02/17 00:38  83

Next day

02/18 09:18 79
02/18 10:36 81
02/18 11:38 85
exercise (ski, more aerobic so my sugar levels do not increase to much. Cannot use the sticks due to low temp)
02/18 18:00 80
low carb meal using  whole grain special atkins bread
02/18 18:31 85
02/18 18:47 98
02/18 19:08 90
02/18 19:30 88
02/18 19:45 93
02/18 20:20 87
02/18 20:40 80
exercise
02/18 21:12 92
02/18 21:58 94
02/18 22:26 91
end of exercise
02/18 23:39 88
02/18 01:17 88
exercise
02/18 02:20 93
end of exercise

Next day similar to my first set of data.

"I am at a loss to understand your reasoning behind the suggestion of constructing a 2-hour curve"

Varies so much per person and meal composition.  Some people will get peak even longer than two hours w/ something like pizza that has lot of heavy grease as well as the carbs.  Or if they have any gastroparesis  issues

Hi, Eric--

Sorry, but I don't know what DexCom 7 is. Can you tell me anything about it?


Hi, Kurt--

The effects of alcohol and alcoholic beverages are complex. The blood sugar effect is only a small part of the equation. Among the most consistent effects are reduced blood sugar with red wine, increased blood sugar with beer.

Hi, Anonymous--

Impressive effort!

Incredibly, just about any primary care doc would declare your values "normal," since you don't "need" medication.

You've found the secret: Carbohydrates screw up health galore.

I almost had a wheat relapse today, but what I realized is that I wanted the butter. So, I ate a small bite of organic butter.

Carbohydrates don't screw up health in most people, but they have to be managed properly. Anonymous's glucose spike occurred because he/she surprised the body with a heavier carb load than it was adapted to. It takes a week or so for the body to upregulate insulin sensitivity and glycogen storage ability. Until that upregulation occurs, high carb intake will indeed cause glucose spikes.

Here's my own anecdote. After switching to a paleo diet for a week, I then switched back to high-carb. Upon eating 200g (dry) of cooked oats, my glucose shot up to 195 mg/dL. A week later, I was able to eat the same 200g (dry) of cooked oats and glucose remained below 120 mg/dL. What happened is that my ability to process glucose downregulated when I switched to paleo, then upregulated after I switched back to high-carb. Both the down and upregulation take a few days. It is probably inadvisable to constantly switch between paleo and high-carb. If you plan to eat high-carb, then do so consistently, so that the body is always prepared for high glucose loads.

My recent VAP blood tests, taken after resuming my usual high-carb regimen, show HDL=66 mg/dL, LDL=61, VLDL=12, Trig=45, Lp(a)=15, HDL-2=23 (most protective HDL greater than Lp(a), thus counteracting the latter), and type A LDL pattern (mostly large buoyant LDL). CRP was .16mg/L, which is very low. Laboratory measurement of fasting glucose was 85 mg/dL, versus 84 for Reli-On Confirm home glucose testing device measured that same morning (the Reli-On device thus appears to be accurate). These results hardly suggest that a high-carb diet necessarily screws up health.

There is also plenty of other evidence that carbs are not unhealthy for people who are lean, get daily exercise, don't have an underlying illness, and eat mostly unrefined carbs. All sorts of primitive peoples (Kitavans, Tarahumara indians, Bantus,  traditional mediterranean people's, etc) eat high-carb diets and have very low incidence of diabetes, heart disease and other chronic illnesses due to diet (they may have chronic illnesses due to parasites).

Depression a variable: Japan 2010 journal "Anti- Aging" showed affect on blood glucose in 5 hour glucose(75 grams) tolerance test on a clinic's depressed in-patient (woman age 36). The articles authors conclude a "very low saccharide diet" is better for the brain, which runs fine on ketones.

Fasting blood sugar = 74
30 min post glucose = 97
1  hour  "    "     = 78
   (coincides with insulin peak)
2 hour post glucose = 54
   (27% below fasting blood    
    sugar)
3 hour post glucose = 99
   (insulin less than 1/2 of
    30 min. insulin & 1/3 of
     2 hour insulin)
4 hour post glucose = 75
5 hour "     "       = 80

I have a big question here.
I persoanlly have my peak at 30 minutes. So my question is:
Is it a BG of 140-160 after 30 minutes if after 60 minutes it is under 100 too bad?

@Might-o'chondri-AL: Can't understand the logic of low-carb for depressed people. High-carb boosts serotonin. The only reason I could think of prescribing low-carb for a depressed person is because they are overweight, and the excess weight is partly responsible for the depression (inability to move about and exercise due to morbid obesity, for example).

revelo, thanks for some sanity.  Reading these blog posts and most of the comments that follow is depressing.  They would have everyone believe that their inability to handle carbs is representative of normal, healthy, individuals.

Maybe they need to get healthy, and then they can actually eat whole-food sources of carbs and stop being so scared and go and live life.

Hi Revelo,
I've got nothing against carbs & am still learning (I eat carbs); your blood profile seems excellent enough to trade for.My thinking on your approach is: that you may find, like me in my 20/30/40s + years, care free
carbohydrates are fine and by
the time hit 60 there's the unforseen to adjust to. The famous quote is: "Old age ain't for sissys."
  
So, back to Japan ....
Psychiatric clinic tested 2,000;
detailed one to show how variable blood sugar/insulin expression is in depression. They claim to have got her off meds and adressed low neuro-transmitters of depression; which clinically they say (depression) is common in metabolic syndrome.

Their flow chart for seratonin is dietary amino acid L-tryptophan as substrate with folic acid, iron, niacin and enzyme tryptophan hydroxylase; yields, 5-HTP with vitamin B6 and enzyme 5-HTP decarboxylase; yields seratonin (which in it's own right is the substrate for
magnesium and SAMe to make into melatonin). I'll skip their GABA and dopamine flow charts.

This was a geriatric symposium paper, so focus was on brain down the line. Their pitch was for preventing cognitive decline;
and that ketones protect the brain from Alzheimers and Parkinsons - just as ketones diets do help in
epilesy and other mental disorders.

They specify that in the brain beta-hydroxy-butyrate (ketone) ups utilization of circulating oxygen more, decreases CO2 in tissues from glucose "burning", and ketones make ATP more efficiently too. As for the mitochondria, they continue to get their essential glucose molecules from gluco-neogenesis.

My impression is they're showing that in geriatrics the potential
accumulation of what Doc's blog
warned about, namely  A.G.E.s
(advanced glycation endproducts)is a risk factor for Alzheimers, etc. The authors conclusion was the central nervous system used ketones just fine;and carbohydrates were not required for old people to have good levels of circulating blood sugar.





sowed data for 1 depressed lady

Dr Davis: Two comments were made asking for your reasoning behind the suggestion for construction of a 2 hr curve. To me the comments are politely made. They are appropriate in my opinion and they deserve a response. It is obvious that you chose deliberately to ignore them.

Your commentary is followed and I expect influences countless readers; some possibly obsessively, ie healthy individual who performed more the 75 glucose checks over a few days time.

With your efforts to maintain this blog come added responsibilities to its readers which you currently are ignoring.

Shame on you.

Anonymous: Your response to this blog is somewhat emotional and critical. Perhaps you could be open to the idea that some people can consume a high, unrefined carbo diet and be healthy; others will suffer adverse effects on a high carbo diet and need a more protein based or mixed diet. For those individuals that are carbo sensitive, there is good dietary advise on the blog. I do not currently test my blood sugar. I do not want to become myopic about health; however,I don't judge others on this blog who want to pursue this strategy even if they are not insulin resistant, diabetic or pre-diabetic. Moreover, I may have to resort to using a monitor in the future. The blood sugar data from another "anonymous" is very interesting and certainly provides real data for determining his or her dietary choices. Please keep an open mind and avoid insulting comments like "shame on you" which add nothing to the dicussion and are meant to insult not to educate or enlighten others.

DexCom 7 is a "continuous" bg monitor for home use. http://www.dexcom.com/products

I have been eating Dr Fuhrman's diet and lately, typical meal contains 3-4 cups chopped leafy greens, 2/3 cups cooked beans, about 2/3 oz raw seeds/nuts, 200 grams starchy root veg, one piece of fruit (most often an apple).  Peak postprandial sugars for me come very close to one hour after end of meal and are in low 120's to high hundred teens, back to fasting by 90-120 minutes Usually 90 minutes).

why do you think that post meal levels of 120 or 140 are "normal"? Simply because are the levels that people get when eat a lot of carbs in a meal.

You body do not like this levels, that is why it try to put them down using insulin. Why is your body doing that if they are "normal levels"?

If you check my levels in the 4 reply you could find that when you do not eat for longs periods of time your body try keep your sugar between 70 and 90. If you are relaxed the level could be in the 70 zone and if you do some exercise it will go to 90 zone. Why your body do no increase it to "normal levels" of 120-140? Probably because this levels are not "normal".

So you have a high carb meal. Your body react to it trying to keep your sugar down, why?. Yes... your body is stupid and doesn't have a degree in nutrition so cannot understand the science behind this "normal levels".

When you body finally got the 85 level your dietitian says that you need to have another high carb meal. So your levels return to 120-140, and you ignorant body starts to reduce this "normal level" to 70-85. When you got that level is time to have another high carb meal, and your ignorant body returns to do the same trick.

Years of doing that and your body cannot maintain the true normal levels your doctor says that you need to do some exercise to well... reduce sugar levels! and of course still doing 5-6 small high carb meals a day.

So now you need to run the New York City Marathon to get rid of all that carbs in all that meals your are eating during the day.

Of course you need increase the carbs in these meals to have energy to do all that exercises. In one of those healthy marathons you also take a high carb drink to... well... you know.

It doesn't work, you end eating more than before because your body needs more energy to run all that healthy marathons and you are all the day hungry.

Later your unscientific and stupid  pancreas collapse and your doctor says that you need to maintain your 34646464 high carbs meals a day, but take some insulin to help your body to reduce all the sugars YOU ARE EATING EVERY 3 HOURS.

Probably our pancreas simply commit suicide because is not able to understand our rock solid science.

Can someone explain to a non-scientist what "up-regulate" and "down-regulate" mean?  Peter

A couple of people have asked why construct your own glucose curve so I thought I'd throw out my thoughts on it.  Every person's glucose will peak at different points either due to slower stomach emptying or a slower absorbed carb or whatever. I have read that many people will peak at 75 minutes.  So if you are trying to get a real idea as to how your body reacts to glucose/insulin then you need to test frequently to find YOUR personal peak.  Then you will know when to test when you try new foods.  Is that others understanding too?
Char

This blog post is so full of Fear, Uncertainty, and Doubt.  People asking questions due to being scared by Dr. Davis' suggestion of "constructing your glucose curve", so they ask him questions in the comments, like what their "glucose curve" should look like.  People thinking now they better be jabbing themselves 15 times after a meal.  Thinking about a meal for hours after a meal.  Guilt for eating that meal.

So Dr. Davis' response?  IGNORE THEM and put up a new blog post with MORE scare-mongering:


Now you should fear the banana!
http://www.heartscanblog.org/2011/02/american-heart-association-diet-makes.html

"Would you like a banana?"


What a joke.  Show us a single person who got fat off of bananas OR potatoes, or any whole food carbs.

Hi Peter,
Up-regulate is an action on a gene that makes it do more of what it's capable of doing. And down-regulate is when a gene is being acted on in a way that it will do less of what it's capable of doing.

A gene can be overactive or underactive. Depending on the dynamic, of how a specific gene ideally should be doing, regulation up or down is desired.

Here is giving nice tips. Thanks for its. I the way you explain us.

Hey there Dr Davis,

Created my own glucose curve as part of my own research and actually got a bit of a scare!

I was doing a high carb meal to try and demonstrate an early carb spike then drop.

While I didn't get the response I was looking for I got something a bit scarier. A fasting glucose indicitive of pre-diabetes reading instead. I am amazed how one bad meal was able to send my sugar awol over night.

Back onto low carbs for me.

Thanks for helping open my eyes to my potential diabetes.

Dr George