I think it's kind of funny sometimes reading low-carb forums and recipe sites.

It's incredible how much time they spend on inventing all sorts of "gluten-free" or "low-carb" cakes, muffins, pancakes and all sorts of stuff that definitely doesn't look healthy even though it might technically be "gluten-free or low-carb".

These things surely aren't the real, wholesome foods that we need to be healthy. Like you say, good as rare indulgences though.

This is spot-on.

What are your latest thoughts on Einkorn flour?

I think the paleo/primal people have it right - remove all grains and processed foods.

Don't substitute a SAD for a GF SAD.

I started to heal when I removed gluten, but doing even better grain free and sugar free.

When i read the ingredients of a shampoo and hair styling products i saw wheat protein. Is this safe applying to my hair?

I started a Paleo/Primal version of tastespotting and while most people have submitted Paleo friendly recipes, I was really surprised at how many recipes we have had to reject because they were Paleo or Primal remakes of some kind of dessert or bread.

Hi, Kris--

I agree. A return to real, whole food is the right path.

Interestingly, I was recently strongly encouraged by an editor of a forthcoming book I'm working on to develop wheat-free, low-carb recipes. I also walked down this path, having to develop recipes that mimicked wheat-containing dishes.

After a 3-month exercise in cooking, cooking again, with several disasters along the way, I continue to believe that these wheat-free, low-carb dishes like "breads" and "muffins" are, at best, meant to be occasional indulgences.


Hi, Tuck-

Thanks.


Hi, Vick--

I continue to believe that einkorn is an interesting replacement for wheat for some, but not all, people.

It raises the question: Are humans meant to consume wheat at all, regardless of form? I believe that most people can get away with occasional consumption of einkorn, but that the majority of people cannot safely consume modern dwarf Triticum aestivum.

I classify einkorn not too far from gluten-free foods: it lacks many of the immunogenic properties of modern wheat, but it still a carbohydrate.

Ideally, I continue to believe that the ideal diet is something close to what Anne is articulating.

Doctor,
How often is "now and then"?

Personally, I eat a one or two small bread rolls on the Sabbath and that's the extent of my wheat consumption.  Does that count as "now and then"?

There are recipes for flax bread made from flax seed meal. Here is one example --
http://lowcarbdiets.about.com/od/breads/r/flaxbasicfoc.htm

I started using Coconut or Almond flour for the occasional dessert type dish with excellent results.

Problems though with making a sauce since there isn't a real substitute that thickens correctly. I rely more on home made-legal marinades for flavor.  

Now that I have been grain free since May, I find any exposure will cause intense illness that lasts for hours.

Hi, Ari--

Provided you have no abnormal celiac markers to wheat, occasional consumption likely has no adverse consequences beyond the "re-exposure syndromes" of gastrointestinal distress, asthma, joint paints/arthralgias, and transient behavioral effects.

There is no threshold to stay below except to individualize your exposure tolerance by such things as blood glucose control, expression of small LDL, triglycerides, etc. Most people can get away with one a month or so exposure.

Long time "listener" first time "caller". Dr. Davis, thank you so very much for all the info you provide here. I am a 42 yr old 4th generation Type 2 diabetic. Six months ago I largely gave up wheat (still have pizza on occasion) and it is the ONLY thing that has EVER dropped my A1c since diagnosis 7 years ago - despite adding medications, etc. It dropped from 6.9 to 6.6. I am currently under an endo's care and am shooting for 6.0 with some tweaking and fine-tuning. As a younger diabetic, I plan to live a long life with this disease so good control is vital to me.

I also wanted to thank you for the info on Vit D. I requested that test and found out I'm deficient - at 20 and 28 is the cutoff to normal. I know now that I had some pretty major symptoms of a deficiency - odd muscle pains, unexplained bone pain around January every year, etc. Not a huge surprise I'm deficient since I live in South Dakota and now coat myself in sunscreen thanks to basal cell carcinoma. My GP wanted me on the VitD2 horse pills to correct the deficiency but I refused. I raised it 8 points in 4 weeks by taking 1000iu/day of Vit D3 gelcaps (I metabolize meds extremely quickly so started small). Nobody could believe it. I did I am taking 2000iu/day now and shooting for a much higher, normal number.

Heart disease is the cancer in both sides of my family so your blog is a Godsend to me. Thank you so very much for the information you provide on this blog.

How do you feel about arrowroot as a thickener to replace cornstarch, etc.?

Hi doc

I have vit d level of 16 but blood calcium of 10. How much milk can i drink daily and what should be my starting dose for vit d

Prachi: Try
D3(IU) = Weight(lbs) * 40
For example, a 150 lb person would take 6000IU D3 per day. Works well for many people.

I have heard from others (on Dr. Bernstein's diabetes discussion forum) that Konjac flour works well as a thickener, without affecting blood glucose levels.

Hi,Jeanne--

Way too much carbohydrate in arrowroot.

Shottle makes a good suggestion: konjac root, similar to that used to make shirataki noodles.

I've got a question..it's not really germane to the blog post but here goes:  I've given up grains, only using natural organic products when possible, take CLO, and a myriad of vitamins including magnesium and all the rest.  I just started taking MK-7 about a week ago and noticed within 24 hours my blood pressure dropped substantially, my energy surged, and my mood has increased a ton.  Can I attribute this to the MK-7 or am I just experiencing a quasi-manic / placebo effect state?

Dr. Davis:

I see einkorn as a great choice when you feel you have a need for that slice of bread or waffle.  When you slip and feel you need a grain... choose einkorn.

I make a small loaf of bread that is sliced and then frozen.  It lasts my wife and I a minimum of 2 weeks.  

We treat as a good choice when we are going to fall off the wagon.

Hi Dr.D,
In your reply to Ari, you mention "re-exposure" syndromes. IMHO, these represent gluten or wheat intolerance and certainly excludes gluten in those testing positive for celiac.
However, even in the non-celiac gluten sensitive population, new studies show damage occuring to joints, increased risks of lymphoma,neurological changes, just as if the person was diagnosed celiac.

Cutting edge wisdom believes if you have any symptoms or re-exposure symptoms you should eliminate it before you either : 1. become celiac 2. develop an autoimmune disease, or 3. neurological damage.

BTW, I agree wholeheartedly with avoiding the gluten free food traps. SO many fall headfirst into them.

More people from the Celiac sites should read this post.

I've found this to be a highly pertinent article for me, gluten-free for four and a half months now. We recently got a new supermarket in town with a big gluten-free section, and bless their hearts, I had several friends tell me about it.

But going there and reading the labels reveals they are very high in sugar and starch; so as a happy low carber, they do me no good at all!

I've gotten a new mixer and am exploring the many ways of Rev Rolls, instead.

Tried to go wheat-free several times, but the withdrawls including insomnia, constipation, head buzz and brain fog, were hell and I gave up. Each time I ate gluten-free breads. Has anyone else experienced this?

I saw lots of people who are getting better after how many days because of gluten free diet and even sugar free. Most people are following the most recommended diet and its gluten free and dairy free.

I am not a fan of any drugs, and as a result, I change primary care physician regularly, usually after two visits.
ON THE FIRST VISIT, I explain to the new doctor that I do not, and will not, take prescription medications. I explain that the only reason I am in their office is to get orders for lab work, so that I can review the results and make my own decisions about lifestyle changes, especially diet. The doctor then calls me" non-compliant" and prints numerous computer-generated prescriptions anyway. Obviously, it is the doctor who is non-compliant, since I have already said I do not want drugs.
ON THE SECOND VISIT, the doctor asks, "Have you been taking your medications as ordered?" When I tell the doctor again, as I did at the first visit, that I do not take medications, the doctor says, "You're crazy and suicidal." I then find the next doctor, and the cycle starts over.
As I see things, I have two choices when I feel ill:
1. I could attack my body with some bizarre BigPharma chemicals that our ancestors' bodies have never dealt with in millions of years of evolution (Oxycodone, hydrocodone? Really? Are doctors nuts?).
2. Or I could get out of the way and let my body heal itself as has been done over many millions of years of evolution. All I want to do is support that process by making sure to give my body the proper nutrition in the form of the appropriate whole foods.

Wow, Jim. Creepy.

Don't despair: I'm confident that you will eventually find a healthcare practitioner who will act as your advocate, not a provider of drugs. It may take, unfortunately, going through quite a few practitioners before you come on such a person.

Great post. I am starting to think there are two kinds of people - those who seek drugs and those who run from them. LOL.
Among other occupations, I am an OR nurse. I have been wined and dined by the best reps ever, to buy their wares for surgery. It's all about the money.The drug companies have a lot to lose if we all quit taking their meds. Which is exactly what I want to do. I do not want to be a slave to a diagnosis and accompanying pill bottle. I want to be freeeeee.
This is not to say there is a time and place for medicine. There IS. But not for every sniffle.

Boy Suze, I can relate!  I'm a nurse as well and spent lots of years in NICU, but a change to chemical dependancy/psych was eye opening and downright disgusting in the amount of meds handed out.

I used to ask patients if they were hungry when dispensing a 6oz. Cup FULL of various pills before breakfast!
Couldn't take it and quit. Couldn't be a party to pharm management over real therapy.  I also take as few pills as possible, especially antibiotics.

Hi Doc,

I just visited my parents, and my mom shared her recent blood work with me.
Her cholesterol was a mere 210, and her doc (general practitioner), put her on a statin !!!
I told her about your blog a bit and particle size, but of course she's hesitant since her doctor obviously has more credibility than me.

Outside of eating better, what next steps should I advise her to take?  She agreed to request a cholesterol particle size test (is there an official name for this?).

Yes, N: Lipoprotein testing, such as NMR Lipoprofile or Atherotech VAP.

It really shouldn't be that tough, but we are battling the incredible ignorance in the primary care community who is spread too thin to master any one area.

The World Health Organization changed impaired fasting glucose levels from 6.9 to 6.1 in 1999.  The curve used to illustrate the incidence of diagnosed type 2 diabetes indicates a steepening at this time.  If data would have been collected for all patients prior to 1999 and utilized as a retrospective for type 2 diabetes in the population, the incidence rate prior to 1999 would likely have been significantly higher.

Very true, Dr. Davis.  Wheat consumption is up since 1970.  The strange thing is, it was much higher in the 19th century...something like 225 pounds per capita.

historical wheat consumption

Maybe we were eating fewer total carbs then, or expending more energy, if in fact the recent increase in diabetes is wheat-related.

I think since so much wheat is eaten in products that are mixtures of wheat, sugar, and vegetable oil, there's no way to know what the culprit is.

Well the reason is that wheat is the most important factor for our lives.

Hi, Anon--

Yes, indeed. Human life was different for at least rural people.

Also, wheat has changed. This is a crucial, crucial point that explains much of this phenomenon, I believe.

It would be interesting to plot diabetes rates against various possible culprits (pointing out on the graph when diagnostic cutoff changed): wheat, all carbohydrates, size of sodas, computer ownership, average size of restaurant meals, bicycle ownership, hours spent commuting, population older than 65, exposure to Agent Orange, service in Gulf War, and some really silly things like hair length and popular nailpolish colors.

If only wheat consumption seemed correlated, this would be suggestive.

Wre there ads for All Bran bars and wheat links on this site?

Wheat is ingrained in us, beginning with bread as the "staff of life."

correlation does not equal causation.

I don't eat wheat, I suffer from all of the problems you describe and it's also related to my psoriasis.  Good hypothesis with all your measurements of post consumption measurement of blood sugars, but someone needs to do a mass study.

The graph on this post is also very educational:
http://www.gnolls.org/1086/the-lipid-hypothesis-has-officially-failed-part-1-of-many/

The concentrations of zinc, iron, copper and magnesium remained stable between 1845 and the mid 1960s, but since then have decreased significantly, which coincided with the introduction of semi-dwarf, high-yielding cultivars.
at the same time
wheat breeding may have contributed to increased prevalence of celiac disease. and other conditions.
Perhaps other readers are not aware that MAGNESIUM deficiency increases iron absorption so there is increasing danger of Iron Behaving Badly and resulting damage to mitochondrial function.

Hi, Ted--

Great find!

I wasn't aware of these data. Yet another way that increased yield comes at a price.

Dramatic changes in the slope of a curve are easy to see if you're looking for them, but you've displayed an arithmetic, not a logarmitic axis.  Your point would be better made if you could switch the axis and if we still see the association between the variables.

Gretchen - Well said.

I think many things in our modern environment play a role in tipping the scales toward diabetes - including disrupted circadian cycles and environmental toxins, such as fire retardants, plasticizers, and pesticides.  (I don't have time right now to find links from stuff I've read on this - but try Googling these things - the research is there.)  

Jenny Ruhl claimed a short time ago that while prediabetes has risen, actual diabetes has not.  She is a good resource and I would take her arguments on most things diabetes pretty seriously.  Check her blog if interested:  Diabetes Update.  

As a mother of a kid with celiac disease, and for other reasons, I am hardly pro-wheat or pro-gluten, but I'm not convinced grains have caused a rise in diabetes.  My daughter's gastroenterologist, however, has Type I diabetes and says that eliminating gluten has greatly improved her glucose control.

When I eyeball this figure, it looks like the change occurs around 1993-1996.

Helen has a point that under counting of who is "pre-diabetic" is quite possible skewing the data. The CDC changed it's diabetes diagnosis criteria; 1985 wasn't when they did that however.

CDC took their raw 1995 - 1997 data and in 1998 decided to only use fasting glucose, and not the old standard oral glucose tolerance test, as the CDC diabetes template. For all individuals  whose data was showing greater than ( or equal to) 126 mg/dl fasting glucose they were then counted as diabetic by the CDC.

This methodology caused CDC to say U.S.A. diabetics went from 8 million in 1995 to 10.3 million diabetics in 1997; a statistically massive 2 year jump of diabetics. And furthermore, the number of un-diagnosed diabetics was claimed to have gone down (in same period of time); they cut out a whole slew of "pre-diabetics", so to speak.

The other criteria CDC website shows from 1998 is, that when non-fasting glucose hits 200  mg/dl (or more) they are considered diabetic. The reproduced graph Doc posted shows an exponential climb upward right at the time CDC  began using it's altered criteria.

"Note that, from 1958 until 1985, the curve was climbing slowly. After 1985, the curve shifted sharply upward."

As I look at the presented graph, from 1986 to about 1991 the trend decelerated slightly, then resumed its prior long-term value, then accelerated in about 1997

However, I must admit that 1997 is "after 1985."

Other suspects that became prevalent in the food stream in the 1980s were high-fructose corn syrup and artificial trans-fatty acids, both of which are linked to hepatic insulin resistance and metabolic syndrome.

I think of all the intelligent, scientifically-reasoned arguments all lead back to the commonsensical notion "Don't eat junk." To start, anything with enriched (aka processed) flour, partially hydrogenated oils, or high fructose corn syrup qualifies as junk. Which isn't to say all disease eminates from just those three ingredients, but I believe completely eliminating those three ingredients would yield a large health benefit to most Americans.

It takes years for type 2 diabetes to develop. A shift in the rate at which people are diagnosed with it would be caused by something that happened some time before the shift.

1960 to 1970 is also the time frame that chemical fertilizer came into the mainstream. On the farm I was raised on, along with chemical fertilizers came mineral supplements for the hogs that were living on the fertilized barley. They "failed to prosper" on fertilized barley, where they did just fine on unfertilized barley. By the why, fertilized barley produced over twice the volume of grain, and I assume the same mineral absorption. You can blame the grain, but I believe it could be the fertilizer.

@  justdoinglife
You can blame the grain, but I believe it could be the fertilizer.
Does early-life exposure to organophosphate insecticides lead to prediabetes and obesity?
Slotkin TA.

The chart for the growth of the national debt looks the exact same. I wonder if there is a correlation between the advance of socialism and the cultural ascendancy of the Lipid hypothesis? I'd bet the ranch that the destruction of American health and the destruction of the American economy is not a coincidence.

Duke university 2008 study fed new born rats 0.1 mg/kg body weight of the organophosphate pesticide parathion, for 4 days. When the rats were adults and fed a high fat diet they noticed a different response among the sexes.

In the adult females the high fat diet resulted in a 30% higher weight gain ( vs. high fat fed males' 10% weight gain) over controls (according to respective sex) on the same diet. This type of pesticide exposure to young children may be part of how obesity is rising; the standard western fare is high in generic fat content.

For the parathion early exposed adult male rats fed on a normal diet (ie: not high fat) the results also seem troubling. They gained weight, glucose levels rose, fat break down was inhibited and they were pre-diabetic; as compared to male controls.

Counter-intuitively, another group of male new born rats fed parathion at 0.2 mg/kg body weight (4 days) when fed a normal diet as male adults actually weighed less than their male controls. Whereas, the female rats (fed normal diet in this case) who got both 0.1 & 0.2 mg/kg parathion (4 days) all weighed less than their female controls. Mothers, don't try this at home.

Another culprit:

SSRIs.  Prozac was first marketed in 1988.  (It was not the first, however - some came on the market slightly earlier that decade.)  SSRIs impair glucose tolerance and are associated with an increased risk of diabetes.  

I think there are some modern-day smoking guns more convincing that increased grain consumption for increased obesity, insulin resistance, and risk of diabetes.  Although they are a neolithic food some of us may not be exquisitely adapted for, they have been around for 5,000 years, while the obesity epidemic is quite recent.

Hi Helen,
In 1938 there was a U.S.A. National Conference of Governmental Industrial Hygienists ; since 1941 the word national was replaced by "American" (ie: now is the ACGIH). 1946 the ACGIH set maximum limits on 148 compounds; which in 1956 became their "Threshold Limit Value", (TLV).

TLV is not saying "x" level is always safe; just what is supposedly tolerable exposure for most "healthy" adults. ACGIH lays their TLV data out for industrial hygenists to use in their field, not for laymen's general use.

2-butoxy-ethanol TLV (as a gas or evaporating vapor) is set at 20 ppm. This chemical is the favorite solvent in household spray and wipe cleaning products.

It makes me wonder if the U.S.A. adult female house cleaner suffers metabolic syndrome at a higher rate than other individuals. If so then might not close decades of breathing 2-butoxyethanol droplets have had/has epigenetic synergy?

1971 O.S.H.A. took 470 TLVs from ACGIH data and now calls those TLV by the phrase "Permissible Exposure Limit" (PEL). Meanwhile, as of 2010 there are 642 TLVs set out by ACGIH.

The European Union has a registry of 143,000 chemicals in use (or used); and there are +/- 50,000,000 chemicals known to exist (as per Chemical Abstract Service Registry). The EPA has more details; for searching if you're curios: www.epa.gov/grtlakes/toxteam.
pbtrept/pbtreport.htm

2012 the European Union is set to report on chemical testing of all chemicals manufactured in excess of 1,000 tons annually. You'll see that as data reported from "REACH" (Registration, Evaluation, Authorization and Restriction of Chemical Substances).

If you want to track down what chemical is in a product then search out the manufacturers "MSDS" (material safety data sheet). Some claim "trade secret" ingredients and then you can only guess on what is involved.

I love the triglyceride posts as I have been working on mine for a number of months.  Was well over 1000.  On low carb, virtually no grains, tricor (200mg), and a healthy dose of fish oil I was still at 233.  I am wondering if it will take my body/metabolism some time to heal before I can get lower.  As you might imagine I am sporting an HDL below 25.  I am working it diligently, have lost a ton of weight and get healthier by the day.  I should be sending Dr Davis a stipend for my improvement!

Dr. Davis,
please kick out of your spam filter the post I just sent on the 12th saying "Hi Helen,". It had resources for her interest in modern chemicals.

To Helen,
If my 12th post doesn't show up soon (2 days?) and you request it on this thread I will try to recreate it here. Maybe you've moved on to newer threads; I don't usually monitor old threads, but I will this for a few days.

Unfortunately, it doesn't seem like this ascent is going to slow down anytime soon.  Even if people in recent years seem to be taking a more health-savvy approach to their eating habits, it wouldn't be surprisingly to see this trend continue regardless.

Western countries have also seen a rise in sugar consumption along with wheat consumption over the same time period.

Taubes has just published a piece
"Is Sugar Toxic" and winds his way through diseases of Western cultures from sugar causing metabolic syndrome to sugar be implicated in cancer formation.
http://www.nytimes.com/2011/04/17/magazine/mag-17Sugar-t.html?pagewanted=1&_r=2&ref=magazine

No where was there any mention of wheat..I don't think we can isolate wheat as the primary culprit in Diseases of Civilization.  Wheat Plus Sugar, the double whammy.