After-eating effects: Carbohydrates vs. fats

In the ongoing debate over whether it's fat or carbohydrate restriction that leads to weight loss and health, here's another study from the Oxford group examining the postprandial (after-eating) effects of a low-fat vs. low-carbohydrate diet. (Roberts R et al, 2008; full-text here.)

High-carbohydrate was defined as 15% protein; 10% fat; 75% carbohydrate (by calories), with starch:sugar 70:30.

High-fat was defined as 15% protein; 40% fat; 45% carbohydrate, with starch:sugar 70:30. (Yes, I know. By our standards, the "high-fat" diet was moderate-fat, moderate-carbohydrate--too high in carbohydrates.)

Blood was drawn over 6 hours following the test meal.




Roberts R et al. Am J Clin Nutr 2008

The upper left graph is the one of interest. Note that, after the high-carbohydrate diet (solid circles), triglyceride levels are twice that occurring after the high-fat diet (open circles). Triglycerides are a surrogate for chylomicron and VLDL postprandial lipoproteins; thus, after the high-carbohydrate diet, postprandial particles are present at much higher levels than after the high-fat diet. (It would have been interesting to have seen a true low-carbohydrate diet for comparison.) Also note that, not only are triglyceride levels higher after high-carbohydrate intake, but they remain sustained at the 6-hour mark, unlike the sharper decline after high-fat.

It's counterintuitive: Postprandial lipoproteins, you'd think, would be plentiful after ingesting a large quantity of fat, since fat must be absorbed via chylomicrons into the bloodstream. But it's carbohydrates (and obesity, a huge effect; more on that in future) that figure most prominently in determining the pattern and magnitude of postprandial triglycerides and lipoproteins. Much of this effect develops by way of de novo lipogenesis, the generation of new lipoproteins like VLDL after carbohydrate ingestion.

We also see this in our Track Your Plaque experience. Rather than formal postprandial meal-testing, we use intermediate-density lipoprotein (IDL) as our surrogate for postprandial measures. A low-carbohydrate diet reduces IDL dramatically, as do omega-3 fatty acids from fish oil.

Comments (17) -

  • darnoconrad

    11/25/2009 3:19:52 PM |

    The Graphs are too small to read even when clicked on.

  • Robert McLeod

    11/25/2009 5:31:22 PM |

    It's not solely the fault of de novo lipogenesis, as even on a high fructose meal with radio-nucleotide labeled carbon in the fructose, only like 20 % of the triglycerides in the blood are from DNL.  Glucose consumption doesn't seem to result in DNL unless the liver is already full of glycogen.

    Insulin is known to down-regulate acylation stimulating peptide (ASP), which is the paracrine hormone that regulates uptake of lipoprotein (i.e. "cholesterol") micelles into fat cells.

  • Ms. X

    11/25/2009 5:46:34 PM |

    Dr. Mike Eades wrote a while back that fats, especially saturated fats go into the lymph system after digestion, and not immediately into the bloodstream.

    Why is it then that "since fat must be absorbed via chylomicrons into the bloodstream" is an "accepted" notion?  You implied it was wrong, without actually saying so...Do most medical practioners really not know how fat is absorbed into the body?

  • DrStrange

    11/25/2009 8:02:26 PM |

    You MUST look at this in context!  Excess dietary fat, especially saturated fat, causes insulin resistance.  It takes about 2 weeks of consistently eating approx 10% calories from fat, not more and not cheating, to remove that huge component of insulin resistance.  If the study were done in that context the results would be quite different.  How do I know?  I have done it several times on myself!!!

  • DrStrange

    11/25/2009 8:03:30 PM |

    oops, forget to request email follow-ups. So now I have.

  • TedHutchinson

    11/25/2009 10:42:41 PM |

    @ darnoconrad
    Dr Davis did say "full-text here hoping people would follow the link, download the PDF, and have their own copy to enlarge as required.

  • Stephan

    11/25/2009 10:42:41 PM |

    Hi Dr. Davis,

    Thanks for posting this.  It answered a question I've had for a while now.  The palmitate is interesting as well.

  • Helen

    11/26/2009 2:18:06 AM |

    Very interesting and kind of scary, with family members of mine with heart disease pounding down the carbs and cutting the fat.  

    I'm a bit confused by the Track Your Plaque Program, though.  In some of the info on the main site, saturated fats are described as inflammatory and something to be avoided.  But you seem to consider them okay - am I right?  And Dr. B G at AnimalPharm, who says she is counseling her clients with the TYP program, is big on saturated fats.  Can you explain the discrepancy?

  • Dr. William Davis

    11/26/2009 2:38:08 AM |

    Hi, Helen--

    The Track Your Plaque program stand on a number of issues, including saturated fat, has evolved over the years. We now do not restrict them, but nor do we suggest a carte blanche  approach, since we do continue to maintain rather strict LDL targets for plaque reversal.

    I believe that Dr. BG was expressing her own opinion in the Animal Pharm blog. While she's got plenty of great thoughts on this issue, it does not represent the "official" stand of the program.

  • Nigel Kinbrum BSc(Hons)Eng

    11/26/2009 9:18:52 AM |

    Is it possible that the higher fat diet hit an optimum fat/carb mixture, where carbs were low enough to keep fasting TGs low and fats weren't high enough to spike post-prandial TGs?

  • Dr. William Davis

    11/26/2009 2:51:39 PM |

    Hi, Nigel--

    Good question. Stay tuned--plenty more on this conversation to come.

    The entire world of postprandial metabolism is truly a fascinating, though complex area, that is only beginning to yield to investigation. The Oxford group has made enormous contributions to this understanding.

  • Anonymous

    11/27/2009 10:00:20 PM |

    Thanks for this, Gretchen, that's a lot of work!

    It's interesting that my husband's endocrinologist, whom he is seeing for high blood pressure, insists on non-fasting labs.  He has my husband get his tests (blood and urine) one hour after a meal.  He says the fasting tests are very misleading.

  • Helen

    11/28/2009 2:34:27 AM |

    Another question on saturated fats.  I know they raise LDL, and lately I've been reading that they raise the benign kind, not the vLDL.  But I have read in many places (including the Track Your Plaque article I mentioned) that they are "inflammatory."

    Is that a false accusation, confusing saturated fats with trans-fats (since hydrogenated fats were used in some experiments regarding saturated fats)?

    Or is it one of those things that depends - on other dietary factors or disease states, such as diabetes, etc.?  Or is it unknown?

    It's hard for me to believe that nature would only want us to eat monounsaturated and omega-3 fats (as omega-6's are inflammatory, too).  That would seem fairly limiting for an omnivore.  Of course, it could be a proportion thing, too.

  • StephenB

    11/30/2009 7:32:50 PM |

    Helen wrote:
    "Another question on saturated fats. I know they raise LDL"

    The above may not be true. There may be a small near term rise, but long term I don't believe they have no impact or even lower LDL. You might find this blog entry interesting.

  • Anonymous

    1/16/2010 1:25:20 PM |

    Rather interesting site you've got here. Thank you for it. I like such themes and anything that is connected to this matter. BTW, try to add some images Smile.

  • buy jeans

    11/3/2010 3:48:57 PM |

    It's counterintuitive: Postprandial lipoproteins, you'd think, would be plentiful after ingesting a large quantity of fat, since fat must be absorbed via chylomicrons into the bloodstream. But it's carbohydrates (and obesity, a huge effect; more on that in future) that figure most prominently in determining the pattern and magnitude of postprandial triglycerides and lipoproteins. Much of this effect develops by way of de novo lipogenesis, the generation of new lipoproteins like VLDL after carbohydrate ingestion.

  • simvastatin

    5/25/2011 5:22:39 PM |

    Consequently, one of the advantages of glucose and other carbohydrates is that they can enter into the oxidation process much more quickly and provide energy more rapidly.

Loading
Wheat Belly coming to bookstores!

Wheat Belly coming to bookstores!

Anyone following the conversations on these pages know that I have some very serious concerns about this thing being sold to us called "wheat"--cause it ain't wheat! It is the result of incredible genetics shenanigans inflicted on this plant, mostly in the name of increased yield per acre.



I now classify wheat as "Public Enemy #1," the prime nutritional culprit underlying obesity, heart disease, "cholesterol" abnormalities, hypertension, arthritis, psychiatric illness, and on and on. Once you read the full story, I believe that you will agree: Modern Triticum aestivum, the plant that now serves as the source for virtually all the wheat flour products now consumed--organic, whole grain, multigrain, sprouted . . . it makes no difference--does not belong in the human diet. So many people, searching for solutions for their fatigue, weight gain, leg edema, incurable rashes, joint pain, etc., will find their answers here.

Wheat Belly: Lose the wheat, lose the weight and find your path back to health will be on bookstore shelves including Barnes and Noble August 30, 2011 or is available for preorder here at Amazon. Wheat Belly will also be available as a downloadable Kindle book and as unabridged audio CDs.

You can also follow the Wheat Belly conversations on my Wheat Belly Blog. One of my recent posts discusses the herbicide-resistant semi-dwarf wheat strain, Clearfield, that is now making its way to more and more supermarket shelves.

You'll also find more conversation on the Wheat Belly Facebook pages.

Comments (18) -

  • Jana Miller

    7/31/2011 5:47:19 PM |

    Congratulations...thanks for all you do to educate and inform us about wheat!!
    all the best,
    jana

  • BJ

    7/31/2011 5:55:00 PM |

    The date of the book arrival must be incorrect?  2001?
    I am anxious to read this one!

  • Lori

    7/31/2011 6:05:42 PM |

    I've pre-ordered Wheat Belly and look forward to reading it.

    I'm enjoying my second summer free of hay fever--coincidentally, the first summer was right after I eliminated wheat from my diet. Hurray!

  • Princess Dieter

    7/31/2011 6:39:26 PM |

    Will it be a Nook book? I love my Nook! And I've got Mercola's No Grain diet, some Primal/Paleo books on there already. Would love to have yours, too. Thanks.

  • Princess Dieter

    7/31/2011 6:40:47 PM |

    OMG, I just read Lori's comment, and realize that I've been less asthmatic/allergenic this summer since ditching wheat/gluten. I've been able to scale back (stop Nasonex and cut back on inhaled steroid dosage, even) .  August-September is the worse, runny-nose-wise, so I'll get to observe and see. Hm.

  • Diana

    8/1/2011 12:34:08 AM |

    Congrats on the book! Can't wait to read it!
    Continuing on a comment above, I too have had no seasonal allergies since doing a diet which is wheat-free. Have you ever covered this topic in your blog, or could you in the future?

  • Might-o'chondri-AL

    8/1/2011 9:52:09 AM |

    7 times Sunday/Monday tried to get  just 2 sentence post about ApoE4  in previous thread and got "Server Error", so testing again in this tread ... this lousy server did this before with me.

  • Might-o'chondri-AL

    8/1/2011 10:04:44 AM |

    Anyone still checking this thread want me to continue with some ApoE4 comments here ? I went back to try previous thread and still got "server error" there. I  ask for interest because I myself don't always follow  new thread comments section  - and maybe those with ApoE4 interest are not reading here now.

  • Might-o'chondri-AL

    8/1/2011 5:39:19 PM |

    Just tried to use "reply" box of  Dr. K.'s comment on previous ApoE4 thread  to contribute and got "Server Error";
    let's see if I am still welcomed on this thread by the server....

  • Melinda

    8/1/2011 8:13:42 PM |

    Might-o'chondri-al,

    Yes, I would be interested in your replies about ApoE4.  I always read your comments around the web and like many, I wish you had your own blog so I wouldn't miss any of your output.

  • Might-o'chonri-AL

    8/2/2011 12:57:19 AM |

    Hi Melinda,
    Please copy and post this in previous thread for ApoE4 ... .
    Continuation about ApoE4:
    % of ApoE4 messes dynamic inside tissue cell so that ApoB turns to use Scavenger Receptors to try to start cascade which gets signal transducer (Specificity Protein 1) to up-regulate the cell membrane transporter protein ( ABCA1, ATP binding cassette transporter A1) that puts excess cholesterol out from that cell.   I believe this is where Doc Davis' stated ApoB irregularities  add to the problem with ApoE4 (since normal human ApoE3  works all by itself to get that signal transducer to bind to ABCA1 to work shucking cholesterol) . When cholesterol gets to build up inside the cell the large LDL can acetylate and form  excessive "droplets" in that cell's cytoplasm; while the small LDL can oxidize from CuSO4- and load up inside that cell's lysosome.

    Meanwhile % of  ApoE4 doesn't just dock with tissue cell LDL receptors and so the macrophage scavenger receptors pick up too much cholesterol laden ApoB/ApoE lipo-protein carrier molecules. Once in the macrophage the same problem of oxidized LDL piling up  in lysosome and acetylated LDL burdening cytoplasm occurs; and for that matter, in macrophages,  it is down to ApoB to get  the signal transducer going if any cholesterol is to be put out by cell membrane transporter protein ABCA1.  This is the recipe for  risky pro-atherogenic  "foam cell" formation; while the individual genetics of ApoE, ApoB, assorted receptor types, signal transducer and transport protein all make it hard to predict how ApoE4 plays out.

    Dr. Kruse broaches ApoE4 in alzheimers and this is in large part because ApoE4 causes the brain neurons to  get less than optimal cholesterol from the brain's astrocytes. It is ApoA1 working in HDL complex that controls the astrocyte cholesterol balance and when there is inflammation there is a risk of ApoA1 mis-folding to  foster amyloid aggregations.  Low intact ApoA1 and ApoE4 together increase the risk factor for cognitive problems and dementia several fold.

    Diabetics with ApoE4 have that % of ApoE4 as an  additional  limitation;  however,  irregardless of  the ApoE iso-form diabetic dementia risk arises from their glucose loads impairing kidney tubules, and thus fostering the uremic environment that stymies ApoA1 bio-synthesis. The normal role of ApoA1 is to bind to the transport protein which secures cholesterol into a safe bond with HDL; so low ApoA1 from any factor will  challenge the brain neuron over time. I suggest there are individuals whose age impaired kidneys contribute to senile dementia from impairing ApoA1 levels being made and also possibly speeding up the normal 4-6 days kidney elimination of ApoA1 ; and  so Patri's comment on limitation of high protein intake is relevant due to it's demand on aging  kidneys.

  • Dr. William Davis

    8/2/2011 1:58:16 AM |

    Oooops! Too many zeros and too few ones!
    Yes, indeed, 2011. Thanks, BJ.

  • Dr. William Davis

    8/2/2011 1:59:11 AM |

    Hi, Lori-
    I personally experienced the very same effect.
    I remember days in which my eyes were swollen shut, sinuses achingly closed, wheezing. All now a distant memory!

  • Dr. William Davis

    8/2/2011 2:00:39 AM |

    Yes, great idea, Diana. I'll cover that topic, though likely more appropriate for the Wheat Belly Blog.
    I will likely mirror this post in both blogs. It affects a LOT of people.

  • Dr. William Davis

    8/2/2011 2:02:19 AM |

    Hi, Might--
    Sorry for all the posting struggles. I'm still working with working out the kinks.
    The changes here are occuring with some back room changes in database software, etc., that is making for more than the usual headaches.
    Please don't give up in frustration. Your comments are truly valued.

  • MJ Klein

    8/2/2011 2:07:31 AM |

    is this primarily a US problem?

  • Might-o'chonri-AL

    8/2/2011 5:25:41 AM |

    Hi MJ,
    ApoE4 =  14-19% Germans & Finns and  7-12% Italians & French
    ApoE3 = +/- 60% of people
    ApoE2 = 3-4% Japanese, Finns & Nigerians and 2-4 % Mexican Americans & American Indians

  • Stella

    11/11/2011 10:55:36 AM |

    Just wondered if you were aware that for several days now (all this week, for sure) Amazon UK has been displaying the following message on the Wheat Belly page:

    "Item Under Review
    This product is not currently offered by Amazon.co.uk because a customer recently told us that the item he or she received was not as described.
    We are working to resolve this as quickly as possible. In the meantime, you may still find this product available from other sellers on this page."

    Maybe they were expecting bagel recipes? There is no explanation, and the three accompanying reader reviews are all 5*

Loading