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

Did you see the WSJ article today?

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

The last sentence is priceless:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Tommy,

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

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

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

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

Hi, Tuck--

That's great!

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

42--

Well said!

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

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

Tommy-

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

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

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

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

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

Hi Dr. Davis.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Dr. Davis?

Interesting blog. I take it you are not an invasive cardiologist. In 2004, I was told I needed an immediate CABG or I would most certainly face heart attack, stroke, or death within three months. That was three years ago and rather than the quintuple bypass, I opted for the medication regimen of a noninvasive cardiologist. Check out my story at http://wordworks2001.blogspot.com

The first man with the calcified valve will unfortunately require a new prosthetic aortic valve sometime in his future. This is usually determined with the help of an ultrasound, or echocardiogram, a better test for assessment of the aortic valve (though useless for detection of coronary plaque).

Thanks so much for this. I'm a T2 diabetic controlling my blood sugar with a low carb diet. The only thing in my recent lab work that my GP is unhappy with is an elevated vitamin D level. A few years ago, a friend gave me a copy of The China Study (along with Fuhrman's Eat to Live, because they had "changed [her] life" and she hoped they would change my life as well. Based on my experience and reading about blood sugar regulation and insulin levels, what both had to say just felt wrong to me, over and beyond the simplification one might expect in a mass-audience book. So, I was skeptical about their broader health-related claims, though I wasn't concerned enough to investigate further (and have actually considered the ethics of regifting books that I think make dangerous recommendations). Because of this, it's quite gratifying to find my initial suspicions confirmed by detailed analysis.

When I looked up The China Study on Amazon, I found this statistical analysis of the China Study dataset under the comment section.  This is simply amazing and backs up pretty much everything you've said in your blog.  I hope someone can do an analysis to confirm this analysis.

http://www.amazon.com/Analyzing-the-China-Study-Dataset/forum/Fx1YJPR95OHW08P/TxY4S5EZD8Y2XE/1/ref=cm_cd_dp_ef_tft_tp?_encoding=UTF8&s=books&asin=1932100660&store=books

Very glad to see this analysis featured here, too.  I groan every time someone recommends The China Study to me as a great authoritative book, so Minger's detailed review was most welcome.

We must keep in mind however, Minger's review and different conclusions not withstanding, that The China Study is epidemiological data and it can only show association, not causation.   It still doesn't prove in any way that consuming wheat is harmful to health.  Don't get me wrong, I'm no fan of wheat anymore and no longer consume it myself or serve it to my family.  But it *is* fuel for the argument that considerably more study is needed before the government and health agencies continue to push wheat consumption on the public as matter of policy.

Perhaps the most astonishing thing about this analysis is that is is done by an "amateur" without any axes to grind.  It is a telling comment on the dihonesty and/or stupidity of most government and industry funded research.

Campbell doesn't deny that processed refined wheat flour (which is what they eat in china) is unhealthy.  He advocates eating whole plant foods.

Whole wheat, brown rice, beans, and steel-cut oats all seem to raise my blood sugar about the same amount, which is quite a lot depending on how much I eat.  Are they equally problematic?

happy to see denise mingers study featured here.

    wheat asides, milk pasteurised or uht causes a pretty massive immune system flare up for me.

How do we explain the positive correlation between plant protein and cancer?  I'm not ready to give up my kale and chard just yet!

Denise's astute analysis gives rise to the importance "digging a little deeper". I have always thought the benefit of eggs was contrary to the "official" line of thought. Little did I know the controversial aspects of wheat until stumbling along Dr. Davis' musings.

Sorry to come off topic here but i dont have the program in my  computer to email you. Dr. what do you think of this http://www.westonaprice.org/blogs/are-some-people-pushing-their-vitamin-d-levels-too-high.html

ramon25-

Very interesting study.  I would love to hear a reply as well.

Here is the T Colin Campbell's response to Denise's debunking of the China Study:

http://tynan.net/chinastudyresponse

Some commenters have wondered whether the wheat flour assessed in the study was refined wheat.  Chinese today eat mostly refined wheat products, but in the 70s, rural Chinese on collectives might have eaten differently, so I emailed a few Chinese professors of nutrition to ask.  It's morning now in China, and I got one response from Dr. Duo Li of Zhejiang University.  He told me in a brief reply that rural Chinese ate whole wheat products and the refined wheat was rare.

Denise's analysis of The China Study is heavily flawed and therefore invalid.  Debunked by a cancer epidemiologist...

Here it is...
http://www.30bananasaday.com/group/debunkingthechinastudycritics/forum/topics/a-cancer-epidemiologist

The proper testing procedure as stated by an expert on analysing stats...
http://www.30bananasaday.com/group/debunkingthechinastudycritics/forum/topics/my-response-to-denises

Campbells response to Denise..
http://www.30bananasaday.com/group/debunkingthechinastudycritics/forum/topics/campbells-response-to-denises

Campbell, in his response, thinks Minger is probably an undercover agent in a larger conspiracy.  The  debunking epidemiologist, in his, points out that correlation and association aren't the same, which will probably not come as news to Minger.  Could be Minger has kicked the hornets' nest.

What I'd like to know is how correlations > 1 and < -1 are being generated, since that's impossible.

Thanks for sharing the research point of view,yes with the obesity that is hitting America it is necessary to learn that the cause of obesity is eating more of high protein diets and fats over vegetables and fruits.

Gary Taubes says Campbell's co-worker on the original study, Oxford professor of epidemiology and statistics Richard Peto also thought the data did not support Campbell's hypotheses.

Dr. Davis

The way wheat is consumed  in the west is very different from the way it is consumed in the east(fermenting/sprouting/sourdough etc.).

This post might be helpful to 300 million americans but mislead 4 billion asians.

With due respect I'd suggest you consider the above before going all guns blazing against global wheat consumption.

But Pallav, how can the Chinese be mislead when it's the Chinese's own wheat consumption that is being looked at in The China Study?

In reality, that study can only generate ideas, it can't test them. So even if it generates the idea that wheat is bad for humans, we must test that idea before it becomes the truth. As far as I know, Dr Davis did test this idea and came with the conclusion that it was the type of wheat that made the difference. Maybe the Chinese ate the bad wheat and that's why it shows up that way?

Anonymous wrote: "What I'd like to know is how correlations > 1 and < -1 are being generated, since that's impossible."

Denise says right in the post that she gave the numbers in percentage rather than decimals to make it easier to read. I.E. +33 = 33% = .33

Martin,
The way Dr. Davis tested einkorn and wheat currently generally available in usa (http://heartscanblog.blogspot.com/2010/06/in-search-of-wheat-einkorn-and-blood.html) is probably is what brings real value to this blog.
The subhead Europe:Sourdough bread http://wholehealthsource.blogspot.com/2010/06/fermented-grain-recipes-from-around.html is very close to how wheat is consumed in India. This process very likely breaksdown a large part of the offending ingredients such as gluten and phytic acid from a cursory search i did on google scholar.
I would trust a test on this process by Dr. Davis than on statistics, which as you rightly said generate ideas but need testing.
However, when Dr Davis goes on to implicate wheat in general for all sorts of diseases like in this blogpost, that applies to americans (the specific way of consuming wheat) and not necessarily to those who process grain differently like in asia.
That is the point where things get icky and can be misleading for those consuming wheat in asia and reading such posts.
Perhaps we can all come to a better way of processing grains than cutting them out from the diet altogether?

"a diet high in animal protein, especially casein"

Quickly, briefly, because my story is only tangentially related to this post by means of Dr Davis's almost stray remark I quote above...

I am ~5 weeks into my wheat free diet -- to zero success. I do not measure myself daily in any way, but the obvious one: do I lose weight? Yes, but only ~5lbs, which represents 2% of my total body weight. I should have lost that amount easily within 1 week, if I were proceeding on this diet correctly.

And then the other stray remarks began to pile up:
1) The 20 year old girl with celiac disease who dropped wheat AND 20lbs in 2 months. (What about me?!)
2) The dinner at PF Changs. I ordered the chicken lettuce wraps and skip the rice noodle thingees. Good job, I thought. Then I lingered over the menu, saw the restaurant offers an entire page of gluten free items, and the dish I just ordered was not one of them. I called for the waiter. He explained the sauce...
3) I drink protein shakes. A lot. As fate would have it, I migrated to casein protein because it broke down more slowly thus causing satiety to last longer. Until I read this post from Dr Davis with his stray remark, did my homework, and discovered to my chagrin that on a cellular level casein protein is so similar to gluten that it might as well be the same. (In essence.)

Okay, lesson learned. This gluten free, wheat free, grain free, carb free diet is not as easy as it looks at first glance. There is way more to it than skipping bread, and pasta, etc. But now I think I have it. So Sunday is Day 1. Shame I lost those first 4 or 5 weeks, but this time...

It may be true that wheat is a major cause of heart disease, but I'm not sure the high correspondence between wheat and cvd in this study makes that case.  Richard Peto, the Oxford professor of epidemiology who was part of the original study said what the data showed was that in places where people started adopting more of a western diet their health deteriorated.  I doubt the study spells out which parts of the western diet did the harm, wheat might be a marker for western diet.

People feel threatened when facts are released that go against the standard, cultural beliefs. We are raised as children to eat animals and animal secretions and so it is understandable why so many people feel threatened when they find out that the food mama gave them is helping to promote heart disease, cancer, diabetes, obesity, autoimmune diseases, digestive disorders, etc. The China Study is the longest, most unbiased studies ever conducted and show statistically significant results, worldwide, that ingesting animal foods create chronic ill heath in humans. I have helped 400 people in the last 4 years to eat a healthy, low fat, plant based diet and they have all rid themselves of the diseases listed above. Now, I have also some Kaiser doctors who, instead of handing pills or surgery, are handing out this book and getting the same results. Thank you Dr. T. Colin Campbell for your 35 year long work. And, I know that you went into this study trying to prove the opposite results!
When people hear that their upbringing needs to be challenge, they lash out with untruths….just as yound, 23 yr old Mindy has done.

People feel threatened when facts are released that go against the standard, cultural beliefs. We are raised as children to eat animals and animal secretions and so it is understandable why so many people feel threatened when they find out that the food mama gave them is helping to promote heart disease, cancer, diabetes, obesity, autoimmune diseases, digestive disorders, etc. The China Study is the longest, most unbiased studies ever conducted and show statistically significant results, worldwide, that ingesting animal foods create chronic ill heath in humans. I have helped 400 people in the last 4 years to eat a healthy, low fat, plant based diet and they have all rid themselves of the diseases listed above. Now, I have also some Kaiser doctors who, instead of handing pills or surgery, are handing out this book and getting the same results. Thank you Dr. T. Colin Campbell for your 35 year long work. And, I know that you went into this study trying to prove the opposite results!
When people hear that their upbringing needs to be challenge, they lash out with untruths….just as yound, 23 yr old Mindy has done.

To David M Gordon - how much of the lettuce wraps did you eat. PF Changs has nutritional info on the website and says this dish has 4 servings of 5oz. Each serving is 11 carbs so if you ate the whole thing yourself, that was 44 carbs.

It is very easy to underestimate carb counts. I have found a scale can be very useful. Mine measures carbs and other stuff.

That little dish is 4 servings?  C'mon! You bet, I bet I ate the whole thing, Anne.

What is in it that weighs so much? Some iceberg lettuce leaves, chicken, the rice noodle thingees I did without, and the sauce -- which is NOT gluten free, but I changed to a gluten free sauce. I bet that swap changes the calorie count etc. (Hey, I can hope!

Sure I want to lose weight -- okay, I must lose weight -- but my issue is visceral fat and its resulting potential problems: diabetes and heart issues (inflammation).

Thank you for your comments.

Instead of driving yourself with all these numbers why not just look for visable proof in REAL people.  I decided to try plant based eating and here is what happened:  (the numbers have actually gotten better since this was published last October)  Why I'm a believer in Dr. Campbell's advice:
http://www.drmcdougall.com/stars/mike_teehan.htm

Instead of driving yourself with all these numbers why not just look for visable proof in REAL people.  I decided to try plant based eating and here is what happened:  (the numbers have actually gotten better since this was published last October)  Why I'm a believer in Dr. Campbell's advice:
http://www.drmcdougall.com/stars/mike_teehan.htm

Mike, good for you. See this:
http://www.proteinpower.com/drmike/ketones-and-ketosis/low-carb-gaining-a-foothold-with-the-mainstream/

If Campbell is right that a plant-based diet is best for most humans, why did the low carb group do better than the other two groups (Ornish and LEARN diets) in the intervention study above? Not only did the low carb group do better in weight loss, they did better in all things measured.

Denise Minger wrote:

"Here we have evidence that areas in China with the highest rates of Western-type diseases also eat the most processed starch and sugar. Maybe not in the grotesque amounts that Americans eat them, but then again, China’s “affluent disease” rates were also lower than America’s"

This could easily be the headline "Minger accuses Americans of grotesque eating habits"

Debate is good but be healthy, not paranoid
Trevor

How can anyone tell anyone else what to eat?  We all NEED plants to survive.  However, some do better with wheat in their diet and some do better with meat in their diet.  It all depends on the person.  I wouldn't go bashing The China Study until you try the whole foods plant-based diet.  Dr. Campbell also stresses that nutrition is NOT about a single nutrient or food group.  It's all about the synergy of everything working together.  I would love to see Denise's analysis of the aflatoxin rat studies.  Everyone needs to take control of their own health.  No one should rely solely on the china study as what they should do.  I personally believe in what the china study is saying, but it might not work for everyone - especially when people are raised to eat animal protein.  I know I have issues with animal protein, but others might be able to tolerate it.  Don't go bashing Dr. Campbell for trying to help people.

Dr. Bill Misner Ph.D. said:
The BMI body mass index of rural Chinese is 21.0 supported by a daily calorie intake of over 2600k/cal/day from largely plant foods.
Americans on the other hand consume largely animal sourced foods of 1989 calories per day resulting in an obese BMI of over 27.0! All one has to do is compare the source of total calories with resulting BMI.

Eating 2600 calories whole plant foods that contribute to a lean healthy BMI of 21.0 is preferred to eating 1989 calories from largely animal sources resulting in an obese 27.0 BMI.

Elevated Body Mass Index associated with food category choice are also associated with the typical disease patterns in obese persons.  The China Study shows these numerical correlations precisely.

I confirm the report that overweight exists more in cultures consuming largely animal source calories than in those whose diet is primarily whole plant foods.

Interestingly, I have observed all of the above in Americans who change their menu from animal source to whole plant source food protocols.

Warm regards,

Bill Misner Ph.D.

"I would love to see Denise's analysis of the aflatoxin rat studies."

You can read an excellent analysis HERE. In a nutshell, what those rat studies prove is that complete protein provides better nourishment than incomplete protein. Wheat is naturally deficient in lysine, and when lysine was added to the wheat protein diet, it behaved just like the casein.

Cancers are very fast growing cells, so of course they're going to grow a whole lot better if they're better nourished. I'd wager that if the rats had been fed a complete vegetable protein blend, e.g. rice and pea protein in the correct ratio, the tumor growth would have matched both the casein and wheat plus lysine.

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Friends,

  You don’t need to believe Dr. Campbell. Just read The China Study, slowly and completely, and figure out the truth for yourself. Facts speak for themselves.

  I, and a few of my acquaintances, tried a whole-foods plant-based diet (coupled with biweekly exposure to sunlight in noon and some physical activity) for a few months (strict compliance), and it is working wonders for us, so we continue to be on it. Some of my friends failed, because they were mostly eating junk (plant-based) foods.

  The China Study book is not just about Dr. Campbell’s work, but more than that it describes the work and results of numerous other research studies, independent and unbiased, that point to the undeniable benefits of a whole-foods plant-based diet.

  Denise has adopted a detailed but very narrow view that is insufficient to relate to the larger context. This approach will only add to confusion and misleading conclusions.

As a physician with the health of your patients at stake, Would you accept conclusions that were not peer reviewed?

Wonderful post... Very informational and educational as usual!

Acai Berry Optimum

I thought that chylomicrons produced by the gut became bouyant fluffy LDL and that IDL produced by the gut became small dense LDL.  No?

Also, it occurs to me that this "gut-produced particle clearing" phenomena could be all/part of the cholesterol benefit of intermittent fasting.  By allowing the body time to fully convert/reduce the gut produced lp particles, the body has more time to restore a homeostatic balance of blood lipid particles.

Both meals were high-carb and high-fat. Can you be more specific in placing the blame on either the high-fat or high-carb component? I am inclined to believe that a high-fat (but low-carb) diet would not show the same stacking effect.

Hi Dr. Davis,

So I guess that we could either not eat for approximately 7 hours after each meal (which I just kinda eyeballed from the chart where I thought that it would end up back at baseline) or eat something that does not contribute to either plasma TG or chylo concentrations. In the "Grazing" post you had replied that veggies probably wouldn't have much of a negative post-prandial effect. Would anything else be safe to eat without affecting these numbers? Probably not, LOL! Just trying to look for a practical application of this information, because If I had to go 6 or 7 hours without eating, I would have to struggle with compliance. Thanks!

Nice summary, Dr. Davis.

I eat two low carb meals per day. A small breakfast in the morning and a large dinner at the end of the day. I also fast 1-2 days per week. I am definitely in favor of spacing out meals far apart. This also helps with insulin sensitivity and weight management. Even on a low carb diet, insulin spikes when we eat. This is countered by glucagon, of course, but palmitic acid still creates a temporary (and reversible) insulin resistance for awhile after this, and it just doesn't make sense to keep feeding this cycle with frequent meals - low carb or not. It is very freeing to eat less often. You can devote your time to other things. Hunger takes care of itself once gluconeogenesis kicks in and blood sugar is under control, and you stop obsessing over food. It's great.

Posts like this make me glad I've changed my eating habits to eliminate all snacks and often have just two meals a day.

This only probes that when one eats a glycemic meal.

Hi Dr. Davis,

Seems like these meals had high levels of both carbohydrate and fat.  Don't postprandial chylomicrons and triglycerides reflect dietary fat rather than dietary carbohydrate?

Dan

I tend to graze, and I once tested the effect of grazing vs 3 meals on my blood sugar levels.

On Day 1, I ate as I normally do (grazing), but every time I ate something, I put an equal amount of the food aside.

On Day 2, I divided the set-aside food into three groups and ate 3 meals, with no snacks.

Results were what you might expect. With the 3 meals, the peaks were higher, but because there was more time between meals, the blood sugar dropped lower before the next meal.

The overall average blood sugar was almost exactly the same.

I suspect lipids are similar.

I once tested my triglyceride levels every hour all day on a low-carb and a low-fat diet.

You can see the results graphed in the second edition of my book "The First Year: Type 2 Diabetes."

On the low-fat diet, at first the TGs went down, but then they started to climb and by the end of the day they were higher than they had been when I started.

Of course with a home meter I couldn't differentiate different types of TG.

I had been eating LC, so I was adapted to that way of eating. I didn't eat low-fat for a week before doing the low-fat trial, so those results might be questionable.

How much of an impact does/do you suspect that the quality of food choice have/has on this "stacking effect"?

Is this much of an issue for someone eating every 3-4 hours or so and consuming lean meats, fresh fruits and vegetables, moderate amounts of fat from avocados, coconut, olives, nuts/seeds, and so on?

The offerings in the study, while possibly common fair for many folks, is hardly indicative of what a lot of health-conscious fitness types are doing these days, which is why I ask.

I'm curious if the same issue would still exist with more health-promoting choices, even if to a smaller degree, or if it is not an issue in that case.

A clarification: The meal used in this study was not intended to represent some sort of "ideal" meal, but a meal of exaggerated composition that yields useful observations during the testing period. I would not interpret the data to suggest that the diet was good nor bad. (Though, obviously, thes were junk food meals.)

Both fats and carbohydrates affect postprandial patterns in complex ways. Recall, for instance, that fructose causes extravagant distortions of postprandial responses.

perhaps this makes the case for eating (a) high fat, moderate protein meal(s) during the day.

my breakfast consists of fat/meat and lunch is olive oil/bison sashimi or olive oil/lamb sashimi, both with fresh herbs. not much in the way of carbs. i don't know yet, but i have doubts about the negative effects of chylomicrons in the absence of carbs.

But would the 9-hr pattern really be
better if they had the same total intake all in one meal? This is not shown.
Presumably it'd have only one peak, but that peak would be significantly higher.

This contrarian study of low carb linked with atherosclerosis in mice...does raise some questions on high protein/low carb effect on endothelium (edited to fit space)

A new study reported Online in the Proceedings of the National Academy of Science (August 24, 2009) provides information about the effect of the low-carb, high-protein diet on the health of blood vessels.

Conducted by a team of scientists at Beth Israel Deaconess Medical Center (BIDMC), the study found that mice placed on a 12-week low-carb, high-protein diet showed a significant increase in atherosclerosis—and an impaired ability to restore blood vessels.  

Senior author Anthony Rosenzweig, MD, Director of Cardiovascular Research at BIDMC and Professor of Medicine at Harvard Medical School, and lead author Shi Yin Foo, MD, a clinical cardiologist in the Rosenzweig laboratory at BIDMC, conceived the mouse study in a very human manner.

Dr. Foo began thinking about the possible dangers of low-carb, high-fat diets after seeing heart-attack patients who were on the diet—and after Rosenzweig himself went on the diet.

“I asked Shi Yin to do a mouse experiment—so we could know what happens in the blood vessels and so I could eat in peace.”

The doctors fed mice known to develop atherosclerosis in the same manner as humans one of three diets: a standard mouse diet (65% carbs, 15% fat, 20% protein), a “Western diet” in line with the average human diet (43% carbs, 42% fat, 15% protein), and low-carb, high-protein diet (12% carbs, 43% fat, 45% protein). All three diets contained the same amount of calories. The last two diets contained the same amount of fat and cholesterol.

As in most such diets, carbs were replaced with protein.

Significantly, the low-carb mice exhibited a greater degree of atherosclerosis, as measured by plaque accumulation: 15.3% compared to 8.8% for the Western diet group. “Our question was, ‘Why do the low-carb mice have such an increase in atherosclerosis,’” Foo said.

Importantly, traditional markers slightly favored the low-carb group. “None of these results explained why the animals’ blood had more atherosclerotic blockages and looked so bad,” Foo said.  

The researchers looked at the animals’ endothelial or vascular progenitor cell (EPC) counts. “Examination of the animals’ bone marrow and peripheral blood showed that the measures of EPC cells dropped fully 40% among the mice on the low-carb diet—after only two weeks,” Rosenzweig said.

This finding suggests that the low-carb, high-protein led to an impaired ability to form new blood vessels in tissues deprived of blood flow, as occurs with atherosclerosis. The researchers hypothesized that the Western diet and the low-carb/high-protein diet caused “comparable injury and inflammation.” The low-carb group, however, suffered an impaired ability to repair and restore blood vessel function.

Rosenzweig  continued: “Although the precise nature and roll of [EPC] cells is still being worked out, these results succeeded in getting me off the low-carb diet.”

Rosenzweig stressed the apparent disconnect between weight loss and standard blood markers—where the low-carb diet worked—and vascular health. It appears that blood vessel health can be affected by more than fat and cholesterol—in this case, carbs and protein.  

Protein—the bodybuilder’s favorite macronutrient—may actually be an offender. Too much protein (and too little carbohydrate) may damage blood vessels and/or prevent restoration.

“For now,” says Rosenzweig, “it appears that a moderate and balanced diet, coupled with exercise, is probably best for most people.”

Sifter, that study was kind of ridiculous. They used ApoE-/- mice. Read Peter's enlightening take on it here:

http://high-fat-nutrition.blogspot.com/2009/08/low-carbohydrate-high-protein-and-apoe.html

And Part II: http://high-fat-nutrition.blogspot.com/2009/08/low-carbohydrate-high-protein-and-apoe_28.html

Hi,
I tend to eat every three hours, five meals a day. My triglycerides were recently meausred, they're at 33. I guess that does not support your bet, right? Or maybe I am getting this all wrong...
Kind regards,
Felix

Ornish advocates grazing and scored zero on the heart scan, so maybe what you eat is more critical than when, for plaque building.  He, like you, wouldn't go near the refined carbs in the experiment you cite.

When you see the patterns in hundreds or thousands of people, you realize that not everybody is the same. In fact, the range of differing responses is dramatic.

So, no, you cannot draw any conclusions about the experience of one.

I must be missing something, but wouldn't eating smaller meals result in smaller peaks and possibly quicker decline? So yes, stacking may occur, but isn't it conceivable that overall blood levels would be no higher than they would be with the larger meals?

I agree with Beth.

Beth, Jim,

That's the question I alluded to above
(see above, between Shel's & Sifter's
comments).

We would really need to see the corresponding curve for the same subjects, instructed to eat both meals
at one go.

So it doesn't look like this study by itself allows us to draw definite conclusions (on the question of grazing vs. gorging).

What you think about news - GOPers Hold 'Prayercast' to Ask God to Stop Health Reform ?
Wanna hear your opinion

This just reinforces the notion that fasting triglyceride levels are fairly useless for predicting disease.  It's the postprandial that matters since most people spend most of their lives in a postprandial state.

Rosenzweig stressed the apparent disconnect between weight loss and standard blood markers—where the low-carb diet worked—and vascular health. It appears that blood vessel health can be affected by more than fat and cholesterol—in this case, carbs and protein.

Thanks a lot for this unique informative post I like this post.



Smith ALan

"So is the low-carb movement really, at its core, a wheat-elimination movement?"
I think wheat would be the very close runner up to sugar.  Of course, if you eliminate wheat  you've also eliminated a major vehicle for sugar (cookies, cakes, donuts, muffins, hearthealthywholegrain bread...)

Hi, Marilyn--

I would reverse it: wheat is far worse than sugar. Let me explain.

Unlike sugar, wheat has other components, including gliadin, that stimulates appetite. Sucrose does not do this.

Eliminating sucrose does not eliminate desire for wheat; eliminating wheat eliminates desire for sucrose.

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In my low-carb house, being gluten-free and sugar-free go hand in hand. If someone were to "slip" I'd rather see a sucrose slip than gluten!

(Side note, since I've eliminated gluten, I've been free from all headaches - now THAT is telling! I used to get migraines 3x/week!)

I agree, Jackie. Sucrose is not good for you, but it does not invite the appetite stimulation of wheat.

I'm thrilled about your freedom from migraines.

I am new to this site, but have seen numerous remarks about the importance of vitamin D.  I'm a kidney stone former and I'm afraid to take vitamin D supplements.  My wife was put on vitamin D and Calcium supplementation; never had a kidney stone and -- BAM -- got her first one at age 57.  Any wisdom about this?  I am seriously thinking about limited carbs and wheat as Dr. Davis suggests.  We'll see where that takes me.

Dr. Davis, I was diagnosed with primary biliary cyrrhosis of the liver about 5 years ago, stage 2.  I'm a third generation liver disease patient, with a twin sister and a 1st cousin having the same disease also.  At that time, the doc I was seeing was honest enough to tell me he was not very educated about the disease, but did research it and found that low Vit D was a problem associated with PBC.  My level was almost not existent.  After years of taking the wrong vit D and taking it wrong altogether and getting only as high as a 16, I started researching it myself and put myself on the correct VitD and dosage of my choice and now have a level of 99.  Whoops!  I feel better, but I did stop the Vit D about 3 months ago to try to drop it a bit.  My doc did not order a repeat test.  I didn't ask for one as I was being scolded for prescribing my own treatment at the time.  lol  So, being the good Doc, what should I do at this point.  Retest the vit D level and go from there, or just begin a maintenence dose and retest the next time they draw labs, which could be 6-12 months from now?  And what would a maintenence dose be, in your opinion?  I have no reason to believe my level would stay up with nothing bc it was so low and bc of the PBC.

Thank you, Donna

My 93 year old Granny who is still going strong lived on a staple diet all her life of toast for breakfast (wheat) granary brown bread sandwiches every day with cheese or ham usually and in the evening the staple is usually potatos with a meat dish.... My theory is that the situation is highly conditional on how many calories you are burning, if it's being burnt off it makes no difference to a person of normal weight, no?

How do you explain that?