Without doubt, a primary benefit of the paleo diet is the elimination of grains (which contain inflammatory protein--gluten--and plant-defense toxins called lectins).

The high (good) fat aspect of the paleo diet also plays a big role in increasing HDL and lowering triglycerides. These good fats including animal fats, saturated fats (mistaken painted as bad-guy fats), omega-3's, omega-9's (like olive oil and avocado oil), while greatly reducing the inflammatory processed omega-6 oils (corn and soy oil, among numerous others).

The paleo diet also rules out any processed form of fructose:
http://www.thorne.com/altmedrev/.fulltext/10/4/294.pdf

i have eliminated wheat and all grains as you have suggested and my lipid profile from recent NMR has improved: HDL jumped from 40to 54; LDLC of 94 up from 93, and Trg dropped to 20 from 37 and large HDL-P increased from 3.3 to 14.8, particle number dropped from1795 to 1305, but they still remain all small particles.  LDL particle size unchanged at 19.7. So some good things from elimination of wheat and grains, but no change in particle size.  At 5'6" male and 145lbs, hard to lose weight.  Any suggestions on how to change particle size and lower number of particles further? diet is meat fish eggs poultry, whey powder, hard cheese, greek 2% yogurt and fruit and veggies, some red wine and dark(85%+ chocolate)  Vitamin D3 measures at 38(25oh). with family history, doc wants 20 mg Lipitor.  Excellent post in both cases. Perhpas Paleo not work for all, although Eades would say i should add more sat fat to diet

I love reading in more and more places that saturated fats are not evil!

The word is getting out, and one of these days, dietary researchers won't have to apologize about their results or come up with elaborate strategies to make sure that they can't be perceived as saying that saturated fat might be (gasp!) good for you.

Remember the Okinawans.  Previous generations of Okinawans are among the longest lived people on the planet.  Pork, fish, non-starchy vegetables (cooked in lard), and a little bit of rice make up almost all of their diet.

Dr. Davis, it wasn't that long ago that you were very cautious about fats and saturated fats, but I've seen a substantial shift in your comments over the past several months.  I salute your resolve to really understand what is good for our hearts and then going beyond that by doing your best to communicate what you've learned back to everyone who will listen/read.

This is the first time I have seen someone call out Gluten as the component of wheat that causes inflammation response.  Good to know as it is often a primary source of protein for vegetarians.

I don't see the fructose argument though.  This is a simple sugar that is broken down to glucose in the digestive tract like any other sugar eaten; according to high-school human biology......

Dr Davis,

Do low carb eaters need to be concerned about the aging effects of oxoaldehydes such as methylglyoxal?

I read recently that the concentration of such compounds increases during ketosis and that they are much more reactive than glucose, readily forming protein cross links which age the body.

-- Tom

Some people may be wondering how it was that eating wheat and other high fibre grains caused humans to become weaker, shorter and fatter.

This paper http://www.ncbi.nlm.nih.gov/pubmed/6299329 Reduced plasma half-life of radio-labelled 25-hydroxyvitamin D3 in subjects receiving a high-fibre diet.
unearthed by Stephan at Whole Health Source, provides one possible explanation as it shows a high-fibre diet reduces the half-life of 25(OH)D3 thus speeding up vitamin d deficiency.

Yes!  I thoroughly enjoyed Dr. Eades commentary on that study.  Although I do wish that study authors wouldn't obsess so much over saturated fat.

Steven from http://wholehealthsource.blogspot.com/ also did a bang up review.  His blog is also quite fantastic.  He did a series on Tokelau Island migrant studies that was very interesting.  They are a people that eat quite a lot of saturated fat, from coconut, and yet had virtually no heart disease.

I cut out wheat a long time ago but haven't had blood work recently.  If cholesterol has nothing to do with heart disease, why worry about it?  Why eliminate saturated fats if they're not contributing to atherosclerosis?

kevin

The wheat connection is interesting, it's far and away the worst grain for spiking my glucose levels, even wheat bran will do it.

My athlete cousin is already showing signs of the familial insulin resistance in her thirties and while she stuffs her body with far more carbs than I do she has noticed a marked improvement from avoiding wheat.

The horrible irony is that a diabetic colleague diagnosed my diabetes over twenty years ago and a friend who knew my diet suggested I might be wheat intolerant. My doctor wrote that I had "fanciful notions" and hypochondria. Now here I am. Meanwhile the GP died "unexpectedly" which was ironic

I wonder if wheat has always been this (comparatively) toxic or if it's the modern strains specifically. Originally it was a transgenic cross, kind of natural GM, with far more chromosomes than is good for it, but has been majorly tweaked over the years to provide current yields

It's odd to me how often folks state that there's no proof that saturated fat intake causes heart disease. I know the standard arguments, I've read Good Calories, Bad Calories and many of the websites dedicated to disproving the lipid hypothetesis.

But the fact is, there are quite a few studies that demonstrate that saturated fat intake IS associated with higher incidence of heart disease (not just cholesterol profiles).

A few examples:
http://content.nejm.org/cgi/content/abstract/337/21/1491

http://content.nejm.org/cgi/content/abstract/337/21/1491

http://www.ajcn.org/cgi/content/full/70/6/1001

The majority of the studies I've seen on low carbohydrate, high fat diets have all been pretty short-term and didn't actually measure heart disease. They just measured cholesterol and, occasionally, inflammation.

To Anonymous's question about fructose.  It's very important that you understand the metabolic pathway for fructose.

Fructose is carried by the blood from your gut directly to your liver.  Once detected, your liver stops everything else and converts fructose to triglycerides.  It does this because fructose is a highly reactive sugar and is treated as a dangerous substance by your body.  Triglycerides aren't nearly as bad (but if you've been reading this blog, you know that they're pretty bad, too).  

Most of the triglycerides are released into the blood (where they represent the wrong side of the HDL/triglycerides heart health ratio), while some small fraction remain trapped in the liver tissues.  If you keep hitting your liver with triglycerides (via fructose), and live long enough, those triglycerides get stored in the liver and you'll end up with fatty liver disease.

Fructose is all sorts of bad news for your health.  Sucrose, HFCS, honey, cane solids, corn syrup solids, etc: all contain significant quantities of fructose, and over time, all pose a risk to your heart, your liver, and via insulin resistance and glycation reactions, your entire body.

I am new to trying to understand the most healthy diet and just finished reading Dr. Eades book (who does not eschew whole grains in his meal plans).  I am reminded of Michael Pollan's comments that preface his book - 'In Defense of Food' in which he claims there is much ideology with regard to diet and nutrition.  

I understand many people have strong opinions, but I am hoping someone can provide insight into this website that includes whole wheat as one of the most important foods in our diet -- http://www.whfoods.com/genpage.php?tname=foodspice&dbid=141.

I am not asking this to be controversial, but would genuinely like to hear some factual counterpoints.

This is great news for the paleolithic community: the British Medical Association has just recognised the importance of paleolithic diets in this recent report (see pages 5/6): http://www.bma.org.uk/health_promotion_ethics/child_health/earlylifenutrition.jsp

This is truly a great read for me!! I love the quality information and news your blog provides Smile I have you bookmarked to show this to all!Thanks.


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I have read your article Michael Eades on the Paleolithic diet' good article The diet consists of an inflexible meal plan. The diet does not allow forsubstitutions or deviations

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This is the first time I have seen someone call out Gluten as the component of wheat that causes inflammation response. Good to know as it is often a primary source of protein for vegetarians.

I tend to gain weight when I work a lot of night shifts at the hospital.  My sleep/wake pattern gets very messed up and I turn to extra carbs to fight off fatigue.  Working rotating shifts must take a toll on health.

Well I am living proof that 4 and 5 exist. Very low carb diet ( 10 g a day ) for 3 months and less than 2kg weight loss. My Leptin is 32 ( norm is 8 here ).

So how do I sort out Cortisol and Leptin ??

Surprised to see high-fructose corn syrup so far down on the list....don't really consume any of those but enlighting still.

Could it be as easy as these people might actually need to cut down on something else instead... I am most often in favor or cutting wheat in diets but if you look at blood type there is actually some grains that are good for some people with a certain blood type. Type A is one of the group that could possibly be seeing nothing when they stop eating wheat and continue to eat other things that is not good for them, such as red meat. Off course there could be other issues too, just what you are saying in your post, but I think it could mention that blood type do play a role in what your body can do with the food you give it...

I eliminated wheat in 1999. Lost 100 lbs and my arthritis, but stalled out at about 50 lbs over goal.

I have been "tweaking" lately. I already take an iodine supplement (didn't appear to make any difference, although my low morning body temperature isn't as low).

I'm guessing that all those trans-fats damaged my metabolism. Or maybe it was a combination of trans fat, HFCS, and wheat.

My latest experiment for breaking the nearly decade-long stall is IF, combined with Fred-Hahn style slow-burn twice a week. That appears to be working, at least in the short term.

I am interested in the Leptin resistance idea, and especially in ways to fix it if that is the problem.

@Helena: "eat other things that is not good for them, such as red meat. "

Nutritional ignorance abounds. You are confusing red meat with fuzzy gray-green meat. The latter is not good for you, but the former is.

Yes, it does, Jay.

The sooner you can escape this unnatural sleep-wake pattern, the sooner you can regain better health.

Let's cover in a future post, Jo. There's no quick answer.

Hi, Howard--

Let's cover the leptin question in future.

I do love the Slow Burn idea, too, a way to make substantial gains with a minimum of effort.

Dr Davis,

Do you have some references for the term "best" as in "best accomplished with salivary cortisol assessment"?

I  would prefer this comment to be private:

It seems that maybe excessive alcohol consumption might be a factor in not losing weight after cutting out wheat.  I am wondering why you don't talk  frankly and directly about alcohol consumption when you talk about the patients you have helped.  You do say moderate consumption is  better, but you do not go into any detail about what overcunsumption is and what it does, or what advice you give to those who are drinking too much when you help them.  You have given vivid examples of people whose lives have been saved by the avoidance of wheat, but is that really the whole story?  My guess is that at least 10% of the people who are reading your blog or who have bought your book are drinking alcohol to excess.  What advice would you give that 10% ?  I applaud you for your diligent efforts to help people recover their health, and I would encourage you to consider those people who might still be outside your scope of interest.

Hi Dr. Davis:
If one has an abnormal salivary cortisol or is leptin resistant, what steps must be undertaken to overcome each of these?  Thanks.

I have not eaten wheat, (or any grains) for over a year. I do not eat sweets except occasionally fruit like berries. (When peaches were in season last summer I could not resist.) I have been able to stop gaining weight, but losing weight is elusive. I have Hasimoto's disease. My TSH is around 1 with 45 mg Armour Thyroid, but my T3 and T4 are in the lower range of normal. I do take about 750 mcg  iodine, Standard Process Thytrophin PMG (which is supposed to help with the autoimmunity) and a product called Sea Vegetables Plus which has sea vegetables, L-Tyrosine and Bioperine . Are there any other ways to optimize thyroid function?

I've long eliminated all of what you list from my diet and reaped benefits. I'm very lean but for a very small handle around my mid-section -- I'll call it my 'fruit belly' as fruit is the one indulgence I refuse to give up.

I live in a region with fresh fruit stands on almost every corner and I eat it aplenty. I think there are a few pleasures in life worth a little weight gain (if it causes any in me at all). And certainly there must be some benefits to a diet full of many different types of fresh fruit.

Hi, Oc--
Great topics for future discussions!

I hear you, Michael.

I suppose that I am guilty of not saying the obvious, at times, such as smoking causes heart disease over-consumption of alcohol, e.g., more than 3 drinks per day, is unhealthy for a long list of reasons. Thanks for the reminder.

None that I know about, Susan. In fact, I am skeptical that ANY iof the "thyroid support" supplements available do anything at all.

Iodine works, no question. Selenium might work in Hashimoto's thyroiditis. Beyond this, I know of nothing that makes the thyroid work better, including tyrosine. Giving your thyroid tyrosine is like putting more gas in your gastank: It won't make the car go any faster.

Just beware of glycation, Clark.

Gauge glycation by your HbA1c. I regard anything above 5.0% as an undesirable level of glycation.

This is a comment about a statement in the first chapter of Wheat Belly but I did not know how where to send it to.

You have repeated the oft statedidea' that humans share 99% of their genes with chimpanzees. The correct number is closer to 95% if you take into account insertions and deletions. The 99% was an early estimate based on older technology and has been superseded. See http://www.ncbi.nlm.nih.gov/pmc/articles/PMC129726/ "Divergence between samples of chimpanzee and human DNA sequences is 5%, counting indels"

How big of an effect can borderline hypothyroidism have on lipid profiles? I've been fighting high triglycerides and low HDL (and presumably small LDL) all my life.  Even on a gram of niacin, lots of fish oil and topped up vitamin d, I'm running 300ish on TG and 33-35 HDL. I'm not obese or even overweight by more than perhaps 5 pounds. Even when I'm a fanatic about exercise and low carb, the best I've ever done was 160 TG. As much as I hate the idea, I'm ready to throw in the towel and resort to Tricor and/or a statin. I've been on testosterone replacement for over two years (I'm 41), and I may have my thyroid evaluated as we make adjustments to that. I don't think I'm big-time hypothyroid, but if its running a little slow, can fixing that have a marked impact on lipids?Is whole extract usually/always better than synthroid?

Or another possible reason - I had already sharply reduced carbohydrate intake for several months, and hit a stable plateau of just over 250 lbs (tall and muscular guy, but still 30 lbs too fat).  Going off all wheat six weeks ago hasn't helped break below that weight.  I've never been symptomatic for coeliac or other auto-immune reactions from wheat so for me it was just a tightening of my carb intake.  Activity levels pretty high - regular gym work, some running & walking, outdoors for soccer coaching.  But stuck above 250.

I admire  your way with words, and I imagine you're a very good looking man as well.

Aw shucks.  But lots of people say that.

Hi, Kenneth--

Thyroid can exert a BIG effect on lipids. The worse the hypothyroidism, the bigger the effect.

And, if thyroid replacement is necessary, the extracts are nearly always better than T4 alone as Synthroid.

Thanks, Peter. Good to know.

Dr. Davis, I'm one of those who gained doing Archevore (eliminated all grains, legumes, sugar, seed oils but kept whole cream, cheese and butter).. In 10 mths I'd lost inches everywhere but start gaining wt the last couple mths. On your blog you suggested that I might have a thyroid issue. I bought myself a glass thermometer and did basal temp checks 3 mornings in a row at same time before rising - 96.9, 97.1 and 97.1. I understand the normal range is 97.4-98.2.  My average of 97 indicates hypothyroid right? If most people don't see symptom resolutions using thyroid meds, is there any reason for me to get tested?

I also concurrently gave up all dairy and substituted coconut milk. I am happy to say I am now seeing a wt loss of 1/2 - 1 lb a day this week! I have even been able to up my carbs from VLC (25) to moderate (60-100) with no adverse effects!  While I had given up milk, I really did not think cream, butter or cheese was holding me back. Boy was I wrong! The joint achiness is also now gone!

Hi, Sandra--

Normal temperature if taken orally immediately upon awakening is 97.3 F. So your temperatures are marginally low. Worth watching over time.

That's great with the dairy products. While I've included limited dairy products in the diet I advocate, there are undoubtedly people like you with exceptional sensitivities.

Please make sure you still have a good calcium source. Most western people are very vitamin D deficient, especially during the winter. Which means you don't take up all the calcium from the food. So keep an eye on your 25(OH)D3 level, and calcium intake.

You should check your 25(OH)D3 and B12 levels to make your sleep more effective: http://www.youtube.com/view_play_list?p=35D93D52577FB34C

And if you are not a night owl, don't work nightshifts..

Dr. Davis
This gentleman, Dr. Kruse, is all the rage at Marks Daily Apple site. I'm curious about your thoughts on his Lipten Reset approach.
Here is a link to his bog, and his Leptin Prescription.
http://jackkruse.com/my-leptin-prescription/
Thank you.

Dr. Kruse's advice is very reasonable. One modest difference: I tend to rely on an even lower carbohydrate intake, e.g., 10-12 grams per meal, while trying to regain control over metabolic distortions.

Thanks Dr. What are your thoughts on eating 50 gr. of protein within a half hour of waking up?  I'm never hungry till after11 AM.

Interesting Blog. I've read this far, and I see over and over again one theory that has me a bit baffled, which is fruit. Hi carb to be sure, but the 80/10/10 diet by Dr. Graham suggests that fat is the culprit that drives up blood sugar.  My blood sugar has been very stable on a strict fruit/veggie diet. I'm curious what your take would be with regards to small LDL particles on a strict fruit and veggie regimen?