William Davis, MD, is a preventive cardiologist whose unique approach to diet allows him to advocate reversal, not just prevention, of heart disease.
He is the founder of the 
It’s a frequent question: Can I eat quinoa . . . or beans, or brown rice, or sweet potatoes? Or
how about amaranth, sorghum, and buckwheat? Surely corn on the cob is okay!
These are, of course, non-wheat carbohydrates. They lack several undesirable ingredients found in wheat including no:
Gliadin–The protein that degrades to exorphins, the compound from wheat digestion that exerts mind effects and stimulates appetite to the tune of 400 additional calories (on average) per day.
Gluten–The family of proteins that trigger immune diseases and neurologic impairment.
Amylopectin A–The highly-digestible “complex” carbohydrate that is no better–worse, in fact–than table sugar.
So why not eat non-wheat grains all you want? If they don’t cause appetite stimulation, behavioral outbursts in children with ADHD, addictive consumption of foods, dementia (i.e., gluten encephalopathy), etc., why not just eat them willy nilly?
Because they still increase blood sugar. Conventional wisdom is that these foods trend towards having a lower glycemic index than, say, table sugar, meaning they raise blood glucose less.
That’s true . . . but very misleading. Oats, for instance, with a glycemic index of 55 compared to table sugar’s 59, still sends blood sugar through the roof. Likewise, quinoa with a glycemic index of 53, will send blood sugar to, say, 150 mg/dl compared to 158 mg/dl for table sugar–yeah, sure, it’s better, but it still stinks. And that’s in non-diabetics. It’s worse in diabetics.
Of course, John Q. Internist will tell you that, provided your blood sugars after eating don’t exceed 200 mg/dl, you’ll be okay. What he’s really saying is “There’s no need for diabetes medication, so you’re okay. You will still be exposed to the many adverse health consequences of high blood sugar similar to, though less quickly than, a full diabetic, but that’s not my problem.”
In reality, most people can get away with consuming some of these non-wheat grains . . . provided portion size is limited. Beyond limiting portion size, there are two ways to better manage your carbohydrate sensitivity to ensure that metabolic distortions, such as high blood sugar, glycation, and small LDL particles, are not triggered.
So these non-wheat carbohydrates, or what I call “intermediate carbohydrates” (for lack of a better term; low-glycemic index is falsely reassuring) still trigger all the carbohydrate phenomena of table sugar. Is it possible to obtain the fiber, B-vitamin, flavonoid benefits of these intermediate carbohydrates without triggering the undesirable carbohydrate consequences?
Yes, by using small portions. Small portions are tolerated by most people without triggering all these phenomena. Problem: Individual sensitivity varies widely. One person’s perfectly safe portion size is another person’s deadly dose. For instance, I’ve witnessed many extreme differences, such as 1-hour blood sugar after 6 oz unsweetened yogurt of 250 mg/dl in one person, 105 mg/dl in another. So checking 1-hour blood sugars is a confident means of assessing individual sensitivity to carbs.
Some people don’t like the idea of checking blood sugars, however. Or, there might be times when it’s inconvenient or unavailable. A useful alternative: Count carbohydrate grams. (Count “net” carbohydrate grams, i.e., carbohydrates minus fiber grams to yield “net” carbs.) Most people can tolerate 40-50 grams carbohydrates per day and deal with them effectively, provided they are spaced out throughout the day and not all at once, i.e., 13-16 grams carbs per meal. Only the most sensitive, e.g., diabetics, people with the genetic pattern apo E2, those with familial hypertriglyceridemia, are intolerant to even this amount and do better with less than 30 grams per day. Then there are the genetically gifted from a carbohydrate perspective, people who can tolerate 50-60 grams, even more.
People will sometimes say things like “You don’t know what the hell you’re talking about because I eat 200 grams carbohydrate per day and I’m normal weight and have perfect fasting blood sugar and lipids.” As in many things, the crude measures made are falsely reassuring. Glycation, for instance, from postprandial blood sugars of “only” 140 mg/dl–typical after, say, unsweetened oatmeal–still works its unhealthy magic and will lead long-term to cataracts, arthritis, and other conditions.
Humans were not meant to consume an endless supply of readily-digestible carbohydrates. Counting carbohydrates is a great way to “tighten up” a carbohydrate restriction.
Hi Dr.,
I am just starting to go wheat free and it is working out great, I feel really well. I am a 23 year old woman with terrible acid reflux although I am very slim. I have been eating starchy vegetables, ample fats and proteins, but I am having some feelings of low blood sugar after around 3-4 hours of not eating. Do you think is due to just changing over to this new diet so recently (less than a week)? What can I do to help that?
Thanks so much!
This usually means 1) you are overconsuming carbohydrates, and 2) you are more prone to diabetes than other people.
In other words, you are experiencing high blood sugars that are inevitably followed by low blood sugars, a pre-diabetic pattern.
The cure is not to eat something with carbs to bring blood sugar back up, though that is the often-repeated conventional advice. The solution is to not allow the high blood sugar in the first place, i.e., cut way back or eliminate the starchy vegetables or any other food that raises blood sugar.
At the risk of making things too complicated, doesn’t what you eat with those carbs have a significant impact on your blood sugar? So, quinoa custard made with eggs may have less impact than quinoa porridge? Or is it just too risky and unpredictable to play that game?
Dr. Davis you seemed to have skipped over this question, if you could please explain this to us. Thanks.
Also I recently read that the glycemic index was measured using patients who were fasting..thus changing the result of people not consuming carbohydrates in a fasted state. Could this not play a significant role?
And I know that this site is geared towards normal insulin resistant people looking to lose weight, but what do you recommend for athletes training 6x a week if consuming carbs and spiking bloods sugar levels is not recommended? I know you mentioned small portions of carbohydrates, but you state not going over 50g a day. Surely this is not enough to sustain energy levels and may even cause catabolism and injuries due to muscle glycogen being depleted.
If you could clear up this confusion for me. Thank you,
Christian
Sorry, Christian: I didn’t understand your fasted state question.
Yes, athletes engaging in long endurance efforts can safely supplement healthy carbs DURING their effort, e.g., bananas, energy bars, Gu, cooked sweet potatoes, other fruit. However, the better you are at this diet, the less you will need. Note that primitive humans and members of primitive societies can run for hours without such supplemental carbs. The Masai might stop to drink cow’s blood, but no Gu or energy drinks here!
Wow thanks for the speedy response!
About the fasted question. The poster above and I was just asking/saying that when relatively healthy carbs are consumed with proteins and fats it slows down the digestion of sugars, making the absorption of carbs/sugars in the bloodstream slower, and consequently lowering the spike of insulin as opposed to eating carbs in a fasted state. Which is why GI numbers can be misleading.
Anyways thank you for your time and continue to keep up the good work!(Especially against the modern SAD and gluten) You and others are doing a great thing for society.
Christian
Hi Christian,
That is why the concept of glycemic load was defined and is thought to be more relevant. The GI is a measure of how fast 50g or 100g of some carbs will go into your blood stream. However, even though a carrot has a relatively high GI, its glycemic load – which is a combination of GI and amount of carbs the carrot contains – will be ridiculously small. Of course, everybody is different and the best thing to do is to have a glucometer with you, measure your blood sugar level one hour after eating a carrot ALONE (breaking some fasting period), and repeat the same thing but this time after eating a carrot and say a bit chunk of fat like a 3-4 egg yoke omelet cooked in butter.
The result will apply to you only and mine could be totally different. It depends on how much insulin resistant you are.
Regarding athletes, you may want to browse Peter Attia’s blog which addresses exactly that (effect of nutritional ketosis on physical performance):
http://eatingacademy.com/
I am a type 2 diabetic, I tried some quinoa pudding last night and my blood sugar went through the roof. I never would have done it but was misinforned that quinoa was mostly protein. I realize my account is anecdotal but am suggesting those like myslf who are very sensitive to carbs proceed with great caution.
You did the exact right thing, Daniel: Check a 1-hour after-eating blood sugar and ELIMINATE the foods that raise blood sugar AT ALL.
You quickly discover that foods like oats or quinoa have no role in your diet, as they CAUSE diabetes.
My Wheat Belly book should be arriving from Amazon on the 29th…yay!
My question right now is about blood sugar. I do not have medical insurance so do not even know my ‘numbers’, and frankly, don’t even know how to test for my level of blood sugar.
What I have noticed for years is that if I eat sweets or say, two slices of bread, my heart rate greatly increases and I just plain feel rotten. I have to sit and mentally work at decreasing my heart rate. I don’t recall any lows later but I wasn’t paying attention to that. It has always concerned me that I had an insulin problem.
So my question: Is what I describe high blood sugar?
Note:
The pretzels are the villain right now because there is an IBS site that recommends soluble fiber and avoiding insoluble fiber especially for IBS-D. Well, I have avoided such foods for years but after following this advice – ahem, I think I am addicted to pretzels! Plus, my appetite has increased ten-fold, but not in a good way.
I’ve always been very slim but now I’m seeing an uncomfortable pooch. The pretzels seemed to work at first, (especially since it seemed everything I was eating was making me sick) in ‘settling things down’ and settling my stomach, but now I think they have brought up more IBS symptoms/miseries.
The way I found this site was from a snippet I heard of an upcoming newscast, “…up at 11, is wheat possibly making you more hungry?….” That’s what I googled.
A healthy diet does not require monitoring of blood sugar.
That said, it sounds (to this non-physician) like it might be worthwhile for you to know yours. Glucose monitoring devices are widely and inexpensively available in most countries, along with any needed lancets and test strips.
Pretzels are poison if they are made from wheat, which they usually are. Go low carb grain-free paleo, and be prepared for your blood sugar to stabilize, and the IBS to vanish.
Yes, this is the classic set of symptoms of high blood sugar.
I fear that it is the gliadin opiate of wheat that has been stimulating your appetite, compounded with the amylopectin A that is responsible for sky-high blood sugars.
It all unwinds by losing the wheat!
Thank you, Boundless. After seeing my concerns in my own writing for the first time, yes – it may be worthwhile.
After reading (and reading and reading) what others have said, my plan has been to read Wheat Belly to be able to determine exactly what I needed to ditch, besides the pretzels, and then either buy the Wheat Belly cookbook or look into Paleo, or both. The more I’ve come across anything Paleo, the more I see that there are different versions, and I guess, opinions on what can be included. I just googled what you wrote, ” low carb grain-free paleo”, and I will go from there.
Thanks again,
Sue
Until the book arrives, start here on what to eat:
http://www.wheatbellyblog.com/2012/12/wheat-belly-quick-dirty-2/
Can you please comment on the Glycemic Index value of Quinoa ?
According to this site… “A half-cup of cooked quinoa ranks just under 10 (that’s low!) on the glycemic load scale”
http://www.realage.com/living-younger-with-diabetes/10-best-foods-for-diabetes-9
And here… “A cup of cooked quinoa contains 25 grams of carbohydrates and has a glycemic load of 13″
http://www.livestrong.com/article/258598-quinoa-the-glycemic-index/
Not much of a rise in Blood Sugar after consumption on this forum…
http://www.diabetesforums.com/forum/dieting-and-nutrition-diabetes/59821-quinoa.html
Who to believe ???
Regards,
Kevin.
You can believe your own experience, Kevin.
Get an inexpensive glucose meter and check a fingerstick blood sugar 1-hour prior to eating, then 1-hour after to assess peak glucose. More than likely, you will see a substantial rise, though it differs widely from individual to individual.
Even better, get an NMR lipoprotein analysis before, then the next day after consuming it: Big rise.
I’ve been on a mostly carb-free diet since Oct. 2012 and have lost about 20 lbs. (Dukan Diet) and my pre-diabetic condition seems to have resolved itself. Can I now add Hummus to my diet? Thank you.
We just purchased your book ‘Wheat Belly’. While you write a convincing argument regarding the negativity of wheat, I am yet to find any real discussion of other carbohydrates ie. brown rice, quinoa, etc. or gluten free breads made with various flours. Similarly, why not use such flours for pizza crusts etc.? Rather disappointing!
Hugh
Please read the book again and you will find that you may have overlooked extensive discussions of this issue. It is also discussed extensively on this blog.
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I have been looking for gluten free oats and came across a new product called Cavena Nuda – Naked oats. Oats without the hull. It is said to be low glycemic and is gluten free. Can be substitute for rice, barley – has a chewy texture like brown rice. Dr.Davis, what do you think of this product. It is non GMO.
High Beta Glucan Levels – The high levels of beta glucan in Cavena means that it can lower your cholesterol levels, improving your cardiovascular system without the use of drugs or artificial supplements.
Wheat Free – For those that are gluten intolerant or celiac, Cavena can offer a new source of nutrition for their diets.
High Protein – naturally high in protein, Cavena has a very easily digested protein content, with very high levels of lysine-the key to good muscle growth. Because it is not heat treated, it retains all of its protein until eaten by you.
Nutritional Analysis per 100g Cavena White Rice Oats
Energy 397 calories 365 calories 421 calories
Total Dietary Fibre 12.0g 1.3g 11.6g
Soluble Fibre (beta Glucan) 4.4g 0.0g 3.8g
Protein 17.2g 7.13g 14.0g
Calcium 45.2mg 28.0mg 57.0mg
Iron 5.7mg 0.80mg 4.60mg
Total Fat 8.8g 0.66g 6.90g
Omega 3 0.1g 0.00g .1g
Omega 6 3.3g 0.00g 2.4g
Saturated Fat 1.9g 0.27g 1.30g
Monounsaturated Fat 3.5g 0.21g 2.20g
Polyunsaturated Fat 3.4g 0.18g 2.50g
Trans Fatty Acid n.d. 0.0g 0.0g
Cholesterol n.d. 0.0g 0.0g
Sodium 3.8mg 5.0mg 4.40g
Potassium 385mg 115mg 384g
Carbohydrates 62.2g 79.9g 74.0g
Total Sugar 0.6g 0.12g 0.0g
YIKES……the way I read that is around 50 grams of net carbs!
That’s lower than the rice or regular oats.
What is the big deal about net carbs? Isn’t the nutrition factor over the rice more important. Also I need a substitute for barley in soups that is gluten free. This works well, while adding nutrition. I have given up wheat entirely, but hard to give up all grains, oats is my only grain left. As this is a permanent lifestyle change, not a diet, I have to be able to live with it.
I think the WB guideline suggests 15 – 20 grams of net carbs per meal.
I bought this bread called ” The Paleo Bread” by JulianBakery that was awful used as bread but worked absolutely marvelous cut into very small cubes and used in soup. It’s made with almond flour and egg whites. 1 net carb per slice. It’s way too rubbery to enjoy as bread, but that characteristic is what makes it ideal in soup! I sautéed the cubes in butter and then added to my already dished up soup.
Jacqueline……I bought a loaf of their “new improved” and independently tested (apparently they had some trouble in their labs). It was terrible…..spongy! I saved it in the freezer, thinking I could do something else with it and tried it in Dr. D’s strata recipe…..after spending the night in my refridge, soaking up the egg mixture, then being cooked in the oven….it morphed into inedible baby sponges. Waste of money!
You can think of WB as
- gluten-bearing-grain-free but also very low carb, or as
- very low carb but also free of gluten-bearing-grain-free
… plus some other recommendations.
Either approach alone would bring significant health benefits, but doing both is substantially more effective (and makes doing the low carb easier, due to eliminating the confounding effects of wheat).
WB is 50 net carb grams per day or less, and 15 net grams per meal or 6-hour period. A single serving of anything with 50 blows the budget and spikes the blood sugar.
Regarding Julian bakery, see (among other sites):
http://livinlavidalowcarb.com/blog/julian-bakery-customer-tests-low-carb-bread-claims-requests-they-immediately-cease-sales/14568
They may have since fixed the products. It’s going to take a lot longer to fix their reputation.
Wow. Let the buyer beware in spades! Thanks Boundless for the heads up. This junk is going straight to the trash!
Hi, I am new to this site as I just heard about this regimen. A friend of mine told me last night; she lost 10 lb in less than two month. I have a question; our main food is bread especially morning for breakfast. I was able to find ‘Quinoa bread’ in Toronto, Canada- checked Sobyes, & Longos groceries.
- Can I substitute ‘pumpkin bread’ or ‘barley bread’ instead of wheat bread?
Thanks
> Can I substitute ‘pumpkin bread’ or ‘barley bread’ instead of wheat bread?
Probably not and definitely no.
With the pumpkin, it’s largely a matter of net carbs per slice, assuming there aren’t any other problematic ingredients, such as trans fats or excessive omega 6 oils.
Barley (and rye) products are straight off the shopping list. They are gluten-bearing grains, like wheat, very high glycemic, and due to cross-breeding, may well have other wheat toxins.
I have just read your book and was searching through your blog archives to find a few answers. I know you advocate eating lower carb in general, in the book you referenced between 50-100 grams per day. However, I am a marathon runner, so I am struggling to find what the right balance is. I have totally eliminated all wheat sources from my diet, but am still eating rice, oats, and potatoes (1-2 servings per day). Do you have a suggestion for a good amount of carbs to consume for someone in my position who still wants to lose a few pounds?
It means converting to limited carbohydrate but accepting impaired performance for the first 4 weeks while your body makes the transition to a more fatty acid oxidizing metabolism.
Carbs remain useful, but only during a very long distance effort, e.g., mile 8-10 of a run, mile 20-25 of a bike. People who are truly not dependent on carbohydrates should not need carbs prior to an event.
I’m not totally understanding about carbs and glycemic index. In looking up glycemic charts they all say that a food with a number of 50 or less is considered low. What is the highest number of a single food that you recomend? The same question for carbs. ( For example, on a chart I was looking at avacados were very high in carbs but you recommend eating.) I’m not exactly sure how to work the two together. And why, exactly, do I subtract the protein?
> I’m not totally understanding about carbs and glycemic index.
Focus on net carbs, which is total carbs minus fiber carbs.
I completely ignore GI. It seems to be frequently optimistic compared to net carbs. You’ll get an eyeful searching on “glycemic index misleading”. GI seems to be a useful number for the food industry to keep diabetics dependent on insulin. Going very low net carb, on the other hand, can remiss the entire condition.
> What is the highest number of a single food that you recomend?
The WB recommendation ignores GI entirely and targets 50 grams net carbs per day and no more than 15 grams per meal or six-hour period.
> … on a chart I was looking at avacados were
> very high in carbs but you recommend eating.
One avocado is 12 grams total carb, 9 grams fiber carb, for a net of 3. That’s pretty low.
> And why, exactly, do I subtract the protein?
Um, where did that come from?
Ok, so subtract the fiber. I had that mixed up with protein. thanks for your explanation.
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Dr. Davis,
I bought your book last summer and have eliminated wheat from my diet, but fall of the wagon every so often. I lost 20 pounds pretty easily but have stalled still ABOUT 45 POUNDS overweight. I watched a talk show with the host of extreme makeover, weight loss edition and was intrigued. he promotes a healthy carb on carb off diet and seemed to have impressive results. A carb on day tout boosting metabolism, then the carb off day burns fat. he suggests eating brown rice, beans, oatmeal, lentils as carb sources not wheat or potatoes. I did some research into the cyclic ketogenic diet (or carb-cycling).
The goals of a refeed or carb day are threefold:
a) to refill depleted glycogen stores
b) to upregulate hormones and thyroid activity that is depressed during dieting
c) to provide a psychological “break” that makes the rest of the diet easier to bears.
The refueled glyocgen stores can then be used for higher-intensity training to maintain or increase endurance / muscle mass after the refeed. Normally this sort of training would be relatively impossible on a pure ketogenic diet, as glycogen stores in the body are almost constantly depleted.
For example, if I scheduled a high carb day, say Saturday that I could look forward to red beans and rice, or black beans and rice with pork or shrimp and grits I think I could better avoid slip ups.
I think if I allowed myself a carb day now and then I might be better at sticking to the carb moderation you suggest and would be less likely to crack for a pepperoni pizza , the main food I seem to fall of the wheat wagon for. What is your opinion of this type of approach? would you recommend alternating days at all as extreme weight loss suggests using healthy carbs, then no carbs?
Dr Davis,
I have a couple of questions.
My major obstacle in moving what I eat to your wheat belly or paleo(which I did do for 2 months, felt great) is getting my husband on board. He is a wheatophile, fattymeatophile, you get the picture. I was recently diagnosed with Wheat allergy, dairy and other things. Since there is now a physican diagnosis I am getting more cooperation but he is reeling from the absence of traditional breads etc. Is there some way to help him bridge this gap.
Also I am having a hip replacement, will this way of eating help with healing after surgery and slow down the arthritis problems I am dealing with. I tried to put off the surgery but I can hardly walk and xrays have it bone on bone with acetabular cysts. I do think it has to go.
Anne