A comment was posted on the Facebook page for the Wheat Belly Blog about tracking the wheat-free experience. It concerned me because he/she was going to track things like cholesterol values.
Sadly, cholesterol values can be a crude and often misleading set of measures. (Anyone following my discussions on the Heart Scan Blog or the Track Your Plaque program knows that conventional cholesterol values are next to useless. Tracking the right data is crucial.) Cholesterol values can actually look worse after weight loss on a wheat-free diet, since LDL cholesterol, for instance, is a calculated and not a real measured value (what I call “fictitious LDL) and total cholesterol is an awful mix of both good (HDL) and bad (LDL).
So if you want to chronicle your wheat-free experience with measures that properly reflect the metabolic transformation, here are the measures to consider:
Waist circumference–After all, the whole conversation started talking about wheat bellies!
Fasting blood glucose, HbA1c–The HbA1c reflects your prior 60 days of around-the-clock blood glucose values. I aim for blood glucose 90 mg/dl or less and HbA1c 5.0% or less.
HDL, triglycerides–Unlike calculated LDL, these two values are measured and do reflect your wheat-free experience accurately with increased HDL and reduced triglycerides.
LDL particle number or apoprotein B–These are the real measures of LDL particles that plummet with wheat elimination.
Small LDL particles–Although most people don’t measure this, when you do you will witness huge reductions in measures of small LDL. I use the NMR method in my office and drops from, say, 2400 nmol/L to 300 nmol/L are common with wheat elimination. Recall that small LDL is the #1 most common cause for heart disease in the U.S., not “high cholesterol.” Wheat consumption increases small LDL particles; wheat elimination is the most powerful tool available for reduction of small LDL particles, particularly when combined with weight loss.
C-reactive protein–The reason why so many people talk about c-reactive protein (CRP) is because the pharmaceutical industry has fueled the discussion about it in the media with clinical trials like the JUPITER trial of Crestor in people with high CRP. But CRP and other measures of inflammation drop to the floor with wheat elimination.
Also, be sure to not have these sorts of measures until weight has stabilized. Blood drawn during ongoing weight loss will show confusing patterns, including reduced HDL, increased triglycerides, high blood glucose, and other distortions, all resulting from the flood of fatty acids that come from mobilization of stored fat. (For more discussion on this, see this Heart Scan Blog post.) I ask people to wait about 6-8 weeks after weight has plateaued before having blood drawn.
I am a big believer in tracking your experiences. But you’ve also got to choose the right values to track. No sense in tracking the speed you are driving by looking at the odometer.