A grain eater’s cholesterol panel

Much of the $23 billion spent each and every year on statin drugs is really targeting the treatment of “high cholesterol” created by consuming grains.

It doesn’t initially seem this way, as people (including most of my colleagues) focus on fat consumption, especially saturated fat, as the cause for high cholesterol. So let me try and clear up this somewhat confusing issue.

Here is a typical panel of someone who consumes grains:

Triglycerides 170 mg/dl
LDL cholesterol (calculated) 150 mg/dl
HDL cholesterol 40 mg/dl
Total cholesterol 224 mg/dl

In other words, HDL cholesterol is lowish, triglycerides high, LDL cholesterol and total cholesterol high. What does this mean? Let’s take each, one by one:

Triglycerides are the byproduct of two digestive processes: 1) De novo lipogenesis or the liver’s conversion of the amylopectin of grains into triglyceride-rich VLDL particles that enter the bloodstream, and 2) absorption of dietary fats (which are triglycerides themselves). De novo lipogenesis dominates triglyceride levels in the bloodstream, far outstripping consumption of fat as a determinant of triglyceride levels. This simple fact was only identified recently, as the rise in triglycerides that occurs after consuming fats and oils develops within 2-4 hours, but the much larger rise in triglycerides from carbohydrate-to-triglyceride conversion starts 6-8 hours later, a fact not uncovered in older studies that failed to track this phenomenon this far out in time. (And, in certain genetic types, such as apo E2, the rise from carbohydrates in grains and sugars can last for days to weeks.)

LDL cholesterol is calculated, not measured. The Friedewald calculation, developed in the early 1960s to provide an easy but crude means of estimating the quantity of cholesterol in the low-density lipoprotein fraction of the blood appled several basic assumptions: 1) that everyone consumes an average diet of average macronutrient composition, and 2) that the triglyceride content of all lipoproteins remained constant from person to person (which is not true, but wildly variable, and 3) that all LDL particles are the same size (also not true, as LDL particles vary in size within a wide range of diameters).

Grain consumption, thanks to the process of de novo lipogenesis, increases blood levels of triglycerides and VLDL particles. VLDL particles interact with LDL particles, enriching LDL particle triglyceride content and reducing cholesterol content. This leads to a process of LDL particle “remodeling” that creates small LDL particles–glycation-prone, oxidazable, adherent to inflammatory blood cells, and persistent in the bloodstream for 7 days, rather than the 24 hours of more benign large LDL particles. Grains thereby trigger the process creating small LDL particles; fats trigger the process that does not.

When we cut out grains, the Friedewald calculation is therefore no longer valid, as the assumptions–weak to begin with–are completely disrupted. LDL cholesterol, this crude, surrogate effort to indirectly quantify LDL particles, is therefore completely useless. This has not, unfortunately, dampened enthusiasm among my colleagues nor the drug industry for trying to treat this number with statin drugs.

Better ways to quantify LDL particles: NMR LDL particle number (which includes quantification of small and large LDL particles) or an apoprotein B. (Each LDL particle contains one apo B, which thereby provides a virtual count of LDL particles, but no breakdown into small vs. large.)

HDL cholesterol is, unlike LDL cholesterol, a measured and reliable value. Ironically, it is among the most ignored. Grain-consuming humans tend to have low HDL because the high triglyceride/VLDL particles interact in the bloodstream with HDL particles, enriching HDL particles in triglycerides and reducing cholesterol content. This leads to a reduction in HDL size and HDL quantity, thus the lowish or low HDL cholesterol values. The lower the HDL, the higher the cardiovascular risk, a relationship that has held up many times over the years.

Total cholesterol is the sum of all three values: LDL cholesterol + HDL cholesterol + triglycerides/5. (More accurately, LDL cholesterol is the calculated value: LDL = total chol – HDL – trg/5.)

Given the mix of values, total cholesterol is therefore essentially useless. A large increase in HDL, for instance–a GOOD thing–will raise total cholesterol; a large reduction in HDL–a BAD thing–will reduce total cholesterol: the opposite of what you would think. Total cholesterol can indeed yield useful prognostic information when applied to a population, though it is crude and the relationship weak. But it is useless when applied to an individual.

If we reject the silly and simpleminded notions of cholesterol panels, and apply the greater insights provided by advanced lipoprotein analysis, several nutritional observations can be made:

–Saturated fat increases HDL, shifts HDL to larger particles, and triggers formation of large LDL particles.
–The amylopectin carbohydrates of grains trigger higher triglycerides, thereby providing more VLDL particles to interact with HDL and LDL particles, the process that leads to triglyceride enrichment and smaller ineffective HDL and smaller atherogenic LDL (heart disease causing).
–Given the unusual persistence time of small (7 days) vs large (1 day) LDL particles, grain consumption is FAR worse than fat consumption.

You can begin to appreciate how overly simplistic this notion of “reducing LDL cholesterol” using statin drugs is–$23 billion per year of overly simplistic. You can also appreciate that the real situation is a bit complicated and beyond the reach of most busy primary care physicians, while being outside the interests of most cardiologists, obsessed as they are with revenue producing activities like heart catheterizations, stent and defibrillator implantation.

But don’t fall for it: The common distortions of cholesterol panels can be easily explained by the chain of events that emits from a diet rich in “healthy whole grains.”

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Comments & Feedback...

  1. Denise

    I read this twice and am still a bit confused. I recently had my bloodwork done by family doctor who has heard of you and read your book and is “75%” off of grains. I received the annual phone call from his office telling me my cholesterol was high and he recommends Crestor. I politely declined and asked for the numbers (he had refused to test the particle size, dismissing it – there is nothing to do with the numbers according to him).
    My numbers are as follows:
    total cholesterol – 373
    HDL – 59
    LD 290
    Triglycerides 118 (last year after removing grains it was 90 but before going grain-free I never had it below 150, even on statins)
    Blood sugar – 97
    Thyroid (not sure of what test was used) – 2.130 (I currently take 50 mcg Levothyroxin)
    His only recommendation, as I said was Crestor, which is debilitating.
    Dr. Davis, would you consider any of these numbers problematic or is there not significant information to determine that?

    • Susan

      Hi Denise,
      I am a pharmacist and I wouldn’t take a statin! I have seen too many patients have their quality of life disappear due to side effects; memory loss, muscle pains, sexual dysfunction, etc.

      Besides that the research does not show improved mortality outcomes in women. Here is a quote from the Mercola website (I would link to the study but then I will be caught up in moderation):

      “According to Dr. Barbara Roberts, author of The Truth About Statins, studies haven’t shown that statins are beneficial for women who do not have heart disease, even if they have risk factors like obesity or family history.”

      Follow the Wheat Belly diet or another version like Paleo/Primal, it will do your heart and brain a lot more good than a statin!

      • Doug

        Statins should be avoided at all cost. Look for the book “How statin drugs really lower cholesterol & kill you one cell at a time” by James & Hannah Yoseph or read Zoe Harcombe’s review of it.

        Reading this should prompt you to beg any loved one to get off statins asap.

        Doug

  2. Anne Rhodes

    I have been wheat-free since 8/14/13. I just received my cholesterol panel last week
    Triglycerides 38 mg/dl
    LDL cholesterol (calculated) 49 mg/dl
    HDL cholesterol 159 mg/dl
    Total cholesterol 216 mg/dl

    But my internist did NOT recommend lowering my statin dose per day which is 80mg.

    Does that seem correct to you?

    Anne Rhodes
    Houston, TX

    • I had my blood panel recently done too.
      I’ve been doing Dr Davis’s plan for over a year.
      Here’s the stats…
      Blood Pressure 116/71 (last year 125/85)
      HDL Cholesterol 153 (last year 113)
      LDL Cholesterol 52 (last year 71)
      Ratio 1.4 (last year 1.7)
      Triglycerides 39 (last year 38)
      A1c 5.1 (last year 4.9)

    • Malcolm

      Hi Anne:

      If your HDL is 159mg/dl I would guess you are immune to heart disease. I know women tend to have higher HDL than men, but 159, wow! I’ve never heard of such a high number.

      And here’s something else worth considering, assuming what I have been reading lately is valid, take a look at your triglyceride to HDL ratio. It is 0.24. A good ratio is 2 or under. A ratio of 1 is considered excellent. So 0.24 is superb. The lower the ratio, the greater the likelihood you have non-damaging, fluffy LDL particles that likely would never get oxidized and hence do no harm.

      I would never take a statin, and if my HDL was off the charts like yours is, there is no need to – again, based on what I’ve read in various books and on some Web sites.

      Best regards,

      Malcolm

  3. Julie Sellers

    I just got my results and think there is some wrong.
    2012 2013
    total 224 299
    LDL 189 199
    HDL 50 60
    Triglycerides 245 140
    Just from these numbers I don’t trust the results. Of course this was followed by you need to take a statin and they got there standard “NO”.

  4. Jennifer

    Dr Davis,
    Thankyou for this info.
    You once responded positively to my situation on another site, where I explained that I had taken myself off all oral diabetic drugs, all statins, all anti-hypertensives, against my GP ‘s advice. I have now been drug-free for 7 months, and kept off the 30 lbs I lost quickly in 3 months after taking almost all CHO out of my diet.
    I am as fit as a fiddle, and I have no observable diabetic complications, a very healthy B/P, and no idea of my cholesterol status!
    Thus….I have no reason whatsoever to visit my GP or diabetic nurse, and so I am keeping well away from their surgery. I have come to the conclusion that the medical world ( I started in the NHS in 1965 , and have seen a few changes!) is now so phara-orientated, that people’s lives are being constantly intruded upon for this test or that test, until eventually something will show up that warrants a tablet of some sort or another. The problem being, that some treatments have now been shown to be based on poor research conclusions.
    I am 66, and I am content to take the risks of coming off all medications that my GP suggested would be very serious should I go against present day protocols. Well, all I can say to that is, I am fitter, leaner and stronger than I was taking multiple meds. My husband can’t believe the change in my constitution, whereby I am back to striding out like I did in my 20s.
    I put the vast improvement down to…
    .1) changing to very low CHO, and thus removing all grains from my diet.
    2) stopping all medications.
    3) being able to exercise now, due to increased vitality, and never feeling lethargic.
    It seems incredible that I have transformed my seemingly irreversible situation into my present, fantastic health status, and I am only sorry that I have had to do it without the facilities of my GP, whereby I could have had blood tests to show my chemical markers. But, hey ho, I am happy to continue my regime, and delighted that you, and others, are adding more evidence to support my changes. Thankyou very much. Jennifer.
    http://www.capitalpress.com/apps/pbcs.dll/article?AID=%2F20130930%2FARTICLE%2F130939982&nocache=1

    • rich

      This quote is attributed to Benjamin Rush, one of the signers of the Declaration of Independence:
      “The Constitution of this Republic should make special provision for medical freedom. To restrict the art of healing to one class will constitute the Bastille of medical science. All such laws are un-American and despotic. … Unless we put medical freedom into the constitution the time will come when medicine will organize into an undercover dictatorship and force people who wish doctors and treatment of their own choice to submit to only what the dictating outfit offers.”
      He is to have said this over 200 years ago. To a certain extent this rings true today…
      Of course, up here in Canada we have already gone much further down that path.

  5. Lynn

    In February my chol. was 168, LDL 81, HDL 38 and Triglycerides were 245. I have been on zocor for a few years. I started Wheat Belly in June and in September my Chol. was 147, HDL 54, LDL 76 and Trig. were 85. Since then, I have stopped my statin drug and can’t wait to see what my levels are when I’m tested next.

    • Alex

      I had the same results Lynn (though luckily I wasn’t on a statin at the time) after going wheat free for only 6 weeks! Unreal, no?! Congratulations!

    • > I think doctors are statin-prescription happy these days.

      They may even be getting financial kick-backs from the pharma companies – in addition to the usual free “educational” dinners and “seminar” trips to Vail keep them “up to date” on why all of their patients should be on statins.

      They need to beware. I confidently predict that statins are the next gold mine for the class action ambulance chasing lawyers guild. Physicians need to ask themselves if the defendant list will be limited to the just those who make the drugs, or whether it might extend also to those who blindly prescribe them to all and sundry, relying on lipid tests based on defective science.

      MD: Well, we ran the “Should-You-Be-On-Statins” panel, and the conclusion is a resounding “Yes – Immediately”.

      You: Does that test ever return a result of “No”?

      MD: My non-disclosure agreement with Big Pharma does not permit me to answer that question.

  6. Derita

    Dr. Davis,
    I would like to know the particulars on wheat grass juice and wheat germ oil.
    I am assuming they are to be avoided?

    Thanks

  7. Bob

    I am posting here because no one beside’s wife cares. I am wheat free one year today. My next blood work is not due until March but last showed improvement and I feel great (arthritis gone).
    I hope I can find a Dr when we move that will be a help to us. Take cholesterol and bp medicine. My cholesterol is high but last check HD was 60 and tri at 90 ( down from 180). So I will continue to follow this blog and try to stay educated even tho reading this last post almost made my poor simple head explode. I am hoping to get off my meds someday.

    • > I hope I can find a Dr when we move …

      Here’s a simple screening test: ask the prospective new doctor if they will order an NMR lipoprofile or apoprotein B test, or any test that actually measures and reports Small LDL-P (not -C).

      If the answer is “no”, then they are probably still stuck in 20th century lipid delusions. Find a real physician.

      And if “no”, also ask if they ever prescribe statins. If the answer to that is “yes”, run the heck away, because they are a public health menace.

      > Take cholesterol and bp medicine.

      Statin, perchance?
      Are you at least compensating for the CoQ10 damage?

      > … this last post almost made my poor simple head explode.

      To express part of this article in simple English, the “standard” lipid panel ordered by most MDs is mostly useless.

      The triglyceride number is useful. The total cholesterol number is usually not. The LDL-C number is fictitious and usually incorrect for low carb diets. The various “scores” that come out of these numbers are likewise worthless and seem to exist largely to sell statins, which drugs should not be taken by 97.3% of the people who are on them.

        • > … would your typical GP/Internist even know how to order it?

          As it happens, mine didn’t, but was willing to refer me to someone who would (who then grossly misinterpreted the results and told me I should be on statins – sorry doc, you’ll need to find some other sucker to help you with the BMW payments).

        • Jeff

          This is not so hard…..for most labs, it is a “send-out” test. Tell the doc to order the NMR (nuclear magnetic resonance) Lipoprofile provided through Liposcience, Inc., 2500 Sumner Boulevard, Raleigh, NC 27616 – 877-547-6837. Have your doc educate him/her self at liposcience’s website: http://www.liposcience.com.

    • Jeff

      This is a typical report of a “study” drawing extremely flawed conclusions. Just remember this: CORRELATION DOES NOT EQUAL CAUSATION! Most studies are biased by the theory being studied and the source of funding for the study. There are plenty of “studies” that show a correlation between something and “X” – but few are exhaustive of all other possible factors and if one actually analyzes the results from the “study” many conclusions can be drawn other than what is reported in the media (which is always looking for a sensational story). Before I draw any conclusions, I check out the scientific journal report, check the research and references, and then look for the motive (follow the money). There’s a lot of garbage out there…..

  8. Annie

    Wouldn’t C reactive protein test be a better indication for cardiovascular disease/heart attack risk? Cholesterol is just a response to inflammation.

  9. Doc Wilson

    Hi Denice

    With those number I recommend that you get the NMR lipid profile which shows the particle numbers. A good book to read is the great cholesterol myth by boden and Sinatra. This may clarify some questions you have. If your doctor won’t order the test find another.

  10. Nancy

    Dr. Davis. I have been WB for 5 weeks. MY test results for cholesterol come back today. My cholesterol
    has been 245 and today the number is 317. I’m sensitive to dairy and everything else besides meat and veggies! I have been eating two eggs with bacon for breakfast just about every day. Should eggs be my main concern?

    Thanks so much in advance for a reply.

    • Erica in RSA

      At only 5 weeks into this way of eating, it’s not surprising that your figures have gone up. This should be temporary. Your fat cells will be ditching triglycerides which will push up your overall level as well as the triglyceride level which is part of the total. Your HDLs have probably gone up as well.

  11. Anne Rhodes

    Sorry for the garbled message posted above!

    Dr. Davis, are you going to chime into this discussion!?!?

    • > Dr. Davis, are you going to chime into this discussion!?!?

      Since your Reply got disconnected, which discussion?

      Also, Dr. D. doesn’t seem to check this blog as frequently as many of us read it. My impression is that it can be a week or more between visits, especially when on speaking engagements.

      • Dr. Davis

        I’m actually on here every day, but simply cannot manage to respond to each and every comment, unfortunately.

        Boundless has been wonderfully helpful in providing credible information that, I believe, many people here have found helpful.

        Yes, just what discussion?

  12. GrainFree4Ever

    An excellent presentation today by Dr. Mark Houston on Cholesterol. Well worth watching at TheGluten Summit.com

    • Neicee

      GrainFree4Ever, you might want to wander over to http://www.dietdoctor.com – he’s posted Dr. Robert Lustiq’s latest video (it’s also available at YouTube, along with his first that now has 4 million hits). It’s 1:23:15 long but worth every minute. Sugar and grains all accomplish the same result: death by carbs.

  13. JillOz

    Dr Davis,
    if one IS of the tiny population that should be on statins, and therefore IS on statins,
    what can one do to improve health/functionality in the face of the side-effects??

    (This question is not about me!)

  14. Lee MacMillan

    I am a 65 year old wheat eater. I eat 3-4 slices a day (typically) of whole wheat (homemade) bread, waffles or pancakes on the weekend, pasta once or twice a week, wheat crackers for snacks, etc. I drink beer and whiskey occasionally. I run 12 miles/week and lift weights on the days I don’t run. My latest blood work for my annual physical showed nothing out of range except HDL which were high! I am 5’5″ and weight 130#.

    I have been on statins for 4 years with no ill-effects. My total cholesterol is under 200. My HDL (pre-statin) ranged from 57 to 71. My post-statin HDL has ranged from 79 to 99. Triglycerides have exceed 100 only 4 times in the last 15 years and the latest number was 72.

    I’m not sure what eliminating wheat would do for me. I certainly don’t want to lose any weight.

    • Dr. Davis

      You won’t know unless you run lipoproteins, not lipids.

      And note that wheat elimination is NOT just about obtaining better lipoproteins. For instance, every grain eater is a set up for autoimmune conditions due to the gliadin protein-induced abnormal intestinal permeability.

  15. Here’s a real life lipid panel of a grain eater, me:

    Triglycerides 60 mg/dL
    LDL (calculated) 138 mg/dL
    HDL 54 mg/dL
    Total cholesterol 204 mg/dL
    Chol/HDLC ratio 3.8
    non HDL cholesterol 150 mg/dL

    Cardio CRP 2.0 mg/L
    Homocysteine, vascular 10.4

    I have dabbled in various diets including the low carb Wheat Belly diet of which I gained weight and felt sluggish throughout the day. Adding carbs helped somewhat. But my varicose veins screamed at me no matter what adjustments I made.

    I don’t know what name to give my current diet. I’m wheat free but not grain free as I eat steel cut oats plus quinoa, lentils, buckwheat (not grains but considered grains by many). I am mostly vegan/plant strong, fish & butter keep me from being 100% vegan. Juicing vegetables (beets & their greens, radishes, carrots, ginger, jalapeno, celery, cilantro, parsley, plus some fruit to flavor, ie apples, pears) has made a huge difference in the way I feel. My varicose veins love it, much less pain, no pain many days, less bulging. Plus, no hunger pangs throughout the day, in fact, I have to remind myself to eat. While on WB I felt the swings in my hunger, not so when I drink about 16-24oz each a.m. I’m not getting enough calories, though, which is my road block to significant weight loss.

    I follow the guys from Engine 2 (Rip Esselstyn, yes, son of Dr. Esselstyn) on facebook, mainly for recipes but I often catch “success” stories. These participants are plant strong, eating mostly carbs as veggies, grains, fruits are predominantly carbs. Yet, they report significant drops in their triglycerides & LDL & HDL numbers. I don’t consider dropping the HDL a success. In fact, since my labs were last drawn in February I’ve increased my coconut oil & avocado consumption to increase my HDLs.

    So how am I/ they dropping triglycerides & LDL’s with so much carbohydrate consumption? I see how they drop their HDL’s. It’s the other 2 values I find perplexing.

    • Dr. Davis

      Because the comparative values you are using are typical values, Leigh.

      There is no doubt that an Esselstyn-like diet that has removed all processed foods is better than the average diet, but it is not ideal. To demonstrate this, however, you would have to measure advanced lipoproteins, e.g., NMR, and parameters like HbA1c, not the basic lipid values.

      • Leigh

        Well, I bet you have willing population here to donate some blood! Then contact Dr. Neal Barnard, a plant strong proponent who helps folks cure their T2 diabetes, to help with the comparative study.

        I can’t believe the research hasn’t already taken place.

        My A1c was 5.2 back in February. I wouldn’t fit into either group as I don’t follow a restrictive diet. Maybe the control group would be those following the S.A.D.

  16. Ellen

    I started eating wheat free by reading the excellent books by Dr. Davis, and this blog, thank you Dr. Davis.

    Just before this event, though, I wanted to mention about a false positive for Lp(a), something about 90. I am hoping that research will be done to learn more about this Lp(a). The other part of lipid test reveal about the same typical scores for a wheat consuming person, HDL in mid-30′s, LDL near 150, and TC of 250. And, Crestor was prescribed, and further heart CAT scans with dye where done. This was a life changing event, and I treated this seriously. Luckily, the CAT scan result was zero.

    I strongly believe that the perspective one has in mind can be a strong motivational tool to accomplish anything he/she may want to. For instance, before learning that the high score was in deed false, I started to independently, lose 37 pounds and started a vigorous exercise schedule. I couldn’t have done this without Dr. Davis and this wheatbellyblog. I couldn’t afford the only one specialist’s evaluation that would also include the NMR testing, but I did get a VAP test done. This is when I found the Lp(a) to actually be about 10 which is a good healthy score. The first test, ordered by the heart specialist and the second test (VAP) ordered by myself was done about six weeks apart. So, the Lp(a) didn’t go from 90 to 10 in six weeks! But this was motivational for me to continue to eat wheat free and lose the 37 pounds and continue to keep active.

    Only, now I have become less active, but still eat wheat free, and slowly the weight is creeping back on. I am wondering if I should account this to the big change in activity levels?

    I eat 90/10 (or 10% fat) ground buffalo often, and I take omega 3′s (highly concentrated with EPA & DHA but not the preferred purification process). I have wondered if the buffalo has the EPA/DHA’s?

    And, since I have not found a good primary yet, why should I as I have no other issues anyways?

    I may get the other omega’s like from Nordic Naturals (better process to purify) to replace the omega capsules I get from Ocean Blue. Yet, with all of the buffalo consumption, ground flaxseed and coconut oil, olive oil I eat every day, I am wondering how much a healthy person should need (EPA and DHA)?

    I am feel that the weight creeping back on is not a pleasant experience. And I want to try to return to a more active schedule to maintain the good results I had right after the false positive test and so on. I am preparing to get another VAP to check also. The main reason I started to eat wheat free is now changed, in other words, I am continuing to eat wheat free for a different reason (as to why I started).

  17. While listening to Nora Gedgaudas’s podcast on The Gluten Summit, she remarked that if your HDL number starts climbing much above 75 or 80 (unless a genetic thing) it may imply that it is a reaction to inflammation….she called it ‘acute phase reactant’…..so in this case more is not better. Thouughts?

    • Dr. Davis

      It can, but there is currently no way to distinguish good from not-so-good HDL.

      For the majority with stable HDLs, however, they are truly good.

  18. Peter

    “Here is a typical panel of someone who consumes grains” – very ambiguous.
    “Total cholesterol 224 mg/dl” – Grains do not increase cholesterol levels, in fact, if anything they lower blood cholesterol levels. Vegans have low cholesterol but have a high grain consumption.
    This article is trying to make it sound like grains are the reason for the poor blood panels presented above, which is very irresponsible in my opinion.

    • Dr. Davis

      No ambiguity here: Grain consumption CAUSES distortions of lipid panels, only hinted at by the values.

      And I will continue to proudly exercise my “irresponsibility” by expressing such opinions!

      The data do NOT demonstrate that grains reduce cholesterol. They demonstrate that, when white flour products are replaced by whole grains, there are apparent benefits. They do not show that grains are superior to a diet of NO grains.

      Had you read the book, you would see that this discussion is a modest supplement to the extensive discussions in the book.

      • Leigh

        I think it would help greatly to see actual lipid panels with the advanced testing, ie NMR, apoprotein B, and compare various diets. Theories need to be put to the test.

        • > … it would help greatly to see actual lipid panels with the
          > advanced testing, ie NMR, apoprotein B, and compare various diets.

          You realize that Dr. Davis (a cardiac specialist) has been doing that for years, and as a result, has phased out of acute care for diseased hearts, and into the much more effective strategy of preventing the CVD in the first place, and reversing it, merely by telling people what to eat. WB is based on results, not conjecture.

          > Theories need to be put to the test.

          I expect that nusi dot org plans to do just that. Meanwhile, you need to decide what your next meal is, and it’s pretty clear that there is no consensus on that (well, there is, but it’s fatal).

          For more than you wanted to to know about lipids, see:
          http://eatingacademy.com/cholesterol-2/the-straight-dope-on-cholesterol-part-i

          • Leigh

            Hmmmm, dinner tonight….yellow curry with mounds of veggies on a bed of rice….at least I’ll die happy:) So why should I consume a diet that makes me feel like crap only so I can have a great NMR panel?

            I was asking to see an NMR results. I guess I was asking too much.

          • > So why should I consume a diet that makes me feel
            > like crap only so I can have a great NMR panel?

            Unrelated questions. Both should be possible. And the NMR panel is telling you something.

            > I was asking to see an NMR results.
            > I guess I was asking too much.

            If you’re just asking for representative results from a typical grain-free LCHF eater, that’s not too much to ask. Surprising, I don’t quickly find anything on WBB that answers that (there might be on trackyourplaque). I’m sure Dr. D. has an average panel he could post.

            All of the reader data posted here has so far been based on the nearly useless standard panel.

            > Maybe the 2nd edition can be renamed Carb Belly
            > since wheat is just a fraction of the focus?

            There were several books prior to WB that took that approach. Name one. They had little effect. Yes, the WB recommendations turn out to be not just about the wheat: low carb, high fat, near 0 fructose, borderline ketogenic, and advocate specific fats. WB is also way far not just about weight.

            This is the reality of the human nutritional situation. The trick is getting people to at least try it for a month. WB has succeeded where earlier efforts did not.

          • Leigh

            Boundless, if you tell me how to cure my varicose veins, I will give WB another try. Maybe give it more than the 3 weeks I initially attempted. I don’t see why consuming a diet that makes the pain in my legs worse logical.

          • > … if you tell me how to cure my varicose veins,
            >I will give WB another try.

            I don’t think WB has ever promised to fix varicose veins, even though a family member would be delighted if it did.

            > I don’t see why consuming a diet that makes the
            > pain in my legs worse logical.

            Said family member, however, has gotten significant relief from supposed “fibromyalgia” leg pain on WB (plus glucosamine chondroitin supplements I might add).

      • Leigh

        It does make me wonder if there is something in Dr. Esselstyn’s dietary recommendation that counter acts the harmful effects of whole grains. He has demonstrated that his vegan, extremely low fat diet reverses heart disease, clears the arteries.

        Is it the removal of inflammation?

        His son, Rip, is not as extreme as his target audience is those with less severe conditions, ie T2 diabetes, HTN, thus the recipes he suggests have honey, maple syrup, avocado, coconut oil, nuts.

        Another group worth studying would be Joe Cross’s followers, the 60 day juicers, inspired by “Fat, Sick, and Nearly Dead”. No grains, no meat, but lots of juice (fruit & veggie), no fiber.

        I think nutrition science is very complex. Even you recommend a 5 to 1, vegetable to animal protein ratio to buffer the acidifying effects of animal protein on the blood.

        Lots of questions yet to answer in this diverse, complex world.

          • Leigh

            Why the personal attack? Is it that difficult for you to intact with someone who’s had different experiences? Do you read other peer review research that contradicts one’s beliefs? Do you ever challenge yourself? Or is this just a by product of social media, saying something to people you wouldn’t dare say to them across the table?

            I work with folks who have autoimmune conditions nd routinely recommend the Wahls Protocol, so don’t accuse me of being ant-anti-wheat or whatever it is you are irritated about.

            I have seen plant strong diets work wonders for patients, just like I’ve seen Paleo-like diets work well for others. Often times I believe that just getting processed food out of one’s diet is key to much improved health.

            As for me, I get plenty of essential amino acids, plus 1-2 avocados a day and about 1/4 cup of coconut oil. I’ll side with Dr. Permutter on this one;) but thanks for your concern.

          • Leigh

            Oh, wait, I did get irritated once while on WB’s facebook page recently. Someone had posted a question re: sauteed onions & a few regulars chimed in & said they were a no-no, too much sugar (which is why they carmelize so nicely, YUM!) Any way, I can’t imagine a diet so restrictive that sauteed onions were off limits. Lucky for the poster, Dr. Davis (or who ever runs his fb page) chimed in and said “eat ‘em up!”

            So Jan, do you or any others here cheat, especially this time of year with all the yummy starch squashes, ie butternut, pumpkin, acorn? It’s likely just my lack of discipline but I would have to lock myself in my house to avoid eating starch this time of year.

  19. Leigh

    And you guys wonder why I ask so many questions? I came across this while trying to learn more. According to this post, my HDL’s should go way up with the elimination of wheat. And that my triglycerides should be high due to my high carb intake. Neither has happened. My triglycerides are 60, Dr. Davis’ recommended target #. My HDL’s are still low.

    http://www.wheatbellyblog.com/2012/12/cholesterol-belly/

  20. reader1

    I have been reading in Good Calories, Bad Calories that Ivan Frantz, Jr. who worked under Keys at the University of Minnesota did the Minnesota Coronary Survey that disproved Keys. Although this was on 9,000 people looking at the low-cholesterol diet the study was not published til Frantz retired and then it was only published in a journal called arteriosclerosis read only by cardiologists.

    Franz himself said he was looking to prove Key’s theory.

    So mush for publishing results going against what they wanted.

    • Leigh

      I thoroughly enjoyed Raw Food SOS’s critique of The China Study. He/she has also posted extensively on Ancel Keys, it appears. I have only skimmed it but will read later this weekend.

      http://rawfoodsos.com/2011/12/22/the-truth-about-ancel-keys-weve-all-got-it-wrong/

      I always thought it was suspicious that Dr. Atkins family refused an autopsy. It was found that he had CHF in his later years via medical records. I wanted to see what his coronary arteries looked like. In fact, it would be interesting to see the lab results of all the doctors that encourage specifc diets, McDougall, Furhman, Barnard, Esselstyn, Davis, Perlmutter, Attia, etc.

      BTW, Boundless, Attia’s site is wonderful, especially the lipid lectures. I like his style of presentation. Thanks for the link.

      • STG

        Health is so much more complicated than nutrient intake and cholesterol numbers. If you want to define your health in terms of numbers, diet wars and nutritional correctness so be it. Environmental and epigenetic factors are important: personal interactions, emotions and socio-economic status effect health as well. You also might consider exploring epigenetics and health effects. Also, you might start thinking about the reality of longevity and death. Is it better to die of a massive heart attack at 75 or die at ninety of a broken hip in a nursing home? Perhaps this is too existential for you to deal with now but at some point in your life you will have to deal with it!

    • Leigh

      I see that Keys lived to be 100, a stroke at 98 did him in. He lived 28 of his last 29 years in southern Italy. I wonder if he ate Einkorn wheat?! This reminds me of a NYTimes article about a guy who was given a terminal cancer dx only to return to his homeland of Greece & live another 30+ years. He’s now 97 years old. Interesting article. Yes, correlation is not causation but one can’t ignore these populations.

      http://mobile.nytimes.com/2012/10/28/magazine/the-island-where-people-forget-to-die.html?redir_esc=&client=ms-android-hms-tmobile-us&source=android-browser-type&v=133247963,133247963&qsubts=1384531098897&action=devloc&q=nytimes%20fotget%20to%20die

       

      • reader1

        Leigh, I think that what you are saying is not in accordance with this site. I hope you consider going to another site to insult people.

  21. Roberta

    Grain free for a year (one exception is 2 slices of sprouted grain (flourless) bread a week); no refined sugars; coconut oil, coconut milk, raw dairy for coffee, grass-fed butter, virgin olive oil, grass-fed beef, wild cod & salmon, loads of vegetables, pastured eggs, some fruits on a daily basis; eliminated Rx drugs including statins, more than a year ago; . What do you make of these panels? The first two reflect a heavy grain diet and a drug cocktail, the last reflects the new diet and a weight loss of 60+ pounds, but not the exercise that is admittedly needed.

    Component Standard Range 12/20/2010 6/12/2012 3/11/2013
    CHOLESTEROL 175 169 258 H
    HDL CHOLESTEROL 41 40 49
    LDL CHOLESTEROL 87 114 180 H
    CHOL/HDL RATIO 4.3 4.2 5.3 H
    TRIGLYCERIDES 234 176 147
    PATIENT FASTING? NO YES

  22. Hmm is anyone else experiencing problems with the images on
    this blog loading? I’m trying to figure out if its a problem on my end or if it’s the blog.
    Any suggestions would be greatly appreciated.

  23. Uncle Roscoe

    Leigh,

    You endorsed two of the biggest vegetarian diet gurus on the planet, Dr. Eselstyn and T. Colin Campbell. Do you have a relationship with either of them, either personal or business? Are you one of these two people? Readers should keep the anonymous nature of the internet in mind. People can claim to be anyone they please.

    Being a believer in vegetarian diets, I can see why you came to the Wheat Belly Blog, as the success of wheat-free paleo dieting has far eclipsed the failures of vegetarian diets in the last few years.

    T. Colin Campbell is the author of the book The China Study. Traditionally, “the China Study” refers to a large scale study commissioned by Chinese Premiere Cho En Lai, in which a huge number of Chinese people filled out a questionnaire. The questionnaire asked respondents what they ate and what diseases they had. So from the title one would expect Campbell’s say what the real China Study revealed about the relationship between diet and disease.

    One would be wrong. The book’s title is a lie. Campbell devotes only a few pages making vague references to the China Study. Campbell devotes the vast majority of the book The China Study attempting to use extremely flawed, extremely small studies to justify his belief in vegetarianism. The relationships between the studies’ findings and Campbell’s beliefs are distorted to the point of absurdity. One example cites a small Philippine study which statistically links eating peanuts with ill health. Campbell cites this correlation as an example of how animal protein causes ill health. Insane.

    Another example is predictable given the vegetarian community’s distrust of dairy. Campbell cites a small statistical study which reveals a relationship between dairy ingestion and ill health. Campbell tortures this correlation into a correlation between animal fat and ill health. Again, insane.

    Read Denise Minger’s statistical analysis of what the real China Study reveals about the relationship between heart disease and diet.

    http://rawfoodsos.com/2010/09/02/the-china-study-wheat-and-heart-disease-oh-my/

    There is no statistically significant relationship between animal protein or animal fat and heart disease …….None. However, the real China Study does reveal a STRONG relationship, a 0.67 correlation, between wheat ingestion and heart disease.

    T. Colin Campbell is a charlatan.

    And Caldwell Esselstyn? You complained about the lack of personally-run studies by our host, Dr. Davis. Why might you have done this? Presumably because Dr. Esselstyn recorded the results of his private medical practice into a statistical record. The subjective results say that Dr. Esselstyn was able to help his patients through treatment. But Dr. Esselstyn’s treatment method was not limited to vegetarian diet intervention by any stretch.

    Dr. Esselstyn prescribed pharmaceutical drugs and exercise for his patients. Yes, I believe Dr. Esselstyn is honest in his intent. But Dr. Esselstyn’s methods suffer from the same fatal flaws which ANY private practitioner’s methods would suffer from if the practitioner tried to report his practice as a study. The method is invalid, and any attempt by Dr. Davis to report his private practice as a study would also be invalid.

    And finally I’ll note the format of this discussion. We are not discussing this subject in a neutral public forum. A proponent of vegetarian diets came to a blog which eschews wheat ingestion to complain about the wheat-free diet and the blog’s author. You are not the first vegetarian to do this. In fact there has been a steady stream of you people, and I don’t understand it. Nobody is trying to force you to eat meat. I know of no one here who went to your vegetarian site to complain about the site, its author, or vegetarianism. We are here to discuss the benefits of not eating wheat. If that bothers you, then the solution is simple.

    Leave. Nobody asked you here anyway.

    • Uncle Roscoe

      Another thing about Dr. Esselstyn’s “study”. Besides pharmaceutical drugs and exercise, Dr. Esselstyn also advised his patients to cut back on “pastries”.

    • Leigh

      If you read my comments you will see where I praised Raw Food SOS’s critique of The China Study. And good luck trying to label me as I don’t follow a specific diet dogma, but here, I’ll try: wheat-free, plant based, fish eater, and all of it lathered in coconut oil;O)

      I am intrigued by nutrition science. If you discover that something flies in the face of what you believe is true, does your interest get piqued or do you pull the blinders? I am a fan of the work of Weston A Price, the foundation that bears his name, not so much. If you knew that there was a culture that ate rice 3x a day yet suffered from little chronic ailments, disease, or cancer would you question your beliefs that all grains are bad. And they eat soy though fermented. Of course, the Japanese have since discovered vegetable oils & McDonalds…unfortunately. Then there is the French Paradox.

      I like data, not just anecdotal data which is why I’d like to see NMR panels, A1c, & CRP labs from folks following the various diets. I guess as Western Med embraces a deeper understanding of cholesterol & inflammation then maybe we’ll see the lab data, too.

      I work with people with auto-immune conditions & quite often recommend the Wahls Protocol as she not only recommends elimination of certain foods but the addition of nutrient dense (organ meat, bone broth, etc) foods to “mind the mitochondria” to use her term.

      So use me as a punching bag if it makes you feel better. But don’t think for one moment that y’all got it all figured out. I see how Dr. Davis is evolving as he learns more. And I hope the individuals reading this are open to adjustments in their diets if things aren’t going well, specifically speaking of the low carb aspect of WB.

      • Uncle Roscoe

        “So use me as a punching bag if it makes you feel better.”

        Oh, you poooooor person. You use our host, Dr. Davis, as a punching bag. Then when someone says the simple solution is for you to leave, you act all hurt.

        Deal with it ……But do so elsewhere.

        • Tom Street

          I am currently on a wheat free diet to see if I can lose weight, improve my lipid panels, and decrease my blood pressure. Based upon reading the book, I am willing to give this approach a chance as I think it is more sustainable than a calorie counting, high exercise approach. I will continue to get plenty of exercise in biking and running every day and I will continue my mostly vegan, sometimes vegetarian diet as well.

          Having said that, I welcome those like Leigh who have questions and critiques about this diet. I am interested in the critique and the responses to that critique. They seem perfectly reasonable and I don’t think it is helpful or justified to tell Leigh to leave, or anyone else for that matter unless they are abusive.

    • Leigh

      Uncle Roscoe, we both seem to be fans of the Raw Food SOS blog. She also seems to be the darling of the low carb & primal folks. I sure wish she posted more. But do you know what’s fascinating, the diet the blogger follows. Look her up, check it out. You might be surprised.

  24. Uncle Roscoe

    Most studies which show health improvements displayed by vegetarians are simple statistical studies of Western populations. They compare vegetarians with omnivores. The aspect which most invalidates these studies is that they compare apples to oranges. Separating vegetarians from the general population separates out young short-term health nuts. Sure, if you compare fat sedentary 48 year old omnivores to 20 year old fresh air and exercise nuts, you’ll start off with a massive bias. But the statistical results separating the two groups reported in these studies? ……fall far short of the results one might expect.

    How might we compare vegetarians to the general population in a way which mitigates this built-in statistical bias? By separating out people who become vegetarians for life, people who become vegetarians for reasons other than that they want to make vegetarianism part of their otherwise healthy lifestyle.

    Vegetarian Taiwanese women showed elevated (real) markers for cardiovascular disease…..

    http://ymj.or.kr/Synapse/Data/PDFData/0069YMJ/ymj-52-13.pdf
    ——————————————————
    Abstract:
    Purpose: Many studies supported that vegetarians have a lower risk of cardiac diseases and mortality, partly due to better blood pressure and serum cholesterol profiles. However, the inflammatory markers, especially lipoprotein-associated phospholipase A2 (Lp-PLA2), have not been well-studied. This study aimed to compare inflammatory markers and conventional risk factors between vegetarians and omnivores.
    …..
    Materials and Methods: One hundred and seventy-three vegetar-ians and 190 omnivores were studied. Fasting blood samples were obtained to compare levels of glucose, total cholesterol, triacylglycerol, high density lipopro-tein (HDL) and low density lipoprotein (LDL) cholesterol, homocysteine, Lp-PLA2 activity, and high-sensitivity C-reactive protein (hs-CRP).
    ……
    Conclusion: In addition to lower total choles-terol, LDL-cholesterol, and HDL-cholesterol, Taiwanese female vegetarians have lower serum Lp-PLA2 activity but higher levels of hs-CRP, homocysteine, and tri-acylglyerol. It might be due to geographic differences of vegetarian diets, and fur-ther studies are needed.
    ——————————————————-

    The above study is a study of mostly religious vegetarians. The fact that religious vegetarians tend to abstain from alcohol should skew toward a less inflammatory result. Instead the results say that vegetarians produce far higher inflammatory markers.

    • Leigh

      Dairy products, which can be a large part of a vegetarian’s diet, are inflammatory so it’s of no surprise that the research demonstrated that. You do realize there is a difference between vegan & vegetarian, right? The terms are far from interchangeable. Dr. Barnard promotes a vegan diet & I think Esselstyn & McDougall also are vegan diet promoters. Seven Day Adventist diet is vegetarian if I recall correctly.

      I’ve seen numerous folks benefit from the various diets, ie vegan, vegetarian, pescatarian, Paleo, low carb which is why I haven’t made up my mind nor likely ever will.

      Oh, and Leigh is my real name. If you are on WB’s facebook page you might run into me but I’m hardly on fb. Maybe search for that onion post:)

  25. Susan Fox

    This is unrelated to the subject of the post but I have a question about blood thinners. Natural versus Coumiden or the newer blood thinners. I recently had atrial fib, the paroxysmal type ( with flutter). I’ve been wheat free for over 2 years and after reading Dr. Davis’ book Wheat Belly I started following all of his advice on foods. I also dropped all grains, beans and sugar. I also read Brain Grain and took it a step further. I’m off all root vegetables and take Omega 3 fish oil and Vitamin D. I’m 67 and in great shape and active with a low heart rate and low blood pressure. So this atrial fib thing was a rude awakening. I don’t want to do pharmaceuticals and would like to know what natural ways I can be fairly certain I’m protecting myself. I’m supposed to be on aspirin daily until I see my doctor to discuss whether I need coumadin or one of the newer drugs. I only took aspirin for 2 days and stopped. I read of too many negative effects. But I do have to use common sense if there’s no alternative to protect myself. After the ICU doctor calculated my risk of stroke he said it’s 2 %. Dr. David what have you learned about natural blood thinners versus pharmaceuticals?

  26. Mary

    Thank you so much for this post! It is very timely for me since I just had blood work done for the first time in about five years (I’m 25). My total cholesterol came back as 253, my triglycerides were 26, my HDL was 103.8, LDL was 144, and my VLDL was 5. My doctor said that my total cholesterol was high but he said my HDL is extremely high – he told me it’s rare to see someone with HDL over 100, and that since my ratio of cholesterol/HDL is 2.4, that I’m fine. Naturally I’ve been worrying about this even though I know it’s silly. Thanks for putting me at ease! (By the way, I’m wheat-free since July and about 90% grain-free for a few months now, too, I’m actively keeping soy from my diet, and cook with heat-safe fats, so my diet is mostly healthy)

    • Dr. Davis

      And at some point, Mary, insist on an NMR LDL particle number or an apoprotein B to know the REAL value, not some make-believe fictitious number!

  27. NZbeachgranny

    My doctor rang yesterday with seemingly bad results from fasting cholesterol levels.
    High risk for heart disease.
    I have been doing wheat free /low carb and high good fats for only a week
    . I have a hx of familial hypercholesterolaemia.
    Have been on Lipitor in the past but of late have taken a daily dose of 1200mg dose of red rice bran. If I join the track your plaque will it read my values even though they are a different value from the USA?

    In advance I say thank you!

  28. NZbeachgranny

    Re previous post

    My results are
    HDL mmol/L -1.97
    LDL mmol/L – 6.1
    Total cholesterol – 8.4 mmol/L
    Ratio -4.3

    Thanks for any help,

  29. Roye

    I’ve been on the Wheat Belly Diet since January 2013. I am on meds for cholesterol so my numbers weren’t horrible to begin with but I’ve just gotten my blood work done this month and thought I’d compare to last year. These are the results:
    December 2012
    Cholesterol 162
    HDL 58
    LDL 80
    Triglycerides 118

    November 2013
    Cholesterol 154
    HDL 80
    LDL 61
    Triglycerides 63

      • Roye

        Thank you Dr. Davis! Happy cholesterol (HDL) is higher and Lousy cholesterol (LDL) is lower. Happy & Lousy is what my Dr. calls it to help me distinguish the difference LOL. And my Triglycerides, Wow, knowing that I eat butter, uncured bacon, olive oil, coconut oil and even mayonnaise goes to prove it’s not the fat that raises your cholesterol or triglycerides.
        I have lost 15 lbs, not nearly what everyone else has reported but since I only needed to lose around 30 lbs to begin with 15 lbs isn’t bad.
        I’m 69 years old, have pre-diabetes (on meds), HBP (on meds) and high cholesterol (on meds). And a cancer survivor. I can’t help but think starting your diet is helping keep me healthy. I just wish my Dr. would take me off some meds LOL. When she saw my numbers she was very impressed, I told her it’s the Wheat Belly Diet and I started telling her what I was doing, she started taking notes LOL.

  30. Dennis

    Since my 3rd heart attack 12/04 I’ve been taking fish oils and not doing the high carb veggie eating…always got tired and weak after 4 weeks plus it did not prvent any attacks…70 yrs now and I’m enjoying life not taking any statins etc. and still waiting for the 4th one….Think I’ll just keep eating my eggs n steaks….never did make it to see Dr Davis in Wi but read all his blogs and books and was on TYP site as roaminghermit.
    NMR panel has me having much dense stuff so the low carb seems to help, plus more energy to paddle around the lake and hike the hills thou slower now…don’t want to tumble n break something…LOL
    Was a fan of Jack L and He said “if man makes it don’t eat it” Seems like good advice

  31. Dr. Davis,
    Here are my most recent cholesterol stats. I’m one week into Wheat Belly 100% wheat grain gluten & sugar free & Keeping carbs low. I’m reading that early on cholesterol can increase, I’m afraid if mine increases I’ll stroke out! Do you have any suggestions! I am 63, 5’4, 168 lbs!

    Print
    LIPID PANEL 10/05/2013 (#145948, Final, 10/4/2013 9:06am)
    Report Result Ref. Range Units Status Lab
    CHOLESTEROL, TOTAL 305 100-199 MG/DL High Final 01
    TRIGLYCERIDES 327 0-149 MG/DL High Final 01
    HDL CHOLESTEROL 42 >39 MG/DL Final 01
    ACCORDING TO ATP-III GUIDELINES, HDL-C >59 MG/DL IS CONSIDERED A
    NEGATIVE RISK FACTOR FOR CHD.
    VLDL CHOLESTEROL CAL 65 5-40 MG/DL High Final 01
    LDL CHOLESTEROL CALC 198 0-99 MG/DL High Final 01
    COMMENT: LDLCOM Final 01
    POSSIBLE FAMILIAL HYPERCHOLESTEROLEMIA. FH SHOULD BE SUSPECTED WHEN
    FASTING LDL CHOLESTEROL IS ABOVE 189 MG/DL OR NON-HDL CHOLESTEROL
    IS ABOVE 219 MG/DL. A FAMILY HISTORY OF HIGH CHOLESTEROL AND HEART
    DISEASE IN 1ST DEGREE RELATIVES SHOULD BE COLLECTED. J CLIN LIPIDOL
    2011;5:133-140
    RESULT NOTE FASTING YES
    Thank you! Bri

    • Uncle Roscoe

      Looks like Dr. Davis hasn’t been able to get to your post for 3 days. I suggest staying the wheat-free sugar-free course, but don’t add in too many fats for a couple weeks.

      Those numbers don’t look good to me. The wheat-free sugar-free diet will likely cause you to start losing weight, and your fat cells will start shedding fat. Your liver needs to recuperate from glycation, stop producing VLDL, and start producing HDL before you add extra fats.

      This is a problem time any way you look at it. The cause is in your past. The only way I know of returning to normal is to try and weather the transition.

      Good luck. I am not a physician.