Dr. William Davis

Cardiologist + Author + Health Crusader

"The food you eat is making you sick and the agencies that are providing you with guidelines on what to eat are giving dangerous advice with devastating health consequences. You can change that today."

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The ABCs of your post-grain experience

By Dr. Davis | March 28, 2015 27 Comments

Running from cupcakes 123rfWheat/grain elimination is an exceptionally powerful tool for restoring health, reducing inflammation, returning metabolic distortions such as high blood sugar and blood pressure back to normal, and for losing weight. But many of the adverse health effects of years of grain consumption do not fully reverse with their elimination. Specific efforts may therefore need to be undertaken to accelerate your return to full health. Taking these extra steps stacks the odds heavily in your favor that you will enjoy full recovery from abnormal health conditions.

Among the strategies to consider are:

Cultivate and nourish healthy bowel flora
I like to think of bowel flora, the thousand or so species of microorganisms that inhabit the human gastrointestinal tract, as a
garden. Probiotics, i.e., anything that provides microorganisms believed to be among the desired inhabitants such as the various Lactobacillus or Bifidobacteria species, are like planting seeds for peppers and zucchini in your garden in spring time.

But what if you planted your seeds, then neglected to water and fertilize your garden? If you’re lucky, you might have a few peppers and zucchini after a few weeks, but you’re more likely to have a few stunted vegetables or nothing except a few shriveled vines. A successful garden requires water and fertilizer.

So it goes with bowel flora. You eliminate the extraordinary bowel-disruptive effects of grains–gliadin, gliadin-derived peptides, wheat germ agglutinin, indigestible D-amino acids, trypsin inhibitors, and others–then “plant” some desired species from a probiotic preparation or fermented food, but then fail to nourish them. It means that desired species may not proliferate, they may not outnumber and overpower unhealthy species such as E. coli, Staphylococcus aureus, Clostridium difficile, and Firmicutes. Unhealthy species are allowed to proliferate, thereby increasing intestinal permeability and resulting in higher blood levels of the bacterial byproduct, lipopolysaccharide, that is highly inflammatory. It also means that healthy bacteria fail to produce fatty acids, especially propionate and butyrate, that are required by intestinal cells for normal metabolism, heal “tight junctions” between cells (disrupted in conditions such as ulcerative colitis), and reduce potential for colon cancer. It also means that metabolic benefits, such as reduced insulin and blood sugar levels, reduced triglycerides, reduced blood pressure, and reduced visceral fat do not result–all because desirable bowel flora were not “fertilized.”

So what acts as water and fertilizer to bowel flora? What feeds them, allows them to proliferate and yield factors such as butyrate? Fibers. But not all fibers.

In a fascinating tale of symbiosis, the coexistence of microorganisms and Homo sapiens, a specific class of fibers, i.e., polysaccharides or polymeric sugars, that are indigestible to the human digestive apparatus but digestible via the enzymes expressed by specific bacterial species, allow all these beneficial health effects to occur. It means that food, chewed, swallowed, bathed in stomach acid, emulsified by bile, broken down into constituents by pancreatic enzymes, exposed to 20-some feet of small intestine, finally reaching the colon where most microorganisms dwell, contains little remaining nutrients to nourish bacteria. The desirable species that thrive in this unique environment are those that can digest the undigested remains of your meal–fibers. But not cellulose fibers, i.e., wood fiber, of the sort that dominates in grains and is found in bran cereals. Cellulose is essentially indigestible by both our own digestive apparatus, as well as the bacteria that humans are capable of carrying. (It is digestible by ruminants.)

The proper care and feeding of bowel flora therefore causes proliferation of healthy Bacterioidetes, Lactobacillus, and Bifidobacteria that produce bacteriocins that suppress growth of unhealthy species, metabolize fibers to butyrate that yields metabolic benefits, even improves bowel habits and allows you to have normal, healthy bowel movements without “crutches” like the bulk of cellulose fibers, laxatives, or enemas.

Is this evolutionarily appropriate? Is there precedent in human adaptation on this planet for such unique fibers? I ask this question because this is my litmus test for the suitability of any dietary strategy we consider. Recall, for instance, that grains were added 300 generations ago, or 0.4% of our time on earth, a mere moment in time ago. They are inappropriate for human consumption, now made worse by the genetic fiddlings of agribusiness. (I have to concede that grains do indeed have some fibers that have health benefits, such as arabinoxylan in wheat and beta glucan in oats, but they come with such undesirable other components that it is simply not worth it.) Yes, consuming such fibers is evolutionarily appropriate, as it dates back well over 8000 generations of human existence, predating even the appearance of the Homo species, even predating carnivory, as it was practiced by pre-Homo hominids, Australopithecus (especially “robust” strains). It is therefore deeply instilled (I almost said “ingrained”–acchhh!) into the adaptive physiology of our species.

So how do we obtain such indigestible fibers that nourish healthy bowel flora, so-called “prebiotics” or “resistant starches”? Well, do what a member of the Hadza of sub-Saharan Africa or Yanomamo of the Brazilian rainforest would do and grab a stick, stone, or bone fragment and dig in a field or forest for the underground tubers of plants. If you don’t want to do that, you can incorporate foods available in modern grocery stores that mimic such practices. Among the foods that yield such fibers:

  • Green unripe bananas or plantains–with around 27 grams prebiotic fibers per medium sized banana
  • Raw peeled potato–with around 20 grams per 3 1/2-inch medium
  • Inulin powder–with 5 grams per teaspoon
  • Bob’s Red Mill raw unmodified potato starch–8 grams per tablespoon
  • Legumes, lentils, chickpeas, hummus–Around 3 grams per 1/4-cup. But we have to be careful here, as any more than this quantity and blood sugars start to climb to unhealthy levels.

These are the most efficient sources, with lesser quantities in other below-ground vegetables. I pick one of the above foods and include them in a smoothie every morning along with, for instance, a cup of unsweetened coconut milk, some blueberries or other berries, a few drops of stevia, etc. If you choose the banana, peel it like an apple or chop off the ends and slit the skin, as it is very tough to skin when green. Chop both banana and potato coarsely before putting in the blender; a blender with a strong motor is advised. Rely on NO MORE than 2 level tablespoons of the potato starch, as more will raise blood sugar; use other choices to amp up your intake.

The science that examines bowel flora composition tells us that 20 grams of such fibers yield substantial effects. While the average grain-consuming human obtains around 3 or 4 grams per day, us grain-deniers can fall below this and experience undesirable bowel and metabolic effects. Benefits begin around 8 or 9 grams per day, with maximal benefit likely around 20 grams. (Interestingly, there is anthropological evidence of intakes as high as 135 grams per day.) When new to this experience, start with no more than 10 grams fiber per day; more and abdominal pain and bloating can occur; build up over days to weeks. Full benefits, such as reductions in blood pressure and blood sugar, require 4 to 8 weeks to show themselves, likely due to the shifts in bowel flora species.

Vitamin D
I rank correction of vitamin D deficiency as second only to wheat and grain elimination as the two most powerful strategies for overall health I have ever seen in my 20+ years of medical practice.

Vitamin D deficiency is rampant, given life in northern climates, wearing clothes year-round, working indoors, and the gradual loss of the ability to activate vitamin D in the skin as we age. It means that having a favorable vitamin D level in the body is uncommon outside of tropical climates or during summer months with plenty of skin surface area exposure in young people.

Among the benefits of restoring vitamin D are: improved mood and freedom from seasonal mood fluctuations; rise in HDL, drop in triglycerides; reduction in insulin and blood sugar; reduction in blood pressure; improved bone and joint health, including increased bone density; reduction in coronary disease risk and cancer; reduction in potential for dementia. And you just feel so much better.

The ideal approach to restoring vitamin D is to take a dose that raises 25-hydroxy vitamin D blood levels to 60-70 ng/ml (150-180 mol/L). While dose needs vary from individual to individual because of body weight, relative proportion of body fat, time of year, age, and genetics, most people require 4000-8000 units per day in gelcap or droplet form (not tablets: very poorly absorbed, sometimes not at all). Note that, if you are following blood levels, it requires 3 months for levels to stabilize after initiating supplementation or any change in dose.

Iron, zinc, magnesium
Absorption of positively-charged minerals, especially iron, zinc, and magnesium, is blocked by the phytates of grains. The second most common worldwide cause for iron deficiency anemia, for instance, is grain consumption, second only to blood loss (e.g., menstrual cycles). The phytate content of a bagel or two slices of whole wheat bread is enough to block iron absorption by 90%. Iron deficiency results in fatigue, lightheadedness, feelings of being cold, poor physical performance. Zinc deficiency most commonly results in skin rashes, itchiness, impaired growth in children, learning impairment, and gastrointestinal distress. Magnesium deficiency shows up as muscle cramps/”charlie horses,” higher blood pressure and blood sugar, loss of bone density, and heart rhythm disorders.

While mineral absorption improves dramatically with wheat and grain elimination, iron and magnesium typically need to be supplemented to make up for severe deficiency. Iron is best managed by checking a blood level of ferritin and a complete blood count (CBC), as iron overload can also occur. Magnesium can be safely supplemented on your own by the vast majority of people; I recommend taking the magnesium malate form, 1200 mg twice per day (180 mg “elemental” magnesium twice per day). Zinc can also be safely supplemented, 10-15 mg once per day.

Iodine deficiency—
Most of us have forgotten that, up until the early 20th century, iodine deficiency and goiters (enlarged thyroid glands) were major health problems worldwide, affecting 20% of people in most regions. The addition of iodine to table salt, along with encouragement to use plentiful salt solved the issue of iodine deficiency . . . but then led to adverse effects of overuse of salt in at least some people.

So modern people have been advised to cut back on salt–but everyone forgot about the iodine. Iodine deficiency has numerous health implications. It can take on special significance in the early wheat- and grain-free experience in that it can impair your ability to lose weight and impair full recovery of health.

I therefore urge people to obtain an inexpensive iodine supplement such as iodine drops or kelp tablets (dried seaweed) that provides 500 mug of iodine per day, what I believe to be the ideal intake of iodine. People with Hashimoto’s disease, Grave’s disease, or history of thyroid nodules or thyroid cancer should work with their doctors on iodine issues (though seek out a healthcare practitioner knowledgeable about this issue–most doctors are not), since iodine restoration needs to be managed carefully in these situations. However, those of us without these conditions can simply supplement iodine, allowing the thyroid gland to operate at full capacity.

Omega-3 fatty acids
The omega-3 fatty acids, EPA and DHA, available only from fish oil in truly healthy quantities (NOT flaxseed, chia seed, nor krill oil) yield considerable health benefits that include accelerated clearance of the byproducts of digestion (that contribute to heart disease), reduced triglycerides, and reduced overall cardiovascular risk and cancer risk.

However, a sufficient dose needs to be taken to achieve such benefits. I therefore advise people to take 3000 mg per day of EPA and DHA, divided in two. This is the level that raises the level of omega-3 fatty acids in blood cells to 10% or greater in most people, the level associated with maximum benefit. The best fish oil is the triglyceride form, i.e., the form that occurs naturally in fish. This is available as liquid fish oil from producers such as Halifax’s Ascenta NutraSea.

No gluten-free junk carbs
This bears repeating, as so many people interpret the Wheat Belly message as a “gluten-free” message, then booby-trap their health with gluten-free foods.

Let me be very clear: I do NOT advocate consumption of gluten-free processed foods made with cornstarch, tapioca starch, potato flour, or rice flour–they raise blood sugar sky-high, cause visceral fat accumulation, inflammation, and increase risk for cataracts, hypertension, diabetes, heart disease, cancer, and dementia.

We therefore replace wheat and grains with healthy choices that do not cause such problems. Don’t replace a problem–wheat and grains–with another problem–gluten-free junk carbohydrates.

Be aware of dairy casein beta A1
There are a number of tricky issues with dairy products, including lactose, potential exposure to antibiotic residues and bovine growth hormone, and estrogens. However, the real problem for many people may be a form of casein dairy protein produced by North American cows called casein beta A1.

Casein beta A1 is an immunogenic (immune system stimulating) form of casein that appeared through a chance mutation in cows around 6000 years ago. It is believed to underlie at least some cases of type 1 diabetes in children, some instances of autoimmune diseases like rheumatoid arthritis, heart disease, even sudden infant death syndrome.

Most dairy products in North America contain the casein beta A1 form, though it is present in small quantities in cheese and butter. Goat and sheep products do not have this form of casein.

 

That’s it!
Yes, it takes a bit of effort. But if your goal is to stack the odds in favor of full recovery from any condition, or to powerfully prevent such conditions, these strategies are your best, most accessible, inexpensive, yet effective ways to do so.

More discussions like this can be found in Wheat Belly Total Health.

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Filed Under: Wheat Belly Lifestyle Tagged With: bowel flora, fish oil, iodine, probiotics, resistant starch, Thyroid, vitamin D, Weight Loss

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About Dr. Davis

Cardiologist Dr. William Davis is a New York
Times #1 Best Selling author and the Medical Director of the Wheat Belly Lifestyle Institute and the Undoctored Inner Circle program.

Nothing here should be construed as medical advice, but only topics for further discussion with your doctor. I practice cardiology in Milwaukee, Wisconsin.

Comments & Feedback...

  1. Barbara in New Jersey

    March 28, 2015 at 9:59 am

    Would certified raw dairy products from grass fed cows make any difference in the digestibility of casein beta A1 proteins in cows milk? Would this eliminate the potential immune response?

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    • Bob Niland

      March 28, 2015 at 8:16 pm

      re: Would certified raw dairy products from grass fed cows make any difference in the digestibility of casein beta A1 proteins in cows milk?

      It doesn’t appear so, from a casual search of the web. You need cows with A2 genetics. One domestic brand (Beyond Organic) claims to have such a herd and provide such products. I have no further information on that, but it gives you something to look into.

      This also suggests that imported dairy, possibly including Kerrygold, might not be from A1 cows, but I wasn’t quickly able to confirm that.

      Caprine (goat) dairy is looking more attractive all the time.

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  2. Malcolm Achtman

    March 28, 2015 at 1:48 pm

    I have started the prebiotic-probiotic strategy that Dr. Davis recommends. Is there any particular timing for doing this? I am drinking my prebiotic smoothie at breakfast and taking my probiotic capsule before going to bed. I’m thinking if the probiotics get nice and hungry overnight while I’m asleep they will enjoy their prebiotic “meal” the next morning when I drink my smoothie.

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    • Bob Niland

      March 28, 2015 at 8:37 pm

      re: … prebiotic-probiotic… Is there any particular timing for doing this?

      It seems to depend on the probiotic product to a large extent. Some formulators recommend taking the probotic before breakfast, when the upper GI is the least acidic, to ensure safe passage to the large intestine. Other products with a more robust enteric coating may not need this, but then might need extra time for the capsule to open. Check the maker’s instructions.

      re: I’m thinking if the probiotics get nice and hungry overnight …

      They might also starve to death, but either conjecture could be wide of the mark. My inclination would be to craft a breakfast that contains the prebiotic fiber, and take the probiotic before that breakfast.

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  3. Malcolm Achtman

    March 28, 2015 at 1:56 pm

    When using prebiotics as per Dr. Davis, is it better to mix things up, and if so, how frequently should the choices that are available be changed? I prefer using a green banana every day, but would it be better interject a raw potato and/or Bob’s potato starch every now and again?

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    • Bob Niland

      March 28, 2015 at 9:14 pm

      re: When using prebiotics as per Dr. Davis, is it better to mix things up, …

      Yes, according to Wheat Belly Total Health, page 195: “As with probiotics, a mixture of prebiotic fiber sources is ideal.”

      re: … how frequently should the choices that are available be changed?

      That might be a separate question: rotation (vs. mix). I didn’t quickly find an answer to that.

      “There is therefore benefit to varying your prebiotic fiber/resistant starch routine, and not doing the same thing day in, day out. More about this to come in future.”
      See:
      https://www.wheatbellyblog.com/2015/01/remember-cultivate-healthy-bowel-flora/

      If what we are doing is to mimic ancestral behavior of consuming whatever could be foraged from day to day over a season, plus some fermented preparations off season, that model probably provided variation during the day, and over time in the season/annually.

      The exposure to soil-based micro-organisms was also changing at the same time, and the genetic biome spectrum of surviving hunter-gatherer populations is radically different vs. most modern humans.

      This appears to leave us fundamentally scratching our heads. There’s clearly something important here, but how to optimize it is not yet nailed down.

      Personally, I rely on a daily mix of prebiotic fibers.

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  4. Tim Steele

    March 28, 2015 at 2:49 pm

    Dr. Davis – While I love the fiber replacing strategies, this is sure starting to look like a mighty restrictive low carb diet! If you are limiting potato starch I hate to see what you think of potatoes.

    Potatoes are not the “bags of sugar” most think! A ginormous potato, 1/2 pound…the size of a baseball, only has about 35g of carbs, much is fiber, and if pre-cooked and allowed to cool overnight, also converts to RS.

    I’m thinking your people are going to start seeing the same low carb issues that have plagued all of paleo if they are restricting all sugary fruit and starchy veggies. Some of us have actually been enjoying adding in whole grains such as teff, quinoa, oats, and buckwheat, just for a change in fiber-types.

    But I am 100% behind you in avoiding the Gluten-Free goodies.

    Keep up the good work…change is good, glad you aren’t ever satisfied and always looking to improve diet and health.

    Cheers,
    Tim

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    • Bob Niland

      March 28, 2015 at 9:51 pm

      re: … this is sure starting to look like a mighty restrictive low carb diet!

      Tim, this is starting to look like you haven’t read the books (and Wheat Belly Total Health would be the one to start with now). The WB target of 50 grams net carb per day has always been pretty low carb, borderline keto by most measures. The WB recommendations have evolved over time, as results and unconfounded science dictate, but the 50g net carb target has not so far changed (which I don’t take to mean that it never will).

      re: If you are limiting potato starch I hate to see what you think of potatoes.

      It’s just a complex carb to manage (15g net carb for whole meal),
      and without too much reading between the lines: go for organic and non-GMO as well.

      re: Potatoes are not the “bags of sugar” most think! A ginormous potato, 1/2 pound…the size of a baseball, only has about 35g of carbs, much is fiber, …

      It’s a numbers game. And the name of the game is BG (and its relentless pal HbA1c). BG either matters, or it doesn’t, and if it does, then the glucometer rules, and is the final arbiter after we consume a potato dish.

      re: … and if pre-cooked and allowed to cool overnight, also converts to RS.

      Ah yes, but how much? I’ve seen estimates that only 15% of the available carb repolymerizes.

      I personally will eat small portions of cooked potato, and slight larger portions of potato salad (and of course as much raw potato as I feel like).

      re: I’m thinking your people are going to start seeing the same low carb issues that have plagued all of paleo if they are restricting all sugary fruit and starchy veggies.

      Which issues did you have in mind?

      re: Some of us have actually been enjoying adding in whole grains such as teff, quinoa, oats, and buckwheat, just for a change in fiber-types.

      And are they tracking BG and/or HbA1c?

      By the way, do you have any insights on the pre/probiotic timing and per mix/rotation issues that were raised on the blog today?

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      • Tim Steele

        March 28, 2015 at 11:19 pm

        lol, I was afraid that last comment was too long…as to the rest:

        “By the way, do you have any insights on the pre/probiotic timing and per mix/rotation issues that were raised on the blog today?”

        I think that most people do not get near enough fermentable fiber, even when eating goodly amounts of starchy carbs. Cooling gives back some RS, but not a whole lot. Eating green bananas and raw potatoes great, but not always feasible.

        I shoot for getting 20-50g/day in fiber of all types, it’s hard to count them, because many (RS especially) are hidden from food labels and cooking can change fiber content. So, I just eat a wide selection of fiber-rich veggies, nuts, fruit, dark chocolate, whole grains, honey (yes, contains prebiotics!), and dairy. But most days, I still fall short on fiber, so I may include some type of fiber with each meal. Sometimes mixed in with something like sour cream or yogurt or just mixed with water as a meal “chaser”. But I think always best to include supplemental fibers with meals. Makes sense, no?

        As to fiber types, my favorite is potato starch, just for price, ease, and reliability. Some hate it, that’s fine. There are others….

        I also use inulin or inulin/FOS, Partially Hydrogenated Guar Gum, Wheat Dextrin, Larch AG, XOS, psyllium husk, and maybe a few others I’m forgetting.

        I keep two jars on my cupboard…one filled with plain potato starch, the other contains a mixture of other fibers, with a main base of inulin. You’ll find that these other fibers are price-limiting and inulin is the cheapest of the mix, but also a fiber found in great quantity in nature, so makes sense to have the bulk of fiber from inulin.

        Resistant Starch is also plentiful in nature, moreso maybe than inulin, so I think it is wise to mimic these proportions when deciding on fibers, not to say that you could not get your entire fiber need from PHGG or larch AG, but it doesn;t really pass my sniff test.

        If I had to choose one or two, it would be PS and Inulin, mixed or straight.

        Also, to make things easy, just get in the habit of eating lots of fiber rich foods, and taking 1-3 spoonfuls per day near a meal. Miss a day or two? No problem.

        Probiotics, same thing…take with meals to mimic unintentional ingestion of novel microbes.

        I’m not a huge fan of probiotics. I think you get all you need from fresh veggies and fermented foods. Probiotics are shown to help heal a gut, but I personally would rather have a gut with thriving communities of microbes that want to be there because I am feeding them foods they love…as Louis Pasteur said, on his deathbed presumably: “Le germe n’est rien, c’est le terrain qui est tout.” (The microbe is nothing, the soil is everything).

        I think we can see wisdom in that when applied to the gut.
        Tim

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  5. Nome

    March 28, 2015 at 6:54 pm

    What would you recommend for school lunches for children that don’t want their lunch to stand out as different to everyone else’s?

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    • Bob Niland

      March 28, 2015 at 9:30 pm

      re: … school lunches for children that don’t want their lunch to stand out …

      This might be the main use of “mimic” foods (foods crafted for various diets that look and taste like SAD junk, but are actually nutritious, and lack the target toxins).

      An obvious source of ideas is the various Wheat Belly cook books. The Grain Brain cookbook (Perlmutter) is likely also a safe source.

      There are many paleo, primal, low-carb, LCHF and gluten free books that can serve as inspiration. These require some caution however, as they are frequently oblivious to various hazards, principally excess carbs (usually as “natural” sugars, but also hi-gly GF grains).

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  6. Cathy Silver

    March 28, 2015 at 7:24 pm

    What do you think of green banana flour in a smoothie everyday for resistant starch?

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    • Bob Niland

      March 28, 2015 at 9:17 pm

      re: … green banana flour in a smoothie everyday …

      I would recommend using actual green banana. Keep them in the fridge to prevent ripening.

      On green banana flour, keep the glucometer handy, and don’t be surprised if it causes BG elevation.

      I thought I had read somewhere that Dr. Davis had actually had some GBF tested for available carb, and found it to be unacceptably high. Search didn’t turn up a reference, alas.

      The conjecture, as I recall it, was that the processing, in particular the milling, was effectively cooking the flour, and converting some of the RS to available starch.

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      • Tim Steele

        March 28, 2015 at 10:57 pm

        Hi, Bob – Thanks for the thoughtful comments/questions.

        I’m a big fan of Wheat Belly, it is one of three diet books I’ve bought in the past 5 years, the others being Perfect Health Diet and Live Young Forever by Jack Lalanne (a man well ahead of his time!). Wheat Belly, though, is the only book I regularly buy as a gift, having given it to 5 or 6 family members and friends.

        That said, I never realized it advocated 50g of carbs per day. Reading through the book now, still not jumping out at me. the recipes in the back are not really low carb.

        I have been cheering Dr. Davis’ embracing of eschewing Gluten Free treats and also thinking about fermentable fiber. I couldn’t agree more.

        What you are describing makes it sound as if Wheat Belly has a diet protocol meant specifically for diabetics. If that is the case, I am well out of place here. And sorry for intruding.

        However, if “reg’lar folk” read Wheat Belly and just reinforce that wheat does not belong in the human diet, I hate for them to also get the impression that “carbs” are the enemy. The carbs in the SAD diet are out of control! Give up wheat and you by default give up most of your processed carbs. The Gluten Free movement replaces these carbs with loads of other processed carbs, still bad…

        In my ideal world, people do not worry about the carbs found in real foods, and will find they are self limiting in the 100-200g/day range, a carb load every non-diabetic should be able to handle.

        For me, low carb paleo brought on dry eyes, dry skin, poor sleep, raised FBG, raised PP BG, and a weight loss plateau that could not be broken. “Trying harder” under a LC plan means cutting carbs even further, leading to worsening of symptoms.

        Unless truly diabetic, and controlling diabetes through carb restriction, a la Steve Cooksey at Diabetes Warrior, I don’t think that Low Carb has any place in healthy eating. It may be fine for short term weight loss, but leads to long term problems.

        I’m NOT here to cause problems, just pointing this out as I think i have been around long enough to spot the troubling trends. A good diet for most should include lots and lots of plant matter including potatoes, rice, beans, and even whole grains…but not flour or processed grains for the most part. Most non-diabetic people will find that a meal that includes a big pile of a starchy veggie, fruit and whatever else they eat spike blood sugar to 120-160 range, returning to baseline in a couple hours. Restricting carbs to 50g per day will ensure no BG spikes, but when you do eat carbs, you find you have lost control of your ppBG and FBG also starts to climb. Maybe best to keep carbs as a normal part of the repertoir.

        I’ll let Jimmy Moore talk for me…look at today’s blog, it’s very sad, on many levels:

        http://livinlavidalowcarb.com/blog/i-will-no-longer/24535

        “I’ve been very open and honest about this and working diligently behind-the-scenes to create strategies that will help control the stress that is raising my cortisol and blood sugar levels making it next to impossible to lose weight right now despite faithfully eating low-carb, high-fat. With so many people writing to me sharing their own frustrations about the lack of weight loss despite everything being right in their diets, I wanted to offer up some encouragement to them and myself that all hope is not lost. Keep in mind there are so many non-diet reasons why your weight is stuck or going up, including stress-induced cortisol spikes (what I believe I’m dealing with), lack of sleep, hormonal imbalances, getting older, and more. I’m always amused by those who say the ketogenic diet must not work because people like me don’t have the “perfect” body and weight.

        I will no longer…

        …worry about my weight and how I look in the eyes of others.

        It’s not the business or concern of anyone about what I weigh. I choose to share about it openly with my followers to let you know what’s happening with me, but I’m under no obligation to share. I feel good and live well and that’s all that really matters to me.

        …let others make me feel bad for sharing about healthy living.” (Jimmy Moore, 2015).

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        • Bob Niland

          March 29, 2015 at 8:00 am

          Good morning Tim,

          re: Wheat Belly, though, is the only book I regularly buy as a gift, having given it to 5 or 6 family members and friends.

          Do move on to Wheat Belly Total Health (WBTH) for that. Among other things, it fully embraces the gut biome issue overlooked in the original book.

          Re: That said, I never realized it advocated 50g of carbs per day. Reading through the book now, still not jumping out at me.

          It was not prominently featured, and just looking in my copy, I cannot easily find it either. There is a remark about target total carbs on page 216. This blog emphasized the point almost from the outset, see:
          https://www.wheatbellyblog.com/2011/08/the-holy-grail-gluten-free-but-low-carb/
          and later re-focused on the net carb concept.

          Re: … the recipes in the back are not really low carb.

          The lack of macronutrient data for those recipes provoked some complaints. The later cookbooks have that data.

          Re: What you are describing makes it sound as if Wheat Belly has a diet protocol meant specifically for diabetics.

          If people don’t pay considerable attention to carb intake, they are headed for the spectrum of problems that end up as T2D and its complications. It’s perhaps the main pandemic of our time. Simply replace wheat with quinoa, and IBS might abate, but metabolic syndrome, pre-diabetes and T2D won’t budge (and probably not the weight either).

          Re: If that is the case, I am well out of place here. And sorry for intruding.

          No problem; useful discussion.

          Re: … I hate for them to also get the impression that “carbs” are the enemy.

          Carbs are the enemy until proven otherwise. Another target number that WBTH makes more prominent is HbA1c. The WB target is 5.0% or less, based on the problems that arise above that. Perlmutter (Grain Brain) targets 5.2% or less. Compare these to the 7.0% ADA goal for T2D, or even their “stringent” goal of 6.0%.

          Re: In my ideal world, people do not worry about the carbs found in real foods, and will find they are self limiting in the 100-200g/day range, a carb load every non-diabetic should be able to handle.

          I presume that’s total carbs, and not net carbs, which is the metric here. If someone can beat 5.0% on a higher carb diet, they might well be OK, but their diet needs to be based on results. “Handle” and “thrive” might be separate concepts here.

          Re: For me, low carb paleo brought on dry eyes, dry skin, poor sleep, raised FBG, raised PP BG, …

          I don’t recall seeing complaints about dry eyes and dry skin (and the blog seems to hear from pretty much everyone who doesn’t get textbook results). Poor sleep I’d expect to be handled by attending to gut biome. BG creep, or PIR as the issue is sometimes framed hasn’t been addressed specifically, and I’m wondering if it’s yet another thing that gets managed by a more optimized gut biome.

          I also don’t see these complaints on the Cureality forum (formerly the Track Your Plaque) forum, which goes back a decade.

          Re: … and a weight loss plateau that could not be broken.

          That is common enough that it’s the subject of a whole series of articles here, which largely amount to: once you shut off the effects of wheat, and the full-time moderate/high gly diet, it can reveal further problems that need attending to.

          Re: “Trying harder” under a LC plan means cutting carbs even further, leading to worsening of symptoms.

          Going full keto is actually not the first thing to try. Only an “occasional person will actually require a ketogenic state to achieve weight loss” according to one of the Lost the Wheat but not the Weight articles.

          Re: Unless truly diabetic, and controlling diabetes through carb restriction, a la Steve Cooksey at Diabetes Warrior, I don’t think that Low Carb has any place in healthy eating. It may be fine for short term weight loss, but leads to long term problems.

          I suspect that Dr. Davis would disagree with you there, and he has considerable clinical experience, having refined his recommendations over a couple of decades based on actual results. I’m also personally not seeing any problems I might relate to low carb (well into 3rd year of WB lifestyle).

          Re: I’ll let Jimmy Moore talk for me…look at today’s blog, it’s very sad, on many levels:

          Jimmy (and Jane Plain) are doing remarkable work, but my impression is that they both represent highly idiosyncratic metabolic situations, and that their full-time keto management has only limited applicability to the wider population. If either one of them can make a breakthrough that eases their dietary challenges, it may well turn out to be a real breakthrough for many people.

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          • Hélène

            April 8, 2015 at 3:30 pm

            If either of them can make a breakthru…
            AMEN!
            I am one of those idiosyncratic ppl.
            And I am one of several million, methinks. …at least extrapolating from web/media and book perusal.
            We are watching. And we are waiting.

  7. CC

    April 1, 2015 at 3:51 pm

    Hi. What brand of Vitamin D do you recommend? I’ve tried numerous and they haven’t really worked. Also, what brand do you recommend for Ferritin? Thank you.

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    • Bob Niland

      April 1, 2015 at 9:23 pm

      re: What brand of Vitamin D do you recommend?

      Until a more official answer arrives, the likely answer is:
      • as sunshine, and if not trivial (or over 40),
      • as D3 (cholecalciferol), gelcap, oil-based

      I would then rely on 4 things to narrow down the list of brands:
      • product approved by consumerlab.com
      • safe oil base (not soy or an industrial grain oil)
      • wheat-free of course
      • cost per 1000 IU

      Wheat Belly Total Health suggests 4000-8000 IU for most people, but the real target is the measured blood level, which is 60-70 ng/dl (and there are various elevated risks in going much below or much above that).

      re: I’ve tried numerous and they haven’t really worked.

      What formulations, doses and outcomes?

      re: Also, what brand do you recommend for Ferritin?

      That does not appear to be a supplement recommended by Wheat Belly. These have been discussions here about having your serum ferritin levels checked, but my impression is that the corrective measure is to address the underlying problem, and not just try to compensate with ferritin supplements (they can be risky).

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      • Hélène

        April 8, 2015 at 3:34 pm

        Codliver oil is a food. It has been consumed since ancient times. It properly ratios the Vit A to Vit D. Add high-vitamin butteroil to it (for Vit K) and it’s just about unbeatable. EFAs included also!
        A daily no-brainer to me.
        The fermented brands are the premium (Green Pastures and Rosita). I am very low-budget and I still take them. I don’t bother taking any if I can’t afford them.

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  8. Anita

    April 2, 2015 at 11:02 am

    Hi,
    I’m on my 4th day of being wheat free and I’m getting nervous. Easter is coming up and we’ll be travelling out of town. The menu my family is offering up is nothing but casserole dishes and cupcakes. And travelling out of town means we’ll probably stop at a fast food restaurant on our way. My question is …

    How have you adjusted your lifestyle so it’s easy for travelling w/those who aren’t wheat free..or eating around others who aren’t wheat free? I don’t want to seem snobby or picky around them…I love and enjoy food! I’m thinking of even quitting just because it seems so restrictive!

    Any advise?

    Thanks!

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    • Bob Niland

      April 2, 2015 at 12:51 pm

      Re: I’m on my 4th day of being wheat free and I’m getting nervous.

      You probably don’t yet know what your re-exposure reactions will be. Once you know, it becomes a useful defense when people offer toxic treats. “Thank you for offering, but I can’t eat XYZZY. It causes …”

      re: And travelling out of town means we’ll probably stop at a fast food restaurant on our way.

      We all end up learning what dishes at what chains are safe. My family often ends up with a salad at Chipotle, or a naked (no bun) burger at Red Robin or Smashburger.

      For enroute snacks, you can pack along home preparations, or rely on cheese, nuts or Quest bars.

      Re: … eating around others who aren’t wheat free?

      “We’re doing a wheat and sugar elimination trial, and need to avoid them while we do this.”

      Re: I don’t want to seem snobby or picky around them…

      Back when …, was it snobby when people said “no thanks” is response to “would you like a cigarette?”. Would you, for example, even dine at a home where the hosts smoke, at the table, during the meal?

      In any event, many people will perceive you as snobby regardless of how diplomatic you are, particularly if you become or remain slender, and they aren’t (resentment with a topping of envy – and they could easily be unaware of both). You may need to decide if your own health trumps certain relationships.

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  9. Naomi

    April 9, 2015 at 8:17 am

    What is the difference between magnesium malate and citrate? And which one is it that Dr. Davis suggests?

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    • Bob Niland

      April 9, 2015 at 8:37 am

      re: What is the difference between magnesium malate and citrate?

      You can find many explanations on the web. I haven’t any particular insights.

      re: And which one is it that Dr. Davis suggests?

      It depends on what you are trying to do. As a general supplement Wheat Belly Total Health recommends malate, glycinate, or Mg water made from milk of magnesia (instructions in book).

      For regularity specfically, use citrate.

      Also get Mg from food, esp. spinach and pumpkin seed.

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      • Naomi

        April 9, 2015 at 8:53 am

        Ok thanks very much. I’ve been doing WB for 4 months now. Not seeing too many results ( only down 12 pounds and need to lose about 75 more!) so was trying to give as many of Dr.Davis’ suggestions a try. Already doing the probiotic And vit. D. Just started adding potato starch to my spinach smoothie every morning. Wanted to try the magnesium supplement too. I bought the citrate because it said on the bottle “assists the body to metabolize carbs, fats and proteins.” I’ll finish the bottle and try the malate next! Thanks again Bob!

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        • Bob Niland

          April 9, 2015 at 9:33 am

          re: … need to lose about 75 more!

          You’ve probably seen all this, but if not, check out the key articles and videos on the WB Blog on that topic, conveniently linked -back here from Wheat Free Forum by user Boundless:
          WBB Links: Lost the Wheat But Didn’t Lose the Weight
          http://wheatfreeforum.com/index.php/topic,1913.0.html

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          • Naomi

            April 9, 2015 at 5:26 pm

            Yes I have viewed all these before but I did refresh my memory, thank you. I eat very little dairy but maybe I should try cutting that out. I have an appointment with my doc next week and I’m going to insist on a FULL thyroid test as the last one came back ‘normal’. My mother and maternal grandmother both had their thyroids removed and my mother has Graves disease. I’ve been working on the healthy gut Flora since day one. Carb counting seems daunting and I have yet to find a helpful app to assist me in that. They all seem to want to count calories and fat and not so much carbs. Lots of good tips and reminders and I’ll just keep plugging along with it til something finally clicks for my body!

          • Bob Niland

            April 9, 2015 at 5:47 pm

            re: … going to insist on a FULL thyroid test …

            Be sure to review:
            https://www.wheatbellyblog.com/2011/10/thyroid-tune-up-checklist/

            re: … as the last one came back ‘normal’.

            Probably the not-terribly-informative TSH – did you even get a number? And what does the doctor think is normal?

            re: They all seem to want to count calories and fat and not so much carbs.

            Beyond that, you want something that figures “net carbs” (total carbs minus fiber carbs). This is easy to calculate from the NF panel for processed foods. For raw foods, if no app presents itself, you need to rely on web databases.

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