I’m Expecting A Lecture From My Doctor

If I were a betting man, I’d bet a thousand dollars I’m going to get a lecture from my doctor when I see him for a follow-up visit in a couple of weeks.  I already gave myself a little lecture, too.  I’ll explain why in a moment, but first a little background:

We moved to Tennessee four years ago, but I didn’t bother to look for a G.P. until recently.  I’m rarely sick and don’t like going to doctors, so I didn’t see the need.  On the other hand, I’ll turn 55 in a few months.  By the time my dad was 70, he had colon cancer, severely blocked coronary arteries, and Alzheimer’s.  My health habits are way better than his and I don’t expect to develop any of those diseases, but I don’t want to be stupidly overconfident.  I was already enrolled in the Vanderbilt health network because of the knee surgery last year, so I scheduled an appointment for a checkup with a doctor at the Vanderbilt clinic that’s closest to our house.

Given all my dad’s health issues, the doctor of course ordered a slew of bloodwork.  My appointment at the lab was scheduled for last Wednesday – a few days after my goddaughter’s wedding.  At the wedding reception, I ate the carbage that was on the buffet and drank several beers.  Special occasion and all that.  The next morning, I extended the special occasion by eating two chicken-fried steaks with biscuits and gravy.  It was the most junk-filled two days I’ve had in many moons.  I had forgotten I had a lab test coming up in a few days, but I probably would have eaten the junk anyway.  Like I said, special occasion and all that.

Today I logged onto the Vanderbilt site to check my lab results.  Here are the numbers that will no doubt prompt a lecture from my doctor:

Total cholesterol:  245
LDL (calculated): 165

Here are the numbers that prompted a lecture from me to myself, even though the lab report declared them within the normal range:

Fasting glucose:  110
Triglycerides: 123
HDL: 55

I’ve had three lipid panels (not including last week’s) since going low-carb nearly five years ago.  Each time, my total cholesterol was between 200 and 210, HDL was over 60 and triglycerides were below 75.  I check my fasting glucose at home a couple of times per week, and it’s pretty much always between 80 and 90.  Even after meals, my glucose is rarely above 105.

So there are two possibilities here.  The first is that my lipids have been getting worse without me knowing it, since it’s been a couple of years since my last lipid panel.  The second is that the party-hearty weekend skewed the lab results.  Since my fasting glucose was 20 points higher than usual, I suspect it’s the latter.

On the 2012 low-carb cruise, someone asked Dr. William “Wheat Belly” Davis about having a cheat day on weekends.  He replied that if you cheat with wheat or other refined carbohydrates, it’s a bad idea.  Just one day of eating wheat can screw up your lipids for the next 3-5 days, he explained, so one cheat day per week can mean you’re spending the majority of the week producing more triglycerides and small LDL.  I don’t know if beer produces similar effects, but I can’t think of anything good that comes from drinking beer.

Anyway, I suspect I’ll be getting an earful from the doctor when we go over my labs.  Depending on what he does or doesn’t know about nutrition, I may even have to endure recommendations for a low-fat diet and a statin.  Naturally, I’ll ignore those recommendations.

The earful I gave myself went something like this:

Hey, Dummy:  don’t cheat with wheat.  Period.


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123 thoughts on “I’m Expecting A Lecture From My Doctor

  1. Jeff

    The 3-5 days probably explains why my cholesterol was high when I had a physical for my life insurance. I’d just gotten back from a vacation in Cancun about 3-4 days before and it wasn’t just a cheat day or two – more like a cheat week. Hence the scary call from the insurance agent asking if I really needed that much insurance – my cholesterol was high. I’d thought the four days would be enough to “recover”. Oops. And now I’m paying for that “oops” monthly.

    Apparently four days wasn’t enough. This is the first time I’ve had a lipid panel so close to a junk-food weekend, so I wasn’t sure how much of a change the junk food would produce. I still don’t know for sure until I have another lipid panel.

  2. Marilyn

    Isn’t there a possibility of some variation from one lab to another? Also, I remember seeing a graph of total mortality plotted against total cholesterol readings. Based on that, you’re right where you want to be. Yes, here it is:

    http://perfecthealthdiet.com/2011/06/blood-lipids-and-infectious-disease-part-i/

    I’m more concerned about my Trig/HDL ratio being over 2.0 for the first time since I started tracking it. I’m usually closer to 1.0. If the doctor raises a fuss about it, I’ll suggest we run the lipid panel again.

  3. Rae

    I usually don’t cheat with wheat – a more enjoyable cheat for me is gelato or nachos. But I was on vacation for two weeks in July and I ate everything… all the pizza and donuts I wanted. It was fun, sure, but the eczema has *just* gone away… I don’t ever want to be super rigid about food (I did that enough as a vegan!) but it was an effective reminder about why I need to stay away from wheat.

    I wish those reminders would come in the form of a nice greeting card.

    1. Chris

      My husband likes Dr. Houston a lot, no crazy “eat more fiber” suggestions from him. DH’s “world renowned” cardiologist (self proclaimed), well not so much.

  4. Steve

    If you went out of town for this wedding I am guessing the travel might do strange things as well.

    Although I have had my share of health problems, I never (knowingly) had any particular issue with wheat. After being grain-free for over a year, the occasional slice (or 2+) of real pizza (my one true lost love, Mineo’s is heavenly if you have not tried) I get all gassy etc…

    Maybe you are having a similar hyper reaction to the whole carb fest? – even though I know you are not a cold and distant stranger to a few beers 🙂

    It could be a bit of a hyper reaction. I’ll get another lipid profile at some point to compare.

  5. charles grashow

    Since you haven’t had your lipid panel checked in the 2 years prior to this most recent one the 3rd possibility is your diet.

    Perhaps you should get a NMR test to check your LDL-P and small LDL-P.

    It’s possible, but my numbers improved after I adopted the diet. An NMR test would be a good idea regardless.

  6. Jeff

    The 3-5 days probably explains why my cholesterol was high when I had a physical for my life insurance. I’d just gotten back from a vacation in Cancun about 3-4 days before and it wasn’t just a cheat day or two – more like a cheat week. Hence the scary call from the insurance agent asking if I really needed that much insurance – my cholesterol was high. I’d thought the four days would be enough to “recover”. Oops. And now I’m paying for that “oops” monthly.

    Apparently four days wasn’t enough. This is the first time I’ve had a lipid panel so close to a junk-food weekend, so I wasn’t sure how much of a change the junk food would produce. I still don’t know for sure until I have another lipid panel.

  7. Marilyn

    Isn’t there a possibility of some variation from one lab to another? Also, I remember seeing a graph of total mortality plotted against total cholesterol readings. Based on that, you’re right where you want to be. Yes, here it is:

    http://perfecthealthdiet.com/2011/06/blood-lipids-and-infectious-disease-part-i/

    I’m more concerned about my Trig/HDL ratio being over 2.0 for the first time since I started tracking it. I’m usually closer to 1.0. If the doctor raises a fuss about it, I’ll suggest we run the lipid panel again.

    1. Dr Andrew

      Keep it simple. If your lipids are messed up, it is unnecessary to re-check them just to be sure, or just hoping they would turn out better.

      If you have any other risk increasing factors for atherosclerosis (smoking, family history, diabetes, elevated blood pressure), you should start using a statin.

      I wouldn’t take a statin unless you held a gun to my head. Even then, I’d have to think about it.

      1. Daci

        >I wouldn’t take a statin unless you held a gun to my head. Even then, I’d have to think about it.

        I feel the same way…Don’t do it!

        I won’t. Ever.

  8. Bret

    Enjoy the lecture from the wise physician. I can relate. At my annual military physical last month, I had a lipid panel–they measure every five years and this was the fifth. Nurse called me later that afternoon to tell me my cholesterol was high. She was eager to tell me to eat less red meat and more whole grains to pull my total down from 232. She of course glossed right over the HDL of 75–clearly responsible for the jump in the total–and trigs 67. Apparently I have to get checked every year now due to the increase.

    I started combing through the Doctor’s Heart Cure, Wheat Belly, and Good Calories Bad Calories with a highlighter to arm myself with a rebuttal, but then figured what’s the point. Doesn’t matter how well informed I prove I am. They are professionals with all the right answers and I am just a dumb patient. So I’ll just smile and nod at their arrogant advice. Maybe they’ll even put me on a statin (my doctors have the right to force me to fill prescriptions). If so, I will enjoy flushing the pills down the toilet.

    Yikes. At least my doctor can’t order me to take a drug. If he preaches about low-fat diets, I won’t waste my breath arguing.

  9. Lori

    If a cheat day now and then is what someone needs to allow himself to improve his diet, then overall, it’s a good thing. But after years of cheat days turning into cheat weekends, and wheat creeping into my diet every day, I’ve found it’s easier for me to be totally wheat-free. I’m lucky, though, since more than trace exposure gives me acid reflux and horrible sinus congestion within 20 minutes. And I hate beer.

    I think cheat days now and then are fine, but I won’t be cheating with wheat again anytime soon.

  10. Rae

    I usually don’t cheat with wheat – a more enjoyable cheat for me is gelato or nachos. But I was on vacation for two weeks in July and I ate everything… all the pizza and donuts I wanted. It was fun, sure, but the eczema has *just* gone away… I don’t ever want to be super rigid about food (I did that enough as a vegan!) but it was an effective reminder about why I need to stay away from wheat.

    I wish those reminders would come in the form of a nice greeting card.

    1. SB

      I empathize with the eczema comment. I knew, as I ate the ice cream with cookies in it, that I would regret the decision. Ugh. I’m willing to be pretty rigid on certain types of food when the consequences are that obnoxious.

      1. Leon

        Eczema used to ruin me too, when I ate carbage. Couldn’t believe my eyes when it simply vanished after I began eating low carb.

        It’s become a good rod of discipline; Do I really want to look like a leper for a week, just for a night of donuts and ice-cream spiders?

    2. Walter Bushell

      We wouldn’t pay attention to a greeting card. Seems to me the reminders are well titrated to discourage, more results for more serious (self) violations. Considering long term results the reminders are probably more gentle than warranted.

    1. Chris

      My husband likes Dr. Houston a lot, no crazy “eat more fiber” suggestions from him. DH’s “world renowned” cardiologist (self proclaimed), well not so much.

  11. Steve

    If you went out of town for this wedding I am guessing the travel might do strange things as well.

    Although I have had my share of health problems, I never (knowingly) had any particular issue with wheat. After being grain-free for over a year, the occasional slice (or 2+) of real pizza (my one true lost love, Mineo’s is heavenly if you have not tried) I get all gassy etc…

    Maybe you are having a similar hyper reaction to the whole carb fest? – even though I know you are not a cold and distant stranger to a few beers 🙂

    It could be a bit of a hyper reaction. I’ll get another lipid profile at some point to compare.

  12. charles grashow

    Since you haven’t had your lipid panel checked in the 2 years prior to this most recent one the 3rd possibility is your diet.

    Perhaps you should get a NMR test to check your LDL-P and small LDL-P.

    It’s possible, but my numbers improved after I adopted the diet. An NMR test would be a good idea regardless.

  13. Bret

    Enjoy the lecture from the wise physician. I can relate. At my annual military physical last month, I had a lipid panel–they measure every five years and this was the fifth. Nurse called me later that afternoon to tell me my cholesterol was high. She was eager to tell me to eat less red meat and more whole grains to pull my total down from 232. She of course glossed right over the HDL of 75–clearly responsible for the jump in the total–and trigs 67. Apparently I have to get checked every year now due to the increase.

    I started combing through the Doctor’s Heart Cure, Wheat Belly, and Good Calories Bad Calories with a highlighter to arm myself with a rebuttal, but then figured what’s the point. Doesn’t matter how well informed I prove I am. They are professionals with all the right answers and I am just a dumb patient. So I’ll just smile and nod at their arrogant advice. Maybe they’ll even put me on a statin (my doctors have the right to force me to fill prescriptions). If so, I will enjoy flushing the pills down the toilet.

    Yikes. At least my doctor can’t order me to take a drug. If he preaches about low-fat diets, I won’t waste my breath arguing.

    1. Phyllis Mueller

      Don’t flush the statins (or any other prescription drugs) down the toilet. We don’t need them in the water supply. Some places have programs for disposing of unwanted/expired/leftover prescription drugs. Look for one, please, and dispose of them that way.

  14. Lori

    If a cheat day now and then is what someone needs to allow himself to improve his diet, then overall, it’s a good thing. But after years of cheat days turning into cheat weekends, and wheat creeping into my diet every day, I’ve found it’s easier for me to be totally wheat-free. I’m lucky, though, since more than trace exposure gives me acid reflux and horrible sinus congestion within 20 minutes. And I hate beer.

    I think cheat days now and then are fine, but I won’t be cheating with wheat again anytime soon.

  15. kevin

    Bret,

    Please don’t flush statins down the toilet… there are already too many doctors advocating putting statins in our drinking water…

  16. Troy Wynn

    Trigs will rise because of the beer. uh… why cheat? What’s wrong with the existing nutrition that’s done you so well. I don’t get it..

    Nothing’s wrong with the diet that’s done me well, but I don’t believe an occasional cheat is harmful. It’s a matter of what we cheat with and how often. It was eye-opening to see n=1 evidence supporting what Dr. Davis says about the effects of wheat lasting for days. So a once-per-week cheat with wheat is indeed a bad idea.

    1. Jill

      Dr Davis said sugar stays in the body for about a week.

      Does wheat cause the blood sugar to rise for the same amount of time (ie one week)or is it the wheat itself that stays in the body?

      He described it as wheat prompting your body to produce excess triglycerides and small LDL for several days. I presume the wheat itself is gone by then.

  17. Brian

    My fasting blood glucose use to be hovering just above 100 but now is around 88. Just wondering if being low carb for extended period of time puts us at GREATER risk of elevated fasting blood glucose levels when we do cheat? Are we more susceptible to elevated blood glucose than we would have been had we just modestly reduced excess sugar from our diet? I’ve seen other posts of others eating a “normal” meal and registering high blood sugar levels. Just wondering??

    Yes, I believe we lose some tolerance for the foods we stop eating.

    1. Over 60

      Brian, please reconsider your use of the the phrase ‘Greater risk of elevated fasting blood glucose”, etc. Please read Peter at Hyperlipid. A slightly raised FBG may also be known as ‘physiologic fasting BG’, not necessarily a bad thing, and not correlated at all with a high HbA1C. My morning BG is around 105, but HbA1c is 5.2. Go figure. Which do _you_ believe is more important? PS: I am VLC, verging on ZC.

  18. FrankG

    Yes I love the little chats I have with my Doctors… them focusing only on the LDL-C and me pointing at the HDL-C and Trigs! Unfortunately here in Canada the LDL particle count and phenotype is not yet widely used.. despite receiving a cursory mention in the national guidelines.*

    Actually I can report somewhat of a breakthrough… I was sent to a Lipdologist (I think as a last ditch attempt to convince me to go back on statins). He looked at my HDL-C and Trigs and told me to keep on doing what I am doing 🙂

    If I were you (rich, handsome and famous!) I would probably get another set of tests done after a couple of weeks and not be too concerned in the meantime.

    I seem to recall a presentation or interview, where the Doctor (I’ll try to find it) suggested that it can take around 2 weeks to reestablish ketosis after dropping out of LCHF eating.

    As for your Fasting BG you may recall that: after a full year of a “lean and fat meat only” diet (under medical supervision) Stefansson and his colleague Andersen initially showed a reduced tolerance to carbohydrates (on an OGTT) which resolved after 2 to 4 weeks of a “general diet”.

    Of course if you continue to avoid those carbs, then the reduced tolerance ain’t really an issue 🙂

    http://www.jbc.org/content/83/3/747.full.pdf

    http://www.comby.org/documents/documents_in_english/stefansson-diet-adventures.htm

    * a side note concerning the USA national cholesterol guidelines was this interesting blog post by Dr Malcolm Kendrick… http://drmalcolmkendrick.org/2013/08/02/who-shall-guard-the-guardians/

    Who shall guard the guardians? “Imagine if eight Supreme Court judges, ruling on any issue, had seventy two direct financial conflicts of interest to do with that issue…”

    —————-

    Rich, handsome and famous? Are confusing this blog with Mark Sisson’s?

  19. John Zacharias

    I noticed something similar during my last carb binge Tom. My blood sugar was steady at 85-95 for weeks. I had 12 days of carb indulgence, my blood sugar has been elevated 99-120 for the remainder of the month. It has taken two weeks for my blood sugar to get anywhere close to normal.

  20. David

    I do not cheat with wheat since it hurts my body. Last year I went through a time where I wasn’t spending much and beer was one of the things I cut spending on. And when I had some weeks later once I had a complimentary one, I didn’t feel very good (sinuses tightened and asthma symptoms came around) along with feeling moody. Plus when I had Italian rolls because my previous roommates wanted to actually see me eat bread, I did and it upset my stomach. But luckily a gluten free pizza from Uncle Maddios (recently new Atlanta area chain) or Mellow Mushroom doesn’t do any of that to me even on the rarest occassion. And I am fine having gluten free distilled alcohol and beers (Redbridge) without that but in moderation.

    As far as recent lab results, I haven’t actually went back for lipids to avoid lectures but I did do a free clinic visit on campus (Kennesaw State University) and the nurse was amazed by how excellent my vital signs were for a college student and asked what I do. She got every nurse in the room to hear about it and they are looking into going low carb now thanks to me!

    Those are some open-minded nurses.

    1. David

      At first my nurse did say that cutting on the bad carbs sounds healthy but she questioned the fat as everyone is taught it is bad. I said she should read up information that it was misinformed but I made it sound more appealing by recommending the natural fats like coconut oil, olive oil, nuts, avocados, and butter instead of going into saying “bacon and lard are good!” since that may not have worked. But to those who freak out when they hear “Atkins diet” or associate HFLC as Atkins, I say “well you don’t have to eat those foods if you don’t want! Just use the known healthy fats and proteins while restricting refined carbs and your health and weight will still improve!” But she said it made a lot of sense to her.

  21. desmond

    My last lipid panel was excellent. I am sure I did not cheat-with-wheat beforehand, but I had probably had a couple beers within 3-4 days (I don’t like wheat beer, so it would have been barley-based).

    My glucose was a bit high, though. Unusually for me, I had a late-night snack of berries before my test, but nothing during the fasting period.

    Next time I will avoid beer and excessive fruits for a few days, and see what the numbers say.

  22. Tom Welsh

    Well, it’s been several years now since the eye-opening week when I first read “The Diet delusion” (the UK edition of “Good Calories, Bad Calories”). Not that long after, I came across Dr Cordain’s book on the Paleo diet, and immediately lost a stone or so.

    Then I started to think it was all a bit extreme and regimented and… well, harsh. After all, I enjoy doughnuts, and scones with jam and cream, and ice cream, and even a fesh bagel with unsalted butter is delightful. We would go into the coffee shop and order a latte, and they have these absolutely wonderful apricot croissants with just enough sweet custard…

    Oddly enough, I soon regained all the weight and since then haven’t really lost any. A week ago, the worm turned after I read enough comments on the Web about how cheating can prevent you from getting anywhere. So I decided to cut out all carbs, all the time, and so far it’s looking good. I even stopped drinking wine – most of the time. It still seems unfair to have to decline cakes and cookies and all that stuff, but then I ask myself “How much do you enjoy living, and how much more of it would you like to do?” Suddenly the carbage becomes less appealing.

  23. kevin

    Bret,

    Please don’t flush statins down the toilet… there are already too many doctors advocating putting statins in our drinking water…

    1. Bret

      Good point. Perhaps I’ll save them up for a bonfire. Maybe those charred statin fumes will give my neighbors some wild hallucinations.

    2. Molly56

      I was going to say the same thing…I already only drink spring water that is verified to not be tap water from somewhere or other. I’ve heard that municipal water purification can’t do a good job of removing traces of many pharmaceuticals.

    3. Walter Bushell

      Oh there are already statins in many peoples drinking water, most if not all pharmaceuticals and metabolites and other drugs get passed through to one extent or another.

      Some can be removed by filtration.

  24. Austin Pitts

    I seem to have hyper reaction to wheat/beer now too. I usually have a few beers one day a week but last weekend had that 2 days in a row. I couldn’t believe how bad I felt yesterday and still today.

  25. neilfeldman

    Hi Tom,

    Regarding your blood glucose level. Have you had your Hemoglobin A1C (HbA1c) level checked recently? That would show your last 3 months trend and would be what I would be concerned about (if it is high).

    That wasn’t on the lab report.

  26. Troy Wynn

    Trigs will rise because of the beer. uh… why cheat? What’s wrong with the existing nutrition that’s done you so well. I don’t get it..

    Nothing’s wrong with the diet that’s done me well, but I don’t believe an occasional cheat is harmful. It’s a matter of what we cheat with and how often. It was eye-opening to see n=1 evidence supporting what Dr. Davis says about the effects of wheat lasting for days. So a once-per-week cheat with wheat is indeed a bad idea.

    1. Jill

      Dr Davis said sugar stays in the body for about a week.

      Does wheat cause the blood sugar to rise for the same amount of time (ie one week)or is it the wheat itself that stays in the body?

      He described it as wheat prompting your body to produce excess triglycerides and small LDL for several days. I presume the wheat itself is gone by then.

  27. Brian

    My fasting blood glucose use to be hovering just above 100 but now is around 88. Just wondering if being low carb for extended period of time puts us at GREATER risk of elevated fasting blood glucose levels when we do cheat? Are we more susceptible to elevated blood glucose than we would have been had we just modestly reduced excess sugar from our diet? I’ve seen other posts of others eating a “normal” meal and registering high blood sugar levels. Just wondering??

    Yes, I believe we lose some tolerance for the foods we stop eating.

    1. Over 60

      Brian, please reconsider your use of the the phrase ‘Greater risk of elevated fasting blood glucose”, etc. Please read Peter at Hyperlipid. A slightly raised FBG may also be known as ‘physiologic fasting BG’, not necessarily a bad thing, and not correlated at all with a high HbA1C. My morning BG is around 105, but HbA1c is 5.2. Go figure. Which do _you_ believe is more important? PS: I am VLC, verging on ZC.

  28. Shannon

    Good luck with the doctor!

    I don’t cheat on wheat because for me, the symptoms are really quick (within the hour). While it would be nice if I could have a piece of pizza or wedding cake or something, it’s just not worth it for me since I’m going to feel badly so quickly (and it’s dose dependent – if I eat enough, I’ll even miss the rest of the function because I’ll be in the loo). I honestly do think I’m lucky in that regard. It definitely does make it easier to not eat the stuff when the reaction is so quick!

    Sugar however (sigh). I feel great when I eat sugar. My waistline and my blood panels don’t appreciate it though 😛

    That sugar buzz is, unfortunately, hugely rewarding to many people.

  29. Susan

    I little bit of tough love here.

    Isn’t that what we all say, “I’ll never do that again” when the truth is we indeed falter over and over again?

    After all, if someone like you has researched and knows the consequences of wheat and still resorts to consuming what you know is bad for you, how do you think the average Joe is dealing with such temptation? Alas, I think there’s something else going on here beyond addiction.

    Either that, or we’ve got to stop beating ourselves up over the little things trying to control every aspect of our lives. Otherwise, we may be setting ourselves up for failure.

    It isn’t an addiction in my case. I don’t crave wheat or have to fight urges to consume it. It was a conscious decision: special occasion, this is what they’re serving, what the heck, I’ll enjoy. It was educational to have a lipid panel done three days later and see that Dr. Davis is apparently correct about how one day of cheating leads to several days of messed-up lipids.

  30. FrankG

    Yes I love the little chats I have with my Doctors… them focusing only on the LDL-C and me pointing at the HDL-C and Trigs! Unfortunately here in Canada the LDL particle count and phenotype is not yet widely used.. despite receiving a cursory mention in the national guidelines.*

    Actually I can report somewhat of a breakthrough… I was sent to a Lipdologist (I think as a last ditch attempt to convince me to go back on statins). He looked at my HDL-C and Trigs and told me to keep on doing what I am doing 🙂

    If I were you (rich, handsome and famous!) I would probably get another set of tests done after a couple of weeks and not be too concerned in the meantime.

    I seem to recall a presentation or interview, where the Doctor (I’ll try to find it) suggested that it can take around 2 weeks to reestablish ketosis after dropping out of LCHF eating.

    As for your Fasting BG you may recall that: after a full year of a “lean and fat meat only” diet (under medical supervision) Stefansson and his colleague Andersen initially showed a reduced tolerance to carbohydrates (on an OGTT) which resolved after 2 to 4 weeks of a “general diet”.

    Of course if you continue to avoid those carbs, then the reduced tolerance ain’t really an issue 🙂

    http://www.jbc.org/content/83/3/747.full.pdf

    http://www.comby.org/documents/documents_in_english/stefansson-diet-adventures.htm

    * a side note concerning the USA national cholesterol guidelines was this interesting blog post by Dr Malcolm Kendrick… http://drmalcolmkendrick.org/2013/08/02/who-shall-guard-the-guardians/

    Who shall guard the guardians? “Imagine if eight Supreme Court judges, ruling on any issue, had seventy two direct financial conflicts of interest to do with that issue…”

    —————-

    Rich, handsome and famous? Are confusing this blog with Mark Sisson’s?

  31. John Zacharias

    I noticed something similar during my last carb binge Tom. My blood sugar was steady at 85-95 for weeks. I had 12 days of carb indulgence, my blood sugar has been elevated 99-120 for the remainder of the month. It has taken two weeks for my blood sugar to get anywhere close to normal.

  32. Judy B

    What I’m wondering is when doctors are ever going to lose this obsession with lipids? Far too many of us have not only had to endure lectures but also be coerced to take drugs so as not to be dropped from a doctor’s practice.

    The evidence of the failure of the lipid hypothesis is right in front of them but they refuse to see it. One wonders about the amount of harm that has been done in the name of “preventive medicine.” So much for the Hippocratic Oath!

    Unfortunately, many doctors memorized what they were taught in med school and get their ongoing education credits at seminars sponsored by drug companies. This is my first introduction to this doctor, so I don’t know yet what he believes about lipid levels. I’ll find out in a few weeks.

    1. Firebird

      Beer = liquid bread. I use to let a slice of bread sit on my tongue and dissolve. After the initial sweetness wears off, the next taste is the yeast, and that slice of bread tastes like beer.

  33. David

    I do not cheat with wheat since it hurts my body. Last year I went through a time where I wasn’t spending much and beer was one of the things I cut spending on. And when I had some weeks later once I had a complimentary one, I didn’t feel very good (sinuses tightened and asthma symptoms came around) along with feeling moody. Plus when I had Italian rolls because my previous roommates wanted to actually see me eat bread, I did and it upset my stomach. But luckily a gluten free pizza from Uncle Maddios (recently new Atlanta area chain) or Mellow Mushroom doesn’t do any of that to me even on the rarest occassion. And I am fine having gluten free distilled alcohol and beers (Redbridge) without that but in moderation.

    As far as recent lab results, I haven’t actually went back for lipids to avoid lectures but I did do a free clinic visit on campus (Kennesaw State University) and the nurse was amazed by how excellent my vital signs were for a college student and asked what I do. She got every nurse in the room to hear about it and they are looking into going low carb now thanks to me!

    Those are some open-minded nurses.

    1. David

      At first my nurse did say that cutting on the bad carbs sounds healthy but she questioned the fat as everyone is taught it is bad. I said she should read up information that it was misinformed but I made it sound more appealing by recommending the natural fats like coconut oil, olive oil, nuts, avocados, and butter instead of going into saying “bacon and lard are good!” since that may not have worked. But to those who freak out when they hear “Atkins diet” or associate HFLC as Atkins, I say “well you don’t have to eat those foods if you don’t want! Just use the known healthy fats and proteins while restricting refined carbs and your health and weight will still improve!” But she said it made a lot of sense to her.

  34. desmond

    My last lipid panel was excellent. I am sure I did not cheat-with-wheat beforehand, but I had probably had a couple beers within 3-4 days (I don’t like wheat beer, so it would have been barley-based).

    My glucose was a bit high, though. Unusually for me, I had a late-night snack of berries before my test, but nothing during the fasting period.

    Next time I will avoid beer and excessive fruits for a few days, and see what the numbers say.

  35. Tom Welsh

    Well, it’s been several years now since the eye-opening week when I first read “The Diet delusion” (the UK edition of “Good Calories, Bad Calories”). Not that long after, I came across Dr Cordain’s book on the Paleo diet, and immediately lost a stone or so.

    Then I started to think it was all a bit extreme and regimented and… well, harsh. After all, I enjoy doughnuts, and scones with jam and cream, and ice cream, and even a fesh bagel with unsalted butter is delightful. We would go into the coffee shop and order a latte, and they have these absolutely wonderful apricot croissants with just enough sweet custard…

    Oddly enough, I soon regained all the weight and since then haven’t really lost any. A week ago, the worm turned after I read enough comments on the Web about how cheating can prevent you from getting anywhere. So I decided to cut out all carbs, all the time, and so far it’s looking good. I even stopped drinking wine – most of the time. It still seems unfair to have to decline cakes and cookies and all that stuff, but then I ask myself “How much do you enjoy living, and how much more of it would you like to do?” Suddenly the carbage becomes less appealing.

  36. Austin Pitts

    I seem to have hyper reaction to wheat/beer now too. I usually have a few beers one day a week but last weekend had that 2 days in a row. I couldn’t believe how bad I felt yesterday and still today.

  37. neilfeldman

    Hi Tom,

    Regarding your blood glucose level. Have you had your Hemoglobin A1C (HbA1c) level checked recently? That would show your last 3 months trend and would be what I would be concerned about (if it is high).

    That wasn’t on the lab report.

  38. Jill

    Timely – I almost gave in to eating wheat today! Then I thought – nahhhhhhhhhhhhhh!

    But I began looking at dessert portions etc online and came across the Australian Heart Foundation dessert page:
    http://www.heartfoundation.org.au/healthy-eating/food-and-nutrition-facts/Pages/carbohydrate-sugars.aspx

    I’m not happy.
    Care to comment on the very peculiar way they talk about carbs, “sugar as a nutrient” and “scientific consensus’?

    (I hope this is not hijacking the topic!)

    “The advice of the Heart Foundation of Australia is based on sound science.” That’s after they blame saturated fat and sodium, for which there’s no sound science.

  39. Jill

    Relating to the beer thing, I cannot stand drink culture, esp. that which results in hungover aggressive idiots driving drunk and killing people, vomiting, getting violent with others.

    The only drunk I like is the one who giggles or falls asleep. 🙂

    I become sentimental and fall asleep — the “I love you, Man” drinker. I don’t trust people who become aggressive or abusive after a few pops. I figure they’re just repressing those urges while sober.

    1. Lori

      I don’t have anything against people having a few drinks, but I usually don’t care to have more than one. My coworkers think I’m shy, but truth to tell, I can’t think of a duller way to spend an evening than hanging around drinkers.

      That depends on the drinkers.

  40. Shannon

    Good luck with the doctor!

    I don’t cheat on wheat because for me, the symptoms are really quick (within the hour). While it would be nice if I could have a piece of pizza or wedding cake or something, it’s just not worth it for me since I’m going to feel badly so quickly (and it’s dose dependent – if I eat enough, I’ll even miss the rest of the function because I’ll be in the loo). I honestly do think I’m lucky in that regard. It definitely does make it easier to not eat the stuff when the reaction is so quick!

    Sugar however (sigh). I feel great when I eat sugar. My waistline and my blood panels don’t appreciate it though 😛

    That sugar buzz is, unfortunately, hugely rewarding to many people.

  41. Robinowitz

    As a side note about beer: my husband is a home brewer and says that it’s easy to make beers that aren’t full of gluten. Wheat isn’t in all beers…there’s malt, barley, hops, sometimes millet in a gluten-free one he might make. Beer isn’t liquid wheat–just Liquid carbs;)

    And if you REALLY won’t ever completely give it up (like my husband) you just find ways to strictly limit it and choose less inflammatory versions.

  42. Susan

    I little bit of tough love here.

    Isn’t that what we all say, “I’ll never do that again” when the truth is we indeed falter over and over again?

    After all, if someone like you has researched and knows the consequences of wheat and still resorts to consuming what you know is bad for you, how do you think the average Joe is dealing with such temptation? Alas, I think there’s something else going on here beyond addiction.

    Either that, or we’ve got to stop beating ourselves up over the little things trying to control every aspect of our lives. Otherwise, we may be setting ourselves up for failure.

    It isn’t an addiction in my case. I don’t crave wheat or have to fight urges to consume it. It was a conscious decision: special occasion, this is what they’re serving, what the heck, I’ll enjoy. It was educational to have a lipid panel done three days later and see that Dr. Davis is apparently correct about how one day of cheating leads to several days of messed-up lipids.

    1. Susan

      “It isn’t an addiction in my case. I don’t crave wheat or have to fight urges to consume it. It was a conscious decision: special occasion, this is what they’re serving, what the heck, I’ll enjoy. It was educational to have a lipid panel done three days later and see that Dr. Davis is apparently correct about how one day of cheating leads to several days of messed-up lipids.”

      Whereas the film gives the impression that it’s a simple matter of “just saying no” to sugar and carbs, social politics are also a factor whereby, like you, many of us will “fall on our dietary swords” depending on the situation. Otherwise, why call yourself a dummy.

      That’s why I feel it’s too simplistic to say, “we’re all free to make our own choices” because such a grand statement does not include the interdependence of how life often works.

      I was free to make a choice, and I don’t care about social politics. I could have skipped the bready stuff and drank wine instead of beer, which is what I usually do. It was a “what the heck” decision, not a case of giving in to some irresistible pull. Now that I’ve seen those lousy lipids three days later, I won’t “what the heck” with wheat foods.

  43. Deb C

    Tom,

    Around here you can find pharmacies that do lipid and glucose panels for very little cost. Have you tried that? The pharmacist I go to charges $25, (the average in the area is $25 to $35) and I have the results in 10 minutes. (Glucose, Total Cholesterol, LDL, HDL, Triglycerides, and TC/HDL ratio.) He generally insists on a fasting panel, and since he is located in the closest supermarket, I fast, get my blood tested, and then pick up some groceries. I copy my results. keep one in my purse (for bragging rights, usually!), and send one to my clinic and ask them to add it to my file. It’s there in my file when my doctor sees me. Since my triglycerides are always lower than my HDL, I think I’m in a pretty good place. . .

    I also did some tests through Lifeline awhile back, and they have special forms to submit the results to your doctor. The “independent test” route is a way to get better control over the testing process (without the lecture). Maybe if you had done this prior to your cheat weekend, you could have had some basis for comparison?

    I didn’t know it was possible to get a full lipid panel that quickly. The instant tests I’ve seen in the past only measured total cholesterol. I’ll take a look around.

  44. Judy B

    What I’m wondering is when doctors are ever going to lose this obsession with lipids? Far too many of us have not only had to endure lectures but also be coerced to take drugs so as not to be dropped from a doctor’s practice.

    The evidence of the failure of the lipid hypothesis is right in front of them but they refuse to see it. One wonders about the amount of harm that has been done in the name of “preventive medicine.” So much for the Hippocratic Oath!

    Unfortunately, many doctors memorized what they were taught in med school and get their ongoing education credits at seminars sponsored by drug companies. This is my first introduction to this doctor, so I don’t know yet what he believes about lipid levels. I’ll find out in a few weeks.

    1. Jill

      Doctors are bad enough, but what about nagging parents, friends and relatives all of whom are convinced they know how you should eat and look??

      Oddly enough, overweight men tend to tell women – even slim ones – what they should be eating.

      1. Jill

        I should point out here that my doctor is absolutely happy with what I’m doing (no wheat, never statins in the future), esp. as, though my asthma is still severe, I have had far fewer visits to her since I gave up wheat than in years before that.

        Now I have my attacks in the comfort of my own home. 😉

    1. Loofus

      Only if it is brewed with wheat. I occasionally drink a gluten-free micro brewed with barley and do not suffer through the same bloating and pain that a conventional beer causes. Still, I try to minimize my intake because it is a heavy carb load.

    2. Firebird

      Beer = liquid bread. I use to let a slice of bread sit on my tongue and dissolve. After the initial sweetness wears off, the next taste is the yeast, and that slice of bread tastes like beer.

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