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Carbohydrates: Why Quality Trumps Quantity


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Do you obsessively count carbs? The good news is you probably don’t need to—if you eat the right foods. Recent research suggests that the answer to obesity and metabolic disease lies not in how much carbohydrate we eat, but rather what types of carbohydrate we eat. Read on to see what we can learn from ancestral diets, how the Paleo diet shapes up in controlled studies, and what carbohydrates should make up the bulk of your diet.

quality carbs
Quality carbohydrates such as these sweet potatoes are key to a healthy diet. istock.com/HausOnThePrairie

The media and scientific community are constantly changing their minds as to what macronutrient (protein, carbs, or fat) is making us fat. “If it fits your macros” is a common mantra among individuals in the weightlifting and bodybuilding community. Meanwhile, weight loss “experts” point to the total “calories in, calories out” as the answer to health. On the carbohydrate spectrum, you have people who eat plenty of carbs (but avoid fat at all costs), those who reduce carb intake so much that they enter ketosis, and just about everything in between. I’ve weighed in on this topic myself, with several blog posts about the risks and benefits of low-carb diets and how to optimize your carbohydrate intake.

As I pointed out in those posts, the bulk of the evidence suggests that the quality of food matters a lot more than the quantity of macronutrients—at least for most people. A recent hypothesis suggests that the dense, acellular carbohydrates (bear with me; I’ll define that shortly) found in processed foods may be contributing to our epidemic of modern chronic disease. The researchers propose that foods with a high carbohydrate density promote an inflammatory microbiota, leading to leptin resistance, metabolic syndrome, and obesity (1). In this article, we’ll break this down and see how we might use this information.

Leptin Resistance and Its Role in Obesity

Leptin is a mediator of long-term regulation of energy balance. It is secreted by adipose tissue and signals to the brain: “Hey, we’ve got enough energy stores!” This suppresses food intake and thereby induces weight loss. In fact, the most common mouse model of obesity is the mutant “ob/ob” mouse, which is unable to produce leptin at all. These mice eat excessively and quickly become two to three times the size of a normal mouse.

But most obese humans don’t have a problem secreting leptin. Instead, they have leptin resistance, where the body develops a decreased sensitivity to leptin.

Similar to insulin resistance, chronic overexposure to the leptin hormone results in a decreased sensitivity of leptin receptors to the circulating leptin hormone. To compensate, the body produces more leptin, almost as if “shouting” at the brain and other parts of the body that are not responding to the leptin signal. Meanwhile, the person does not get the food intake suppression signal and continues to eat.

So what causes leptin resistance? Studies suggest that inflammation can damage the hypothalamus (2), the center of the brain that receives the primary signal from leptin and suppresses food intake. Inflammation can come from many sources, but diet and the gut microbiota tend to be prime sources in developed countries. In the next section, we’ll look at leptin levels among ancestral populations and how they compare to the typical consumer of a Western diet.

Carbohydrates: why quality—not quantity—matters most.

Comparison of Western Diets with Ancestral Diets

We can learn a lot from looking at the diets of populations that eat more ancestral health diets. Many of them have similar macronutrient compositions to a Western diet, yet they have a virtual absence of Western-type diseases.

For example, the Kitavan Islanders of Melanesia live as horticulturists, with little access to Western foods. Carbohydrates make up 60 to 70 percent of their energy intake, much of that coming from fruit or tubers with a fairly high glycemic index (3). Their saturated fat intake is also high. Yet despite obvious similarity between Kitavan and Western diets in both macronutrient composition and glycemic index, Kitavans boast levels of fasting insulin and blood glucose that are even lower than the levels deemed healthy in Western populations (4, 5). They also have lower levels of leptin and a virtual absence of diabetes, atherosclerosis, and excess weight (6, 7, 8).

These people aren’t just genetically superior: islanders who leave for the mainland and begin to eat a Western diet quickly become overweight (5). Similarly, when they maintain a traditional lifestyle, the Ache hunter–gatherers of Paraguay and the Shuar people of the Amazon are lean and have low leptin concentrations (9, 10). However, hunter–gatherer populations that transition to a Western diet develop Western metabolic diseases (11). Maintaining high levels of physical activity only provides a small degree of protection (12).

Other analyses of modern hunter–gatherer populations, including the Masai, Kavirondo, and Turkhana, suggest that high intake of unprocessed meat and saturated fat does not result in poor cardiovascular or metabolic health (13). I’ve written and talked extensively on the meat-heart disease myth though, so for this article, we’ll focus more on carbohydrates.

Paleolithic Diets Prevail in Randomized Controlled Trials

In general, the absence of grains and refined carbohydrates in hunter–gatherer populations results in incredibly low incidences of Western diseases like obesity and metabolic syndrome. But what about in the Western world?

Many of us have adopted a modern “Paleolithic” diet in an attempt to restore our health. Does mimicking the diet of our ancestors have proven benefits?

Absolutely. While replacing refined grains with whole grains results in only modest health improvements (14), removing grains altogether and adopting a Paleolithic diet improves health across the board. Twelve weeks on a Paleolithic diet with unrestricted food intake reduced leptin levels by 31 percent and caloric intake by 20 to 30 percent (15). In another study, a Paleolithic diet resulted in greater reductions in weight and waist circumference compared to Mediterranean or diabetes diets and normalized type 2 diabetic glucose intolerance (16, 17).

Unfortunately, this is the extent of the RCTs assessing the effectiveness of a Paleo diet—after all, no pharmaceutical or food manufacturer serves to profit from a study that finds that real food prevents disease! Nevertheless, in these few studies, the effects of a Paleo diet in restoring health are robust.

The Role of Chronic Inflammation in Obesity and Metabolic Disease

Obesity is increasingly recognized as a condition characterized by low-grade, systemic inflammation that often begins in the gut. Early GI inflammation, changes in the gut microbiota, and increased GI permeability (leaky gut) precede and predict obesity in mouse models (18). A leaky gut allows bacteria and components of bacterial cell walls, like lipopolysaccharide (LPS), to cross the gut barrier. Termed “metabolic endotoxemia,” this influx of bacterial toxins into the bloodstream launches an inflammatory immune response that is thought to be a major mechanism in the pathology of obesity.

Furthermore, the microbiota of obese individuals show altered expression of bacterial genes involved in metabolism of carbohydrates, lipids, and amino acids (19). Microbial changes in the upper GI tract can result in leptin resistance in the vagus nerve, reducing satiety signaling (20). We’ll see in the next section how carbohydrate density might lead to these microbial changes and gut inflammation.

Carbohydrate Density

Not all carbohydrates are created equal. The amount of carbohydrates present in 100 grams of food is referred to as a food’s carbohydrate density and does not necessarily correlate with glycemic index.

Cellular plant foods have a low carbohydrate density compared to Western foods. Root tubers, fruits, leaves, and stems store their carbohydrates as part of fiber-walled living cells. These cells are thought to remain largely intact during cooking (21). The fact that carbohydrates are stored within cells means that the maximum carbohydrate density they can have is around 23 percent.

In contrast, flour, sugar, and grains are among the most commonly consumed foods in the Western diet and are considered “acellular” carbohydrates, meaning they lack intact cells. Processed foods made from these ingredients can have a very high carbohydrate density—as high as 75 percent. This leads to a dramatic difference in the slurry of food and stomach acid that reaches the gut:

“The chyme produced after consumption of acellular flour and sugar-based foods is […] suggested to have a higher carbohydrate concentration than almost anything the microbiota of the upper GI tract from mouth to small bowel would have encountered during our coevolution.” (22)

We can easily imagine how this increased carbohydrate concentration could lead to small intestinal bacterial overgrowth (SIBO), gut dysbiosis, and ultimately leptin resistance and obesity. Inflammation caused by changes in the gut microbiota can cause damage to the hypothalamus and afferent vagus nerve endings, inducing leptin resistance. Without leptin to curb food intake, overeating and weight gain is highly likely.

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Summary: Eat Real Food

Hopefully this research has helped convince you that food quality trumps quantity. Here are a few of the main takeaways:

  1. Macronutrient composition is important, but the quality of those macronutrients and the context they are found in are likely far more important. Our ancestors ranged from an intake of as little as 8 percent of calories from carbohydrate to as high as 70 percent calories from carbohydrate with few health problems. Only when they introduce refined Western foods do they develop metabolic disease.
  2. Low-carb diets are somewhat effective at achieving weight loss because they tend to reduce acellular carbohydrates, but if an individual is still eating enough to produce an inflammatory microbiota, he or she may stall in weight loss.
  3. Even small amounts of sugar or refined grains could lead to an inflammatory microbiota and leptin resistance. Ancestral peoples’ health tends to be very sensitive to even small influences of Western foods (23, 24). This means that the popularized 80-20 rule may not work for many people if that 20 percent is carbohydrate-dense enough to cause dysbiosis.
  4. Eat real food. Focus on fresh, whole foods that are minimally processed and have their carbohydrates encased in cellular compartments. These foods will not only have a lower carbohydrate density but will also likely be accompanied by a wide variety of micronutrients.
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Join the conversation

  1. Great advice from everyone to treblig. It horrifies me that patients leave hospital with so much appalling advice or none at all! Thank goodness for the likes of Chris and others in the Functional Medicine arena.

    • I agree with you about the advice I received at the hospital…they were no help at all. It was like they were saying, “Go home, take care of yourself and you’ll either die or get better….and oh, by the way, here’s a bill for $45K for the 3 days you were here”.
      Seriously though, I’m doing the best I can with all the non-information I received from the doctors. As for the things I eat….the whole purpose of my diet is to remove the plaque from my arteries, that’s it!! So my diet is designed to greatly decrease the bad cholesterol in my arteries.

      Soy dogs – .5g Saturated fat, 0 trans fats, 0 cholesterol, less than 1g sugar, no MSG, no nitrates, 13g protein

      Rice milk – 0 sat fats, 0 trans fats, made from organic rice, 1g sugar per serving

      Soy Cheese – 2g Sat fats, 0 trans fats, 0 sugar

      Organic cereal – 0 sat fats, 0 trans fats, 0 cholesterol, 5g sugar per serving, organic whole wheat, organic milled corn, whole rolled oats, organic brown rice

      Egg whites, mostly protein, 0 cholesterol, 0 sugar, 0 sat fats, 0 trans fats

      Blueberries – high in antioxidants (helps with inflammation in the arteries)

      Bread – Multigrain, 0sat fats, 0 trans fats, 0 cholesterol, 0 sugar, organic sprouted whole grain wheat, organic sprouted millet seeds, spelt kernels, barley kernels.

      All meats contain ingredients that increase blood cholesterol. Although wild salmon is good for you it still contains some bad fats (along with all the good fats).

      I was in ketosis for the last 3 years, no sugar, very few carbs. I went into ketosis to stop my diverticulitis symptoms. How that I’ve had a heart attack I can only attribute the attack to the protein (meat) I was eating. I was eating meat and good fats/oils (no bad fats). Thinking that really high quality EVOO was good for me I consumed 4 Tbls per day and plenty of avocados. I hadn’t done enough homework??? After the heart attack I did extensive research and found that even the best EVOO on the market and the best Salmon contains some bad fats. In fact EVOO contains saturated fats. If you consume enough EVOO or avocados it’s not good for you. Of course it depends on your individual metabolism??
      Now that I’ve taken the great majority of bad fats out of my diet my angina symptoms are slowly disappearing. In fact yesterday was one of the best days I had since I left the hospital!! I can only contribute my unbelievable recovery to my diet and exercise because the doctors didn’t really tell me much at all, except that there wasn’t much they could do for me.
      I don’t mind all the recommendations but before you make a recommendation please check to make sure you’re not telling me to consume any bad fats/oil. My body (arteries) can not tolerate any more bad fats/oils. One artery is/was 90 percent closed, that does leave much room for error!!

      Thanks and Happy T-Day,

      • Don’t forget that bread and cereals soon turn to sugar once eaten. I avoid most grains. Your carb allowance is best kept for real veggies.
        Be careful with blueberries. Non organic types may have quite a coating of unwanted pesticides.
        And finally, cholesterol is cholesterol, it is the lipid carrier ratio that is important. We need the stuff to repair artery walls etc. Cut out the cereals and the cholesterol problem will go away.

        • Thanks for the advice!! The funny thing is that for 3 years prior to my heart attack I wasn’t eating hardly any carbs at all (in any form). I was on a strict no sugar low carb diet. I have known for years that sugar causes inflammation so I avoided sugar and carbs at all cost to greatly decrease my diverticulitis symptoms. It was during the low carb, no sugar diet that my arteries closed up. I do take Omega 3 and 6 supplements to keep my good cholesterol in check. I eat the cereal for the crabs and fiber even though I prefer not to eat cards. But since I don’t eat any sugar or meat/fish I need to get protein from somewhere. Many of the beans don’t agree with me.


      • May I ask what your diet consisted of in the previous years when you were “ketogenic”?

        How much stress has there been in your life? Exercise?

        Sorry you have gone through this!

        • My keto diet consisted of egg whites, some bacon (not too much), Salmon, grilled shrimp, pinto beans, green beans (very low carb), super low sugar intake (less than 15g a day), occasional hamburger with cheese (no bun), tuna salad, chicken salad, EVOO, lots of avocados, occasional fruits, almost no carbs. no breads, no pastas, no pastries or rice. No sweets at all. Maybe 30 carbs a day (sometimes less). I used to run 5 miles a day for years and also use a stationary bicycle but I had to stop all my exercising because I was losing too much weight while in ketosis. I hadn’t exercised for about 2 years just to keep the weight on.
          I’m having trouble maintaining my weight on this new “heart healthy” diet as well. I have a very, very high metabolism. I have to exercise now to help my arteries heal and clear out the plaque. Exercise also keeps bad cholesterol in check although my cholesterol was only 180 or so when I had the heart attack. I have never had high cholesterol, the highest I ever recorded was 215 but that was over 15 years ago.
          The doctors did say (after cath and heart sonogram) that my heart was in excellent shape and my heart valves were impressive. Great blood flow. All my major arteries were spotlessly clear except for those 3 diagonal arteries. FYI, I’ll be 65 next month, still very, very active. Type A personality, can’t sit still!!

          thanks for the encouragement,

      • Your body won’t use cholesterol to line your arteries if it can use collagen to repair them instead. For that, it needs at least 4g of vitamin C a day, plus plenty of magnesium and the amino acids glycine, lysine and proline, from foods or supplements. You would also benefit from some Vitamin K2 to remove the calcium from your arteries and redirect it to your bones and teeth where it belongs.

        • I take about 2G of vitamin C per day and magnesium supplements. I’ll need to check on the K2 benefits. Garlic supplements as well.


      • While you may have had some problems handling saturated fats, please don’t refer to them as “bad fats”. They are not “bad” for most people. If we removed all the saturated fat from our bodies, we would die. In reality, the only “bad fats” are trans fats.

  2. The newest trend is the so-called ketogenic diet, which includes intermittent fasting, such as for example, fasting from 6 PM until 12 noon of the next day. I don’t want to elaborate on this in such a short space, but encourage the reader to see why a ketone rather than a glucose based diet can prevent diabetes and heart disease and also extend the life span.

  3. Thanks Chris. I always learn something new when I read your articles. How good is it to receive this important information free of charge. Appreciated!

  4. I am curious as to the thought of how sprouted grains and nuts made into breads fit into this topic as the sprouted grains digests as vegetables.
    Meats consumed should be from pasture fed animals free of grain feed as what the animal eats is passed onto the person. Organic vegtables and fruits are also a must if at all possible. Not only are they basically free of pesticides and herbasides they are much higher in nutrients then non organic.

  5. Can you please give examples of the preferred carbohydrates your discussing? Thank you very much and have a great Thanksgiving!

  6. First of all this calories in versus calories out nonsense should be thrown on the same mythical heap that all of the other failed medical theories should be. Weston A Price spent 7 years of his life travelling the world and studying different diets proving that diets should be individualised especially if a physiological disorder has ignited. Furthermore food affects the functioning of the autonomic nervous system which must be balanced. Metabolic typing is being used in one clinic to ascertain individualised dieting. Typically a sympathetic dominant person would do better on a plant based diet, whereas a parasympathetic dominant person thrives on a mainly meat diet. However in the main people tend to thrive on a more balanced diet which tends to maintain ANS balance. In my humble opinion if God didnt make it dont eat it. Everyone needs to conduct some research to sensibly choose the right food to get the correct fuel into the body. Yes food and eating is a pleasure, but from the aspect of the body it just needs 90 essential nutrients ( 60 minerals, 16 Vitamins, 12 amino acids and 3 essential fatty acids ) and as we age proteolytic enzymes to off load the pancreas from making digestive enzymes and concentrate producing metabolic enzymes to help rebuild the body. Furthermore, the intake of the 3 precursor amino acids for Gluthathione production ( Glutamic acid, Lysine, Glutamine ) and possibly a sulphate ( which is vital for the body ) supplement like Chondroitin, Glucosomine and Methyl sulphate (MSH). Estrogen production tends to rise as we age so this needs to be controlled by eating plenty of cruciferous vegetables not to mention the additional sulphur content. Grass fed meats once or twice a week is benefical as is 4 eggs a day to assist the live with cholesterol production ( the human body produces approx 3000 g/day ) so 4 eggs @ 385g/egg off loads the bodys responsiblity. I recommend fruit although be aware that the liver can only metabolise 25g of fructose per day in general ( we are all unique so these are fast and furious figures). I believe it is beneficial to include some raw food in the diet and since you need 4700g of potassium/day ( which is 12 bananas which I would not recommend ) so I tend to blend dark leafy greens like kale, swiss chard, beetroot leaves ( 1 cup = 1300mg of potassium), Cress, spinach sometimes ( be careful of the high oxylate content 1 cup= 856), sometimes Alo Vera, with Ginger, lemon/lime, apple cider vinegar ( helps with appropriate stomach acid for nutrient absorption), celery, cucumber ( contains silica to ward off 85% of ovarian cancer ).

    For weight loss the key is to maintain insulain at zero, as soon as insulin begins to spike it shuts down all of the main 6 fat burning hormones. The ideal weight loss diet content is approx 5-10% carbs ( vegetables), 20-25% protein ( eggs, cheese, meat etc) and 60% fat ( achieved from the protein foods). Your article refers to leptin resistance but my understanding is that one of the main drivers of obesity is insulin and if driven too high blocks the leptin signal from the adipose tissue ( ref Dr Robert Lustig ) so the individual remains hungary coupled with the lack of nutrients ( Obesity like so many conditions are due to nutrient deficiency. Obesity is the same as cribbing in horses, if a horse is nutrient deficinet he starts eating the barn). And I hear allopathic physicians say that vitamins and minerals creates expensive urine. Now I believe that the inmates have taken over the insane asylum with their disease management juggernaut.

    • Hi, You write 3000 g / day cholesterol . Ups it is 3 kg!! The same with potassium 4000 g / day! 4 kilograms! If mistyping pls correct, if You really confirm the figures They are just wrong!

    • Hey Eric, it was interesting what you wrote, but I don’t really think you can give a ‘one size fits all’ approach to weight loss as you have described. You recommend be 5-10% carbs with up to 60% fat. Of course I’m a single person story, but I did that for two years exactly as you prescribed as ‘ideal for weight loss’. Ate only real food when hungry, stopping when full. I didn’t loose a thing, in fact after about 18months in my hair started to fall out, increasing over time which was scary.

      I happen to read Paul Jaminet’s book The Perfect Health Diet which advocates safe starches and decided to increase my carbs to about 45% and fat around 30%. Mainly potato, sweet potato and seasonal fruit to taste. Within three days my hair stopped falling out. I didn’t put on any weight, and after three months I started loosing weight… be it slowly. I finally started to loose weight by eating carbs which was so awesome. One year on I’ve lost 5kg. Slow like I said, but hey I feel the best I ever have and eating ‘real food’ no counting, no stress, is the happiest I’ve ever been.

      So grateful to posts from Chris that gives sound and science based advice away from the gimmicks.

  7. What about D-ribose as a sugar? It is necessary for ATP production so how does that figure into your argument. Is it OK to take as a supplement?

  8. Hey Chris, is there a list of the carbs that are NOT acellular. I’ve been on a paleo diet and mostly consume tubers …rice maybe biweekly…but no other grains. It has made a huge difference in my health. I need more Tubers or carbs that you describe in the article…

  9. Chris, I’ve heard that smoothies are much worse for you than eating the same amount of fruit without putting it in a blender. Is that related to what you describe here? Is it because the blender destroys cell walls?

    • I wondered the same thing.
      I like to cook a sweet potato and blend it in the vitamix with some coconut milk for a pudding of sorts, but wonder if the blender destroys those important cells.

      • I’d be just as concerned with the food smashing against the Bisphenol ladened plastic jugs used in high powered blenders.

      • It breaks down the complex carbs already in easy to digest simple carbs, so the sugars in the plant or fruit go much more quickly into the bloodstream and cause a much higher insulin response.

  10. How can you speak of “leptin resistance” without speaking of it’s real cause, the diminished production of adiponectin, usually caused by visceral adipose tissue (VAT)??? VAT interferes with adiponectin production, and without adiponectin, leptin can’t be transported. According to Dr. David Brownstein, the world’s de facto foremost expert on this subject, the vast majority of cases of “leptin resistance,” if not all of them, are actually cases of “adiponectin deficiency.” Leptin trying to work without adiponectin to transport it is like thyroid hormone trying to work without cortisol to transport it; you could be drowning in it and it wouldn’t do anything.

    • How did the VAT get there to begin with if the adiponectin wasn’t deficient before the VAT was deposited?

  11. I’m a Mormon and in my religion there’s a health code (The Word of Wisdom) that we believe was a revelation from God given in the 1830’s to our prophet of that time, when nutrition was still in the dark. And if we follow it, the scriptures say we’ll have health and greater spiritual insight. I believe my faith.

    I really would like to know what Chris Kresser thinks about the diet specifically in the Mormon health code.

    It pretty much says that the bulk of our diet should be fruits, vegetables, whole grains, beans. Eat cheese, milk, eggs, fish, nuts, seeds. Eat little meat. Everything as little processed as possible. Eat preferably in season. That’s about it.

    It also says we should avoid coffee, real tea, alcohol, smoking. It is advised to fast once a month for 24h, no water or food, for spiritual purposes.

    A great book (The Word of Wisdom – A Modern Interpretation) written in the 1930’s by one of the apostles of the Mormon church is impressively accurate with the new scientific findings in nutrition.
    God really pours His knowledge when He sees fit.

    • I don’t suppose you will get an admin response, so if you don’t mind my opinion, the diet sounds borderline perfect. To make it absolutely perfect, instead of as little processed food as possible, none would be touching perfection as long as the meat is organic, grass fed animals, even though I am a non animal eater I can see the value of not consuming monsanto poisoned meat.
      Clearly you have a well defined belief system handed down over the generations and as you brought the subject up, my personal opinion is that no man could have created such astonishing beauty and wisdom. A Goddess however………..?

  12. what about potato chips?
    how bad are they really, if we put aside for a second the unhealthy vegetable fats (and the salt too if you would like)?
    do they still have resistant starch, potassium and cellular carbs inside?
    Surely, there are better options, like real potatos for example, but sometimes you really feel like having some of those treats.
    i wonder if anyone know the answer for this.

  13. I saw that this was a recently published article, so I thought I’d click through on all the linked studies to see if there was anything really recent cited, since you’re always saying that all the good research is within the last 5 years or so. All the cited studies in here are from 2012 or earlier. Many are in the 90s Three of the most recent study links are numbers 2, 14, and 21. 2 and 21 are both about rats fed a HIGH FAT DIET, which then induced inflamation and negative leptin changes or something. Interesting how he neglected to mention that little detail… 14 says that there weren’t any significant negative health outcomes they could find that correlated with eating moderate amounts of refined grains! I don’t see how any of these lend support to your basic thesis on diet. Would be great if Chris would respond to this discrepancy. Amber Boas

    • It’s not mentioned becuause Chris and countless others in the primal/ancestral/paleo community have debunked the “low carb, high-fat diet = weight gain for mice” and any correlation to humans theory a while ago. Humans have evolved on fat, mice have not. Also, the type of fat given to mice in the studies is often canola oil, whey, and many other fats that both aren’t part of a mouse’s evolutionary diet and/or high-heat processed fat. It’s pretty common sense: most mice gain weight on LCHF diets, most humans lose weight on LCHF diets.

      But pieces of these studies relating to other areas (e.g., inflammation of the hypothalamus) can be useful to reference.

    • Has anyone thought about the toxins on the grains in the Western diet compared to our ancestors. I think if everyone grew their own without any of the chemicals they put on them these days. Maybe the outcomes from studies on grains might be different. (not that this is anyway practical)
      There are sulfites in sugar products

  14. Thanks for yet another lucid distillation of some complex science. Reading you saves me countless hours of journal-hopping.

    The above accords with my experience very nicely. I get blood-sugar reactions of some kind (I’ve never got round to nailing down what it is) whereby I crash for about 6 days from eating too much processed carb. There’s no high – just fatigue & brainfog, which peaks on days 3 & 4.

    But I don’t get these blood-sugar events from eating whole food carbs – veges, fruit: only from processed carb (bread, alcohol, sugar, chocolate), and increasingly small amounts of it.

    • Hi John, yes I used to get the same and I think it is likely you have a leaky gut and therefore food intolerance – all your symptoms are classic. I would eliminate gluten for two weeks, take L Glutamine and leave off the alcohol and then see how you feel. In my case it was dairy and soy as well but you can only do the elimination and then find out by trial and error.

  15. Hi Teblig, congratulations on surviving the heart attack and for trying to change your diet !!!
    You lr new diet is filled with lots of processed grains (cereal, toast) and processed soy and rice ( Also Really unhealthy for most)
    The occassional Pear or apple is healthiest thing you eat. Lot of non starchy Greens (real organic leafy Greens lextracted in a Nutrbullet or Ninja) not the green powder, are really important in restoring your health Have recipes I can send you
    And offer many more suggestions

    HOWEVER before I offer suggestions, would have to know more about you –
    What’s your glucose and HbA1C?
    Any other chronic conditions?
    What’s are your liver enzymes like?
    Last Blood pressure? How mobile are you, can you walk uphill or up a short flight of stairs?

    I wouldn’t want to offer you an entire way of eating without knowing a lot more about you. In human nutrition., one size does not fit all

    Great articles Chris!!!! Quality quality quality trumps both the IIFYM of fitness community and “nutritionism” of the ADA and USDA,

    In the end Quest bars and granola bars are both refined carbs packaged to cater to different groups.

    • What’s your glucose and HbA1C? My fasting glucose is around 102. I’m supposed to be taking another blood test to get the A1C in about a month. Every doctor I see tells me that 102 is OK. I don’t like it but that’s what it was (102) when I was on my low carb, no sugar diet as well.

      Any other chronic conditions? Diverticulitis (no symptoms for years because of diet. I used to have allergies and asthma but they also disappeared on the low carb,no sugar diet. I was in stage 2 kidney (75 percent efficiency) failure but I’ve been taking Chinese herbal tea (made here in town by a Master Acupuncturist), since taking the tea my kidney function has increased to 90 percent.

      What’s are your liver enzymes like? Don’t know??

      Last Blood pressure? Currently BP is normally at 115/72 but I’m on some blood pressure medications.

      How mobile are you, can you walk uphill or up a short flight of stairs? I can run full speed and bicycle for an hour but I will (sometimes) get an angina attack although it’s at a very low intensity. I usually slow down during the mild attack then continue cycling…..I couldn’t do that 2 months ago. I can easily go up a flight of stairs but if my heart rate stays too high for too long I sometimes get a mild angina attack. The angina was 10 times worse when I came home from the hospital 2 1/2 months ago. I used to have to take a nitroglycerin pill 4-5 times a day to stop the pain in my left arm. I am also taking isosorbide mononitate 30mg ER and metroprolol ER succinate25mg.

      The doctors I’ve seen don’t seem to be worried about any of this. When I get an angina attack my heart rate slows to 35 BPM. I bought a oxymeter because I couldn’t hardly feel my heat beat during the angina attack. The oxymeter verified what I was feeling. I’ve never passed out but it’s pretty scary. After I changed cardiologists I (again) complained about the slow heart rate during the angina. The doctor said that low BP wasn’t possible and had me wear a halter for 24 hours. He just called me the other day (before Thanksgiving) to give me the results. He didn’t give me any results, he just said that it was nothing life threatening and that I need to come by to see him in a week and a half. I had already had a scheduled follow up appointment for January until he saw the halter results.
      I still get the less intense angina attacks and my heart rate still goes way down sometimes. The angina isn’t intense enough to make me take a Nitro pill under my tongue but my heart rate will go way down for a couple of minutes. The low heart rate doesn’t occur with every angina attack (it used to a few weeks ago). But like I said, I’ve been improving and haven’t had to take a Nitro pill for a couple of weeks.

      thanks for any help,

      PS – How can the cardiac specialist know so little. Haven’t they seen hundreds of patients with my exact same problem “diagonal disease”??? Don’t they know what happened to all those other patients or what they did to help them. I have real good health insurance so it’s a issue of “quality of care”!!

      thanks again,

  16. I’m not sure how I stack up. I had a heart attack about 8 weeks ago and changed my diet. I had been on a low carb, low sugar diet for a few years before the heart attack. Anyway, as soon as I got home from the hospital I searched the internet for solutions.
    They found 3 clogged arteries, luckily they were the diagonal arteries which are very small although they can still give you tremendous pain when clogged.
    I’ve been eating spinach and arugula mixed with 4 egg whites for breakfast (no oil), 1/4 cup of diced potatoes along with two slices of whole wheat bread (no preservatives at all). Then at 11AM I eat a bowl of cereal (ingredients – organic milled corn, organic whole wheat, organic granola. organic brown rice, etc) with 1/4 cup of unsweetened rice milk and about 30 fresh blueberries. At 3PM I eat two 100 percent soy hot dogs on two slices of the same whole wheat bread. At 6PM I eat another bowl of the same cereal with blueberries. I’ve been eating this same meal everyday since I got out of the hospital. I snack on macadamia nuts daily (1/4 cup). The angina pains have greatly decreased. I haven’t had to take a nitroglycerin pill (under the tongue) for about 1 1/2 weeks now. I can ride the stationary bike for 45 min (daily) with no angina at all.
    So I guess I’m slowing clearing out my clogged arteries????

    PS – a fresh apple or pear every now and then. Maybe 2-3 grams of saturated/trans fat per day, 5g of sugar (in the cereal).

    • I’m not a doctor, but IMHO, I’m not surprised, your diet is terrible. A lot of processed food in there and a lot of grains. If I was in your position I’d cut out 80% of what you eat. I’d simply eat fresh vegetables (many of it raw), lots of fruits, pastured eggs, fermented-only full fat dairy if you can (e.g. home-made kefir), soaked legumes, some nuts (don’t go overboard with them), quite some of WILD oily fish (e.g. 2-3 times a week), some meat (doesn’t have to be a lot, maybe up to once a week if previously vegetarian), and shellfish (farmed ok, oysters are the best). I’d avoid all sugar except some raw honey. I’d avoid all grains AND pseudograins, except maybe some rice once a week. Don’t be afraid of fats, just make sure they’re the right ones: animal fats, coconut, real olive oil, avocado oil, butter (avoid all industrial seed oils). I would also supplement with D3 (2-3 times a week), Magnesium (before bed), K2-Mk4 (twice a week if high dose), CoQ10 Ubiquinol (twice a week), and maybe get a methyl-based B-complex once or twice a week. And lots of walks outside under the morning sun (proper circadian rhythms). That’s ought to do the trick.

        • The sole purpose of the diet is to greatly lower the amount of bad cholesterol in the blood. In the absence of bad cholesterol (or at least at very low levels) the human body tends to remove built up plaque in the arteries. If I eat any foods that increase my bad cholesterol it will increase the probability of further closing off my already clogged arteries. The diet that I am currently using is based on a diet designed by a cardiologist who has conducted studies showing that cardiac disease (narrowing of the arteries) can be reversed (naturally). I need protein (egg whites, soy dogs, soy cheese, nuts), I also need carbs (veggies, bread, nuts, cereal, blueberries, etc) because I’m not supposed to eat any meat. Very little or no saturated/trans fats. It would be foolish for me to change my diet now that I’ve all but eliminated the angina. 8 weeks ago I couldn’t exercise at all without taking a nitroglycerin pill, now I can exercise for long as I like with no symptoms. 8 weeks ago I had to take a nitroglycerin pill every hour to hour and a half (the pain was terrible). The arteries are too small to stent and too small to bypass. So there are only two ways out of my situation: grow new arteries (which is a very slow process) or get my body to remove the plaque in my arteries. There are no other choices (according to both of my cardiologists). I have one artery 90 percent closed and two others that are 70 percent closed.
          When you find something that works you don’t change what you’re doing without good cause.
          I can’t simply eat fruit because I need protein although beans are an option. I used to eat (use) olive oil (the best EVOO I could buy) but even olive oil contains bad fats. Don’t get me wrong, EVOO is better than most other oils, but it contains quite a bit of the bad oils too. I do take Magnesium daily and Potassium. People don’t realize that many of the foods that contain the good fats actually contain a good proportion of bad fats. I choose macadamia nuts for a snack because they have the highest (best) proportion of good to bad fats. If you research Avocado, EVOO, coconut and animal fats you’ll find that they all contain appreciable amount of bad fats (as well as the good). I can’t afford to introduce any bad fats into my diet if I want to live. Remember, the Doctors say that there is nothing they can do (surgery/stenting) to fix my clogged arteries. I even changed doctors because I couldn’t believe what they were saying!! No one can help me but me.

          Thanks for all the input, but honestly, what would you do if all the doctors (experts) told you that there was nothing they could do to fix your problem????


          • I would be very interested to know which (if any) bad fats, as you call them, are contained in true EVOO. This product, in many scholarly articles, is considered extremely healthy and would be preferable over most other fats.

            As for a cardiologist suggesting you eat foods which will compromise both trypsin and chymotrypsin in your pancreas, this in itself is no surprise, just like an oncologist would suggest you poison your body with scatter gun chemo.

            Just because a doctor gives dietary advice, as they are not nutritionists, you might find yourself improving, simply because of all the mass of total rubbish you previously consumed being eliminated. You may still be consuming some nasty junk foods as advised by people who know nothing about diet, which is clear from their advice.

            • Henry,
              To answer your question 10g of EVOO contains 1.5g of a Saturated fat. 10g is about 3/4 of a tablespoon. I was ingesting 4 tablespoons per day which would be (more or less) 4.5g of Sat fat per day. Add this to the bad fats/oils in avocado and the meat/cheeses I used to eat and you get more than you need to clog your arteries. I agree that EVOO is good for you in certain quantities but when you’re in my position you can’t afford one more gram of bad fats/oils. Like I wrote earlier, I had been on a low carb, low sugar diet (no dairy) for 3 years prior to the heart attack. I was very, very active. I was eating mostly good fats (EVOO, avocado, grilled Salmon, Omega3 and Omega6). I’m pretty sure it was a combination of the meat/cheese/EVOO/avocados that was the straw that broke the camel’s back. I don’t know what else I could attribute it to since I wasn’t eating hardly any carbs and almost no sugar. My only sugar intake was in the 85 percent pure Cocoa chocolate (10g sugar) per day for blood pressure.
              The only EVOO I bought was the cold pressed expensive stuff. I researched many of the EVOO products before taking any of them. I eat whole grains with no preservatives, the bread is kept in the freezer at the grocer because it contains no preservatives. The rice milk contains no bad fats/oils and only 1g of sugar per serving. The soy hot dogs only contain .5 sat fat, no trans fats and 1g sugar (no MSG or nitrates).
              I know my diet isn’t perfect but I had to figure it out by myself and since I’m improving on a daily basis I hesitate to change what I eat.. What would you do if your angina pains started disappearing? What do the old timers say, “Never change horses in the middle of the stream”.


                • Henry,


                  Saturated 3.19 g
                  Monounsaturated 9.8 g
                  Polyunsaturated 1.82 g
                  Omega-3 0.11 g
                  Omega-6 1.69 g

                  I thought I could eat all the avocados that I wanted to eat but as you can see 150g of avocado contains 3.19g of Saturated fat. Yes, the avocado contains plenty of good fats/oils and I’m not saying that people shouldn’t eat them. What I’m saying is that I can’t afford any more bad fats/oils in my system. Good fats yes, in controlled quantities. So I have to pick my foods/drinks carefully until I get “out of the woods”.
                  I don’t do things willy nilly, I conduct as much research as time allows and I can continue on any diet for a very long time in order to live a longer life. I still have kids in school and they need me!!


                • All the fats you quoted can be used healthily by the body from proper sources of which avocado is an excellent source.
                  No one is saying that you should eat loads of avacados or get these fats from rubbish sources.
                  These fats are only bad if they come from rubbish processed foods, avocado is one of the best sources of these fats.
                  Your research has not taken into account the source of the fat or you wouldn’t say that olive oil and avocados have bad fats, they categorically don’t and are an excellent source for heart protection.
                  The oleocanthals and the phenolics in EVOO are heart protective and the site you quoted confirms this.
                  There are hundreds of scholarly articles confirming this.
                  You need to understand the difference between rubbish source fats and quality source fats of which EVOO and avacados are top of the list of quality heart protective fats.

                • I guess we’ll have to let the public decide whether or not avocados contain Saturated fats or not. Individuals can also decide if saturated fats are good for you or bad for you, regardless of source.


                • Avocados are a monounsaturated fat, which has nothing to do with public opinion at all. It is a nutritional fact accepted by all nutritional schools of thinking.
                  A monounsaturated fat, which is a “good” fat in avocados, can help lower bad cholesterol, as long as you eat them in moderation.
                  Your ideas about avocados and quality EVOO having bad fat are completely wrong, you should find someone to help you who isn’t biased against heart healthy fats.
                  Water will kill you in excess!

      • Additional suggestions include trace minerals, in particular selenium for better assimilation of the vitamin B family. The MK 7 form of vitamin K 2 lasts longer, especially in the presence of zinc, vitamin A, vitamin D 3 and magnesium. Stress management tools/techniques like that offered by HeartMath Institute helps, as does laughter therapy – what, laughter – really! Do the research. I wish you well and bid you peace!

    • I hope you will seek out good information on diet and lifestyle from cardiologists Dr. William Davis and Dr. Stephen Masley. You are, IMO doing some things right, but many things sound very wrong for heart and overall health.

    • Treblig, Eugenia and John are correct. You are eating far too many grains in the bread and hot dogs and also too much sugar. Fructose from fresh fruit and honey are as bad as cane or beet sugar, so reduce those. A healthy diet is fresh salads or steamed vegetables, home cooked simple meats – not deli meat- chicken and fish, plus animal fats. Al that crap about animal fats being bad for you was promoted by the seed oil and margarine industry – not true. Eggs are also very good. There is no harm in eating a dozen eggs a week, preferably free range, not ‘vegetarian.’ I don’t know who started this nonsense that hens are vegetarian. They thrive on grubs, slugs, snails and other insects. Mine have a large run now devoid of ‘meat’, so I feed them 25g each of minced meat every day. It’s their favourite meal.

      • Wow! Minced meat for your chickens!

        I’d love to eat your chickens’ eggs. I bet they’re wonderfully nutritious.

      • Fructose from raw honey and fruits is not bad at all. That’s keto ideals which have been proven wrong since then. Fruit is only a problem if it is taken without its fiber. Raw honey can be eaten once a week on a raw dessert without a problem either (it’s not an everyday thing).

    • Trans-fats? Yikes. Do you live on the moon? By now everybody should know that stuff is an artery bomb. I agree with the other commenters. Lose the grain and soy products and the sugar. Stick with real food (meat, fish, poultry, vegetables, fruit, eggs, a few nuts). Egg yolks won’t hurt you. That idea was debunked a long time ago.

    • Hi ,

      A good product to use for clearing arteries is “EDTA Chelate” its a natural treatment for for your heart / arteries ……..it works well

    • Check our Dr Greger’s website Nutrition Facts dot Org. Given your recent health crisis I would thoroughly investigate and rely on studies he has studied and come to your own conclusions. His 5 minutes videos are interesting and entertaining.

      • Christie A,

        I checked out Dr. Greger’s website….extremely informative, it should be required reading for everyone!! The videos confirmed that what I am doing is correct. NO meat of any kind (red meat, fish, dairy)!! I’m doing my best to follow Dr Ornish’s CVD reversing diet. Ornish is one of the Doctors that Dr. Greger recommended in one of his articles. I may not doing it perfectly but I doing the best I can considering the lack of assistance I’m getting from the so-called “Specialists”!!
        I printed Dr. Ornish’s diet recommendations and have done my best to stay within the guidelines. I mix in 3/4 cup of Arugula and baby spinach with my egg whites every morning. Vegetables don’t agree with me so I have to use them prudently. I keep my Saturated fat intake to below 3g a day. between the Omega 3, Omega 6 supplements and the macadamia nuts I’m trying to keep my good cholesterol up.

        Thanks for the website info!! I saved it to my favorites and plan to read and listen to more of the information!!