Before there was refrigeration, there was fermentation. This was how our great grandparents managed to pick radishes, cucumbers, or asparagus in summer and then consume them throughout fall and winter. They’ve allowed foods to ferment, which is the process of degradation by bacteria and fungi. If you eat kosher pickles, prosciutto, salami, and yogurt, you are already consuming fermented foods, whether you know it or not.
Fermentation: The old way for humans to store food for more than a few days after picking or harvesting. – Tweet this!
Fermented foods are a source for lactate-fermenting organisms such as Lactobacillus and Bifidobacterium. Lactic acid reduces pH and kills dangerous organisms. There is a wonderful intersection between lactic acid fermentation and human health, as the bacteria contained in fermented foods are also among the species that have been found to exert the greatest health benefits in humans, such as
- Reductions in LDL cholesterol,
- Improved intestinal health, and
- Weight control.
The number of bacteria contained within the fermented food varies widely depending on:
- What food it is, how long fermentation was allowed to proceed,
- The ambient temperature,
- The availability of other nutrients such as amino acids and fatty acids, and
- Other factors
The number of bacteria range from trivial (as in most commercial yogurts and kefirs) to substantial (as in naturally fermented dairy products: kimchi fermented, sauerkraut not in a can and unheated-not the stuff sold in grocery stores that is pickled in vinegar rather than fermented).
Cheese and cottage cheese do not provide substantial probiotic bacteria, as the whey fraction that is removed after fermentation contains much of the bacterial content.
Just about any fruit or vegetable can be subjected to fermentation. – Tweet this!
Some other sources include:
Kombucha (a fermented tea)
Takuan (Japanese fermented daikon radish)
Natto (fermented soybeans that are exceptionally rich in vitamin K2)
Garum (fermented fish sauce).
While fermented foods cannot replace a high-potency probiotic (especially if the probiotic contains a large variety of bacterial strains) they can be very helpful for maintaining healthy flora and bowel health over the long term. There are some foods that you can easily make in your own home, thereby avoiding all the nasty and unnecessary ingredients used by food manufacturers and saving lots of money.
If you aren’t up for making your own fermented foods, which is exceptionally easy and satisfying, look for fermented foods in the refrigerated section of health food stores or supermarkets. The label will usually say “contains live cultures” or something similar.
Avoid canned or bottled fermented foods, as the canning or bottling process kills the bacteria. – Tweet this!
Yours in grainless health,
Dr. William Davis
PS: Living a grain-free life still means enjoying delicious and affordable foods. I have some great recipes to share with you from our friends at Wheat-Free Market:
I have lost 139 lbs. on the Wheat Belly program, most of it on a ketogenic version of the diet since I was diagnosed with breast cancer in July of 2015. I recently achieved the milestone of “normal” BMI, although I probably do still need to lose another 15 lbs. Never thought I would see this day. I get criticism for this lifestyle because there is still this perception that keto and low carb diets in general are unhealthy. For my critics I just whip out my most recent blood lipid profile and watch their eyes glaze over:
Total cholesterol: 149
Triglycerides: 65
HDL: 64
LDL: 72
My A1C is also down to 4.9.
It’s worth mentioning that I also take a drug for the cancer that can cause hypertriglyceridemia (high triglycerides), and mine are less than half of what they were when I started. The medicine is also supposed to make it nearly impossible to lose weight. I find it strange that most people are so closed-minded to the idea of giving up grains and lowering carbs, even when faced with the very obvious evidence of my success. Why not just try it when everything else you have done has failed? How could it possibly be worse than the results your are already getting? I credit this lifestyle with saving my life as I am healthier now than I was before the cancer.
Kali wrote: «…on a ketogenic version of the diet since I was diagnosed with breast cancer…»
I trust that you are plugged into the leading research into metabolic therapies for cancer. I was just watching a Keto Summit video interview with Travis Christofferson, author of Tripping Over The Truth, and his personal opinion on a treatment plan (from some unknown time earlier this year, perhaps already outdated) included KD, exogenous ketones, a glycolytic inhibitor, a glutamine inhibitor, a couple of other agents I didn’t catch the names of, hyperbaric oxygen, and further tweaks.
The promising future for cancer therapy is rather looking like this sort of cocktail. His site might prior further leads: http://metabolicoptimization.com/
«I get criticism for this lifestyle because there is still this perception that keto and low carb diets in general are unhealthy.»
Just push back with: Are you willing to be mistaken about what you’ve been told? We are betting our lives on how we act on this.
«Triglycerides: 65
HDL: 64
My A1C is also down to 4.9.»
Very nice numbers. The TG could be lower, but may just reflect on-going weight loss, or the cancer med.
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http://www.makesauerkraut.com/
I think this is a very helpful site
Hi Sally,
Thanks for posting this link. Super site! :-)
” … the greatest health benefits in humans, such as
– Reductions in LDL cholesterol”
I thought we don’t care about reducing LDL any more.
Gary,
LDL is among the greatest indicators of ‘heart attack’ risk.
Target LDL – below 70.
Target TBC – below 150.
Practically no one is ever admitted to hospitals having a heart attack with TBC under 150.
Here’s the largest study on this: https://www.ncbi.nlm.nih.gov/pubmed/19081406
Here’s a very safe place to be: 70(LDL)+60(HDL)+100(TG)=150TBC.
This must be achieved without the aid of Lipid-lowering meds of course.
It would be nearly impossible at that point to suffer from a heart attack.
Casper
Casper Gomez wrote: «LDL is among the greatest indicators of ‘heart attack’ risk.»
No, it’s not. There are much more tightly correlated indicators:
☤ CAC (coronary artery calcium)
☤ Pattern of 3-hour insulin assay
Odds are most people will have never heard of these, much less had one run. CAC, of course, is not just a correlated risk factor – it images artifacts of the actual disease.
Ivor Cummins (TheFatEmperor) has been intensively researching the history and state of the art in CVD risk and disease assessment testing. Here’s a recent article of his: http://www.thefatemperor.com/blog/2016/8/10/repeat-after-me-calcification-score-blows-away-risk-factors-always
«Target LDL – below 70.
Target TBC – below 150.»
If you care about LDL, get it actually measured. I presume that TBC is total cholesterol. TC can be largely ignored.
Which is not to say that the standard lipid panel is entirely useless. WB does suggest:
Target TG – below 60 mg/dL
Target HDL – above 60 mg/dL
«This must be achieved without the aid of Lipid-lowering meds of course.»
Yep. The failed CETP inhibitors were clearly able to drive down the mythical LDL-C, but they also clearly aggravated all-cause-mortality.
«Practically no one is ever admitted to hospitals having a heart attack with TBC under 150.»
In the WB and Cureality programs, TC is basically ignored, although if you do manage to drive your TC really low, your odds of dying from something else (probably neuro) go up substantially; perhaps preceded by dementia and memory loss, which might prevent any realization that there’s a problem.
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Bob wrote: <>
Bob, can you elaborate on what you mean and the evidence for it? e.g. do you mean that really low TC itself confers an independent risk of neurological problems? Or just that actions people take to achieve really low TC (e.g. going vegan, etc.) can lead to these problems? Or…
K. wrote: «…can you elaborate on what you mean and the evidence for it? e.g. do you mean that really low TC itself confers an independent risk of neurological problems?»
You can search this blog on “total cholesterol” for numerous articles by Dr. Davis on the various elements of the lipid panel, but to get directly to your question, perhaps the most [in]famous charts of TC vs. mortality are those based on the data from the Multiple Risk Factor Intervention Trial (MRFIT) study {a pre-statin study, which itself neglected to plot the TC data}.
Here’s one easily found by Google:
http://wholehealthsource.blogspot.com/2009/07/mrfit-mortality.html
with some comments by Stephan Guyenet (whose dietary advice was not aligned with Wheat Belly, last I looked into it).
Confounding factors abound, of course, not the least of which is the suicide issue that Stephan raises. Low TC is very likely a driver of neurological pathology. He didn’t mention it, but I have to wonder about increased rates of fatal neuro diseases like Alzheimer’s and Parkinsons. Mortality goes up at the high end as well. We’re likely seeing the effect of standard diets there, as the low-carb movement, apart from Atkins, was basically non-existent at the time.
There are, of course, entire books on the insane consensus lipid dogma generally. A typical one I have at hand is The Cholesterol Myth by Bowden&Sinatra (2012). It’s full of cites.
Context matters. If, following the Wheat Belly lifestyle recommendations, and at a stable weight, I had a sky high TC, I’d be curious about it. Which lipoproteins were pushing it up, and why. If it turned out to be a common or obscure lipidemia, I’d further want to know if I actually needed to do something about it, and then what – this is an uncommon scenario.
«Or just that actions people take to achieve really low TC (e.g. going vegan, etc.) can lead to these problems?»
That too. There are probably multiple ways to drive TC too low, and I would conjecture that the direct consequences of the low TC are only one of several adverse side effects of whatever diet is involved in shoving that marker around.
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Bob wrote:
“… perhaps the most [in]famous charts of TC vs. mortality are those based on the data from the Multiple Risk Factor Intervention Trial (MRFIT) study …
Confounding factors abound, of course, not the least of which is the suicide issue that Stephan raises.”
Interestingly, the plot shows mortality starting to increase at TC that’s really not so low i.e. around the 140 mark. The old WB “rule of 60” (min for HDL, max for TG, formerly max for LDL [now dropped]) lands one right in this region.
The suicide issue is interesting too: one could say it’s a confounder… or one could say it raises the question of neurological damage, leading to suicidal ideation.
K. wrote: «Interestingly, the plot shows mortality starting to increase at TC that’s really not so low i.e. around the 140 mark. The old WB “rule of 60” (min for HDL, max for TG, formerly max for LDL [now dropped]) lands one right in this region.»
That was the old TrackYourPlaque 60-60-60 rule, which was probably near retirement by the time Wheat Belly came out. 60 max TG and 60 min HDL still apply, LDL-C being recognized as largely useless now. I’ve summarized other WB/Cureality targets for various labs in an article linked from my username on this one response.
«The suicide issue is interesting too: one could say it’s a confounder… or one could say it raises the question of neurological damage, leading to suicidal ideation.»
That old study also failed to account for meds, many of which have suicide risk.
But when we consider the diseases of civilization, many of them (cancers, neurodegeneratives) may be caused by aspects of a low-TC diet, but also, once developed often result in poor appetite or frank inability to eat, perhaps resulting in low TC. So what caused what for any given data point?
Meanwhile, on the TC vs. all-cause topic, here’s another relevant link:
Uffe Ravnskov: The benefits of high cholesterol
http://www.ravnskov.nu/2015/12/27/myth-9/
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Gary Katch wrote: «I thought we don’t care about reducing LDL any more.»
We don’t care about reducing the fictional LDL-C anymore, as it’s not an actual measurement of anything, but merely a very crude algorithm based on assumptions that fall apart for people not on the presumed diet of the time it was crafted.
https://drdavisinfinitehealth.com/2016/08/treat-cholesterol-exorcise-bogeyman/
We do care about actual low density lipoproteins, particularly small, glycated, oxidized LDL particles. These need to be actually measured, such as by NMR lipoprotein testing, which reports various LDL-P numbers.
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The best source of prebiotics and probiotics comes from a Whole, Plant-Based diet. Load up on Resistant Starch and Fiber (70g-100g) and your gut microbiota will reward you for it by eliminating disease and getting your immune system strong again.
Casper Gomez wrote: «…Whole, Plant-Based diet.»
The leading caps on “Plant-Based” suggest that’s a code phrase for vegetarian or vegan. It is possible to follow Wheat Belly on those diets, but there are a number of crucial micronutrients that need to be attended to:
https://www.cureality.com/forum/topics.aspx?id=18308
«Load up on Resistant Starch and Fiber (70g-100g)…»
Wheat Belly presently recommends working up to 20 grams per day of mixed and varied prebiotic fibers. Yes, there are existing hunter-gatherer populations that are well above even 100g, but most of us don’t share their spectra of gut microbes.
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Bob, do you mean I should only have around 20g? I’ve never seen an actual recommendation from Dr. D. Also, which 3-4 nutrients do you feel are in jeopardy if you had to choose?
Thanks
Casper
Casper Gomez wrote: «…do you mean I should only have around 20g? I’ve never seen an actual recommendation from Dr. D.»
It’s been part of the program since Wheat Belly Total Health (2014), and mentioned many times on the blog, perhaps most recently here: https://drdavisinfinitehealth.com/2016/04/prebiotic-fibers-finer-points/
«Also, which 3-4 nutrients do you feel are in jeopardy if you had to choose?»
Well, as I lead off with in that “Doing Wheat Belly as Vegetarian” summary linked above, all 16 micronutrients are critical, and have serious downsides for deficiencies. Everyone, on any diet, needs them all, but omnivores have many of them covered by default. Most people, however, on any diet, end up supplementing Iodine, Omega 3 (ω3) DHA+EPA, Vitamin D and Zinc.
Rather than try to narrow the list, I’d suggest that a “plant-based” consumer start by confronting the DHA+EPA issue. WB recommends 3.6 grams of ω3 DHA+EPA per day. The ancestral way to get this was from ample seafood, or, for uplanders, consuming entire terrestrial critters, including brains. For some context, this would be 3-4 small cans of wild-caught sardines per day. What this implies for our broader understanding of human dietary requirements is rather sobering.
I was lately watching a video series on leading edge protocols for slowing, arresting or reversing Alzheimer’s Disease, which is a growing threat for moderns. DHA or DHA+EPA supplementation was critical for nearly every approach. One exception was a doctor, who was silent on DHA, but was honest enough to admit that his plant-based approach was only for risk reduction, and offered nothing once there was a diagnosis.
Vegetarian sources for DHA&EPA did not exist until recently (marine algae extracts or yeast-produced), and getting sufficient DHA&EPA needs some scrutiny for dose and ratio. My estimate is that the ratio needs to be in a range of somewhere between 1:3 and 2:1. DHA alone won’t do it.
A myth in the V community is that ω3 ALA is an adequate source, as we can endogenously convert some of it to DHA&EPA. Not enough. Someone doing that would be lucky if their ω3 RBC Index reached ⅓ of someone taking fish oil at 3.6g/day.
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The Institute of Medicine recommends roughly 25-40g of fiber per day. So, I’d be very concerned about only getting 20g of fiber per day.
Fiber is widely known in the scientific / biochemistry community to normalize bowel movements, maintain bowel health, lower cholesterol levels, reduce blood pressure and inflammation, control blood sugar levels, and aid in weight loss.
Fiber feeds the gut bacteria that benefits us most. So, I understand the concept of cutting out some grains like Wheat, but I don’t see why there’s such a dangerously low recommendation for Fiber which is a human being’s #1 Friend.
Plus, Omnivore diets result in gut bacteria that feed off Carnitine and Choline mainly found in animal foods, and this has already been proven to result in TMAO which contributes to atherosclerosis.
Finally, when people starve themselves (eat less than 50g) of Fiber, bacteria in the gut ends up chomping on the mucosal lining of the colon, which eventually leads to Leaky gut syndrome. With Leaky gut, Dairy and Wheat proteins enter the bloodstream easily and that’s when the body responds adversely.
So, I don’t see why I can’t load up on non-Wheat fiber foods since there are so many great ones out there. I can still eliminate Wheat, and choose better (pseudo)grains like Quinoa, Amaranth, etc. without the concerns over Gluten/Gliadin.
Casper Gomez wrote: «The Institute of Medicine recommends roughly 25-40g of fiber per day.»
Well, we may have some trouble with taxonomy here. There is:
Ѯ Digestible fiber (e.g. ripe banana)
Ѯ Soluble fiber (e.g unripe banana)
Ѯ Insoluble fiber (e.g. psyllium husk)
Digestible fiber is net carbs. It gets cleaved to glucose and/or fructose before reaching the large intestine, and either spikes blood glucose, or does its usual fructose thing (fatty liver and visceral fat).
Soluble fiber, aka prebiotic fiber, and including resistant starches, is not cleaved by human enzymes to simple saccharides. It provides substrate for the microbes in the large intestine. This is the stuff we seek, and the topic of that 20 gram target.
Insoluble fiber, aka roughage, just passes through as is. We need some of this in diet, but too much can have adverse consequences, including being a bowel lining irritant.
And unfortunately, the “Fiber Carbs” listed on Nutrition Facts panels lumps the later two together.
«So, I’d be very concerned about only getting 20g of fiber per day.»
20g prebiotic fiber per day, from whole foods, is typically going to be a much higher amount total fiber per day.
«…I don’t see why there’s such a dangerously low recommendation for Fiber which is a human being’s #1 Friend.»
That IoM range you quoted earlier is probably fine for total.
«Plus, Omnivore diets result in gut bacteria that feed off Carnitine and Choline mainly found in animal foods, and this has already been proven to result in TMAO which contributes to atherosclerosis.»
https://drdavisinfinitehealth.com/2015/10/go-ahead-eat-your-meat/
That TMAO mantra seems to have become a fixture of vegan lore since it first popped (and was discussed here) in 2011.
«Finally, when people starve themselves (eat less than 50g) of Fiber, bacteria in the gut ends up chomping on the mucosal lining of the colon, which eventually leads to Leaky gut syndrome.»
As I understand it, the biggest provoker of leaky gut is the zonulin provoked by gliadin in wheat (in everyone, not just those with celiac disease or NCGS). The next are the direct gut wall antagonists, including WGA (wheat germ agglutinin, found in several grains other than wheat) and emulsifiers common in most processed food-like substances.
«With Leaky gut, Dairy and Wheat proteins enter the bloodstream easily and that’s when the body responds adversely.»
Yep, and the fix is to eliminate the needless antagonists like wheat, minimize others opportunistically, and optimal prebiotic fiber and gut microbial spectrum to promote an intact gut wall with tight junctions.
It’s not uncommon for people who get off grains to discover that their dairy issues vanish, but this is not universal. Some might further need to eliminate beta casein A1 dairy (get A2), wait longer, or just dial down dairy indefinitely.
«So, I don’t see why I can’t load up on non-Wheat fiber foods since there are so many great ones out there. I can still eliminate Wheat, and choose better (pseudo)grains like Quinoa, Amaranth, etc.…»
Blood glucose is the problem. Quinoa and amaranth are OK in very limited amounts. But if consuming them bumps the postprandial BG, then you’re asking for future trouble (in addition to perpetuating any current ones caused by a full-time moderate to high-glycemic diet). In addition, grain carbs like amylopectin A are vary rapidly cleaved to glucose by human enzymes, starting before you even swallow them, with serious considerations for dental health.
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I made a couple of sauerkraut batches but made the mistake of putting a mason jar inside to weigh down the cabbage. The lid ended up rusting and I can’t be sure if I should be eating lid fragments (though none are visible anywhere in the kraut). David Perlmutter seems to advocate plenty of fermented foods as well.