Ray had the usual protuberant belly overhanging his beltline of someone who was over-reliant on processed starches, particularly wheat and other foods that raise blood sugar.
After all, he ran a sandwich bakery. He sheepishly admitted that he ate the products of his own production line every day while at work, even bringing a few sandwiches home.
At 5 ft 10 inches, 201 lbs, he wasn't terribly overweight, but all the excess was in his beltline. That in itself is a problem. He had the cholesterol panel to match: HDL 38 mg/dl (too low), triglycerides 180 mg/dl (too high), 83% of all LDL particles were small (small is worse than large). Blood pressure: 140/88-on the high side. Blood sugar: 112 mg/dl-in the pre-diabetic range.
With a CT heart scan score of 698, signifying moderate to advanced heart disease, Ray had some work to do.
Among the strategies we discussed was a need to dramatically reduce - perhaps eliminate - wheat products and other high-glycemic index foods (i.e., foods that cause a rapid and dramatic surge in blood sugar).
"You've got to be kidding me" he exclaimed. Besides the inconsistency with his business, he was puzzled on what foods were safe for his pattern. We discussed how he could easily replace his reliance on wheat and breads with more vegetables, more fruits, more lean proteins, and more healthy oils.
"But I won't get any fiber!" he declared. That was why he tried to choose whole wheat bread for his sandwiches.
This is a common concern when we discuss how grains (particularly wheat) need to be sharply reduced when patterns like Ray's low HDL, high triglycerides, and pre-diabetic patterns begin to develop.
Contrary to popular opinion, replacing wheat products and whole grain foods with fiber-rich vegetables like broccoli, green peppers, spinach, and celery, increase your intake of fiber. In other words, when wheat and other grains are replaced with vegetables, fiber intake goes up-enormously. When matched by weight, fiber intake can actually increase six-fold, even more if refined foods are replaced by vegetables.
In other words, reducing or eliminating "fiber-rich" grains and replacing their calories with fiber-rich vegetables dramatically increases fiber content of your diet.
For Ray, whose livelihood depends on promoting and perpetuating the use of wheat breads, it will be tough to keep him on the right track. My prediction: the results he will see will be substantial and it will become difficult to return to eating his own products.
There's no doubt that this concept can be economically disruptive for many people, including Ray. It's a tough situation we've created: a huge industrial complex based on growing grains and wheat, processing it into breakfast cereals, bagels, pretzels, crackers, and sandwiches. But it has also contributed to the epidemic of obesity and the patterns that people like Ray have.
But the startling fact remains: If replaced with vegetables and fruits, reducing grains increases the fiber content of your diet, and not just a little bit, but enormously. If green peppers and spinach had brand names like "Fiber One" and "Smart Start" along with flashy boxes, then maybe it would be an easier concept to grasp.
So fiber is good, provided it comes from the right source. In my view, the prevailing view that all fibers like those from wheat are good for us is flat wrong. Yes, whole grain bread is better than white bread. But green vegetables are a whole lot better,
as they are
far richer in fiber and they never make you fat or diabetic.