How to become diabetic in 5 easy steps

14. January 2011 William Davis (35)
If you would like to become diabetic in as short a time as possible, or if you have someone you don't like--ex-spouse, nasty neighbor, cranky mother-in-law--whose health you'd like to booby trap, then here's an easy-to-follow 5-step plan to make you or your target diabetic.


1) Cut your fat and eat healthy, whole grains--Yes, reduce satiety-inducing foods and replace the calories with appetite-increasing foods, such as whole grain bread, that skyrocket blood sugar higher than a candy bar.

2) Consume one or more servings of juice or soda per day--The fructose from the sucrose or high-fructose corn syrup will grow visceral fat and cultivate resistance to insulin.

3) Follow the Institute of Medicine's advice on vitamin D--Take no more than 600 units vitamin D per day. This will allow abnormal levels of insulin resistance to persist, driving up blood sugar, grow visceral fat, and allow abnormal inflammatory phenomena to persist.

4) Have a bowl of oatmeal or oat cereal every morning--Because oat products skyrocket blood sugar, the repeated high sugars will damage the pancreatic beta cells ("glucose toxicity"), eventually impairing pancreatic insulin production. (Entice your target even further: "Would you like a little honey with your oatmeal?") To make your diabetes-creating breakfast concoction even more effective, make the oatmeal using bottled water. Many popular bottled waters, like Coca Cola's Dasani or Pepsi's Aquafina, are filtered waters. This means they are devoid of magnesium, a mineral important for regulating insulin responses.

5) Take a diuretic (like hydrochlorothiazide, or HCTZ) or beta blocker (like metoprolol or atenolol) for blood pressure--Likelihood of diabetes increases 30% with these common blood pressure agents.

There you have it! Perhaps we should assemble a convenient do-it-yourself-at-home diabetes kit to help, complete with several servings of whole grain bread, a big bottle of cranberry juice, some 600 unit vitamin D tablets, a container of Irish oatmeal, and some nice bottled water.
Tags :

Comments (35) -

  • Anonymous

    1/14/2011 12:26:58 PM |

    When someone dies suspiciously, and someone else benefits, (e.g. big insurance payoff) that "someone" is the first suspect.
    But not if you've been known to promote a heart healthy diet for the deceased...

    Jeanne

  • Anonymous

    1/14/2011 12:44:34 PM |

    You've recommended oat bran in the past for other reasons. Is cooked oat bran a suitable breakfast food?

  • Matt Stone

    1/14/2011 1:16:59 PM |

    This list is way off.  To become a type 2 the most important things that you do are:

    1) Get insufficient sleep
    2) Subject yourself to maximal levels of stress
    3) Do insane amounts of endurance exercise punctuated by long periods of total sedantarism
    4) Eat a low-carb diet punctuated by repeated bouts of carbohydrate bingeing, or a low-fat diet punctuated by bouts of high-fat bingeing
    5) And most importantly, cycle your weight up and down by restricting calories followed by bingeing followed by restricting calories followed by bingeing

    Those are the most effective ways to increase visceral fat, although the soda does help.  You got that one right at least.  Off to eat oatmeal for breakfast and have my blood glucose spike all the way to a ghastly 80 mg/dl afterward.

  • Anonymous

    1/14/2011 1:55:46 PM |

    Dasani has minerals added back in.

  • allison

    1/14/2011 3:23:27 PM |

    I hope the Good Doctor is including saturated fat in his tongue-in-cheek recommendation.

  • Dream_Puppy

    1/14/2011 4:37:37 PM |

    I have eat low carb, am thin, lift weights and do HIIT but have high blood pressure due to genetics (140/100)- I take 12mg of atenolol a day....is there anything else you would recommend to do instead? I have to take something : /

  • Eric

    1/14/2011 5:45:17 PM |

    I've been following Dr. Davis' advise to improve heart health as I'm 34 years old and dealing with calcification of my aorta and chronic hypertension.

    In 2 weeks without grain and oatmeal and taking D3+K2 w/ Fish Oil and my BP has been normal 128/54 and I've already lost 4lbs.

    Some of us follow the advise to save our lives and not over eat the oatmeal to get the pretty beach muscles.

    Thanks Dr. Davis

  • vic

    1/14/2011 5:51:29 PM |

    New to the blog.. the only thing that  I'm a bit surprised about is the no grain thing.

    Aren't whole grains good for insoluble fiber and don't raise your blood sugar like processed (white) flour?   I suppose if you are gluten sensitive you should avoid wheat, but for blood sugar?

    Similarly, doesn't oatmeals' soluble fiber slow down the insulin spike?

    For about 7 years I've been eating the same wheat/oatmeal cereal that has 7g of sugar, 6g of insoluble fiber, and 6g of soluble fiber  (12g of dietary fiber).    I work at a desk so I don't get much (if any) exercise.  

    I don't take supplements (vit. d or otherwise) and drink a soda or two occasionally.  

    I could probably stand to lose a few pounds but I have normal blood sugar levels.  

    Why am I not diabetic if I'm following the 5 easy steps?

  • Nigel Kinbrum

    1/14/2011 6:02:51 PM |

    vic said...
    "New to the blog.." Try reading the blog before posting.

    "Why am I not diabetic if I'm following the 5 easy steps?" Luck? Genes? Who knows?

  • Eric

    1/14/2011 6:10:35 PM |

    Also, Dr. Davis could you expound upon how taking HCTZ and Metropolol affects blood sugar- I currently take both of these to treat (not well) my hypertension?

    Thanks again!

    Eric

  • revelo

    1/14/2011 6:24:47 PM |

    I have a hard time accepting this theory of the pancreas beta cells "wearing out" like the tires on a car because they are asked to produce a little insulin now and then. The problem, IMO, is not asking the pancreas to do what it is designed to do (produce insulin) but rather insulin resistance in the muscles, and that comes from being obese and not exercising. If you maintain a proper weight and get enough exercise to maintain your insulin sensitivity, you shouldn't develop insulin resistance, which means you can eat carbs without problems. When you eat carbs, blood sugar will begin to rise, the pancreas will produce a small amount of insulin, this small amount of insulin will push the blood sugar into the muscles, and blood sugar will stop rising.

    People have been eating wheat and other grains and living long healthy lives, without diabetes, in much of the world. The key is that they don't overeat and they get exercise, and hence they don't develop insulin resistance. The traditional people of Sardinia and Crete, for example, were extraordinarily healthy and long-lived, despite eating a huge amount of wheat products. By contrast, modern Mediterranean peoples are developing diabetes at a phenomenal rate, due to overeating and insufficient exercise.

  • Peter

    1/14/2011 7:01:49 PM |

    Re: oat bran question.  I used to eat tons of oat bran back when Dr. Davis said it was the best cholesterol lower around.  Then I became anemic. Then I read somehere that oat bran blocks iron absorption, so I quit the oat bran, and the anemia went away immediately.  Of course, that might not have been why, you never know.

    Re: the Institute of Medicine didn't say "limit yourself to 600 iu of Vitamin D", that was a minimum not a maximum.

  • Onschedule

    1/14/2011 8:27:51 PM |

    @Peter re Institute of Medicine Vitamin D guidelines

    The chart on the Institute of Medicine's website lists 600 IU/day as the "Recommended Dietary Allowance" and 4000 IU/day as the "Upper Level Intake" for almost all age categories 9 years old and older.

    The way I read this, 600 IU/day is their recommendation, and 4000 IU/day is their upper limit caution. As such, I think Dr. Davis's characterization of 600 IU/day as the Institute of Medicine's recommendation is accurate. While the IoM is not saying "don't intake more than 600 IU/day," they are implying that their 600 IU dietary recommendation is adequate.

  • David

    1/14/2011 10:20:22 PM |

    @Eric- These antihypertensive drugs impair glucose metabolism. See this study here: http://care.diabetesjournals.org/content/31/5/982.long

  • c

    1/15/2011 4:00:42 AM |

    Matt Stone....let see some proof of your 80mg/dl postprandial oatmeal reading....I seriously doubt it.

  • LynP

    1/15/2011 4:32:12 AM |

    I'm obese & still losing (low carb), take Maxzide for lower leg edema.  Every time I stop taking it, I gain 2-3#s (yeah fluid) and get short of breath.  With apnea, I don't need anything else making me anxious about breathing.  Any other diuretics reduce lower leg edema and don't mess with glucose control? I drink low-sodium V8 & eat a lot of parsley to keep my potassium levels in the normal range. Suggestions?  I exercise, take mag citrate, take 15,000 IU D3/day to keep levels 60+, 1500 mg metformin XR/day, 88 mg levothyroxin.

  • revelo

    1/15/2011 5:49:03 AM |

    Per Dr Davis recommendation to test blood sugar (I have no reason to believe I'm diabetic, but I am interested in longevity so I'm following many of his recommendations), I ordered and today received a blood glucose monitoring system. Included in the package was a free sample of a Slim-Fast bar, whose ingredients are as follows:

    sugar, corn syrup, dry roasted peanuts, milk chocolate coating (sugar, partially hydrogenated vegetable oil ...

    Perfect diet for a diabetic, eh?

  • Anton

    1/15/2011 1:56:09 PM |

    Suggesting we stay away from wheat and other cereals is interesting, and following such a diet would certainly a radical departure for a species that has had bread and other grain products as a dietary staple for over 3,000 years.

  • Dr. William Davis

    1/15/2011 3:06:27 PM |

    Several commenters--

    Diuretics and beta blockers (metoprolol, atenolol, etc.) can be replaced in many people by other agents that do not provoke diabetes. However, some people do indeed require these agents for specific problems, e.g., water retention, atrial fibrillation, other abnormal rhythm issues.

    Elimination of wheat on the background of a low-carbohydrate diet is, however, a marvelously effective way to reduce BP (though it requires many months to work).

  • PaleoMom

    1/15/2011 6:57:33 PM |

    @Anton: Mankind, at least SOME of it, has eaten grains for  centuries BUT not nearly in the quantity we eat it in the Western world. When baked into breads, wheat was frequently soaked or sprouted, either on purpose or incidentally through more time in the fields before silage or drier silage, which deactivates the phytates in grains and seeds (and nuts) and makes them more digestible. Bread dough was raised more slowly before fast-acting yeast, giving the moisture in the dough time to do the same with the wheat flour; sourdough serves a similar function today. In some parts of the world today we still see grains treated in what we would consider primitive ways, like soaking and fermenting grains and treating corn with lime - pellagra, anyone? - while we Westerners eat copious amounts of industrially processed grain products without a second thought. This is not the way early agrarian man consumed grains, and not the way most humans did until the last few decades in our evolution.

    What do you suppose man primarily subsisted on for the millennia (not centuries, but millennia!) before becoming agrarian and growing grains? Yep - meat, vegetables, greens, nuts, seeds, and fruits. Maybe the odd serving of grain here and there if enough could be gathered to be mealworthy. Oh, and no dairy, either. It might be suggested that grains themselves are the "radical departure" from a much longer evolutionary background of a very different diet for mankind.

    I would like to know more about the sugar-spiking effect of oats compared to other grains. We do sometimes have them soaked and sprouted first, as porridge or in bread or the odd pancakes, but I've seen my daughter's behavior go crazy on oats before we knew about that practice and that part of this entry rang a bell there. Smile

  • Might-o'chondri-AL

    1/15/2011 7:26:24 PM |

    Oats were a boon crop for the rural Scottish and Irish. The people relished warm belly food in the morning.  

    Then everybody got up and went to perform physical work/chores. They used the glucose for available energy until they were fortunate enough to eat again.

    Moderns get up from the table and lead sedentary lives. Athletes training hard can still get up from breakfast and "feel their oats".

  • Anonymous

    1/15/2011 11:16:03 PM |

    What about oats groats?

  • Helen

    1/16/2011 12:30:37 AM |

    I wrote a long response to this yesterday that didn't go through the system.  Perhaps I'll try again tomorrow.  For now, suffice it to say that I am mildly diabetic and have found, through trial and error, that oatmeal at breakfast does NOT spike my blood sugar.  At one hour it may be 110-135, and at two hours I've had readings from 75 to 100.  (I take no meds.) It does not give me higher readings as the day wears on, either.  This is if I eat very little fat (about 8 grams total) as part of my breakfast.

    After 9 months on a low-carb (about 60 carbs a day, usually) diet, following my diagnosis in May, I found, thanks to dietary changes to address gallbladder trouble, that I am a diabetic whose blood sugars are messed up by fat, not carbs.  

    I respect Dr. Davis' work, but diabetes - high blood glucose and poor glycemic control - is more than one disease.  You can come to the same "diagnosis" through different genetic routes.  The part of your system that is malfunctioning may be very different from the part malfunctioning in the person sitting next to you at the endocrinologist's.  Your best bet is to check your meter after meals.  Many diabetics cannot deal with carbs.  Some cannot deal with fat.

    @ Concerns about anemia: phytic acid in oatmeal, which blocks mineral absorption, is a real concern.  I soak mine overnight with yogurt and buckwheat flour to break down the phytic acid.  I eat gluten-free oatmeal, as I have celiac disease.  

    @ Wearing out the pancreas:  The reality is that chronic high blood sugars (not carbs per se - you have to be hampered in your ability to deal with an influx of glucose to begin with) can and do destroy insulin-producing beta cells in the pancreas, creating a terrible feedback loop and diabetic progression.  People susceptible to diabetes generally have less capacity to produce more and/or larger beta cells in response to greater insulin demands.  This is why most obese people, while not healthy, actually do not develop diabetes, while others can become diabetic when slim.

  • Sandy

    1/16/2011 5:19:13 AM |

    Hi @PaleoMom, in reference to your daughter's behavior after eating the occasional oats, I can totally relate. I have experienced severe brain fog, ADD-like symptoms, and lethargy whenever I've eaten any high carb meal-whether it's whole grain or not.  

    Off the top of my head, I'd suspect 2 things:

    1. Does your brand of oats  specifically say "gluten free?"  There is usually cross-contamination with wheat via containers and equipment.  This is where I would look first. Bob's Red Mill has Gluten Free oats.

    2. It is also possible that your daughter could be particularly sensitive to the effects of carbs. Try adding butter, cream, coconut milk, or some other fat to the oatmeal (+ a dash of cinnamon).

    Hope this helps!

  • Anonymous

    1/17/2011 6:19:43 PM |

    I'd certainly like to read a response to Helen's post. I've never heard of fat driving up BG levels unless it was consumed with plenty of carbs. Helen, can you give personal/specific examples?

  • Helen

    1/18/2011 2:34:32 PM |

    Response to Anonymous, Part I:

    Anonymous -

    I'll give a snapshot here of my evidence, though I can't include everything.

    One point:  It's not the fat that drives up my glucose per se (although I believe it drives up my fasting glucose).  It's that fat impairs my ability either secrete insulin or for my cells to accept glucose, or both.  

    So carbs in the presence of a high-fat diet spike me more, *even small amounts of carbs.*

    First example:  When I had gestational diabetes three years ago, toward the end of my pregnancy, there was a possibility I was developing intrahepatic cholestasis of pregnancy.  I adopted a low-fat diet, which is thought to help mitigate the risks.  I was on insulin and checking my blood sugar about eight times a day.  I found my insulin requirements over the last several weeks of my pregnancy plummeting, until I required none on the day I delivered.

    Although I had had that experience, when I was diagnosed with diabetes last spring, I discounted that and adopted a low-carb diet.  I saw no improvements in my glucose control.  From May to November, I saw my A1C drop from only 6.4 to 6.0, despite increased exercise, a 25-pound weight loss (I'd been only 10 pounds over my ideal weight range at diagnosis), and watching carbs very carefully.  In contrast, my father-in-law saw a drop in his A1C from 11 to 5.7 basically just taking Metformin!  (I think he's particularly lucky.)  Metformin didn't work for me.

    Second example:  I have a log of a day on which I'd had a fasting glucose of 126, had a breakfast of cottage cheese with olive oil, consuming about 7 g carbs total, and ended up with my glucose spiking to 183 at 1/2 hour, with it coming down to 148 at one hour and 122 at two.

  • Helen

    1/18/2011 2:35:18 PM |

    Response to Anonymous, Part II:

    In the interest of full disclosure, I found something similar happened yesterday, when I checked my glucose a little earlier than at one hour.  It went up to about 183, but then came down to 110 by 90 minutes or so post-prandial.  But I'd eaten at least 60 grams of carbohydrates.  

    I think that my glucose may be spiking higher at 30 minutes, but is pretty darn good at 1 hour pp, whether I'm on a low-fat diet or a low-carb diet.  The difference may be that it comes down faster and goes and stays lower on low-fat.  For a few days I was on an almost no-fat diet (though I heard that was actually bad for my gallbladder and stopped).  I had trouble keeping my blood glucose UP.  That's when I saw two-hour readings of 75 after a hearty bowl of oatmeal.  My readings aren't as wonderful now that I'm eating low-fat, not no fat, but they're still much better than high-fat.  I'm certain that on average, it's  at least a 10 point difference, possibly 15.  And I no longer have to live with the insanity of having ever more vanishing quantities of carbs spike me.  

    I'm not and have never been an anti-fat person.  When I was diagnosed I had been following a WAPF-type diet, was gluten-free and nearly grain-free, trending toward Paleo.  I'd been telling everyone I knew not to be afraid of fat, especially saturated fat.  The irony!

    Jenny Ruhl at Blood Sugar 101/Diabetes Update has heard of others like me, though she says it's quite rare.

    Peter at Hyperlipid hypothesized that there may be people like me, since there are some rodents that respond to fat this way.  As you probably know, he's pro-fat, but open-minded.  

    I do think I have something other than a "typical" Type II diabetes. I had a genetic test for monogenic glucokinase-deficient diabetes (MODY 2), but didn't have that.  My insurance is not going to pay for another specialized test.  I'm not sure what I'd ask to be tested for, anyway.

  • Dana Seilhan

    1/22/2011 12:07:32 AM |

    According to the Weston A. Price Foundation, oats are the grain with the highest phytate content.  Eating them without proper preparation not only spikes your blood sugar but chelates the minerals your body needs to stave off diabetes before you've even had a chance to absorb them.

    If you follow the typical "healthy" advice to cut fats out of your diet, you'll eat the oatmeal made with water instead of milk or cream, exacerbating the problem.

    Studiously ignoring Matt's claim about low-carb diets.  Eating low-carb for part of the year and higher-carb for part of the year would approximate the prehistoric European experience of having mostly meats available for food in the winter but lots of plant foods in the summer.  Amazing that type 2 diabetes in particular has never been a problem in Europe up to modern times, despite their long history (post-agricultural revolution) with famines.

    Anyone following a low-fat diet is at increased risk of diabetes because they lack the fat-soluble vitamins and the minerals necessary to sustain endocrine health.  Why anyone still endorses low-fat as healthy for, well, anyone really is beyond my comprehension.  If you can tolerate a higher carb intake that's one thing (and if I were you I would favor starchy tubers over grains and beans), but no human being should have to do without dietary fat, and it's unhealthy to attempt it.  Even people who are missing their gallbladders or who suffer from gallstones can eat certain types of fats without too much worry.

  • Gallbladder Gone

    1/22/2011 5:06:59 AM |

    @Dana Seilhan:

    I'm 51 years old, and I just had my gallbladder removed due to rather severe gallstone problems (I tried to avoid the surgery, but it became an emergency, and I had no choice).

    Can you provide links to good materials on what kinds of fats to avoid, and why?  My wife and I eat a moderate low-carb, high protein diet and don't shy away from fats.  

    I'm concerned about long-term health issues, but I've not found good educational materials on the what, how, and why of post-gallbladder removal fat-related health problems, short or long term.

    Thanks for any guidance you can provide.

  • Helen

    1/22/2011 3:09:04 PM |

    @Dana -

    Actually, without a gallbladder, most people don't have to follow a low-fat diet at all.  It's when you have gallstones or a sludgy gallbladder that fat can exacerbate symptoms.  This doesn't mean that it causes gallbladder trouble, but that it causes pain from stimulating gallbladder contractions, which it's supposed to do.  When you have sludge or gallstones in there, though, that can hurt.

    I'm going to work at making sure I have the fat-soluble vitamins I need, and I'm pretty educated about this.  But my experience has shown me that the WAPF and Dr. Davis' points of view, though they may be helpful to many people, unfortunately don't apply to me.  I realize that lot of people who have found that a certain approach works best for them will think it will work for everyone, and that I'm just ignorant, but I've studied this all pretty deeply for a layperson, tried different approaches, and have finally had to follow the evidence of my own glucose meter and other health indicators.  My diabetes couldn't have been caused by a low-fat diet because I'd not been on one until recently.  

    Agreed about properly preparing oatmeal.  

    I think a problem with so much of the health advice I see, whether it's low-fat or pro-fat or low-carb, is that it makes blanket recommendations.  Different people whose physiologies are malfunctioning may have them malfunctioning for different reasons.

    You can find somewhere a "traditional" diet to support just about any claims you want.  I think the common denominators in healthy traditional diets are really not high-fat vs. low-fat, but lack of industrial vegetable oils, refined sugars, and refined carbohydrates.  I do think improperly prepared grains and gluten (however prepared) are nearly universally problematic.

    If you look Stephan Guyenet's Whole Health Source, he has examples of populations on high-carb diets that do not have poor glucose tolerance or elevated incidence of diabetes.  You also have to look at the possibility that traditional peoples had more homogeneous gene pools, and perhaps therefore their diets and genes meshed more than peoples' today.

    They also had less exposure to toxic chemicals in the modern environment, and other factors like social isolation and disrupted circadian rhythms, all of which can wreak havoc with endocrine function.

  • Anonymous

    1/23/2011 10:24:09 PM |

    I eat oatmeal and I only spike to 120 or less, so that doesn't seem too bad to me. I think it's only bad if it spikes too high. Fruit is a problem for me, however. I would imagine if I ate fruit mixed with protein I might be able to handle it.

  • Sophie

    1/29/2011 3:06:01 AM |

    Diabetes is one of the leading cause of death listed on U.S. I am afraid that this will increase if people will not be aware of the factors that leads to diabetes. Information dissemination is a must. People need to be active and learn to know the foods to be avoided as well.

  • jodi

    5/2/2011 6:52:07 PM |

    you may not be diabetic, YET, but you are headed down that path.  give it time.

  • Gary Snow

    7/15/2012 8:07:43 PM |

    Helen..Excessive carbs DID cause my T2 Diabetes..and yes, oatmeal DID spike your BG..9Damage begins at 140) Take it down to less than 30 carbs @ day and you will reap the benefits!

Add comment

Loading
Cureality | Real People Seeking Real Cures

An exercise in optimism

5. May 2007 William Davis (0)
Followers of the Track Your Plaque program already know that maintaining an optimistic viewpoint is important in gaining control over coronary plaque.

In fact, I believe that, in many cases, a sense of optimism may make or break your CT heart scan score-reducing efforts. Pessimists rarely drop their score, while optimists do so all the time.

This week posed a challenge to my optimism. I spent the last week on jury duty hearing the details of a murder case. For four days, I listened to blow-by-blow testimony about the totally pointless, unprovoked death of a young man by a drug-dealing thug. Much of the witness testimony was from people who shared the hopeless, violent world of the defendant.

I was, however, completely impressed by the dedication of the prosecuting attorney, a 50-some year old man who was clearly deeply dedicated to his mission and didn't once provide any indication that he was grandstanding or looking for some personal glory. He was doing his job and trying to obtain justice for the fallen victim. I was equally impressed by the judge, who seemed unfazed by the events but carefully explained why the system worked the way it did. After the trial, he provided some further insights to us jury members and I saw him as a human being who, like the prosecutor, was trying to make a small contribution to making the world better.

Though many of the witnesses who testified against the defendant shared his world, I was impressed with their courage in coming forward. They face the threat of reprisals, I'm sure, for coming forward to the law and testifying against a known career criminal. Several of them said that they were not after any reward, but simply wished to do the right thing and provide testimony that proved damning against the defendant.

I acted as the jury foreman and I was proud of how the jury members listened carefully, asked intelligent and probing questions, and then helped us render a confident and expeditious sentence: guilty.

If anything, despite the tragic circumstances, I was much heartened at how all the participants in this process played their part and justice (at least in the legal sense) was served.

Let optimism prevail, even in dire circumstances.

No need to re-invent the wheel

2. May 2007 William Davis (0)
I seem to be repeating myself lately, but I think this does bear repeating:

There's no need to re-invent the wheel when it comes to gaining control over your heart scan score.

The Track Your Plaque program is the most powerful approach known to help you gain control over your coronary atherosclerotic plaque and CT heart scan score, bar none. While 100% of people do not drop their score, more and more people every week are doing so. (One of the admitted weaknesses of the Track Your Plaque website is our failure to list more success stories; we're working on it.)

The basic program is quite simple:

--The Rule of 60 for lipids (LDL 60 mg/dl; HDL 60 mg/dl or greater; triglycerides 60 mg/dl or less)

--Identify hidden causes of plaque, esp. small LDL, Lp(a), and IDL, followed by specific corrective action

--Fish oil--minimum 1200 mg per day of EPA + DHA

--Normal vitamin D3 blood levels (We aim for 25-OH-vitamin D3 of 50-60 ng/ml)

--Normal blood sugar (<100 mg/dl)

--Normal blood pressure (<130/80)

--An optimistic attitude



Much of the other stuff--vitamin K, matrix metalloproteinase reducing strategies, flavonoid strategies, exercise-induced hypertension, etc.--are, for the majority, fluff. Their real role is in people who may have failed in stopping the rise of their heart scan score just doing the basics of the program.

If you neglect the basics, hoping to find some magic potion, I'm afraid the overwhelming likelihood is that you will fail. I've seen it happen time and again. Someone will come to my office with an extraordinary list of supplements--hawthorne, dozens of anti-oxidants, EDTA, concentrated flavonoid preparations, and on and on. Not only is it shockingly expensive to do this, it's also unnecessary and foolhardy. This kind of unfocused, hocus-pocus in the hopes of getting it right fail time after time.

The Track Your Plaque program, while not foolproof, is the best I know of. Stick to the basics and wander off when the basics fail. But there's extraordinary power in just achieving the basics.

Are we a front for drug companies?

2. May 2007 William Davis (3)
I was shocked recently when someone accused me and the Track Your Plaque website of being nothing more than a front for the drug industry, that we are promoting concepts with the hidden pharmacuetical agenda behind us.

Don't make me laugh. How in the world that kind of impression could be gotten from either the Heart Scan Blog or the Track Your Plaque website is beyond me.

But I occasionally do need to state explicity: We do not promote drugs, neither this Blog nor the Track Your Plaque website has ever sought nor been backed by pharmaceutical money. The only money that supports this website is our own and that from paying Track Your Plaque members.

In fact, I am quite proud of the unbiased content and commentary on both venues. I challenge anyone to point out how and where there is any suggested relationship to a hidden source of commercial backing. I assure you, there is none.

If I say a drug is worth you and your doctor considering, then I say so with a true belief in it, not because somebody or some company paid me to say so. If I say a drug stinks, I believe that too. If we use a specific supplement in the program, it's because we believe it truly adds value to a plaque-reversal program. We receive no money from drug, supplement, or other commercial interests to promote their products. Period.

What is "normal"?

1. May 2007 William Davis (2)
When it comes to laboratory values and medical testing, a common dilemma is knowing what is "normal." Let me explain.

First of all, when you receive a laboratory result for a test, a "reference range" or "normal range" is usually provided. Where did that range come from?

It varies from test to test. For instance, a low potassium is easy, because low potassium levels can lead to life threatening consequences, e.g., dangerous heart rhythms. High potassium likewise, because dangerous phenomena develop when potassium generally exceeds 5.5 mg/dl or so.

But what about something like HDL or LDL. Here's where confusion reigns. Often, "normal" is obtained by taking the average and saying that any value plus or minus two standard deviations (remember that painful class?) represents normal or reference range.

If that were true, what if we applied that principle to body weight. If we weighed several thousand adult women, the average would be in the neighborhood of 172 lbs (no kidding). Does that mean that 172 lbs plus or minus two standard deviations is normal? No, of course not.

There is therefore a distinction between "normal" and "desirable". For HDL cholesterol, your laboratory report might say that an HDL cholesterol of 40-60 mg/dl is normal. But is it desirable? I don't think so. The most frequent HDL level for a male with a heart attack is 42 mg/dl--hardly desirable.

Let's take triglycerides. The average triglyceride level in the U.S. is somewhere around 140 mg/dl. For those of us who do a lot of lipoprotein testing, we can tell you that triglycerides at this level, though generally regarded as being within the normal range, are associated with flagrant and obvious excesses of several abnormal lipoprotein particles that contribute to coronary plaque growth (VLDL and often IDL; small LDL; drop in HDL and shift towards small HDL).

So, always take the so-called "normal" or "reference" values on a lab report as crude guidelines that often have little or nothing to do with health or desirability. Unfortunately, many physicians are not aware of this and will declare any value within the normal or reference range as okay. An HDL of 40 mg is not okay. A triglyceride level of 140 mg is also not okay.

What is okay? What is desirable? That depends on the parameter being examined. From a basic lipid standpoint, of course, we regard desirable as 60-60-60. Desirability from a lipoprotein standpoint we will cover in a more thorough Track Your Plaque Special Report in future.

The wisdom of the masses

1. May 2007 William Davis (0)
My sister sent me these quotes:



"We don't like their sound, and guitar music is on the way out."

Decca Recording Co. rejecting the Beatles, 1962


"Stocks have reached what looks like a permanently high plateau."

Irving Fisher, Professor of Economics, Yale University, 1929


"Airplanes are interesting toys but of no military value."

Marechal Ferdinand Foch, Professor of Strategy, Ecole Superieure de Guerre, France


"Everything that can be invented has been invented."

Charles H. Duell, Commissioner, US Office of Patents, 1899



No doubt, conventional wisdom can often be laughably (tragically?) wrong. The problem is that, as absurd as all the above sentiments seem to us now and in retrospect, they represented the view of many people years ago. These views were held by many, including many people in positions of power and decision-making responsibility.

A more relevant but nonetheless laughable and widely held belief in 2007: coronary heart disease should be treated with hospital procedures.

Why is a disease that requires 30 years to develop treated only at the final moments with a procedure? Do you only change your car's oil when the engine is on its last legs? Or, do periodic, relatively effortless oil changes during the life of the car make better sense?

I witness just how brainwashed the public has become with this crazed notion when I meet someone socially at, say a fundraiser or cocktail party. When they ask what I do, I tell them I'm a cardiologist. The invariable response: "Oh, what hospital do you work out of?"

I tell them I don't, that I take care of the majority of heart disease right from the office. 99% of the time I get a puzzled look. If we had comic bubbles above our heads revealing our internal thoughts, it would read "Yeah, right. What a kook."

The notion that coronary heart disease is something that is manageable with simple tools for the majority of us in the early stages is entirely foreign to almost everybody. The hospitals and the medical industry have so succeeded in dazzling the public with images of staff in scrubs, rushing from emergency to emergency, lights flashing, scalpels flying. . . how can you possibly accomplish this at home or anywhere outside of the high-tech world of the hospital?

Well, I'm a cardiologist and I do it every day. We all need a figurative dose of electroshock therapy to shake ourselves of this crazy notion.

How important is l-arginine?

30. April 2007 William Davis (13)
Perhaps more than any other supplement, l-arginine causes frustration and confusion. It’s difficult to find, sometimes quite expensive, and some preparations cause loose stools.

Just how necessary is it?

L-arginine, you’ll recall, is a source of nitric oxide, or NO. Though it’s the same stuff as in car exhaust, NO provides a critical signaling role in your body’s cells that regulate a multitude of functions. Among the important roles of NO is to powerfully dilate, or relax, arteries. A constant flow of NO is required for health, particularly since each molecule persists only a few seconds.

L-arginine is the body’s source of nitric oxide. In addition, a peculiar but very effective blocker of l-arginine called asymmetric dimethylarginine, or ASDM, has recently been discovered to prevent the production of NO. Varied conditions like hypertension, diabetes, high cholesterol, excessive saturated fat or processed carbohydrate intake all lead to heightened levels of ASDM, often several-fold greater levels, and thereby effectively blocking NO production.

The “Arginine Paradox” is the name that some researchers in this field have given to the unusual property of l-arginine supplementation to “overpower” the blocking effects of ASDM. This is somewhat unusual in biologic systems in that an agent that blocks a receptor cannot usually be outmuscled by providing excess material for a reaction. Kind of like hoping that your car runs faster simply by topping up the gas tank.

Concrete observable benefits have been made for l-arginine in clinical trials, such as arterial relaxation that results in arterial enlargement (which can actually be seen in the cath lab); anti-inflammatory effects; reduction of blood pressure; enhancement of insulin responses, etc. All of these effects can be connected to beneficial properties that may facilitate atherosclerotic plaque regression and, indeed, there are limited data to document that this is true.

Drug companies may be greedy, but they’re not stupid. They’ve been vigorously pursuing this line of research for some years, a research path that led inadvertently to the erectile dysfunction agent, sildenafil (Viagra), and all its subsequent competitors. (Erectile dysfunction is another expression of endothelial dysfunction, since male erections are driven by the ability to dilate penile arteries.) The wonderful properties of NO enhancement continue to occupy research labs around the world.

Wow. So what’s the reluctance? In the early years of the Track Your Plaque program (meaning just a short 7-8 years ago), I was thoroughly convinced that l-arginine was a crucial, necessary part of a plaque regression program. Without it, you would rarely succeed. With it, the odds were tipped in your favor.

However, something curious has emerged recently. I’ve seen more and more people dropping their heart scan scores. Not just a little bit, but a huge amount. Witness our most recent record holder, Neal, who dropped his score 51% in 15 months. Just five years ago, this magnitude of reversal was unimaginable. Granted, Neal is our record holder, but others are obtaining 10, 18, 24, 30% drops in scores all the time. Many have done it without l-arginine.

Now, how about the people who have failed to stop a rising score? Would they do better with l-arginine as part of the mix? I believe so, but sometimes we never quite know except in retrospect. It has been a great dilemma for us trying to predict from the starting gate who will or who won’t drop their heart scan score.

My view from the trenches is that l-arginine packs its greatest atherosclerosis-fighting punch in the first year or two of use, when “endothelial dysfunction” is likely to be present (abnormal artery constriction). But as all other strategies take hold—fish oil, correction of lipid and lipoprotein abnormalities, weight loss (big effect), vitamin D (another very big effect), etc.—endothelial behavior improves over time. Perhaps l-arginine becomes a less necessary component over time.

There’s no doubt that uncertainty still surrounds the use and science surrounding l-arginine. However, if you’re interested in stacking the odds in your favor, particularly during the first year or two of your plaque-reducing efforts, I think that l-arginine is worth considering. It is cumbersome, it can be expensive, some preparations may even be foul. But in the big picture of life, with hospitals trying every possible ploy to get your body on a table for a procedure, doctors perverting their mission by signing employment contracts with hospitals and agreeing to usher you into the hospital as a paying patient whenever possible, and drug companies viewing you and me as a market for medications which may or may not be helpful, l-arginine is surely not that big a burden.

Track Your Plaque and non-commercialism

29. April 2007 William Davis (6)
If you're a Track Your Plaque Member or viewer, you may know that we have resisted outside commercial involvement. We do not run advertising on the site, we do not allow drug companies to post ads, we do not covertly sponsor supplements. We do this to main the unbiased content of the site.

We've seen too many sites be tempted by the money offered by a drug company only to see content gradually drift towards providing nothing more than cleverly concealed drug advertising. I personally find this deceptive and disgusting. Ads are ads and everyone knows it. But when you subvert content, secretly driven by a commercial agenda, that I find abhorrent.

That said, however, I do wonder if we need the participation of some outside commercial interests to help our members. In other words, many (over half) of the questions and conversations we have with people is about what supplement to take, or what medication to take. While we cannot offer direct medical advice online (nor should we) because of legal and ethical restrictions, I wonder if could facilitate access to products.

Many people struggle, for instance, with trusted sources for l-arginine, vitamin D, fish oil. Other people struggle with finding a heart scan center because of the changing landscape of the CT scanning industry. Could we somehow provide a clear-cut segment of the website that clearly demarcates what is commercial and non-Track Your Plaque-originated, yet at least provides a starting place for more info?

Ideally, we would have personally tried and investigated everything there is out there applicable to the program. But that's simply impossible at this stage.

I feel strongly that we will never run conventional ads on the site. Nor will we ever permit any outside commercial interest to dictate what and how we say something. The internet world is full of places like that. Look at WebMD. I find the site embarassing in the degree of commercial bias there. We will NEVER sell out like that, regardless of the temptation. People with heart disease are all conducting a war with the commercial forces working to profit from them--hospitals, cardiologists, drug companies, medical device companies (yes, even they advertise to the public, e.g., implantable defibrillators--no kidding). Genuine, honest, unbiased information is sorely needed and not from some kook who either knows nothing about real people with real disease, or has a hidden agenda like selling you chelation.

I'd welcome any feedback either through this Blog or through the contact@cureality.com.

The nattokinase scam

28. April 2007 William Davis (179)
A conversation about vitamin K2 commonly leads to confusion. Several people have asked about something called nattokinase.

The scientific data on the potential role of vitamin K2 deficiency in causing both osteoporosis and vascular calcification is fascinating. Along with vitamin D3, vitamin K2 may be an important factor in regulation of calcium metabolism. Supplementation may prove to be a major strategy for inhibition of vascular calcification.

Obtaining K2 in the diet is tricky, since it's present in just a handful of foods: egg yolks, liver, traditional cheeses, and natto. This is where the confusion starts.

Natto is a Japanese fermented soy product. I've had it and it's quite disgusting. Nonetheless, Japanese who eat natto experience less fracture. (A parallel study in heart disease has not been performed.) Natto is also a source of another substance called nattokinase.

Advocates (otherwise often known as supplement distributors) claim that nattokinase is a "fibrinolytic", or blood clot-dissolving, preparation that "improves blood flow, protects from blood clots, and prevents heart attacks and strokes."

Don't you believe it. This is patent nonsense. There are several problems with this rationale:

--Any oral fibrinolytic agent is promptly degraded in the highly acid environment of the stomach. That's why all medically used fibrinolytics are given intravenously. Drug companies have struggled for years to encapsulate, modify, or somehow protect protein (or polypeptide) products taken orally from degrading this way. They've never succeeded. That's why, for instance, growth hormone (a polypeptide) remains an injection, not an oral agent. An oral growth hormone, by the way, would sell like mad, so the drug companies would very much like to figure out how to bypass the degradative effects of stomach acid. One of the "researchers" behind the nattokinase claims boasts that he has single-handedly figured out how to protect the nattokinase molecule in the gastrointestinal tract. However, he won't tell anybody how he does it. Right.

--Fibrinolytic agents are extremely dangerous. In years past, we used to treat heart attacks with intravenous fibrinolytic agents like tissue plasminogen activator, urokinase, streptokinase, and others. They have fallen by the wayside, for the most part, because of limited effectiveness and the unavoidable dangers of their use. Fibrinolytics are "dumb": they dissolve blood clots in both good places and bad. While they might dissolve the blood clot causing your heart attack, they also degrade the tiny clot in your cerebral (brain) circulation that was protective. That's why fatal brain hemorrhages, bleeding stomach ulcers, and blood oozing from strange places can also occur with fibrinolytic administration. Believe me, I've seen it happen, and I've watched people die from them.

The idea that a small dose taken orally is healthy is ridiculous. Even if nattokinase worked, why the heck would you take an agent that has known dangerous and very real consequences?

Don't let this idiocy reflect poorly on the K2 conversation, which, I believe, holds real merit and is backed by legitimate science. This is symptomatic of a larger difficulty with the supplement industry: Insane and unfounded claims about one supplement erodes credibility for the entire industry. It gives regulation-crazed people like the FDA ammunition to go after supplements, something none of us need. You and I have to sift through the nonsense to uncover the real gems in this rockpile, real gems like vitamin D3, omega-3 fatty acids from fish oil, and, perhaps, vitamin K2. But not nattokinase.

Blood pressure with exercise

27. April 2007 William Davis (10)
Here's a frequently neglected cause for an increasing CT heart scan score: High blood pressure with exercise. Let me explain.

Paul's blood pressure at rest, sitting in the office or on arising in the morning, or at other relatively peaceful moments: 110/75 to 130/80--all in the conventional normal range.

We put Paul on the treadmill for a stress test. At 10 mets of effort (on the protocol used, this means 3.4 mph treadmill speed at 14 degree incline), Paul's blood pressure skyrockets to 220/105. That's really high.

Now, blood pressure is expected to increase with exercise. If it doesn't rise, that's abnormal and may, in fact, be a sign of danger. Normally, blood pressure should rise gradually in a stepwise fashion with increasing levels of exercise. But any blood pressure exceeding 170/90 is clearly too high with exercise. (Not to be confused with high blood pressures not involving exercise.) A handful of studies have suggested that a "breakpoint" of 170/90 also predicts heightened risk of heart attack over a long period.)

I see this phenomenon frequently--normal blood pressure at rest, high with exercise. This also suggests that when Paul is stressed, upset, in traffic congestion, under pressure at work, etc., his blood pressure is high during those periods, as well. I wouldn't be surprised to see other phenomena of underappreciated high blood pressure, like abnormally thick heart muscle (left ventricular hypertrophy), an enlarged thoracic aorta (visible on your heart scan), left atrium, perhaps even an abnormal EKG or abnormal kidney function (evidenced by an elevated creatinine on a standard blood panel).

Unfortunately, the treatments that reduce blood pressure are "stupid," i.e., they have no appreciation for what you are doing and they reduce blood pressure all the time, whether or not you're stressed, exercising, or sleeping.

Blood pressure reduction should begin with weight loss, exercise, reduction of saturated fats and processed carbohydrates (esp. wheat), magnesium replacement, vitamin D replacement. Think about CoQ10. After this, blood pressure medication might be necessary.

The message: Watch out for the blood pressures when you have a stress test. Or, if you have a friend who is adept at getting blood pressures, get a blood pressure immediately upon ceasing exercise. It should be no higher than 170/90.

Vitamin D2 vs. vitamin D3

26. April 2007 William Davis (21)
An interesting question came up on the Track Your Plaque Member Forum about vitamin D2 vs. vitamin D3. This often comes up among our patients, as well.

Vitamin D is measured in the blood as 25-OH-vitamin D and is distinct from 1,25-diOH-vitamin D, a kidney measure, a test you do not need unless you have kidney failure.

The human form of vitamin D is cholecalciferol and is usually obtained via activation of a precursor molecule in the skin on activation by the sun. You can also take cholecalciferol and it increases blood levels of 25-hydroxy vitamin D reliably.

However, there is a cheap, plant-sourced, alternative to vitamin D3, called vitamin D2, or ergocalciferol. D2 has far less effect in the body. Taking D2 or ergocalciferol orally is an extremely inefficient way to get D. Unfortunately, it's the form often used in milk and many supplements, even the prescription form of D. About half the multivitamins and calcium supplements I've looked at contain ergocalciferol rather than cholecalciferol.

Taking vitamin D2 yields very little conversion to the effective D3. This particular issues is maddening, as the USDA requires dairy farmers to add 100 units of vitamin D to milk, and D2 is often used. In other words, the D in many dairy products barely works at all. There are many children who rely on D from dairy products who are at risk for rickets and are not getting the D they need from dairy products because of this cost-saving switch. Do not rely on milk for vitamin D for your children.

D2 or ergocalciferol is often included in the blood measures of vitamin D along with vitamin D3. The only reason it's checked with blood work is to ensure "compliance,", i.e., see whether or not you're taking a prescribed ergocalciferol. Beyond this, it has no usefulness.

25-OH-vitamin D3, or cholecalciferol, is both the blood measure and the supplement you need. This is the one that packs all the punch. Keep in mind also that it is the oil-based gelcap you want, with more consistent and efficient absorption. Tablets usually barely work at all, even if it contains cholecalciferol. Most people who take calcium tablets with D, or multivitamin with D, not only are getting a powdered form of D, but also in trivial doses. It's the pure vitamin D3, cholecalciferol, in gelcap form you want if you desire all the spectacular benefits of vitamin D.