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.
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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!

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Cholesterol effects of carbohydrates

24. March 2009 William Davis (31)
Let's take a hypothetical person, say, a 50-year old male. 5 ft 10 inches, 160 lbs, BMI 23.0. He's slender and in good health.

Our hypothetical man eats a simple diet of vegetables, some fruit, nuts, and meats but avoids processed industrial foods. By macronutrient composition, his diet is approximately 30% protein, 40-50% fat, 20-30% carbohydrate. His starting lipid panel:

Total cholesterol 149 mg/dl
LDL cholesterol 80 mg/dl
HDL 60 mg/dl
Triglycerides 45 mg/dl

His starting lipids are quite favorable (though I don't often see this kind of starting panel nowadays except in athletes). We begin here because this hypothetical man is going to serve as our test subject.

We ask our hypothetical man to load his diet up on "healthy whole grains." He complies by eating whole grain cereals for breakfast, whole wheat toast; sandwiches made with whole grain bread; dinners of whole wheat pasta; snacks of granola bars, whole wheat pretzels and crackers.

Three months later, his lipids show:

Total cholesterol 175 mg/dl
LDL cholesterol 130 mg/dl
HDL 45 mg/dl
Triglycerides 150 mg/dl


You can see that LDL cholesterol has increased, HDL has dropped, and triglycerides have increased. This wave of change is the hallmark of carbohydrate excess, but more specifically of overreliance on wheat products. Beyond his lipid panel, the man has gained 10 lbs, all concentrated in a soft roll around his abdomen, his blood sugar is now in the "borderline range" of between 110 and 126 mg/dl, i.e., pre-diabetic.

If we were to examine this man's advanced lipoproteins (e.g., NMR from Liposcience, or VAP from Atherotech), we would see that there has been an explosive increase in small LDL particles, along with a shift of large HDL to small, and the appearance of multiple abnormal classes of particles called VLDL and IDL (signalling abnormally slowed clearance of dietary by-products from the blood).

Familiar scenario? The "after-carbohydrate" situation is the rule among the people who I first meet who claim to be eating a "healthy" diet, though their patterns are usually much worse, with higher LDL, lower HDL, and much higher triglycerides, an exaggeration of our hypothetical man's abnormalities.

What if our hypothetical man now goes to his conventionally thinking (read "taught medicine by the pharmaceutical industry") physician? What will likely be the advice he receives? Reduce his saturated fat intake, eat plenty of healthy whole grains, take a statin drug.

Although my illustrative man is hypothetical, I've seen this scenario play out many thousands of times. It happens in real life all the time. It is predictable, it is highly manipulable. Sadly, it is rarely recognized for what it is: the result of excess carbohydrates, or what I call "Carbohydrate Intolerance Syndrome."

The misinterpretation of this condition has created 1) an epidemic of diabetes and pre-diabetes, 2) a nation of frustrated obese Americans, 3) a $27 billion per year statin industry, 4) another growth opportunity for the drug industry in diabetes drugs.

Wheat Belly Revisited

23. March 2009 William Davis (24)
Do you have a wheat belly?

When I first coined this phrase back in July, 2007, I had witnessed the phenomenal health effects of wheat elimination in several hundred patients.

In the nearly two years that have passed since my original post, I have witnessed hundreds more people who have done the same: eliminate pretzels, crackers, breads of all sorts, bagels, pasta, muffins, waffles, pancakes, etc.

If anything, I am convinced now more than ever that wheat is among the most destructive foods in the human diet. At least 70% of people who eliminate wheat from their diet obtain at least one, if not several, substantial health benefits.

Now, if I were trying to sell you something, say, an alternative to wheat, then you should be skeptical. If I tell you that drug or nutritional supplement X is great and you should take it, only to follow it with a sales pitch, you should be skeptical.

What am I selling? Nothing. I gain nothing by telling everyone to avoid wheat. In fact, I wish it wasn't true. Wheat foods taste good. Wheat flour makes great comfort foods. In years past, I spent many hours sitting at the bagel shop reviewing papers over a cup of coffee and a bagel. No longer.

So here, back by popular demand, the original Wheat Belly post:



Wheat Belly

You've heard of "beer bellies," the protuberant, sagging abdomen of someone who drinks excessive quantities of beer.

How about "wheat belly"?

That's the same protuberant, sagging abdomen that develops when you overindulge in processed wheat products like pretzels, crackers, breads, waffles, pancakes, breakfast cereals and pasta.



(By the way, this image, borrowed from the wonderful people at Wikipedia, is that of a teenager, who supplied a photo of himself.)

It represents the excessive visceral fat that laces the intestines and triggers a drop in HDL, rise in triglycerides, inflames small LDL particles, C-reactive protein, raises blood sugar, raises blood pressure, creates poor insulin responsiveness, etc.

How common is it? Just look around you and you'll quickly recognize it in dozens or hundreds of people in the next few minutes. It's everywhere.

Wheat bellies are created and propagated by the sea of mis-information that is delivered to your door every day by food manufacturers. It's the same campaign of mis-information that caused the wife of a patient of mine who was in the hospital (one of my rare hospitalizations) to balk in disbelief when I told her that her husband's 18 lb weight gain over the past 6 months was due to the Shredded Wheat Cereal for breakfast, turkey sandwiches for lunch, and whole wheat pasta for dinner.

"But that's what they told us to eat after Dan left the hospital after his last stent!"

Dan, at 260 lbs with a typical wheat belly, had small LDL, low HDL, high triglycerides, etc.

I hold the food companies responsible for this state of affairs, selling foods that are clearly causing enormous weight gain nationwide. Unfortunately, the idiocy that emits from Nabisco, Kraft, and Post (AKA Philip Morris); General Mills; Kelloggs; and their kind is aided and abetted by organizations like the American Heart Association, with the AHA stamp of approval on Cocoa Puffs, Cookie Crisp Cereal, and Berry Kix; and the American Diabetes Association, whose number one corporate sponsor is Cadbury Schweppes, the biggest soft drink and candy manufacturer in the world.

As I've said many times before, if you don't believe it, try this experiment: Eliminate all forms of wheat for a 4 week period--no breakfast cereals, no breads of any sort, no pasta, no crackers, no pretzels, etc. Instead, increase your vegetables, healthy oils, lean proteins (raw nuts, seeds, lean red meats, chicken, fish, turkey, eggs, Egg Beaters, low-fat yogurt and cottage cheese), fruits. Of course, avoid fruit drinks, candy, and other garbage foods, even if they're wheat-free.

Most people will report that a cloud has been lifted from their brains. Thinking is clearer, you have more energy, you don't poop out in the afternoon, you sleep more deeply, some rashes disappear. You will also notice that hunger ratchets down substantially. Most people lose the insatiable hunger pangs that occur 2-3 hours after a wheat-containing meal. Instead, hunger is a soft signal that gently prods you that it's time to consider eating again.

You will also make considerable gains towards gaining control over your risk for heart disease and your heart scan score, a crucial step in the Track Your Plaque program.

Thank you, Crestor

20. March 2009 William Davis (9)
I'm sure everyone by now has seen the Crestor ads run by drugmaker, AstraZeneca. TV ads, magazine ads, and the Crestor website all echoing the same message:

"While I was busy building my life, something else was busy building in my arteries: dangerous plaque."

While previous drug trials with Mevacor, Pravachol, Zocor, and Lipitor have focused mostly on examining whether the drugs reduced incidence of cardiovascular events, Crestor studies have also focused on effects on atherosclerotic plaque volume. The best example is the ASTEROID trial that demonstrated approximately 7% reduction in plaque volume by intracoronary ultrasound.

So the AstraZeneca decision makers took the leap from cholesterol reduction to plaque reduction.

I'm sure this switch wasn't taken lightly, but was the topic of discussion at many meetings before the decision to make plaque reduction the focus of hundreds of millions of dollars of advertising. After all, billions of dollars are at stake in this bloated statin market.

Ordinarily, I couldn't care less about how the drug manufacturers conduct their advertising campaigns. But this one I paid attention to because the Crestor ads are helping fuel a new way of thinking about coronary heart disease: It's not about the cholesterol; it's about the atherosclerotic plaque that accumulates in arteries.

It's not cholesterol that grows, limits coronary blood flow, and causes angina. It's not cholesterol that "ruptures" its internal contents to the surface within the interior of the blood vessel and causes blood clot and heart attack. It's not cholesterol that fragments from the carotid arteries and showers debris to the brain, causing stroke. It's all plaque.

I took the same leap years ago, though not backed by hundreds of millions of dollars of marketing money. When I first called my book Track Your Plaque, some of the feedback I got from editors included comments like "I thought this was a book about teeth!" Even now, the word "plaque" in the book title and website is responsible for confusion.

But AstraZeneca is helping me clear up the confusion. As the word plaque gains hold in public consciousness, it will become increasingly clear that cholesterol reduction is not what we're after. We are looking for reduction of plaque.

If you are trying to develop an effective means to reduce or reverse coronary heart disease, then there are two simple equations to keep in mind:


Plaque = coronary heart disease

Cholesterol ? coronary heart disease


Plaque is the disease, cholesterol is not. Cholesterol is simply a crude risk for plaque.

While I'm no friend to the drug industry nor to AstraZeneca, some good will come of their efforts.

Supermarkets and buggy whips

17. March 2009 William Davis (17)
Will supermarkets eventually phase out, joining the history books as a phenomenon of the past? Or are supermarkets here to stay, an emblem of the industrialization of our food--easy access to foods that are convenient, suit the undiscriminating masses, stripped of nutritional value despite the prominent health claim on the package front?

Anna left an insightful comment on the last Heart Scan Blog post, Sterols should be outlawed, along with some useful advice on how to avoid this trap for poor health called a supermarket:


I rarely shop in regular supermarkets anymore (farm subscription for veggies, meat bought in bulk for the freezer, eggs from a local individual, fish from a fish market, freshly roasted coffee from a local coffee place, etc.). What little else I need comes from quirky Trader Joe's (dark chocolate!), the fish market, farmer's markets, a small natural foods store, or mail order.

When I do need to go into one of the many huge supermarkets near me, not being a regular shopper there, I never know where anything is, so I have to ramble a bit around the aisles before I find what I'm looking for (and I almost always can grab a hand basket, instead of a trolley cart).

It's almost like being on another planet! There's always so many new products (most of them I hesitate to even call food). It's really a shock to the senses now to see how much stuff supermarkets sell that I wouldn't even pick up to read the label, let alone put in a cart or want to taste. I'm not even tempted by 99% of the tasting samples handed out by the sweet senior ladies in at Costco anymore (only thing I remember tasting at Costco in at least 6 mos was the Kerrygold Irish cheese, because I know their cows have pasture access and it's real food).

What's really shocking to me is how large some sections of the markets have become in recent years. While Americans got larger, so did some sections of the supermarket (hint - good idea to limit the consumption of products from those areas). Meat and seafood counters have shrunk, though. Produce areas seem to be about the same size as always (but more of it is pre-prepped and RTE in packaging.

But the chilled juice section is h-u-g-e! And no, I don't think there is a Florida orange grove behind the cases. Come on, how much juice do people need? Juice glasses used to be teeny tiny, for a good reason. To me it looks like a long wall stocked full of sugar water. Avoiding that section will put a nice dent in the grocery expenses.

The yogurt case is also e-n-o-r-m-o-u-s! Your 115 yo Bulgarian "grandmother" wouldn't know what to make of all these "pseudo-yogurts"! Chock full of every possible variety, but very little fit to eat. The only yogurts I'll look at are made with plain whole milk, without added gums, emulsifiers, or non-fat milk solids, and live cultures (I mostly buy yogurt now and then to refresh my starter culture at home). I can flavor them at home if needed. The sterols are showing up in processed yogurts, too, along with patented new strains of probiotic cultures (I'll stick to my old fashioned, but time-proven homemade lacto-cultured veggies and yogurt instead).

I found the same "cooler spread" in the butter & "spread" section. The spread options were just grotesque sounding. Actually, the butter options weren't much better, as many were blended with other ingredients to increase spreadability, reduce calories or cholesterol/saturated fat, etc. A few plain butters were enhanced with "butter flavor" - say what? And on no package could it be determined if the butter came from cows that were naturally fed on pasture or on grain in confined pens.


Well said, Anna.

There's a huge supermarket about 1 mile away from my house similar to the one Anna describes with aisle after aisle of eye-catching cellophane-wrapped foods. I go there about every 3 or 4 months, and then I only go to get something I need in a pinch. Every time I go, I too am reminded just how many products there are that look more like junk food than real food.

But there's no real money in real food. Who gets rich off of selling green peppers, tomatoes, and eggs?

Supermarkets sell these modern industrial foods because people buy it: Look around you. You don't get to be a 250 lb 5 ft 2 inch-woman by eating too many cucumbers.

Like Anna, I drive an additional several miles to Trader Joes', buy at farmers' markets whenever possible, buy some odds and ends like wine and cheese and raw nuts at specialty stores. I grow my own basil in a big pot I keep in the kitchen and we are just about to start turning over the soil in the back yard for our vegetable garden. I don't need nor do I miss having the choice among 40 different chips, 25 brands of ready-made microwavable dinners, an entire aisle of breakfast cereasl (all of which are virtually the same with different names and labels), or 75 varieties of salad dressing.

The supermarket for me--and I hope for many of you--has become a place rarely frequented, and only for the odd forgotten item. Oh, I forgot the dog chewies the grocery does have--my dogs love them. So perhaps they are good for something after all.

Sterols should be outlawed

14. March 2009 William Davis (10)
While sterols occur naturally in small quantities in food (nuts, vegetables, oils), food manufacturers are adding them to processed foods in order to earn a "heart healthy" claim.

The FDA approved a cholesterol-reducing indication for sterols , the American Heart Association recommends 200 mg per day as part of its Therapeutic Lifestyle Change diet, and WebMD gushes about the LDL-reducing benefits of sterols added to foods.


Sterols--the same substance that, when absorbed to high levels into the blood in a genetic disorder called "sitosterolemia"--causes extravagant atherosclerosis in young people.

The case against sterols, studies documenting its coronary disease- and valve disease-promoting effects, is building:

Higher blood levels of sterols increase cardiovascular events:
Plasma sitosterol elevations are associated with an increased incidence of coronary events in men: results of a nested case-control analysis of the Prospective Cardiovascular Münster (PROCAM) study.

Sterols can be recovered from diseased aortic valves:
Accumulation of cholesterol precursors and plant sterols in human stenotic aortic valves.

Sterols are incorporated into carotid atherosclerotic plaque:
Plant sterols in serum and in atherosclerotic plaques of patients undergoing carotid endarterectomy.




Though the data are mixed:

Moderately elevated plant sterol levels are associated with reduced cardiovascular risk--the LASA study.

No association between plasma levels of plant sterols and atherosclerosis in mice and men.




The food industry has vigorously pursued the sterol-as-heart-healthy strategy, based on studies conclusively demonstrating LDL-reducing effects. But do sterols that gain entry into the blood increase atherosclerosis regardless of LDL reduction? That's the huge unanswered question.

Despite the uncertainties, the list of sterol-supplemented foods is expanding rapidly:




Each Nature Valley Healthy Heart Bar contains 400 mg sterols.












HeartWise orange juice contains 1000 mg sterols per 8 oz serving.













Promise SuperShots contains 400 mg sterols per container.














Corozonas has an entire line of chips that contain added sterols, 400 mg per 1 oz serving.














MonaVie Acai juice, "Pulse," contains 400 mg sterols per 2 oz serving.














Kardea olive oil has 500 mg sterols per 14 gram serving.










WebMD has a table that they say can help you choose "foods" that are sterol-rich.

In my view, sterols should not have been approved without more extensive safety data. Just as Vioxx's potential for increasing heart attack did not become apparent until after FDA approval and widespread use, I fear the same may be ahead for sterols: dissemination throughout the processed food supply, people using large, unnatural quantities from multiple products, eventually . . . increased heart attacks, strokes, aortic valve disease.

Until there is clarification on this issue, I would urge everyone to avoid sterol-added "heart healthy" products.


Some more info on sterols in a previous Heart Scan Blog post: Are sterols the new trans fat? .

Texas today, tomorrow . . . the world?

10. March 2009 William Davis (0)
Texas state representative, Rene Oliveira, has introduced legislation that mandates heart scans for adults in the state of Texas.

Rep. Oliveira

A press release from the SHAPE Society ( Society for Heart Attack Prevention and Eradication) reads:

Assessment of heart attack risk on the basis of traditional risk factors alone such as high cholesterol and high blood pressure and so forth, while useful, misses many who are at high risk and also incorrectly flags some for high risk who are in fact at very low risk of near term heart attack; on the other hand detection of atherosclerosis by non-invasive imaging, as suggested by the SHAPE group, accurately identifies plaque and improves the ability to identify at-risk individuals who could benefit from aggressive preventive intervention while sparing low-risk subjects from unnecessary aggressive medical therapy," said Dr. P.K. Shah, Director of Cardiology at Cedars Sinai Heart Institute in Los Angeles, a leading member of the SHAPE Task Force who is also an active member of the American Heart Association. "Sadly, these vulnerable patients go undetected until struck by a heart attack, because insurance companies don't cover the newer heart attack screening imaging tests."


Rep. Oliveira, whose coronary disease was first uncovered by a heart scan and prompted a bypass operation, states:

"It is about time that we cover preventive screening for the number one killer in Texas, and take action to reduce healthcare costs through preventive healthcare. Right now, we are extending the lives of those who can afford the procedure while hundreds of thousands of Texans with hidden heart disease go undetected because of antiquated thinking. The time has come for this change."


Is this what we've come to? Since practicing physicians are either so entranced by the drug and procedural solutions to heart disease, do we need to resort to heart scan by legislation?

It does indeed appear that we've come to this point. Should this trend catch on, it will surely mean an upfront increase in healthcare costs to cover the expense of heart scans. But in the long run, it will mean reduction in healthcare costs--dramatic reduction--if heart scans prompt effective preventive action.

What your doctor doesn't know about heart disease

9. March 2009 William Davis (12)
What causes coronary heart disease or coronary atherosclerotic plaque, this thing that we track with heart scans?

Well, here are a few little-publicized facts about heart disease that you are unlikely to hear from your When's-the-next-stent? cardiologist or the What is there besides statins? primary care doctor.

(Since everybody knows that smoking is a modifiable risk for heart disease that can be readily identified, let's focus on the blood tests that reveal heart disease causes.)


What's the number one most common cause for heart disease?

Small LDL particles. The proliferation and popularity of the snack food/processed food culture, compounded with the "eat more healthy whole grain " propaganda has launched small LDL solidly to first place as the most common reason to have heart attacks, stents, and bypass. All that advice to increase your "healthy whole grain" intake? It increases heart attack risk.


What's the number one most aggressive cause for heart disease?

That's lipoprotein(a), or Lp(a). It's certainly not high cholesterol, though the drug industry loves that you think that. We could argue over whether smoking is more aggressive, but the two are pretty darned close. Combine the two--Lp(a) in a smoker--and the combination is an explosively powerful trigger for heart disease and stroke.


What's the number two cause for heart disease?

After small LDL comes low HDL cholesterol. Ask anyone who has had a heart attack: What was your cholesterol panel like? 9 out of 10 will say "My LDL cholesterol was 135 mg/dl" while knowing little or nothing about HDL, which is commonly in the 30-42 mg/dl range--sufficient to contribute to heart disease risk considerably.


Can "normal" thyroid hormone tests still contribute to heart disease?

Yes. Hypothyroidism is an exceptionally powerful risk factor for heart disease. Many people have been told that their thyroid tests are "normal," when in reality risk for heart disease may be as much as tripled from low thyroid with thyroid blood tests in the "normal" range.


Does a "balanced, healthy diet" prevent heart disease?

No, it does not. In fact, the modern notion of a "balanced, healthy diet" increases risk for heart disease. Of course, the dangers of such diets vary, depending on how you define it. If it's the diet advocated by the USDA Food Pyramid, then it is an enormously destructive diet that causes your health to careen towards both diabetes and heart disease. The American Heart Association TLC diet is little better.


Does eating fish twice a month reduce heart attack risk?

Yes, it does--but just barely. Unfortunately, large studies that show that eating fish as infrequently as twice per month reduce risk for dying from heart attack have led some authorities to suggest that's all you need to do. What they fail to understand is that the benefit is dose-dependent--the greater the intake of omega-3 fatty acids, the greater the benefit (within reason, of course). So, while the effect can be detected by eating fish twice per month, it doesn't mean that full benefits are achieved with this "dose." Full benefits are obtained by mimicking the omega-3 intake of the Japanese.


Do nutritional supplements reduce risk for heart attack?

If you are referring to vitamin D, then, yes, nutritional supplements reduce risk for heart attack . . . enormously. We need more data to validate this phenomenon, though epidemiologic observations strongly bear this out, including the Health Professionals Follow-up Study, the Framingham Heart Study and NHANES, all of which demonstrate a graded effect: the lower the vitamin D blood level, the greater the risk for heart attack.

Over the years, we've experienced more than our share of disappointments in nutritional supplements for heart disease, including vitamin E and B vitamins to reduce homocysteine. But I believe that nothing approaches the solid feel of vitamin D--no other nutritional supplement raises HDL, reduces triglycerides, reduces blood sugar, enhances insulin responses, reduces the inflammatory C-reactive protein, reduces blood pressure like vitamin D. Vitamin D is here to stay--and I'm very grateful.

And don't forget omega-3 fatty acids from fish oil, yet another supplement with unquestioned benefits for reduction of heart attack and death from heart attack.


Why didn't your doctor counsel you on the importance of these issues?

The primary reasons your doctor didn't tell you any of the above:

1) He/she has been persuaded that only drugs are of any real use in health. Nutritional supplements? Hah!

2) Neither the number one cause of heart disease in the U.S.--small LDL particles--nor the most aggressive cause for heart disease--Lp(a)--are corrected by patent-protectable, high profit pharmaceutical agents promoted to your doctor. Instead, these abnormalities can be corrected inexpensively, without prescription. That means no expensive commercials, no media spots, no write-ups in magazines.

3) Your doctor's business is to treat crisis: sore throat, broken ankle, lung tumor, heart attack. Prevent heart disease 10 or 20 years before it shows itself? Heck, no (unless the marketing pull of the drug industry is involved, of course).


It's best that you bear in mind: What your doctor doesn't know can kill you.

Thank you, Dr. Eades

6. March 2009 William Davis (7)

Thanks to some readers of The Heart Scan Blog, I've become acquainted with Dr. Michael Eades' wonderful blog, Health and Nutrition by Dr. Michael R. Eades, MD.

Dr. Eades is co-author (with his wife, Mary Dan Eades, MD) of Protein Power

In one of his conversations, I stumbled on this exchange between Dr. Eades and one of his readers:



Reader: Regarding EBT scans, I looked up the topic on Google and read an informative 5-page article: EBT (Ultrafast CT) Scans - Godsend, or Scam? Dr. Fogoros says that false positives (where the EBT shows the presence of calcium, but the patient has little coronary artery blockage) occur about 50 percent of the time. The next step, if the EBT is positive, is to do a heart catherterization to find out whether there actually is coronary artery blockage. So the odds are that I’d have to worry!

Dr. Michael Eades: The info you got from Google is one of the reasons one shouldn’t get medical information online. As far as I’m concerned the EBT is the BEST way to determine the presence of plaque. If you have a positive calcium score, you have plaque, and there’s an end on’t (as Samuel Johnson would say). Now you may have a low calcium score for your age or you may have a calcium score that doesn’t change, which means you have stable plaque, but if you have a positive calcium score, you have some amount of plaque in your coronary arteries.

And whoever says that the next step to take if you receive a positive calcium score is a coronary artery cath is a real moron. That’s probably the last thing you would want to do if you are asymptomatic. All the cath procedure does is shows whether or not you have a blockage - you can have huge amounts of plaque (which are a disaster waiting to happen) and have a normal cardiac cath.

If you want to get a little more information on the validity of EBT than what you find on Google, take a look at Dr. Davis’ blog or get a copy of his book: Track Your Plaque. I’m not crazy about all of Dr. Davis’ dietary recommendations because he comes to diet from a different perspective than I, but the EBT info in his book is terrific.

Cheers–

Dr. Eades "gets" it. He understands that quantification of coronary plaque is a tool for prevention, not something to be subverted into the service of procedures for the financial benefit of my colleagues.

And I think that he is absolutely correct on the diet discussed in Track Your Plaque--it's due for a revision. I wrote the book in 2003, while we were still locked into the low-fat mindset. Much has changed.

Since then, our enormous experience in metabolic manipulation and lipoprotein analysis has shown that there is a far better way to correct the causes of coronary plaque and seizing hold of heart scan scores. In particular, the explosion of small LDL has prompted major changes in the diet, specifically removal of wheat and cornstarch, the foods that trigger small LDL particles.

(I am still in the midst of negotiations for release of a bigger and better Track Your Plaque II. In the meantime, Track Your Plaque Members can refer to the New Track Your Plaque Diet, Parts I, II, and III.)

Can millet make you diabetic?

5. March 2009 William Davis (10)















If wheat is so bad, what about all the other grains?

First of all, I demonize wheat because of its top-of-the-list role in triggering:

--Appetite--Wheat increases hunger dramatically
--Insulin
--Blood sugar--Wheat is worse than table sugar in triggering a rapid, large rise in blood sugar
--Triglycerides
--Small LDL particles--the number one cause for heart disease in the U.S.
--Reduced HDL
--Diabetes
--Autoimmune diseases--Most notably celiac disease and thyroiditis.

Most other "healthy, whole grains" aren't quite as bad. It's a matter of degree.

Millet, quinoa, oats, sorghum, bulghur, spelt, barley, cornmeal--While they don't trigger appetite nor autoimmune diseases like wheat does (oat can in some people), they still pose a significant carbohydrate load sufficient to generate the other phenomena like excessive insulin and blood sugar responses. The grams of carbohydrate of these grains are virtually identical to wheat: 43.5 grams per 1/2 cup (uncooked). The exceptions are barley, which is especially loaded with carbohydrates: 104 grams per 1/2 cup, while oats are lower: 33 g per 1/2 cup.

It's all a matter of degree. Some people who are exceptionally carbohydrate-sensitive (like me) can have diabetic blood sugars with just slow-cooked oatmeal or quinoa. Others aren't quite so sensitive and can get away with eating them.

People with high blood sugars (100 mg/dl or greater) can be very sensitive to the blood sugar effects of these grain carbohydrates. The best marker of all are small LDL particles measured on a lipoprotein panel, such as NMR. Small LDL particles are exquisitely sensitive to your carbohydrate intake: small LDL gets worse with excessive sensitivity to grain carbohydrates, gets better with reduction or elimination.

Flagrant small LDL, in combination with low HDL, high triglycerides, and pre-diabetic or diabetic patterns all develop from carbohydrate indulgence, along with "wheat belly."

Don't believe it? The prove it to yourself: Go to Walmart and buy an inexpensive glucose meter and check your blood sugar one hour after eating. You can gauge the health of these foods by observing the blood sugar increases. (Small LDL closely parallels blood sugar rises.)

The grain that fails to trigger any of these abnormal patterns? Flaxseed. Flaxseed is entirely protein, fiber, and healthy oils, with virtually no digestible starches. In fact, flaxseed is one of the few foods that reduces the quantity of small LDL particles.

Are you a tree?

5. March 2009 William Davis (6)
I assume you answered no. Then why would you consider taking the plant form of vitamin D (ergocalciferol)? That's the prescription form of vitamin D, often dispensed as 50,000 unit tablets.

There's nothing wrong with plants. Some of my favorite foods are plants, full of nutritional value.

Then why shouldn't vitamin D2 from plants be every bit as good as the human form of vitamin D?

I believe the issue boils down to taking hormones from non-human sources. (Remember: Vitamin D is a hormone, a very powerful one at that.) Plants can be wonderful sources of flavonoids, fibers, protein, fats, vitamins, minerals, and other healthy components. But hormones?

There are other examples of non-human hormones being given to humans with undesirable or unpredictable effects:

--Xenoestrogens, phytoestrogens, and non-human mammalian estrogens--While non-human estrogens may partially mimic human estrogens, they can also block estrogen effects, or exert altogether novel effects. Non-human mammalian estrogens like Premarin can exert very peculiar (side-)effects, despite their role as prescription estrogen supplementation in humans.

--Progestins--The synthetic versions of human progesterone, like their non-human estrogen counterparts, exert weird effects that are a world apart from real progesterone.

--Sterols--Similar in structure to human cholesterol (while not a hormone, a building block for hormones), sterols have been used to reduce intestinal cholesterol absorption. However, if sterols are absorbed into the blood, they can enormously accelerate growth of atherosclerotic plaque.

--Anabolic steroids--These modifications of the testosterone molecule build muscle, but also cause liver cancer, kidney failure, violent behavior, suicide and homicidal behavior. That's not normal.

Outside of a pharmacologic effect (e.g., prednisone in place of human cortisol), there is no reason to take a non-human hormone in place of a human hormone. For that same reason, there is NO reason to take plant vitamin D2 (prescription or over-the-counter) in place of human vitamin D3.

If the non-human hormone is identical to the human form, then there is no difficulty. The best example of this are thyroid hormones from pigs. That's what Armour Thyroid is, a thyroid hormone replacement that works wonderfully well.

You will notice that virtually all of the examples of non-human hormones substituted for human hormones share one common motivation: profit. Synthetic or modified versions are more readily patent-protectable, unlike their natural counterparts which are not.

Vitamin D2 is an anemic facsimile of the real human hormone, vitamin D3 (cholecalciferol). Stay away from it.