Are Your Cosmetics Safe?

11. June 2014 Dawn D (0)

If you are reading The Cureality blog chances are you care about your health. You care about what you eat. You want to remain healthy, free of disease, feel good and possibly even want to look and feel as vibrant as you were when you were 20. Many of us think of food all day long. Many of us love to eat. We plant gardens so we know our food is free of pesticides and other toxic chemicals. Food can be a cause of disease and it can minimize our chances of disease. We try and take care of our insides but did you ever wonder what in the world you apply to your skin on a daily basis? What do these products contain and are they safe? Why are there more endocrine disorders popping up. Could it be that some of things we apply to our skin every single day may be harmful to our insides?

A portion of the skin health section of Cureality will take a look at skincare products and cosmetics. Are the products we apply to our skin gluten-free, paraben-free and free of other harsh chemicals that can cause skin irritations and possible other unwanted diseases. I came across Mirabella cosmetics and I wanted to learn more about this particular product line so I tracked down John Maly, founder and CEO of Mirabella Cosmetics. Mr. Maly was gracious enough to take time out and answer my questions.This is what Mr. Maly has to say about Mirabella:

DD: Tell us about some key features about Mirabella, gluten-free cosmetics. What made you get started in a gluten-free line?

JM: We didn't start as gluten-free. Over time we have continued to make our line more beautiful AND more healthy for women. First we began with a mineral foundation. Then as we introduced new products, we made sure they were as clean and healthy, while still being fashion forward. We saw the benefits to our clients to take out those ingredients that didn't help them look and feel their best such as glutens, parabens and talcs.

DD: Some cosmetic companies carry partially gluten-free cosmetics. Are all of Mirabella products gluten-free, paraben-free and talc-free?

JM: Everything is paraben-free and talc free. And our brand is all gluten-free except our Skin Tint Creme foundation. That is a product that women love and we just cannot make the formula without a wheat protein to perform as well...yet! We will continue to work on it!

DD: Are there other ingredients in cosmetics that women should be cautious of using if they have skin sensitivities or allergies?

JM: Some women are sensitive to fragrance as well.This is another thing that we avoid with our brand. The biggest ingredients that women find that helps with their skin health is mineral products. They are natural and very breathable on a woman's skin.

DD: I think your velvet lip pencils are by far the most extraordinary lip pencil on the market. What are some of your other standout products your customers love?

JM: Pure Press Mineral Foundation is still our #1product. But the fastest growing product is Magic Marker Eyeliner. It is easy to use, doesn't smudge and lasts all day.

DD: Anything new on the horizon for Mirabella that you can share with us?

JM: In August we launch CC crème. This product has all the good for you ingredients to help with Anti-Aging like avocado oil, argan oil and Acai (Assai) berry. Plus it is a mineral formula, gluten-free, and paraben-free. And it has an SPF of 20. One of the biggest issues that women have with aging is lips. That is why we put Litchi Chinesis Fruit Extract in our Colour Vinyl lipstick. Then in your favorite Velvet Lip Pencil, we put Pomegranate Extract, Vitamin C and E in to assist with in Anti-Aging.

DD: Is Mirabella only sold in the US or do you have international distribution as well.

JM: We are sold in Canada, Australia, Finland and Russia.

DD: Where can we purchase your cosmetics?

JM: Our products are available at www.mirabellabeauty.com and at over 1,500 of the finest salons and spas. Go to our salon locator to find a retailer near you.

Keeping Up with the Kids

5. June 2014 Amber B (0)

On Saturday my husband and I took our niece Anna out her annual birthday date. That date started with a trip to the Humboldt park playground. As with most kids, Anna ran straight to the spider-web jungle gym which I have to admit it looked pretty cool. Just before she began to climb up, she turned to look at me and said “Auntie Amber, climb up too!”

I was not wearing my playground apparel on Saturday. I had a cute pair of pink loafers on, skinny jeans, tank and a jean jacket. But it did look like fun so I decided to climb. No problems yet. I was good to go climbing around on the ropey, spider web apparatus. But of course, just climbing around was not enough. Anna suggested that we should race. Not just to the top, but to the top of the jungle gym over the side, across the rope bridge and down the slide. This is when my skill was put to the test.

As you could have guessed, Anna smoked me during our race. Not only that, but the jean jacket was off and I was working up a sweat. Was I getting a workout from my 9-year-old niece? I think so. But we both were having so much fun. We continued to climb up and down the fake rock wall, monkey bars and run around the playground. It was a blast.

But as I looked around the playground, I was the only adult climbing around the playground and playing. The other adults were sitting on park benches watching. One parent near by had to decline the request of a child they were with to join them on the playground equipment. I felt really good that I could be there with my niece running around, climbing and swinging.

Keeping up with our kids, grandkids, nieces and nephews is really important as we age. Otherwise we sit on the sidelines. How do you train for the playground? Get in the weight room. Lift heavy things, jump, pull yourself up, move side ways, and challenge your body to do movements beside sitting or standing. If it’s been awhile or you’re just not sure where to start then get a trainer and join some group workouts.

It’s time to get moving. Because it starts out at the playground now but soon it will be mud runs, Frisbee, triathlons and weekend football games. You need to keep up!

4 Tips to Boost Kids Veggie Intake

3. June 2014 Lisa G (0)

Vegetables are arguably the most important food group, the key to any healthy diet. They are one of the most nutrient dense food groups and serve the foundation to healthy meals and snacks. A frequent comment from people enjoying the Cureality way of eating is, “I am eating more vegetables than I ever have in my life!”

This is great because plentiful consumption is associated with decreased heart disease, reduced weight, lower blood pressure, glowing skin and decreased risk of some cancers. However, perhaps you’re reading this and feeling great that you eat your veggies but struggle to get your kids to do the same. If you are a parent, who is simply trying to provide nutritious options to your kids, give these tips a try.

1. Add cheese or butter to enhance flavor and increase the absorption of fat soluble vitamins A, D, E and K. Younger kids like to dip foods, so often pairing with a dip, such as hummus, can increase intake.

2. Try the “rule of 15” — putting a food on the table at least 15 times to see if a child will accept it. Don’t give up after a few attempts. This can indeed be frustrating, but have patience and continue to offer a small portion to expose children to veggies without forcing intake. Often parents feel like it’s their job to just make their children eat something. I suspect most children will always select apple pie over an apple. It is important to set the stage, at an early age, with what is offered. In addition, being a good food model is important. You can’t expect your child to try broccoli, if you make negative comments about its taste, texture or smell.

3. Once a food is accepted, parents should use “food bridges,” finding similarly colored or flavored foods to expand the variety of foods a child will eat. If a child likes pumpkin pie, for instance, try mashed sweet potatoes and then mashed carrots. If a child loves corn, try mixing in a few peas or carrots. Even if a child picks them out, the exposure to the new food is what counts.

4. Allow children to engage, as able. When grocery shopping or offering a snack, ask your child which option they would like to eat (e.g. ask which healthy foods they would prefer, blueberries or strawberries, cucumbers or carrots, etc.). When children are included in more food decisions it can decrease resistance. Include children in age appropriate preparation, as well, for example cutting produce, making a vegetable soup, or selecting produce at the grocery store.

Lisa Grudzielanek, MS, RDN, CD, CDE
Cureality Nutrition Coach

When is the Best Time of Day to Workout?

2. June 2014 Amber B (0)

There are various theories about the best time of day to workout. At the personal training studio I own, training sessions start as early as 5:45am and the latest sessions start at 8pm. We have people that get up early and get their workout done first thing in the morning. We also have other people that get it done after work to release the stress of the day.

So which group is getting the better workout?

If you’re an early bird or have too many evening commitments then a morning workout is ideal for you. Here are some benefits to training in the morning.

1. Very few things can get in the way when you workout in the morning. (Except for the snooze button.) Later in the day extra phone calls, meetings and tasks can get in the way of getting your workout done.

2. After a strength or interval training session, your metabolism is elevated for hours after your workout. Enjoy these post exercise benefits while you are awake and active instead of when you are at rest.

3. Exercise will boost your energy. Use the momentum from a morning workout to arrive at work energized, present and focused instead of feeling sluggish because you just got out of bed.

4. Exercise on an empty stomach before breakfast is a great way to burn more body fat. Upon waking, the body is in a fasted state. Without ready available glucose in the bloodstream, the body is forced to use fat as an available fuel source for the workout.

However, some of us need our sleep or need to burn off the steam of a hectic workday. Here are some of the benefits of working out in the evening.

1. Getting enough sleep is crucial for health and recovery. If you have to skimp on regular sleep to get up for an early workout, the benefits of the workout start to diminish.

2. Instead of taking that stress of work home, you hit the gym after work. Even after the worst workdays, exercise will boost your mood. Friends and family will be grateful that you get your workouts (aka therapy session) completed.

3. Often people feel stronger when they workout in the evenings. When performing strength tests people tend to lift heavier during evening workouts. This could be due to the fact that they are more awake or that they have food fuel to utilize during their exercise session.

4. Research shows that you can build more muscle with evening workouts because cortisol levels are lowest in the evening. The result of this will be a higher testosterone to cortisol ratio leading to a less catabolic workout.

So which time of day comes out on top for the best workout time? In my opinion, it’s the time that you can do consistently. It’s the time that works best with your natural energy rhythms, work schedule, and family commitments.

Experiment working out at different times to see what works best for you. When you find the right fit, schedule your workouts on your calendar to build the exercise habit.

What is Cureality all about?

27. May 2014 William Davis (1)

“Looking over your medical record, Nancy, I’m a bit concerned about your risk for osteoporosis and hip fracture. It looks like your mom had a hip fracture at age 67. Is that right? ”

“Yes, she did,” Nancy responded. “And her life was never quite the same for the 15 years she lived after that.

“You’re 53 year old. Bone thinning develops over many years. Let’s get you scheduled for a bone scan.”

Two weeks later:

“Your z-score is 1.5, Nancy. This means you’ve got a mild form of osteoporosis called ‘osteopenia.’ Here: This is a prescription for alendronate, what used to be called Fosamax.”

“Aren’t there side-effects with that drug? A friend of mine said that her mom had a leg fracture from it.”

“Well, yes. All prescription drugs have potential side-effects. They’re rare, but they can happen and we can’t predict it. Besides leg fracture, there’s something called jaw osteonecrosis in which the jawbone dies and has to be surgically replaced. But would you rather run the risk of a hip fracture?”

“Before we jump to drugs, aren’t there natural things I could do first?”

(Big sigh.) “You can take calcium, but that only helps a bit. You’ve got to make a choice: Take the drug or risk a hip fracture.”

“I’m going to explore some natural remedies on my own first.”

Nancy’s dialogue with her doctor is fictional but based on similar encounters that occur thousands of times every day nationwide. Identify a problem, prescribe a drug. Natural remedies? “They don’t work.” “I don’t know anything about that.” “None of that is proven.” “I only practice evidence-based medicine.” You’ve probably heard a few of these explanations yourself if you ever question the wisdom of conventional medical care.

Each of Nancy’s fictitious interactions were no more 10 minutes long. If she is like most people, she will have one or two such interactions over the course of a year, unless she develops some acute illness. So she’s got something like 20-30 minutes per year to compress all of her “health” advice into the time allotted. 20-30 minutes per year to discuss bone health, nutrition, blood sugar issues, cholesterol issues, blood pressure, female issues, and all the other facets of health. Perhaps she has developed some chronic gastrointestinal complaints, too, and an odd rash on her elbows, maybe headaches a few times per week that she didn’t have before. Regardless, she’s going to have to make do with those few minutes, likely receiving one or more prescriptions or imaging procedures for each.

Such is the nature of modern healthcare: Provide the minimum interaction, address only a few, perhaps no more than one, problem, then prescribe a drug. This is, more often than not, wrong. Plain wrong. Tragically, awfully, unethically, unnecessarily wrong.

Let’s pick up again with Nancy. Upon learning of her osteopenia and long-term risk for hip fractures of the sort that changed her mom’s life and health irretrievably, Nancy started searching for solutions. Not only did she discover that, yes, there are indeed a number of safe and effective ways to deal with osteopenia. She also learned that such strategies have even been examined in clinical trials, some of the strategies pitted head-to-head with drugs and performed on a par, sometimes better, than prescription drugs. She also found that there are online communities that she could join and discuss her health situation with people all sharing the same health interests. During one such interaction at the start of her effort, when she was still a bit unsure and tentative, a woman she didn’t know but who shared a similar interest in restoring bone health, commented to Nancy, “Don’t sweat it, Nancy. I was in your shoes a little over a year ago. I followed a program for bone health: vitamin D, vitamin K2, magnesium, I made sure that I included leafy green vegetables at least once or twice per day, and I added strength training for a few minutes twice per week. I started with osteoporosis. My most recent bone density test showed that I reversed it completely—it’s entirely normal! So hang in there and be sure to share your questions and concerns with us here.”

THAT is what Cureality is all about. Cureality fills the gap of knowledge in health that is not being provided in a few minute-long medical interaction. Cureality reveals the astounding amount of credible, safe, scientific information that allows you to participate, sometimes take over completely, various aspects of health. You don’t have to fire your doctor; these efforts supplement the information and advice you obtain (or don’t obtain) in the doctor’s office. While critics may sometimes say that this can be dangerous or that misdiagnoses and dangerous treatments might be risked, our experience is the exact opposite: People do better by taking the reins of health themselves, choosing to use the health care system for acute or catastrophic illness—but not necessarily for health.

Our fictional woman, Nancy, returns to her doctor one year later after undergoing a repeat bone scan. The doctor opened her chart, clearly expecting to scold her for her foolhardy and careless attitude. Instead, he was speechless. After a pause, he said, “I don’t know how you did it, but your bone density is now normal, the density of a healthy 30-year old woman. Just continue doing what you’re doing.” He closed the chart and walked out.

Yes: “Just continue what you are doing”—not “Please tell me what you did so that I might learn something new,” or “Where did you learn about such strategies? I knew nothing about this!” Just “do what you’re doing.” Too often, that is the response you get that defines what modern health care has become.

You don’t want that kind of health care. Sure, it’s reassuring to know that the doctor and hospital are there in case you injure yourself or develop pneumonia. But obtain day-to-day health advice of the sort that keeps you slender, keeps blood pressure normal, maintains normal insulin and blood pressure responses, helps keep bowel health ideal, can even be used to reverse conditions such as autoimmune joint pain, diabetes, osteoporosis, or skin rashes, while costing next to nothing and yielding health care benefits for you and your family in multiple areas of health? That is the kind of health care you want.

That’s why we developed Cureality.

William Davis, MD
Author of #1 New York Times Bestseller Wheat Belly: Lose the wheat, lose the weight and find your path back to health, The Wheat Belly Cookbook, and Wheat Belly 30-Minute (or Less!) Cookbook published by Rodale, Inc.
Author, Track Your Plaque: The only heart disease prevention program that shows how the new CT heart scans can be used to detect, track, and control coronary plaque

How Can I Lose Weight Eating Fat?

26. May 2014 Lisa G Carbohydrates, Lipids, Nutrition (0)

For new comers to the Cureality nutrition approach, this question may invariably pop up. For many years, fats and oils, whether classified as good or bad, were demonized because they contain 9 calories per gram. Meaning, they contain more than twice the 4 calories per gram of carbohydrate or protein.

So this familiar logic stated, if you eat less fat, which by default meant more carbohydrate, you would eat fewer calories and lose weight. This misguided logic was based on the assumption that caloric density was the primary reason people either gained or lost weight. The result - obesity rates have climbed and low-fat diet recommendations have proven unsuccessful in thwarting the battle of the bulge.

Why? There are a multitude of reasons, as discussed in the Cureality Diet Track. The following two explanations are important to to avoid needlessly suffering on a low-fat diet.

1) Appetite satiation is drive by insulin response, not calorie density.

Meals that trigger a substantial insulin response trigger increased appetite and fat storage. Carbohydrates, such as whole grain bread, whole wheat waffles, and fruit juice trigger insulin release. Continuous insulin provocation equates to one heck of a time trying to lose weight, as insulin is a fat-storage hormone. In comparison, oils and fats are the least insulin provoking with protein a close second. Consuming adequate fat intake is essential to quench appetite and avoid the insulin surges and crashes that are the result of eating plenty of “healthy whole grains”.

2) Modern wheat increases appetite thereby increasing intake.

Portion control becomes a major challenge because the gliadin protein in modern wheat stimulates appetite to the tune of 400 calories more per day, 365 days per year. That’s a recipe for weight gain, not loss.

The Cureality nutrition approach encourages the generous use of healthy fats and oils to support healthy weight loss and cardiovascular health. These topics are discussed in much more detail in the Cureality Member Forum.

Lisa Grudzielanek, MS, RDN, CD, CDE
Cureality Nutrition Coach

Drowning in a Sea of "Endocrine Disrupter Toxins"

20. May 2014 Chris K Drug advertising (1)

In my previous post I spoke about the close connection between gut health and thyroid health. Of course, as someone who lives with Hashimoto’s Thyroiditis I have a keen interest in anything related to the thyroid.

Just today, I came across an article revealing the 100 most-prescribed drugs in America and was stunned at what drug topped the list with more than 23 million prescriptions in 2013 – levothyroxine – the most commonly prescribed drug for treating hypothyroidism (but not necessarily the best in my opinion).

Some observers have warned about a pending epidemic of thyroid disorders. I believe the revelation of a thyroid drug as the most prescribed drug in America suggests that this epidemic is already a “fait accompli” (that’s French for the more colloquial expression “it’s a done deal!”).

I also believe it is due, in part, to the grim observations of experts like Dr. Davis who warn that we are literally “swimming in a sea” of endocrine disruptors, toxins that disrupt our hormonal glands such as the thyroid, adrenals, pancreas, ovaries, and testes. I would go farther to say we are drowning in that sea. Here are just a few examples of how ubiquitous and pervasive these toxins are.

Bisphenol A (BPA) in plastic containers has gotten a lot of bad press recently yet it still considered by the FDA to be safe in certain applications even though it has been shown to disrupt the sex glands and bind to thyroid receptors.

Triclosan is commonly used in hand-sanitizers and similar applications. Triclosan is known to decrease circulating levels of the thyroid hormone thyroxine (T4).

Polybrominated diphenyl ether (PBDE) is common used to make flame retardant clothing. PBDEs have been shown to disrupt both estrogen and thyroid hormones. The effects of PBDE exposure both in utero and shortly after birth can persist into adulthood.

Perfluorooctanoic acid (PFOA) in Teflon coated pots and pans and even microwave popcorn bags has been detected in the blood of more than 98% of the general US population. PFOA has implicated as both a carcinogen as well as an endocrine disruptor associated with thyroid disruption.

With all these “thyro-toxins” floating about it might not seem you like have a fighting chance to achieve thyroid health. But, the first step is to educate yourself - then take action. It is the essential sequence in what I call “Informed, Self-directed, Healthcare” (ISH).

Now that you have a better understanding of how to navigate the “thryo-toxin minefield” there are also positive steps you can take to stack the odds in favor of a healthy thyroid. If you participate in the Cureality program make certain to check out the Thyroid Health Track for a powerful list of proactive steps you can take.

Chris K. (aka HeartHawk)
Cureality Member Advocate

Source: IMS National Prescription Audit, IMS Health.

Italian Food the Cureality Way

19. May 2014 Lisa G (0)

100% grain elimination is the theme that drives the Cureality nutrition approach. A common mistake made when eliminating grains is replacing wheat-based foods with gluten-free foods. Most gluten-free foods, as they are currently available in the supermarket, are made with rice starch, tapioca starch, cornstarch, and potato flour. These dried pulverized starches generate more insulin and blood sugar surges than wheat. Gluten-free foods made with these undesirable ingredients are free of the appetite stimulating gliadin protein and wheat germ agglutinin, a lectin protein unique to wheat that causes direct intestinal damage. However, at best they can be referred to as “less bad” or unwelcome additions to the diet. Increasing your intake of these junk carbohydrates is a recipe for weight gain, inflammation and sky high blood sugar.

When removing grains from the diet, the goal is to replace them with truly healthy alternatives that do not contribute to negative health consequences. There are several reasonable substitutions available that allow your favorite sauce and protein combos to shine in tasty pasta-like dishes. People following the Cureality nutrition approach frequently comment that they do not miss “real” pasta because of the available healthy replacements they have learned about and incorporated into their lifestyle.

Our nutritionist, Lisa G., is the champion at helping navigate this lifestyle. In this video, she demonstrates how to prepare spaghetti squash, which can be used to replace wheat-based pasta. In another video zucchini noodles are the star. Homemade meatballs, a zesty tomato sauce and zucchini “pasta” combine for a delicious meal. Who needs grains when you can enjoy meals that support increased energy and less joint pain?

Traveling, while being wheat-free and dairy-free. Can it be done?

16. May 2014 Dawn D Dairy products, Wheat-free (0)

Summer vacation is right around the corner. The temptation to deviate from your normal healthy eating habits may occur… but resist. So how in the world do you continue to eat The Cureality way when you're traveling internationally? Let me tell you how I do it. I would also like to add I am allergic to dairy and I avoid all wheat containing foods. This has been my way of life for years and actually is extremely simple for me to manage while away from my own kitchen.

I decided to pay Italy a visit. I knew I would be overwhelmed with wonderfully fresh smelling bakery, pasta, cheese, gelato, and pizza. All foods I either can't consume due to my dairy allergy or foods I choose to avoid because of their health effects.

I was correct in my food assessment: the grains, bakery, and gelato were in every nook and cranny I encountered. Food choices can be difficult while traveling but I ask numerous questions regarding ingredients and I am certainly not afraid to swap out french fries for grilled vegetables.

Here's what I did the first few days on vacation with my diet routine to minimize dietary booby traps:

Day 1:

Breakfast, Hmmmm….Italians like their bakery. WOW. Tough when most of the foods being served are grains and eggs with dairy mixed in. I had two hard boiled eggs, tomatoes, sausage and espresso.

Lunch: Arugula lettuce topped with a chicken breast, roasted peppers and tomatoes. A side of salmon and lots and lots of olive oil on top. Very tasty and filling with the olive oil.

Dinner: Hamburger (no bun) with tomato, mayo, lettuce topped with a mountain of sauteed spinach. Water and yes…Italian wine found it's place at the table.

Day 2:

Breakfast: I devoured two hard boiled eggs with lettuce, cucumbers, shredded carrots, tomato and pineapple slices. Two cafe Americanos and water.

Lunch: Lunch was spectacular: Beef tips, arugula, lettuce, shredded carrots, tomatoes, olive oil and raw salmon. Yes, I mixed it all together and it was fabulous. Plenty of water with the "frizzle."

Dinner: I'll be honest: I had a difficult time with this meal due to our location and choice of foods, but I managed. Another hamburger with no bun, salad with mixed vegetables, and a few potato wedges. Wine and water.

Day 3:

Breakfast: Hardboiled eggs were getting old. Nonetheless, I had two of them chopped with tomato. Deli meat--Italians love their deli meat as well. Cafe Americano and water.

Lunch: Seafood salad-shrimp, octopus and squid mixed with argulua, fresh tomatoes, cucumbers and olive oil. Water.

Dinner: One hefty salad with shrimp, pear slices, ginger, tomatoes, avocado and olive oil. Wine and water.

Day 4:
Breakfast: Scrabbled eggs/sauage and pineapple slices. Cafe Americano and plenty of water.

Lunch/Dinner: I had to combine these two meals today. I had a delicious meal of curried shrimp (I made sure there was no dairy in the curry sauce) and a very large plate of grilled vegetables. Wine and water.

My diet may not be the most lavish to some but I enjoy my choices. I'm confident I will have no troubles with the remainder of my vacation. I haven't eaten wheat for a number of years so I don't experience the craving for bakery, pasta, or pizza. Dairy, I simply have to avoid, because I truly experience ill-effects from consuming it. My experience with travel and food choices have always worked in my favor. Ask questions and resist putting on that 5-10 pounds of vacation weight.

Ciao-Ciao~

All posts by william-davis

Are you a skinny fat person?

29. September 2006 William Davis (1)

AT 186 lbs. and 5 feet 10 inches, Doug did not regard himself as overweight. Sure, he had a little extra "love handles", a small bulge in the belly and a waist of 34 inches. But he was by no means fat, particularly compared to most of his friends, neighbors, and co-workers, many of whom were 50-100 lbs heavier.

But examine Doug's lipoprotein patterns and, if you didn't know what he looked like, you'd guess that he's at least 50 lbs or more overweight. His prominent patterns included low HDL, small LDL, high triglycerides, the after-eating IDL, and borderline high blood sugar of 116 mg/dl. His blood pressure usually ranged around 138/82.

In other words, Doug is among the 5-10% of people who have most of the features of the so-called "metabolic syndrome", but don't look the part. They usually (though not always) have a modest excess of visceral abdominal fat. While some people have to be 100 lbs overweight before they express these patterns, someone like Doug could do it with minimal excess weight, sometimes as little as 5-10 lbs.

Several specific genetic patterns can account for this exagerrated sensitivity to weight, but the solutions remain much the same. Heightened sensitivity to processed carbohydrates, particularly those containing wheat, is commonly present. A sharp reduction in processed carbohydrates like breads, breakfast cereals, and pretzels yields a huge benefit. Reduction in weight, of course, can also yield marked improvement in these patterns. This means that Doug should consider achieving his truly ideal weight of <175 lbs and become a truly skinny skinny person. Though his patterns might not be fully corrected, he will see substantial improvement across the board.

These patterns are also potent triggers for coronary plaque growth. Correction of low HDL, small LDL, etc. is crucial if you are to seize hold of your heart scan score.

Heart disease "reversal" gives health a bad name

28. September 2006 William Davis (0)

Put the search phrase "reverse heart disease" into your internet search engine, and you'll uncover an astonishing range of sites, all making extravagant promises.

The treatment programs offered range from the bizarre (colonic irrigation, magnetism, etc.), to centers using conventional approaches like statin drugs and low-fat diets, to sites that make lofty predictions with few unique tools (slash the fat and heart disease dissolves).

95% or more of the sites you turn up are clearly pandering to the unknowing, the unsophisticated, the hopeless, or other helpless niche groups. Homeopathic preparations, chelation, magnical combinations of herbals, you name it, you'll find it attached to claims for heart disease reversal.

I've seen people use many of these treatments. Is there any effect on the rate of increase of the heart scan score? Do they impact on the 30% per year expected rate of increase? Absolutely not.

Unfortunately, this gives anyone practicing truly effective methods to reverse coronary plaque a bad name. Just associating with this suspect group of "practitioners" can make us look bad--guilt by association.

Whenever someone claims to have the secret of heart disease reversal, I ask "Can you prove it?" Show me some evidence. It doesn't necessarily have to be $30 million drug company sponsored study, but some evidence of effectiveness should be available. The only thing we should take on faith is our religion, not our health care.

Our growing number of people who have, indeed, reversed their heart scan scores--reversed heart disease--to me is persuasive evidence of the value of the Track Your Plaque approach. Not foolproof, not 100%, but the best damned approach I'm aware of, by a long shot.

Trans fats to be banned

27. September 2006 William Davis (0)

Sometimes good may come from legislation.

The City of New York is contemplating a ban on trans-fat use by restaurants, bakeries, and other food establishments in preparation of their foods. (Trans-fats are also known as hydrogenated fats.)

At this point, I believe it's unclear, should this pass, what the response will be. If food preparers turn to butter, that's not much better. (Don't get fooled by the non-sensical argument of which is better, butter or margarine--they're both terrible.) Subtracting hydrogenated fats will no doubt cause major disruption of food preparation habits. It may even increase the cost of food slightly.

I believe that the true positive effect of this situation, however, will be the tremendously heightened awareness it will raise in the public, both in New York and elsewhere, on just how bad and pervasive trans-fats are. It may increase awareness that foods like donuts and pastries are not just about excessive quantities of sugars, but also trans-fat content.

If you're already a Track Your Plaque follower, you already know that the easiest way to dodge trans-fats in your diet is to minimize your use of processed foods--the cellophane-wrapped, pulverized, dried, just-add-water, microwavable and ready-to-eat foods that line supermarket shelves. Trans-fats are purely man-made. You won't find them--not a stitch--in green peppers, lettuce, olive oil, almonds. . .unprocessed foods. Watch for an in-depth report on trans-fats on the Track Your Plaque website in which we will detail the scientific evidence behind this movement, how to recognize when foods contain trans-fats, etc.

Back to basics!

27. September 2006 William Davis (0)

Harold is energetic and highly motivated. His heart scan score of 997 really threw him for a loop: his view of himself as a healthy, slender, 58-year old clearly needed revision.

So Harold set himself on a quest to find new ways to help him deal with his heart disease risk. He enrolled in the Track Your Plaque program. Unfortunately, he skimmed through the information but didn't really put much of it to use.

Instead, he wanted the "secret" information that other people didn't know about, "insider" information that couldn't be found in magazines, wasn't know by doctors.

He'd read that hawthorne was useful for opening coronary arteries, so he bought hawthorne at the health food store. He read that coenzyme Q10 was a little know way to strengthen the heart, so he added that. A Chinese doctor in town was advertising chelation therapy that "dissolved plaque". He subscribed to a once-a-week intravenous infusion at the doctor's holistic clinic of Eastern medicine. He'd heard that testosterone opened up arteries, so he purchased a preparation of chrysin, horny goat weed, yohimbine, and saw palmetto. He was suspicious of many conventional medicines, but he didn't want to ignore his LDL cholesterol of 172 mg/dl. So he added guggulipid and a combination cholesterol-reducing product that contained about 10 ingredients.

Harold pursued his quest, often adding new agents that came with promising stories. One year later, Harold eagerly got another heart scan, certain that his extraordinary efforts were sure to yield a dramatic drop in his heart scan score. The score: 1372, a 37% increase.

Harold was therefore several thousand dollars poorer and several steps closer to taking the plunge, allowing a potentially fatal disease to cut his life short.

The message: There's no need to re-invent the wheel. There are no top-secret ways to reverse atherosclerotic plaque.

Don't neglect the basics. You can't do calculus until you learn how to add, subtract, and divide. From a heart scan score reducing perspective, achieving 60-60-60 in basic lipids, normalizing blood pressure and blood sugar, identifying any hidden lipoprotein patterns like small LDL and Lp(a), losing weight to your ideal weight, taking fish oil, normalizing vitamin D blood levels to 50-70 ng/ml--these are the necessary prerequisites to achieve control over your coronary plaque and stop the increase in your heart scan score.

You don't need to waste your time with the rants of some supplement-hawker eager to sell you the next cure for heart disease. I'm often amazed at the number of people who do so yet have never even taken care of someone with heart disease. Would you allow someone to try and repair your car if they've never actually laid their hands on an engine before? Then why would you entrust such a person with your health?

The Track Your Plaque approach is not fool-proof, but it's the best there is by a long shot.

I don't care about hard plaque!

25. September 2006 William Davis (10)

I ran into a cardiology colleague this weekend. He was aware of my interest in CT heart scanning and plaque reversal.

Out of the blue, he declared "I don't care about hard plaque! I only care about soft plaque." He then proceeded to describe to me how everyone--EVERYONE--needs a CT coronary angiogram to identify "soft plaque".

Is there any truth to this view? Are we only identifying "hard plaques" by focusing on calcium and calcium scores on simple CT heart scans?

Several issues deserve clarification. First of all, CT heart scans don't identify hard plaque. They identify total plaque. Because calcium is a component of the majority of atherosclerotic plaque, comprising approximately 20% of its volume, a calcium "score" can be used to indirectly quantify total plaque, both "hard" and "soft".

Anyone cardiologist who performs a lot of the procedure, intracoronary ultrasound, knows that most human plaque is also not purely soft or hard, it is mixture of both. (I've been performing this procedure since 1995.) Quantifying only soft or only hard plaque is therefore only possible in theory, not in practice.

I believe my colleague does have a valid point in one regard, however. There is indeed a small percentage of people, probably around 5% of all people who have CT heart scans, who have scores of zero yet have a modest quantity of pure "soft" plaque. These people may be misled by having a zero score. How can these people benefit from better information?

Several ways. First, people like this tend to have very high LDL cholesterols, generally 180 mg/dl or greater. They may have a very worrisome family history, e.g., father with heart attack in his 30s or 40s. This small proportion of people with zero heart scan scores may benefit from receiving X-ray dye with their heart scan, i.e., a CT coronary angiogram. Keep in mind that we're assuming everyone is without symptoms, also. If symptoms are part of the picture, everything changes.

But should everybody get a CT coronary angiogram? I don't believe so. A CT coronary angiogram involves far more radiation exposure, greater expense (usually $1800 to $4000), and, with present day technology, does not yield quantitative (measurable) information that is useful for longitudinal use for repeated scans. You don't want to undergo yearly CT coronary angiograms, for instance.

Stay tuned for more on this issue. In the meantime, I continue to try and inform my colleagues about what is right, what is wrong, what is preferable for patient safety and yields truly empowering information, and try to impress on them that the practice of cardiology is not just about enriching their retirement accounts.

Try an experiment in a wheat-free diet

23. September 2006 William Davis (1)

Years back, I'd heard some people argue that wheat-based products were detrimental to health. At the time, I thought they were nuts. After all, wheat is the principal ingredient in a huge number of American staples like breakfast cereals and bread.

What changed my mind was the low-fat movement of the 1980s and 1990s. Proponents of low-fat diets claim that heart disease is caused by excess fat in the diet. A diet that is severely restricted in fat therefore might cure or reverse heart disease.

But low-fat diets evolve into high-carbohydrate diets. This nearly always means an over-reliance on wheat products. People will say to me "I had a healthy breakfast: shredded wheat cereal in skim milk and two slices of whole wheat toast." Yes, it is low-fat, but is it healthy?

Absolutely not. Followers of the Track Your Plaque program know that low-fat diets ignite the formation of small LDL particles (a VERY potent trigger of coronary plaque growth), drops HDL, raises triglycerides, causes resistance to insulin and thereby diabetes, raises blood pressure. They also make you fat, with preferential accumulation of abdominal visceral (intestinal lining) fat.

Look at people with gluten enteropathy, a marked intolerance to wheat products that results in violent bowel problems, arthritis, etc. if unrecognized. These people, if the diagnosis is made early, are strikingly slender and commonly unusually healthy otherwise. There's a message here.

If you need convincing, try an experiment. Eliminate--not reduce, but eliminate wheat products from your diet, whether or not the fancy label on the package says it's healthy, high in fiber, a "healthy low-fat snack", etc. This means no bread, pasta, crackers, cookies, breads, chips, breading on chicken, rolls, bagels, cakes, breakfast cereal...Whew!

You won't be hungry if you replace the lost calories with plentiful raw almonds, walnuts, pecans, sunflower and pumpkin seeds; more liberal use of healthy olive oil, canola oil and flaxseed oil; adding ground flaxseed and oat bran to yogurt, cottage cheese, etc.; and more lean proteins like lean beef, chicken, turkey, and fish.

I predict that, not only will you lose weight, sometimes dramatically, but you will feel better: more energy, more alertness, sleep better, less moody. Time and again, people who try this will tell me that the daytime grogginess they've suffered and lived with for years, and would treat with loads of caffeine, is suddenly gone. They cruise through their day with extra energy.

Success at this can yield great advantage for your heart scan score control and reversal efforts. It will give you greater control over small LDL and pre-diabetic patterns, in particular.

Bigger, faster plaque reversal

22. September 2006 William Davis (0)

Perhaps it's too early to tell whether it's true, but believe that we're seeing coronary plaque reversal--i.e., reduction of CT heart scan score--that is BIGGER and FASTER than ever before. We are now witnessing 20-30% reductions in score, even in the first year.

Early in our experience, I was thrilled with a slowing of plaque growth. Recall that coronary plaque grows at the rate of 30% per year. We would often seen slowing to 10-15% per year in the first year, then a levelling off to little or no increase in the 2nd or 3rd year. Regression, or reduction of score, was less common.

Now, with some further tweaking of our program, we are seeing these large magnitudes of coronary plaque reversal routinely. Not in everybody, of course. There are exceptions that mostly includes people who are less motivated and occasional people with more difficult to control lipoprotein patterns.

I believe that part, or perhaps most, of our recent success is from normalizing blood levels of 25-OH-vitamin D3 levels to 50-70 ng/ml. I'm unable to tell you why this occurs, but I am convinced that it has added huge advantage. Raising blood vitamin D levels to normal carries enormous implication: reduction of colon and prostate cancer risk, reduction of blood pressure, sensitization to insulin, prevention of arthritis and multiple sclerosis, and--I believe--control over coronary plaque calcification and growth.

Watch for a profile of one of our latest success stories, a physician who was experiencing 20% per year plaque growth three years in a row until he followed the Track Your Plaque approach and promptly experienced an 18% reduction in heart scan score. You'll find it in our next newsletter. To subscribe, go to the www.cureality.com homepage and click on the free book download.

I need to do more procedures!

22. September 2006 William Davis (0)

I sat next to a cardiology colleague of mine last evening at a dinner. He was lamenting the fact that, because of changes in hospital affiliations of his several-member cardiology group, he'd seen a drop in the volume of heart catheterizations he was performing.

"I'm used to doing 5 cases a day! Now I'm down to 3 or 4 a day." He went on to tell me how he's working to increase his volume. "I'm branching out into doing carotid stents and anything I can find in the legs." He also described how he was cultivating referring physicians to send him more procedural patients.

Now, this colleague, I believe, is a hard-working, conscientious physician. But his attitude reflects the perverse logic of many physicians: I need to do more procedures, not because it benefits patients, but because that's what I want to do--to be busy, make more money, acquire more experience, build my ego, etc.

Doing more procedures has nothing to do with an altruistic goal of doing more good for society. It is purely for selfish reasons. Beware of this shockingly common, pervasive attitude. There's a proper time and place for heart procedures, or any procedure, for that matter. But feeding your doctor's ambitions is not a good reason.

Fast food and quick plaques

20. September 2006 William Davis (0)

Such was the title of Dr. William Roberts' editorial back in 1987 discussing the health effects of fast foods.

If you need a graphic illustration of the extraordinarily damaging health effects of fast foods, take a look at trends in mainland China. A recent editorial in the American Journal of Cardiology written by Dr. Tsung Cheng of George Washington University makes several points:

--The popularity of fast food in China is booming, with Chinese now more likely than Americans to eat in a fast food restaurant. Each week, 41% of Chinese eat in a fast food restaurant at least once, compared to 35% in the U.S.

--Average total cholesterol levels have skyrocketed from 150 mg/dl in 1958 to 230 mg/dl in 2003.

--50% of Chinese with normal blood pressure in 1992 are now hypertensive.

--Hospitalization for heart disease rose from the 5th most common diagnosis to #1, now constituting nearly 50% of all hospital admissions.

McDonald's and KFC dominate the fast food landscape in China, but up and coming competitors are growing at exponential rates. A media conversation that will surely be reported in the near future is the boom in obesity and diabetes in China as these trends express themselves in weight gain, as it has in the U.S.

I hope you've all seen the entertaining but frightening documentary, Supersize Me chronicling the travails of 30-something Morgan Spurlock as he eats all his meals for one month at McDonald's restaurants in 20 cities. Though focusing on McDonald's, the movie is about a lot more than that. It paints a picture of how fast food as well as food manufacturers in general have changed--distorted--our eating habits.

If you haven't yet seen it, I would urge you to do so and watch it with the rest of the family. My kids (ages 8, 12, and 14) were shocked (and entertained) and they haven't set food in a fast food restaurant since.

But fish oil is too drastic!

20. September 2006 William Davis (0)

Ted is a 74-year old physician, still conducting a busy practice. He came to me because of some vague fatigue and breathlessness. He also got himself a CT heart scan. His score: 1277.

When he came to my office, he clearly became breathless with just minimal effort. A stress test confirmed an area of much reduced blood flow to the front of his heart muscle. A heart catheterization identified a severe blockage of 95% in the left anterior descending artery and a stent was inserted. This resulted in relief of Ted's symptoms.

When Ted returned to the office after his discharge from the hospital, I advised him that some major changes in his prevention program were overdue. "After all, Ted, you were lucky this time. You were provided some warning. It doesn't always work that way." So I advised Ted to make a number of changes in his diet (he was following an old-fashioned, and quite self-destructive, low-fat diet), have lipoproteins assessed to identify hidden causes of coronary plaque, and take fish oil.

"Fish oil? I don't think so. That's pretty drastic!" he exclaimed. He felt that all the nutrition he needed was contained in the food he ate. Even after several lipoprotein abnormalities were uncovered like small LDL and excessive after-eating (post-prandial) patterns, he still resisted any changes. "I'm going to just wait and see how I feel. But I will take aspirin."

Such is the state of mind of the older physician: procedures are okay, low-fat diets prevent heart disease, and the Beatles are touring America. But fish oil? No way!

Unfortunately, Ted's attitude encapsulates the attitudes of many of my medical colleagues who don't share the excuse of age. They still practice the woefully outdated ways of physicians like Ted, clinging to notions of "balanced diets", nitroglycerin representing a rational treatment for coronary disease, and adequate rest being curative for heart conditions.

The world is changing. We're entering an exciting age of self-empowerment. The ridiculous notions of health practiced in the last half of the 20th century are withering and dying. Poor Ted. He must view the current healthcare landscape as increasingly incomprehensible to a guy who started out delivering babies at home. Perhaps, in some respects his world was better. But, in coronary disease prevention, attitudes like this need to go the way of steam engines and racial segregation--good riddens!

Triglyceride and chylomicron "stacking"

10. November 2009 William Davis (24)

Continuing the comments started in Grazing is for cattle, here's an interesting study from the Oxford Center for Diabetes, Endocrinology and Metabolism.

Volunteers were fed a test meal breakfast of Rice Krispies, a banana, and a chocolate milkshake (76.4 grams carbohydrates, 51.9 grams fat, 12.2 grams protein). Lunch was served 5 hours later and consisted of a cheese sandwich and a second chocolate milkshake 43.4 grams carbohydrates, 49.6 grams fat, 24.0 grams protein). Frequent blood samples were then assessed over the day. (Don't try this at home: These are obviously very dangerous foods!)

Here's the pattern of triglycerides that was observed (1st dotted vertical line = breakfast, 2nd dotted vertical line = lunch):

Note that triglycerides only begin to decline 3-4 hours after breakfast, only to peak higher after lunch.

Here's the pattern observed for chylomicrons, the "granddaddy" of lipoproteins that derives from intestinal absorption of fatty acids:

Both graphs from Heath RB et al Am J Phyiol Endocrinol Metab 2006.

With chylomicrons, note a similar pattern to triglycerides: Chylomicrons begin to decline at 3-4 hours, only to peak higher after lunch.

This is the first study to examine the effect of sequential meals on such postprandial (after-eating) patterns. But it makes the graphic point that, if insufficient time is permitted between meals, both triglycerides and chylomicrons will "stack" themselves higher and higher. (Chylomicrons are subjected to processing by the enzyme, lipoprotein lipase, to form highly atherogenic, or plaque-causing, chylomicron remnants.)

While not examined in this study, my bet is that "grazing," i.e., eating small meals or snacks frequently, is an extreme instance of triglyceride, chylomicron, and chylomicron remnant stacking. That can only lead to one thing: accelerated heart and vascular plaque.

What is a healthy vitamin D blood level?

9. November 2009 William Davis (32)

When measuring blood levels of vitamin D (as 25-hydroxy vitamin D), what constitutes a desirable level?

There's no study that directly examines this question, no study that enrolled thousands of people and assigned a placebo group and groups receiving escalating doses of vitamin D and/or achieved higher levels of vitamin D, then observed for development of cancer, diabetes, depression, heart disease, multiple sclerosis, osteoporosis, osteoarthritis, etc. Such a study would requires many thousands of participants (particularly to observe cancer and multiple sclerosis incidence), many years of observation, and many tens of millions of dollars. Nope, only a drug company could afford such costs.

So we have to piece together various observations and extrapolate what we believe to be the ideal level of vitamin D. Epidemiologic observations in several cancers (breast, colon, prostate, and bladder) suggest that a 25-hydroxy vitamin D level of 30 ng/ml or higher is desirable (with less cancer incidence above this level). Other data suggest a level of 52 ng/ml or greater is desirable. Unfortunately, much cancer research looked at intake of vitamin D from food and supplement sources, rather than actual blood levels. We also have to factor in the great individual variation in vitamin D metabolism, with a single dose yielding variable blood levels (as much as a 10-fold difference). There's also the variation introduced by vitamin D-receptor variation (genetic polymorphisms).

A new study using vitamin D administration helps chart the desirable levels of vitamin D.

Vitamin D supplementation reduces insulin resistance in South Asian women living in New Zealand who are insulin resistant and vitamin D deficient - a randomised, placebo-controlled trial.

In this New Zealand study, 42 women (23 to 68 years old) were given 4000 units vitamin D, 39 women given placebo. Median 25-hydroxy vitamin D levels increased from 21 nmol/L (8.4 ng/ml) to 75 nmol/L (30 ng/ml). Both HOMA (a measure of insulin sensitivity) and fasting insulin levels improved, with greatest improvement seen at 25-hydroxy vitamin D levels of 80-119 nmol/L (32-47.6 ng/ml) or greater.

We also know that a vacation on a Caribbean beach in a bathing suit will increase vitamin D blood levels to the 80-110 ng/ml range without ill-effect (at least in young people who maintain the capacity to activate vitamin D in the skin, a phenomenon that declines as we age).

So do we really know the truly ideal level of vitamin D to achieve? I believe that, given the above observations, it is reasonable to extrapolate that the ideal vitamin D blood level likely lies somewhere above 50 ng/ml. We also know that vitamin D toxicity (i.e., hypercalcemia) is virtually unheard of until vitamin D blood levels approach 150 ng/ml, and even then is inconsistent. The health benefits of vitamin D supplementation are so tremendous, that I am not willing to wait for the prospective data to explore this question fully. For now, I aim for a blood level of vitamin D of 60-70 ng/ml (150-175 nmol/L).

Grazing is for cattle

5. November 2009 William Davis (17)

Many dietitians and nutritionists advise many people today to "graze," i.e., to eat small snacks every couple of hours. They argue that it blocks the drop in insulin and blood sugar that can trigger greater appetite and claim it can facilitate weight loss.

This is an absurd notion. Humans are not meant to graze. Humans are meant to find a wild boar or other animal, kill it, gorge on the meat, organs, and fat, then revert to berries, roots, leaves, and other foraged foods until the next kill. A human living in the wild does not have a cupboard or refrigerator full of ready-to-eat snacks to graze on.

The several hours after a meal is the most dangerous for creating coronary atherosclerotic plaque, i.e., the post-prandial period. In other words, eat dinner and, for the next 6-12 hours, your intestinal tract degrades the food; food byproducts are absorbed into the blood or lymph system. The blood is literally flooded with the byproducts of your meal.

Postprandial abnormalities are emerging to be a potent, and much underappreciated, means of causing heart disease and atherosclerosis in other vascular territories (especially carotid arteries and thoracic aorta).

Not eating--i.e., the fasting state--for extended periods is good for you. Encouraging people to graze amplifies atherosclerotic risk, since it creates an abnormal prolonged postprandial state.

The disastrous results of a low-fat diet

4. November 2009 William Davis (16)

Rob was never that committed to following the program in the first place.

I met Rob because of a modest heart scan score and consultation for a cholesterol abnormality. Rob had been cycled through all the statin agents by his primary care physician, all of which resulted in terrible muscle aches that he found intolerable.

I started out, as usual, characterizing his cholesterol abnormality with lipoprotein testing (NMR):

LDL particle number 1489 nmol/L
LDL cholesterol (Friedewald calculation) 143 mg/dl
Small LDL 52% of total LDL
HDL 50 mg/dl
Triglycerides 82 mg/dl

(LDL particle number is the emerging gold standard for LDL quantification, superior to calculated or Friedewald LDL cholesterol for prediction of cardiovascular events.)

Rob is a busy guy. After only a couple of brief visits, life and work got in the way and Rob let his attentions drift away from heart health. Since the information I provided made little impact on his thinking, he reverted to the low-fat diet his primary care doctor had originally prescribed and that he read about in magazines and food packages. He also ran out of the basic supplements I had advised, including fish oil and vitamin D, and just never restarted them.

A couple of years passed and Rob decided that just poking around on his own might not cut it. So he came back to the office. We repeated his NMR lipoprotein analysis:

LDL particle number 2699 nmol/L
LDL cholesterol (Friedewald calculation) 229 mg/dl
Small LDL 81% of total LDL
HDL 53 mg/dl
Triglycerides 78 mg/dl

Two years of a low-fat diet had caused Rob's LDL particle number to skyrocket by 81%, nearly all due to an explosion of small LDL. Recall that small LDL is more susceptible to oxidation, more inflammation-provoking, more adhesive--the form of LDL particles most likely to cause heart disease.

Also, note that, despite the enormous increase in small LDL, HDL and triglycerides remained favorable. This counters the popular rule-of-thumb offered by some that small LDL is not present when HDL is "normal."

Low-fat diets as commonly practiced are enormously destructive. In Rob's case, a low-fat diet caused both calculated Friedewald LDL as well as LDL particle number to increase dramatically. In many other people, low-fat diets increase calculated Friedewald LDL modestly or not at all, but cause the more accurate LDL particle number to increase significantly, all due to small LDL.

I'm happy to say that, once Rob witnessed how far wrong he could go on the wrong program, he's back on Track. (Sorry, pun intended.) He has resumed his supplements and eliminated the food triggers of small LDL--wheat, cornstarch, and sugars.

Dr. David Grimes reminds us of vitamin D

3. November 2009 William Davis (13)

In response to the Heart Scan Blog post, Fish oil makes you happy: Psychological distress and omega-3 index, Dr. David Grimes offered the following argument.

Dr. Grimes is a physician in northwest England at the Blackburn Royal Infirmary, Lancashire. He is author of the wonderfully cheeky 2006 Lancet editorial, Are statins analogues of vitamin D?, questioning whether the benefits of statin drugs simply work by way of increased vitamin D blood levels.

There is a fashionable interest in Omega-3 fatty acids, and these become equated with fish oil.

But fish oil is much more. Plankton synthesise the related squalene (shark oil) which, in turn, is converted into 7-dehydrocholesterol (7-DHC). The sun now comes into play and it converts 7-DHC into vitamin D (a physico-chemical process).

Small fish eat plankton, large fish eat small fish, and we eat large fish. So vitamin D passes through the food chain.

This has been a vital source of vitamin D for the the Inuits and also for the Scots and other dwellers of northwest Europe. (Edinburgh is on the same latitude as Hudson Bay and Alaska, further north than anywhere in China). In these locations there is not adequate sunlight energy to guarantee synthesis of adequate amounts of vitamin D, again by the action of sunlight on 7-DHC in the skin.

When the Scots moved from coastal fishing villages to industrial cities such as Glasgow, they became seriously deficient in vitamin D, and so the emergence of rickets. This was followed by a variety of other diseases resulting from vitamin D deficiency: tuberculosis, dental decay, coronary heart disease, and even multiple sclerosis and depression (the Glasgow syndrome).

And so it was with the Inuits. When their diet changed from fish for breakfast, fish for lunch, fish for dinner, they became deficient of vitamin D and they developed diseases characteristic of industrial cities, where there is indoor work for long hours, indoor activities, and atmospheric pollution.

It is the vitamin D component of fish and fish oils that is important.

I recently saw an elderly lady from Bangladesh living in northwest England. I would have expected her to have a very low blood level of vitamin D, as her exposure to the sun was minimal. However the blood level was 47ng/ml, not 4 as expected. She eats oily fish from Bangladesh every day, showing its value as a source of vitamin D with subsequent good health. I expect her blood levels of omega-3 fatty acids would also be high.

But it is unfashionable vitamin D that is important, not fashionable omega-3.

David Grimes
www.vitamindandcholesterol.com

Excellent point. The health effects of omega-3 and vitamin D are intimately intertwined when examining populations that consume fish.

In this study of Inuits, it is indeed impossible to dissect out how much psychological distress was due to reduced vitamin D, how much due to reduced omega-3s. My bet is that it's both. Thankfully, we also have data examining the use of pure omega-3 fatty acids in capsule (not intact fish) form, including studies like GISSI Prevenzione.

Nonetheless, Dr. Grimes reminds us that both vitamin D and omega-3 fatty acids from fish oil play crucial roles in mental health and other aspects of health, and that it's the combination that may account for the extravagant health effects previously ascribed only to omega-3s.

Why does fish oil reduce triglycerides?

2. November 2009 William Davis (9)

Beyond its ability to slash risk for cardiovascular events, omega-3 fatty acids from fish oil also reduce triglycerides.

There's no remaining question that omega-3s do this quite effectively. After all, the FDA approved prescription fish oil, Lovaza, to treat a condition called familial hypertriglyceridemia, an inherited condition in which very high triglycerides in the 100s or 1000s of milligrams typically develop.

The omega-3 fraction of fatty acids are unique for their triglyceride-reducing property. No other fraction of fatty acids, such as omega-6 or saturated, can match the triglyceride-reducing effect of omega-3s.

But why does fish oil reduce triglycerides?

First of all, what are triglycerides? As their name suggests, triglycerides consist of three ("tri-") fatty acids lined up along a glycerol (sugar) "backbone." Triglycerides are the form in which most fatty acids occur in the bloodstream, liver, and other organs. (Fatty acids, like omega-3, omega-6, mono- or polyunsaturated, or saturated, rarely occur as free fatty acids unbound to glycerol.) In various lipoproteins in the blood, like LDL, VLDL, and HDL, fatty acids occur as triglycerides.

Of all lipoproteins, chylomicrons (the large particle formed through intestinal absorption of fatty acids and transported to the liver via the lymph system) and VLDL (very low-density lipoprotein, very low-density because they are mostly fat and little protein) particles are richest in triglycerides. Thus, we would expect that omega-3s exert their triglyceride-reducing effect via reductions in either chylomicrons or VLDL.

Indeed, that seems to be the case. The emerging evidence suggests that omega-3 fatty acids from fish oil reduce triglycerides through:

--Reduced VLDL production by the liver (Harris 1989)
--Accelerating chylomicron and VLDL elimination from the blood
--Activation of peroxisome proliferator-activated receptor gamma (PPAR-gamma)--Omega-3s ramp up the cellular equipment used to convert fatty acids to energy (oxidation) (Gani 2008)

Combine omega-3 fatty acids from fish oil with wheat elimination and you have an extremely potent means of reducing triglycerides. Read a previous Heart Scan Blog post here to read how a patient reduced triglycerides 93.5% from 3100 mg/dl to 210 mg/dl in just a few weeks using fish oil and wheat elimination.

Fish oil makes you happy: Psychological distress and omega-3 index

30. October 2009 William Davis (24)

For another perspective on omega-3 blood levels, here's an interesting study in northern Quebec Inuits.

Traditionally, Inuits consumed large quantities of omega-3-rich seal, fish, caribou, and whale, even eating the fat. However, like the rest of the world, modern Inuits have increased consumption of store-bought foods, largely processed carbohydrates. Along with this trend has emerged more heart disease, diabetes, and depression.

A group from Laval University and University of Guelph, both in Canada, examined the relationship of plasma EPA + DHA levels and measures of psychological distress. This group had previously shown that Inuits older than 50 years had twice the plasma omega-3 levels (11.5%) compared to those younger than 50 years (6.5%), reflecting the shift away from the traditional diet.

Psychological distress was measured with The Psychological Distress Index Santé-Québec Survey (PDISQS-14): the higher the score, the greater the psychological distress. (In the graphs, tertile 1 is least distressed; tertile 5 is most distressed. Sorry about the small chart graphic--click on the graphic to make it bigger.)

From Lucas M et al 2009 (http://www.nutrasource.ca/NDI/Assets/Articles/Plasma%20omega-3%20and%20psychological%20distress%20among%20Nunavik%20Inuit.pdf)

"Our main finding was that women in the second and third tertiles of EPA+DHA concentrations in plasma PLs [phospholipids] had a 3 times lower risk of having a high-level PD [psychological distress] score than women in the lowest tertile."

While the relationship is stronger for women, you can see that, the higher the EPA + DHA plasma level, the lower the likelihood of psychological distress. Interestingly, the tertile with the greatest distress and lowest EPA + DHA levels had a plasma level of 7.0-7.5%--far higher than average Americans.

(Plasma levels of EPA + DHA were used in this study, which tend to reflect more recent omega-3 intake than the more stable and slower-to-change RBC Omega-3 Index that we use. Plasma levels also tend to run about 10-20% lower than RBC levels.)

Of course, there's more to psychological distress than omega-3 blood levels. After all, eating fish or taking fish oil capsules won't make money worries go away or heal an unhappy marriage. But it is one variable that can be easily and safely remedied.

Hospitals are a hell of a place to get sick

29. October 2009 William Davis (19)

I answered a page from a hospital nurse recently one evening while having dinner with the family.

RN: "This is Lonnie. I'm a nurse at _____ Hospital. I've got one of your patients here, Mrs. Carole Simpson. She's here for a knee replacement with Dr. Johnson. She says she's taking 12,000 units of vitamin D every day. That can't be right! So I'm calling to verify."

WD: "That's right. We gauge patients' vitamin D needs by blood levels of vitamin D. Carole has had perfect levels of vitamin D on that dose."

RN: "The pharmacist says he can replace it with a 50,000 unit tablet."

WD: "Well, go ahead while Carole's in the hospital. I'll just put her back on the real stuff when she leaves."

RN: "But the pharmacist says this is better and she won't have to take so many capsules. She takes six 2,000 unit capsules a day."

WD: "The 50,000 units you and the pharmacist are talking about is vitamin D2, or ergocalciferol, a non-human form. Carole is taking vitamin D3, or cholecalciferol, the human form. The last time I checked, Carole was human."

RN: (Long pause.) Can we just give her the 50,000 unit tablet?

WD: "Yes, you can. But you actually don't need to. In fact, it probably won't hurt anything to just hold the vitamin D altogether for the 3 days she's in the hospital, since the half-life of vitamin D is about 8 weeks. Her blood level will barely change by just holding it for 3 days, then resuming when she's discharged."

RN: (Another long pause.) Uh, okay. Can we just give her the 50,000 units?"

WD: "Yes, you can. No harm will be done. It's simply a less effective form. To be honest, once Carole leaves the hospital, I will just put her back on the vitamin D that she was taking."

RN: "Dr. Johnson was worried that it might make her bleed during surgery. Shouldn't we just stop it?"

WD: "No. Vitamin D has no effect on blood coagulation. So there's no concern about perioperative bleeding."

RN: "The pharmacist said the 50,000 unit tablet was better, also, because it's the prescription form, not an over-the-counter form."

WD: "I can only tell you that Carole has had perfect blood levels on the over-the-counter preparation she was taking. It works just fine."

RN: "Okay. I guess we''ll just give her the 50,000 unit tablet."

From the alarm it raises trying to administer nutritional supplements in a hospital, you'd think that Osama Bin Laden had been spotted on the premises.

I laugh about this every time it happens: A patient gets hospitalized for whatever reason and the hospital staff see the supplement list with vitamin D, fish oil at high doses, iodine, etc. and they panic. They tell the patient about bleeding, cancer, and death, issue stern warnings about how unreliable and dangerous nutritional supplements can be.

My view is the exact opposite: Nutritional supplements are a wonderful, incredibly varied, and effective array of substances that, when used properly, can provide all manner of benefits. While there are selected instances in which nutritional supplements do, indeed, have interactions with treatments provided in hospitals (e.g., Valerian root and general anesthesia), the vast majority of supplements have none.

Does fish oil cause blood thinning?

27. October 2009 William Davis (20)

Omega-3 fatty acids from fish oil have the capacity to "thin the blood." In reality, omega-3s exert a mild platelet-blocking effect (platelet activation and "clumping" are part of clot formation), while also inhibiting arachidonic acid formation and thromboxane.

But can fish oil cause excessive bleeding?

This question comes up frequently in the office, particularly when my colleagues see the doses of fish oil we use for cardiovascular protection. "Why so much fish oil? That's too much blood thinning!"

The most recent addition to the conversation comes from a Philadelphia experience reported in the American Journal of Cardiology:

Comparison of bleeding complications with omega-3 fatty acids + aspirin + clopidogrel--versus--aspirin + clopidogrel in patients with cardiovascular disease.(Watson et al; Am J Cardiol 2009 Oct 15;104(8):1052-4).

All 364 subjects in the study took aspirin and Plavix (a platelet-inhibiting drug), mostly for coronary disease. Mean dose aspirin = 161 mg/day; mean dose Plavix = 75 mg/day. 182 of the subjects were also taking fish oil, mean dose 3000 mg with unspecified omega-3 content.

During nearly 3 years of observation, there was no excess of bleeding events in the group taking fish oil. (In fact, the group not taking fish oil had more bleeding events, though the difference fell short of achieving statistical significance.) Thus, 3000 mg per day of fish oil appeared to exert no observable increase in risk for bleeding. This is consistent with several other studies, including that including Coumadin (warfarin), with no increased bleeding risk when fish oil is added.

Rather than causing blood thinning, I prefer to think that omega-3 fatty acids from fish oil restore protection from abnormal clotting. Taking omega-3 fatty acids from fish oil simply restores a normal level of omega-3 fatty acids in the blood sufficient to strike a healthy balance between blood "thinning" and healthy blood clotting.

Heart Scan Blog readers take impressive doses of omega-3s

24. October 2009 William Davis (28)

Here are the results from the latest Heart Scan Blog poll:

What is your dose of omega-3 fatty acids, EPA + DHA, from fish oil? (Add up the total content of EPA + DHA per capsules; multiply times number of capsules.)

The 479 respondents answered:

Less than 1000 mg per day
65 (13%)

1000-1999 mg per day
145 (30%)

2000-2999 mg per day
98 (20%)

3000-3999 mg per day
79 (16%)

4000-4999 mg per day
33 (6%)

5000-5999 mg per day
14 (2%)

6000 mg per day or more
45 (9%)

The poll did not discriminate between who has heart disease, who does not; who is taking omega-3 fatty acids for high triglycerides or for reduction of lipoprotein(a) (which requires high doses), or other indications. So variation is to be expected.

We can say that nearly all respondents are likely receiving sufficient omega-3s to impact cardiovascular risk, since the benefits begin just by consuming fish twice per month. I am especially impressed at the proportion of respondents (53%) who take at least 2000 mg per day of EPA + DHA. It's clear that people are really embracing the notion that omega-3 fatty acids pack a real wallop of health benefits.

Because different people in different situations and lipid/lipoprotein patterns have different omega-3 needs, there is really no "right" or "wrong" dose of omega-3 fatty acids.

However, there are several factors that enter into knowing your ideal omega-3 intake:

--Higher triglycerides require higher doses
--Lipoprotein(a) can respond to higher doses
--Having coronary or carotid plaque means you desire a "therapeutic" dose of omega-3s, not just a "preventive" dose

Time is a factor, also: The longer you take omega-3s, the higher your blood levels go. You can accelerate the replacement of non-omega-3s with higher doses of omega-3s.

But too much is not good either. Some participants in Track Your Plaque, for instance, have experimented with very high doses of EPA + DHA in the 9000-10,000 per day range and witnessed dramatic increases in LDL.

Much of the uncertainty about dosing will also be cleared up as we get more experience with the Omega-3 RBC Index, i.e, the proportion of fatty acids in red blood cells that are omega-3s. We are currently aiming for an Omega-3 Index of 10%, given the heart attack reductions observed at this level.

Green coffee bean extract in AGF Factor I

7. June 2012 William Davis (16)

Track Your Plaque's new and proprietary formulation, AGF Factor I, is designed to to support a program to achieve low levels of endogenous glycation.

Endogenous glycation, discussed at length in a recent Track Your Plaque Special Report, makes LDL particles (especially small LDL particles) more prone to oxidation and thereby more atherogenic, i.e., more likely to contribute to atherosclerotic plaque. Endogenous glycation also exerts unhealthy effects on long-lived proteins in the body, such as the proteins in the lenses of your eyes (cataracts), the lining of arteries (hypertension), and the cartilage cells of joints (brittle cartilage and arthritis).

Endogenous glycation is reduced by slashing carbohydrates in the diet, especially the most offensive carbohydrates of all, the amylopectin A of wheat, sucrose, high-fructose corn syrup and other fructose sources. Endogenous glycation can also be blocked by using blockers of the glycation reaction, such as benfotiamine (lipid-soluble thiamine), pyridoxal-5'-phosphate (a form of vitamin B6 with greater glycation blocking effect), and chlorogenic acid from green coffee beans, all components of AGF Factor I, which also contains Portulaca oleracea (Portusana), or purslane, for reduction of glucose.

Green coffee bean extract, and thereby chlorogenic acid, is receiving increased attention, most recently due to a study demonstrating substantial weight loss with 750-1050 mg green coffee bean extract, providing approximately 325-500 mg chlorogenic acid per day. Participants lost 15.4 pounds over 8 weeks at the higher dose (500 mg chlorogenic acid per day), while participants lost 8.8 pounds over 8 weeks at the lower dose (325 mg chlorogenic acid per day).

AGF Factor I was not formulated for weight loss but, taken twice or three times per day, does indeed mimic the dose of chlorogenic acid from green coffee bean extract used in the weight loss study. If you wish to take advantage of this application of chlorogenic acid/green coffee bean extract, while also maximizing protection from endogenous glycation, our AGF Factor I is one excellent choice to do so.

Lessons learned from the 2012 Low-carb Cruise

14. May 2012 William Davis (13)

I just returned from Jimmy Moore's Low-carb Cruise, a 7-day excursion to Jamaica, Grand Cayman Island, and Cozumel aboard the Carnival Magic. During our 7 wonderful days, a number of authors and experts spoke, each offering their unique perspective on the low-carb world. The focus was the science, experience, and practical application of low-carbohydrate diets.

The event kicked off with a roast by Tom Naughton of Fat Head fame, who entertained with his insightful low-carb humor and predictions of my demise at the hands of Monsanto!

Among the most important lessons provided:

Dr. Andreas Eenfeldt of the Diet Doctor blog discussed how Sweden is leading the world as the nation with the most vigorous low-carbohydrate following, witnessing incredible weight loss and reversal of carbohydrate-related diseases way ahead of the U.S. experience. I spent several hours with Dr. Eenfeldt who, besides being an engaging speaker, is a new father and an all-around gentleman. At 6 ft, 7 inches, he also towered high above all of us.

Dr. Eric Westman of Duke University and author of The New Atkins for a New You, debunked low-carbohydrate myths, such as "low-carb diets are high-protein diets that make your kidneys explode."

Dr. John Briffa, creator of the popular blog, Dr. John Briffa: A Good Look at Good Health, and author of the wonderfully straightforward primer to low-carbohydrate eating, Escape the Diet Trap, stressed the importance of never allowing hunger to rule behavior. Dr. Briffa's serious writing tone conceals an incredible charm and wit that took me by surprise, having spent several thoroughly engaging hours over breakfast, lunch, and dinner with him over the week.

Fred Hahn, exercise expert, founder of Serious Strength and author of Slow Burn Fitness Revolution and Strong Kids, Healthy Kids, debunked a number of trendy exercise methods, boiling many of the purported benefits of exercise down to that of increased strength.

Dr. Chris Masterjohn of The Daily Lipid and supporter of the Weston A. Price Foundation program, provided a comprehensive overview of the data that fails to link saturated fat with heart disease. He also helped me understand the analytical techniques used in studies of advanced glycation end-products.

Denise Minger, brilliant young usurper of China Study dogma and blogger at Raw Foods SOS, proved an engaging speaker and a truly real person (since some critics of her analyses have actually questioned whether there was even such a person!). She also proved every bit as likable as she seems in her captivating blog discussions.

Dr. Jeff Volek, prolific researcher from University of Connecticut, author of over 200 studies validating low-carbohydrate diet effects, and author of the recently released book with Dr. Stephen Phinney, The Art and Science of Low Carbohydrate Living, debunked myths behind carbohydrate dependence and "loading" by athletes. He also talked about how assessing blood ketones may be the gold standard method to ensure low-grade ketosis on a long-term low-carb effort.

Over a bottle of wine, Jimmy Moore and I reminisced over how his modest start with no experience in blogging or media has now ballooned to an audience of over 100,000 readers/viewers.

All in all, Jimmy's Low-carb Cruise experience was worth every minute, with many wonderful lessons and memories!

Chili Sesame Crackers

3. May 2012 William Davis (0)

Looking for something hot and crunchy?

These chili sesame crackers are perfect for dipping into hummus or salsa. As written, the recipe yields a moderately spicy cracker that you can modify readily by increasing or decreasing quantities of cayenne pepper and Tabasco sauce.

This recipe uses sesame seeds as the "flour." Either brown sesame seeds or the lighter version work, though the lighter seeds yield a slightly less bitter flavor with the spices.

For ease of baking, a shallow baking pan measuring 11 x 17 inches works best, as it allows the batter to fill the pan and spread to a cracker thickness. With a smaller pan, you may have to bake in two batches.

Makes approximately 30 chips

2 cups raw sesame seeds
1 cup shredded Parmesan cheese
2 tablespoons extra-virgin olive oil
1 tablespoon chili powder
½ teaspoon cayenne pepper
2 teaspoons onion powder
1 teaspoon garlic powder
1 teaspoon dry mustard
1 teaspoon sea salt
1 teaspoon Tabasco sauce
1¼ cups water

Preheat oven to 350º F.

In food chopper or food processor, grind 1¼ cups sesame seeds to fine meal. Remove and place in large bowl.

Place shredded Parmesan cheese in food chopper or food processor and pulse briefly until reduced to granular consistency. Add to sesame seed meal and mix. Stir in olive oil.

Add remaining (unground) sesame seeds, chili powder, cayenne pepper, onion and garlic powder, mustard, sea salt and mix thoroughly. Add Tabasco sauce and water and mix. Add additional water, if necessary, one tablespoon at a time, to obtain a consistency similar to pancake batter.

Pour mixture into baking pan and smooth to fill pan and obtain a thickness of a cracker. If too thick, remove some batter and re-smooth. Optionally, roll a clean cylindrical glass or bottle over top to smooth and yield a consistent thickness.

Bake for 30 minutes or until edges browned and center firm. If a dry, extra crunchy cracker is designed, bake an additional 10-15 minutes at 250 degrees F.

Remove and allow to cool. Cut with pizza cutter to desired size.

The standard cholesterol panel . . . dissected

18. April 2012 William Davis (0)

There are four values typically reported on any standard cholesterol panel:

Opiate of the masses

18. April 2012 William Davis (22)

Although it is a central premise of the whole Wheat Belly argument and the starting strategy in the New Track Your Plaque Diet, I fear that some people haven't fully gotten the message:

Modern wheat is an opiate.

And, of course, I don't mean that wheat is an opiate in the sense that you like it so much that you feel you are addicted. Wheat is truly addictive.

Wheat is addictive in the sense that it comes to dominate thoughts and behaviors. Wheat is addictive in the sense that, if you don't have any for several hours, you start to get nervous, foggy, tremulous, and start desperately seeking out another "hit" of crackers, bagels, or bread, even if it's the few stale 3-month old crackers at the bottom of the box. Wheat is addictive in the sense that there is a distinct withdrawal syndrome characterized by overwhelming fatigue, mental "fog," inability to exercise, even depression that lasts several days, occasionally several weeks. Wheat is addictive in the sense that the withdrawal process can be provoked by administering an opiate-blocking drug such as naloxone or naltrexone.

But the "high" of wheat is not like the high of heroine, morphine, or Oxycontin. This opiate, while it binds to the opiate receptors of the brain, doesn't make us high. It makes us hungry.

This is the effect exerted by gliadin, the protein in wheat that was inadvertently altered by geneticists in the 1970s during efforts to increase yield. Just a few shifts in amino acids and gliadin in modern high-yield, semi-dwarf wheat became a potent appetite stimulant.

Wheat stimulates appetite. Wheat stimulates calorie consumption: 440 more calories per day, 365 days per year, for every man, woman, and child. (440 calories per person per day is the average.) We experience this, sense the weight gain that is coming and we push our plate away, settle for smaller portions, increase exercise more and more . . . yet continue to gain, and gain, and gain. Ask your friends and neighbors who try to include more "healthy whole grains" in their diet. They exercise, eat a "well-balanced diet" . . . yet gained 10, 20, 30, 70 pounds over the past several years. Accuse your friends of drinking too much Coca Cola by the liter bottle, or being gluttonous at the all-you-can-eat buffet and you will likely receive a black eye. Many of these people are actually trying quite hard to control impulse, appetite, portion control, and weight, but are losing the battle with this appetite-stimulating opiate in wheat.

Ignorance of the gliadin effect of wheat is responsible for the idiocy that emits from the mouths of gastroenterologists like Dr. Peter Green of Columbia University who declares:

"We tell people we don't think a gluten-free diet is a very healthy diet . . . Gluten-free substitutes for food with gluten have added fat and sugar. Celiac patients often gain weight and their cholesterol levels go up. The bulk of the world is eating wheat. The bulk of people who are eating this are doing perfectly well unless they have celiac disease."

In the simple minded thinking of the gastroenterology and celiac world, if you don't have celiac disease, you should eat all the wheat you want . . . and never mind about the appetite-stimulating effects of gliadin, not to mention the intestinal disruption and leakiness generated by wheat lectins, or the high blood sugars and insulin of the amylopectin A of wheat, or the new allergies being generated by the new alpha amylases of modern wheat.

Jelly beans and ice cream

23. March 2012 William Davis (6)

What if I said: "Eliminate all wheat from your diet and replace it with all the jelly beans and ice cream you want."

That would be stupid, wouldn't it? Eliminate one rotten thing in diet--modern high-yield, semi-dwarf wheat products that stimulate appetite (via gliadin), send blood sugar through the roof (via amylopectin A), and disrupt the normal intestinal barriers to foreign substances (via the lectin, wheat germ agglutinin)--and replace it with something else that has its own set of problems, in this case sugary foods. How about a few other stupid replacements: Replace your drunken, foul-mouthed binges with wife beating? Replace cigarette smoking with excessive bourbon?

Sugary carbohydrate-rich foods like jelly beans and ice cream are not good for us because:

1) High blood sugar causes endogenous glycation, i.e, glucose modification of long-lived proteins in the body. Glycate the proteins in the lenses of your eyes, you get cataracts. Glycate cartilage proteins in the cartilage of your hips and knees, you get brittle cartilage that erodes and causes arthritis. Glycate structural proteins in your arteries and you get hypertension (stiff arteries) and atherosclerosis. Small LDL particles--the #1 cause of heart disease in the U.S. today--are both triggered by blood sugar rises and are 8-fold more prone to glycation (and thereby oxidation).

2) High blood sugar is inevitably accompanied by high blood insulin. Repetitive surges in insulin lead to <em>insulin resistance</em>, i.e., muscles, liver, and fat cells unresponsive to insulin. This forces your poor tired pancreas to produce even more insulin, which causes even more insulin resistance, and round and round in a vicious cycle. This leads to visceral fat accumulation (Jelly Bean Belly!), which is highly inflammatory, further worsening insulin resistance via various inflammatory mediators like tumor necrosis factor.

3) Sugary foods, i.e., sucrose- or high-fructose corn syrup-sweetened, are sources of fructose, a truly very, very bad sugar that is metabolized via a completely separate pathway from glucose. Fructose is 10-fold more likely to induce glycation of proteins than glucose. It also provokes a (delayed) rise in insulin resistance, accumulation of triglycerides, marked increase in formation of small LDL particles, and delayed postprandial (after-eating) clearance of the lipoprotein byproducts of meals, all of which leads to diabetes, hypertension, and atherosclerosis.

I think we can all agree that replacing wheat with jelly beans and ice cream is not a good solution. And, no, we shouldn't have drunken binges, wife beating, smoking or bourbon to excess. So why does the "gluten-free" community advocate replacing wheat with products made with:

rice starch, tapioca starch, potato starch, and cornstarch?

These powdered starches are among the few foods that increase blood sugar (and thereby provoke glycation and insulin) higher than even the amylopectin A of wheat! For instance, two slices of whole wheat bread typically increase blood sugar in a slender, non-diabetic person to around 170 mg/dl. Two slices of gluten-free, multigrain bread will increase blood sugar typically to 180-190 mg/dl.

The fatal flaw in thinking surrounding gluten-free junk carbohydrates is this: If a food lacks some undesirable ingredient, then it must be good. This is the same fatally flawed thinking that led people to believe, for instance, that Snack Well low-fat cookies were healthy: because they lacked fat. Or processed foods made with hydrogenated oils were healthy because they lacked saturated fat.

So gluten-free foods made with junk carbohydrates are good because they lack gluten? No. Gluten-free foods made with rice starch, tapioca starch, potato starch, and cornstarch are destructive foods that NOBODY should be eating.

This is why the recipes for muffins, cupcakes, cookies, etc. in this blog, the Track Your Plaque website, and the Track Your Plaque Cookbook are wheat- and gluten-free and free of gluten-free junk carbohydrates. And put that bottle of Jim Beam down!

Diet by LDL

7. March 2012 William Davis (0)

Conventional notions of heart healthy diets, such as that advocated by the American Heart Association, are largely based on observations of total and LDL cholesterol.

So, cut the saturated fat in the diet, cut the overall fat content, and replace them with polyunsaturated oils like safflower, corn, and vegetable oils and increase consumption of whole grains and total and LDL cholesterol show a modest downturn. Thus, diets like the American Heart Association Total Lifestyle Change approach advocate limiting total fat to no more 25 to 35% of calories and saturated fat to no more than 7% of calories.

Orange Cream Cookies

5. March 2012 William Davis (5)

If you loved Creamsicles as a kid, you'll love these Orange Cream Cookies. (Sorry, no photo: We ate them up before I realized we hadn't taken the photo. And, worse, we did it twice!)

Ingredients:
2 cups almond meal
2 tablespoons coconut flour
1 teaspoon baking soda
½ teaspoon sea salt
¼ cup golden raisins
½ cup chopped pecans
Sweetener equivalent to 1 cup sugar
2 tablespoons finely-grated orange rind
1 large egg
2 tablespoons coconut oil, melted
½ cup whipping cream (or coconut milk)
1 tablespoon vanilla extract

Preheat oven to 350º F.

Combine almond meal, coconut flour, baking soda, salt, raisins, pecans, sweetener and orange zest in bowl and mix.

In separate bowl, whisk egg, then add coconut oil, whipping cream, vanilla extract and mix together. Pour wet mix into dry and blend by hand thoroughly.

Spoon onto parchment paper-lined baking pan (or oiled pan) and flatten with spoon to ½-¾ inch thickness. Bake for 20-25 minutes or until toothpick withdraws dry.

Why are heart attacks still happening?

4. March 2012 William Davis (10)

I'm a cardiologist. I see patients with heart disease in the form of coronary artery disease every day.

These are people who have undergone bypass surgery, received one or more stents or undergone other forms of angioplasty, have survived heart attacks or sudden cardiac death, or have high heart scan scores. In short, I see patients every day who are at high-risk for heart attack and death from heart disease.

But I see virtually no heart attacks. And nobody is dying from heart disease. (I'm referring to the people who follow the strategies I advocate, not the guy who thinks that smoking a pack of cigarettes a day is still okay, or the woman who thinks the diet is unnecessary because she's slender.)

Two high-profile deaths from heart attacks occurred this week:

Davy Jones--The iconic singer from the 1960s pop group, the Monkees, suffered sudden cardiac death after a large heart attack, just hours after experiencing chest pain.

Andrew Breitbart--The conservative blogger and controversy-generating media personality suffered what was believed to be sudden cardiac death while walking.

It's a darn shame and it shouldn't happen. The tools to identify the potential for heart attack are available, inexpensive, and simple. The strategies to reduce, even eliminate, risk are likewise available, inexpensive, and cultivate overall health.

The followers of the Track Your Plaque program who

1) get a heart scan that yields a coronary calcium score (for long-term tracking purposes)
2) identify the causes such as small LDL particles, lipoprotein(a), vitamin D deficiency, and thyroid dysfunction
3) correct the causes

enjoy virtual elimination of risk.

My letter to the Wall Street Journal: It's NOT just about gluten

8. February 2012 William Davis (7)

The Wall Street Journal carried this report of a new proposed classification of the various forms of gluten sensitivity: New Guide to Who Really Shouldn't Eat Gluten

This represents progress. Progress in understanding of wheat-related illnesses, as well as progress in spreading the word that there is a lot more to wheat-intolerance than celiac disease. But, as I mention in the letter, it falls desperately short on several crucial issues.

Ms. Beck--

Thank you for writing the wonderful article on gluten sensitivity.

I'd like to bring several issues to your attention, as they are often neglected
in discussions of "gluten sensitivity":

1) The gliadin protein of wheat has been modified by geneticists through their
work to increase yield. This work, performed mostly in the 1970s, yielded a form
of gliadin that is several amino acids different, but increased the
appetite-stimulating properties of wheat. Modern wheat, a high-yield, semi-dwarf
strain (not the 4 1/2-foot tall "amber waves of grain" everyone thinks of) is
now, in effect, an appetite-stimulant that increases calorie intake 400 calories
per day. This form of gliadin is also the likely explanation for the surge in
behavioral struggles in children with autism and ADHD.
2) The amylopectin A of wheat is the underlying explanation for why two slices
of whole wheat bread raise blood sugar higher than 6 teaspoons of table sugar or
many candy bars. It is unique and highly digestible by the enzyme amylase.
Incredibly, the high glycemic index of whole wheat is simply ignored, despite
being listed at the top of all tables of glycemic index.
3) The lectins of wheat may underlie the increase in multiple autoimmune and
inflammatory diseases in Americans, especially rheumatoid arthritis and
inflammatory bowel diseases (ulcerative colitis, Crohn's).

In other words, if someone is not gluten-sensitive, they may still remain
sensitive to the many non-gluten aspects of modern high-yield semi-dwarf wheat,
such as appetite-stimulation and mental "fog," joint pains in the hands, leg
edema, or the many rashes and skin disorders. This represents one of the most
important examples of the widespread unintended effects of modern agricultural
genetics and agribusiness.

William Davis, MD
Author: Wheat Belly: Lose the wheat, lose the weight and find your path back to health