No flush = No effect

13. November 2006 William Davis (3)


"Inositol Hexanicotinate is the true 'flushless niacin.' Unlike 'sustained-release' niacin, which is just regular niacin in a pill which dissolves more slowly, Inositol Hexanicotinate is a niacin complex, formed with the B-vitamin-like inositol. When you take an IHN supplement, the central inositol ring gradually releases niacin molecules, one at a time delivering true niacin. This, like “sustained-release” niacin, allows you to take niacin at clinically-proven doses without going crazy with the itch."


That above bit of nonsense adorns one manufacturers sales pitch for its no-flush niacin. No-flush niacin is one of the biggest scams in the health food store.

Ordinarily, I love health food stores. There's lots of fun and interesting things available that pack real power for your health program. Unfortunately, there's also outright nonsense. No-flush niacin is absolute nonsennse.

No-flush niacin is inositol hexaniacinate, or an inositol molecule complexed with 6 niacin molecules. So it really does contain niacin. However, although it works in rats, it exerts no known effect in humans.

Just Friday, a 41-year old woman came to my office for consultation because her doctor didn't know what to do with lipoprotein(a). She had seen a cardiologist who told her to take no-flush niacin. Both the cardiologist and the patient were therefore puzzled when lipoprotein(a) showed no drop and, in fact, was slightly higher on the no-flush preparation.

The lack of any observable effect and no studies whatsoever showing a positive effect (there is one study demonstrating no effect), manufacturers continue to manufacture it and health food stores continue to push it as an alternative to niacin that causes the flush. It's quite expensive, commonly costing $30-$50 for 100 tablets.

Don't fall for this gimmick. Niacin is among the most helpful of treatments for gaining control over coronary plaque. It raises HDL, corrects small LDL, reduces triglycerides (along with its friend, fish oil, of course), reduces lipoprotein(a), and dramatically contributes to reduced heart attack risk. No-flush niacin does none of this. Track Your Plaque Members: For a thorough discussion of niacin--how to use it, what preparations work and which do not, read Niacin: Ins and outs, ups and downs on the www.cureality.com website.
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Comments (3) -

  • Hoop

    7/4/2007 8:38:00 AM |

    Then again it maybe this patient was using too low a dose?
    And what else was the patient ingesting? And there is the issue of which class lipid abnormality this patient had.

    In my comments below I've included some abstracts of some human based studies that suggest inositol hexanicotinate isn't useless for altering serum lipid levels.


    If we assume for a moment the validity of your anecdote,
    I won't call inositol hexanicotinate worthless rather I would suggest it might have has narrower scope of uses not including the altering
    blood lipids.  Not everyone (me) takes large doses niacin for it lipid altering properties. Consider Kaufman's work with niacinamide in patients
    with degenerative arthritis. He used doses of 1.5 to 4 grams and
    claimed increased joint mobility after a couple of months.
    In my experience, niacin also works as well as niacinamide
    against my pains in and around my joints. Its benefits against the pain come about gradually but
    nonetheless are quite effective for me.

    The flush can be pretty nasty if one isn't careful about the dose.
    I know when I mixed niacinamide and niacin in the past I seemed
    to have somewhat more flushing. I took niacin for several years
    until it started to be trigger atrial premature beats.
    I'll comment further in this posting on a way around these adverse effects of niacin.


    Inositol hexanicotinate maybe superior provided one chooses
    the right patients? Please see the second abstract below.
    ----------------------------------------------------


    1: Eur. J. Clin. Pharmacol. 1979 Aug;16(1):11-5.


    Nocturnal inhibition of lipolysis in man by nicotinic acid and derivatives.


    Kruse W, Kruse W, Raetzer H, Heuck CC,
    Oster P, Schellenberg B, Schlierf G.


    The effect of nicotinic acid and several derivatives
    on the nocturnal level of free fatty acids was studied
    in 12 healthy young women and men. Free fatty acids
    are an important precursor of plasma triglycerides
    and their concentration is highest at night.
    The drugs used were nictinic acid, beta-pyridyl-carbinol,
    mesoinositol hexanicotinate and xantinol nicotinate.
    The highest plasma nicotinic acid level was observed
    with beta-pyridyl-carbinol, but significant reduction in
    free fatty acids during the entire night was only
    achieved with inositolhexanicotinate and
    xantinol nicotinate. There was no correlation between
    the plasm levels of free fatty acids and nicotinic
    acid at any sampling time. If prolonged reduction
    in free fatty acid concentration is desired in the therapy of
    hyperlipidemias, the inositol and xantinol esters of
    nicotinic acid appear to be superior to the other preparations.


    PMID: 499296 [PubMed - indexed for MEDLINE]
    ========================================


    Inositol hexanicotinate seems to work to lower some
    blood lipids in this next human study and granted
    another drug is also involved.
    -------------------------------------------------------------
    1: Arzneimittelforschung. 1979;29(10):1621-4.


    [Treatment of various types of hyperlipoproteinaemia with
    a combination of Mg-chlorophenoxy-isobutyrate and
    mesoinositol-hexanicotinate (author's transl)]


    [Article in German]


    Bolzano K, Krempler F, Haslauer F.


    50 patients with different types of hyperlipoproteinaemia
    were treated with a combination of Mg-chlorophenoxyisobutyrate
    (700 mg) and mesoinositol-hexanicotinate (500 mg) (Atroplex)
    twice daily. 7 patients had type IIa, 39 patients type IIb
    or IV and 4 patients type V. After a period of one
    month without any treatment the patients were treated
    during two months. While the effects of this combination
    on cholesterol of type IIa patients was poor, the
    drug had an excellent lipid-lowering effect in the patients
    with type IIb, IV and V. After 14 days' treatment the
    plasma cholesterol and triglyceride levels in
    patients of type IIb or IV were significantly lowered.
    This effect became even more pronounced after
    one-month treatment. There was no significant difference
    between the effect of one-month treatment and
    that of two-month treatment. About two-thirds of the
    patients of type IIb or IV were responders. No serious side
    effects could be observed during our study.


    Publication Types:
        English Abstract


    PMID: 583231 [PubMed - indexed for MEDLINE]
    --------------------------------------------------
    So could it have been that this patient had one of the classes
    of hyperlipidemic disorders such as type 1, type
    2-a or type 3 for which inositol hexanicotinate
    maybe ineffective?


    =====================================================
    It may have other uses see next paper.
    -------------------------------------


    1: Clin. Rheumatol. 1988 Mar;7(1):46-9.


    A double blind randomised placebo controlled trial
    of hexopal in primary Raynaud's disease.


    Sunderland GT, Belch JJ, Sturrock RD,
    Forbes CD, McKay AJ.


    University Department of Surgery,
    Glasgow Royal Infirmary, Scotland.


    The peripheral vasospastic symptoms associated
    with Raynaud's disease continue to
    be an unsolved clinical problem. Hexopal
    (Hexanicotinate inositol) has shown
    promise in uncontrolled studies and its use in
    patients with Raynaud's disease may reduce such
    vasospasm. This study examines the effects of
    4 g/day of Hexopal or placebo, during cold weather,
    in 23 patients with primary Raynaud's disease.
    The Hexopal group felt subjectively better and
    had demonstrably shorter and fewer attacks of
    vasospasm during the trial period.
    Serum biochemistry and rheology was
    not significantly different between the
    two groups. Although the mechanism of
    action remains unclear Hexopal is safe
    and is effective in reducing the vasospasm
    of primary Raynaud's disease during the winter months.


    Publication Types:
        Clinical Trial
        Randomized Controlled Trial
        Research Support, Non-U.S. Gov't


    PMID: 3044673 [PubMed - indexed for MEDLINE]
    ====================================================
    : J. Int. Med. Res. 1979;7(6):473-83.


    An experimentally controlled evaluation of the effect
    of inositol nicotinate upon the digital blood flow
    in patients with Raynaud's phenomenon.


    Holti G.


    The vaso-active effects of inositol nicotinate (Hexopal)
    were investigated in thirty patients with primary and
    secondary Raynaud's phenomenon using several
    non-invasive experimental techniques under
    controlled conditions. The earlier formed impression
    that this drug requires a prolonged 'build-up' period was
    confirmed. Recording the time required to induce
    Raynaud's phenomenon as well as assessments of total
    and nutrient digital blood flow showed significant
    beneficial therapeutic effects upon the skin's
    microcirculation by inositol nicotinate. This study
    suggests that the therapeutic effect of this drug is not
    merely due to vasodilation but that other mechanisms
    such as enhanced fibrinolysis and lowering of
    serum lipids may play a significant part in its
    overall effect. Smokers responded slower than non-smokers,
    but even elderly patients with longstanding vasospastic
    disease showed measurably improved digital circulation.
    Unlike some other drugs in this field inositol nicotinate was found
    to be effective orally and to be devoid of unwanted side-effects.
    However, in the majority of patients it failed to
    abolish their increased vascular spasm although
    it diminished it significantly in most. It appears
    to be a safe and well tolerated drug, which,
    together with other symptomatic measures, merits
    to be used in the management of vasospastic
    disease of the extremities even in the
    presence of partial obliteration of the microcirculation.


    Publication Types:
        Clinical Trial
        Randomized Controlled Trial


    PMID: 391622 [PubMed - indexed for MEDLINE]
    =======================================


    Perhaps what is needed is a larger dose in comparison
    to other forms of niacin?

    ---------------------------------------------
    Now to expand the topic to plain old TR niacin and betaine.
    ---------------------------------------------

    Timed release niacin as I recall is twice a effective
    as simple niacin in lowering lipids and twice as toxic.
    So it seems come out about even if one takes a half
    the dose of TR niacin.

    Of course, what I'd love to test is niacin in its various forms
    along with trimethylglycine (TMG) aka betaine. And I won't  
    just consider lipid level effects but also the effects on
    osteoarthritis and other joint pains.

    Why do I mention betaine? I know from personal experience
    high doses of betaine along with niacin pretty well blocks
    the flushing effect as well as completely
    blocking the atrial premature beats (AVB) that I would get
    when taking either high dose niacin or niacinamide.
    I had taken niacin at a rather high doses for about 5 or 6 years
    back a couple of decades ago and then I started
    to get the AVBs when I tried to
    resume the use of doses above 100 milligrams.
    Now of course provided I take the betaine I don't have
    this problem. However, I do get AVBs if I don't use the
    betaine and only take the niacin.
    Granted some suggest niacin lowers the lipid levels
    by "stressing" the liver so if betaine blocks
    this effect it maybe contraindicated for the purpose
    of changing lipid levels.
    Here are Pubmed ID numbers, for some papers that
    reflect similar thinking using betaine to reduce
    the toxicity of high dose B-3.
    PMID: 10985907
    PMID: 17156888

    --------------------------------------------

    I'd be interested in your comments on the points of
    theory and science. I am not looking for personal
    advice. A number of people including myself
    are discussing the niacin topic on the
    Usenet forum....sci.life-extension (which
    is also available by way of the Google Group
    Archive for free provided you have a throw away email address).
    Someone else referred to your blog comments and yet
    another person proposed contacting you for a comment.
    I was elected Wink to contact you.
    The group/forum members were interested as to whether there is
    more to your anecdote concerning the possible ineffectiveness
    of inositol hexanicotinate as a lipid lower agent.

    Thank You.

  • Dr. Davis

    7/4/2007 1:36:00 PM |

    Thanks for your insightful comments.

    My experience is based on the experiences of about 10 patients on the no-flush preparation in doses of 1000-4000 mg per day.

    If the rationale for the no-flush preparation is that it provides niacin in such a way as to avoid the flush, we should see rises in HDL, reductions in triglycerides, small LDL, and lipoprotein(a), regardless of the type of hyperlipidemia present (IIa, IIb, III, etc.).

    After using no-flush for up to one year, I have seen absolutely no effect, accepting my relatively small experience.

    Please also understand that my focus is prevention and reversal of coronary heart disease, something that the Track Your Plaque approach does exceptionally well, so I try not to stray off too far from our focus. But why would no-flush have any beneficial effects on arthritis, etc.,as an alternative method of delivering niacin when niacin itself does not possess these effects? I'm not sure I follow the rationale. To be included in a program of coronary atherosclerotic regression, we would have to see substantial effects, as we do with plain old niacin.

    Nonetheless, I encourage your continuing interesting thoughts.

  • buy jeans

    11/3/2010 12:29:51 PM |

    Just Friday, a 41-year old woman came to my office for consultation because her doctor didn't know what to do with lipoprotein(a). She had seen a cardiologist who told her to take no-flush niacin. Both the cardiologist and the patient were therefore puzzled when lipoprotein(a) showed no drop and, in fact, was slightly higher on the no-flush preparation.

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Watch your weight plummet:Be a super vegetarian

14. January 2007 William Davis (0)
Here's a neat trick for losing weight: Become a strict vegetarian for 3 days.

Before you yawn or say "Yecchhhh!", let me elaborate.

Pick some time period. It doesn't have to be 3 days. It could be 2 days, or 5 days, or two weeks. But, for the period you choose, eat only vegetables. No meat, cereals, breads, milk, cookies, etc.

Vegetables alone could get monotonous, so make them interesting. Possibilities include:


--Hummus--add a little bit of olive-oil, chopped garlic, paprika, red pepper.

--Tabouleh--I get mine from Trader Joe's and it's delicious.

--Salsa--Low in calories, rich in lycopene and other flavonoids, with no nutritional downside. Also, pico de gallo--chopped tomatoes, onions, jalapeno chiles, cilantro, cucumbers.

--Mustards--hot, yellow, brown, spicy, gourmet, horseradish, etc.

--Cocktail sauce--i.e., ketchup and horseradish. Use the low-carb ketchup made without high fructose corn syrup.

--Tapenades--e.g., olive tapenade made with chopped olives, capers, and olive oil.
--Pesto-made with basil, garlic, and olive oil.

--Spices and herbs--basil, arugula, peppers, mustard powder, garlic, cilantro, ginger, etc.

--Vinegars--wine, Balsamic, rice, apple cider.

--Infused olive oils--infused with garlic is especially delicious,e.g., added to hummus.

--Bean dips--white bean dip, roasted bean dip, etc.





With the varieties of ways to jazz up your vegetables, you couldn't possibly be bored.

For example, for breakfast on day 1, eat sliced cucumbers and green peppers dipped in garlic-infused olive oil hummus and a handful of almonds. For a snack, some walnuts, sunflower seeds, sliced zucchini dipped in salsa. For lunch, a salad with an olive oil and balsamic vinegar dressing. For dinner, tablouleh, a cucumber and tomato salad, celery sticks dipped in pico de gallo.

All vegetables can be eaten without restricting portion size, since calorie content of vegetables are so low compared to other calorie-dense foods. (See The Heart Scan Blog from a few days back, "One bit or many mouthfuls?" at http://heartscanblog.blogspot.com/2007/01/one-bite-or-many-mouthfuls.html.)

This approach works nearly as well as fasting. A half-pound per day weight loss or more is common and painless. You'll also feel great living on low glycemic index foods.

(Photos courtesy Wikipedia.)

Dr. Agatston to the rescue

12. January 2007 William Davis (0)

Dr. Arthur Agatston, author of wildly successful South Beach Diet, has just released a new book titled The South Beach Heart Program. Dr. Agatston has started on a media speaking circuit to promote his book and concepts.


A reporter from Time, who interviewed Dr. Agatston, commented:

". . .not enough doctors prescribe niacin for their heart patients, even though the medicine is a proven treatment for raising 'good' cholesterol. Physicians are reluctant, Agatston suggests, because niacin requires diligent follow-up to watch for side effects, taking time that most primary-care practices cannot afford. On the other hand, he says, too many doctors are performing heart operations that represent a financial windfall for hospitals. Bottom line: there isn't as much money to be made in prevention as in treatment."

Amen.

Dr. Agatston echoes many of the concepts that the Track Your Plaque program advocates. His notoriety is going to help disseminate the idea that 1) CT heart scans are the #1 method to identify hidden atherosclerotic coronary plaque, 2) taking control of your heart scan score is the best way to seize hold of your future, and 3) the present-day popularity of heart procedures like stents and bypass is intolerable, inexcusable, and needs to be reined back.

Agatston also brings great credibility and fairness to the conversation and his comments will gain tremendous attention in the press and with the public.

When is a vitamin not a vitamin?

12. January 2007 William Davis (0)
When it's a hormone.

That's the stand that several researchers in vitamin D have taken and I think they're right. Dr. John Cannell has made a fuss over this in his www.vitamindcouncil.com website.

Structurally, vitamin D is most closely related to testosterone, estrogen, and cortisol. You wouldn't call testosterone vitamin T, would you?

Vitamins are also meant to be obtained from food. Yes, vitamin D is in milk but only because humans are required to put it there to prevent childhood rickets. Otherwise, the only substantial food source of vitamin D is in oily fish like salmon and then only a modest quantity.

Vitamin D is cholecalciferol, a hormone. Deficiencies of hormones can have catastrophic consequences. Imagine that every winter your thyroid gland shuts down and produced no thyroid hormone. You'd get very ill, gain 30 lbs, lose your hair, feel awful.

That's what happens when you're sun deprived and thereby deficient in cholecalciferol--you're deficient in a hormone. And it happens to most of us every year for many months.

I continue to witness spectacular effects by bringing 25-OH-vitamin D3 blood levels to 50 ng/ml with supplementation, including an apparent surge in success dropping heart scan scores.

An epidemic of heart disease reversal

10. January 2007 William Davis (3)
Heart disease reversal is nothing new in my office. However, I have to admit that it's not something that generally happens each and every day.

As our approach is refined, we are witnessing an unprecedented frequency of plaque reversal. Since Monday (today is Tuesday), I've seen four people who have regressed their coronary plaque and dropped their heart scan score.

Pat was the most recent addition to this list. At age 53, I was honestly surprised at the ease of dropping her heart scan score from 128 to 42 in the space of a year. I was surprised because among her lipoprotein patterns was the dreaded combination of lipoprotein(a) and small LDL, probably the most aggressive risk for heart disease I know of and also among the most difficult to gain control over. She also suffered a deep personal tragedy in her family, an emotional convulsion that can sometimes wipe out any hope of plaque reversal.

I'm hopeful that this virtual epidemic of heart disease reversal continues. And I hope that you participate in it.

Second heart scan and heart attack risk

9. January 2007 William Davis (0)
At first, Joe felt disappointed, defeated, and frightened. After his heart scan, a radiologist at the center told him that his score of 264 was moderately high. He told Joe that he was at moderate risk for heart attack and that a nuclear stress test was going to be required.

This left Joe feeling confused. After all he'd had a heart scan 18 months earlier and his score was 278, 5% higher.

I reassured Joe that the radiologist had not been aware that Joe had a prior heart scan. The radiologist didn't know that Joe's heart scan score had actually been reduced.

In fact, Joe's risk for heart attack was not moderate--it is now very low, since his score was 5% lower. While growing plaque is active plaque, shrinking plaque is inactive plaque and thereby at far less risk for heart attack.

I wrote about this phemonenon in a previous Blog: When is a heart scan score of 400 better than 200? at http://heartscanblog.blogspot.com/2006_09_01_archive.html. When you've had more than one scan, the risk for heart attack suggested by the score takes a back seat to the rate of change of your score. In other words, even though Joe's score of 264 represented a moderate risk (of approximately 3% per year, roughly 30% over 10 years), this no longer held true, since it actually represented a 5% decrease over a previous score.

Joe's risk for heart attack is probably close to zero. ALWAYS view your second (or any subsequent) heart scan score in the context of your previous score, not in isolation.

Track Your Plaque newsletter subscribers: We will detail more of Joe's story in the coming January 2007 newsletter. If you'd like to read or subscribe to the newsletter, go to http://www.cureality.com/f_scanshow.asp.

Heart scan curiosities #5

8. January 2007 William Davis (1)
Despite the controversy over drug-coated stents, I maintain that the best stent is no stent at all.

Yes, there are indeed times when such things are necessary, but not with the frequency that they are implanted nowadays.

Another reason why stents are an undesirable phenemenon is that they muck up your heart scan. Take a look:





The long white object in the center is a stent in the left anterior descending artery of this 60 year old man. Just beyond the stent (at about 1 o'clock from the stent) is a plaque that could be scored. However, you can see that, with the presence of the stent, the bulk of this artery is no longer "scorable". If this man wishes to "track his plaque", he will have to be content with tracking only the circumflex and right coronary arteries, the other two arteries without stents.

The stainless steel or similar metallic materials of current stents simply prevent us from seeing through them for plaque scoring purposes. It's best if you can simply avoid getting one for this and other reasons.

Track Your Plaque Members: Watch for the upcoming editorial by our Heart Hawk on drug-eluting stents.

One bite or many mouthfuls

6. January 2007 William Davis (0)
A reader brought this beautiful series of food photos to my attention:

http://www.wisegeek.com/what-does-200-calories-look-like.htm

It's simply a graphic display of what 200 calories of various foods look like. You'll note that vegetables and fruits permit large servings to yield 200 calories. Processed foods, on the other hand, require very little to tally up the same calorie load. In particularly, look how little in the way of wheat products are required to match that amount.

Heart scan curiosities #4

5. January 2007 William Davis (2)
Here's an interesting example of a 63-year old man with a heart scan score of 112. However, his aortic valve was also severely calcified (loaded with calcium). In other words, the normally flexible and mobile "leaflets" of the aortic valve were coated with calcium and other tissues that interfere with its free motion. The aortic valve is the starburst white in the center of the heart.








This is what the aortic valve should look like on a CT heart scan--you shouldn't see it at all.

The first man with the calcified valve will unfortunately require a new prosthetic aortic valve sometime in his future. This is usually determined with the help of an ultrasound, or echocardiogram, a better test for assessment of the aortic valve (though useless for detection of coronary plaque).

It's my suspicion that chronic and longstanding deficiency of vitamin D is among the factors that contribute to the abnormal deposition of calcium on the aortic valve. We desperately need more data on this. Nonetheless, perhaps this adds yet another reason to 1)get a CT heart scan, and 2) bring your vitamin D blood level to normal. (We aim for 50 ng/ml year round.)

Fish oil and the perverse logic of hospitals

4. January 2007 William Davis (6)
Hospitals are now starting to carry prescription fish oil, known as Omacor, on their formularies. It's used by some thoracic surgeons after bypass surgery, since fish oil has been shown to reduce the likelihood of atrial fibrillation (a common rhythm after heart surgery).

Why now? The data confirming the benefits of fish oil on atrial fibrillation has been available for several years.

It's now available in hospitals because it's FDA-approved. In other words, when fish oil was just a supplement, it was not available in most hospitals. Whenever I've tried to get fish oil for my patients while in hospital, you'd think I was trying to smuggle Osama Bin Laden into the place. The resistance was incredible.

Now that FDA-approved Omacor is available, costing $130 dollars per month for two capsules, $195 for the three capsule per day dose for after surgery, all of a sudden it becomes available. Why would this irrational state of affairs occur in hospitals?

Several reasons, most of which revolve around the great suspicion my colleagues have towards nutritional supplements. In addition, there's the litigation risk: If something has been approved by the FDA, their stamp of endorsement provides some layer of legal protection.

However, I regard those as pretty weak reasons. I am, indeed, grateful that fish oil is gaining a wider audience. But I think it's absurd that it requires a prescription to get it in many hospitals. Imagine, as the drug companies would love, vitamin C became a prescription agent. Instead of $3, it would cost far more. Does that make it better, safer, more effective?

Of course, no drug sales representative is promoting the nutritional supplement fish oil to physicians nor to hospitals. I now see people adding the extraordinary expense of prescription fish oil to their presription bills.

In my view, it's unnecessary, irrational, and driven more by politics and greed than actual need. Take a look at the website for Omacor (www.omacorrx.com). Among the claims:

"OMACOR is the only omega-3 that, along with diet, has been proven and approved to dramatically reduce very high triglycerides..."

This is a bald lie. Dozens of studies have used nutritional supplement fish oil and shown spectacular triglyceride-reducing effects.

Their argument against fish oil supplements:

"Dietary supplements are not FDA-approved for the treatment of any specific disease or medical condition. Get the Facts: nonprescription, dietary supplement omega-3 is not a substitute for prescription OMACOR."

Does that make any sense to you? Should you buy a GM car because only GM makes genuine GM cars? This is the silly logic being offered by these people to justify their ridiculous pricing.

How about: "The unique manufacturing process for OMACOR helps to eliminate worries about mercury and other pollution from the environment."

Funny...mercury in fish tends to be sequestered in the meat, not the oil. Independent reports by both Consumer Reports and Consumer Lab found no mercury, nor PCB's, in nutritional supplement fish oil. But just suggesting a difference without proving it may be enough to scare some people.

Just because something is used by a hospital does not make it better. The adoption of fish oil is hospitals is a good thing. Too bad it has to add to already bloated health care costs to enrich some drug manufacturer.

Repent for past sins

2. January 2007 William Davis (0)
If the food temptations of the holidays got the best of you, and you're now 5, 10, 15 lbs or more over your pre-holiday weight (our record is 18lbs!), then it's time for serious action.

One easy method to regain the control you may have lost is to pick some period, say, 3 days. During those three days, eat nothing but vegetables--no breads, meats, dairy products, certainly no cookies, cakes, pasta, etc., not even fruit. Follow this routine and weight drops rapidly. Vegetables are wonderful but sometimes boring, so use healthy condiments to spice them up: mustards (hot, brown, yellow, horseradish); healthy salad dressings, which are olive or canola oil-based; salsas, a fabulous garnish with no nutritional downside whatsoever; pesto; tapenades; horseradish added to other condiments or even by itself (wasabi).

Of course, fasting in one of its several variations is another rapid method to regain control. My favorite is to use soy milk in a modified fast, usually 4-6 glasses of a low-fat, low-sugar soy milk per day, along with plenty of water. (Please refer to the precautions detailed in the recent Track Your Plaque Special Report, Fasting: Fast Track to Control Plaque , particularly if you fast 5 days or longer or take blood pressure or diabetic medication.)

Of course, yo-yoing your weight--up during the holidays, down after their conclusion--is not good for you. It does raise the likelihood of diabetes, not to mention cultivate the patterns that contribute to coronary plaque growth, especially small LDL. But if temptation got out of control and you need to regain lost ground, these two strategies work fabulously well for most people.

If you've gained, say, 10 lbs during the holidays, but simply resume your usual habits, chances are you won't lose the weight. Year after year, this can add up to an enormous weight gain. The time to act is now. It's easier to lose the 10 lbs of weight you gained recently, rather than the 50 lbs you've stacked up over the past 5 years.