Is shock therapy the answer to “cure” obesity?

10. August 2014 Lisa G (0)
The next obesity “fix” may be hitting the market known as "VBLOC therapy”.  This implanted device delivers intermittent electrical "blocking signals" to the intra-abdominal vagus nerve.  According to the manufacturer, the device "reduces sensations of hunger and produces satiety leading to weight loss.”

Seems to me like another classic case of conventional healthcare proposing surgery or medications to address the obesity epidemic. Pharmacologic treatment and bariatric surgery have been offered for years to win the battle of the bulge.  As a registered dietitian, who years ago begrudgingly counseled patients prior to undergoing bariatric surgery, I have seen countless people re-gaining all (if not more) of the weight lost after the first year of surgery. Same goes for pharmalogical interventions, such as Phentermine.  Sure it worked in the short-term.  But in every single case, when the medication was stopped, as it is not FDA approved for long-term use, the weight came creeping back.

My take on the releasing a significant amount of weight does not require going under the knife.  How about this instead? Address the cause of increase hunger and appetite.  This is a crucial missing link for many undergoing surgery or using medication(s) as a “solution”.  Not addressing the cause of increased hunger and ravenous eating behaviors precipitously results in rebound weight gain.  Rather than sending an electrical pulse to a nerve in the stomach, maybe the FDA should consider a Cureality-based nutrition program that is wildly successful stimulating a “side effect” of weight loss.  Wheat elimination offers a surgery-free option that reduces hunger and insistent drive to eat every few hours, thanks to freedom from gliadin driven appetite stimulation.  Weight loss is common experience due to reduced hunger and subsequent intake. Give it a try.  What else do you have to lose, but some love handles?

--Lisa Grudzielanek, MS,RDN,CD CDE
Cureality Nutrition & Health Coach

Are Your Beauty Products Toxic?

10. August 2014 Lisa G (0)
As a nutritionist and self-care advocate, I am very careful about what I put in my body.  Health benefits experienced through proper nutrition are well understood.  We avoid highly processed foods, wheat-based products, and sugary snacks because we know that are “unhealthy” for us.  But what about what we put on our skin?

An important piece of the health and wellness puzzle is not only what is on the end of our fork but on our toothbrush, slapped on our bodies and rubbed into our hair.  Skin is the largest organ and what we place on it on a daily basis penetrates the skin, enters the fat stores and contributes to the toxicity and adiposity of our bodies.  According to the Environmental Working Group, the average woman uses 12 beauty products per day, containing about 168 ingredients.  Yikes!

I’ve often held a high suspicious that endocrine disruptors such as parabens, triclosan, fragrance, and other punitive chemicals are a key suspect in the root cause of my endocrine disruption.  Interestingly, scientific evidence is now emerging to support this suspicion.

A few months back, I took a look at my hair, skin, and cosmetic products. I was shocked and horrified.  Parabens, an estrogen-mimicking preservative linked with endocrine disruption, was in dozens of products.  It reminded me of how I felt on that day years ago when I threw out all the products in my kitchen that contained wheat.  What are parabens not in?  Why was it in so many products?

In our next episode of Cureality Connections we will discuss key skin and beauty product chemicals to avoid along with other steps to take to attain beauty from within.

--Lisa Grudzielanek MS, RDN, CD, CDE

Top 3 Strength Training Exercises for Runners

28. July 2014 Amber B (0)
First and foremost, if you’re a runner and you’re not strength training you need to start.  This in and of itself could be an entire blog article.  But here I go with the synopsis. 

Strength training will indirectly help you run longer and faster.  Strength training exercises can improve your running mechanics, so that you run more efficiently.  Efficient running mechanics will lead to less wasted energy with each step and less injuries. 

Think about it.  You will take 80 to 90 steps per foot each minute you run.  If you have muscular imbalances that lead to joint mobility or stability issues you will move through an improper range of motion with each step. 

When you run for 30 minutes you take 2700 steps with each foot for a combined 5400 steps.  That could be 5400 steps of feet rolling in, rounded shoulders, wasted side to side movement or just pure pain.  Needless to say, when you are an endurance athlete it’s important that each step and every workout is adding to improved performance not to injury or fatigue.

The key to becoming a better runner is consistency.  For most runners, injuries are the biggest disrupter of consistent training.  Runners get a few good weeks or months of training, and then they are injured.   That means time off, loss of motivation, and a decrease in fitness. 

Strength training with proper form 2 to 3 times a week will reduce the onset of injuries and improve your running form.  Here are my top 3 strength training exercises for runners. 

Bulgarian Split Squat

You will need a bench, chair or stepper to perform this exercise.  Start by doing this exercise with just body weight and then progress.  The progression could include holding dumbbells, kettlebells or a barbell.  You can also make this exercise explosive. 




 
  • Place the to top of your back foot on.  If you are having a hard time with balance, flex your back toes and place them on the bench.   
  • Stand in a staggered stance about 2 to 3 feet wide.  This should allow your knee to bend while keeping your knees behind your front toes. 
  • Inhale as you begin to bend both knees. 
  • Focus on your back knee pointing straight down toward the ground and your body weight in your front heel.   
  • Keep your front kneecap inline with the 3rd toe of the front foot. 
  • Exhale as you straighten both knees to come back up to standing.  
Start with 10 repetitions on each leg and progress to 15. 

Calf Lowers

Use a stair or a stepper to perform this exercise.  Start by doing this exercise with just body weight.  The progression would include holding a dumbbell in one hand. 


 


  • Place the ball of your foot on the stair while holding on to the wall or railing.   
  • Rise up on the ball of your foot as high as your heel will go.  Make sure you have weight evenly distributed on all of your toes and that you are not rolling onto one side of your foot. 
  • Slowly, lower you heel back to the starting position.  Try counting 3 to 5 slow counts to ensure you really focus on lowering part of the movement.   
Do 10 reputations on each foot to start.  Work up to doing 20 reputations on each foot. 

Band or Cable Row

How many runners do you see hunched over logging long miles.  This exercise is for improved running posture, which can lead to improved respiration. 

To perform this exercise, use a band or a cable.  This exercise can be done with both arms or with just one arm. 





  • Stand in a staggered stance with relaxed knees.  Make sure your ribs on stacked on top of your hips to ensure good posture. 
  • Grab the handles of the band or the cable in the thumbs up position. 
  • Start the movement by protracting the shoulder blades.
  • Then bend the elbows straight back so that your biceps are close to your rib care.  Keep  your knuckles forward. 
  • To release, begin to straighten your elbows and bring your shoulders back to the starting position. 
Start with 10 repitions and work up to 20.  To increase difficulty, use a more difficult band or more weight on the cable system. 

Here’s to improving your running mechanics so that you can train more consistently.  Can’t wait to hear about the PR at your next race. 

How did Cureality get its start?

27. July 2014 William Davis (0)



In the Cureality program, we embrace information and strategies that empower you in health without drugs, without hospitals, without procedures. We convert your doctor from director of healthcare to your assistant in health. He or she is there when you need help, but you largely direct your own health future.

How did we gain the know-how, information, tools, even chutzpah to take on such an ambitious project?

It started around 10 years ago with the awkwardly named Track Your Plaque program. In fact, some of the current followers of the Cureality program are former Track Your Plaque members, having learned of the wonderful list of strategies that can be adopted to gain better control over, even reverse, coronary atherosclerotic plaque and risk for heart attack. They also learned that something special happens when you engage with other people with similar interests, all sharing ideas, insights, and resources to get the self-directed health job done. Over time, what started out as simply a source of better information for coronary health evolved into a self-directed coronary disease management program. We never set out to create something as wildly ambitious as a do-it-yourself-at-home coronary disease risk management program, but that is how it inadvertently turned out.

How we went from Information Provider to Health Empowerment Program

So we never intended to take on something so seemingly impossible as managing coronary risk on your own. But, because we armed people with such empowering, profound insights into better ways to manage their heart disease risk beyond “don’t smoke, cut saturated fat, be active, and take a statin drug”—the typical advice offered by doctors—they returned after an interaction with their doctors disappointed: doctors often declared such strategies unnecessary, or the doctor didn’t understand them—even when there were clear-cut clinical data already available to support their use. In other words, the patients—everyday people, not experts—knew more than their doctors. 

This flip-flop in the balance of knowledge made for some very interesting stories, like “Harold” (not his real name) who, having survived a heart attack and received a stent, was told by his doctor to cut his fat intake, eat more whole grains, exercise, take aspirin and a beta blocker drug, and reduce his cholesterol values with a statin drug. Upon learning all the additional information from the Track Your Plaque program, Harold returned to his doctor and asked “I’m not so ready to just go along with this idea of ‘reducing cholesterol’ to address heart disease risk. Because my goal is to gain as much control over coronary disease as possible, maybe even reverse it, I’d like to address some additional issues that I believe may be important. I’d like to have my advanced lipoproteins drawn to measure the proportion of small LDL particles I have, whether I have lipoprotein(a), an omega-3 fatty acid index and 25-hydroxy vitamin D level, and a thyroid assessment. Oh, and I believe I should also have an assessment of my inflammation status, perhaps a c-reactive protein and phospholipase A2, and my blood sugar status measured with a fasting glucose, insulin, and hemoglobin A1c.” Harold’s doctor was dumbfounded and speechless. Rather than reveal his ignorance, his doctor advised Harold that none of that was necessary, sending him on his way and telling him that he was fine.

But this left Harold with a sour taste in his mouth, having engaged in many online discussions with people who had followed conventional advice that resulted in more heart attack, more heart procedures—the conventional answers simply did not work. He also discussed his situation with people who had successfully obtained the additional information he sought, added it to their program and enjoyed dramatically improved health, including freedom from more heart attacks, heart symptoms, and heart procedures, as well as improved overall health. So Harold found an easy way to obtain the testing on his own. Within a couple of weeks, he returned to his online community and shared all his information. Within moments, he was provided useful discussion to help him understand the values, all leading to changes in nutrition, nutritional supplement choices, how and where to get the simple tools necessary, such as iodine and vitamin D supplements. He even entered his data, choosing which values he was willing to share with others, which remained private, allowing him to compare his own follow-up values several months later. Engaged in this process, self-directed but collaborative, he witnessed marked transformations in his health. Not only did he never again—over several years—ever re-develop heart symptoms nor require any more trips back to the cath lab, he lost weight, reversed a pre-diabetic sugar profile, improved his cholesterol values without drugs, got rid of the acid reflux symptoms he endured for many years, dropped his blood pressure to normal, enjoyed better mood, energy, and sleep. Slender, healthier, all accomplished without his doctor. 

Harold returned to his doctor for a routine follow-up. Slender, energetic, without complaints, on no drugs except the aspirin for his stent, the basic laboratory assessment his doctor ordered in front of him, his doctor admitted,” Well, I don’t know how you’re doing it, but these values look like a 20-year old substituted his blood for yours. They’re unbelievable. What drugs are you taking to do this?” “No drugs,” Harold replied, “I’m following a program to reverse heart disease, but it means doing some things that are different from conventional solutions.” His doctor closed their meeting with the signature response of doctors nationwide: “Well, I don’t understand what you are doing, but just keep doing it.”

Yes, Harold knew more about how to control heart disease than his doctor, more than his cardiologist. The cardiologist knew how to insert a stent or defibrillator. But deliver information that empowered Harold in all aspects of health from head to toe, while also dramatically reducing, perhaps eliminating, his coronary disease risk? As you now know, that is not what conventional healthcare does, nor is it interested in doing so, as it would relinquish control and threaten to cut off this hugely profitable revenue stream that drives “healthcare.”

Having managed to inadvertently create a self-directed coronary risk management program with such spectacular results and in probably one of the most difficult areas of all—heart disease—it became clear that a similar approach could be even more easily applied to many other areas of health, such as weight loss, bone health, cholesterol and blood pressure issues, diabetes and pre-diabetes, hormonal health, autoimmune conditions, and others. You can do it when empowered by safe, effective information, and supported by a community of sharing and collaboration. We don’t fire our doctors; they are there when we need them when, for instance, we get injured or catch pneumonia, or as an occasional resource. But doctors should no longer be able to get away with neglect, misinformation, or blindly directing you to the next revenue-generating procedure because you are empowered by the information and support you receive in Cureality.

As we get more effective in delivering this information and new tools to you, just imagine what we can accomplish in this new age of information and self-empowerment. The future for us is bright with ambitions for better interactive tools with Cureality expert staff, better ways to crowd source health answers, provide more engaging community conversation, all while the health insights that help accomplish our self-directed health goals get better and better. Each person that joins Cureality helps make this service more effective because your wisdom, insights, and experience are added to the collective knowledge. We are more powerful together than we are as individuals.

If you are already a Cureality Member, please add your comments and questions to the growing conversation. If you are not a Member, consider joining our discussions, as each new voice gets us closer and closer to better answers to take back control over health.

Sit Less and Move More.

21. July 2014 Amber B (0)


We sit way too much. Many of us have desk jobs where we sit for 8 to 9 hours a day. After we leave the office, we sit in our car to run errands. We follow that by sitting down to eat dinner. Our day ends by sitting on the couch to unwind by watching some television.

Many of us will be sitting a good 12 to 15 hours each and every day. Unfortunately the research shows that long hours of sitting can lead to obesity, heart disease, diabetes, and even early death. Don’t be fooled that your workout is enough movement. You can still be active and sedentary.

How can you add more movement to your day? First, think about all the times you find yourself sitting during the day. Then come up with a creative way that you can get out of the seat and move your feet.

Here are a couple of examples:

Instead of driving everywhere, jump on your bike. The picture above is of the bike I use to go to work or run errands. Bike riding is great exercise, greener transportation and a great stress relief.

We spend a lot of time at work sitting in front of the computer or the phone. Prop your laptop on a bookshelf to create a standing workstation. You can also purchase a sit-stand workstation you can adjust throughout the day. Get a headset and stand during phone calls.

Walk during your lunch break. Walk to the coffee shop, the mailbox, and the dry cleaners. Get your errands done on foot or just enjoy a stroll outside.

Take a movement break every hour. Do some desk push-ups, squats or walk the stairs. Need to communicate with a coworker? Don't email, walk over and talk to them.

Human beings are meant to move, not sit in chairs all day. I want to challenge you to incorporate more movement into your day. I'd love to read your comments how you move more and sit less.

Have You Had Your Prebiotics Today?

11. July 2014 Lisa G (0)


Prebiotics and resistant starch may be the missing link to your digestive health. Indigestible fibers that allow healthy bowel flora to proliferate and thrive are often called prebiotics. They are also known as resistant starches, because they are resistant to human digestion. I recently had a client call the addition of resistance starch to her diet, “the missing link my body needed”.

A starch that resists digestion and reaches the large intestine becomes food for the healthy bacteria in the large intestine. These bacteria can break down and “feed on” the resistant starch thus providing the friendly bacteria with the fuel they need to survive.

Imbalance of the quantity and type of bacteria species present in the gut contributes to gastrointestinal illness, blood sugar imbalance, obesity, mood disorders, and immune system challenges.

Green unripe bananas and plantains are one of best sources for prebiotic fiber content with 27 to 30 grams of fiber in one medium banana. Green bananas are essentially inedible. They are most easily incorporated into diet by blending into a smoothie.

One mistake frequently made incorporating prebiotic fibers from bananas is consuming bananas that are too ripe. Once the banana ripens the resistant starch is degraded and become a digestible starch. Thus, no longer a good prebiotic fiber source. In fact, the riper the banana becomes the higher the glycemic (blood sugar) response.

It can be difficult to find bananas that are very green. I made several trips to my local grocery store to find these bowel flora champions. I find it helpful to ask the produce clerk to take a look at the shipment that just arrived, noting the day the shipment arrives, for the best chance to gobble up these green beauties.

In an effort to keep green bananas green I tried a few strategies. One that sounded promising was wrapping the end of the banana to prevent the ethylene gas, which ripens the fruit, from dissipating. You can see from the image this clearly did not work. After a mere two days the green bananas were no longer green. What I found works best is placing the green bananas in the fridge. This halts the ripening process. The skin of the banana will turn brown, which is normal, but the fruit inside is still good. I’ve kept bananas in my fridge for up to 8 days and they hold up well other than the brownish black discoloring that develops on the skin. The banana will be firm and require a knife to cut the skin off the banana.

If you’d like to learn more about prebiotics and strategies to support resolution of common gastrointestinal complaints read the recently release Cureality Guide to Healthy Bowel Flora by Dr. Davis. This guide is one of the many valuable resources available exclusively to Cureality.com members.
---Lisa Grudzielanek, MS, RDN,CD,CDE
Cureality Nutrition Specialist

Something is Better Than Nothing

2. July 2014 Amber B (0)


This past weekend I attended a fitness conference with an amazing lineup of presenters. Even after 11 years in the fitness industry, I love attending these events. I’m a lifetime student always learning more and honing my craft.

I went to a presentation by Al Vermeil about joint mobility, not knowing anything about him. To my surprise, Al was the strength and conditioning coach for the Chicago Bulls and the San Francisco 49ers the years these teams won championships in their respective sports. That’s a pretty impressive resume.

Al was a great presenter, full of fun and practical advice. During his presentation, Al said the following statement:

“Every time you miss a workout, the next one is easier to miss.”

This statement really hit home because I’ve seen this time and time again working in the fitness industry and in my own life. One workout is missed, then an entire week of workouts are missed, then it’s been an entire month of never setting foot back into the gym.

It’s easy to get thrown off your workout routine when life gets busy and days get long. So what do you do? Do you just trash your workout plan?

The all or nothing attitude is common when it comes to making health changes. Either you’re following your plan 100% or you not. I’m here to tell you that doing something is better than nothing. Doing part of your workout or a mini workout is better than missing an entire workout.

The other day I had the choice to do something or nothing. I had a full day of work meetings, video, and family commitments. Here is what happened. I did shorter variation of my joint mobility routine. I followed that with a quick kettlebell circuit of 25 kettlebell swings, 12 kettlebell overhead presses, and 12 kettlebell goblet squats. I did three rounds of this circuit. That’s it! The following day, I got back to my regular exercise routine.

Be consistent with movement and you’ll always see improvements. That’s the magic of exercise. You'll get better if you just do it.

What’s the Problem with My “Healthy” Bowl of Oatmeal?

26. June 2014 Lisa G Nutrition, Oatmeal (0)


Food manufacturers have clever ways to market foods to us. Unfortunately, many foods that have a reputation for being healthy are no more than junk food disguised as a healthy food choice. I commonly see people under the influence of a “health halo” effect. This is due to strategic marketing efforts. People overestimate the nutritional value of a food that is labeled “good for you” or they underestimate the negative impact of a food because it contains a healthful ingredient, like flaxseed or fiber. In fact, a recent study from the University of Houston found that terms on food labels such as antioxidants, all-natural, and gluten-free often are used to give an otherwise standard food a "healthy" halo, and influence consumption from the well- intended consumer.

Case in point-- oatmeal. We’ve all heard about the cholesterol lower benefits from soluble fiber contained in oatmeal. It’s blasted all over packages with a paid endorsement from The American Heart Association. However, that’s not the whole story. Most people enjoy a cup of oatmeal with one to two tablespoons of added sugar and fruit such as a ripe, yellow banana. In other words, let’s enjoy a bowl of “send my blood sugar through the roof” high glycemic oatmeal. The glycemic index of oatmeal is 55, and instant oatmeal is 83. Top that with more table sugar, glycemic index 58-65 and better yet top that with a high glycemic, ripe banana with a GI of 62.

Preparing one packet of regular instant oatmeal with one tablespoon of sugar and a medium ripe banana five days per week would result in the sugar equivalent of more than 5 1/2 cups of sugar per month!

Furthermore, the story many Americans are missing is all of that sugar intake, from their so-called “healthy” bowl of oatmeal, actually raises small-dense LDL cholesterol particles, increases blood sugar and contributes to insulin resistance, faulty gut flora, and belly fat.

How do we improve upon our bowl of oatmeal? Enjoy a bowl of hot coconut flaxseed cereal, eggs any variety of ways, or last night’s leftover salmon and vegetables.

The Cureality program provides tools, guidance, and support that does not follow the party line but rather offers nutrition solutions that address the underlying causes for proliferation of many chronic diseases.

Power in Numbers

25. June 2014 William Davis (0)


In his book, The Wisdom of Crowds, author James Surowiecki begins with the story of an ox judging competition in which 800 people—not ox experts nor breeders, just ordinary people attending a county fair—were asked to guess the weight of the ox. The competition was conducted by a scientist, Francis Galton, who held a low opinion of the intelligence of the average person, remarking that “the stupidity and wrong-headedness of many men and women being so great as to be scarcely credible.” He hoped to prove, by examining the various guesses, that the average person had no idea of how to judge the real answer. After all participants casted their written votes, Galton tallied up the total and averaged the result: 1,197 pounds—just one pound off from the real weight of 1,198 pounds. Few individuals actually guessed the correct weight themselves but, when the opinions of many were combined, the result was near-perfect.

Crowds can also be a source of irrational behavior, panic, and stampede. Witness any modern football or soccer game, for instance, in which fights break out over an issue as minor as a disputed call or a heckle. Or go back through history to the countless events when mass hysteria ruled, such as the Salem Witch Trials or Orson Welles’ War of the Worlds radio broadcast.

Let’s put aside examples of mass emotional chaos of the sort that causes crowds to stampede store doors on Black Friday. Let’s focus instead on conscious, considered, thoughtful opinions. We all accept that there are as many opinions on issues as there are people, not uncommonly with widely divergent views. But can we, as Galton’s famous experiment did, combine the opinions of many and come away with some fruitful insight—the correct answer? Just as the people participating in Galton’s experiment were not experts, so Cureality participants—a crowd-sourced collection of opinions—are not experts. If we were to poll everyone to identify their area of expertise or experience, it would likely include finance, the retail industry, raising children, or teaching—but not health. Yes, we have experts curating the direction of content, but we also crowd-source collective opinion.

Right now, Cureality is based on existing science, the philosophy of self-directed health, combined with guidance and community to help the participant along in the sometimes complex world of health questions. But as our processes and procedures improve, can we—like Galton’s ox weight guessers—come away with coalescent wisdom, answers to our health questions, near-perfect solutions to health conditions that have eluded the “experts” for centuries?

I think that we can. No, I know that we can. We enter a new age in information and harness the power of the crowd-sourcing of solutions, even when no single individual has the complete answer herself.

Use This Trick to Boost Exercise Motivation

23. June 2014 Amber B (0)


Are you been struggling to get your workouts in? 

Do you belong to a gym and find that you're not going?

Do you have exercise equipment sitting in your basement collecting dust because you find that you just can’t get yourself down there?

If you answered, “yes” to any of these questions you are not alone. Many people struggle with finding the motivation to exercise.

The problem here is that you have head trash going on. Head trash is that voice inside your head coming up with a million excuses that inhibit you from carving out a bit of time to take care of yourself.

Head trash will tell you that you’re too tired, even though a workout would give you a boost of energy.

Head trash will tell you that you’re too busy, even though you just spent a half hour on Facebook.

Head trash is barking at you to take care of others, even thought you know your health is important for you well being.

Head trash is a real conflict that can get in the way of our health and fitness goals. We start an exercise program with the intentions of a long-term commitment. But after the initial excitement wears off, we find our workouts occurring less frequently. Head trash begins to take over and soon we find ourselves not exercising at all.

Here is my secret for winning the battle over the head trash that keeps getting in way of your workouts. Tell yourself that you are only going to exercise for 10 minutes and evaluate if you want to continue. If you're truly too tired you can stop after 10 minutes. If you're truly too busy you can stop and move onto a task that needs your attention.

Making this deal with your mind that you are only going to exercise for 10 minutes seems reasonable. The head trash will become quite because your mind is convinced it has an out within 10 minutes.

I've used this 10-minute trick myself. I grind through the first few minutes, but then the magic happens. Once you hit the 10-minute mark your body takes over. Exercise feels amazing and your body is energized and enjoying the movement. You have tricked your mind to get over the hurdle of starting and now you’re in the exercise groove.

Try the 10-minute trick next time your head trash is getting in the way of your workout. You'll be amazed how your workout consistency improves.

All posts by william-davis

Heart scan gone wrong

6. February 2010 William Davis (9)
Those of you reading the Heart Scan Blog, I hope, have come to appreciate the power in measuring atherosclerotic plaque, the stuff of coronary artery disease, and not relying on indirect potential "risk factors," especially the fictitious LDL cholesterol.

However, like all things, even a great thing like heart scans can be misused. Here's a story of how a heart scan should NOT be used, submitted by a reader.


Dr. Davis,

First of all, let me start out by commending you on all of the work you are doing with your website, blogs, etc. You are truly a breath of fresh air at a time when conventional medicine is no longer making any sense. In the last 3 years or so, I have spent a lot of time using the internet to try and find answers . . . and just about every time, when I find things that make "sense," it coincides which the recommendations you provide. Thank You!!

I am 56 years old, and roughly 5 years ago I bought your book, Track Your Plaque, primarily because I had asked my then Internal Medicine physician about why we weren't more "proactive" about determining the state of our cardiovascular health...since the means to do so existed (scans). He was trying to get me to go on a statin because my cholesterol #'s were a little high and at the time I smoked. Other than that, I was in perfectly good health with no side effects or issues. The following year at my annual physical, we again discussed this and he gave me a few options and I ended up having a calcium score done, which showed some blockage, but again, I never had any pains, sweats, or any other symptoms whatsoever, and I am a very active former athlete. This is when I bought your book to try and set a course of plan that wouldn't just include pharmaceuticals.

At the same time, my father was in his last months of life dealing with prostate cancer and the multiple radiation and chemo treatments, so I was making many trips from my home to be with him . . . a 4 hour drive, and very disruptive to family, as I still have 3 kids at home. At what I thought was going to be my last visit with him, I stopped at the cemetery he had planned on being buried to confirm details and such and then started home.

As I was driving, a symptom hit me which I was unfamiliar with (pretty sure it was an anxiety attack now) and I stopped at a friend's house in Chicago, as I didn't want this to be a heart attack while I was driving. This is when I began thinking about the heart scan and the blockage, and ended up driving back later that night and went right to the ER....not because I had any chest pains, but thought it best to be checked out because I did not want to go before my dad did. I ended up staying the night. In the morning the cardiologist PA [physician's assistant] came in with a copy of my calcium scoring and said it was best to have a heart cath...which I was in total agreement with since it would definitively tell me the current condition of my coronary vessels. As I was getting ready to be wheeled into the cath lab, they approached me with a form that would allow them to treat (stent). This is where I became very uncomfortable, in that I had never even met the cardiologist . . . and I didn't like this. No one ever had asked if I was experiencing pains or anything else . . . but I buckled and signed the form.

Before you knew it, I was awake watching my heart being cathed and the cardiologist angry because they did not have all the right sizes of stents, so he had to use a couple extra and I ended up w/5 total . . . and my life changed forever! In looking back, I can't necessarily argue the need for intervention, but in hindsight, it would have been nice to have tried an alternative method of reversing my plaque, especially since I had never experienced any symptoms and didn't appear to be in any imminent danger.

Upon release from the hospital I was put on a cocktail of drugs that typically follow and I then began to search and research. No one talked to me about lifestyle changes other that smoking....but nothing on diet or other means of cholesterol control, etc....in fact, when I had to pick out my meals in the hospital, they wouldn't let me have cheese....but the rice crispy treat was fine....how stupid! They originally told me the Plavix had to last 6 months....and then 12....and then 2 years....I stayed on it for 1-1/2 years and it was the only thing other than a baby aspirin. I went to another cardiologist out of town and he wanted me back on 5 or 6 medications and said that now I had the stents....I would have to be on these for life.....and he was the expert that talked at several main conferences.....my last trip to him.

Now, fast forward to about 6 months ago: I was participating in a father-son soccer scrimmage and was playing goalie. It was wet out and I couldn't catch very well. So being the competitive person I am, I resorted to using my chest on several of the saves and also took a direct blow to my eye ( I wear glasses) and the eye started swelling up pretty good. We then finished and went inside to have pizza and everyone was concerned about my eye. About 30 minutes later I excused myself as i felt some pretty significant sweats and subsequently a pretty severe pain directly in the middle of my chest....I was having a heart attack! Called 911 and went to hospital (2-1/2 years since original stents) and my local cardiologist removed the blockage that was at the anterior portion of my 1st stent causing the blockage. The huge disappointment to me is that I had taken many steps to improve my overall health. But now that I have foreign bodies in my vessels, the chance of further clotting is something that i will most likely always have to live with.

BU, Michigan



This is an example of how heart scans should NOT be used. They should NEVER be used to justify a procedure, no matter how high the score or where the plaque is located. The "need" for procedures is determined by symptoms (BU's symptoms were hardly representative of heart disease), blood findings, EKG, stress testing, and perhaps CT coronary angiography. "Need" for procedures can never be justified simply on the basis of the presence of plaque by a heart scan calcium score.

Unnecessary procedures like the one BU underwent are not entirely benign, as his experience at the soccer game demonstrated.

Heart scans are truly helpful things. But, like many good things, they are subject to misuse in the hands of the uncaring or greedy.

Blood sugar: Fasting vs. postprandial

5. February 2010 William Davis (23)
Peter's fasting blood glucose: 89 mg/dl--perfect.

After one whole wheat bagel, apple, black coffee: 157 mg/dl--diabetic-range.

How common is this: Normal fasting blood sugar with diabetic range postprandial (after-eating) blood sugar?

It is shockingly common.

The endocrinologists have known this for some years, since a number of studies using oral glucose tolerance testing (OGTT) have demonstrated that fasting glucose is not a good method of screening people for diabetes or pre-diabetes, nor does it predict the magnitude of postprandial glucose. (In an OGTT, you usually drink 75 grams of glucose as a cola drink, followed by blood sugar checks. The conventional cut off for "impaired glucose tolerance" is 140-200 mg/dl; diabetes is 200 mg/dl or greater.) People with glucose levels during OGTT as high as 200 mg/dl may have normal fasting values below 100 mg/dl.

High postprandial glucose values are a coronary risk factor. While conventional guidelines say that a postprandial glucose (i.e., during OGTT) of 140 mg/dl or greater is a concern, coronary risk starts well below this. Risk is increased approximately 50% at 126 mg/dl. Risk may begin with postprandial glucoses as low as 100 mg/dl.

For this reason, postprandial (not OGTT) glucose checks are becoming an integral part of the Track Your Plaque program. We encourage postprandial blood glucose checks, followed by efforts to reduce postprandial glucose if they are high. More on this in future.

Diabetes from fruit

2. February 2010 William Davis (38)
Mitch sat in my office, looking much the same as he had on prior visits.

At 5 ft 7 inches, he weighed a comfortable 159 lb, though he did have a small visible "paunch" above his beltline.

I had been seeing Mitch for his heart scan score of 1157 caused by low HDL of 38 mg/dl, severe small LDL (87% of total LDL), and lipoprotein (a).

Part of Mitch's therapeutic program was elimination of wheat, cornstarch, and sugars, the three most flagrant triggers of small LDL particles, and weighing his diet in favor of oils and fats to reduce Lp(a). However, Mitch somehow failed to follow our restriction on fruit, which we limit to no more than two 4 oz servings per day, preferably berries. He thought we said "Eat all the fruit you want." And so he did.

Mitch had a banana, orange, and blueberries for breakfast. For lunch, along with some tuna or soup, he'd typically have half a melon, a pear, and red grapes. For snacks, he'd have an apple or nectarine. After dinner, it wasn't unusual for Mitch to have another piece of fruit for dessert.

Up until Mitch's last visit, he'd had blood glucose levels of 100-112 mg/dl, above normal and reflecting mild insulin resistance and pre-diabetes. Today, on his unlimited fruit diet, his blood sugar: 166 mg/dl--well into diabetes territory.

I helped Mitch understand the principles of our diet better and advised him to reduce his fruit intake to no more than the 2 small servings per day, as well as sticking to our "no wheat, no cornstarch, no sugar" principles.

While fruit is certainly better than, say, a half-cup of gummy bears (84.06 g carbohydrates, 50.12 g sugars), fruit is unavoidably high in carbohydrates and sugars.

Take a look at the carbohydrate content of some common fruits:

Apple, 1 medium (2-3/4" dia)
19.06 g carbohydrate (14.34 g sugar)

Banana, 1 medium (7" to 7-7/8" long)
26.95 g carbohydrate (14.43 g sugar)

Grapes, 1 cup
27.33 g carbohydrate (23.37 g sugar)

Pear, 1 medium
25.66 g carbohydrate (16.27 g sugar)

Source: USDA Food and Nutrient Database

Fruit has many healthy components, of course, such as fiber, flavonoids, and vitamin C. But it also comes with plenty of sugar. This is especially true of modern fruit, the sort that has been cultivated, hybridized, fertilized, gassed, etc. for size and sugar content.

When you hear such conventional advice like "eat plenty of fruits and vegetables," you should hear instead: "eat plenty of vegetables. Eat a small quantity of fruit."

The sniff test

31. January 2010 William Davis (0)
It is well established that omega-3 fatty acids from fish oil are free of mercury, PCBs, furans, and other pesticide residues. Several independent analyses have all agreed: little to none are contained in fish oil. In the Consumer Lab series of assessments, for example, no fish oil supplement failed because of any heavy metal or pesticide residue.

However, oxidative byproducts are a problem. Just as fish that sits on the store shelf or your refrigerator too long starts to smell "fishy," so will fish oil. When fish or fish oil becomes rancid, smelling like rotten fish at its worst, it means that

Is there something fishy about fish oil?

27. January 2010 William Davis (0)
To be sure, there's plenty of misinformation out there about fish oil. Take a look at the swill that passes for health information on Woman's Day: On Call with Dr. Sandy: Fish Oil and Mercury:



Reader Question: My doctor recommended that I take a fish oil supplement, but I'm concerned about mercury. Is there any way to tell which brands are lowest in mercury content?



On Call Response: When it comes to OTC supplements, the answer is no. Though most fish oil supplements sold by major brands are probably safe, there's really no way to tell what's in the bottle or how much mercury it might contain.



Perhaps Dr. Sandy should read the many independent analyses performed on nutritional supplement fish oil, including those at Consumer Lab and Consumer Report before she offers her blind criticisms.

Lovaza vs fish oil supplements?

27. January 2010 William Davis (55)
Lovaza is the FDA-approved form of fish oil that is available only by prescription. It contains 842 mg of the omega-3 fatty acids, EPA and DHA, per capsule.

The FDA application for Lovaza is viewable here on the FDA website. Interestingly, while there is plenty of the usual regulatory gobbledy-gook about toxicology, dose escalation, and efficacy in the extensive documentation, there is little said about the issue of contamination.

In other words, critics of nutritional supplement fish oil harp on the possibility of contamination with mercury and pesticide residues, like dioxin and PCBs (polychlorinated biphenyls). Yet there is virtually nothing about these same issues in the FDA application for Lovaza.

Let's take a look at a sample over-the-counter fish oil product. Our friends at PharmaNutrients (a new Track Your Plaque partner for nutritional supplements) have a fish oil product called PharmaNutrients" Cardio. Here's an independent analysis of the Cardio product (per 1000 mg fish oil capsule):

EPA content: 566.1 mg
DHA content: 216.6 mg
(Total EPA + DHA 782.7 mg)

Cardio passed all tests for peroxides, PCBs, dioxin, furans, dioxin-like PCBs, and heavy metals (arsenic, cadmium, lead, mercury) using criteria at least 60% more stringent than European Commission (EC) standards (EC standard <2 picograms/gm for dioxins and furans, PharmaNutrients <1 picograms/gm; EC standard <10 picograms/gm for dioxin-like PCBs, PharmaNutrients <3 picograms/gm). PCBs levels in particular are less than 0.009 ppm, 90% below the industry-wide purity standard of 0.09 ppm. Likewise, mercury is >90% lower than European Commission standards.

In other words, this over-the-counter "pharmaceutical grade" fish oil has virtually nothing but omega-3 fatty acids.

Interestingly, the PharmaNutrients fish oil capsule also contains the third omega-3 fatty acid, docosapentaenoic acid (DPA), a neglected form that some authorities have proposed has superior cardiovascular protective properties over eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). If DPA is included in the analysis, PharmaNutrient's Cardio contains a total of 900 mg omega-3 fatty acids per capsule.

At some point, I'd like to see a head-to-head comparison not just on purity grounds, since I am convinced that high-quality products like Cardio can match or exceed the purity of prescription fish oil, but on efficacy in raising omega-3 blood levels, the omega-3 index. (The omega-3 index is a predictor of heart attack and sudden cardiac death--the higher, the better.) My prediction: High-quality fish oil supplements will match or exceed prescription fish oil.

More on blood sugar

25. January 2010 William Davis (36)
Take any of the following foods:

One chicken breast
Quarter-pound ground beef
6 oz salmon steak
½ cup raw almonds
3 eggs scrambled in olive oil

How much is blood sugar increased by any item in the above list?

If you said virtually zero, you’re correct. Eat any of these foods, regardless of portion size, and blood sugar won’t change substantially. If you started with a blood sugar of, say, 90 mg/dl, 1-2 hours later it would be 90 mg/dl. It might go up or even down a few milligrams, but for all practical purposes it remains substantially unchanged.

How much is blood sugar increased by the foods in this list:

2 slices multigrain bread
1 whole wheat bagel
4 oz high-fiber breakfast cereal
2 whole grain pancakes, 2 oz maple syrup

The foods in this list are a different story from the first. Depending on your body weight, exercise habits, and other factors, a typical blood sugar response in an otherwise healthy non-diabetic person would be 120 mg/dl to 160 mg/dl. In someone with diabetes, it could easily exceed 200 mg/dl.

That isn’t good. Large blood sugar excursions to 140 mg/dl have been clearly associated with greater risk for heart attack, progression to diabetes, inflammatory responses, and other adverse health effects. In fact, blood sugars as low as 100 mg/dl after eating have been associated with increased cardiovascular risk.

Then why are the USDA, American Heart Association, the American Dietetic Association, and the American Diabetes Association telling us to eat more of the foods that shoot blood sugar up to such high levels? “Eat more healthy whole grains”?

To see how much the issue of exaggerated blood sugars after eating applies to you, a simple blood sugar check 1-2 hours after eating can show you. Either your doctor can have the test drawn or you can purchase your own inexpensive glucose meter (e.g., Walmart, Wagreens).

My prediction: You will be very surprised at blood sugar responses after common foods, including “healthy whole grains.” And, by the way, keeping blood sugar excursions to a minimum will facilitate weight loss.

Postprandial blood sugar: Almonds vs. whole wheat bread

22. January 2010 William Davis (0)
Here's my postprandial (after-eating) blood glucose demonstration.



I tested raw almonds vs. 100% whole wheat bread, matched for calories. (Full nutritional composition below.)



Blood sugars:

Raw almonds

Start:

One-hour after eating:





2 slices 100% whole wheat bread

Start:

One-hour after eating:





100% whole wheat bread, 2 large slices

Water (g) 24.69

Energy (kcal) 158

Protein (g) 8.29

Fat, total (g) 2.14

Carbohydrate (g) 26.43

Sugars, total (g) 3.56

Fiber, total dietary (g) 4.4

Cholesterol (mg) 0

Saturated fatty acids, total (g) 0.478

Monounsaturated fatty acids, total (g) 1.022

Polyunsaturated fatty acids, total (g) 0.384





23 almonds, raw



Energy (kcal) 159

Protein (g) 5.86

Fat, total (g) 13.64

Carbohydrate (g) 5.98

Sugars, total (g) 1.07

Fiber, total dietary (g) 3.4

Cholesterol (mg) 0

Saturated fatty acids, total (g) 1.03

Monounsaturated fatty acids, total (g) 8.525

Polyunsaturated fatty acids, total (g) 3.331



To get low-carb right, you need to check blood sugars

19. January 2010 William Davis (60)
Reducing your carbohydrate exposure, particularly to wheat, cornstarch, and sucrose (table sugar), helps with weight loss; reduction of triglycerides, small LDL, and c-reactive protein; increases HDL; reduces blood pressure. There should be no remaining doubt on these effects.

However, I am going to propose that you cannot truly get your low-carb diet right without checking blood sugars. Let me explain.

Carbohydrates are the dominant driver of blood sugar (glucose) after eating. But it's clear that we also obtain some wonderfully healthy nutrients from carbohydrate sources: Think anthocyanins from blueberries and pomegranates, vitamin C from citrus, and soluble fiber from beans. There are many good things in carbohydrate foods.

How do we weigh the need to reduce carbohydrates with their benefits?

Blood sugar after eating ("postprandial") is the best index of carbohydrate metabolism we have (not fasting blood sugar). It also provides an indirect gauge of small LDL. Checking your blood sugar (glucose) has become an easy and relatively inexpensive tool that just about anybody can incorporate into health habits. More often than not, it can also provide you with some unexpected insights about your response to diet.

If you’re not a diabetic, why bother checking blood sugar? New studies have documented the increased likelihood of cardiovascular events with increased postprandial blood sugars well below the ranges regarded as diabetic. A blood sugar level of 140 mg/dl after a meal carries 30-60% increased (relative) risk for heart attack and other events. The increase in risk begins at even lower levels, perhaps 110 mg/dl or lower after-eating.

We use a one-hour after eating blood sugar to gauge the effects of a meal. If, for instance, your dinner of baked chicken, asparagus brushed with olive oil, sauteed mushrooms, mashed potatoes, and a piece of Italian bread yields a one-hour blood sugar of 155 mg/dl, you know that something is wrong. (This is far more common than most people think.)

Doing this myself, I have been shocked at the times I've had an unexpectedly high blood sugar from seemingly "safe' foods, or when a store- or restaurant-bought meal had some concealed source of sugar or carbohydrate. (I recently had a restaurant meal of a turkey burger with cheese, mixed salad with balsamic vinegar dressing, along with a few bites of my wife's veggie omelet. Blood sugar one hour later: 127 mg/dl. I believe sugar added to the salad dressing was the culprit.)

You can now purchase your own blood glucose monitor at stores like Walmart and Walgreens for $10-20. You will also need to purchase the fingerstick lancets and test strips; the test strips are the most costly part of the picture, usually running $0.50 to $1.00 per test strip. But since people without diabetes check their blood sugar only occasionally, the cost of the test strips is, over time, modest. I've had several devices over the years, but my current favorite for ease-of-use is the LifeScan OneTouch UltraMini that cost me $18.99 at Walgreens.

Checking after-meal blood sugars is, in my view, a powerful means of managing diet when reducing carbohydrate exposure is your goal. It provides immediate feedback on the carbohydrate aspect of your diet, allowing you to adjust and tweak carbohydrate intake to your individual metabolism.

Food sources of vitamin K2: Reprint

19. January 2010 William Davis (59)
For some reason, my December, 2007, Heart Scan Blog post, Food sources of vitamin K2, has been receiving a lot of traffic.

I therefore reprint the vitamin K2 post below.




Vitamin K2 is emerging as an exciting player in the control and possible regression of coronary atherosclerotic plaque. Only about 10% of dietary vitamin K intake is in the K2 form, the other 90% being the more common K1.

The ideal source of K2 is natto, the unpalatable, gooey, slimy mass of fermented soybeans that Japanese eat and has been held responsible for substantial decreases in osteoporosis and bone fractures of aging. Natto has an ammonia-like bouquet, in addition to its phlegmy consistency that makes it virtually inedible to anyone but native Japanese.

I say that the conversation on vitamin K2 is emerging because of a number of uncertainties: What form of vitamin K2 is best (so-called MK-4 vs. MK7 vs. MK-9, all of which vary in structure and duration of action in human blood)? What dose is required for bone benefits vs. other benefits outside of bone health? Why would humans have developed a need for a nutrient that is created through fermentation with only small quantities in meats and other non-fermented foods?

Much of the developing research on vit K2 is coming from the laboratories of Drs. Vermeer, Geleijnse, and Schurgers at the University of Maastricht in the Netherlands, along with several laboratories in Japan, the champions of K2.

MK-7 and MK-8,9,10 come from bacterial fermentation, whether in natto, cheese, or in your intestinal tract; MK-4 is naturally synthesized by animals from vitamin K1. While natto is the richest source of the MK-7 form, egg yolks and fermented cheeses are the richest sources of the MK-4 form.

Chicken contains about 8 mcg MK-4 per 3 1/2 oz serving; beef contains about 1 mcg. Egg yolks contain 31 mcg MK-4 per 3 1/2 oz serving (app. 6 raw yolks). Hard cheeses contain about 5 mcg MK-4 per 3 1/2 oz serving, about 70 mcg of MK-8,9; soft cheeses contain about 30% less. Natto contains about 1000 mcg of MK-7, 84 mcg MK-8, and no MK-4 per 3 1/2 oz serving.















Feta cheese

Thanks to the research efforts of the Dutch and Japanese groups, several phenomena surrounding vitamin K2 are clear, even well-established fact:

--Vitamin K2 supplementation (via frequent natto consumption or pharmaceutical doses of K2) substantially improves bone health. While K2 by itself exerts significant bone density/strength increasing properties in dozens of studies, when combined with other bone health-promoting agents (e.g., vitamin D3, prescription drugs like Fosamax and calcitonin), an exaggerated synergy of bone health-promoting effects develop.



--The MK-4 form of vitamin K2 is short-lived, lasting only 3-4 hours in the body. The MK-7 form, in contrast, the form in natto, lasts several days. MK-7 and MK-8-10 are extremely well absorbed, virtually complete.

--Bone health benefits have been shown for both the MK-7 and MK-4 forms.

--Coumadin (warfarin) blocks all forms of vitamin K.





Interestingly, farm-raised meats and eggs do not differ from factory farm-raised foods in K2 content. (But please do not regard this as an endorsement of factory farm foods.)

Another interesting fact: Since mammals synthesize a small quantity of Vit K2 forms from vitamin K1, then eating lots of green vegetables should provide substrate for some quantity of K2 conversion. However, work by Schurgers et al have shown that K1 absorption is poor, no more than 10%, but increases significantly when vegetables are eaten in the presence of oils. (Thus arguing that oils are meant to be part of the human diet. Does your olive oil or oil-based salad dressing represent fulfillment of some subconscious biologic imperative?)

If we believe the data of the Rotterdam Heart Study, then a threshold of 32.7 micrograms of K2 from cheese yields the reduction in cardiovascular events and aortic calcification.

It's all very, very interesting. My prediction is that abnormal (pathologic) calcium deposition will prove to be a basic process that parallels atherosclerotic plaque growth, and that manipulation of phenomena that impact on calcium depostion also impact on atherosclerotic plaque growth. Vitamins D3 and K2 provide potential potent means of at least partially normalizing these processes.

As the data matures, I am going to enjoy my gouda, Emmenthaler, Gruyere, and feta cheeses, along with a few egg yolks. I'm going to be certain to include healthy oils like olive and canola with my vegetables.


All images courtesy Wikipedia.

Copyright 2007 William Davis, MD

Vitamin D for winter blues?

25. April 2006 William Davis (0)
Winter is now over and spring is in the air, even in Wisconsin.

In this part of the country, winter blues are commonplace. Sometimes called Seasonal Affective Disorder (SAD) when it's severe enough to cause functional impairment, feelings of fatigue, lack of motivation, or the blues are very frequent when days are short and sunlight is in short supply.

I've been seeing many people in the last several weeks who were advised to add vitamin D to their program last fall. Christopher's experience was typical.

"You know, since you told me to take vitamin D, I didn't get sad and tired like I do every winter. This is the first time I can remember that happening. I didn't sleep as much and I didn't get that feeling of always being overwhelmed."

I've felt it myself this past winter. I think there's some real truth to this effect.

Dr. Bruce Hollis has published a small experience in treating people with SAD with vitamin D and showed measurable improvement in depression. (One recent study in older women failed to show any effect, however, when small doses of vitamin D of 800 units were administered. In my experience, this dose doesn't even come close to normalizing blood vitamin D levels.)

The best source for in-depth information on vitamin D is Dr. John Cannell's website, www.vitaminDcouncil.com. If you've read Dr. Cannell's discussion on the Track Your Plaque website, you know that he is an articulate spokesman for the benefits of vitamin D replacement. He also persuasively argues that vitamin D deficiency is rampant in northern climates and in people who don't get frequent sun exposure. Interestingly, we now have two studies of populations in Florida and one in Hawaii, both of which showed substantial percentages of people even in these tropical climates to be deficient in vitamin D (around 50% in Hawaii and 30% in Florida).

The dose we've used with much success is 2000 units per day in females, 3000 units per day in males. This yields normal blood levels of around 50 ng/dl in around 80-90% of people. Occasional people will require more, some less. The best way to do it is to check a baseline blood level and a level on therapy to determine the adequacy of your dose.

Dr. Cannell will tell you that it's very important to have your doctor check the right test: 25-OH-vitamin D3, not 1,25-diOH-vitamin D3. These are two very different tests of two different compounds.

In the Track Your Plaque program, we use vitamin D to reduce pre-diabetic tendencies, reduce blood pressure (vitamin D is an inhibitor of the pressure-raising hormone renin), shut down inflammation, and gain better control over coronary plaque (mechanism uncertain). In the process, you will sharply reduce risk of osteoporosis, colon and prostate cancer.

And maybe you'll be brighter when the winter blues come around again.

$4 per gallon gas is good for your health!

24. April 2006 William Davis (0)
Gasoline is now approaching $4 per gallon in some parts of the U.S. But there's a silver lining in this dark cloud. In fact, I see this as a positive for your health.

How can higher gas prices possbily be good for health?

Imagine this trend continues: Fuel prices climb higher and higher. Driving your car will become increasingly more costly. What will be the fall-out?

Well, there will be a number of implications. But among the developments will be a broad impetus towards rejecting fuel-based sources of transportation. This may come as a shock to you, but humans legs were meant for walking!

Remember way back when, Mom would say "We need some milk"? In 1953, you wouldn't get in your car and zip to and from the supermarket. Instead, you would walk a quarter-mile, half-mile or more to the store. And you would carry your bags back. You might walk a mile or two to school and back. In 2006, this seems incomprehensible.

Higher fuel prices will prompt a gradual return to 1953--As transportation costs climb, your town may try and make it easier to walk as an alternative means of getting places.
Imagine that it was easy to walk three blocks to the grocery store, produce stand, work or school, walk along pleasant paths on the weekend, stroll to the home of friends. Drive or walk? Leave the car in the garage and save you and your family hundreds of dollars a month in gas bills.

In a few years, given the current fuel cost trends, there won't be a choice. But it will be in your favor for health.

Another Ornish casualty

23. April 2006 William Davis (0)
Barry's lipoproteins were nearly all corrected to perfection: LDL 64 mg, HDL 57 mg, triglycerides 45 mg. He was approaching the Track Your Plaque goal of 60/60/60, the levels we find tip the scales heavily in your favor for achieving plaque reversal.

But one problem still prominently persisted: small LDL. Of Barry's 64 mg of total LSL, 90% of his LDL were small.

Barry was already on niacin (Slo-Niacin; Upsher Smith)1000 mg per day and fish oil, 4000 mg per day, both of which contribute to correction of this pattern. He had added occasional raw almonds and oat bran to his daily habits, both of which also help suppress small LDL. "I thought you told me that small LDL should go away if I did all this!" he lamented in frustration.

We probed Barry's diet choices more closely. "I eat really healthy foods, just like an Ornish program." Uh oh.

"What do you mean?" I asked.

"For breakfast, I have two slices of whole wheat toast--no butter or margarine, of course! I'll have Shredded Wheat with skim milk. That's it. My typical lunch is low-fat turkey--no mayonnaise!--on whole wheat. I'll add some low-fat whole wheat crackers or pretzels. That's pretty much my habit."

"How about dinner?"

"Dinner varies a lot. I'll usually have a low-fat meat like chicken or turkey, never beef, a vegetable, and a potato. I love rolls but I try to make them whole wheat. I don't use gravy. I love ice cream, so I've been having low-fat frozen yogurt instead. I guess that's about it."

Barry had indeed been counseled on how we approach nutrition. We, of course, do not endorse the low-fat approach of the Ornish program. Low saturated and hydrogenated fat, yes, but not the super-strict low-fat, "all fat is bad" approach of Dr. Dean Ornish.

Barry's diet is typical of someone on a low-fat restriction. When I asked him why he was eating this way, he admitted that he'd seen Dr. Ornish on a TV program in which he persuasively proclaimed that he reversed heart disease in his patients over the past nearly 20 years using this low-fat approach.

That explained it. Barry's nearly pure carbohydrate diet was triggering high blood sugar responses after meals, causing his insulin to skyrocket and magnifying the small LDL pattern.

I advised Barry to dramatically reduce his carbohydates like breads, pretzels, low-fat yogurt, crackers, etc. Instead, he could increase his lean proteins like eggs, egg whites, Egg Beaters, raw nuts and seeds, low-fat (yes, low-fat!) dairy products like yogurt and cottage cheese (both high protein), and healthy oils.

I've seen this happen with many people over the years: A severe low-fat restriction becomes a high-carbohydate diet. It's not uncommon for many people to have more than 70% of calories from carbohydrates on these programs.

The low-fat approach worked in the era of high-fat diets in the 1980s. In 2006, where convenience foods made with carbohydrates, especially wheat, predominate and pack 80% of supermarket shelves, low-fat is now a distorted nutritional mistake that leads to problems like Barry's uncontrolled small LDL, and often pre-diabetic or overt diabetes.

Should you take Plavix?

22. April 2006 William Davis (2)
A question I get fairly frequently nowadays is, "Should I take Plavix?"

For the few of you who've managed to miss the mass advertising campaign for this drug on TV, USA Today, etc., Plavix is a platelet-blocking drug, known chemically as clopidogrel, that "thins" the blood and helps prevent blood clot formation in coronary arteries and carotid arteries, thus potentially reducing heart attack and stroke risk.

What if you have a heart scan score of, say, 450--should you take Plavix?

In general, no. First of all, aspirin and Plavix (generally taken together, since the effect of Plavix is incremental to that of aspirin) only block blood clot formation. They have no effect whatsoever on the rate of plaque growth. Aspirin and Plavix will neither slow it or increase it.

What they do is when a plaque ruptures like a little volcano and exposes its internal contents (inflammatory cells, fat, etc.--like a raw wound), a blood clot forms on top of the ruptured surface. If the clot is big enough, it can occlude the vessel and causes heart attack. Or, if it's a carotid artery, debris from the clot can break off and find its way headward to the artery controlling your speech or memory center. Aspirin and Plavix simply help inhibit clot formation once a plaque ruptures. That's it.

Interestingly, if you view any of Sanofi Aventis' commercials for Plavix, you'd think they came up with a cure for heart disease. It ain't true.

When is Plavix helpful? It's clearly an advantage after someone receives a coronary stent, drug-coated or uncoated;, after coronary bypass, particularly if certain metal punch devices are used to create the grafts in the aorta; and during and after heart attack. These are all situations in which blood clot formation is a forceful process. Blocking it helps.

In general, in asymptomatic people with positive heart scan scores at any level, we do not recommend taking Plavix. The Plavix people are extremely aggressive pushing their drug (hang around any medical office and see!) and, I believe, have gone overboard in promoting its benefits. Rarely, in someone with a very high heart scan score, say 2000 or more, we'll use Plavix for a period of a few months until lipids/lipoproteins and other risk measures are addressed, just as an added safety measure. But, in general, the great majority of people with some heart scan score or another do not receive it and I don't believe that they should.

As always, look beyond the marketing. The purpose of marketing is to increase profits, not to educate.

Dr. Ornish goofed

21. April 2006 William Davis (1)
"I don't think I need the Track Your Plaque program. I've been doing the Ornish program, so I think that my plaque has already regressed."

So proclaimed Bruce, a recent patient I saw in consultation. Having suffered a heart attack three years earlier, he was thoroughly convinced that he was now cured following the Ornish program.


Indeed, back in the 1980s, many of us existed on greasy, high-fat diets of cheeseburgers, French fries, fried chicken, plenty of butter or margarine, mayonnaise, and the like.

Along came Dr. Dean Ornish, who wrote a book called "Dr. Dean Ornish's Program for Reversing Heart Disease: The Only System Scientifically Proven to Reverse Heart Disease Without Drugs or Surgery". This book struck a chord during this era and has been a hot-seller ever since it was published.

Does it work? In my experience, no, it does not.

Dr. Ornish claimed that sharply curtailing fat intake reverses heart disease. Closer to the truth is that, in people who start with high fat intakes, a low-fat restriction is indeed an improvement. This will lead to a modest improvement in blood flow in the coronary arteries due to a phenomenon called "endothelial dysfunction." This means that arteries will dilate modestly when specific changes are made. Thus, you will see minimal improvements in the measures he used (stress testing with nuclear imaging.)

What it does not mean is that plaque has regressed, certainly not "reversed".

In fact, our experience (over 10 years ago, when we first used the Ornish approach) was that the majaority of people did worse on this low-fat program: HDL dropped, triglycerides increased, blood sugar increased, inflammatory measures like C-reactive protein increased. Some people even magnified diabetic or pre-diabetic patterns.

It's almost certain that Bruce has not reversed his coronary plaque. In fact, I would bet that his plaque has grown substantially. Bruce started three years earlier from a diet high in unhealthy fats. If the expected rate of coronary plaque growth is 30% per year, perhaps he slowed it--to 20% or so. Since he didn't have a heart scan score at the time of his heart attack, we'll never know if he truly did reduce the quantity of coronary plaque he had.

But when I met him on his Ornish program, Bruce showed disturbing patterns that included an HDL cholesterol of 38 mg, 70% of all LDL particles were small, triglycerides measured 209 mg, and C-reactive protein was high at 2.8 mg/l. In other words, Bruce's plaque causes were far from corrected. Perhaps they were worse.

The Ornish program, despite it's ambitious claims, has outlived its usefulness. In 2006, it is an antiquated relic of a time past when lifestyle habits and technology were different.

Warning: This product may contain wheat!

20. April 2006 William Davis (0)
Jerry experienced a peculiar sensation in his chest one evening while watching TV with his wife and kids. He squirmed in his chair and experienced a little breathelessness. But he kept it to himself and didn't say anything to his wife.

Fortunately, the feeling passed. But it concerned Jerry enough that he called a local heart scan center and scheduled a CT heart scan.* Minutes later, Jerry had a heart scan score of 112. At 46 years old, this placed him in the 90th percentile compared to other men in his age group.

Jerry came to my office for consultation. Among the first steps we took was to perform lipoprotein testing. Jerry showed striking abnormalities that included an HDL cholesterol of 38 mg, triglycerides of 210 mg, an unimpressive LDL of 133 mg but comprised of 99% small LDL, and excessive IDL (meaning that he was unable to clear dietary fats after eating).

At 5 feet 10 inches, Jerry weighed 190 lbs. He showed a slight excess bulge at the tummy, but hardly obese.

Jerry's history was remarkable, however, for the amount of carbohydrates he ate. "I'm addicted to bread. I love it! If I smell a loaf of fresh baked bread, I sometimes eat the whole loaf!"

Jerry also admitted to over-indulging in bagels (whole wheat), pretzels, low-fat snack chips, Raisin Bran cereal, Cheerios, and noodles. In fact, many days he'd have 5 or 6 servings of any of these foods. He also complained of an extraordinary amount of bowel gas and cramping. "Sometimes, I'm afraid to go to a group function. I might embarass myself."

I suggested an experiment: For a 4 week period, completely eliminate wheat-containing products--breads, pretzels, breakfast cereals, pasta, etc. In their place, increase intake of protein foods like eggs, raw almonds and walnuts, low-fat yogurt, cottage cheese, chicken, fish, and use healthy oils (olive, canola, grapeseed, flaxseed) more liberally.

Just four weeks later, Jerry came to the office a new man: 8 lbs lighter, brighter, with bursts of energy he hadn't had in years. And no gas!

Lesson: Wheat-based carbohydrates can be the culprit behind many lipoprotein patterns, especially low HDL, high triglycerides, small LDL, and others. Wheat can also be responsible for a myriad of abdominal symptoms, even joint pains and rashes. In its most extreme form, it's called "celiac disease". But experiences like Jerry's are quite common--not as obvious and dramatic as full-blown celliac disease, but smouldering and destructive, nonetheless.

Track Your Plaque expert, Dr. Loren Cordain of Colorado State University, tells us that, in his reconstruction of the history of human illness, there was an extraodinary surge in disease just about the time when humans began cultivating wheat around 8000 B.C. (Track Your Plaque members: Read Dr. Cordain's fascinating interview at http://www.cureality.com/library/fl_04-005cordaininterview.asp.)

Do you need to eliminate wheat products entirely from your diet? It's something to think about, particularly if you share any of the difficulties that Jerry had.


*In general, I do not recommend heart scanning as a self-prescribed tool for chest pain or other symptoms. Symptoms should always be discussed with your doctor.

Hospital Administrators' Wish List

20. April 2006 William Davis (0)
I've known enough hospital administrators over the years to understand what most of them want.

Of course, most of them want to deliver high quality care to patients in a safe, efficient setting. They want to comply with national standards of performance, attract quality physicians to use their facilities, and appeal to patients as a desirable place to obtain care.

But one fact is hard for many administrators to ignore: 30% of a hospital's revenues and 50% of their profits come from heart services.

So, if your hospital administrator had a wish list, I believe that among their wishes would be:

--More heart catheterizations, angioplasties, stents, and bypass surgery.
--More pacemaker and defibrillator implantations.
--More heart attacks.
--More heart failure with need for intravenous infusions, defibrillators, and bi-ventricular pacemaker implantations.
--More heart valve surgery.

Highly successful hospitals do more of these procedures than less successful hospitals.

Are you getting the picture? Heart care is a business. It's not very different than Target, Home Depot, or McDonalds--businesses eager to sell more of their product. Yes, there is attention to detail, quality, and competitiveness, but the bottom line is "sell more product, make more profit."

Keep this in mind the next time you catch one of the many TV or newspaper ads, radio spots, physician "interviews", or other media pitches in your town. Does Target run ads for the public good or to generate profitable sales? Does your hospital run ads to broadcast its contribution to public welfare or to generate profitable "sales"? Pretty clear, isn't it?

Poor, neglected vitamin D!

20. April 2006 William Davis (1)
We now routinely check blood levels of vitamin D in all our patients. I am reminded everyday that, if you're a resident of a northern climate (as we are in Wisconsin and similarly in Michigan, Washington, New York, Pennsylvania, Ohio, etc.), the overwhelming likelihood is that you are deficient in vitamin D. And not just a little deficient, but severely deficient.

As humans, we're meant to obtain vitamin D through exposure to sunlight. This was how humans evolved. We are all ill-equipped to get vitamin D through nutritional sources. The average (Wisconsin) patient we see has vitamin D blood levels of 17-30 ng/dl. Most authorities would agree that a level of 30 ng or less would constitute severe deficiency. An ideal level is probably around 50 ng, what many (but not all) residents of southern climates like Florida, Texas, and Hawaii have if they get frequent sun exposure.

When vitamin D levels are normal, bone health is maximized (inhibiting osteoporosis); prostate, uterine, breast, and colon health is heightened and cancer risk diminished; pre-diabetic and diabetic patterns are suppressed and blood sugar reduced; blood pressure drops 10 mgHg, on average;and inflammatory measures like C-reactive protein are substantialy reduced. But, of greatest interest to us, coronary plaque is easier to regress.

Although our experience in the last several hundred people is still anecdotal, I believe that I'm seeing a dramatic increase in the amount and rapidity of coronary plaque regression. People we've struggled with are suddenly regressing. People with higher heart scan scores (e.g., >500) are regressing more readily.

We're accumulating our data and it will take a couple more years to develop it in a scientifically-useful format. But, in the meantime, adding vitamin D to your program or having your vitamin D level checked may be among the most important steps you can take to gain control over coronary plaque. Be sure to ask your doctor to get the right blood test: it must be 25-OH-vitamin D3. (The wrong test is the 1,25-OH2-vitamin D3; though they look and sound the same, they measure very different parts of the vitamin D pathway.) Also, Track Your Plaque members: read Dr. John Cannell's tremendous summary of the vitamin D experience on the Track Your Plaque website.

Leave the greatest legacy to your children

19. April 2006 William Davis (0)
Phyllis was dumbfounded when she learned of her heart scan score of 995. At age 56, this placed her solidly in the 99th percentile--a score that grouped her with the worst 1% of scores for women her age. Track Your Plaque followers know that scores of 1000 (just days away, given the expected 30% increase in score per year!) pose a risk of heart attack, symptoms leading to stent or bypass, or death of 25% per year.

But after Phyllis gathered her thoughts and thought it over, her first question was "What about my children?"

A natural response for a mother. Phyllis' "children" actually ranged in age from 26 to 37. We talked about how, given her high score, she'd probably been creating plaque in her coronary arteries for 20 years. This triggered her mother's concern for her kids.


This is probably the #1 most useful lesson for all of us. If we learn of our own risk for heart disease, we can pass our concerns on to our children. Imagine how much more well-equipped you could be if you started out with the advice and experience of a parent who'd identified and then conquered their heart disease risk.

Pass your awareness and knowledge on to your children, particularly if they are 30 years old or more.

Interestingly, my own personal experience with my 14-year old son taught me a lesson or two. I had previously assumed that, at age 14, how could he be even remotely interested in these issues? (I have a terrible family history of heart disease and I have a high heart scan score myself.) When my son asked that we check his lipid values (I talk about this more than I'd like to admit!), we did a fingerstick lipid panel in my office. Lo and behold, his HDL (good) cholesterol was a shocking 31 mg--exceptionally low for a teenager. His risk for heart disease over the long-term is very high.

Much to my surprise, this awareness has triggered a genuine interest in healthy eating. It's not uncommon to see him examine food labels and to report to me that "Hey, Dad. Can you believe that this yogurt has 43 grams of carbohydrates?"

Pass on the lessons you've learned to your children and to the important people in your life. This is probably the most crucial lesson you can take from the Track Your Plaque experience.

Half effort will get you half results

17. April 2006 William Davis (3)
Greg walked into the office.

"Just back from a 10-day Caribbean cruise, Doc. It was fabulous."

"Yes, but I see you're 14 lbs heavier. What happened?"

"Well, you know, a 24-hour a day open brunch. Anything and everything you wanted. But I only had dessert twice."

"Did you exercise?"

"Come on, Doc! It was vacation!"

With this serious indiscretion, Greg gained 14 lbs in 10 days. That's a total surplus of 49,000 calories Greg put in his body over that period. 49,000!

Greg had started the cruise 40 lbs overweight. Now, he's 54 lbs overweight. The pre-diabetic tendency he showed earlier was now full diabetes. All associated lipoproteins blossomed with it--small LDL, a drop in HDL of 5 points, triglycerides skyrocketing to 320.

He blew it.

Can Greg turn back? Yes, he most likely can, given a serious and rapid effort to lose the weight he gained on the cruise and more.

But can he do it? I doubt it.

Someone who allows himself to gain an extraordinary quantity of weight, completely neglects exercise, then blows it off as having some fun will never succeed.

In all honesty, this is someone who shouldn't waste his time in the Track Your Plaque program. He will fail--period. By failure I mean he will experience explosive plaque growth over the next few years and then end up with stent(s), heart attack, bypass surgery. Some people will die. He will also--should he survive--experience the long-term complications of diabetes, such as retinal disease, kidney impairment, loss of sensation to his feet and legs, and on and on. His life will be substantially abbreviated.

To me, there's no choice. But Greg and many people like him are fooling themselves if they believe that a half-hearted effort will allow them to succeed in controlling or reversing heart disease. Maybe we'll come up with some magic supplement or prescription medication that will erase his heart disease in a few days.

Don't count on it. I'll make no bones about it. Controlling and reversing heart disease requires a commitment--a full commitment to eat and live healthy, to follow the advice we give, and not engage in serious indiscretions that erode your efforts. If you believe that taking 40 mg of Lipitor is all you're going to need to regress heart disease, plan on your first stent or heart attack within a few years. And you'll hobble to the doctor's office in the meantime.