All posts by william-davis

Getting your dose of fish oil right

23. December 2008 William Davis (11)

Confusion often stems from the simplest of calculations: dose of fish oil.

Actually, you and I don't take fish oil for fish oil. We take fish oil for its content of omega-3 fatty acids, the dominant ones being EPA and DHA. The contents of fish oil outside of its EPA + DHA content likely exert little or no benefit (beyond that of other dietary oils).

To determine what you are currently taking, simply examine the back of your fish oil bottle and look for the EPA + DHA composition. This should be clearly and prominently labeled. If not, don't buy that brand again. Add up the EPA + DHA content per capsule, then multiply by the number of capsules you take per day. That yields your daily EPA + DHA intake.

The only other substantial source of omega-3 fatty acids is fish. Other food sources, such as non-fish meats, eggs, etc., contribute little or none. Processed foods that bear health claims of "contains heart healthy omega-3" often contain linolenic acid or flaxseed oil, which contributes very little to total EPA + DHA, or contain relatively trivial quantities of DHA. What are you doing eating processed foods, anyway?

What should the total daily dose of EPA + DHA dose be? That depends on what your goals are.

If your goal is to modestly reduce the risk of dying from heart attack, then just eating fish a couple of times per month will begin to exert an effect, or just taking a dose of 300 mg EPA + DHA per day from a low-potency capsule will do it. However, that's an awfully unambitious goal.

Our starting omega-3 dose in the Track Your Plaque program has, over the years, increased and now stands at 1800 mg EPA + DHA per day. However, the dose for 1) full reduction of triglycerides and/or triglyceride-containing abnormal lipoproteins, 2) reduction of Lp(a), and 3) the ideal dose for coronary and carotid plaque control are substantially higher.

But once you know your desired daily target of total EPA + DHA, you can easily determine the quantity of capsules to take by doing the above arithemetic, totaling the EPA + DHA per capsule. For example, if you have been instructed to take 6000 mg per day EPA + DHA, and your capsule contains 750 mg EPA + DHA, then you will need to take 8 capsules per day (6000/750).

Flat tummy . . . or, Why your dietitian is fat

19. December 2008 William Davis (19)

When I go to the hospital, I am continually amazed at some of the hospital staff: 5 ft 4 inch nurses weighing over 200 lbs, etc.

But what I find particularly bothersome are some (not all) hospital dietitans--presumably experts at the day-to-day of healthy eating--who waddle through the halls, easily 40, 50, or more pounds overweight. It is, to say the least, credibility-challenging for an obese dietitian to be providing nutritional advice to men or women recovering after bypass or stent while clearly not in command of nutritional health herself.

What's behind this perverse situation? How can a person charged to dispense "healthy" nutritional information clearly display such clear-cut evidence of poor nutrition?

How would you view a success coach dressed in rags? Or a reading coach who can barely read a sentence?

Easy: She follows her own advice.

Hospital dietitians are essentially forced to adhere to nutritional guidelines of "official" organizations, such as the American Heart Association and the USDA. There is some reason behind this. Imagine a rogue dietitian decides to advocate some crazy diet that yields dangerous effects, e.g., high-potassium diets in people with kidney disease. There is a role for oversite on the information any hospital staff member dispenses.

The problem, of course, doesn't lie with the dietitian, but with the organizations drafting the guidelines. For years, the mantra of hospital diets was "low-fat." More recently, this dated message has begun--only begun--to falter, but now replaced with the "healthy, whole grain" mantra. And that is the advice the hapless dietitian follows herself, unwittingly indulging in foods that make us fat.

Sadly, the "healthy, whole grain" message also contributes to heart disease via drop in HDL, increased triglycerides, a huge surge in small LDL, rise in blood sugar, increased resistance to insulin, tummy fat, and diabetes. Yes, the diet provided to survivors of heart attack increases risk.

The "healthy, whole grain" message also enjoys apparent "validation" through the enormous proliferation of commercial products cleverly disguised as healthy: Cheerios, Raisin Bran, whole grain bread, whole wheat pasta, etc. The "healthy, whole grain" message, while a health disaster, is undoubtedly a commercial success.

I'll bet that our fat dietitian friend enjoys a breakfast of healthy, whole grains in skim milk, followed by a lunch of low-fat chicken breast on two slices of whole grain bread, and ends her day with a healthy meal of whole wheat pasta. She then ascribes her continually climbing weight and size 16 figure to slow metabolism, lack of exercise, or the once-a-week piece of chocolate.

Wheat has no role in the Track Your Plaque program for coronary plaque control and reversal. In fact, my personal view is that wheat has no role in the human diet whatsoever.

More on this concept can be found at:

What's worse than sugar?

The Wheat-Deficiency Syndrome

Nutritional approaches: Large vs. Small LDL

Are you wheat-free?

Statin drug revolt

16. December 2008 William Davis (28)

I sense a growing revolt against the intrusion of statin drugs into our lives.

No doubt, the statin drug industry is, at least from an economic perspective, a huge success: $27 billion annual revenues at last accounting. The latest big plug for more and more statins was the JUPITER trial that showed reduced cardiovascular events on Crestor in people with "normal" LDL cholesterol levels and increased c-reactive protein.

It seems that not one day passes that doesn't include some news story about the "benefits" of statin drugs: reduction in heart attack, stroke, colon cancer, osteoporosis, heart failure, etc.

Ironically, the overwhelming economic success of the statin drug industry also seems to be encouraging a grassroots revolt.

More and more people are coming to the office, more people commenting on the web over how they want to avoid statin drugs, stop a drug they are already taking, or at least reduce the dose of an ongoing drug.

My day-to-day experience with coronary plaque control and reversal is that, while statin drugs are helpful tools, they are not necessary tools for full benefit of a prevention program. "Need" for statin drugs can differ by the patterns measured, though not the usual patterns suggested by the drug industry. For instance, using C-reactive protein, a la JUPITER, as justification for statin prescription is, in my view, totally absurd and makes no sense whatsoever, since inflammatory responses can be effective reduced with plenty of other strategies besides statin drugs. Conventional LDL, likewise, is a fictitious number that often bear little or no resemblance to the true and genuine measured value (apoprotein B or LDL particle number).

So here are a number of strategies that can help reduce or eliminate the "need" for a statin drug:

--Elimination of wheat and cornstarch--This is no namby-pamby dietary strategy, as low-fat diets were. This is a powerful, enormously effective strategy, particularly if LDL is in the small category. Small LDL drops like a stone when these foods are eliminated. This means no breads, pasta, breakfast cereals, pretzels, crackers, chips, tacos, wraps, etc.
--Non-wheat fibers--Especially raw nuts, ground flaxseed, and oat bran.
--Vitamin D restoration
--Fish oil
--Weight loss
--Niacin

There are additional strategies that focus on specific subsets of LDL cholesterol (e.g., Lp(a) masquerading as LDL). But the above list can reduce LDL cholesterol substantially, reducing the apparent "need" for a statin drug.

You will notice that there are few money makers in the above list, compared to the billions of dollars reaped by the statin drug industry. There is therefore little incentive to allow a pretty sales rep to go to your doctor and pitch the use of over-the-counter vitamin D or make changes in diet.

Statin drugs in my view need to be shoved back into their more limited role as drugs to be used on occasion when necessary (e.g., heterozygous familial hypercholesterolemia with LDL cholesterol values of 250 mg/dl in a person with measurable coronary plaque). These should never have achieved the "celebrity" status they enjoy, complete with gushing endorsements by TV personalities, daily news stories, and back-to-back TV commercials.

Join the revolt!

Lovaza Rip-off

14. December 2008 William Davis (107)

Lovaza is GlaxoSmithKline's prescription fish oil, an ethyl ester modification to allow higher concentration of omega-3 fatty acids, EPA + DHA, per capsule. Each capsule contains 840 mg EPA + DHA.

It is FDA-approved for treatment of high triglycerides (>500 mg/dl). In their marketing, they claim "Unlike LOVAZA, dietary supplements are not FDA approved to treat any disease." They also highlight the "patented five-step" purification process that eliminates any concerns over mercury or pesticide residues.

What does Lovaza cost? In Milwaukee, it costs about $70 per capsule per month (PCPM). Most people are taking four capsules per day: $280 per month, or $3360 per year to obtain 3360 mg of EPA + DHA per day. (Funny coincidence with the numbers.)

Did you catch that? $3360 per year, just for one person to take Lovaza.

What if I instead went to Costco and bought their high-potency fish oil. This is also an ethyl ester form. It costs $14.99 for 180 capsules, or $2.50 PCPM; each capsule contains 684 mg EPA + DHA. I would therefore have to take five capsules per day to obtain the same 3360 mg EPA + DHA per day. This would cost me 5 x $2.50 = $12.50 per month, or $150 per year.

$3360 per year vs. $150 per year to obtain the same dose of omega-3 fatty acids, or a 22.4-fold difference.

Lovaza is FDA-approved for treatment of high triglycerides. But I am seeing more and more people take it for other reasons at this four-capsule-per-day dose. Regardless, this "drug" is adding $3360 per year costs to our healthcare. A school teacher, for instance, recently commented to me that she didn't care about the costs, since her insurance (in Milwaukee county, teachers have unbelievably generous healthcare coverage) covers Lovaza. I've heard this from others: insurance covers it, so they don't care how much it costs.

Guess who eventually has to pay the $3360 per year per person costs? Yup, you and me. We all bitch and moan about the costs of healthcare and health insurance, but many of us are more than willing to shift the costs to our friends and neighbors to save a few bucks. You think Lipitor makes a bundle of money for Pfizer at about $120 per month? Lovaza is making a bundle of money for GlaxoSmithKline, and all because people are cheap and willing to selfishly shift costs to other people.

Keep in mind that $3360 per year is just for fish oil. It's not for surgery, it's not for hospital care, it's just for stinking fish oil.

Santa Claus is alive . . . and works for the drug industry

12. December 2008 William Davis (7)

Maybe your teenagers no longer believe in Santa Claus, but I assure you: Not only is he alive, I believe that we have evidence that he works for the drug industry!

Psshaww! you say. Yet another rant from that kook, Davis. Who can he pick on next? What other imagined "conspiracies" can he uncover?

Let me recount the evidence and I'll let you decide how damning it all is:

--Christmas is a culture of excess, overeating, celebration: Cookies, candy canes, pie, chocolate, egg nog, more cookies . . . A virtual wheat and sugar frenzy!

--Wheat and sugars make us diabetic!

--What does a diabetic look like? How about big protuberant abdomen, florid cheeks, baggy eyes (from sleep apnea)? The red outfit and beard is optional, of course. Could you think of a better representation of what happens to a person when they eat goodies all the time?

I therefore submit that Santa Claus is at the root of a campaign to cultivate diabetes! Diabetes: a growth industry that is raking in billions of dollars for the drug companies!

I'd bet that Mr. Claus would agree with the dietary advice dispensed by the folks at the American Diabetes Association website:

A place to start is at about 45-60 grams of carbohydrate at a meal. You may need more or less carbohydrate at meals depending on how you manage your diabetes.

Eat more carbohydrates, get fatter in the abdomen, require more medication to keep sugar low. Then start over: eat more carbohydrates, get fatter, more medicines. Kaching!

"You may need more?" Personally, I'd be rendered comatose and helpless if I indulged in such carbohydrate gluttony.

If Mr. Claus were, instead, interested in our health and keeping us non-diabetic, Christmas would be a time for pistachios, almonds, dark chocolates, and tea.

You want health advice? Don't ask Santa Claus!

Another case of aortic valve disease reduced with vitamin D

12. December 2008 William Davis (8)

I watched Seth's aortic valve deteriorate over a two year period.

I was first consulted in 2004 to offer an opinion on Seth's heart scan score of 779 and flagrantly abnormal cholesterol patterns, including triglycerides in the 400 mg/dl range. But I heard a murmur, as well, a murmur of a leaky aortic valve, "aortic valve insufficiency."

Over the next two years, I watched Seth's aortic valve worsen, going from mild leakiness to severe.

In 2006-2007, I tiptoed into vitamin D replacement and asked Seth to add some vitamin D. Time passed and Seth's aortic valve got progressively worse.

Over the past year, However, he's maintained a truly healthy level of vitamin D, with blood levels consistently in the 60-70 ng/ml range.

While Seth's last echocardiogram showed a severely leaky aortic valve, the most recent echo showed mild leakiness ("mild aortic insufficiency")--a dramatic reduction.

I continue to see this in many, though not all, patients with aortic valve disease. Though I've more frequently witnessed either stalled progression or reversal of aortic valve stenosis (stiffness), I've now seen a handful of people with aortic valve leakiness (insufficiency) also reverse.

I've posted about this peculiar phenomenon previously:

Aortic valve disease and vitamin D
More on aortic valve disease and vitamin D

Prior to vitamin D, I had NEVER witnessed any aortic valve disease stop or reverse.

A formal trial at some point would be invaluable.

Track Your Plaque Program Data Tracking Tools

7. December 2008 William Davis (3)

At last: After talking about the new Track Your Plaque community tools for the last year, our data tracking software is now available!

Track Your Plaque is, admittedly, somewhat data-intensive. The basic concept relies on the fact that we track heart scan scores, cholesterol values, lipoprotein values like percent small LDL and Lp(a), vitamin D blood levels, intake of omega-3 fatty acids, etc. Our new data tracking tools will help Members track their data over time.

Even more interesting, you can allow other Members (not required) to view your data for comments and feedback. You can also view the program data of other Members (if they choose to make their data "public") to learn how they are going about stopping and reversing their coronary plaque.

In other words, our graphic data tracking tools are yet another way we are using to acquire a collective wisdom on how to put a stop to coronary heart disease, heart attack, and perverse "let's make money with heart procedures" hospital solutions.

One of the aspects that helps make this work is the sharing of data. So far, the people who have begun to enter their data have all made their information "public." It's not truly "public," but viewable only by other Track Your Plaque Members. Also, Members can, in effect, anonymize their data simply by using a nickname, e.g., heartprotection or hearthawk.

The data tracking tools are in beta-test version, so there are bound to be a few glitches. But we're eager to hear from our Members' experiences on how to improve these tools. Report any problems or make your suggestions on the Track Your Plaque Member Forum--Technical Support.

Yet another reason to avoid fructose

6. December 2008 William Davis (5)

Have you seen the Corn Refiners Association commercial campaigns to educate the American public on the safety of fructose? If you haven't, you can view these interesting specimens on You Tube:

"Get the facts--You're in for a sweet surprise: Fructose is safe in moderation!"

Two Moms

Two lovers

Beyond the fact that fructose stimulates liver production of glycerol, which thereby increases liver VLDL production and raises blood levels of triglycerides; likely stimulates appetite; increases cholesterol levels; fructose has also been clearly implicated in increasing blood levels of uric acid.

Uric acid is the substance that, in some people, precipitates in joints and causes gout, the painful inflammatory arthritis that has been increasing in prevalence over the last four decades since the introduction of fructose in 1967. While blood levels of uric acid in the early part of the 20th century averaged 3.5 mg/dl, more recent population assessments have averaged 6.0 mg/dl or higher. (Non-human mammals who don't eat processed foods, drink fruit drinks or beer, and don't eat candy have uric acid levels of <2.0 mg/dl.)

Uric acid is looking like it may prove to be an important risk factor for coronary disease and atherosclerotic plaque. It is no news that people with higher blood levels of uric acid are more likely to experience adverse cardiovascular events like heart attack. People with features of the metabolic syndrome also have higher uric acid blood levels; the more characteristics they have, the higher the uric acid level. However, the prevailing view has been that uric acid is simply an accompaniment of these processes, but not causal.

However, more recent observations suggest that increased levels of uric acid may instead be a cause of metabolic syndrome and high blood pressure.

Increased blood levels of uric acid have been shown to:

--Increase blood pressure
--Induce kidney damage (even in the absence of uric acid kidney stones)
--Antagonize insulin responses

A diagnosis of gout is not required to experience all of the adverse phenomena associated with uric acid. (For not entirely clear reasons, some people, perhaps based on pH or other factors, are more prone to trigger crystallization of uric acid in joints, similar to the phenomena of sugar crystallization when making rock candy.)

Which brings us back to fructose, a sweetener that clearly substantially increases uric acid levels. I suppose that the mothers and lovers in the Corn Refiners' commercials are right to a degree: Our kids will survive, as will you and I, despite increases in triglycerides, enhanced diabetic tendencies, amplified appetites, and increased uric acid due to fructose in our diet. We will also likely survive despite being 100 lbs overweight, partly due to the effects of fructose.

But if long-term health is your desire for you and your family, fructose has no role whatsoever to play.

Interestingly, the obviously expensive and slick ad campaigns from the Corn Refiners' videos have triggered some helpful video counterarguments:

High-fructose corn syrup
Conspiracy for Fat America
High-fructose corn syrup truth

A full discussion of uric acid, the scientific data behind uric acid as a coronary risk factor, and the nutritional means to reduce uric acid will be the topic of a thorough discussion in an upcoming Special Report on the Track Your Plaque website.

Free the Animal

4. December 2008 William Davis (10)

Richard Nikoley from the Free the Animal Blog contributes this informative comment:

'Bout 18 months ago, I was at 230 (5'10) and looked awful. I was on Omeprezole for years for gastric reflux, a variety of prescription meds since early 20s for seasonal sinus allergies, culminating finally in the daily, year round squirts of Flonase-esque sprays (the best for control without noticeable side-effects), and finally, Levothroid for about the last 7 years or so, as I had elevated TSH (around 9ish).

My BP was regularly 145-160 / 95-110.

I decided to get busy. I modified diet somewhat, cutting lots of junk carbs, and began working out -- brief, intense, heavy twice per week. BP began coming down immediately, such that within only a couple of weeks I was borderline rather than full blown high. Then after about six months, a year ago, I went to full blown low-carb, high fat, cutting out all grains, sugar, veg oils, etc, and replacing with animal fats, coconut, olive oil. You know the drill. Then, first of the year I felt great and simply stopped all meds, including the thyroid. I also began intermittent fasting, twice per week, and for a twist, I always do my weight lifting in some degree of fast, even as much as 30 hours.

That's when the weight really started pouring off. Take a look:

http://www.freetheanimal.com/root/2008/09/periodic-photo-progress-update.html

http://www.freetheanimal.com/root/2008/08/faceoff.html

In July I figured it's about time for a physical. Here's the lipid panel, demonstrating am HDL of 106 and Try of 47, great ratios all around:

http://www.freetheanimal.com/root/2008/07/lipid-pannel.html

However, my TSH was even higher -- 16ish. It seems odd that I was able to lose 40-50 pounds of fat (10-15 pounds of lean gain for a 30 pound net loss at that time -- now an additional 10 pounds net loss).

One disclosure is that I was drinking too much, almost daily, and quite a bit (gotta save some vices...). Anyway, I'm at the point now where I want to drill down. I know I need to see an endocrinologist and have T3 and T4 looked at, but in advance, I wanted to see if the recent changes I've made could make a difference:

1. Stopped all alcohol.
2. Stopped most dairy, except ghee and heavy cream, and cheese is now used as a "spice," i.e., tiny quantities -- no more milk.
3. 6,000 IU Vit D per day.
4. 3 grams salmon oil, 2 grams cod liver oil.
5. Vit K2 Menatetrenone (MK-4) -- side story: getting off grains reversed gum disease for which I have had two surgeries, then supplementing the K2 DISSOLVED calculus on my teeth within days -- hygienist and dentist are dumbfounded. Stephan (Whole Health Source), who comments here, has an amazing series on K2.

If you view his photos, you'll appreciate just how far he has come.

Overall, Richard's program is wonderful and his pictures clearly display his success. However, Richard, thyroid function is indeed a problem, a problem that needs to be fixed ASAP. Remember, low thyroid function used to be diagnosed at autopsy at which time the coronary arteries and other arteries of the body were found to be packed solid with atherosclerotic plaque, even in young people.

I'd recommend:

1) Consider 200 mcg Iodine per day from kelp if you do not use iodized salt.

2) Seeing your doctor right away for thyroid replacement, hopefully with consideration of your T3 status.

3) A heart scan--Not to lead to procedures, but something for you to track over time as your program improves and thyroid function is restored.

Beyond this, keep up the great work. Great blog, too!

Low Thyroid and Plaque

3. December 2008 William Davis (12)

Having now tested the thyroid status of several hundred patients over the last few months, I have come to appreciate:

1) That thyroid dysfunction is rampant, affecting at least 25% of everyone I see.
2) It is an enormously effective means to reduce cardiovascular risk.

I'm not talking about flagrant low thyroid dysfunction, the sort that triggers weight gain of 30 lbs, gallons of water retention, baggy eyes, sleeping 14 hours a day. I'm talking about the opposite extreme: the earliest, subtle, and often asymptomatic degrees of thyroid dysfunction that raises LDL cholesterol, lipoprotein(a) (Lp(a), a huge effect!), and adds to coronary plaque growth.

Correcting the subtle levels of low thyroid:

1) Makes LDL reduction much easier

2) Facilitates weight loss

3) Reduces Lp(a)--best with inclusion of the T3 fraction of thyroid hormone.

Recall that, 100 years ago, the heart implications of low thyroid weren't appreciated until autopsy, when the unfortunate victim would be found to have coronary arteries packed solid with atherosclerotic plaque. It takes years of low thyroid function to do this. I advise you to not wait until you get to this point or anywhere near it.

I find it fascinating that many of the most potent strategies we are now employing in the Track Your Plaque process are hormonal: thyroid hormones, T3 and T4; vitamin D (the hormone cholecalciferol); testosterone; progesterone; DHEA, pregnenolone. Omega-3 fatty acids, while not hormones themselves, exert many of their beneficial effects via the eicosanoid hormone pathway. Elimination of wheat and cornstarch exert their benefits via a reduction in the hormone insulin's wide fluctuations.

We haven't yet had sufficient time to gauge an effect on coronary plaque and heart scan scores. In other words, will perfect thyroid function increase our success rate in stopping or reversing coronary plaque? I don't know for sure, but I predict that it will. In fact, I believe that we are filling a large "hole" in the program by adding this new aspect.

Cholesterol effects of carbohydrates

24. March 2009 William Davis (31)

Let's take a hypothetical person, say, a 50-year old male. 5 ft 10 inches, 160 lbs, BMI 23.0. He's slender and in good health.

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

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

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

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

Three months later, his lipids show:

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

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

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

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

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

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

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

Wheat Belly Revisited

23. March 2009 William Davis (24)

Do you have a wheat belly?

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

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

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

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

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

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

Wheat Belly

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

How about "wheat belly"?

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

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

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

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

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

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

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

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

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

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

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

Thank you, Crestor

20. March 2009 William Davis (9)

I'm sure everyone by now has seen the Crestor ads run by drugmaker, AstraZeneca. TV ads, magazine ads, and the Crestor website all echoing the same message:

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

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

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

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

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

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

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

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

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

Plaque = coronary heart disease

Cholesterol ? coronary heart disease

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

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

Supermarkets and buggy whips

17. March 2009 William Davis (17)

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

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

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

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

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

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

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

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

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

Well said, Anna.

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

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

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

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

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

Sterols should be outlawed

14. March 2009 William Davis (10)

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

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

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

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

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

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

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

Though the data are mixed:

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

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

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

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

Each Nature Valley Healthy Heart Bar contains 400 mg sterols.

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

Promise SuperShots contains 400 mg sterols per container.

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

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

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

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

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

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

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

Texas today, tomorrow . . . the world?

10. March 2009 William Davis (0)

Texas state representative, Rene Oliveira, has introduced legislation that mandates heart scans for adults in the state of Texas.

Rep. Oliveira

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

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

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

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

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

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

What your doctor doesn't know about heart disease

9. March 2009 William Davis (12)

What causes coronary heart disease or coronary atherosclerotic plaque, this thing that we track with heart scans?

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

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

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

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

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

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

What's the number two cause for heart disease?

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

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

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

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

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

Does eating fish twice a month reduce heart attack risk?

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

Do nutritional supplements reduce risk for heart attack?

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

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

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

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

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

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

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

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

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

Thank you, Dr. Eades

6. March 2009 William Davis (7)

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

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

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

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

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

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

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

Cheers–

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

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

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

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

Can millet make you diabetic?

5. March 2009 William Davis (10)

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

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

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

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

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

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

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

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

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

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

Are you a tree?

5. March 2009 William Davis (6)

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

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

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

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

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

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

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

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

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

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

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

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

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

All posts by william-davis

The myth of small LDL

28. June 2006 William Davis (1)

Annie's doctor was puzzled.

Despite an HDL cholesterol of 76 mg (spectacular!) and LDL of 82 mg, her CT heart scan showed a score of 135. At age 51, this placed her in the 90th percentile.

Not as bad, perhaps, as her Dad might have had, since he died at age 54 of a heart attack.

So we submitted blood for lipoprotein testing. Surprise! over 90% of all her LDL particles were small. (By NMR, they're called "small". By gel electropheresis, or the Berkeley Lab test, or VAP (Atherotech) technique, they're called "HDL3".)

What gives? Traditional teaching in the lipid world is that if HDL equals or exceeds 40 mg/dl, then small LDL will simply not be present.

Well, as you can see from Annie's experience, this is plain wrong. Yes, there is a graded, population-based effect--the lower your HDL, the greater the likelihood of small LDL. But small LDL is remarkably persistent and prevalent--regardless of your HDL.

We've seen small LDL even with HDLs in the 90's! I call small LDL the "cockroach" of lipids. If you think you have it, you probably do. Getting rid of small LDL requires a specific bug killer. (Track Your Plaque Members: Read Dr. Tara Dall's interview on small LDL.)

Don't let anybody blow off your request for lipoprotein testing just because your HDL is high. That's just not acceptable. Loads can be wrong even with a favorable HDL.

My stress test was normal. I don't need a heart scan!

28. June 2006 William Davis (0)

Katy had undergone a stress test while being seen in an emergency room, where she'd gone one weekend because of a dull pain on the right side of her chest. After her stress test proved normal, she was diagnosed (I believe correctly) with esophageal reflux, or regurgitation of stomach acid up the esophagus. She was prescrbed an acid-suppressing medication with complete relief.

But Katy also had coronary plaque. Three years ago, her CT heart scan score was 157. She'd made efforts to correct the multiple causes, though she still struggled with keeping weight down to gain full control over her small LDL particle pattern.

I felt it was time for a reassessment: another heart scan. After three years, without any preventive efforts, Katy's score would be expected to have reached 345! (That's 30% per year plaque growth.) It's a good idea to get feedback on just how much slowing you've accomplished.

But Katy declared, "But I didn't think another heart scan was necessary. My stress test was normal!"

What Katy was struggling to understand was that even at the time of her first scan, a stress test would have been normal. Plaque can be present with a normal stress test.

Plaque can even show explosive growth all while stress tests remain normal. Just ask former President, Bill Clinton, how much he should have relied on stress tests. (Mr. Clinton underwent annual stress nuclear tests. All were normal and he had no symptoms--all the way up 'til the time he needed urgent bypass surgery!)

Of course, at some point even a crude stress test will reveal abnormal results. But that's years into your disease and a lot closer to needing procedures and experiencing heart attack.

So, yes, Katy would benefit from another heart scan despite her normal stress test.

The message: Don't rely on stress tests to gauge whether or not plaque has grown, stabilized, or reversed. Stress tests can be used to gauge the safety of exercise, blood pressure response, and the potential for abnormal heart rhythms. Stress tests can be used as a method to determine whether blood flow in your coronary arteries is normal through an area with plaque.

But a stress test cannot be used to gauge whether plaque has grown. It's as simple as that. Gauging plaque growth requires a heart scan.

Patient-napping: Yet another reason to stay clear of hospitals!

26. June 2006 William Davis (1)

When I started practicing medicine around 20 years ago, it was common practice to alert a physician when their patient was seen in an emergency room.

If John Smith, for example, went to the emergency room with chest pain, the physician who had an established relationship with the patient--knew their history, had managed their health and illnesses, etc.--was notified, even if the hospital ER had no relationship with the physician. It was not uncommon for the patient to then be transferred to the hospital where their own doctor practiced.

Though cumbersome at times, it preserved the relationship of the patient with their doctor.

Over the past few years, this practice has crumbled. Nowadays, hospitals and their employed physicians (and other unscrupulous physicians acting in the name of profit) "fail" to notify the physician with an established relationship.

Guess what happens? The patient all too often ends up being put through the gamut of testing and procedures.

Why? For hospital profit, of course. If failure to notify a doctor who's had a 10-year long relationship with the patient is "overlooked" or, even more commonly, it's "unsafe" to transfer the patient because the patient is too "unstable" to be transferred, then this patient becomes ripe for picking--heart catheterization, stents, bypass surgery, etc. Ten's, if not hundreds, of thousands of dollars can be reaped by this deception. I call it "patient-napping".

I see this at least several times every month. As hospitals are becoming increasingly competitive, and as they put pressure on their physicians to churn patients for revenues, you're going to see more and more of this.

As always, what is your protection from this expanding influence of hospitals and the doctors too meek to stand up to them? Education and information. Arm yourself with an understanding of what is accomplished in hospitals, when you truly need them, and when you don't.

Take it one step further. At least from a heart disease standpoint--the #1 profit-maker for hospitals--aim to 1)identify your coronary plaque, then 2) seize control over your coronary plaque and reduce your risk for heart attack and heart procedures as much as humanly possible. That's the goal of the Track Your Plaque program.

Don't believe the negative press on fish oil

25. June 2006 William Davis (0)

A British Medical Journal study released in March, 2006 has prompted a media flurry of reports on the worthlessness of fish oil. (Hooper L, Thompson RL, Harrison RA et al. Risks and benefits of omega 3 fats for mortality, cardiovascular disease, and cancer: a systematic review. BMJ March,2006)

Don't believe it for a second.

First of all, the study was a re-analysis of the existing published scientific literature. It was not a new study. It included a wild conglomeration of different clinical observations, as the studies examining fish oil over the years have been extraordinarily heterogeneous--in populations examined, omega-3 supplement (e.g., fish vs. capsule), period of observation, endpoints measured.

The results were skewed by inclusion of a moderate-sized British study by Burr et al in men with angina. In this study, no benefit was demonstrated and, in fact, a negative effect--more heart attack and death--was observed with fish oil. This was not news, since the study was published in 2003. It's results have been a mystery to everyone, since its unexpected negative result for fish oil was so starkly different from virtually every other study that preceded it (suggesting a study flaw or statistical fluke).

Nonetheless, the Burr study served to throw off the overall analysis. It diluted the dramatic and persuasive outcome of the GISSI-Prevenzione Study of 11,000 people in which a 28% reduction in heart attack and 45% reduction in cardiovascular death was observed. Note that the substantial numbers of the GISSI make the study's outcome nearly unassailable.

Another important fact: fish oil is among the most powerful tools available to correct elevated triglycerides. Drops of 50% are common. Recall that triglycerides are a necessary ingredient to create the nasty LDL, as well as VLDL, Intermediate-density lipoprotein, and an undesirable shift from large to ineffective small HDL. Reducing triglycerides is therefore crucial for your plaque control program.

This re-analysis serves to prove nothing. Such analyses can only pose questions for further study in a real study like GISSI: a randomized (random participant assignment), controlled (treatment vs. placebo or other treatment) study.

The weight of evidence remains heavily in favor of fish oil, not only as helpful, but fabulously beneficial, particularly for anyone aiming to reduce coronary plaque.

How important is high blood pressure?

24. June 2006 William Davis (0)

Control of blood pressure is crucial for coronary plaque control and stopping your heart scan score from increasing.

Dr. Mehmet Oz (of Oprah fame and a cardiac transplant surgeon at Columbia University) made graphic point of this on the ABC TV news show, 20/20, last evening on an episode called "Our Bodies: Myths, Lies, and Straight Talk". (See a summary on the ABC News 20/20 website at http://abcnews.go.com/2020/story?id=2109291&page=1)

Although I believe he somewhat overstated the case for hypertension (proclaiming "If you're going to remember one number, if you're going to focus and fixate on one number in your entire health profile, it better be your blood pressure"), he made the point that a blood pressure of 115/75 is what you should have for optimal health.

I couldn't agree more. Unfortunately, the old advice that desirable blood is 140/90 or less is absolutely wrong. At this level, we see flagrant increases in heart scan scores. We also progressive enlargement of the thoracic aorta, the large vessel that leaves the heart and branches to provide the major arteries of the body. Growth of the aorta to an aneurysm is also common at these formerly acceptable blood pressure. (The diameter of your aorta in the chest is an easily obtainable measure on your CT heart scan.)

The blood pressure you need for halting and reversing plaque growth on your heart scan is indeed 115/75 or less. (Not so low, however, that you're lightheaded.) This is the blood pressure that you were meant to have evolutionarily. It's also the blood pressure that helps tremendously in keeping your aorta from enlarging.

Watch for an upcoming exhaustive report on blood pressure and its plaque-raising effects and how to reduce it using nutritional strategies on the www.cureality.com membership website.

Is your doctor in cahoots with the hospital?

21. June 2006 William Davis (0)

I got a call from a doctor about a patient we've seen in past.

"I've got Tricia in the office. She's been having some kind of chest and abdominal pain. I think it's esophageal reflux, but just to be safe I'm sending her to the hospital."

I advised this physician that, given Tricia's low heart scan score, she was unlikely to be having a coronary "event" like heart attack or unstable symptoms. It wasn't impossible, but just highly unlikely.

As the patient was without symptoms at the moment and had driven herself to his office, I offered to perform a stress test immediately. (Though stress tests are of limited usefulness in people without symptoms, they can be useful provocative maneuvers in people with symptoms of uncertain significance.)

The doctor declined. Tricia was, after all, in his office and he was responsible for any decisions despite any objections I voiced. Well, Tricia was directed by her doctor to go to a local hospital, though one with an especially notorious reputation for putting virtually anyone they can get their hands on through as many procedures as possible.

As you might guess, this doctor was closely associated with this hospital. He and his colleagues obtain incentives (or are penalized) if they do not generate revenue-producing procedures for the hospital.

So, guess what? Tricia ended up with several procedures, all of which yielded nothing--except $30,000 in revenues from Tricia's insurance company.

I harp on this deplorable state of affairs because it is utterly, painfully, and shamefully TRUE. Just look at the hospital and you'd better brace yourself for a series of tests that could cost you the equivalent of a nice 3 bedroom home. If they were truly necessary after the failure of preventive and other simple efforts, fine. But, all too often, they are driven by profit motives.

Could I have stopped this somehow from occurring? After all, Tricia was reasonably aware of the way we do things around here. I fear that even this failed to serve Tricia well. But I remain hopeful that, as we build broader awareness of these issues, that more and more people and physicians will stand up and refuse to tolerate the status quo.

Where is the Track Your Plaque program going?

21. June 2006 William Davis (1)

I spend a lot of time worrying about how people can be helped to navigate through this program.

Take, for instance, the man in rural Texas who, while traveling in Dallas, got a heart scan on a whim. His score was 990. When he took the report back to his doctor, he got a smirk--and that's all. When he came to the Track Your Plaque program, he lacked a physician advocate to help him.

Or the woman from Florida who sought opinions from two reputable cardiologists for her heart scan score of 377. Both advised her that she needed a heart catheterization--despite her lack of symptoms, her 5-day-a-week exercise program, and normal stress test. She also lacks a physician advocate who acts on her behalf, helping her achieve success, rather than just churning her for money from hospital procedures.

For people like this and for others, I see the Track Your Plaque program evolving in several directions:

1) An online clinic--You enter and we take your "hand" and lead you step by step through the process, not only at the beginning, but over the months and years. This would help clear up some of the confusion and zigzags that some people experience trying to navigate through the program.

2) Develop physician and non-physician partners--The woman in Florida, for instance, could be referred to a doctor nearby who understands the program and is able to assist her. At present, this is virtually impossible because of the bias towards heart procedures, drugs as the sole treatment for heart disease risk, and the superficial physician-patient relationship. The majority of practicing physicians just don't understand the program despite the fact that it is based on sound clinical and experimental data. But it will in time.

Looking back, we've come a long way. I remember first having patients undergo heart scans 10 years ago. My colleagues laughed or called it "silly". The general public didn't know what they meant.

Now we're talking about how to broadcast the most powerful heart disease prevention program available in the world to a larger audience, but making it easier and more accessible. Mass media like Oprah's two hour-long spots helped, but we need to make the next leap. Not just identifying hidden heart disease to feed the hungry cardiovascular hospital procedure monster, but to educate/inform/empower the public on what to do with the scan once they've had it.

Who cares about triglycerides?

19. June 2006 William Davis (0)

Walter's triglycerides were 231 mg. His LDL cholesterol was "favorable" at 111 mg, HDL likewise at 49 mg.

"Everything looks good," his doctor declared.

"Do you think the triglycerides are okay, too?" Walter asked.

"Well, the guidelines do say that triglycerides should be less than 150, but I believe you're close enough. Anyway, triglycerides don't really cause heart disease."

When I met Walter, I made several comments. First of all, in light of his heart scan score of 713, none of his numbers--HDL, LDL, or triglycerides-- were acceptable. But the triglycerides were glaringly and terribly too high.

Why? What exactly are triglycerides?

Triglycerides are a basic fat particle that, though they do not cause heart disease directly, trigger the formation of an array of abnormal lipoprotein particles in the blood that are among the most potent causes of heart disease known.

These abnormal lipoprotein particles include small LDL, VLDL, and IDL (intermediate-density lipoprotein--a really bad pattern). Excess triglycerides also cause HDL to drop. They also cause a distortion of HDL structure, causing the particles to become abnormally small. Small HDL is also useless HDL, unable to provide the protection that HDL is designed to do.

So Walter's elevated triglycerides are, in reality, a substantial red flag for an entire panel of abnormal particles that contribute to the growth of his coronary plaque.

So, if you get this kind of commentary on your triglycerides, ask for another opinion. (Track Your Plaque Members: Also see Triglycerides: Mother of meddlesome particles at http://www.cureality.com/library/fl_dp002triglycerides.asp.)

Total cholesterol and heart scans

19. June 2006 William Davis (0)

Andy was fearful of heart disease in his life. At age 52, he'd already had four CT heart scans--one each year on or near his birthday.

Yet, when I looked at Andy's scans, his scores had been increasing 20-24% per year. Each and every score was greater by 20% or more over the previous.

So I asked Andy what steps he had taken to stop this relentless progression. "Well, I've always been real health conscious. But ever since my first scan, I really started sticking to a healthy diet, exercising nearly every day, and I take a bunch of supplements."

"What did your doctor advise?" I asked.

"Well, Dr. ---- said that nothing needed to be done, since my total cholesterol was always below 200."

Men's Health magazine's fabulous story about the folly of using total cholesterol to gauge heart disease risk.

Aaaauuuggghhh!! Wrong!

This man was, in fact, at rapidly escalating risk for heart attack. This rate of growth simply can't continue forever without igniting this bomb.

A total cholesterol below 200 is meaningless, as Andy's increasing coronary plaque proved. For instance, you can have a total cholesterol of 165 mg but with an HDL cholesterol of 27 mg. This would constitute very high risk for heart disease despite the low total cholesterol. The low HDL pattern is among the most common reasons for a misleading total cholesterol. Small LDL, high triglycerides, and lipoprotein (a) are other frequent reasons.

Andy, run the other way! Do not heed this doctor's advice! You need a solid answer to the question: Why exactly do I have coronary plaque in the first place?

Then, agree on a treatment program that corrects your specific causes.

Cardiologists out of touch

17. June 2006 William Davis (0)

This weekend, I'm fulfilling some responsiblities I have every so often to some of the local hospitals. It gives me a chance to interact with many of my colleagues who are likewise "on call" for the weekend.

I tried to strike up several conversations with colleagues about how they were managing heart disease prevention. I received blank stares, puzzled looks, indifference. One colleague declared that 80 mg of Lipitor is all you need to know.

These same colleagues are the ones scrambling for the heart attack patients in the emergency room, climbing over one another for consultation in the hospital for patients with chest pain and heart failure. They're consumed with expanding the range of procedures they can perform.

Carotid stenting is hot. So is stenting of the leg arteries. Defibrillators have been a financial bonanza. Opportunities abound on how to add these procedures to a cardiologist's abilities.

But heart disease prevention? How about heart disease reversal?

Frankly, I'm embarassed by my colleagues' lack of interest. Imagine we had a cure for breast cancer--not a palliative therapy that just slows the disease down or prolongs life, but actually cures it once and for all. I would hope that all physicians and oncologists would learn how to accomplish this. What if instead they focused on learning new ways to remove breasts, administer new toxic chemotherapies, etc. but ignored the whole idea of cure?

This is what is happening with coronary plaque reversal. The answer is right in front of them, but the vast majority (99%) of cardiologists choose to ignore it. After all, prevention and reversal simply don't pay the bills.

That means that, in 2006, you simply cannot rely on your cardiologist to counsel you on how to achieve regression or reversal of coronary plaque. How about your internist, family physician, or primary care doctor? Well, they're busy doing pneumovax injections, Pap smears, managing knee and hip arthritis, low back pain, diarrhea, headaches, sinus infections and . . yes, dabbling in heart disease prevention.

And, for the most part, doing a miserable job of it. What you generally get echoes the drug manufacturers pitch: Take a statin drug, cut the fat in your diet.

Until the majority of doctors catch on, you're going to have to rely on sources like the Track Your Plaque program for better information.

For the sake of convenience: Commercial sources of prebiotic fibers

3. May 2015 William Davis (0)

Our efforts to obtain prebiotic fibers/resistant starches, as discussed in the Cureality Digestive Health Track, to cultivate healthy bowel flora means recreating the eating behavior of primitive humans who dug in the dirt with sticks and bone fragments for underground roots and tubers, behaviors you can still observe in extant hunter-gatherer groups, such as the Hadza and Yanomamo. But, because this practice is inconvenient for us modern folk accustomed to sleek grocery stores, because many of us live in climates where the ground is frozen much of the year, and because we lack the wisdom passed from generation to generation that helps identify which roots and tubers are safe to eat and which are not, we rely on modern equivalents of primitive sources. Thus, green, unripe bananas, raw potatoes and other such fiber sources in the Cureality lifestyle.

There is therefore no need to purchase prebiotic fibers outside of your daily effort at including an unripe green banana, say, or inulin and fructooligosaccharides (FOS), or small servings of legumes as a means of cultivating healthy bowel flora. These are powerful strategies that change the number and species of bowel flora over time, thereby leading to beneficial health effects that include reduced blood sugar and blood pressure, reduction in triglycerides, reduced anxiety and improved sleep, and reduced colon cancer risk.

HOWEVER, convenience can be a struggle. Traveling by plane, for example, makes lugging around green bananas or raw potatoes inconvenient. Inulin and FOS already come as powders or capsules and they are among the options for a convenient, portable prebiotic fiber strategy. But there are others that can be purchased. This is a more costly way to get your prebiotic fibers and you do not need to purchase these products in order to succeed in your bowel flora management program. These products are therefore listed strictly as a strategy for convenience.

Most perspectives on the quality of human bowel flora composition suggest that diversity is an important feature, i.e., the greater the number of species, the better the health of the host. There may therefore be advantage in varying your prebiotic routine, e.g., green banana on Monday, inulin on Tuesday, PGX (below) on Wednesday, etc. Beyond providing convenience, these products may introduce an added level of diversity, as well.

Among the preparations available to us that can be used as prebiotic fibers:

PGX

While it is billed as a weight management and blood sugar-reducing product, the naturally occurring fiber--α-D-glucurono-α-D-manno-β-D-manno- β-D-gluco, α-L-gulurono-β-D mannurono, β-D-gluco-β- D-mannan--in PGX also exerts prebiotic effects (evidenced by increased fecal butyrate, the beneficial end-product of bacterial metabolism). PGX is available as capsules or granules. It also seems to exert prebiotic effects at lower doses than other prebiotic fibers. While I usually advise reaching 20 grams per day of fiber, PGX appears to exert substantial effects at a daily dose of half that quantity. As with all prebiotic fibers, it is best to build up slowly over weeks, e.g., start at 1.5 grams twice per day. It is also best taken in two or three divided doses. (Avoid the PGX bars, as they are too carb-rich for those of us trying to achieve ideal metaobolic health.)

Prebiotin

A combination of inulin and FOS available as powders and in portable Stick Pacs (2 gram and 4 gram packs). This preparation is quite costly, however, given the generally low cost of purchasing chicory inulin and FOS separately.

Acacia

Acacia fiber is another form of prebiotic fiber. RenewLife and NOW are two reputable brands.

Isomalto-oligosaccharides

This fiber is used in Quest bars and in Paleo Protein Bars. With Quest bars, choose the flavors without sucralose, since it has been associated with undesirable changes in bowel flora.

There you go. It means that there are fewer and fewer reasons to not purposefully cultivate healthy bowel flora and obtain all the wonderful health benefits of doing so, from reduced blood pressure, to reduced triglycerides, to deeper sleep.

Disclaimer: I am not compensated in any way by discussing these products.

How Not To Have An Autoimmune Condition

20. April 2015 William Davis (0)

Autoimmune conditions are becoming increasingly common. Estimates vary, but it appears that at least 8-9% of the population in North America and Western Europe have one of these conditions, with The American Autoimmune Related Diseases Association estimating that it’s even higher at 14% of the population.

The 200 or so autoimmune diseases that afflict modern people are conditions that involve an abnormal immune response directed against one or more organs of the body. If the misguided attack is against the thyroid gland, it can result in Hashimoto’s thyroiditis. If it is directed against pancreatic beta cells that produce insulin, it can result in type 1 diabetes or latent autoimmune diabetes of adults (LADA). If it involves tissue encasing joints (synovium) like the fingers or wrists, it can result in rheumatoid arthritis. It if involves the liver, it can result in autoimmune hepatitis, and so on. Nearly every organ of the body can be the target of such a misguided immune response.

While it requires a genetic predisposition towards autoimmunity that we have no control over (e.g., the HLA-B27 gene for ankylosing spondylitis), there are numerous environmental triggers of these diseases that we can do something about. Identifying and correcting these factors stacks the odds in your favor of reducing autoimmune inflammation, swelling, pain, organ dysfunction, and can even reverse an autoimmune condition altogether.

Among the most important factors to correct in order to minimize or reverse autoimmunity are:

Wheat and grain elimination

If you are reading this, you likely already know that the gliadin protein of wheat and related proteins in other grains (especially the secalin of rye, the hordein of barley, zein of corn, perhaps the avenin of oats) initiate the intestinal “leakiness” that begins the autoimmune process, an effect that occurs in over 90% of people who consume wheat and grains. The flood of foreign peptides/proteins, bacterial lipopolysaccharide, and grain proteins themselves cause immune responses to be launched against these foreign factors. If, for instance, an autoimmune response is triggered against wheat gliadin, the same antibodies can be aimed at the synapsin protein of the central nervous system/brain, resulting in dementia or cerebellar ataxia (destruction of the cerebellum resulting in incoordination and loss of bladder and bowel control). Wheat and grain elimination is by far the most important item on this list to reverse autoimmunity.

Correct vitamin D deficiency

It is clear that, across a spectrum of autoimmune diseases, vitamin D deficiency serves a permissive, not necessarily causative, role in allowing an autoimmune process to proceed. It is clear, for instance, that autoimmune conditions such as type 1 diabetes in children, rheumatoid arthritis, and Hashimoto’s thyroiditis are more common in those with low vitamin D status, much less common in those with higher vitamin D levels. For this and other reasons, I aim to achieve a blood level of 25-hydroxy vitamin D level of 60-70 ng/ml, a level that usually requires around 4000-8000 units per day of D3 (cholecalciferol) in gelcap or liquid form (never tablet due to poor or erratic absorption). In view of the serious nature of autoimmune diseases, it is well worth tracking occasional blood levels.

Supplement omega-3 fatty acids

While omega-3 fatty acids, EPA and DHA, from fish oil have proven only modestly helpful by themselves, when cast onto the background of wheat/grain elimination and vitamin D, omega-3 fatty acids compound anti-inflammatory benefits, such as those exerted via cyclooxygenase-2. This requires a daily EPA + DHA dose of around 3600 mg per day, divided in two. Don’t confuse EPA and DHA omega-3s with linolenic acid, another form of omega-3 obtained from meats, flaxseed, chia, and walnuts that does not not yield the same benefits. Nor can you use krill oil with its relatively trivial content of omega-3s.

Eliminate dairy

This is true in North America and most of Western Europe, less true in New Zealand and Australia. Autoimmunity can be triggered by the casein beta A1 form of casein widely expressed in dairy products, but not by casein beta A2 and other forms. Because it is so prevalent in North America and Western Europe, the most confident way to avoid this immunogenic form of casein is to avoid dairy altogether. You might be able to consume cheese, given the fermentation process that alters proteins and sugar, but that has not been fully explored.

Cultivate healthy bowel flora

People with autoimmune conditions have massively screwed up bowel flora with reduced species diversity and dominance of unhealthy species. We restore a healthier anti-inflammatory panel of bacterial species by “seeding” the colon with high-potency probiotics, then nourishing them with prebiotic fibers/resistant starches, a collection of strategies summarized in the Cureality Digestive Health discussions. People sometimes view bowel flora management as optional, just “fluff”–it is anything but. Properly managing bowel flora can be a make-it-or-break-it advantage; don’t neglect it.

There you go: a basic list to get started on if your interest is to begin a process of unraveling the processes of autoimmunity. In some conditions, such as rheumatoid arthritis and polymyalgia rheumatica, full recovery is possible. In other conditions, such as Hashimoto’s thyroiditis and the pancreatic beta cell destruction leading to type 1 diabetes, reversing the autoimmune inflammation does not restore organ function: hypothyroidism results after thyroiditis quiets down and type 1 diabetes and need for insulin persists after pancreatic beta cell damage. But note that the most powerful risk factor for an autoimmune disease is another autoimmune disease–this is why so many people have more than one autoimmune condition. People with Hashimoto’s, for instance, can develop rheumatoid arthritis or psoriasis. So the above menu is still worth following even if you cannot hope for full organ recovery

Five Powerful Ways to Reduce Blood Sugar

4. April 2015 William Davis (0)

Left to conventional advice on diet and you will, more than likely, succumb to type 2 diabetes sooner or later. Follow your doctor’s advice to cut fat and eat more “healthy whole grains” and oral diabetes medication and insulin are almost certainly in your future. Despite this, had this scenario played out, you would be accused of laziness and gluttony, a weak specimen of human being who just gave into excess.

If you turn elsewhere for advice, however, and ignore the awful advice from “official” sources with cozy relationships with Big Pharma, you can reduce blood sugars sufficient to never become diabetic or to reverse an established diagnosis, and you can create a powerful collection of strategies that handily trump the worthless advice being passed off by the USDA, American Diabetes Association, the American Heart Association, or the Academy of Nutrition and Dietetics.

Among the most powerful and effective strategies to reduce blood sugar:

1) Eat no wheat nor grains

Recall that amylopectin A, the complex carbohydrate of grains, is highly digestible, unlike most of the other components of the seeds of grasses AKA “grains,” subject to digestion by the enzyme, amylase, in saliva and stomach. This explains why, ounce for ounce, grains raise blood sugar higher than table sugar. Eat no grains = remove the exceptional glycemic potential of amylopectin A.

2) Add no sugars, avoid high-fructose corn syrup

This should be pretty obvious, but note that the majority of processed foods contain sweeteners such as sucrose or high-fructose corn syrup, tailored to please the increased desire for sweetness among grain-consuming people. While fructose does not raise blood sugar acutely, it does so in delayed fashion, along with triggering other metabolic distortions such as increased triglycerides and fatty liver.

3) Vitamin D

Because vitamin D restores the body’s normal responsiveness to insulin, getting vitamin D right helps reduce blood sugar naturally while providing a range of other health benefits.

4) Restore bowel flora

As cultivation of several Lactobacillus and Bifidobacteria species in bowel flora yields fatty acids that restore insulin responsiveness, this leads to reductions in blood sugar over time. Minus the bowel flora-disrupting effects of grains and sugars, a purposeful program of bowel flora restoration is required (discussed at length in the Cureality Digestive Health section.)

5) Exercise

Blood sugar is reduced during and immediately following exercise, with the effect continuing for many hours afterwards, even into the next day.

Note that, aside from exercise, none of these powerful strategies are advocated by the American Diabetes Association or any other “official” agency purporting to provide dietary advice. As is happening more and more often as the tide of health information rises and is accessible to all, the best advice on health does not come from such agencies nor from your doctor but from your efforts to better understand the truths in health. This is our core mission in Cureality. A nice side benefit: information from Cureality is not accompanied by advertisements from Merck, Pfizer, Kelloggs, Kraft, or Cadbury Schweppes.

Cureality App Review: Breathe Sync

7. March 2015 William Davis (0)

Biofeedback is a wonderful, natural way to gain control over multiple physiological phenomena, a means of tapping into your body’s internal resources. You can, for instance, use biofeedback to reduce anxiety, heart rate, and blood pressure, and achieve a sense of well-being that does not involve drugs, side-effects, or even much cost.

Biofeedback simply means that you are tracking some observable physiologic phenomenon—heart rate, skin temperature, blood pressure—and trying to consciously access control over it. One very successful method is that of bringing the beat-to-beat variation in heart rate into synchrony with the respiratory cycle. In day-to-day life, the heart beat is usually completely out of sync with respiration. Bring it into synchrony and interesting things happen: you experience a feeling of peace and calm, while many healthy phenomena develop.

A company called HeartMath has applied this principle through their personal computer-driven device that plugs into the USB port of your computer and monitors your heart rate with a device clipped on your earlobe. You then regulate breathing and follow the instructions provided and feedback is obtained on whether you are achieving synchrony, or what they call “coherence.” As the user becomes more effective in achieving coherence over time, positive physiological and emotional effects develop. HeartMath has been shown, for instance, to reduce systolic and diastolic blood pressure, morning cortisol levels (a stress hormone), and helps people deal with chronic pain. Downside of the HeartMath process: a $249 price tag for the earlobe-USB device.

But this is the age of emerging smartphone apps, including those applied to health. Smartphone apps are perfect for health monitoring. They are especially changing how we engage in biofeedback. An app called Breathe Sync is available that tracks heart rate using the camera’s flash on the phone. By tracking heart rate and providing visual instruction on breathing pattern, the program generates a Wellness Quotient, WQ, similar to HeartMath’s coherence scoring system. Difference: Breathe Sync is portable and a heck of a lot less costly. I paid $9.99, more than I’ve paid for any other mainstream smartphone application, but a bargain compared to the HeartMath device cost.

One glitch is that you need to not be running any other programs in the background, such as your GPS, else you will have pauses in the Breathe Sync program, negating the value of your WQ. Beyond this, the app functions reliably and can help you achieve the health goals of biofeedback with so much less hassle and greater effectiveness than the older methods.

If you are looking for a biofeedback system that provides advantage in gaining control over metabolic health, while also providing a wonderful method of relaxation, Breathe Sync, I believe, is the go-to app right now.

Amber’s Top 35 Health and Fitness Tips

7. November 2014 Amber B (0)

This year I joined the 35 club! And in honor of being fabulous and 35, I want to share 35 health and fitness tips with you!

1. Foam rolling is for everyone and should be done daily.
2. Cold showers are the best way to wake up and burn more body fat.
3. Stop locking your knees. This will lead to lower back pain.
4. Avoid eating gluten at all costs.
5. Breath deep so that you can feel the sides or your lower back expand.
6. Swing a kettlebell for a stronger and great looking backside.
7. Fat is where it’s at! Enjoy butter, ghee, coconut oil, palm oil, duck fat and many other fabulous saturated fats.
8. Don’t let your grip strength fade with age. Farmer carries, kettlebells and hanging from a bar will help with that.
9. Runners, keep your long runs slow and easy and keep your interval runs hard. Don’t fall in the chronic cardio range.
10. Drink high quality spring or reverse osmosis water.
11. Use high quality sea salt season food and as a mineral supplement.
12. Work your squat so that your butt can get down to the ground. Can you sit in this position? How long?
13. Lift heavy weights! We were made for manual work,. Simulate heavy labor in the weight room.
14. Meditate daily. If you don’t go within, you will go with out. We need quiet restorative time to balance the stress in our life.
15. Stand up and move for 10 minutes for every hour your sit at your computer.
16. Eat a variety of whole, real foods.
17. Sleep 7 to 9 hours every night.
18. Pull ups are my favorite exercise. Get a home pull up bar to practice.
19. Get out and spend a few minutes in nature. Appreciate the world around you while taking in fresh air and natural beauty.
20. We all need to pull more in our workouts. Add more pulling movements horizontally and vertically.
21. Surround yourself with health minded people.
22. Keep your room dark for deep sound sleep. A sleep mask is great for that!
23. Use chemical free cosmetics. Your skin is the largest organ of your body and all chemicals will absorb into your blood stream.
24. Unilateral movements will help improve symmetrical strength.
25. Become more playful. We take life too seriously, becoming stress and overwhelmed. How can you play, smile and laugh more often?
26. Choose foods that have one ingredient. Keep your diet simple and clean.
27. Keep your joints mobile as you age. Do exercises that take joints through a full range of motion.
28. Go to sleep no later than 10:30pm. This allows your body and brain to repair through the night.
29. Take care of your health and needs before others. This allows you to be the best spouse, parent, coworker, and person on the planet.
30. Always start your daily with a high fat, high protein meal. This will encourage less sugar cravings later in the day.
31. Approach the day with positive thinking! Stinkin’ thinkin’ only leads to more stress and frustration.
32. You are never “too old” to do something. Stay young at heart and keep fitness a priority as the years go by.
33. Dream big and go for it.
34. Lift weights 2 to 4 times every week. Strong is the new sexy.
35. Love. Love yourself unconditionally. Love your life and live it to the fullest. Love others compassionately.

Amber B.
Cureality Exercise and Fitness Coach

To Change, You Need to Get Uncomfortable

25. September 2014 Amber B (0)

Sitting on the couch is comfortable. Going through the drive thru to pick up dinner is comfortable. But when you notice that you’re out-of-shape, tired, sick and your clothes no longer fit, you realize that what makes you comfortable is not in align with what would make you happy.

You want to see something different when you look in the mirror. You want to fit into a certain size of jeans or just experience your day with more energy and excitement. The current condition of your life causes you pain, be it physical, mental or emotional. To escape the pain you are feeling, you know that you need to make changes to your habits that keep you stuck in your current state. But why is it so hard to make the changes you know that will help you achieve what you want?

I want to lose weight but….

I want a six pack but…

I want more energy but….

The statement that follows the “but” is often a situation or habit you are comfortable with. You want to lose weight but don’t have time to cook healthy meals. So it’s much more comfortable to go through the drive thru instead of trying some new recipes. New habits often require a learning curve and a bit of extra time in the beginning. It also takes courage and energy to establish new routines or seek out help.

Setting out to achieve your goals requires change. Making changes to establish new habits that support your goals and dreams can be uncomfortable. Life, as you know it, will be different. Knowing that fact can be scary, but so can staying in your current condition. So I’m asking you to take a risk and get uncomfortable so that you can achieve your goals.

Realize that it takes 21 days to develop a new habit. I believe it takes triple that amount of time to really make a new habit stick for the long haul. So for 21 days, you’ll experience some discomfort while you make changes to your old routine and habits. Depending on what you are changing, discomfort could mean feeling tired, moody, or even withdrawal symptoms. However, the longer you stick to your new habits the less uncomfortable you start to feel. The first week is always the worst, but then it gets easier.

Making it through the uncomfortable times requires staying focused on your goals and not caving to your immediate feelings or desires. I encourage clients to focus on why their goals important to them. This reason or burning desire to change will help when old habits, cravings, or situations call you back to your old ways.
Use a tracking and a reward system to stay on track. Grab a calendar, journal or index card to check off or note your daily successes. Shoot for consistency and not perfection when trying to make changes. I encourage my clients to use the 90/10 principle of change and apply that to their goal tracking system. New clothes, a massage, or a day me-retreat are just a few examples of rewards you can use to sticking to your tracking system. Pick something that really gets you excited.

Getting support system in place can help you feel more comfortable with being uncomfortable. Hiring a coach, joining an online support group, or recruiting family and friends can be very helpful when making big changes. With a support system in place you are not alone in your discomfort. You’re network is there for you to reach out for help, knowledge, accountability or camaraderie when you feel frustrated and isolated.

I’ve helped hundreds of people change their bodies, health and lives of the eleven years I’ve worked as a trainer and coach. I know it’s hard, but I also know that if they can do it, so can you. You just need to step outside of your comfort zone and take a risk. Don’t let fear create uncomfortable feelings that keep you stuck in your old ways. Take that first step and enjoy the journey of reaching your goals and dreams.

Amber Budahn, B.S., CSCS, ACE PT, USATF 1, CHEK HLC 1, REIKI 1
Cureality Exercise Specialist

The 3 Best Grain Free Food Swaps to Boost Fat Burning

25. September 2014 Lisa G (0)

You can join others enjoying substantial improvements in their health, energy and pant size by making a few key, delicious substitutions to your eating habits. This is possible with the Cureality nutrition approach, which rejects the idea that grains should form the cornerstone of the human diet.

Grain products, which are seeds of grasses, are incompatible with human digestion. Contrary to what we have been told for years, eating healthy whole grain is not the answer to whittle away our waists. Consumption of all grain-based carbohydrates results in increased production of the fat storage hormone insulin. Increased insulin levels create the perfect recipe for weight gain. By swapping out high carbohydrate grain foods that cause spikes in insulin with much lower carbohydrate foods, insulin release is subdued and allows the body to release fat.

1. Swap wheat-based flour with almond flour/meal

One of the most dubious grain offenders is modern wheat. Replace wheat flour with naturally wheat-free, lower carbohydrate almond flour.
Almond flour contains a mere 12 net carbs per cup (carbohydrate minus the fiber) with 50% more filling protein than all-purpose flour.
Almond flour and almond meal also offer vitamin E, an important antioxidant to support immune function.

2. Swap potatoes and rice for cauliflower

Replace high carb potatoes and pasta with vitamin C packed cauliflower, which has an inconsequential 3 carbs per cup.
Try this food swap: blend raw cauliflower in food processor to make “rice”. (A hand held grater can also be used). Sautee the “riced” cauliflower in olive or coconut oil for 5 minutes with seasoning to taste.
Another food swap: enjoy mashed cauliflower in place of potatoes. Cook cauliflower. Place in food processor with ½ a stick organic, grass-fed butter, ½ a package full-fat cream cheese and blend until smooth. Add optional minced garlic, chives or other herbs such as rosemary.

3. Swap pasta for shirataki noodles and zucchini

Swap out carb-rich white pasta containing 43 carbs per cup with Shirataki noodles that contain a few carbs per package. Shirataki noodles are made from konjac or yam root and are found in refrigerated section of supermarkets.
Another swap: zucchini contains about 4 carbs per cup. Make your own grain free, low-carb noodles from zucchini using a julienne peeler, mandolin or one of the various noodle tools on the market.

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

Not so fast. Don’t make this mistake when going gluten free!

25. September 2014 Lisa G (0)

Beginning last month, the Food and Drug Administration began implementing its definition of “gluten-free” on packaged food labels. The FDA determined that packaged food labeled gluten free (or similar claims such as "free of gluten") cannot contain more than 20 parts per million of gluten.

It has been years in the making for the FDA to define what “gluten free” means and hold food manufactures accountable, with respect to food labeling. However, the story does not end there.

Yes, finding gluten-free food, that is now properly labeled, has become easier. So much so the market for gluten-free foods tops $6 billion last year. However, finding truly healthy, commercially prepared, grain-free foods is still challenging.

A very common mistake made when jumping into the gluten-free lifestyle is piling everything labeled gluten-free in the shopping cart. We don’t want to replace a problem: wheat, with another problem: gluten free products.

Typically gluten free products are made with rice flour (and brown rice flour), tapioca starch, cornstarch, and potato flour. Of the few foods that raise blood sugar higher than wheat, these dried, powdered starches top the list.

They provide a large surface area for digestion, thereby leading to sky-high blood sugar and all the consequences such as diabetes, hypertension, cataracts, arthritis, and heart disease. These products should be consumed very rarely consumed, if at all. As Dr. Davis has stated, “100% gluten-free usually means 100% awful!”

There is an ugly side to the gluten-free boom taking place. The Cureality approach to wellness recommends selecting gluten-free products wisely. Do not making this misguided mistake and instead aim for elimination of ALL grains, as all seeds of grasses are related to wheat and therefore overlap in many effects.

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

3 Foods to Add to Your Next Grocery List

25. September 2014 Lisa G (0)

Looking for some new foods to add to your diet? Look no further. Reach for these three mealtime superstars to encourage a leaner, healthier body.

Microgreens

Microgreens are simply the shoots of salad greens and herbs that are harvested just after the first leaves have developed, or in about 2 weeks. Microgreen are not sprouts. Sprouts are germinated, in other words, sprouted seeds produced entirely in water. Microgreens are grown in soil, thereby absorbing the nutrients from the soil.

The nutritional profile of each microgreen depends greatly on the type of microgreen you are eating. Researchers found red cabbage microgreens had 40 times more vitamin E and six times more vitamin C than mature red cabbage. Cilantro microgreens had three times more beta-carotene than mature cilantro.

A few popular varieties of microgreens are arugula, kale, radish, pea, and watercress. Flavor can vary from mild to a more intense or spicy mix depending on the microgreens. They can be added to salads, soup, omelets, stir fry and in place of lettuce.

Cacao Powder

Cocoa and cacao are close enough in flavor not to make any difference. However, raw cacao powder has 3.6 times the antioxidant activity of roasted cocoa powder. In short, raw cacao powder is definitely the healthiest, most beneficial of the powders, followed by 100% unsweetened cocoa.

Cacao has more antioxidant flavonoids than blueberries, red wine and black and green teas. Cacao is one of the highest sources of magnesium, a great source of iron and vitamin C, as well as a good source of fiber for healthy bowel function.
Add cacao powder to milk for chocolate milk or real hot chocolate. Consider adding to coffee for a little mocha magic or sprinkle on berries and yogurt.

Shallots

Shallots have a better nutrition profile than onions. On a weight per weight basis, they have more anti-oxidants, minerals, and vitamins than onions. Shallots have a milder, less pungent taste than onions, so people who do not care for onions may enjoy shallots.

Like onions, sulfur compounds in shallot are necessary for liver detoxification pathways. The sulfur compound, allicin has been shown to be beneficial in reducing cholesterol. Allicin is also noted to have anti-bacterial, anti-viral, and anti-fungal activities.

Diced then up and add to salads, on top of a bun less hamburger, soups, stews, or sauces. Toss in an omelet or sauté to enhance a piece of chicken or steak, really the possibilities are endless.

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

3 Band Exercises for Great Glutes

15. August 2014 Amber B (0)

Bands and buns are a great combination. (When I talk about glutes or a butt, I use the word buns) When it comes to sculpting better buns, grab a band. Bands are great for home workouts, at gym or when you travel. Check out these 3 amazing exercises that will have your buns burning.

Band Step Out

Grab a band and place it under the arch of each foot. Then cross the band and rest your hands in your hip sockets. The exercise starts with your feet hip width apart and weight in the heels. Slightly bend the knees and step your right foot out to the side. Step back in so that your foot is back in the starting position. With each step, make sure your toes point straight ahead. The tighter you pull the band, the more resistance you will have. You will feel this exercise on the outside of your hips.

Start with one set of 15 repetitions with each foot. Work on increasing to 25 repetitions on each side and doing two to three sets.

Band Kick Back

This exercise is performed in the quadruped position with your knees under hips and hands under your shoulders. Take the loop end of the band and put it around your right foot and place the two handles or ends of the band under your hands. Without moving your body, kick your right leg straight back. Return to the starting quadruped position. Adjust the tension of the band to increase or decrease the difficulty of this exercise.

Start with one set of 10 repetitions with each foot. Work on increasing to 20 repetitions on each side and doing two to three sets.

Band Resisted Hip Bridge

Start lying on your back with feet hip distance apart and knees bent at about a 45-degree angle. Adjust your hips to a neutral position to alleviate any arching in your lower back. Place the band across your hipbones. Hold the band down with hands along the sides of your body. Contract your abs and squeeze your glutes to lift your hips up off the ground. Stop when your thighs, hips and stomach are in a straight line. Lower you hips back down to the ground.

Start with one set of 15 repetitions. Work on increasing to 25 repetitions and doing two to three. Another variation of this exercise is to hold the hip bridge position. Start with a 30 second hold and work up to holding for 60 seconds.

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Don't forget the pumpkin in the wheat-free pumpkin bread

25. December 2010 William Davis (3)

Ooops!

Anyone who receives this blog via RSS feed may have received the Wheat-free pumpkin bread recipe in which I failed to list the pumpkin in the list of ingredients.

Here's the recipe with all the ingredients.

Wheat-free pumpkin bread

25. December 2010 William Davis (5)

Try this recipe for a wheat-free, gluten-free yet healthy "bread." Unlike many gluten-free foods that send blood sugar skyward, this will not.

Ingredients:
2 cups ground almond meal (Buy it from Trader Joe's--70% cheaper than other grocery stores.)
1/2 cup ground flaxseed
1/2 cup sour cream (full-fat, of course)
15 oz canned pumpkin (Trader Joe's is bisphenol A-free)
2 medium to large eggs
1/2 cup chopped walnuts or pecans
4 tablespoons butter, melted
2 teaspoons baking powder
2 teaspoons cinnamon
1 teaspoon nutmeg or allspice
Dash of salt
Choice of non-nutritive sweetener (I used 3 teaspoons Trader Joe's stevia extract powder, the one mixed with lactose. Two tablespoons of Truvia, 1/2 teaspoon of the more concentrated stevia extract, or 1/2 cup Splenda are other choices. You can taste the mixed batter to gauge sweetness if in doubt.)

Preheat oven to 350 degrees F. Grease baking pan (e.g., 10 x 6 inch). The pan should be big enough so that the mix will not be more than 2 inches deep, else it will require much longer to bake. (If you have only smaller pans, you will need to cook longer while the pan is covered with aluminum foil.)

Mix all ingredients thoroughly in large bowl. Pour mix into greased baking pan.

Cover with aluminum foil and bake for 30 minutes. Remove foil and bake for additional 30 minutes or until inserted toothpick or knife comes out dry.

Serve with cream cheese or as is.

(I'd have some pictures, but the kids and I ate it up before I thought to take any photographs.)

Vitamin D: Deficiency vs optimum level

19. December 2010 William Davis (20)

Dr. James Dowd of the Vitamin D Cure posted his insightful comments regarding the Institute of Medicine's inane evaluation of vitamin D.

Dr. Dowd hits a bullseye with this remark:

The IOM is focusing on deficiency when it should be focusing on optimal health values for vitamin D. The scientific community continues to argue about the lower limit of normal when we now have definitive pathologic data showing that an optimal vitamin D level is at or above 30 ng/mL. Moreover, if no credible toxicity has been reported for vitamin D levels below 200 ng/mL, why are we obsessing over whether our vitamin D level should be 20 ng/mL or 30 ng/mL?

Yes, indeed. Have no doubts: Vitamin D deficiency is among the greatest public health problems of our age; correction of vitamin D (using the human form of vitamin D, i.e., D3 or cholecalciferol, not the invertebrate or plant form, D2 or ergocalciferol) is among the most powerful health solutions.

I have seen everything from relief from winter "blues," to reversal of arthritis, to stopping the progression of aortic valve disease, to partial reversal of dementia by achieving 25-hydroxy vitamin D levels of 50 ng/ml or greater. (I aim for 60-70 ng/ml.)

The IOM's definition of vitamin D adequacy rests on what level of 25-hydroxy vitamin D reverses hyperparathyroidism (high PTH levels) and rickets. Surely there is more to health than that.

Dr. Dowd and vocal vitamin D advocate, Dr. John Cannell, continue to champion the vitamin D cause that, like many health issues, conradicts the "wisdom" of official organizations like the IOM.

Large LDL counts, too

15. December 2010 William Davis (0)

Chad is a 43-year old father of five kids.

Earlier this year, he developed chest pain that got worse and worse. He ended up with a total of five stents in all three coronary arteries. After a devastating experience with Lipitor that resulted from a ruptured tendon, he came to me for an option.

Chad's lipoproteins:

Slow Burn works

14. December 2010 William Davis (55)

I have been impressed with the results I've been obtaining with Fred Hahn's Slow Burn strength training technique.

Because I have limited time to hang around the gym, any technique that provides outsized results in a limited amount of time, I have to admit, appeals to me. In past, I'd be lucky to squeeze in one or two strength training sessions per week, devoting the rest of the time to biking outdoors, biking on a sedentary bike (while playing XBox), jogging, or doing strenuous yard work like digging trenches and planting shrubs.

Over the years, I've gradually lost muscle, since the strength training effort suffered with my time limitations.

So Fred's time-efficient Slow Burn idea struck a chord. Having now done it with some regularity, usually 1-2 times per week since mid-September, I have gradually added back visible muscle. My Slow Burn workouts, involving 8-10 different movements, seem to have restored the muscle I've lost, with a very modest time effort.

It took a little getting used to. After Fred showed me how to do the movements--slow motion movement in both the "positive" and "negative" directions, with smooth, non-jerking transitions, one set per muscle group, each taken to muscle exhaustion--it left me unusually tired and sore the next day. This surprised me, given the limited time involved. Breathing is also very important; the usual exhale-during-the-positive, inhale-during-the-negative pattern is replaced by breathing freely during the entire set. I didn't get this at first and ended up with headaches that got worse with each set. Breathing freely relieved me from the effect.

I have strength trained since I was around 15 years old. Back in the early 1970s, I had about 2000 lbs of barbells and dumbbells in my garage in New Jersey, while also driving back and forth to the Morristown, NJ, YMCA to train with friends. The Slow Burn movements forced me to break habits established over nearly 40 years of conventional strength training.

I've also played around with mixing conventional movements with Slow Burn movements to keep it fresh. This also seems to work.

If you're interested in giving it a try, here's an animation that demonstrates what Slow Burn movements look like. Fred has also produced an excellent 3-DVD set of videos that more fully describe the practice.

Do your part to save on healthcare costs

13. December 2010 William Davis (37)

While many of the factors that drive the relentless increase in health care costs are beyond individual control, you are still able to exert personal influence over costs. Just as in political elections, your one vote alone may not count; it's the collective effort of many people who share similar opinions that results in real change.

I just got the new monthly premium for my high-deductible health insurance: Up $300 per month, putting my family's total premium over $2000 per month---for four healthy people. (My son fractured his wrist playing high school hockey earlier this year; that may explain at least some of the increase.)

I'm going to shop around for a better deal. However, shopping is likely to only stall the process. It will not address the systemic problems with healthcare that continue to drive premiums up and up and up.

So what can you do to help keep costs down? Here are a few thoughts:

Never accept a prescription for fish oil, i.e., Lovaza. Just buy far less costly over-the-counter fish oil. I treat complex hyperlipidemias, including familial hypertriglyceridemia, ever day. I NEVER use prescription fish oil. A typical 4 capsule per day Lovaza prescription adds around $280 to $520 per month to overall health costs (though your direct out-of-pocket costs may be less, since you shove the costs onto others in your plan).

Never accept a prescription for vitamin D. Prescription vitamin D is the mushroom or invertebrate form anyway. Just buy the human (cholecalciferol, D3) form from your health food store or "big box" store. They yield consistent increases in 25-hydroxy vitamin D levels, superior to the prescription form. And they're wonderfully inexpensive.

Eliminate wheat from your diet. If there is a dietary strategy that yields unexpected and outsized benefits across a wide spectrum of health, it's elimination of this thing we're sold called "wheat," you know, the genetically-transformed, high-yield dwarf mutant that now represents 99% of all wheat sold. Blood sugar drops, pre-diabetics become non-prediabetics, diabetics reduce need for medication or become non-diabetic, cholesterol values plummet, arthritis improves, acid reflux and irritable bowel symptoms improve or disappear, just to mention a few. Wheat elimination alone, I believe, would result in incalculable savings in both healthcare costs and lives saved.

Be sure to obtain iodine. In the fuss to cut salt use, everyone forgot about iodine. Lack of iodine leads to thyroid disease, usually hypothyroidism, that, in turn, causes cholesterol values to increase, weight to increase, and heart disease risk to double, triple, or quadruple. Iodine supplementation is easy and wonderfully inexpensive.

Over time, I hope that all of us can help develop the effort to self-direct more and more of our own health. Our Track Your Plaque program has shown me that, not only can people take the initiative to direct aspects of their own health, they can do it better than 99% of doctors.

I'm sure there are many, many other ways to help reduce costs. Any suggestions?

Fish oil: What's the difference?

10. December 2010 William Davis (27)

Ultra-purified, pharmaceutical grade, molecularly distilled. Over-the-counter vs. prescription. Gelcap, liquid, emulsion.

There's a mind-boggling variety of choices in fish oil today. A visit to any health food store, or any "big box" store for that matter, will yield at least several, if not dozens, of choices, all with varying and often extravagant claims of purity and potency.

So what's the real story?

Given the analyses conducted over the years, along with my experience with dozens of different preparations, I believe that several conclusions can be reached about fish oil:

Fish oil is free of contamination with mercury, dioxin, PCBs, or furans. To my knowledge, only one fish oil preparation has been found to have a slight excess of PCBs. (This is different from cod liver oil that has been found by one source to have a slight excess of PCBs.)

Oxidative breakdown products differ among the various brands. Consumer Lab (http://www.consumerlab.org/), for instance, has found that several widely available brands of fish oil contained excessive oxidative breakdown products (TOTOX). You can perform you own simple test of oxidative breakdown products: Sniff it. Your fish oil should pass the "sniff test." High quality fish oil should smell non-fishy to lightly fishy. Rancid fish oil with excessive quantities of oxidative breakdown products will smell nasty fishy.

FDA approval does not necessarily mean greater potency, purity, or effectiveness. It just means that somebody assembled the hundreds of millions of dollars to obtain FDA approval, followed by lots of marketing savvy to squash the competition.

This means that there are a number of excellent fish oil products available. My favorites are the liquid fish oils from Pharmax, Nordic Naturals, and Barleans. Capsules from Carlson, PharmaNutrients, and Fisol have also performed consistently. The "big box" capsules from Sam's Club and Costco have also performed well and are wonderfully affordable.

Wheat-free pie crust

9. December 2010 William Davis (17)

I've been working on wheat-free yet healthy recipes these past two months.

You can buy wheat-free, gluten-free foods at the store, of course. But the majority of these products are unhealthy because cornstarch, rice starch, potato starch, or tapioca starch are commonly used in place of wheat. Recall that these are among the few foods that increase blood glucose higher than even wheat.

Here's a simple recipe for wheat-free pie crust that works best for cheesecake, pumpkin pie, and cream pies, but not for berry or other fruit pies like apple.

You will need:
?
1½ cups ground pecans
6 tablespoons melted butter?or melted coconut oil
1 teaspoon vanilla extract?
2 teaspoons cinnamon
1 medium egg
2 tablespoons Truvia™ or ½ teaspoon stevia extract or ½ cup Splenda®

Mix all ingredients thoroughly in bowl. Pour mixture into pie pan and press onto bottom and sides.

Fill pie crust with desired filling. You can fill it with your favorite cheesecake recipe (e.g., Neufchatel or cream cheese, sour cream, eggs, vanilla, and stevia; add pumpkin for pumpkin cheesecake) and bake, usually at 350 degrees F for one hour.

Yes, the butter provokes insulin and artificial sweeteners can trigger appetite. But, for the holidays, a slice or two of pie made with this crust will not increase blood sugar nor trigger the uncontrolled impulse eating that wheat crust will trigger.

Have a cookie

9. December 2010 William Davis (0)

Here's a great insight dating all the way back to 1966 from one of the early explorations in lipoproteins from the National Institutes of Health lab of Levy, Lees, and Fredrickson:

The nature of pre-beta (very low density) lipoproteins

The subject is a 19 year old female (among the total of 11 in the this small, diet-controlled study) who was first fed a low-carbohydrate (50 grams per day), low-cholesterol diet; followed by a high-carbohydrate (500 grams per day), low-fat (5 grams per day) diet.

To B or not to B

5. December 2010 William Davis (11)

Apoprotein B (apo B) is the principle protein that resides in LDL particles along with other proteins, phospholipids, triglycerides, and, of course, cholesterol.

There's a curious thing about apo B. Just like one child per family in China or one television per household in 1950s America, there is only one apo B for every LDL particle.

So measuring apo B, in effect, provides a virtual count of LDL particles. (Actually, VLDL particles, the first lipoprotein to emerge from the liver, also have one apo B per particle but LDL particles far outnumber VLDL particles.) While apo B structure can show limited structural variation from individual to individual, the effect on measured apo B is negligible.

One apo B per LDL particle . . . no more, no less. What about the other components of LDL particles?

The other components of LDL particles are a different story. Cholesterol and triglycerides in LDL particles vary substantially. Diet has profound effects on cholesterol and triglyceride content of LDL particles. A diet rich in carbohydrates, for instance, increases triglycerides in LDL particles while reducing cholesterol. This means that measuring cholesterol in the LDL fraction will be misleading, since cholesterol will be falsely low. LDL cholesterol is therefore a flawed means to assess the behavior and composition of LDL particles. In particular, when LDL particles become enriched in triglycerides, they go through a process that transforms them into small LDL particles, the variety most likely to cause atherosclerosis.

In other words, when the worst situation of all--an abnormal abundance of small LDL particles develops--it is usually not signalled by high LDL cholesterol.

Because apo B is not sensitive to the composition of LDL particles--high cholesterol, low cholesterol, high triglycerides, etc.--it is a superior method to characterize LDL particles. While apo B doesn't tell you whether LDL particles are big, small, or in between, it provides a count of particles that is far more helpful than measuring this deeply flawed thing called "LDL cholesterol."

(Even better: Count LDL particles and measure LDL size, since size gives us insight into sensitivity to oxidation, glycation, adhesiveness, ability to trigger inflammatory pathways via monocyte chemoattractant protein, various interleukins, tunor necrosis factor and others. This is why cholesterol panels should go the way of tie dye shirts and 8-track tapes: They are hopelessly, miserably, and irretrievably inaccurate. Cholesterol panels should be replaced by either apoprotein B or lipoprotein measures.)

An exercise in optimism

5. May 2007 William Davis (0)

Followers of the Track Your Plaque program already know that maintaining an optimistic viewpoint is important in gaining control over coronary plaque.

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

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

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

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

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

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

Let optimism prevail, even in dire circumstances.

No need to re-invent the wheel

2. May 2007 William Davis (0)

I seem to be repeating myself lately, but I think this does bear repeating:

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

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

The basic program is quite simple:

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

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

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

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

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

--Normal blood pressure (<130/80)

--An optimistic attitude

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

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

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

Are we a front for drug companies?

2. May 2007 William Davis (3)

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

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

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

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

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

What is "normal"?

1. May 2007 William Davis (2)

When it comes to laboratory values and medical testing, a common dilemma is knowing what is "normal." Let me explain.

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

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

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

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

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

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

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

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

The wisdom of the masses

1. May 2007 William Davis (0)

My sister sent me these quotes:

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

Decca Recording Co. rejecting the Beatles, 1962

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

Irving Fisher, Professor of Economics, Yale University, 1929

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

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

"Everything that can be invented has been invented."

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

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

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

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

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

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

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

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

How important is l-arginine?

30. April 2007 William Davis (13)

Perhaps more than any other supplement, l-arginine causes frustration and confusion. It’s difficult to find, sometimes quite expensive, and some preparations cause loose stools.

Just how necessary is it?

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

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

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

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

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

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

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

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

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

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

Track Your Plaque and non-commercialism

29. April 2007 William Davis (6)

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

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

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

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

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

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

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

The nattokinase scam

28. April 2007 William Davis (179)

A conversation about vitamin K2 commonly leads to confusion. Several people have asked about something called nattokinase.

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

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

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

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

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

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

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

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

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

Blood pressure with exercise

27. April 2007 William Davis (10)

Here's a frequently neglected cause for an increasing CT heart scan score: High blood pressure with exercise. Let me explain.

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

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

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

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

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

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

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

Vitamin D2 vs. vitamin D3

26. April 2007 William Davis (21)

An interesting question came up on the Track Your Plaque Member Forum about vitamin D2 vs. vitamin D3. This often comes up among our patients, as well.

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

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

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

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

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

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