Are you hungry?

6. December 2011 William Davis (43)
Eliminate modern high-yield semi-dwarf Triticum aestivum . . . and what is the effect on appetite?

A reduction in appetite is among the most common and profound experiences resulting from wheat elimination. I know that I have personally felt it: Wake up in the morning, little interest in breakfast for several hours. Lunch? Maybe I'll have a few bites of something. Dinner . . . well, I'd like to exercise first.

The wheatless report that:

--Appetite diminishes to the point where you can't remember whether you've eaten or not. It is not uncommon to miss a meal, perfectly content. Calorie intake drops by 400 calories per day, on average, calories you otherwise would not have needed but all went to . . . you know where.
--Hunger feels different: It's not the gnawing, rumbling hunger that plagues you every 2 hours. In its place, you will find that hunger feels like a soft reminder that, gee, maybe it's time to have something to eat because you haven't had anything in--what?--4 to 6 hours. And it's a subtle reminder, not a desperate hunt that makes you knock people aside at the food bar, steal coworkers' lunches stored in the refrigerator, salivating at the mere thought of food.
--The simplest foods satisfy--It no longer requires an all-you-can-eat buffet to satisfy, but a few small pieces of healthy food. (Yeah, but what happens to revenues at Kraft, Nabisco, and Kelloggs, not to mention the revenues at agribusiness giants ADM and Monsanto? Slash consumption by, say, 30%, you likewise slash revenues by 30%. What would shareholders say?)
--Even prolonged periods of not eating, i.e., fasting, is endured with ease.

Hunger and the relentless search for something to eat disappear for most people. By eliminating the appetite-stimulating properties of wheat, we return to a natural state of eating for sustenance, to satisfy physiologic need. We are no longer victims of this incredibly powerful appetite-stimulant called gliadin from wheat.

This is why many diets fail: They fail to remove this powerful appetite stimulant. You might eat only lean meats, limit your calories, and exercise 90 minutes per day, but as long as the gliadin protein is pushing your appetite button, you will want to eat more or you will have to mount monumental willpower to resist it. You can lose 20 pounds on phase 1 of the South Beach diet, for instance, only to regain it in phases 2 and 3 when "healthy whole grains" are added back.

So the key is to remove the gliadin protein from your life, i.e., eliminate all things wheat.

 
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Comments (43) -

  • SamK

    12/6/2011 6:14:11 PM |

    Dr. Davis,
    The question arises - why has nature put the gliadin protein in a seed. If it is an appetite stimulant it is likely a predator will want more and more of it. That is not in the interest of the seed whose purpose is to propagate itself. Please let us know your thoughts.  Thank you for all that you do.

  • Howard

    12/6/2011 6:25:31 PM |

    The elimination of wheat may or may not have been what decreased my appetite enough to allow me to lose 100 lbs without much effort, but I did notice one effect that was even more important to me. I wrote about the complete remission of crippling arthritis in my post on http://guestdietblog.com/2011/05/a-story-about-gluten/

  • Kurt

    12/6/2011 6:39:55 PM |

    This hasn't been true for me. Your advice has helped me improve my cholesterol profile dramatically, lower my fasting blood sugar, lower my blood pressure, etc. However, there's been no change in my appetite, and I eat a larger volume of food now because I cut down on some high calorie foods like butter, cheese, etc.

  • Phyllis

    12/6/2011 6:56:35 PM |

    I too have noticed the diminished appetite, but also I have noticed a new and very pleasant feeling *after* eating. The feeling of fullness... of having had enough food, without the overstuffed feeling that I used to experience.
    It is truely a nice, warm, satisflied feeling.
    Going from a size 16 to a size 4 jeans is a nice feeling as well!

  • Princess Dieter

    12/6/2011 8:44:45 PM |

    I did notice an appetite reduction. Hubby did not. Maybe because I'd had a freaky bingey appetite and he never had...well...more noticeable. I could eat 5K calories a day, EASY, if I had wheat back in. For sure.  I do fine with 1500, 1600 now.

  • Mark Sanders

    12/6/2011 9:15:35 PM |

    One item I don't see mentioned here is heartburn.  I used to have severe episodes when I'd have to down a bunch of Tums and milk to deal with them, and they could occur anytime day or night.  I stopped eating wheat about 2 years ago,  for other reasons, and it took me about 2 months before I realized I wasn't having anymore heartburn episodes.  The occasional times my stomach might feel upset, I just drink water and it goes away.  Even though I've been free of these for the last 2 years, I still carry Tums around with me because I'm still paranoid it's going to happen again.

  • Ute

    12/6/2011 11:45:28 PM |

    Kurt, are you eating enough fats and proteins? I went paleo about a year ago, and I increased fats and protein. Lost almost 30lbs and my hunger is just as described in this post.

  • Donald Kjellberg

    12/7/2011 2:21:02 AM |

    It had a similar effect on my heartburn. I find it fascinating that one of the causes of heartburn is completely missed by my doctor and generally, the medical establishment. I also believe that I was eating much more, (due to appetite alterations, food reward, etc.), my full stomach, and excess fat also played a role in exacerbating the symptoms. Target the etiology and the problem vanishes. Much improved over targeting the symptoms allowing the precipitant to return again and again and again . . . .

  • Shreela

    12/7/2011 4:52:27 AM |

    Wow, I never put wheat and heartburn together, but now that they've been brought up together, I believe wheat may have been causing my heartburn too, which reappears whenever I fall off the wheat-wagon. BTW, whenever I fall off the wheat-wagon, my hypoglycemic symptoms are more likely to reappear too.

  • Might-O'chondri-AL

    12/7/2011 5:12:18 AM |

    Hi Howard,
    +/- 4% of the cell protein in wheat grain is LEA (late embryo-genesis abundant protein) that helps the plant bear up without osomotic failure when temperatures drop & also keeps the grain proteins from melding together when conditions get very dry. Modern wheat breeding has manipulated LEA protein conformations to improve crop cultivation habits; I think this fits into what Doc calls a "frankengrain" .

    The group 3 variety of LEA protein's high molecular weight molecules are not broken down readily by proteo-lysis in the gut . When they are taken up by the body the LEA protein is capable of "sensitizing" some individuals to it like an antigen irritant. We don't know what precise amino acid wings the LEA we ingest in a modern wheat breed have. And stripping gluten from the grain doesn't necessarily mean the LEA molecule is also removed.

    LEA can bind to IgE (immunolo-globulin E) from our joint's synovial mast cells. The subsequent release of histamine in the joint tissue incurs the auto-immune  response of  inflammation with  subsequent pain. I think LEA  "sensitization" is what you experience as arthritis due to wheat..

  • Dacia Felix

    12/7/2011 9:55:12 AM |

    For me, one of the effects of elimination of wheat was the  disappearing of dandruff. My dandruff was really bad and no special shampoos or treatments could alleviate the problem. A few months after giving up wheat,  I noticed that I no longer had dandruff!!!!  I even kept my hair unwashed for nearly a month, yet my hair remained dandruff free. Nowadays I wash my hair once a week instead of every day.

  • Susan Clarke

    12/7/2011 6:41:01 PM |

    Yeah, but chasing symptoms rather than looking for causes is the modus operandi of the entire US medical system. Well, most of it anyway.  Don't try to figure out what's causing the problem, just throw another drug at it.

  • puddle

    12/7/2011 7:27:19 PM |

    Yup. (and yup and yup and YUP)

  • calma60

    12/8/2011 12:05:14 AM |

    Just started eliminating wheat and reducing high carb foods around Thanksgiving. My fasting blood sugar used to be around 150; now it's 123. I actually have blood sugar readings after meals that are between 95-115. Once in awhile I get hungry, but I don't crave sweets like I used to. This program overall feels like something I can make a permanent change to.

  • Might-O'chondri-AL

    12/8/2011 12:13:05 AM |

    Hi D. Felilx,
    Dandruff relief from quitting wheat is likely due to eliminating the non-digestible wheat protein fragments  that you were sensitive to. Those wheat fragments had been going on to bind with  IgE put out from local basophils (basophils are +/- 0.6%, or 0.006,  of our bone marrow generated white blood cells). The degree of itchy scalp is a factor of the amount of histamine put out from those basophils. Usually a itch response is to hot extremes of both water and air; but some are wired to itch in response to cold extremes of water/air.

    When wheat protein fragments activate the basophil's IgE this causes the hair follicle wall to respond in an immunological manner & inflammatory cells in the follicle wall hold more sebum oil; with different dandruff results. In most individuals that sebum oil isn't used enough to normally  re-lubricate the surrounding scalp because the local increase of  sebum fatty acids gets taken advantage of and hijacked by the common scalp  yeast Pithyrosporum ovale. With the fast replication of lipo-phylic (fat loving)  P. ovale there is a lot of new progeny & sloughing off of  obsolete P. ovale cells, plus shed (lipid deprived) skin cells that we see as small "snowy" dandruff ; & this is usually accompanied by itching. The other situation is when the building up sebum seeps  to the surrounding scalp skin &  in this case the dandruff manifests as thick scales that usually doesn't provoke much itching; this is a scalp seborrhea & has a genetic predisposition to run in some families.

  • Dr. William Davis

    12/9/2011 3:25:32 AM |

    I don't think that wheat is aware that humans are a "predator."

    And the gliadin protein of modern wheat is not the natural form; it is the form created by geneticists.

  • Dr. William Davis

    12/9/2011 3:27:30 AM |

    The relief from acid reflux and "heartburn" is a very frequent accompaniment to elimination of wheat, as is relief from the cramps and diarrhea of "irritable bowel syndrome."

    Of course, it makes you wonder what else wheat is capable of in the gastrointestinal tract if this occurs so commonly.

  • Dr. William Davis

    12/9/2011 3:29:21 AM |

    This has happened to enough people, Dacia, that I believe it is likely to be a real association.

    This is a lesson I've learned about here and other online forums, as it's not something I purposely track in the office experience.

    This is yet another manifestation of how incredibly varied the skin expression of wheat's health disruptive effects can be.

  • Bob

    12/9/2011 4:17:23 AM |

    What about oat bran and steel cut oat meal? Are they as bad as wheat. They are supposed to be good for cutting LDL.
    Thanks

  • Annie

    12/11/2011 11:23:08 PM |

    Why would wheat be a pre curser to heart burn? I too suffer from bad heart burn on a regular basis and I can't seem to stop it.

  • Kurt

    12/12/2011 8:27:58 PM |

    Yes, I am eating enough fats and proteins.

  • Patrick

    12/12/2011 10:45:00 PM |

    No you are not...eat more butter and cheese!  Preferably from grass fed animals, as the "fat profile"  is proven MUCH better for human consumption.   Fat will NOT ruin your health...though it will ruin your cholesterol reading with those "cheapy" tests that ESTIMATE LDL measures.  NMR profiles are generally improved.   Check into Dr. Davis's archives for more on these topics.
    Yum.  Loves me some FAT!

  • Carl Crawford

    12/13/2011 9:20:07 PM |

    I believe you have a problem.
    I am not receiving your blog posts.
    Feedburner notifies me that my email addresses is in your database, but I receive no email notifications from your site.
    This has been a problem since you changed your site several months ago. Before that time I was receiving your emails.
    Could you look into this issue please?

    Regards, Carl

  • Dr. William Davis

    12/14/2011 2:52:22 AM |

    Oat products do not provoke appetite nor abnormal intestinal permeability like wheat. However, oats send your blood sugar sky-high. That's why we avoid it.

  • Lee Woodruff

    12/15/2011 2:32:28 PM |

    When I saw my Doctor eight months ago and told her my weight loss had stalled, she smiled and said "well you have  just reached an age where you can't loose a weight", and prescribed me a statin. In a sense she was right. Post 50+ the hormones are running against you. Well I'm now 28 lbs lighter, and at the lower end of my BMI and my tummy almost flat. Thanks basically to intermittent fasting, keeping the carbs down, oh and elimination wheat. The statin prescription went in the bin by the way,

  • Martyn

    12/15/2011 9:01:04 PM |

    A more general end-of-year thanks to you, Dr Davis, for the work you have done on the blog, and on Wheat Belly. I believe your work in practical preventative medicine is quite brilliant, and way ahead of its time.

    I have read every post, and look forward to reading more from you in 2012.

    Many Thanks

  • Lindas

    12/15/2011 9:16:12 PM |

    Dr. I have to take cranberry juice, (organic, concentrate, no sugar) for Urinary track infection,  BS goes to 119-127)  what to do?
    Also, D- Mannose, helps also, but know its a sugar?
    Prescribed Cipro, but cautious to take after reading side effects.

  • Lindas

    12/15/2011 9:19:47 PM |

    Yes, Doctor, I also want to thank you for the "against the grain" courageous stance you've taken!!!!!
    Much happiness and joy for you and your family in the year ahead.

  • Julie

    12/20/2011 5:51:38 AM |

    Sorry, my question is off-topic.
    But my father just had a stress test done because he had chest pain when exercising. Unfortunately, the test results were positive (abnormal). His doctor suggested doing Coronary angiography and possibly putting a stent in. As well as adding a beta-blocker. My father is already taking a statin.
    These results really scared me. What should he do to reduce the risk of a heart attack? Would you recommend any additional tests? Is it worth it to make a heart scan in this case?

    Thank you very much!!!!

  • Sam Sinderson

    12/20/2011 10:30:39 PM |

    Low carb is fine and doing so has "normalized" my blood sugar, reduced my hemoroid, increased hair growth and decreased nasel infections.  However, in doing a diet anaylsis I find I am eating 120 to 170 grams of protein, because of the addition of meat of all kinds and also cheese to my diet, which according to several other sources, Dr. Rosedale for one, is detremental.  If I limit my protein to 1 gm per kg of weight , I have seen recommended several places, plus a little becasue of my rather rigerous excercise program, I would be at 70 gm of protein per day.  Yesterday I did that, and I literally have to eat either olive oil or coconut oil by the tablespoon to get my calorie level up to 2200 or so to maintain my weight at 145 lbs and that is after 4 tbls of oil cooking two eggs in the morning!  Does Dr. Davis's protocal have any limits on protein?  My wife thinks I'm nuts eating coconut oil, which melts in ones mouth and is actually quite tasty.

  • Might-o'chondri-AL

    12/21/2011 10:02:35 PM |

    Dec. 2012  The Journal of the Norwegian Medical Association report of Arnold Berstad & Jørgen Valeur of Lovisenberg Diakonale Hospital explain that a meal's glucose monitored in the stomach registers in the brainstem which then reflexively signals the muscles in the stomach wall to relax.
    Quote: “... it can decrease the pressure on the stomach and reduce the sensation of being full....The problem is that ...the brakes on carbohydrate consumption are five metres further down, at the lower end of the small intestine....Fat, however, is absorbed higher up in the system and triggers a high-placed brake. It makes you quickly full."

  • Might-o'chondri-AL

    12/21/2011 10:04:18 PM |

    Journal's date should be 2011 Dec.

  • James

    12/23/2011 5:54:29 PM |

    I have eliminated wheat and all sugars & carbs for about 6 months. I have lost almost 30# (from 200 to 173) in those 6 months. But now I am stalled. I have been at 173 for almost a month and have done nothing different. I want to lose another 10-15#. I am 5' 6" and still have some abdomal buldge. My weight loss was an almost straight line down for 6 months. What causes this plateau? I understand that my caloric needs will have changed due to the loss of 30# and I have adjusted for that. Anyone have any ideas?

  • Might-o'chondri-AL

    12/24/2011 4:09:18 AM |

    Hi James,
          I can only relate an interpretation of my experimentation this last year plus. Since I never have struggled with my weight it may not translate to others. My goal was mainly to see what changes were possible in MNR tests of lipid particles I could achieve with Doc's insight (excellent results I'd say).
           I recently completed several months when my only fat intake daily was a combination of coconut oil (2 tablespoons daily , as 28 grams total fat) , plus fish oil (4.5 grams total fat, as 1 teaspoon = 1.5 gr. EPA + 0.75 gr. DHA), plus 90% chocolate's cocoa butter (60 grams, as 33 grams total fat), plus some olive and restaurants' cooking oils. And I also specify that there was no intake of animal fat (ie: no meat) , fowl fat  (ie: no chicken or eggs) or dairy fat (ie: only fat free dairy) - unless a restaurant used some in their food preparation.
           My experience without any low calorie restraint, nor over eating,  was that I lost weight and  continued to do so beyond what I find suitable. In other words I had to periodically resort to over ingesting carbohydrate calories to stop from getting too thin. Of course I made sure to keep my daily protein intake consistently high enough all throughout the year.
         When I started my experiment it was by daily using only 1 tablespoon of  raw unrefined coconut oil  & lost weight at nights.  I took my first ever MNR test after a handfull of months of this.
         After the initial MNR test I added the daily 1 teaspoon of fish oil , kept to the 1 tablespoon coconut oil (14 gr. fat) , but an irregular chocolate intake was daily limited to 40 grams (22 gr. fat) &  even lost more weight. I took a 2nd MNR test after 4 months of that to see what was doing with my lipids.
         Then I upped the daily raw coconut oil to 2 tablespoons, chocolate up to regularly 60 grams & kept fish oil at same 4.5 grams for 7 months before I took a 3rd MNR test . It was during this latest stretch of experimentation that I sometimes needed to regulate my weight upwards by deliberately adding back more carbohydrates - & I was not pursuing a daily very low carb intake anyway.
          All that staged experimentation seems to indicate that using coconut oil as my primary fat is what drove my weight loss. When I added in fish oil the weight loss rate was not noticeably accelerated & I can't distinguish it from the pattern  begun with coconut oil. However when I eventually  went up to 2 tablespoons of coconut oil daily I sometimes had to fight to just hold on to my weight. The chocolate intake seems to be less of a factor in my weight loss.
          So retrospectively, in my case I think the exclusion of animal/fowl/dairy fat kept certain specific fatty acids out of play and then the distinct fatty acids in coconut oil were both metabolized and incorporated in unique ways that resulted in sustained weight loss for me. I was concerned  that 2 tablespoons of coconut oil a day might be excessive yet last MNR done is superb (I don't seem to be ApoE 4).
         Doc, you may know, has several posts about using finger stick testing of your blood sugar before and after meals. He explains how to use a simple home glucose meter to know which meals spike your blood sugar and lose weight by controlling after eating glucose "excursions".

  • Might-o'chondri-AL

    12/24/2011 8:03:09 AM |

    Hi S. Sinderson,
    Since Doc hasn't answered you about his protein protocol yet this may orientate you. Protein intake can't exceed the ability of liver enzymes to make urea as a consequence of liver's nitrogen metabolism. Basically, if one is healthy,  beyond 3.9 grams protein daily per kg. of our body weight we can't  urinate all nitrogen "waste" from the kidneys adequately.
    1973 Rudman set a periodic daily physiologically safe upper limit of 3.8 gr./kg one weighs (ie: not always every day) .... 2000 Metges calculated a top long term daily protein limit should be 2 gr/kg one weighs .... 1996 Eades pegged exercisers wanting to lose weight should use 1.7 gr./kg one weighs....2010 Speth analysis of paleo-anthropology suggests no more than 35% of calories were ever from protein (ie: less than 3.9 gr/kg hunter weighed daily).

  • Kathy

    12/31/2011 4:42:45 PM |

    So.........
    Has this blog been abandoned by Dr. Davis, in favor of the Wheat Belly blog?

  • Laura

    12/31/2011 11:52:15 PM |

    Hi Might - regarding your 12/24 post on the coconut oil, etc. experiement.  If you did not eat dairy, meat, fowl or eggs (?) for protein what did you eat for protein.  I am very curious because I have been in a stall for a loooonnngggg time (about 6 months).  I also take coconut oil daily (2 tsp) and Omega 3 fish oil (950 mg of EPA & DHA combined).  I also should mention that I am diabetic (T2).  My carb intake is 30-60 grams per day.
    I am trying to find a way to break this stall and your post intrigued me greatly.  
    Thank you,

  • Might-o'chondri-AL

    1/3/2012 6:07:11 AM |

    Hi Laura,
        I buy 1 gallon of fat free milk & culture it into Kefir, which I then drain the whey from and go on to eat the milk solids. I roughly weigh the kefir "quark" that goes into the refrigerator because each batch will have it's own variable amount of whey remaining . Once I know the batch weight I do a simple calculation to divide the  total weight of that batch by 6 to know roughly how much protein is in a 1/6th portion.
        When I know much 1/6 of the kefir quark made from tthat 1 gallon of milk I will then eat one of those 1/6th proportioned amounts in the morning, again during the day a  2nd 1/6th amount  and  then a 3rd  final 1/6th amount of the kefir quark.  
       The result is that in 1 single day the milk solids are equal to 1/2 gallon of fat free milk.  I approximate this as containing, in total,  around 70 grams of protein which for me is a good minimum protein requirement . Then any other protein I eat in the day is not crucial & usually in form of nuts, hummus or  some stray egg ingredient which can't measure reliably. I think my daily protein consumption is around 120 grams or more protein daily  (I certainly am not eating only 1 gram protein per kg of my weight).
         In terms of people stalling on low carb & pseudo-paleo diets I do have some nuanced ideas if you'd like, but I don't know how applicable the research might be. It isn't like a formula & needs longer context to elaborate .

  • Might-o'chondri-AL

    1/3/2012 11:55:02 PM |

    Hi Laura,
    Please see what I also tagged you at Doc's next thread (1st in 2012) on this same blog.

  • Anna

    1/17/2012 6:04:22 PM |

    Dr. Davis....what do you say to people who claim they are emotional eaters and can eat over the "no appetite" feeling?
    Thanks.

  • pjnoir

    2/18/2012 12:10:49 AM |

    nothing satisfies hunger better than homemade beef or chicken stock,with beef being the best. One of my diet secrest when doing my low carb/Paleo regiment.

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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.

How did Cureality get its start?

27. July 2014 William Davis (0)



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

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

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

How we went from Information Provider to Health Empowerment Program

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

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

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

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

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

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

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

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

Power in Numbers

25. June 2014 William Davis (0)


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

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

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

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

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

What is Cureality all about?

27. May 2014 William Davis (1)

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

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

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

Two weeks later:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

That’s why we developed Cureality.


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

Omega-3 fatty acids likely NOT associated with prostate cancer

18. July 2013 William Davis Omega-3 fatty acids (6)
A weakly constructed study was reported recently that purportedly associated higher levels of omega-3 fatty acid blood levels and prostate cancer. See this CBS News report, for instance.

Lipid and omega-3 fat expert, Dr. William Harris, posted this concise critique of the study, exposing some fundamental problems:

First, the reported EPA+DHA level in the plasma phospholipids in this study was 3.62% in the no-cancer control group, 3.66% in the total cancer group, 3.67% in the low grade cancer group, and 3.74% in the high-grade group. These differences between cases and controls are very small and would have no meaning clinically as they are within the normal variation. Based on experiments in our lab, the lowest quartile would correspond to an HS-Omega-3 Index of <3.16% and the highest to an Index of >4.77%). These values are obviously low, and virtually none of the subjects was in “danger” of having an HS-Omega-3 Index of >8%. So to conclude that regular consumption of 2 oily fish meals a week or taking fish oil supplements (both of which would result in an Index above the observed range) would increase risk for prostate cancer is extrapolating beyond the data.

This study did not test the question of whether giving fish oil supplements (or eating more oily fish) increased PC risk; it looked only a blood levels of omega-3 which are determined by intake, other dietary factors, metabolism and genetics.

The authors also failed to present the fuller story taught by the literature. The same team reported in 2010 that the use of fish oil supplements was not associated with any increased risk for prostate cancer. A 2010 meta-analysis of fish consumption and prostate cancer reported a reduction in late stage or fatal cancer among cohort studies, but no overall relationship between prostate cancer and fish intake. Terry et al. in 2001 reported higher fish intake was associated with lower risk for prostate cancer incidence and death, and Leitzmann et al. in 2004 reported similar findings. Higher intakes of canned, preserved fish were reported to be associated with reduced risk for prostate cancer. Epstein et al found that a higher omega-3 fatty acid intake predicted better survival for men who already had prostate cancer, and increased fish intake was associated with a 63% reduction in risk for aggressive prostate cancer in a case-control study by Fradet et al). So there is considerable evidence actually FAVORING an increase in fish intake for prostate cancer risk reduction.

Another piece of the picture is to compare prostate cancer rates in Japan vs the US. Here is a quote from the World Foundation of Urology:

"[Prostate cancer] incidence is really high in North America and Northern Europe (e.g., 63 X 100,000 white men and 102 X 100,000 Afro-Americans in the United States), but very low in Asia (e.g., 10 X 100,000 men in Japan).”

Since the Japanese typically eat about 8x more omega-3 fatty acids than Americans do and their
blood levels are twice as high, you’d think their prostate cancer risk would be much higher...
but the opposite is the case.

Omega-3 fatty acids are physiologically necessary, normalizing multiple metabolic phenomena including augmentation of parasympathetic tone, reductions of postprandial (after-meal) lipoprotein excursions, and endothelial function. It would indeed make no sense that nutrients that are necessary for life and health exert an adverse effect such as prostate cancer at such low blood levels. (Recall that an omega-3 RBC index of 6.0% or greater is associated with reduced potential for sudden cardiac death.)

I personally take 3600 mg per day of EPA + DHA in highly-purified, non-oxidized triglyceride form (Ascenta Nutrasea liquid) that yields an RBC omega-3 index of just over 10%, the level that I believe the overwhelming bulk of data suggest is the ideal level for humans.

Are statins and omega-3s incompatible?

18. June 2013 William Davis (4)
French researcher, Dr. Michel de Lorgeril, has been in the forefront of thinking and research into nutritional issues, including the Mediterranean Diet, the French Paradox, and the role of fat intake in cardiovascular health. In a recent review entitled Recent findings on the health effects of omega-3 fatty acids and statins, and their interactions: do statins inhibit omega-3?, he explores the question of whether statin drugs are, in effect, incompatible with omega-3 fatty acids.

Dr. Lorgeril makes several arguments:

1) Earlier studies, such as GISSI-Prevenzione, demonstrated reduction in cardiovascular events with omega-3 fatty acid supplementation, consistent with the biological and physiological benefits observed in animals, experimental preparations, and epidemiologic observations in free-living populations.

2) More recent studies (and meta-analyses) examining the effects of omega-3 fatty acids have failed to demonstrate cardiovascular benefit showing, at most, non-significant trends towards benefit.

He points out that the more recent studies were conducted post-GISSI and after agencies like the American Heart Association's advised people to consume more fish, which prompted broad increases in omega-3 intake. The populations studied therefore had increased intake of omega-3 fatty acids at the start of the studies, verified by higher levels of omega-3 RBC levels in participants.

In addition, he raises the provocative idea that the benefits of omega-3 fatty acids appear to be confined to those not taking statin agents, as suggested, for instance, in the Alpha Omega Trial. He speculates that the potential for statins to ablate the benefits of omega-3s (and vice versa) might be based on several phenomena:

--Statins increase arachidonic acid content of cell membranes, a potentially inflammatory omega-6 fatty acid that competes with omega-3 fatty acids. (Insulin provocation and greater linoleic acid/omega-6 oils do likewise.)
--Statins induce impaired mitochondrial function, while omega-3s improve mitochondrial function. (Impaired mitochondrial function is evidenced, for instance, by reduced coenzyme Q10 levels, with partial relief from muscle weakness and discomfort by supplementing coenzyme Q10.)
--Statins commonly provoke muscle weakness and discomfort which can, in turn, lead to reduced levels of physical activity and increased resistance to insulin. (Thus the recently reported increases in diabetes with statin drug use.)

Are the physiologic effects of omega-3 fatty acids, present and necessary for health, at odds with the non-physiologic effects of statin drugs?

I fear we don't have sufficient data to come to firm conclusions yet, but my perception is that the case against statins is building. Yes, they have benefits in specific subsets of people (none in others), but the notion that everybody needs a statin drug is, I believe, not only dead wrong, but may have effects that are distinctly negative. And I believe that the arguments in favor of omega-3 fatty acid supplementation, EPA and DHA (and perhaps DPA), make better sense.



DHA: the crucial omega-3

22. May 2013 William Davis (5)
Of the two omega-3 fatty acids that are best explored, EPA and DHA, it is likely DHA that exerts the most blood pressure- and heart rate-reducing effects. Here are the data of Mori et al in which 4000 mg of olive oil, purified EPA only, or purified DHA only were administered over 6 weeks:



□ indicates baseline SBP; ▪, postintervention SBP; ○, baseline DBP; •, postintervention DBP; ⋄, baseline HR; and ♦, postintervention HR.

In this group of 56 overweight men with normal starting blood pressures, only DHA reduced systolic BP by 5.8 mmHg, diastolic by 3.3 mmHg.

While each omega-3 fatty acid has important effects, it may be DHA that has an outsized benefit. So how can you get more DHA? Well, this observation from Schuchardt et al is important:

DHA in the triglyceride and phospholipid forms are 3-fold better absorbed, as compared to the ethyl ester form (compared by area-under-the-curve). In other words, fish oil that has been reconstituted to the naturally-occurring triglyceride form (i.e., the form found in fresh fish) provides 3-fold greater blood levels of DHA than the more common ethyl ester form found in most capsules. (The phospholipid form of DHA found in krill is also well-absorbed, but occurs in such small quantities that it is not a practical means of obtaining omega-3 fatty acids, putting aside the astaxanthin issue.)

So if the superior health effects of DHA are desired in a form that is absorbed, the ideal way to do this is either to eat fish or to supplement fish oil in the triglyceride, not ethyl ester, form. The most common and popular forms of fish oil sold are ethyl esters, including Sam's Club Triple-Strength, Costco, Nature Made, Nature's Bounty, as well as prescription Lovaza. (That's right: prescription fish oil, from this and several other perspectives, is an inferior product.)

What sources of triglyceride fish oil with greater DHA content/absorption are available to us? My favorites are, in this order:

Ascenta NutraSea
CEO and founder, Marc St. Onge, is a friend. Having visited his production facility in Nova Scotia, I was impressed with the meticulous methods of preparation. At every step of the way, every effort was made to limit any potential oxidation, including packaging in a vacuum environment. The Ascenta line of triglyceride fish oils are also richer in DHA content. Their NutraSea High DHA liquid, for instance, contains 500 mg EPA and 1000 mg DHA per teaspoon, a 1:2 EPA:DHA ratio, rather than the more typical 3:2 EPA:DHA ratio of ethyl ester forms.

Pharmax (now Seroyal) also has a fine product with a 1.4:1 EPA:DHA ratio.

Nordic Naturals has a fine liquid triglyceride product, though it is 2:1 EPA:DHA.