Optimal medical therapy

9. April 2007 William Davis (6)
I was re-reading some of the details behind the recently announced COURAGE Trial comparing angioplasty/stent in 1100 people compared to "optimal" medical therapy in another 1100. You'll recall that no difference was found.

In particular, over approximately 5 years, 20% of participants in each group died, experienced heart attacks, or strokes. Of those treated with "timal" medical therapy, 32% ended up getting a procedure like stents or bypass anyway due to deteriorating symptoms.

What is "optimal" medical therapy? I bring this up again because the study investigators in COURAGE, as well as in similar trials, say this with a straight face. Optimal medical therapy means aspirin and/or Plavix (the anti-platelet, aspirin-like blood thinner); "aggressive" statin drug therapy to reduce LDL cholesterol to 60-85 mg/dl; and "anti-ischemic" therapy (that reduces angina and the phenomena of poor coronary blood flow) using nitroglycerin preparations, beta blockers, and other drugs.

I do give credit to the investigators for having the courage to perform this trial in a world hell bent on doing procedures and still reporting the neutral outcome. But the notion of "optimal" medical therapy begs for comment.

Indeed, this is regarded as optimal by most practitioners. Some would even argue excessive, based on the low LDL target achieved. Would you be satisfied with a 20% likelihood of heart attack, stroke, or death or 5 years, a 1 in 5 roll of the dice? I would not. Recall that we aim for near-total elimination of risk.

What could have been further "optimized"? Plenty. For instance:

--What is the real LDL, not the fabricated, calculated LDL? The two can be commonly 100 mg/dl different.

--How about raising HDL to 60 mgd/?

--What about reducing the proportion of small LDL particles? After all, small LDL is the number one cause of heart disease in the U.S., not high LDL.

--What is Lp(a)? If you treat LDL with a statin drug, Lp(a) is unaffected and continues to trigger huge plaque growth. You will fail if this is not identified and corrected.

--What is vitamin D3? One of the most powerful facilitators of plaque reversal I know of.

--What are triglycerides? Triglycerides create hidden particles in the blood like intermediate-density lipoprotein, potent triggers for coronary plaque growth. Speaking of intermediate-density lipoprotein, that's another very important pattern to identify, the after-eating persistence of dietary fats.

--Why aren't they taking fish oil? With a 28% reduction in heart attack and 45% reduction in sudden death from heart attack, this alone would have halved the number of "events" in the "optimal" medical treatment group.

Of course, there's more. But the idea that aspirin, statins, and anti-ischemic therapy is somehow optimal is silly and sad at the same time. But that's the bias. The COURAGE Trial does represent a step forward, a step away from the "stent everyone and everything" mentality that motivates my colleagues, aided and abetted by their co-conspirators, the hospitals. But you and I know better. "Optimal" medical therapy, in truth, can mean a far better approach that can dramatically reduce, perhaps eliminate, risks for events like heart attack. The conventional "optimal" medical therapy will suffice only if you're content with a 20% likelihood of heart attack, death or stroke, or a 32% likelihood of an urgent procedure in your future.

Niacin, postprandial patterns

9. April 2007 William Davis (0)
For a detailed report on the very important postprandial (after eating) patterns that contribute hugely to heart disease risk, read my recent article in Life Extension Magazine, available (no cost) at:

Uncovering a Hidden Source of Cardiovascular Disease Risk
at http://www.lef.org/magazine/mag2007/mar2007_report_heart_01.htm


For a report on using niacin to reduce risk of heart disease, see another report in the same issue of Life Extension:

Ask the Doctor: Using Niacin to Improve Cardiovascular Health
at
http://www.lef.org/magazine/mag2007/mar2007_atd_01.htm.

Also, keep your eyes open for a lengthy report focused exclusively on the Track Your Plaque program in an upcoming issue of Life Extension. I'll provide links in this Blog when it comes out.

What's better than fish oil?

9. April 2007 William Davis (1)
One of the recent questions on our Track Your Plaque Forum related to what to do about a triglyceride level of 101 mg/dl while on fish oil.

Recall that, contary to conventional thinking like that articulated in the ATP-III cholesterol treatment guidelines, we aim to reduce triglycerides to 60 mg/dl or less. This is important to suppress the formation of abnormal triglyceride-containing lipoprotein particles, especially small LDL, reduced HDL, lack of healthy large HDL, VLDL. ATP-III advises a level of 150 mg/dl or less. Unfortunately, triglyceride levels this high guarantee appearance of all these undesirable particles and an increasing heart scan score.

What's better than 4000 mg of fish oil for its 1200 mg of EPA and DHA (omega-3 fatty acids)? More fish oil. In other words, the 4000 mg fish oil providing 1200 mg EPA + DHA is our minimum. A simple increase to 6000 mg to provide 1800 mg EPA + DHA is usually all that is necessary to reduce triglycerides and put a halt to the cascade of abnormal lipoprotein particles that trigger plaque growth. Occasionally, a somewhat higher dose may be required. Doses are best divided into two, with meals (e.g., three capsules twice a day).

Another important issue: An over-reliance on wheat products can also increase triglycerides. This includes any flour product like breads (regardless of whether it's white, whole wheat, or whole grain--they all raise triglycerides), pretzels, bagels, breakfast cereals, and pasta. A dramatic reduction in wheat-containing products will reduce triglycerides substantially, help you reduce your abdominal fat, reduce blood pressure, raise HDL and reduce small LDL, clear your mind, provide more energy, avoid afternoon "fogginess" . . . Huge benefits.

Valve disease and vitamin D

8. April 2007 William Davis (1)
There are two common forms of heart valve disease: aortic valve stenosis (stiffness) and insufficiency (leakiness), and mitral anular calcification.

Both valve issues are regarded as evidence of senescence, or aging--the older you are, the more likely you will have one or both. Both conditions involve progressive calcium deposition and, to some degree, cholesterol deposition. They might be regarded as phenomena of "wear and tear" just like hip arthritis.

There are no known therapies to stall or stop the development of mitral anular calcification. However, several attempts have been made over the years to identify treatments that can slow or stop the progression of aortic valve disease, which is becoming increasingly common and is addressed by surgical valve replacement when severe. The most recent trials have examined whether high-dose Lipitor (80 mg) has any effect (it did not) and high dose Crestor (40 mg), which slowed but did not stop the deterioration of stiff valves.

It's been my suspicion that vitamins D and K2 may play a crucial factor in valve health. After all, vitamin D is the master controller of calcium deposition. Preliminary data also suggest that people who are intentionally made vitamin K deficient with the drug, Coumadin, develop twice the calcium deposition on aortic valves that non-Coumadin takers develop.

I saw a patient Friday, Marianne. In addition to a moderate heart scan score of 379 at age 71, Marianne had a leaky (insufficient) aortic valve. By an echocardiogram 18 months ago, the valve was moderately leaky. I put Marianne on vitamin D, 4000 units, to raise her blood level to 50 ng/ml.

Last week, I asked Marianne to have another echocardiogram. This time, no leakiness whatsoever--none. I have never seen this happen before. Although Marianne is only one example and we don't want to extrapolate too far from the experience of one person, it's hard not to attribute this phenomenal response to vitamin D supplementation.

I wonder what would have happened if we had added vitamin K2, as well?

Anyway, just another potential wonderful effect of vitamin D restoration.

Homocysteine and coronary plaque

8. April 2007 William Davis (4)
If you’ve watched the news over the past year, you know that doubt has been cast over the idea that reducing homocysteine blood levels with high doses of B vitamins (B6, B12, and folic acid, or B9) results in reduced risk for heart attack.

Is the homocysteine concept dead? Shall we empty our bottles of costly B vitamins into the trash and move on?

I don’t think so. As detailed in one of our Track Your Plaque Special Reports from a few months ago, I think the homocysteine issue still deserves lots of respect and further investigation. After all, hundreds of clinical studies have connected higher homocysteine levels with greater risk for heart disease, stroke, and aneurysm. Numerous studies, for example, have repeatedly and consistently demonstrated a tripling of heart attack risk when homocysteine levels exceed 14 ?mol/l. Can we dismiss this association because several more recent studies—NORVIT, HOPE, and VISP—suggested that, when starting homocysteine levels are 12.5, that B vitamin supplementation does not reduce heart attack risk?

I think there’s lots more to know about the homocysteine connection. That said, I have never seen a patient who I thought had heart disease strictly because homocysteine was increased.

I believe that we can at least use homocysteine as an index of lifestyle: the higher the homocysteine, the poorer the diet, or the less effective the absorption of B vitamins (especially vitamins B12 and folic acid). Homocysteine levels of <9 micromol/l suggest both adequate intake and absorption of these B vitamins.

If homocysteine is tightly connected with risk for heart disease, yet supplementation of B vitamins fails to reduce risk, might there be another means of connection? Or, could both homocysteine and heart disease be connected in some way that has nothing to do with B vitamins?

Don’t close the book on homocysteine. Just because conventional experience fails to draw connection does not necessarily mean that none exists. If it’s any consolation, taking B vitamins has been correlated with better memory, concentration, and other health benefits, even if no reduction in heart disease develops.

Big heart scan scores drop

6. April 2007 William Davis (0)
High heart scan scores of, say, greater than 1000 are more difficult to reduce than lower scores.

I learned this lesson early in the experience of trying to drop scores. In the first few years of trying to drop scores, I saw relatively modest scores of 20, 50, or 100 drop readily, even when the usual targets were not fully achieved, and even before the incorporation of some of the more exciting recent additions to the Track Your Plaque program, like vitamin D.

But big scores of 1000, 2000, or 3000 are a tougher nut to crack. In the first few years, what I usually saw was a slowing , or "deceleration," of growth from the expected rate of annual score increase of 30% that would continue for a year or two, followed by zero change. In the first year of effort, for example, a score increase of 18% was common. 10% was common in year two, then finally zero change in year three. Somehow, the more plaque you begin with, the more "momentum" in growth is present and the longer it takes to stop it. Kind of like stopping a compact car versus stopping a freight train.

But more recently, I'm seeing faster drops. Today, Charlie came to the office to discuss his second heart scan. 18 months earlier, Charlie's first scan showed a score of 3,112, high by anybody's standard.

His repeat score: 3,048. While the drop is relatively small on a percentage basis and may even fall within the expected rate of error for heart scans (which tends to be <2% at this high a score), I told Charlie that it still represented a huge success. Not only did he not increase his score by the expected 30% per year, he also brought a charging locomotive to a rapid stop.

Next year, Charlie is targeting a big drop. Given the tools he now has available, I'm optimistic that he will succeed.

Watch for the Track Your Plaque May, 2007 Newsletter in which we will detail Charlie's story further.

Does the American Heart Association diet reduce heart disease?

5. April 2007 William Davis (0)
If you have a heart attack and land in the hospital where, invariably, you will have a heart procedure. Or, if you get a stent or coronary bypass operation, sometime before your discharge from the hospital, a well-meaning hospital staff dietitian will provide instruction in the American Heart Association (AHA) diet.

Does this diet reduce the risk of heart disease?

The answer depends on where you start. If you begin with a conventional American diet that is enormously influenced by convenience, food manufacturers like Nabisco, General Mills, Quaker Oats, ADM, and Cargill, or food distributors like McDonald’s, Pizza Hut, and Taco Bell, then the American Heart Association diet is indeed an improvement. But just a small one. If LDL cholesterol is the yardstick, the average reduction in LDL is between 10 and 15 mg/dl. This is the same amount of change you’d experience by adding 1 tablespoon of oat bran to your diet. Hardly worth boasting about. HDL, triglycerides, blood glucose, and body weight do not change.

The diet could be substantially better. After all, it’s become common knowledge that other diets, such as the so-called Mediterranean diet, the South Beach Diet, and similar broad projects result in far greater changes than the AHA diet dispensed by your hospital and cardiologist. These diets more effectively reduce LDL, raise HDL, reduce triglycerides, reduce C-reactive protein, reduce blood pressure. Diets like South Beach also yield substantial weight loss and reversal of diabetic tendencies, with the magnitude of benefit dependent on the amount of weight lost.

Why this stubborn adherence to the outdated concepts articulated in the AHA diet? Cardiologists would argue that insufficient data has been generated to permit widespread application of these diets. They also differ on whether they really work. Of course, the majority remain ignorant and dismiss them as fad diets.

A little digging into the financial disclosures of the AHA suggests another, more malignant influence: who is paying the bills? Until recently, drug manufacturers were major contributors to the AHA. However, more recently AHA administrators have become sensitive to the public perception that they might be nothing more than a voice box for the drug industry. They have since limited contributions from the drug companies to 8% of annual charitable revenues.

The drug manufacturers have been replaced by the food industry. In addition to food manufacturers that make the cereals on your grocery shelf, it includes the multi-national conglomerates that produce unimaginable revenues and carry enormous political clout, like ADM and Cargill. Ever wonder how it is that Honey Nut Cheerios received a “Heart Healthy” endorsement from the AHA?

The AHA diet does not provide the answers we’re looking for, not even close. It is a perversion from an organization that has its strings pulled by industry. The answers to health will not come from the AHA, AMA, the American College of Cardiology, the American Hospital Association, and it won’t come from your doctor. It won’t come from a titillating report on the evening news or Good Morning America. It will come from collective and expanding wisdom placed directly into the hands of the public. It will be untainted by the temptation of drug industry dollars. It will not be dirtied by million dollar contributions, or the multi-million dollar behind-closed-doors lobbying of the food manufacturers. It will come from the truth relayed to the healthcare-consuming public. I hope you recognize it when you see it.

If you want a healthy diet for your heart, throw away the pamphlets from the AHA unless you are partial to bread, breakfast cereals, corn, and the supporters of their misguided nutritional advice.

Vitamin K2 and coronary plaque

4. April 2007 William Davis (1)
The vitamin K2 story, though still preliminary, is becoming increasingly interesting from the perspective of CT heart score reduction.

The origin of this concept came from some unexpected observations. One, the observation that osteoporosis (lack of bone calcium that leads to fractures) arises from deficiency of vitamin K2. Two, deficiency of K2 leads to unrestrained calcium deposition in animal models, leading to heart attack in just weeks.

Vitamin K2 has been largely ignored for years, since the more widely understood K1 is rarely deficient. K1 deficiency can occur from prolonged antibiotic use, or from severe malnutrition. But deficiency in otherwise well people is very uncommon. Vitamin K2, however, may be a different story. Deficiency may be common.

The Rotterdam Heart Study of cheese-eating Dutch showed that greater K2 intakes resulted in a halving of heart attacks. Cheese (traditional varieties, not Velveeta or other make-believe cheese products) is a modest source of K2, as is the Japanese native food, natto. (If you've ever seen natto, I dare you to eat it. I have a pretty strong stomach and curiousity for food, but natto is the one thing I could not eat--it is truly horrible.)

The weight of evidence suggests that vitamin K2 supplementation may prove to be a useful addition to your coronary plaque control program. Clearly, more data are needed, particulary therapeutic obserations, i.e., observing people who take dose X of a K2 prepartion and tracking some feedback measure, e.g., bone density, CT heart scan score, "events" like heart attack, etc.

Nonetheless, the K2 story is clearly worth reading about, perhaps even considering supplementation. Please watch for the Special Report on the www.cureality.com website in the coming days.

Exercise and blood pressure

4. April 2007 William Davis (5)
The media has gotten a hold of a case report from the University of Maryland describing a 51-year old physician who, despite being a long distance runner, had a high heart scan score.

An example of the report can be found at

Heart Disease In A Marathon Runner: Is Too Much Exercise A Bad Thing?

http://www.sciencedaily.com/releases/2007/03/070315091100.htm in Science Daily.



"The mystery was all the more intriguing because his resting blood pressure and fasting cholesterol levels, the usual measures of cardiovascular health, were in the normal range."


When this man was put on a treadmill for a stress test, his blood pressure skyrocketed from a normal 118/78 to 230/78--extremely high, even for exercise. The physicians reporting the case raised the question of whether long-distance running represents a risk for heart disease and if the high blood pressure with exercise is a contributor or cause of the high heart scan score.

These are phenomena we are very familiar with. We have stressed the importance of exercise blood pressure as a trigger for coronary plaque for years. While 230/78 is clearly too high, we find that any blood pressure over 170/80 with exercise adds to the fire and can trigger plaque growth.

However, I think it is absurd to suggest that marathon running itself is a trigger of coronary plaque. I think it is far more likely that the person described in the report had lipoprotein(a), a potent trigger for both exercise-induced hypertension and high CT heart scan scores in seemingly well people. He likely also suffered from a deficiency of vitamin D deficiency, another contributor. There's no need to indict exercise.

If you are in the Track Your Plaque program, you know that stress tests are of questionable helpfulness for the detection of hidden heart disease. But they are useful for assessment of blood pressure responses during exercise. If BP exceeds 170/80 at 10 mets (a measure of exercise effort achieved by walking 3.4 mph at a 14% grade for 3 minutes), then blood pressure may be a contributor to your heart scan score.

"Fish oil is stupid"

3. April 2007 William Davis (13)
"Fish oil is a waste of time and money. It's stupid. Just stop it."

So a patient of mine was advised by another physician when he complained that he occasionally experienced a fishy aftertaste.

This attitude perplexes me. After all the confirmatory data that support the enormous health benefits of omega-3 fatty acid supplementation, including the 11,000 participant GISSI-Prevenzione Trial, you'd think this attitude would be history. What's a little fish aftertaste when heart attack risk is slashed 28%?

Perhaps the tendency to pooh-pooh fish oil is because it's available as a nutritional supplement. This shouldn't make fish oil appear inconsequential. Far from it.

If you witness the extraordinary power for fish oil to reduce triglycerides, you will be immediately convinced of its effectiveness. The ability of omega-3 fatty acids from fish to eliminate intermediate-density lipoprotein (IDL), the persistent abnormal lipoprotein which signals an inability to clear dietary fats from the blood, can also convince you. More than 90% of people with excessive IDL have it completely eliminated by 4000-6000 mg of fish oil (providing 1200-1800 mg EPA + DHA) per day.

The fact that fish oil is available as a prescription "medication," as well as an over-the-counter supplement, causes some physicians to dismiss the power of the supplemental form. This is nonsense. The over-the-counter form is every bit as effective as the prescription form.

The makers of prescription Omacor also make the claim that their preparation is safer and purer. That may be true, but I'd like to see independent verification from the FDA, USDA, or an unbiased organization like Consumer Reports before I accept their marketing as fact--particularly at $120 to $240 per month! If Omacor proves to contain substantially less mercury and pesticide residues, then that will need to be factored in. (Please note that both Consumer Reports and Consumer Labs measured no substantial mercury or pesticide residues in their analyses of 16 and 41 brands, respectively.)

I try to persuade my colleagues that the idea of taking supplements is a wonderful trend that allows people to express ownership of their own health. What people need is guidance, not salesmanship for a more expensive version, nor dismissal of nutritional preparations that actually possess considerable benefits.
Unexpected effects of a wheat-free diet

Unexpected effects of a wheat-free diet

17. September 2009 William Davis (59)
Wheat elimination continues to yield explosive and unexpected health benefits.

I initially asked patients in the office to eliminate wheat because I wanted to help them reduce blood sugar and pre-diabetic tendencies.

A patient would come to the office, for example, with a blood sugar of 118 mg/dl (in the pre-diabetic range) and the other phenomena of pre-diabetes or metabolic syndrome (high blood pressure, high inflammation/c-reactive protein, low HDL, high triglycerides, small LDL), and the characteristic wheat belly. Eliminate wheat and, within three months, they lose 30 lbs, blood sugar drops to normal, blood pressure drops, triglycerides drop by several hundred milligrams, HDL goes up, small LDL plummets, c-reactive protein drops.

People also felt better, with flat tummies and more energy. But they also developed benefits I did not anticipate:

--Improved rheumatoid arthritis--I have seen this time and time again. Eliminate wheat and the painful thumbs, fingers, and other joints clear up dramatically. Many former rheumatoid sufferers people tell me that one cracker or pretzel will trigger a painful throbbing reminder that lasts a couple of hours.

--Improved ulcerative colitis--People incapacitated with pain, cramping, and diarrhea of ulcerative colitis (who are negative for the antibodies for celiac disease) can experience marked improvement. I've seen people be able to stop all their nasty colitis medications just by eliminating wheat.

--Reduction or elimination of irritable bowel syndrome

--Reduction or elimination of gastroesophageal reflux

--Better mood--Eliminating wheat makes you happier and experience more stable moods. Just as wheat is responsible for a subset of schizophrenia and bipolar illness (this is fact), and wheat elimination generates dramatic improvement, when you or I eliminate wheat, we also experience a "smoothing" of mood swings.

--Better libido--I'm not sure whether this is a consequence of losing a belly the size of a watermelon or improvement in sex hormones (esp. testosterone) or endothelial responses, but more interest in sex typically develops.

--Better complexion--I'm not entirely sure why, but various rashes will often dissipate, bags under the eyes are reduced, itching in funny places stops.


It's also peculiar how, after someone eliminates wheat for several months, re-exposure of an errant cracker or sandwich results in cramping and diarrhea in about 30% of people.

Obviously, people with celiac disease, who can even die of exposure to wheat, are even worse. What other common food do you know of that makes us sick so often, even occasionally with fatal outcome?
Tags :

Comments (59) -

  • Olga

    9/17/2009 1:08:20 PM |

    Hi Dr. Davis:

    Are you familiar with Dr. Wolfgang Lutz from Austria.  He has a book entitled "Life Without Bread."  He has been treating patients with a low carbohydrates diet for over 40 years and he has seen improvements in the same conditions in his patients.  In his book he presents data from his patients over the last 40 years and it's very impressive.  Here is the amazon.com link to the book:
    http://www.amazon.com/Life-Without-Bread-Low-Carbohydrate-Diet/dp/0658001701/ref=sr_1_1?ie=UTF8&s=books&qid=1253192708&sr=8-1

    Thanks so much for writing this blog.

  • Adam Wilk

    9/17/2009 1:23:39 PM |

    I absolutely agree with what you're saying here--for the most part, I do not eat wheat, but I must tell you, the desire for any wheat product never leaves (in my case, anyway) and is frequently craved--but what a punishment for indulging, even once in a great while:
    A few days ago, whilst enjoying a delicious mostly protein and fat dinner at Outback, my wheat devil got the best of me, and I took a mere slice of that delicious bread they put on the table, with a generous pat of butter.  Within 5-10 minutes, I literally felt my nose and sinuses swelling up on me.  Not fair, but reality.
    Hmmph.

  • Helena

    9/17/2009 1:43:44 PM |

    Oh this is so true! I love myself when I stop eating wheat and a lot of sugars - can't get enough sex och have much more energy!

    But from time to time I fall back and just crave that pasta... and every time I do, I regret it; Stomach cramps is always what will be served for dessert!

  • Anonymous

    9/17/2009 2:35:30 PM |

    Dairy and lots of sugar.
    But wheat might be the worst.

  • Susan

    9/17/2009 2:48:41 PM |

    Two years ago, my knees hurt so badly that I avoided sitting in low chairs (I couldn't get out of them) and I was "one-footing" stairs. Then I went on a low-carb diet and the pain cleared up. I failed to put two and two together until a trip to France where I "allowed" myself small amounts of bread and suddenly it became important to know if a metro stop had an escalator. Now I know that eating wheat will result in knee pain 48 hours later.

    Fast forward to this summer when my 24-year-old daughter was having stomach pain--it was after meals, but sometimes the pain woke her in the night. "Heartburn," said her physician, maybe related to stress, and put her on Nexium for a month to see if it cleared up. It did, but returned when her prescription was over. Having read about the side effects of PPI use, I suggested to my daughter that she consider eliminating gluten and/or milk products for a while to see if that helped. She did (although she whimpered a bit about giving up beer). The pain disappeared almost immediately, and a bit of experimentation showed that it was wheat and only wheat that caused the pain (cheers).

    When my daughter described the pain, I realized that I had the same symptom when I was her age, but I didn't have it looked into because it never lasted long enough to bother with (I'm one of those doctors' kids who avoid doctors).

    So my question is, in light of all of the signs that point to wheat intolerance as a cause of gastrointestinal distress and joint pain and a whole lot of other things, why is eliminating wheat not the first course of action?

    By the way, I found the recent article in Scientific American on celiac disease, leaky gut and automimmune disease to be very interesting.

  • Chris

    9/17/2009 3:37:49 PM |

    Does wheat elimination include eliminating beer, particularly, wheat beer?

    It's the only wheat--or grain for that matter--in my regular diet.

  • Gretchen

    9/17/2009 6:25:00 PM |

    "after someone eliminates wheat for several months, re-exposure of an errant cracker or sandwich results in cramping and diarrhea in about 30% of people."

    I gave up wheat a long time ago when I found it triggered acid reflux. And I found just the opposite.

    As long as I didn't eat wheat regularly, I could have the occasional wheat with no problems.

  • Anonymous

    9/17/2009 8:01:42 PM |

    Does anyone know if Ezekial 100% sprouted whole grain bread (yes contains some sprouted wheat + many other grains) is still considered "wheat" as I want to have a zero wheat diet.  Hmmm  think I just answered by own question.  thanks!

  • Dr. William Davis

    9/17/2009 9:06:54 PM |

    Hi, Chris--

    Beer is clearly the least desirable of all alcoholic beverages, partly because of its wheat origin. However, perhaps because of fermentation or some other modification, it doesn't seem to exert all the adverse effects of other products, though celiacs will still react to the gluten.

    Anon--

    Likewise with Ezekiel. I believe it's better, though not necessarily perfect. It still trigers carbohydrate responses.

  • Dr. William Davis

    9/17/2009 9:07:33 PM |

    Hi, Olga--

    Amazing how we are re-learning many lessons learned previously before drugs and fancy hospital procedures.

  • Sara

    9/17/2009 9:29:02 PM |

    Another factor in the increased libido may be a reversal of very early nerve damage from high glucose levels. Peripheral neuropathy starts at blood glucose levels that are not really very high at all -- around 140mg/dL, which a person may be seeing after meals for YEARS before they hit the diabetic diagnostic criteria of 180mg/dL after meals or 126mg/dL fasting (and very many diabetics do have measurable neuropathy at diagnosis, for exactly this reason). People worry about their feet when they're considering diabetic neuropathy, but ALL the nerves are adversely affected by being bathed in excessive glucose, and those in the sexual organs are among the most sensitive; I think it's a reasonable theory that one would see a decrease of sensation there even before you have measurable effects in the hands and feet. Fortunately, if neuropathy isn't very advanced, it can be reversed by getting blood glucose under control, and of course that would improve sensation and increase the enjoyability of sexual activity, which would naturally factor into the desire for same. I'm sure there's more to the story, including some or all of the factors you've named, but I think this is probably part of it too.

  • Thomas

    9/17/2009 10:11:38 PM |

    How do the various grains compare: wheat, rye, barley, corn, rice etc.?

  • Robert McLeod

    9/17/2009 10:16:22 PM |

    It's called wheat allergy, look it up.  Different antibodies to celiac, different symptoms, but same cause and same cure.

  • William Trumbower

    9/17/2009 11:13:05 PM |

    There are gluten free beers available, based on sorgum.  Budweiser makes one called Red Bridge, but there are others on the market.    My sister has active celiac and so I eat an anti-inflamatory gluten-free diet.  Last year at my highschool reunion I had pizza and beer with the boys.  I had bloody stools for several days after!  I believe that most of us are gluten intolerant, that is we cannot really digest the gluten molecule. Many of us develop "leaky gut" from the gluten and then go on to antibody production against the gluten-gliadin molecule.  This protein has several key amino acid sequences in common with tissue proteins in many various organ systems (thyroid, pancreas, adrenal,gut, skin, uterus, placenta  etc) and autoimmune disease begins.  Which organ system is affected depends on your genetic make up.   The persistance of GI docs in refusing to diagnose gluten enteropathy without a small bowel biopsy is amazing to me.  see enterolab.com

  • Anne

    9/18/2009 2:21:33 AM |

    A lifelong depression lifted when I went wheat and gluten free 6 yrs ago. I am 66 years old and I wake up with no joint pain. Peripheral neuropathy is better, but not perfect. I have a long list of health improvements.

    As far as my heart, dropping wheat and gluten totally relieved my pitting leg edema and shortness of breath. I had cardiac bypass over 9 years ago, but I did not start to heal until I went gluten free. I am sure that gluten contributed to my CAD.

    I have no idea what would happen if I were to eat a wheat cracker or a slice of wheat bread. I never want to feel that sick again so I have not been tempted to try even one bite. An accidental crumb is enough to cause my brain to fog and my energy level to bottom out.

    This past year I dropped sugars and all grains in order to level out my blood glucose - this has worked well.

    I have heard the celiac experts say that no one is able to digest wheat well.

  • Anonymous

    9/18/2009 3:30:27 AM |

    Dr. Davis,
    A majority of beer recipes are based on Barley, not wheat. Sure it could contain wheat as an ingredient and most "summer" beers often contain a malted barley/malted wheat mix with the latter as a minor component. Beer (at least other than the generic mass market brews like coors, bud etc) contain substantial polyphenols from hops which I would assume have antioxidant value.

    I don't buy this obsession approach that everything that might contain a grain is probably bad. H1N1 is called the "swine flu" so what has happened; people have stopped eating pork.......  I am grateful for the discussion on this site but just sometimes I get a little disheartened with the  generalizations.
    Trevor

  • Anonymous

    9/18/2009 5:18:01 AM |

    Dr. Davis, my diabetic friend just announced to me today that her Triglycerides dropped from 400 to 200, her total cholesterol dropped to 178 and all other blood values are now within normal range just by changing her diet and eliminating all starchy foods (white and brown rice, all wheat products, etc.). Her wheat-free diet truly gave her some unexpected effects. Josephine

  • Anonymous

    9/18/2009 10:08:32 AM |

    Dr. Davis
    I'm 66 years and was diagnosed with migrene from 20. At 62 I startet to eat lowcarb and high fat. My migrene was gone after 14 days. I thougt that sugar was the worst, but I have come to understand that wheat and barley trigger my headaches more than sugar does.
    Other pleasant side effects are no more anal- itching and nearly no more nightly peeing.

  • William Trumbower

    9/18/2009 1:14:22 PM |

    My concern about the sprouted grain breads is the inclusion of soy.  I am not sure that the sprouting process eliminates all the toxins from soy (phytic acid, estrogen, goiterogens, protease inhibitors etc. ). Traditional cultures often soaked grains, sprouted them, and then used lactofermentation (sourdough)  methods to prepare their breads or porridges.  This reduced many of the toxic portions of the grains, but soy is much more resistant.  Traditional Asian cultures often fermented soy for months before using as food.

  • donny

    9/18/2009 1:33:52 PM |

    Before the phrase "wheat-belly" was phrased, there was the phrase "beer-belly." Personally, I don't care if it's made from barley or wheat, beer poses a clear danger either way.

  • pooklaroux

    9/18/2009 4:50:34 PM |

    I suffered from IBS for years, and discovered the "cure" when I went on Atkins in 1999.  I'm afraid, though that in my case, eliminating wheat alone isn't sufficient, I seem to have problems with any grain that is high in fiber. One or two amaranth based cookies was enough to trigger IBS symptoms for a whole weekend.

  • DropYourAllergies

    9/18/2009 5:34:49 PM |

    Gluten >> Allergy ? > InTolerance ? > Celiac ?

    Did YOU Know / Have you been told ?

    That > If YOU suspect that You have a Gluten InTolerance / Celiac Disease > Do NOT begin a Gluten Free DIET > Until You have been Medically Diagnosed ( See Below ).

    IF ..
    You would like information regarding a >  Personal Use >  Self Test / Finger Stick Kit > That will test You for presence of Celiac AntiBody ..
    Contact / CALL >  DropYourAllergies.com

    > FDA Approval Status ? > In the Works > But already used extensively WorldWide by Medical Communities to Screen their populations for Celiac Disease ...
    And this Test > CAN be obtained for YOUR Personal Use... NOW !

    Why Wait ? > Certainly > Your Celiac Disease and HEALTH Will Not.

    Research indicates that > Children will visit 6 Pediatricians BEFORE their Celiac Disease is Diagnosed... WHY ?

    ALSO > Allergy Mothers of Allergy Children > Who wish to > Take the FEAR Out of FOOD > i.e. Eat a Peanut = Trouble for their Child > Need only visit their Primary Care Dr. for an Insurance covered, FOOD Allergy Blood Test.

    Test to Determine if InTolerance of ALLERGY.

    Once Test ID’ed > You receive a Custom FOOD allergy DIET Plan > Suggesting FOODs to Eat, Not Eat, Restrict & ReIntroduce > All based on EACH Patient’s unique Test Result.

    And..
    The SAME Blood Test CAN be used to Identify YOUR Child's Offending Seasonal & Year-round Enviro Allergens .. with Neutralization via Child Friendly, Drug FREE > NaturesAllergyDrops.com > Immuno-DROPs ( Think SHOTs But No OUCH !) > Which Neutralize the SOURCE of Your Child's Test Identified Offending Enviro Allergens / Allergy Disease.

    STOP ! > A Lifetime of Medicating Your allergy SYMPTOMs > While your Enviro Allergy Disease > Continues / Exacerbates UnAbated ..

    Leading EACH Sufferer on a LifeTime, Slippery Slope of “Allergy Driven” diseases ( allergic ASTHMA to Name One ), recalcitrant Health Issues & compromised Quality of Life / Poor Self Image. > Achoo & OUCH !  

    YES > You CAN take ALLERGIES > Out of Your Child's Future ...

    Best Health = Wealth Regards

    Stephen
    DropYourAllergies.com

    Celiac Information:

    > Serology ( Blood testing ) as well as Biopsy requires the presence of antibodies to gluten.

    > A gluten-free diet reduces circulating antibodies thus compromising a proper diagnosis.  There are no clear guidelines for a proper gluten challenge to ensure sufficient circulating antibodies for a positive result; some individuals requires 1 month, other years.  

    > Key Take HOME Message !

    With 1 in 100 being affected,
    Rule out Celiac Disease > Before going Gluten-Free
    Regardless of Rationale.

  • kris

    9/18/2009 7:55:11 PM |

    Susan,
    couple weeks ago, I had to take a trip and drove for 8 hours right after my hard work out at gym. didnt have time to eat at my regular time. that night i had stomich spasm, so bad that it almost made me cry. (now i am completely wheat free for more than 10 months now). only thing that helped me immediate,was powdered Magnesium. the pain would start around 2am and stay on until I take liquid magnesium. the pain wouldnt go away for week or so. funny thing is that in the morning i would go to gym and workout hard with no pain at all. 4 days ago I had to see my doctor and he put me on on Nexium. That was the first night that there was no pain how ever the side effects of Nexium were sharp headache and stomach spasm for 5 minutes. I think that when body is firing on all cylinders, it is important to eat regularly, small meals, more often.

  • Suresh

    9/18/2009 8:38:46 PM |

    Dr. Davis,

    I have seen the mention of eliminating wheat from the diet in many of your articles. Does that mean something like rice is not as bad as wheat namely is wheat is the worst among the grains rice, barley, corn etc ?

    Thanks!

    -Suresh

  • water

    9/18/2009 9:04:16 PM |

    Sara,

    I found your comments extremely interesting and would like to know more about your research, especially relative to this:
    "those in the sexual organs are among the most sensitive"  Do you have reference I can follow?

    I've been reading about periperhal neuropathy and autonomic neuropathy and this article was particularly interesting:

    Unlike PN, AN is often asymptomatic. Among symptomatic patients (55%), erectile dysfunction seems to be the sole symptom, in line with the higher degree of parasympathetic damage.  

    pns.ucsd.edu/JPNS/Ravaglia.accepted.06.16.04.pdf

    An improvement in his ED was definitely an unexpected results of a gluten free diet (wheat free was not enough), but my spouse saw further improvements without dairy and soy.

  • Anonymous

    9/19/2009 3:23:47 AM |

    William,
    Your comment on the fermentation of soy in Asian cultures appears to imply that this is important to render "safe" food from Soy.  So do you make the same generalization about cow's milk.....? IE it should be cheese and yoghurt before consumption?

    Donny,
    what is the scientific relation between "wheat belly" and "beer belly" ? none, I would argue. Other than both are not desirable and result from over indulgence.

    There are a surprising number of people who are sensitive to specific foods.  I love sushi.  My wife is allergic to raw seafood yet she can down a piece of wheat gluten (seitan) with no affects. I have friends who can't go near gluten without severe cramps. My wife can also eat beef yet it gives me terrible gas. On the other hand, beans have absolutely no impact to my gas productivity.  I write this to highlight that many many people have issues with certain foods while other remain unaffected. YMMV as the saying goes, so lets celebrate those who find relief in changing their diets but lets not claim panacea
    Trevor

  • Dr. William Davis

    9/19/2009 1:59:09 PM |

    Suresh--

    Yes, wheat stands out as a uniquely destructive grain. While other grains can also increase blood sugar and trigger adverse patterns, wheat is undoubtedly the worst. I know of no other grain than wheat that is accompanied by addictive behavior, also.

  • Anonymous

    9/19/2009 3:24:20 PM |

    Re: beer and barley

    Barley also contains gluten, so if you're avoiding wheat because of the gluten, you'll need to avoid barley (and rye) as well.

    Re: rice

    The data that the idiotic "China Study" book is allegedly based on suggest that rice is the best grain to eat if you're going to eat grain. The highest rate of heart disease in China is found in the province where wheat is a dietary staple and little meat is consumed.

  • Anne

    9/19/2009 4:27:57 PM |

    1:100 may have celiac disease, but estimates of those with non-celiac gluten sensitivity range from 10-40% of the population.

    It is true, if you want to be tested for celiac disease(villous atrophy), then you do need to keep eating gluten until the testing is completed. If the tests come out negative it does not mean that you have no problem with gluten. You may still have latent celiac disease, non-celiac gluten sensitivity, wheat allergy or wheat intolerance. I am beginning to see more journal articles about gluten sensitivity. Dr. Green recently wrote in the JAMA that more attention needs to be given to gluten sensitivity.

    I did not go through blood a biopsy testing as my doctors refused to run these tests. I used Enterolab to confirm I have antibodies to gluten. This was enough proof for me. Enterolab cannot diagnose celiac disease, but it can tell you if you are reacting to gluten and you can be wheat/gluten free for up to 2 years for this test.

    There is nothing dangerous about a gluten free or wheat free diet and, luckily, we don't need a doctor's prescription to change our diet. A gluten free diet can be as healthy or as unhealthy as one wants to make it. Along with gluten free, I follow Dr. Davis' recommendation of a low sugar diet to keep my blood glucose in check.

  • taemo

    9/21/2009 1:23:30 PM |

    Ouch! much sugar? Damn! diabetes is you will get.

  • Anonymous

    9/21/2009 5:20:19 PM |

    Dr. Davis,

    Okay... wheat is BAD.  But... does this include wheat bran, often used as a source of fiber in the diet?  I mean the bran only, NOT wheat germ, or whole wheat, or wheat flours.

    Thanks for all you do!

    madcook

  • Dr. William Davis

    9/21/2009 9:43:47 PM |

    Hi, Mad--

    No, wheat bran is essentially inert. It does not interact with anything and so does not exert any adverse effects. It's like eating wood.

  • Anonymous

    9/22/2009 9:25:21 PM |

    I disagree with wheat bran being inert.  It is a source of phytic acid which has mineral binding properties.  Also, reading sites like FiberMenace.com, bran fiber is certainly not benign.

  • denparser

    9/22/2009 11:40:04 PM |

    @Anonymous (before me)

    I agree with your statement. Its a fact, try read health book.

  • Stan (Heretic)

    9/23/2009 11:48:20 AM |

    I have to mention one more benefit to your list, that I noticed:

    - hugely improved dental health and self-healing (sealing) of damaged teeth.

    We know that wheat's agglutins (WGA) affect and reduce D3 transport, I have a suspicion that wheat may be also interfering with K2 (thus teeth) but haven't seen much esearch on this yet.

    Stan (Heretic)

  • Anonymous

    9/24/2009 7:41:01 PM |

    TedHutchinson, there are many other sources that agree that fiber is not beneficial and is indeed harmful if you don't care for the one referenced.

    Nevertheless, Dr. Davis is incorrect about bran being inert.  It does contain phytic acid which interferes with mineral absorption.  Another reason wheat avoidance helps teeth and bones.

  • dves

    9/27/2009 12:53:06 PM |

    @taemo

    haha. you're right.. control use of sugar to avoid diabetes.

  • denparser

    9/27/2009 12:54:22 PM |

    @Thomas

    it has different nutrition level and most of all, its taste.

  • Anonymous

    9/28/2009 5:34:44 PM |

    I have a question: after spending a year in France, I realized that yes, French people are typically lean and thin, however, they eat so much wheat! Pastries, white pastas, cereals...
    Do French people display the same numbers when it comes to celiacs disease and wheat intolerance? I am curious to know. Or might it have more to do with volume or the fact that their breads are more often homemade? Thoughts?

    I went gluten free for nearly two years and then have been dabbling back into spelt and wheat. My primary reasons for trying the elimination were skin-related (itch, chronic eczema). Sad to say, it don't help much, though I did feel pretty healthy. I just ate a croissant the other day from an organic bakery that stone mills. It was heavan. I didn't feel foggy or anything, so perhaps the key is moderation?
    Anyway, great site, very informative. Looking forward to hearing your thoughts on those skinny french people.
    PS-I don't have a weight problem and ironically I didn't lose weight when I went gluten free. Ended up eating more meat (allergic to nuts)...

  • trinkwasser

    10/2/2009 4:03:33 PM |

    Interesting that inflammation would appear to be a component of nearly all these symptoms which wheat elimination "cures".

    My depression and mood swings appear to be closely correlated with blood glucose swings, which may be why that also improves.

    I'm another one for whom wheat bran is not inert: it generates BG spikes, although not to the degree of whole wheat. Lectins, phytic acid or wheat germ agglutinin?

    http://high-fat-nutrition.blogspot.com/2007/11/how-toxic-is-wheat-well-first-point-is.html

  • Anonymous

    10/3/2009 2:40:52 AM |

    Ted,
    Thanks for the link to the livin lavida low carb site interview with Dr. Davis.  Your links are always informative.
    In my opinion, all newbies visiting this web site should be directed to this reference for a great summary of what is important in taking care of your heart via diet changes. v.cool, thanks
    Trevor

  • Sew Bee It

    10/6/2009 10:28:46 PM |

    I've just found your blog via Feed the Animal, and I'm so happy I did!  Thank you so much for you posts, I'll be reading often.  

    You have a few comments here, but I figured I'd add to your collection of anecdotal evidence:  I'd gone paleo for about a month when I took one 24 hour period off (dinner to dinner).  3/4 of a medium pizza, a snickers bar, 1/2 can pringles, and a dozen chocolate coated gingerbread cookies ended up on the menu.  Within 30 minutes of eating the pizza my heartburn had returned, withing hours of eating bits of the rest I was in PAIN.  Why I kept eating this junk for the next day, I have no idea.  The more of it I ate the worse my stomache got.  Severe upset stomache, badly sufuric burps, bowel discomfort, you name it!  And after that 24 hours I finally reached a level of toxicity where my body literally rejected the food.  So toxic was this junk that use to be "normal" food, that my body threw it up in self defense.  

    Needless to say I'm totally commited to the paleo eating now!

  • Jenny

    10/10/2009 12:59:02 AM |

    What element in wheat are you referring to? everyone needs fiber which is a major component of wheat, people can't be allergic to fiber as their digestive system would pack up if you didn't have any.

  • Anonymous

    10/12/2009 11:24:02 PM |

    Does abstaining from wheat include staying away from spelt and kammut and Emmer wheat as well..or is it the GMO wheat that is the problem?
    Some doctors believe spelt is more digestable than regular wheat.

  • Jamie

    11/2/2009 1:06:55 AM |

    Jenny,

    Not true at all. I eat very little fiber and am more regular and have less digestive issues than I ever have. As long as one eats enough fat, there is no need for fiber.

  • Beverly

    3/28/2010 6:24:41 PM |

    You can get Gluten-Free beer.  One brand is called Red Bridge.  There's another, but I forget the name.  I drink the Red Bridge.  Not bad.

  • Beverly

    3/28/2010 6:48:23 PM |

    Besides, you can get your "roughage" from raw veggies and salad.  I've been low-carb for about 6 wks. now; haven't had any bread, rice, pasta, wheat, etc.  I've never felt better and have more energy.  My brain is functioning better, too.  Also, have lost 4 lbs.

    Beverly

  • Julianne

    6/25/2010 11:17:42 PM |

    Hi Dr Davis,
    Thanks for a great blog.
    I just wanted to share my experience of wheat free (I actually went paleo so fully grain and legume free)
    No more swelling knees. Probably mild auto-immune, mother has it also.
    Large - I mean large and multiple bumps - ganglion cyst that I had for 10 years shrank and disappeared.
    PMS with horrid breast pain - gone.
    Menstrual pain - less with fish oil, gone with paleo.
    Constipation - gone
    Pre-menopausal spotting the week prior to menstruation, had this for 10 years - gone.
    Lost weight - that last 3 pounds that make me look my best.

    I wrote about it here, I for one want to spread the news as a nutritionist.
    http://paleozonenutrition.wordpress.com/2010/05/24/my-nutrition-journey/

  • Alina M

    9/7/2010 1:51:47 PM |

    Is whole grain wheat also harmful?

    Thank your very much for all your information.

  • legend_018

    9/10/2010 1:16:13 AM |

    So people just give up having

    1. bread and butter with meals or crusty bread with pasta
    2. peanut butter and jelly sandwiches, tuna fish sandwiches etc.
    3. pancakes

    That seems hard to give up.

  • Anonymous

    9/12/2010 10:03:37 AM |

    As an experiment and in an attempt to lose weight, I put my whole family on a low-carb diet. Cutting out wheat was part of it.
    My husband has suffered from a mild type of colitis for the last 15 years. One year ago an awful smell developed with the colitis. Whenever he went to the toilet or passed wind an obnoxious, sour smell like old cheese/rotten eggs lingered a long time after. It caused me to move out of our bedroom, as the smell would cause me to wake up repeatedly. 3 weeks on the wheat-free diet the smell was suddenly gone. It was nothing short of a miracle. It was not something I had expected from the diet, but a very welcome side-effect indeed, as I hate bad smells. By the way - can anyone tell me what generates that particular sour, rotten smell?

  • Rusa

    9/28/2010 11:51:02 PM |

    legend 018 said:
    So people just give up having

    1. bread and butter with meals or crusty bread with pasta
    2. peanut butter and jelly sandwiches, tuna fish sandwiches etc.
    3. pancakes

    That seems hard to give up.



    Yes. They are addictive, aren't they? Isn't that the point? Wheat is addictive.

  • KMebust

    11/9/2010 4:16:59 PM |

    A criticism, then a question:
    Any food you give up for months will cause diarrhea and cramping when you come back to it, because you've lost the bacteria that help you digest it.  I've experienced this with dairy, meat, and potatoes.  I am skeptical that wheat is any different than other foods in that regard.
    I have family members who have experienced benefits from gluten free diets, but don't want to give it up altogether, for various reasons.  Does cutting back-- say, not eating bread but not actively eliminating gluten from all your food choices-- have lesser but similar effects?

  • Anonymous

    12/17/2010 7:55:34 PM |

    Thank you so much Dr. Davis.  You have confirmed our worst fears that seemingly "healthy" wheat is actually a form of subtle malnutrition.  Please mention that it is the gluten that causes the problems.  Not in the allergic sense, but by blocking the important nutrients from fruits and veggies to vitamins and minerals.  Gluten forms a mucoid plaque which covers the small intestine thus causing subtle malnutrition and is therefore responsible for dozens of illnesses.

  • James

    1/18/2011 8:13:42 PM |

    I have given up wheat because of its effects on myself including acid reflux, rapid heart beat, irritated hemmoroids.  

    All of the effects you have mentioned have been documented as far back as 1995.  This is especially true of RA. I remember articles in the nutrition press stating that wheat was one of the triggers for RA. Thanks for all the information.

  • Ravi

    2/9/2011 5:28:47 PM |

    Hello Dr. Davis,

    We would like to invite you to summit your exceptional posts to our new ParadigmShift BlogShare at DaiaSolGaia.  
    Please check it out! Thank you. http://daiasolgaia.com/?p=2212

  • Ravi

    2/9/2011 5:30:25 PM |

    ... fingers: type "submit"... thank you. Wink

  • Pixie

    3/11/2011 10:59:55 PM |

    I wish this was the case for me.  I have suffered with IBS for 27 years.  I have gone on gluten elimination diets for up to 30 days twice in the past 15 years with no change.  Incorporating it back in, the only thing I noticed was a little bit of heartburn if I had wheat in the morning. I've tested negative for Celiac's and wheat allergies.
    I'm not saying your are wrong. But for me a wheat free diet was no cure for IBS.  Frown  (I WISH!)
    -Karen

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Can natural treatments "cure" or "treat" any disease?

30. August 2006 William Davis (0)
According to current FDA policy, the answer is a flat "NO!"

No natural treatment, whether it be fish oil (as a nutritional supplement), l-arginine, vitamin D, magnesium, various flavonoids like theaflavin or resveratrol, can be declared to treat or cure any disease. That's why you see the evasive and vague wording on nutritional supplements, nutraceuticals, and various foods, like "Supports heart health" or "Supports healthy cholesterol". Claiming, for instance, that taking 6000 mg per day of a standard OTC fish will reduce triglycerides and stating so on the label of a supplement is unlawful and prosecutable.

Think what you will of Mr. Kevin Trudeau (author of Natural Cures They Don't Want You to Know About"): visionary, consumer advocate, David vs. the Goliath of the FDA and "Big Pharma", or huckster, scam artist, and one-time felon. But Trudeau got it right on one important issue: The FDA dictates what claims can be made to treat disease. On one of his ubiquitous informercials, Trudeau states:


"...the way the system works today, you have the Food and Drug Administration—the FDA, and you have the drug industry. They really work in tandem. Unfortunately, there’s an unholy alliance there. People don’t know that the majority of commissioners of the FDA, which allegedly regulates the drug industry, and the food industry—Food and Drug Administration, the commissioners of the FDA—the majority of them—go to work directly for the drug companies upon leaving the FDA and are paid millions and millions and millions of dollars. Now in any other format, that would be called bribery; that would be called a conflict of interest; that would be called payoffs. That’s exactly what’s happening right now. So what has occurred is the Food and Drug Administration is really working in tandem with the drug industry to protect their profits. Example: The Food and Drug Administration says that only a drug can diagnose, prevent, or cure any disease."


He goes on to say that

"...the Food and Drug Administration says only a drug--nothing else--can cure, prevent, or diagnose a disease. Therefore the Food and Drug Administration continues to call more and more and more things diseases. Therefore they eliminate all-natural remedies. No one can say what a natural remedy can do if it’s been classified as a disease. So Attention Deficit Disorder is now a disease. Therefore only a drug can cure, prevent, or diagnose it. Cancer is a disease. Acid reflux is now a disease. Obesity is now a disease."

(PLEASE do not construe this as an endorsement of Mr. Trudeau's overall opinions. But I do think he's right on this one point.)

The stated purpose of this restrictive policy is to protect the public. Indeed, in years past before protective legislation, ineffective and even poisonous products were commonly sold as therapeutic treatments. (Remember cocaine and morphine in cold remedies? Lead and other toxic agents were also common.) Unfortunately, a huge gap has emerged as clinical data accumulates that support the efficacy of nutritional treatments and other non-traditional methods to treat or alleviate diseases. Any disease, or anything construed as disease as Trudeau points out, can onlybe treated by a drug.

In the FDA's defense, they have made slow progress in allowing "claims" of benefits for several supplements and food substances, such as the beta-glucan of oat products, soy protein, and most recently barley (for cholesterol reduction). The scrutiny is quite thorough and the wording of the policy is quite specific. Regarding oat products, for instance, the policy states:

"FDA concluded that the beta-glucan soluble fiber of whole oats is the primary component responsible for the total and LDL blood cholesterol-lowering effects of diets that contain these whole oat-containing foods at appropriate levels. This conclusion is based on review of scientific evidence indicating a relationship between the soluble fiber in these whole oat-containing foods and a reduction in the
risk of coronary heart disease.

Food products eligible to bear the health claim include oat bran and rolled oats, such as oatmeal, and whole oat flour...To qualify for the health claim, the whole oat-containing food must provide at least 0.75 grams of soluble fiber per
serving. The amount of soluble fiber needed for an effect on cholesterol levels is about 3 grams per day."

(Source: FDA Talk Paper which can be viewed in its entirety at http://www.fda.gov/bbs/topics/ANSWERS/ANS00782.html.)

In light of the boom in nutritional and non-traditional research that validate or refute efficacy, is such a policy still necessary? Or does it inhibit the open dissemination of information and result in a extraordinary monopolization of health treatment for the drug companies?

This debate will likely rage for the next two or more decades, particularly as drug companies are increasingly viewed as profit-seeking enterprises and more validation is gained by non-drug treatments.

For the moment, don't dismiss a "treatment" because it doesn't come by prescription. But don't reject a drugjust because it is a prescription. We need to strike a healthy, rational balance somewhere in between.

Can procedures alone keep you alive?

29. August 2006 William Davis (0)
My days in the hospital remind me of what heart disease can be like when no preventive efforts are taken--what it used to be like even with my patients before taking a vigorous approach to prevention (though over 12 years ago).

Several cardiologists in my hospital, for instance, express skepticism that heart disease prevention works at all. Yes, they know about the statin cholesterol drug trials. But they claim that, given their experience with the power of coronary disease to overpower an individual's control, statin drugs are just "fluff". Coronary disease is a powerful process that can only begin to be harnessed with major procedures, i.e., a mechanical approach.

So these cardiologists routinely have their patients in the hospital, often once a year, sometimes more, for heart catheterization and "fixing" whatever requires fixing: balloon angioplasty, stents, various forms of atherectomy. Year in, year out, these patients return for their "maintenance" procedures. Their cardiologists maintain that this approach works. The patients go on eating what they like, taking little or no nutritional supplements, and medications prescribed by their primary care physicians for blood pressure, etc. But no real effort towards heart disease prevention beyond these minimal steps.

Can this work? Very little at-home, preventive efforts, but periodic "maintenance" procedures?

It can, perhaps, for a relatively short time of a few years, maybe up to 10 years. But it crumbles after this. The disease eventaully overwhelms the cardiologist's ability to stent or balloon this or that, since it has progressed and plaque has growth diffusely the entire period that maintenance procedures have been performed. In addition, acute illness still occurs with some frequency--in other words, plaque rupture is not affected just because there's a stent in the artery upstream or downstream.

Not to mention this can be misery on you and your life, with risk incurred during each procedure. It's also terribly expensive, with hospitalization easily costing $25,000-$50,000 or more each time. (Compare that to a $250 or so CT heart scan.)


As people become more aware of the potential tools for prevention of heart disease, fewer are willing to submit to the archaic and barbaric practice of "maintenance" heart procedures in lieu of prevention. But it still goes on. If you, or anybody you know, are on this pointless and doomed path, find a new doctor.




Bloodletting, another antiquated health practice

Support your local hospital: HAVE A HEART ATTACK!

25. August 2006 William Davis (0)
I'm kidding, of course. But, in your hospital's secret agenda, that's not too far from the truth. Catastrophes lead to hospital procedures, which then yields major revenues.

Prevention, on the other hand, yields nothing for your hospital. No $8,000 to $12,000 for heart catheterization, several thousand more for a stent, $60,000-plus for a bypass, $25,000 or more for a defibrillator. In other words, prevention of heart attack and all its consequences deprive your hospital of a goldmine of revenue.

The doctors are all too often conspirators. I heard of yet another graphic example today. A man I didn't know called me out of the blue with a question. "I had a heart scan and I had a 'score' that I was told meant a moderate quantity of plaque in my arteries, a score of 157. My doctor said to ignore it. But I got another scan a year later and my score was 178. So I told this to my doctor and he said, 'Let's get you into the hospital. We'll set up a catheterization and then you'll get bypassed.' Of course, I was completely thrown off balance by this. Here I was thinking that the heart scan was showing that my prevention program needed improvement. But my doctor was talking about bypass surgery. Can you help? Does this sound right?"

No, this is absolutely not right. It's another tragedy like the many I hear about every day. Heart scans are, in fact, wonderfully helpful tools for prevention. This man was right: he felt great and the heart scan simply uncovered hidden plaque that should have triggered a conversation on how to prevent it from getting worse. But the doctor took it as a license to hustle the patient into the hospital. Ka-ching!

This sort of blatant money-generating behavior is far from rare. Don't become another victim of the cardiovascular money-making machine. Be alert, be skeptical, and question why. Of course, there are plenty of times when major heart procedures are necessary. But always insist on knowing the rationale behind such decisions, whether it's you or a loved one.

Hospitals contain experts in ILLNESS

25. August 2006 William Davis (0)
Hospitals contain many experts in sickness. This seems obvious. But walk down the hallways of any hospital, and you'll quickly be convinced that hospitals contain almost no experts in health.

People (hospital staff, that is, not the patients) in hospitals are especially good at identifying and treating disease. They lack knowledge of health.

If your nurse is 100 lbs overweight and struggles to walk down the hall because of arthritis in both knees, would you entrust her with health advice?

If your doctor sits down in the cafeteria and eats his lunch of a ham sandwich with cheese on a bun, fried onion rings, and a milkshake and pastry, can you believe that he/she possesses any insight into health and nutrition?

If your physical therapist or cardiac rehabilitation counselor struggles nearly as much as you while climbing a single flight of stairs, can you accept their advice on how to regain your stamina and use exerise to full health advantage?

The answer to all these questions is, of course, no. Hospital staff are generally expert at dressing surgical wounds, stopping bleeding, identifying infections, and providing the support services for surgical and diagnostic procedures. In contrast, they are generally miserable at conveying genuine health advice. They certainly fall short in being examples of health themselves.

To hospitals and their staff, health is a temporary situation that persists only until you become ill. Illness is an inevitability in the hospital staff mindset. Health is a temporary state in between illnesses.

We need to shake off this perverse mentality. Health is the state of life that should dominate our practices and philosophies. Illness via the occasional catastrophe, e.g., broken leg from skiing, car accident, etc., is the province of hospitals. We should gravitate towards this philosphy and away from the over-reliance on hospitals that has come to dominate our present perceptions of health. Hospitals are not glamorous. They are, for the most part, profit-seeking businesses intent on portraying themselves as champions of health.

When I walk down the halls of hospitals, I am shocked and ashamed at the extraordinary examples of ill-health presented by hospital staff. Yet they falsely paint themselves as experts in both illness and health. Don't believe it for a second.

Are there still unexplored causes of heart disease?

23. August 2006 William Davis (0)
I met a woman today. She had her first heart attack at age 37. She just had her 2nd heart attack this morning, at age 40.

Several issues are surprising about her story. First, she's pre-menopausal. Heart attacks before menopause are unusual. We'll occasionally see women have a heart attack before or during menopausal years only if they're heavy smokers and/or they have had diabetes (either type I or type II) for many years. But this young woman had neither. She is slender and has never smoked.

Even more surprising are her basic lipid values: LDL cholesterol 35 mg/dl, HDL 150 mg/dl, triglycerides 317 mg/dl. This is a very unusual pattern.

Unfortunately, this is all developing acutely in the hospital. (I've just met her today--she's not a Track Your Plaquer!) Lipoprotein analysis would be extremely interesting. In particular, I'd like to see whether she has any other markers besides elevated triglycerides of a "post-prandial" abnormality, i.e., persistence of abnormal particles after eating. The high triglycerides make this quite likely.

If this proves true, the omega-3 fatty acids from fish oil will be a lifesaving treatment for her, since they dramatically reduce both triglycerides as well as persistent postprandial particles like intermediate-density lipoprotein (IDL). (Track Your Plaque Members: See the Special Report on Postprandial Abnormalities on the present home page at www.cureality.com for a more in-depth discussion of this fascinating collection of patterns that is just started to be explored.)

In the real world, especially acute care medicine, there's always a kicker: she speaks no English. Unfortunately, communicating the intricacies of a powerful program like ours that aims to identify all causes of heart disease, then corrects then and aims for coronary plaque regression, is difficult if not impossible.

I also do occasionally worry that, given this woman's extraordinary risk at a young age, and overall very unusual lipid patterns (HDL 150?!), if there are causes presently beyond our reach. We have to make use of the tools available to us for now.

Everything causes heart attack!

22. August 2006 William Davis (1)
The media are presently gushing about a recent study that associates caffeine intake with heart attack.

CBS News: That cup of coffee you're craving might not be such a good idea. Research in the September issue of Epidemiology suggests coffee can trigger a heart attack within an hour in some people.


Some reporters and their quoted sources are musing about whether it's the caffeine, cream vs. other whiteners, time of day, interaction with other risk factors, etc.

My advice: Get a grip! How many relatively benign, every day factors in life can be blamed for dire health risks?

The problem with many of these studies is that they are cross-sectional. They do not enroll participants, then "treat" with coffee (or other substance in question) vs. placebo. In other words, it is not a randomized trial, the sort of trial necessary to prove a hypothesis. That's all that can be generated by a study like this one: a hypothesis.

Perhaps there's a bit of warning for the person with uncorrected lipids and lipoproteins, has no idea that they have extensive coronary plaque because they've never had a heart scan, and have a slovenly lifestyle. Maybe that person might have exaggerated risk from a cup of coffee.

But for us, involved and intensively addressing all causes of coronary plaque to the point of stabilizing or reducing it, coffee is likely a non-issue.

For more conversation on coffee and this report, go to the www.cureality.com home page.

Excessive Heart Procedures Makes New York Times Headline

18. August 2006 William Davis (0)

One example of flagrant cardiac procedure excess has made New York Times headlines:


Heart Procedure Is Off the Charts in an Ohio City
The number of angioplasties performed in Elyria is so high that Medicare is starting to ask questions.

(The full article can be accessed through the New York Times website at http://www.nytimes.com/2006/08/18/business/18stent.html?pagewanted=2&ei=5094&en=b81be5f43f98a99b&hp&ex=1155960000&partner=homepage)



Cardiologists in little Elyria, Ohio, about a 30-minute drive west of Cleveland, do more coronary angioplasties and insert more stents than any other location in the U.S.--four times more than the national average, three times more than the Cleveland average. They perform even more than the recently-indicted cardiologist in Louisiana, who performed twice the national average of procedures.


The Times article, part of a series about financial incentives in medical care, provides a responsible and incredibly balanced report on the situation in Elyria. I have to give them credit, because from the eyes of a colleague (myself), this looks like blatant and extreme profiteering: "cathing for dollars".

I find it outrageous that this group of cardiologists claims that they have some special insight into heart care that justifies this extraordinary reliance on heart procedures. There's bound to be variation in practice patterns, but this is so outside the norm that I believe criminal behavior will be exposed. In fact, I believe that even the "norm", or average, rate of procedures is also excessive.

This is symptomatic of the perverse equation in heart disease care. If there's money to be made in major heart procedures, who wants to bother with prevention? Programs like the Track Your Plaque program present real potential to stop coronary heart disease in its tracks for many, if not most, participants--but don't expect to hear about it from your cardiologist. Don't expect to hear about it from the increasingly hospital-employed primary care physician.

Hopefully, media exposure like that in the New York Times is just the beginning of a public re-analysis of not only what's wrong with medicine today, but recognition of the tremendous power in preventive strategies when everyone stops being so enamored with hospital-based procedures. CT-based heart scanning that ignites your heart disease prevention program is your way to dodge the mainstream obsession with procedures.

More on "Bio-identical hormones" and Wyeth Pharmaceuticals

18. August 2006 William Davis (0)
In October 2005, Wyeth petitioned the FDA, requesting that it completely ban the bioidentical alternatives that women have been using in ever-increasing numbers to achieve optimal hormone balance. With bioidentical replacement therapy clearly reducing its market share, Wyeth asked the FDA to outlaw all compounded bioidentical hormone formulations that compete with its own discredited drugs. If Wyeth is successful, then menopausal women will have no choice other than to take potentially life-threatening hormone drugs or to forgo hormone replacement therapy altogether, thus enduring the physically and emotionally debilitating effects of menopause-induced hormone depletion.

Dave Tuttle
Life Extension Magazine
August, 2006



For more commentary on Wyeth Pharmaceutical's outrageous and brazen petition to the FDA to bar prescription "bio-identical" hormones, i.e., hormones that are identical to natural human forms, read Life Extension's article, Health Freedom Under Attack!
Drugmaker Seeks to Deny Access to Bioidentical Hormones




This well-researched article is in the August, 2006 issue of Life Extension Magazine. The article can also be accessed online at http://www.lef.org/magazine/mag2006/aug2006_cover_attack_01.htm

or go to www.lef.org and click on the August, 2006 issue.

The author, Dave Tuttle, details the baseless arguments raised by Wyeth, a pathetic and amazingly selfish act in the name of protecting profits for Premarin, their prescription agent. It's bad enough to be selling this worthless drug. It's even worse--criminal, in my mind--to try to stamp out our right to have a physician write a prescription for a pharmacy to mix up hormones identical to that humans produce, individualized to our needs.

If you are as angry about this as I am, please go to the Life Extension online reprint that provides access to the International Academy of Compounding Pharmacists website to send the FDA an e-mail describing your opinion, or go to www.iacprx.org.

How accurate is LDL cholesterol?

17. August 2006 William Davis (0)
Watch TV and you'd get the impression that the world revolves around LDL cholesterol: Commercials for Lipitor, Zetia, Vytorin, etc., all drugs to reduce cholesterol (total and LDL). Your doctor looks first and often only at LDL cholesterol.

If there's so much attention paid to LDL, how accurate is it? 100%? 90%? 80%?

Well, it varies widely. Occasionally, it's truly accurate, but most of the time it's miserably inaccurate . Every single day, I see people with LDL cholesterols that underestimates true (measured) LDL by 40%, 50%, and even over 100%. In other words, LDL cholesterol might be 120 mg/dl by the conventional method, but the genuine measured value might be 160 mg/dl, or even 240 mg/dl. It can be that far off--and it's not rare.

The converse can occasionally be true, though rarely in my experience: that conventional LDL overestimates true LDL. I saw someone in the office today like this, with a conventional LDL of 142 mg/dl but a true measured LDL of 115 mg/dl. I may see one or two more people like this the rest of this year.




Why is LDL so inaccurate? Several reasons:

--LDL in most labs is calculated, not measured. The "Friedewald calculation" derives LDL by substracting HDL and triglycerides (divided by 5) from total cholesterol. The higher triglycerides are, especially above 150 mg/dl, the more inaccurate the calculation becomes. As HDL drops below 50 mg/dl, this also introduces greater and greater inaccuracy.

--LDL particles vary in size. A more accurate representation and measure of LDL's dangers are therefore found in measures of LDL particle number , rather than a weight-based measure or calculation. LDL particle number can be measure as just that, LDL particle number (NMR), or as apoprotein B, the protein in LDL that occurs one apoB per LDL.

I liken conventionally calculated LDL cholesterol to a broken speedometer. You simply won't have an accurate measure of how fast you're going, though you may have a ballpark sense. But try telling that to the state patrol.

Or, as a cardiologist colleague said to me in a similar conversation about LDL: "Well, it's better than nothing!"

The lesson: If you're interested in plaque control, and control or reduction of heart scan score, you need a measured LDL, preferably LDL particle number by NMR or an apoprotein B. Another option is "direct" LDL.

Green tea: friend or faux?

15. August 2006 William Davis (0)
The www.HealthCastle.com website is a helpful website on healthy eating that sends out a free newsletter. The content is all produced by licensed dietitions and nutritionists. Although I don't agree with everything said on the site, there's still some good information.

I'm a fan of green tea. Although I believe the effects are relatively modest (weight reduction, cholesterol reduction, anti-oxidation, etc., with theaflavin and/or green tea as a beverage,) they alerted me to the fact that the Lipton Green Tea product is one you should steer clear of. Here are their comments:



"More like Soft drink than Green Tea!With 200 calories, 13 teaspoons of added sugar and a long list of artificial ingredients, Lipton Iced Green Tea is more like a bottle of soft drink than tea, in our opinion."


The Lipton website lists the ingredients:

Water, high fructose corn syrup, citric acid, green tea, sodium hexametaphosphate, ascorbic acid (to protect flavor), honey, natural flavors, phosphoric acid, sodium benzoate (preserves freshness), potassium sorbate (preserves freshness), calcium disodium edta (to protect flavor), caramel color, tallow 5, blue1.

An 8 oz serving yields 21 grams of sugar. If you drink the full 20 oz. bottle (not hard to do!), that yields 52.5 grams of sugar! You will also notice that the second ingredient listed after water is high fructose corn syrup. This ingredient, you may recall, causes triglycerides to skyrocket, causes an insatiable sweet tooth, and is a probable contributor to obesity and diabetes.

In their defense, the Lipton people do also offer a sugar-free alternative without the excessive sweeteners and empty calories.

Do the Lipton products offer the same kind of benefits from green tea catechins (flavonoids) offered by freshly brewed teas? This product has not been formally tested by an independent lab to my knowledge, though, in general, commercially prepared and bottled teas tend to have dramatically less catechin/flavonoid content compared to brewed. (The USDA website provides access to an extraordinary collection of flavonoid food content at their USDA Database for the Flavonoid Content of Selected Foods - 2003. You'll find it at http://www.ars.usda.gov/Services/docs.htm?docid=6231.)

I think the HealthCastle people got it right: Brew your own, making sure to steep for at least 3 minutes. Alternatively, a green tea or theaflavin supplement provides many of the benefits. (Theaflavin has been used in trials at doses of 375 to 900 mg per day.) An in-depth report on green tea will be coming in a future Special Report on the www.cureality.com Membership website.
All posts by william-davis

The Track Your Plaque “Rule of 60”

6. November 2006 William Davis (0)
The Track Your Plaque recommended targets for conventional lipids (i.e., LDL, HDL, triglycerides) are LDL 60 mg/dl, HDL 60 mg/dl, and triglycerides 60 mg/dl: 60-60-60.

Not only is this set of values easy to remember—60-60-60—but is grounded in science and the results of clinical trials.

LDL 60 mg/dl
The LDL target is based on experiences such as that of the Reversal Trial, the PROVE-IT Trial, and the Asteroid Trial, all of which showed that LDL cholesterol values in the range of 60 mg/dl dramatically enhance the likelihood of stopping plaque growth or achieving regression, reducing risk of heart attack more than more lenient LDL targets.


HDL 60 mg/dl
Achieving HDL cholesterol of 60 mg/dl is not as well grounded as LDL targets, mostly because increasing HDL is more difficult. There’s also no tremendously profitable way to raise HDL, as there is for reducing LDL (statin drugs). But epidemiologic observations strongly suggest that HDL of 60 mg/dl provides maximum control over both coronary plaque growth, as well as slashing rates of heart attack. Numerous smaller trials have borne this phenomenon out.


Triglycerides 60 mg/dl
Triglycerides of 60 mg/dl is based principally on studies that have shown a virtual elimination of abnormal lipoproteins, especially small LDL, when this value is achieved. Reduction of triglycerides is an effective means to reduce hidden lipoproteins like small LDL and VLDL. Triglycerides in the conventionally acceptable range of 100-150 mg/dl can be associated with dramatic abnormalities of lipoproteins.


Thus, the Track Your Plaque “Rule of 60”. In our day to day experience of trying to stamp out plaque growth from its terrifyingly rapid 30% per year, or reversing it—-dropping your heart scan score—-the Rule of 60 has held up time and again. Getting your lipids to 60 mg/dl does not guarantee that plaque growth stops, but it appears to be a necessary requirement that tips the scales heavily in your favor.

Those of you who’ve discussed lipid targets with your doctor will quickly recognize that the Track Your Plaque targets appear laughably ambitious, perhaps unnecessary. Recall that your doctor likely has no idea of what coronary plaque regression means. He/she likely conforms to the lax targets set by the National Cholesterol Education Panel (NCEP). (These targets depend on a number of factors such as whether you’re diabetic, sex, risk factors, etc.) Based on trial experiences like the few mentioned above, as well as my experience with purposeful coronary plaque reversal, the lipid guidelines as advocated by NCEP guarantee heart disease. Let me emphasize that again: Follow the guidelines set by the NCEP for your doctor to follow, and progression of heart disease is a virtual certainty. At best, it may slow growth of plaque and delay your heart attack or bypass surgery, but it will not stop it.

Now, that point made, let me make another: Just knowing about the targets and even becoming a member of the Track Your Plaque program does not mean that your lipids with automatically go to 60-60-60. We’ve actually had an occasional person tell us that they were disappointed that, by becoming Members, why hadn’t their lipids gone to 60-60-60?

Knowing that the 60-60-60 targets provide real advantage is not the same as actually achieving them.

A little bit of fish oil

5. November 2006 William Davis (12)

The British National Health Service (NHS) has announced that, in light of the substantial data documenting that omega-3 fatty acid intake from fish reduces likelihood of cardiovascular events by around 40%, that Brits discharged from hospital following a heart attack should be "prescribed" 1000 mg of prescription fish oil per day.

Hardly a revolutionary concept. Part of the timidity of the British NHS seems to relate to the potential cost to the government, since apparently much of the cost will be borne by the government-subsidized health system.

But prescription fish oil? Why prescription fish oil? Prescription Omacor, one capsule per day, costs around $70 (U.S.) per month. If I go to Sam's Club the same quantity of omega-3 fatty acids (in three capsules) will cost around $2.50. That's less than 5% of the cost of the prescription form.

Omacor is clearly more concentrated. But is the prescription form better--more effective, more purified, less contaminated, etc.? I have seen no independent verification of this. Of course, manufacturers make all sorts of claims. The only independent, unbiased testing I'm aware of comes from organizations like Consumer Reports and www.consumerlabs.com. Omacor has not been compared to non-prescription fish oil in any of their analyses. Head-to-head comparison of Omacor to nutritional supplement fish oil is unlikely to come from Solvay, the manufacturer of Omacor. Drug companies powerfully resist head-to-head comparisons, fearing it will not play out in their favor. Let the public remain ignorant and hope marketing conquers all.

Why would the NHS only recommend eating fish and prescription fish oil? I don't know, but it smells awfully fishy to me. As soon as an opportunity for profit is built into a treatment, all of a sudden it gains endorsement. Perhaps lobbying by those parties with potential for profit drove the process.

Nonetheless, despite the filthy politics and under-the-table dealings, some good comes out of the NHS's action: broader recognition of the power of fish oil. Perhaps when a British patient or an American patient gets discharged with a prescription for Omacor, the patient will take the initiative and go to the health food store instead and save him (or his insurer) $67.50 per month.

For your coronary plaque control program and control and/or reversal of your heart scan score, we start at 4000 mg per day of standard fish oil, providing 1200 mg per day of omega-3 oils. This amount as a nutritional supplement costs only a few dollars a month. And you have the satisfaction of not only taking a powerful step for your health, but also not enriching the overflowing pockets of drug companies.

AHA: Doctors don't have time for prevention

3. November 2006 William Davis (0)
Doctors "don't have enough time to educate their patients and to stop and think about what measures the patient really needs," says Dr. Raymond Gibbons, new head of the American Heart Association.

Dr. Gibbons highlighted how the system reimburses generously for performing procedures, but reimburses relatively little (often just a few dollars) for providing preventive counseling. He claims to have several ideas for solutions.

Good for Dr. Gibbons. There's no doubt that the lack of truly effective preventive information and counseling is a systemic, built-in flaw in the current medical environment. It is especially true in heart disease.

Another problem: "If a doctor didn't say it, it must not be true." That's the attitude of many of my colleagues. Despite their broad and systematic failure to provide preventive counseling, most physicians (my colleagues the cardiologists especially) pooh-pooh information that comes from other sources. Yet, it's my prediction that much of healthcare will go the way of optometry--direct access to care, often delivered in non-healthcare settings like a store or mall. People are hungry for truly self-empowering health information. Too many physicians can't or won't provide it. You've got to turn elsewhere for it.

That's one of the main reasons I set up the Track Your Plaque program. It's direct access to self-empowering information. A flaw: You still require the assistance of a physician to obtain lab values, lipoproteins, and to monitor certain treatments (e.g., niacin at higher doses). If I knew of a way around this, I'd tell you. But right now I don't. We remain constrained by legal and moral obligations.

Nonetheless, phenomena like CT heart scanning and the Track Your Plaque program are just a taste of things to come.

Confusion about Lp(a)

3. November 2006 William Davis (2)
Since the recent reader question about Lp(a), I've had several other instances of confusion over Lp(a).

To help you navigate through some of the often confusing issues behind this complex genetic abnormality, here are some common sense rules to follow. When you ask your doctor to draw a Lp(a), try to be certain that:

--the same laboratory is always used. Just going from lab to lab can account for huge variation in Lp(a). As standardization proceeds internationally, this will be become less important. But in 2006, it's still an issue.

--you and your doctor resist the temptation to check Lp(a) frequently. I saw a patient recently who was having Lp(a) levels nearly every month. This is pointless. Lp(a) changes very slowly. Checking it frequently will not allow any treatment to be fully reflected. All you'll observe is random variation that can be frustrating. We wait at least 6 months before re-checking after a new treatment is introduced.

If you have a choice, I would recommend you opt for the measure provided by Liposcience (NMR). The technique they use is a particle count measure, rather than a weight-based measure. This may be more accurate, particularly when Lp(a) is small.

Lp(a) remains among the more difficult patterns to understand and correct. Don't be surprised if you encounter a lot of confusion from your doctor, as well. You may end up providing much of his/her education.

Calculus of the cardiologist

2. November 2006 William Davis (1)
I call this the "calculus of the cardiologist":

Heart procedures = big money

More procedures = more big money

You do the math. If you do more procedures, you get more money.
What if your patients don't need more procedures? That's easy. You lower the bar on reasons to do procedures. You scare the pants off people and lead them to think that all heart disease or questions about heart disease are potentially life-threatening. You could even appear to be doing the patient a big favor. "My Lord! This is potentially dangerous. We need to perform a procedure without delay!"

There are incentives beyond direct cash payment. A patient of mine today showed me a memo to employees in his company that showed why certain hospitals are targeted for care. The criteria for choosing centers was based on number of procedures performed. In other words, the more procedures performed at a hospital, the more procedures will be directed there. Of course, this makes sense at some level. More procedures can also mean greater skill.

But have we lost sight of the fact that the mission is not more procedures and more money, but to get rid of a disease? If the intensity of effort devoted to heart procedures were re-directed to early detection, prevention, and reversal of disease, we'd have half the hospitals we now have. We'd also chop a huge chunk out of the national healthcare budget.

Lipoprotein(a) treatment alternatives

1. November 2006 William Davis (2)
A question from a reader:


Two years ago, my doctor recommended a comprehensive lipid screening because both of my parents had heart disease. My only blood component way out of line was LP (a) [lipoprotein(a)]. It was 130. According to the lab that conducted the screening, Berkeley Heart Lab, a level above 30 should be cause for concern. I was stunned that mine was more than quadruple the danger level.

I began taking two grams [2000 mg] of niacin a day in addition to the Lipitor I was already taking. The next reading, a few months later, was 87. Over a period of about 18 months, I had a total of four readings from Berkley Heart Lab. My LP (a) fluctuated in the 80-130 range – still way above normal. My doctor said there was little else I could do to control it.

That doctor has since retired. I now see another doctor who uses a different lab. My first LP (a) reading with him a few months ago was 17, which is normal. I am still taking the same amount of niacin and Lipitor and I can’t think of anything that would account for the huge discrepancy. I’m going to have another test again soon.

Is one of the labs giving erroneous readings? If so, how can I tell which? If Berkeley Heart Lab is correct, is there anything I can do about my increased coronary risk due to high LP (a)?
Tom D.

Tom's frustration on the variation of Lp(a) is due to the fact that laboratories run the Lp(a) test by several different techniques and will generate tremendous variation in values. The key is to stick to the same measure over and over from the same lab, else you'll be terribly confused and frustrated. Tom essentially should ignore the value obtained that was unexpectedly low.

Another issue: Lp(a) is a turtle. It responds very slowly. In fact, we rarely check it more than once or twice a year. Check it too soon after a treatment change and it won't fully reflect the effect. You've got to wait at least several months before re-checking.

How about treatment alternatives? They are:

--More niacin. Not my favorite choice, since niacin >2000 mg per day begins to generate more side-effects, but it is a choice. You can go to 4000-5000 per day, but only with your doctor's supervision due to liver effects.

--Testosterone for males. We use topical testosterone from Women's International Pharmacy in Madison, Wisconson. Prescription patches like Testim are also effective.

--Estrogen for females. This is less "clean" than testosterone, introducing questions about endometrial and breast cancer risk, but it is a choice.

--DHEA--A small effect but every little bit can help. We use 25-50 mg per day, depending on blood levels and only if you're 45 years old or older.

--l-carnitine--In my experience, a small effect. It requires 2000 mg per day, which is expensive. Sometimes, an expected large effect develops, so it's worth a try if it fits in your budget.

--Fibrates--These are the drugs Tricor and Lopid. I don't like these agents very much because I think they're weak, including the effect on Lp(a) reduction. But they are choices for you and your doctor.

Lastly, you can simply be guided by your heart scan score. For example, if Tom's initial heart scan score is 200, and he continues his current program and one year later his score is 300, then alternative treatments are worth considering. But what if Tom's score is 189--he's regressed his coronary plaque. Then, who cares what his Lp(a) is?

Another issue to keep in mind is that, in the presence of Lp(a), keeping LDL to very low numbers (e.g., 60 mg/dl) may added value in preventing coronary plaque growth.

Trapped in a low-fat world

1. November 2006 William Davis (2)
If you would like to...

--Reduce (good) HDL

--Raise triglycerides, sometimes by hundreds of points

--Raise blood sugar into the pre-diabetic range

--Raise blood pressure

--Accelerate coronary plaque growth

then go on a low-fat diet like the one promoted by long-time super low-fat advocate, Dr. Dean Ornish. Every day I have to educate patients that a low-fat diet as advocated by Dr. Ornish is a destructive, counter-productive process that makes coronary plaque grow and increases your heart scan score.

If you want to gain control over coronary plaque, do not follow the Ornish program or anything resembling it. The Ornish program is a dead end.

Instead, the crucial components of a healthy diet for plaque control are:

--Low saturated and hydrogenated fat, but not low all fats.

--High monounsaturated and omega-3 fats

--Low glycemic index (i.e., slow sugar release)

--High fiber

That simple. An excellent program to put these limits to practical use is the South Beach Diet. Or, follow the more detailed guidelines on the Track Your Plaque website (open content section).

Blame the niacin

31. October 2006 William Davis (7)
Despite the fact that niacin is:

1) A vitamin--vitamin B3

2) One of the oldest cholesterol-reducing agents around with a long-standing track record of effectiveness and safety

3) Available as a prescription drug as well as a variety of "nutritional supplements"

most physicians remains shockingly unaware of its benefits, effects, and side-effects. Most, in fact, are either ignorant or frightened of advising their patients on niacin use. As a result, I commonly have to tell my patients to resume the niacin that their primary care physician has (wrongly) stopped because of itchy feet, grumpiness, groin rash, urinary tract infections, nightmares, diarrhea, hair loss, runny nose, etc. All of these are REAL reasons doctors have advised patients to stop niacin (though none were actually due to niacin).

Is niacin really that troublesome? No, it's not. In fact, if used properly, it's among the most effective and safe tools available for correction of low HDL, small LDL and other triglyceride-containing lipoproteins, lipoprotein(a), and dramatic reduction of heart attack risk. If added to a statin agent, the heart attack risk reduction can approach 90%.

Statins are just too easy for doctors to prescribe. Niacin, on the other hand, requires a good 15-20 minutes to describe how to use it. It could generate an occasional phone call from a patient who struggles with the annoying but largely harmless and temporary "hot-flush" feeling, a lot like a hot blush. Given a choice, most doctors would simply choose not to be bothered. For this reason, I'll commonly see many, many people with uncorrected low HDLs and other patterns.

Have a serious discussion and press for confident answers if you find your doctor reflexively telling you that the wart on your thumb should be blamed on niacin.

Here are the steps we advise that really make taking niacin easy and tolerable:

1) Take with dinner.

2) Take with 2 extra glasses of water. If you experience the hot-flush later on, drink an additional 2 8-12 oz glasses of water i.e., a total of 16-24 oz). Extra hydration is extremely effective for blocking the hot-flush.

3) Take a 325 mg, uncoated aspirin. This is only necessary in the beginning or with any increase in dose, rarely chronically for any length of time.


This is not to say that there aren't occasional people who are truly and genuinely intolerant to niacin. It does happen. But those people are a small minority, less than 5% of people in my experience. Niacin is far more effective and safe than most physicians would have you believe.

Eat fish three times a day

29. October 2006 William Davis (1)
Patients commonly ask, "Why can't I get vitamin D from food? I drink milk and eat fish."

They're absolutely right: both vitamin D and some oily fish contain vitamin D. However, it's a matter of quantity. An 8 oz. glass of milk contains 100 units of vitamin D (at least it's supposed to; this is not always true). A serving of oily fish like salmon or herring may contain up to 400 units. Thus, if you ate fish three times a day like the Eskimos or the Inuit, you might obtain sufficient vitamin D to prevent the broad and alarming spectrum of phenomena associated with deficiency.

I suspect that most people don't want to eat fish three times a day, nor drink the 20 to 50 glasses of milk per day that would be required to obtain a truly healthy quantity of vitamin D.

The vocal and outspoken Dr. John Cannell of the Vitamin D Council (www.vitamindcouncil.com) has written eloquently on the potential relationship between influenza and vitamin D deficiency. He and his co-authors on a recently published paper point out that the peculiar and unexplained seasonality of influenza corresponds to vitamin D levels. Read his eloquent discussion in Medical News Today at http://www.medicalnewstoday.com/medicalnews.php?newsid=51913.

In the article, Dr. Cannell explains:

"The vitamin D steroid hormone system has always had its origins in the skin, not in the mouth. Until quite recently, when dermatologists and governments began warning us about the dangers of sunlight, humans made enormous quantities of vitamin D where humans have always made it, where naked skin meets the ultraviolet B radiation of sunlight.
We just cannot get adequate amounts of vitamin D from our diet. If we don't expose ourselves to ultraviolet light, we must get vitamin D from dietary supplements...Today, most humans only make about a thousand units of vitamin D a day from sun exposure; many people, such as the elderly or African Americans, make much less than that. How much did humans normally make? A single, twenty-minute, full body exposure to summer sun will trigger the delivery of 20,000 units of vitamin D into the circulation of most people within 48 hours. Twenty thousand units, that's the single most important fact about vitamin D. Compare that to the 100 units you get from a glass of milk, or the several hundred daily units the U.S. government recommend as “Adequate Intake.” It's what we call an “order of magnitude” difference.

"Humans evolved naked in sub-equatorial Africa, where the sun shines directly overhead much of the year and where our species must have obtained tens of thousands of units of vitamin D every day, in spite of our skin developing heavy melanin concentrations (racial pigmentation) for protecting the deeper layers of the skin. Even after humans migrated to temperate latitudes, where our skin rapidly lightened to allow for more rapid vitamin D production, humans worked outdoors. However, in the last three hundred years, we began to work indoors; in the last one hundred years, we began to travel inside cars; in the last several decades, we began to lather on sunblock and consciously avoid sunlight. All of these things lower vitamin D blood levels. The inescapable conclusion is that vitamin D levels in modern humans are not just low - they are aberrantly low."


Like Dr. Cannell, I am absolutely convinced that vitamin D deficiency plays an important role in a number of illnesses, including coronary disease. The more we mind our patients/participants vitamin D status (blood levels of 25-OH-vitamin D3), the more easily we gain control over LDL cholesterol, pre-diabetic patterns, blood pressure, blood sugar, and coronary plaque. In fact, I am becoming rapidly convinced that vitamin D deficiency is an extremely important coronary risk factor.

Because I live in Wisconsin (bbrrrrr!) where seeing the sun is a cause for celebration and sun exposure is possible three months a year, I take 6000 units per day vitamin D. This is the amount necessary to raise my blood levels into the true, physiologic range of 50-70 ng/ml. My wife takes 2000 units per day, and each of my kids takes 1000 units per day, though I believe that my 14-year old son (my size now) should take more. We'll judge by blood levels.

If there is a little-known secret to reducing heart scan scores, vitamin D is that "secret".

To read more from Dr. Cannell or to subscribe to his free and very informative newsletter, go to Vitamin D Council

What if I had a cure for coronary disease?

29. October 2006 William Davis (0)
If I had a cure for coronary disease, what would it look like? What would constitute cure? Would you recognize it if I showed it to you?

In the strictest sense, "cure" means an absolute elimination of any sign of coronary plaque, as well as elimination of any and all dangers associated with coronary disease. It would also mean elimination of the factors that created coronary atherosclerotic plaque in the first place.

In a more practical sense, you could argue that "cure" means a reduction of the amount of material that constitute coronary disease along with a dramatic reduction of the associated risks (i.e., heart attack).

You might call this second, more lax definition "regression" or "reversal".

Is "cure" in the strictest sense possible? No, not to my knowledge in 2006. Yes, there are many (kooks) who claim this is possible, but there's no objective evidence of this occurring.

Regression, or reversal, however, is indeed possible. In fact, I've seen it countless times following the participants in the Track Your Plaque program. If your heart scan score goes from 1000 (a bad score with high risk for heart attack) to 750, you've experienced a large reduction in the amount of atherosclerotic plaque that is behind coronary disease. You've also reduced your risk of an "event" like heart attack to near zero (provided you remain on the program that achieved regression in the first place).

Unfortunately, with present technology regression or reversal does not mean that the original causes of coornary plaque are eliminated. They're just controlled. Fish oil, for example, powerfully reduces triglyceride-containing lipoproteins that trigger coronary plaque growth. But if you stop fish oil, the evil lipoproteins come right back and start injuring your coronaries, causing more plaque growth.

The Track Your Plaque program is the closest thing I know of to a "cure" for coronary disease, that is, "cure" in the sense of regression or reversal. Perhaps in future we'll have a "cure" in the strict sense. Until now, this program is the best there is.