Are Your Cosmetics Safe?



If you are reading The Cureality blog chances are you care about your health. You care about what you eat. You want to remain healthy, free of disease, feel good and possibly even want to look and feel as vibrant as you were when you were 20. Many of us think of food all day long. Many of us love to eat. We plant gardens so we know our food is free of pesticides and other toxic chemicals. Food can be a cause of disease and it can minimize our chances of disease. We try and take care of our insides but did you ever wonder what in the world you apply to your skin on a daily basis? What do these products contain and are they safe? Why are there more endocrine disorders popping up. Could it be that some of things we apply to our skin every single day may be harmful to our insides?

A portion of the skin health section of Cureality will take a look at skincare products and cosmetics. Are the products we apply to our skin gluten-free, paraben-free and free of other harsh chemicals that can cause skin irritations and possible other unwanted diseases. I came across Mirabella cosmetics and I wanted to learn more about this particular product line so I tracked down John Maly, founder and CEO of Mirabella Cosmetics. Mr. Maly was gracious enough to take time out and answer my questions.This is what Mr. Maly has to say about Mirabella:

DD: Tell us about some key features about Mirabella, gluten-free cosmetics. What made you get started in a gluten-free line?

JM: We didn't start as gluten-free. Over time we have continued to make our line more beautiful AND more healthy for women. First we began with a mineral foundation. Then as we introduced new products, we made sure they were as clean and healthy, while still being fashion forward. We saw the benefits to our clients to take out those ingredients that didn't help them look and feel their best such as glutens, parabens and talcs.

DD: Some cosmetic companies carry partially gluten-free cosmetics. Are all of Mirabella products gluten-free, paraben-free and talc-free?

JM: Everything is paraben-free and talc free. And our brand is all gluten-free except our Skin Tint Creme foundation. That is a product that women love and we just cannot make the formula without a wheat protein to perform as well...yet! We will continue to work on it!

DD: Are there other ingredients in cosmetics that women should be cautious of using if they have skin sensitivities or allergies?

JM: Some women are sensitive to fragrance as well.This is another thing that we avoid with our brand. The biggest ingredients that women find that helps with their skin health is mineral products. They are natural and very breathable on a woman's skin.

DD: I think your velvet lip pencils are by far the most extraordinary lip pencil on the market. What are some of your other standout products your customers love?

JM: Pure Press Mineral Foundation is still our #1product. But the fastest growing product is Magic Marker Eyeliner. It is easy to use, doesn't smudge and lasts all day.

DD: Anything new on the horizon for Mirabella that you can share with us?

JM: In August we launch CC crème. This product has all the good for you ingredients to help with Anti-Aging like avocado oil, argan oil and Acai (Assai) berry. Plus it is a mineral formula, gluten-free, and paraben-free. And it has an SPF of 20. One of the biggest issues that women have with aging is lips. That is why we put Litchi Chinesis Fruit Extract in our Colour Vinyl lipstick. Then in your favorite Velvet Lip Pencil, we put Pomegranate Extract, Vitamin C and E in to assist with in Anti-Aging.

DD: Is Mirabella only sold in the US or do you have international distribution as well.

JM: We are sold in Canada, Australia, Finland and Russia.

DD: Where can we purchase your cosmetics?

JM: Our products are available at www.mirabellabeauty.com and at over 1,500 of the finest salons and spas. Go to our salon locator to find a retailer near you.

Top 5 Tips to Get Ready for Tough Mudder


When it comes to mud runs, Tough Mudder is a big deal.  This event covers ten to twelve miles of muddy running interspersed with challenging obstacles.  Using the word “challenging” when describing the obstacles along the course is an understatement.  Obstacles include getting an electrical shock, running through ice-cold water, jumping over fire, climbing over walls, and things you’ve seen when watching American Ninja Warrior.  Plus these obstacles are all done on a rugged, muddy terrain.  So, maybe the word dirty-insane-challenging would be a better fit to describe the Tough Mudder.

Don’t let this description lead you to think that this is an impossible feat.   The Tough Mudder website states that 1.3 million people have completed this event since it’s inauguration.  If Tough Mudder is on your bucket list, know that if they can do it so can you.  Here are 5 tips to get you ready to tackle the Tough Mudder.

1) Train: This tip seems obvious, but it’s not.  Many people are standing at the start line hoping for the best.  This strategy puts you at high risk for injury and not completing the event.  You need to train anywhere from 8 to 12 weeks for the Tough Mudder.  Use this guideline if you have a regular workout routine established.  If you’re new to exercise or have been on a workout hiatus you may need 4 to 6 months to get ready.  Carve out time in your schedule to train 3 to 5 days a week to prepare for this event.  If you need some guidance, join a training program to provide a road map to Tough Mudder success.

2) Run:  Tough Mudder is like a half-marathon on steroids.  Running is critical component when you find that you’re traveling up to a mile between obstacles.  Incorporate running intervals, hills, and fartleks into your training program.  Start your training off with a new pair of running or minimalist shoes so that by the time your Tough Mudder comes around your shoes are ready to get trashed.

3) Simulate Obstacles:  To feel confident at the start line of Tough Mudder, you need to practice skills that can help you with the obstacles.  This will reduce your risk of obtaining any injuries during the event.  Utilizing stairs, fences, playgrounds, rock climbing walls, football fields, lakes, and beaches are great places to start when looking to simulate obstacles.  Check out the Tough Mudder website to see a list obstacles.  Use your imagination to find ways to incorporate obstacle training in your workouts.   

4) Simulate Terrain: Running covered in mud with wet shoes is much different from running on the treadmill.  Running in the grass, on the sand and through the water is much different from running on asphalt.  Get ready to be a little uncomfortable.  Your shoes will begin to slide around on your feet and your clothes will cling to your body.  Get ready to work a little harder.  Your stride will be affected by the changes in terrain.  Practice running on the grass, in the water, and in the sand.  Make sure you get wet and run with soaked shoes and clothes. You’ll realize what shoes and clothes to wear on race day to be the most comfortable and effective.

5) Team: Teamwork is what Tough Mudder is about.  Teamwork is what keeps drawing people back to the Tough Mudder venue.  From the start to the finish, it’s about getting everyone across the finish line.  If you’re struggling to get over a wall, a hand is there to help pull you up.  When fatigue is setting in, another person is there to bring up your spirits.  You’re not alone out there.  At other races you find you’re left in the dust.  At Tough Mudder you are overcoming challenges with your muddy buddies. Get together with friends or a training group to form a team bond that will keep you accountable with your training and support you to the finish line.

Want personalized training???  Schedule a virtual appointment with Amber.

Keeping Up with the Kids



On Saturday my husband and I took our niece Anna out her annual birthday date. That date started with a trip to the Humboldt park playground. As with most kids, Anna ran straight to the spider-web jungle gym which I have to admit it looked pretty cool. Just before she began to climb up, she turned to look at me and said “Auntie Amber, climb up too!”

I was not wearing my playground apparel on Saturday. I had a cute pair of pink loafers on, skinny jeans, tank and a jean jacket. But it did look like fun so I decided to climb. No problems yet. I was good to go climbing around on the ropey, spider web apparatus. But of course, just climbing around was not enough. Anna suggested that we should race. Not just to the top, but to the top of the jungle gym over the side, across the rope bridge and down the slide. This is when my skill was put to the test.

As you could have guessed, Anna smoked me during our race. Not only that, but the jean jacket was off and I was working up a sweat. Was I getting a workout from my 9-year-old niece? I think so. But we both were having so much fun. We continued to climb up and down the fake rock wall, monkey bars and run around the playground. It was a blast.

But as I looked around the playground, I was the only adult climbing around the playground and playing. The other adults were sitting on park benches watching. One parent near by had to decline the request of a child they were with to join them on the playground equipment. I felt really good that I could be there with my niece running around, climbing and swinging.

Keeping up with our kids, grandkids, nieces and nephews is really important as we age. Otherwise we sit on the sidelines. How do you train for the playground? Get in the weight room. Lift heavy things, jump, pull yourself up, move side ways, and challenge your body to do movements beside sitting or standing. If it’s been awhile or you’re just not sure where to start then get a trainer and join some group workouts.

It’s time to get moving. Because it starts out at the playground now but soon it will be mud runs, Frisbee, triathlons and weekend football games. You need to keep up!

4 Tips to Boost Kids Veggie Intake



Vegetables are arguably the most important food group, the key to any healthy diet. They are one of the most nutrient dense food groups and serve the foundation to healthy meals and snacks. A frequent comment from people enjoying the Cureality way of eating is, “I am eating more vegetables than I ever have in my life!”

This is great because plentiful consumption is associated with decreased heart disease, reduced weight, lower blood pressure, glowing skin and decreased risk of some cancers. However, perhaps you’re reading this and feeling great that you eat your veggies but struggle to get your kids to do the same. If you are a parent, who is simply trying to provide nutritious options to your kids, give these tips a try.

1. Add cheese or butter to enhance flavor and increase the absorption of fat soluble vitamins A, D, E and K. Younger kids like to dip foods, so often pairing with a dip, such as hummus, can increase intake.

2. Try the “rule of 15” — putting a food on the table at least 15 times to see if a child will accept it. Don’t give up after a few attempts. This can indeed be frustrating, but have patience and continue to offer a small portion to expose children to veggies without forcing intake. Often parents feel like it’s their job to just make their children eat something. I suspect most children will always select apple pie over an apple. It is important to set the stage, at an early age, with what is offered. In addition, being a good food model is important. You can’t expect your child to try broccoli, if you make negative comments about its taste, texture or smell.

3. Once a food is accepted, parents should use “food bridges,” finding similarly colored or flavored foods to expand the variety of foods a child will eat. If a child likes pumpkin pie, for instance, try mashed sweet potatoes and then mashed carrots. If a child loves corn, try mixing in a few peas or carrots. Even if a child picks them out, the exposure to the new food is what counts.

4. Allow children to engage, as able. When grocery shopping or offering a snack, ask your child which option they would like to eat (e.g. ask which healthy foods they would prefer, blueberries or strawberries, cucumbers or carrots, etc.). When children are included in more food decisions it can decrease resistance. Include children in age appropriate preparation, as well, for example cutting produce, making a vegetable soup, or selecting produce at the grocery store.

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

When is the Best Time of Day to Workout?



There are various theories about the best time of day to workout. At the personal training studio I own, training sessions start as early as 5:45am and the latest sessions start at 8pm. We have people that get up early and get their workout done first thing in the morning. We also have other people that get it done after work to release the stress of the day.

So which group is getting the better workout?

If you’re an early bird or have too many evening commitments then a morning workout is ideal for you. Here are some benefits to training in the morning.

1. Very few things can get in the way when you workout in the morning. (Except for the snooze button.) Later in the day extra phone calls, meetings and tasks can get in the way of getting your workout done.

2. After a strength or interval training session, your metabolism is elevated for hours after your workout. Enjoy these post exercise benefits while you are awake and active instead of when you are at rest.

3. Exercise will boost your energy. Use the momentum from a morning workout to arrive at work energized, present and focused instead of feeling sluggish because you just got out of bed.

4. Exercise on an empty stomach before breakfast is a great way to burn more body fat. Upon waking, the body is in a fasted state. Without ready available glucose in the bloodstream, the body is forced to use fat as an available fuel source for the workout.

However, some of us need our sleep or need to burn off the steam of a hectic workday. Here are some of the benefits of working out in the evening.

1. Getting enough sleep is crucial for health and recovery. If you have to skimp on regular sleep to get up for an early workout, the benefits of the workout start to diminish.

2. Instead of taking that stress of work home, you hit the gym after work. Even after the worst workdays, exercise will boost your mood. Friends and family will be grateful that you get your workouts (aka therapy session) completed.

3. Often people feel stronger when they workout in the evenings. When performing strength tests people tend to lift heavier during evening workouts. This could be due to the fact that they are more awake or that they have food fuel to utilize during their exercise session.

4. Research shows that you can build more muscle with evening workouts because cortisol levels are lowest in the evening. The result of this will be a higher testosterone to cortisol ratio leading to a less catabolic workout.

So which time of day comes out on top for the best workout time? In my opinion, it’s the time that you can do consistently. It’s the time that works best with your natural energy rhythms, work schedule, and family commitments.

Experiment working out at different times to see what works best for you. When you find the right fit, schedule your workouts on your calendar to build the exercise habit.

What is Cureality all about?


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

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

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

Two weeks later:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

That’s why we developed Cureality.


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

How Can I Lose Weight Eating Fat?


For new comers to the Cureality nutrition approach, this question may invariably pop up. For many years, fats and oils, whether classified as good or bad, were demonized because they contain 9 calories per gram. Meaning, they contain more than twice the 4 calories per gram of carbohydrate or protein.

So this familiar logic stated, if you eat less fat, which by default meant more carbohydrate, you would eat fewer calories and lose weight. This misguided logic was based on the assumption that caloric density was the primary reason people either gained or lost weight. The result - obesity rates have climbed and low-fat diet recommendations have proven unsuccessful in thwarting the battle of the bulge.

Why? There are a multitude of reasons, as discussed in the Cureality Diet Track. The following two explanations are important to to avoid needlessly suffering on a low-fat diet.

1) Appetite satiation is drive by insulin response, not calorie density.

Meals that trigger a substantial insulin response trigger increased appetite and fat storage. Carbohydrates, such as whole grain bread, whole wheat waffles, and fruit juice trigger insulin release. Continuous insulin provocation equates to one heck of a time trying to lose weight, as insulin is a fat-storage hormone. In comparison, oils and fats are the least insulin provoking with protein a close second. Consuming adequate fat intake is essential to quench appetite and avoid the insulin surges and crashes that are the result of eating plenty of “healthy whole grains”.

2) Modern wheat increases appetite thereby increasing intake.

Portion control becomes a major challenge because the gliadin protein in modern wheat stimulates appetite to the tune of 400 calories more per day, 365 days per year. That’s a recipe for weight gain, not loss.

The Cureality nutrition approach encourages the generous use of healthy fats and oils to support healthy weight loss and cardiovascular health. These topics are discussed in much more detail in the Cureality Member Forum.

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

Drowning in a Sea of "Endocrine Disrupter Toxins"


In my previous post I spoke about the close connection between gut health and thyroid health. Of course, as someone who lives with Hashimoto’s Thyroiditis I have a keen interest in anything related to the thyroid.

Just today, I came across an article revealing the 100 most-prescribed drugs in America and was stunned at what drug topped the list with more than 23 million prescriptions in 2013 – levothyroxine – the most commonly prescribed drug for treating hypothyroidism (but not necessarily the best in my opinion).

Some observers have warned about a pending epidemic of thyroid disorders. I believe the revelation of a thyroid drug as the most prescribed drug in America suggests that this epidemic is already a “fait accompli” (that’s French for the more colloquial expression “it’s a done deal!”).

I also believe it is due, in part, to the grim observations of experts like Dr. Davis who warn that we are literally “swimming in a sea” of endocrine disruptors, toxins that disrupt our hormonal glands such as the thyroid, adrenals, pancreas, ovaries, and testes. I would go farther to say we are drowning in that sea. Here are just a few examples of how ubiquitous and pervasive these toxins are.

Bisphenol A (BPA) in plastic containers has gotten a lot of bad press recently yet it still considered by the FDA to be safe in certain applications even though it has been shown to disrupt the sex glands and bind to thyroid receptors.

Triclosan is commonly used in hand-sanitizers and similar applications. Triclosan is known to decrease circulating levels of the thyroid hormone thyroxine (T4).

Polybrominated diphenyl ether (PBDE) is common used to make flame retardant clothing. PBDEs have been shown to disrupt both estrogen and thyroid hormones. The effects of PBDE exposure both in utero and shortly after birth can persist into adulthood.

Perfluorooctanoic acid (PFOA) in Teflon coated pots and pans and even microwave popcorn bags has been detected in the blood of more than 98% of the general US population. PFOA has implicated as both a carcinogen as well as an endocrine disruptor associated with thyroid disruption.

With all these “thyro-toxins” floating about it might not seem you like have a fighting chance to achieve thyroid health. But, the first step is to educate yourself - then take action. It is the essential sequence in what I call “Informed, Self-directed, Healthcare” (ISH).

Now that you have a better understanding of how to navigate the “thryo-toxin minefield” there are also positive steps you can take to stack the odds in favor of a healthy thyroid. If you participate in the Cureality program make certain to check out the Thyroid Health Track for a powerful list of proactive steps you can take.

Chris K. (aka HeartHawk)
Cureality Member Advocate


Source: IMS National Prescription Audit, IMS Health.

Italian Food the Cureality Way


100% grain elimination is the theme that drives the Cureality nutrition approach. A common mistake made when eliminating grains is replacing wheat-based foods with gluten-free foods. Most gluten-free foods, as they are currently available in the supermarket, are made with rice starch, tapioca starch, cornstarch, and potato flour. These dried pulverized starches generate more insulin and blood sugar surges than wheat. Gluten-free foods made with these undesirable ingredients are free of the appetite stimulating gliadin protein and wheat germ agglutinin, a lectin protein unique to wheat that causes direct intestinal damage. However, at best they can be referred to as “less bad” or unwelcome additions to the diet. Increasing your intake of these junk carbohydrates is a recipe for weight gain, inflammation and sky high blood sugar.

When removing grains from the diet, the goal is to replace them with truly healthy alternatives that do not contribute to negative health consequences. There are several reasonable substitutions available that allow your favorite sauce and protein combos to shine in tasty pasta-like dishes. People following the Cureality nutrition approach frequently comment that they do not miss “real” pasta because of the available healthy replacements they have learned about and incorporated into their lifestyle.

Our nutritionist, Lisa G., is the champion at helping navigate this lifestyle. In this video, she demonstrates how to prepare spaghetti squash, which can be used to replace wheat-based pasta. In another video zucchini noodles are the star. Homemade meatballs, a zesty tomato sauce and zucchini “pasta” combine for a delicious meal. Who needs grains when you can enjoy meals that support increased energy and less joint pain? 


Traveling, while being wheat-free and dairy-free. Can it be done?

Summer vacation is right around the corner. The temptation to deviate from your normal healthy eating habits may occur… but resist. So how in the world do you continue to eat The Cureality way when you're traveling internationally? Let me tell you how I do it. I would also like to add I am allergic to dairy and I avoid all wheat containing foods. This has been my way of life for years and actually is extremely simple for me to manage while away from my own kitchen.

I decided to pay Italy a visit. I knew I would be overwhelmed with wonderfully fresh smelling bakery, pasta, cheese, gelato, and pizza. All foods I either can't consume due to my dairy allergy or foods I choose to avoid because of their health effects.

I was correct in my food assessment: the grains, bakery, and gelato were in every nook and cranny I encountered. Food choices can be difficult while traveling but I ask numerous questions regarding ingredients and I am certainly not afraid to swap out french fries for grilled vegetables.

Here's what I did the first few days on vacation with my diet routine to minimize dietary booby traps:

Day 1: 

Breakfast, Hmmmm….Italians like their bakery. WOW. Tough when most of the foods being served are grains and eggs with dairy mixed in. I had two hard boiled eggs, tomatoes, sausage and espresso.

Lunch: Arugula lettuce topped with a chicken breast, roasted peppers and tomatoes. A side of salmon and lots and lots of olive oil on top. Very tasty and filling with the olive oil.

Dinner: Hamburger (no bun) with tomato, mayo, lettuce topped with a mountain of sauteed spinach. Water and yes…Italian wine found it's place at the table.

Day 2: 

Breakfast: I devoured two hard boiled eggs with lettuce, cucumbers, shredded carrots, tomato and pineapple slices. Two cafe Americanos and water.

Lunch: Lunch was spectacular: Beef tips, arugula, lettuce, shredded carrots, tomatoes, olive oil and raw salmon. Yes, I mixed it all together and it was fabulous. Plenty of water with the "frizzle."

Dinner: I'll be honest: I had a difficult time with this meal due to our location and choice of foods, but I managed. Another hamburger with no bun, salad with mixed vegetables, and a few potato wedges. Wine and water.

Day 3: 

Breakfast: Hardboiled eggs were getting old. Nonetheless, I had two of them chopped with tomato. Deli meat--Italians love their deli meat as well. Cafe Americano and water.

Lunch: Seafood salad-shrimp, octopus and squid mixed with argulua, fresh tomatoes, cucumbers and olive oil. Water.

Dinner: One hefty salad with shrimp, pear slices, ginger, tomatoes, avocado and olive oil. Wine and water.

Day 4:
Breakfast: Scrabbled eggs/sauage and pineapple slices. Cafe Americano and plenty of water.

Lunch/Dinner: I had to combine these two meals today. I had a delicious meal of curried shrimp (I made sure there was no dairy in the curry sauce) and a very large plate of grilled vegetables. Wine and water.

My diet may not be the most lavish to some but I enjoy my choices. I'm confident I will have no troubles with the remainder of my vacation. I haven't eaten wheat for a number of years so I don't experience the craving for bakery, pasta, or pizza. Dairy, I simply have to avoid, because I truly experience ill-effects from consuming it. My experience with travel and food choices have always worked in my favor. Ask questions and resist putting on that 5-10 pounds of vacation weight.

Ciao-Ciao~

An exercise in optimism

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

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

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

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

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

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

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

Let optimism prevail, even in dire circumstances.

No need to re-invent the wheel

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

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

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

The basic program is quite simple:

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

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

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

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

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

--Normal blood pressure (<130/80)

--An optimistic attitude



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

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

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

Are we a front for drug companies?

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

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

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

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

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

What is "normal"?

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

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

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

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

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

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

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

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

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

The wisdom of the masses

My sister sent me these quotes:



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

Decca Recording Co. rejecting the Beatles, 1962


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

Irving Fisher, Professor of Economics, Yale University, 1929


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

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


"Everything that can be invented has been invented."

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



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

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

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

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

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

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

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

How important is l-arginine?

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

Just how necessary is it?

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

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

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

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

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

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

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

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

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

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

Track Your Plaque and non-commercialism

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

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

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

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

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

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

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

The nattokinase scam

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

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

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

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

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

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

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

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

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

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

Blood pressure with exercise

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

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

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

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

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

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

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

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

Vitamin D2 vs. vitamin D3

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

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

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

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

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

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

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

The Fanatic Cook: A fabulous Blog about food and nutrition

I came across this Blog authored by a nutritionist when it was highlighted on Blogger as an interesting site:

The Fanatic Cook at http://fanaticcook.blogspot.com/

I was thoroughly impressed with the insightful and entertaining commentary. I'd highly recommend this site to you for reading on nutrition. In particular, her coenzyme Q10 column was exceptionally well written and clear.(http://fanaticcook.blogspot.com/2005/02/statins-and-not-well-publicized-side.html)

Also read her column, Super NonFoods at http://fanaticcook.blogspot.com/2005/07/super-nonfoods.html.

There's also oodles of recipes, all for the taking.
Loading