Time to stop bashing primary care docs, doc. Online sites are full of B.S.
Show me the evidence that testing with CAC improves outcomes (Sure it predicts risks, not the same as actually preventing disease, especially in those at lower risk of CAD.)

Hi Jan,
Since you accept plaque showing up as being a cardio-vascular risk factor then if Doc reports he has treated some patients whose measurement of plaque has diminished using his protocol would you also accept the proposition that those patients have reduced one of their cardio-vascular risk factors?
If Doc has patient records showing diminished plaque and therefore one less risk might that not be considered preventative due to his patient following his protocol ?
As for those individuals with hypothetically lower risk of CAD (ex: the 63 year old low cholesterol example Doc gave) are they not going to undergo changes as they age ?  
A primary care physician is valuable and yet older westerners are increasingly engaging specialists for good reasons.  Doc has a self-professed specialty tracking plaque  that he wants to impart; sure, his blogging tone may not always be mellow.

Dear Might,
Your comment is akin to those who report the association of statin use with lowered risk of MI. A correlation does not prove causation until valid  scientific research confirms.
How do we know treating CAC lowers risk of MI until a study proves this? Docs have been wild to accept the association of statin use lowering cholesterol components as the mechanism of effectiveness for prevention of MI, ignoring studies in which dietary measures that did the same were ineffective. Just pointing out the need for caution in going so far as to treat a test without evidence that the intervention is working on the test findings (rather than something else).
Perhaps there are studies that are underway or perhaps the evidence, er association, is just considered too strong, (Bradford-Hill criteria) to ethically justify a trial. My concern is for individuals who score in the lower range of abnormal. At what cost do we label and treat those?

just remembret the lyon heart study, by  Renaud & de Lorgeril demonstrating the efficacy  of mediterranean diet in lowering the risk of recurrent MI in French patients. although cholesterol levels were higher with diet than with statins. Dietary measures seem there to demonstrate  efficacy

Not only is it NOT time to stop bashing primary care docs, but it's time to begin accepting that their role is outdated. In fact, an average nurse practitioner or physician's assistant can do an equal, if not better, job than most primary care physicians. How health care is dispensed is going to undergo dramatic transformation, just as the business of travel agents and real estate have been transformed by rapid information exchange.

In our program, we see virtually NO heart attacks. Not a randomized clinical trial, but watching heart attacks drop from a weekly event to almost never is good enough for me to not accept the status quo and continue to work along a path that, from every indication, works exceptionally well.

If high crab diets are considered unhealthy then why do some cultures like the rural Chinese live long healthy lives on nearly 100% crabs,mostly rice and vegetables?

Isn't the best thing for calcium on wrong places vitamin K2 ?
In my country doctors even prescribe it for calcification issues.
Dose is around 100mcg/day for 6-12 mo.

Read Gary Taubes' "Good Calories, Bad Calories" to find several instances of other cultures eating the typicial high carb food yet seemingly stay within the healthy range.

Trust my care (or a family members care) to a NP or PA who does not have the capability of complex medical decision making - no thanks. NP's actually are complimentary to physicians with different skill sets. So glad to know your level of knowledge about them. PA's are nothing but junior medical students with enormous salaries. Working 9 to 5 - oh, yeah!

I'm certain your referral network of primary care docs would be interested in your belief system.

Dr. Davis:
I don't know if you've seen this new video yet, but I think you'll want to.
http://www.youtube.com/watch?v=3vr-c8GeT34&feature=player_embedded
If you do watch it, I have a question. This doctor thinks sugar (by itself) plays a huge role in causing plaque to rupture and cause heart attacks, etc. If after watching the video you agree with him, would you please tell me how (biologically) it does this?
Thanks!

Joe

Hi Jan,
True correlation does not necessarily equate to causation. As for statins, it seems that statins act to lessen inflammatory processes; and it is this dynamic, rather than numerically lowering cholesterol, that is a crucial way that statins correlate with reduced risk. Which, to me,  seems to further support Doc's contention here in this posting that  low cholesterol levels doesn't  tell one if they have abnormal plaque (ex: patient above with "exceedingly high" score) .

I will accept Doc's data, as given ,that very high plaque is a 15-20% risk factor since many other published sources cite even carotid plaque as a risk factor . As far as who to test for what, and when, I am not qualified to make recommendations. I do know that time can remodel some cellular dynamics and the aging cardio-vascular system is vulnerable to alterations.  Doc's got my attention because no one at all in my paternal male ancestral line lived past their late 50's due to heart problems and I am 60; while my 61 year old brother already was hospitalized from transient ischemic attack  .

Mediterranean diet's efficacy for heart health is probably due to the % of poly-amines per calorie consumed and of course isn't in keeping with Doc Davis' detestation of modern wheat (among other protocols). As we age our poly-amine levels decrease and Mediterranean diet supplies lots of poly-amines.

Poly-amines ( molecules inelegantly named spermine, spermadine and putrescine) are all anti-inflammatory, especially spermine; in our body we synthesize poly-amines from arginine. Mediterranean diet's high poly-amine levels spares the amount of arginine our body uses in synthesizing poly-amines; and thus we can more readily produce the vaso-dilator signalling molecule NO (nitric oxide) from body's arginine. NO is valuable to keep oxygenated blood reaching the heart muscle cells; NO keeps vessels from constricting dangerously.

Poly-amines lower inflammation and in the context of age associated problems the less low grade inflammation the better.  Inflammation leads to defectively functioning cells and molecular processes; with time the  over stimulation of immunological responses (both innate and adaptive immunity) leaves the body burdened with unknown clones of T cells (both memory and effector types). Eventually the build up of  T cell clones limits new variants and what occurs is more macrophages circulating; once an over abundant macrophage stage reins the body is essentially always in low grade inflammation , and prone to various age associated pathology (including cardio-vascular).

@jan....
A vast majority of primary care doctors are extremely limited in their abilities to treat/advise patients for CVD risks. They don't understand nutrition, effects of supplements upon serum biomarkers, nor effective diagnostic testing for heart disease.
CAC is a much better biomarker for who is at greater risk of CVD than serum markers:
http://www.eurekalert.org/pub_releases/2011-08/jhmi-sfc081611.php

I seriously doubt even 1:100 primary care docs see studies like the aforementioned one.
And I seriously doubt the one doc would understand it....
Dr. John

An interpretation of the same study for a broader audience just appeared at http://www.webmd.com/heart-disease/news/20110818/is-calcium-test-the-best-way-to-check-for-heart-risk.

I'd accept a bashing of physicians in general.   But to single out primary care physicians - overwhelmed with paperwork and patients with multiple problems, and vastly underpaid and underappreciated, and continually put down by "Partialists" - Really ? Cardiologists are superior? Really ?

Forget my support and admiration henceforth.

CRP (C-reactive protein), an inflammation marker surrogate, does not directly correlate with whether there is coronary artery calcium (CAC), or the degree of CAC severity. CRP is also subject to variables of race and age, so it loses some potential as a predictive marker. Yet looking at CAC along with CRP is considered useful for complex insight into a patients pathology.

Analysis of the Multi-Ethnic Study  of Atherosclerosis (MESA) involving 6,800 men & women seems to indicate that inflammatory markers (ex: CRP) relate to the physiology of pathological processes other than CAC laid down; possibly because plaque undergoes morphological changes over time. The CRP level is proposed, by some, to relate more to the stability of plaque from rupturing and the incidence of blood clotting in a thrombosis.

The inflammatory marker of Interleukin-6 (IL-6) anti-bodies seems to be better than CRP and fibrinogen for correlating an individual's trend toward CAC. Thus the cytokine IL-6 is a better indicator of sub-clinical atherosclerosis; Doc likes to cut to the chase, eyeball the plaque and track it with current technology ( that is not available worldwide).

Is it typical for someone with such low ldl and high hdl to have such a high CAC score? Had he previously had a higher LDL and then been placed on a statin?

The energy expenditure of the rural Chinese is very high.  They don't drive, they walk, or ride bicycles.  They don't sit in office from 9am to 5pm, they work hard in the rice field from 5am to 9pm.  They can eat anything without gaining weight.
For the urban Chinese, it is a different story.  They have the same life sytle as ours, and they are getting heavier every year.  More and more people become diabetic, even young kids.

K2 is indeed a fascinating nutrient. There are extensive discussions about it on the Track Your Plaque website.

Thanks, Joe. I watched the entire thing and was impressed with Dr. Diamond's grasp of the issues.

I'm going to post this on the main page because I think his overview was extremely effective.

Sorry you see it that way. This was a comment directed at the system of primary care in general.

I reread the post and I didn't see the name "Dr. Thomas White" mentioned anywhere. If you choose to feel slighted in some way, that's your choice.

Jan, I would certainly trust my care (or a family members care) to a NP or PA who looks outside just the pharma driven medical journals which primarily support a diagnose & drug philosophy.  And I'll take an NP or PA who actually uses some common sence rather than being a puppet given to the pushy drug rep.

I live in a family of MD's, and they have made it clear as to their terribly limited training and knowledge they gain from med school on the level of building and supporting the body from within.  Example, I have an Aunt that is currently suffering from stage 4 cancer. Due to the chemo treatment that she's instructed to not spend time in the Sun. Her Dr. has not even checked her for vitamin D levels. This is not the exception, but the norm when it comes to common sence treatment, pathetic.

Okay, Dr. Davis.  I'll be looking for it. When you do, please take a moment and explain how you think that sugar might be responsible for plaque rupture.
Thanks again!

Joe

Sugar is just one part of the equation.  As Dr. Davis has covered on this website, small LDL is also a villian and needs to be minimized as much as possible.

Hi Joe,
Thanx for the video ... maybe the following answers you.

Regarding sugar: see 59:33 into presentation, where diagram shows "sugar" blurb  - lecturer is using compact word sugar to represent how glucose's glycation end products alter the artery and make the artery vulnerable. It is not a molecule of sugar acting all by itself; lecturer explains slide when talks of how glycation is a problem (another of  Doc Davis'  peeves).

Follow up at 1:01 into presentation: see diagram's top left  where the various adverse influences on artery  are specified as "modified lipoprotein", "hemodynamic insult" (includes, but is not limited to blood sugar's  glycation end products affect on artery), "reactive oxygen species" (ROS) and "infectious agents".

Thank you for all your hard work and dedication to your web site and education.

I apologize for cluttering up the discussion with a personal statement.

TRW

Thank you, Might. I guess I'm going to have to do some research on glycation before I can fully understand what you're saying above.

I didn't even notice the PowerPoint Presentation that was included with Dr. Diamond's video presentation.  Sigh.

Thanks again!

Joe

AMEN! Right on target.

I don't know if you're aware of the differences between calculated test that most doctors use and NMR that Dr. Davis uses. When your diet consists of mostly carbohydrates leading to chronic high blood sugar level, it tends to raise your SMALL DENSE LDL level but calculated cannot measure it accurately. It often greatly underestimate it.  Dr. Davis has covered it many times. Dig through his website for it.

Optimal vitamin D level helps lower IL-6. It can be a big problem with black people as they tend to have the lowest vitamin D level of any races. Dr. Cannell mentioned that in his new book called Athlete's Edge Faster Quicker Stronger with vitamin D with the hope that the word about vitamin D would spread out faster if more and more professional athletes started using it to gain some advantage over opponents much like what East Germany and formerly USSR used to do in 1960 and 1970s at the Olympic games and other world events.

Yes Joe i have seen the video you linked. That's right i also think the same.

[...] http://blog.trackyourplaque.com/2011/08/how-far-wrong-can-cholesterol-be.html [...]

Dr. Eselstyn claims that animal protein damages the endothelium.  Dr. Weil says that a high fat meal lowers artery function.   But I had a heart attack and have a stent and have been following your diet for about a year.  If I start eating significant quantities of carbs, I used to get chest pains.  Since then I have went from 305 to 235 and want to get to 175.  I got the stent three years ago.

Is there any truth to either Weil's or Esselstyn's claims?

Now I take no medication except a daily 325mg aspirin and a bunch of supplements, including hawthorne and of course, fish oil.  I control my blood pressure with medical MJ and it works great to lower my blood pressure.

Do I need to worry about saturated fat and high blood pressure?  I used to be on Plavix, blood pressure medication, and statins.  I tried three different statins and they all caused me leg pains.  In fact I seem to have chronic but intermittent leg pain since the statins.

I don't think so.

They understand this disease incompletely. I can't blame an ENT surgeon for not fully understanding a disease he has never treated.

Esselstyn says this based on the fact that animal protein has higher levels of methionine.  But this study,  Toxicity of Methionine in Humans, by Peter J. Garlick, refutes this claim:
----------------------------------------------------------------------------------------------------------
Conclusions. Although methionine was labeled as being the most toxic amino acid in relation to growth in animals (1), the evidence in humans does not point to serious toxicity, except at very high levels of intake. Despite the function of methionine as a precursor of homocysteine, and the role of homocysteine in vascular damage and cardiovascular disease, there is no evidence that dietary intake of methionine within reasonable limits will cause cardiovascular damage. A single dose of 100 mg/kg body weight has been shown to be safe, but this dose is about 7 times the daily requirement for sulfur amino acids, and repeated consumption for 1 wk was shown to result in increased homocysteine levels (37,42). Daily doses of 250 mg (i.e., 4 mg/kg per day) are only 25% of the daily requirement and have been shown to be safe. Overall, the literature suggests that the single dose which is typically given in the methionine loading test (100mg/kg/d) does not cause any serious complications, except in the extreme case when a 10-fold excess of methionine appears to have been given, and in patients who have schizophrenia or inborn errors of sulfur amino acid metabolism, such as hypermethioninemia.
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Wow, these numbers are wild.  It'd be great to see where they are in six months, assuming a change in diet.

Did you see the WSJ article today?

"Giving Up Gluten to Lose Weight? Not So Fast"

The last sentence is priceless:

“Also, for dieters, going back to gluten after avoiding it can lead to stomach cramps, bloating, diarrhea and other symptoms, at least temporarily.”

If an egg had that effect on you, they'd do a recall.

http://online.wsj.com/article/SB10001424052748703846604575447413874799110.html

great post! would be cool if you could pipe the links to your posts into your twitter account as well (there are online services), so that it can easier be forwarded by followers of you.

The WSJ should give up the diet reporting and stick to what they (supposedly) know - financial news.  

There's giving up gluten and then there's giving up gluten but maintaining a high starch alternative grain  GF diet.   Of course replacing one starch with another won't result in weight loss if one is overweight.  It's even possible to gain weight on such a GF diet.    

Are people really silly enough to take diet advice from "creaky bones" Gwenyth Paltrow?

I watched the WSJ video.  It wasn't bad.  It was mainly ridiculing "gluten-free" imitation products.  The lady recommended eating natural foods that are gluten free.

I am completely baffled by some of the lipid panel numbers I see. She had 7 stents put in but there are many out there seemingly with no problems, with high numbers like that. Meanwhile I have eaten right and exercised seriously for the last 30 years, have never been overweight, always been in shape, had good lipid panel results but suffered a heart attack last year anyway. I just had bloodwork shortly before the attack and once again (as had been the case for years) I was told I was in perfect health. My triglycerides were good as was my CRP and my complete lipid panel. Actually any test I took ever, always produced good results. Even after my heart attack they couldn't get my heart rate up high enough in my stress test unless I ran longer and at the steepest incline. I'm still in great shape.....but I had a heart attack.  I never had a belly or bulge and still don't. 5'10" 169 lbs.  Go  figure.

My results after eight months: http://paleohacks.com/questions/9124/first-post-paleo-blood-work-results

After 8 months and -50lbs  I can safely say that the std American flour/sugar diet is complete bullshit.

I bet that poor woman has forgotten what it's like to feel good. She'll surely feel better with an improved diet. I wish her the best.

Re: WSJ article, I got a stomach ache that lasted two days the last time I ate a chocolate chip cookie made of wheat flour. That's some kind of "temporarily"!

Lipids after two years of high-fat, moderate-protein, very low-carb eating:
Total Cholesterol: 220, Triglycerides: 69,
HDL: 98,
LDL: 108.
I think I'll carry on that way.

After 7 stents and she still refuses to change her eating habits? I think that got my attention more than anything else in your report of this patient. I guess I am baffled on why people do not take charge of their health especially when expert advice is offered on a "silver platter".

Tommy,

Sorry to hear that.  I guess it goes to show nothing is a guarantee.  No matter what we do, the chance is always there.

Tommy, your case only goes to prove that cholesterol doesn't cause heart attacks.  
There is something else causing CVD.
Inflammation from Poly fat and grains seem the most plausible to me.

"Tommy, your case only goes to prove that cholesterol doesn't cause heart attacks.
There is something else causing CVD.
Inflammation from Poly fat and grains seem the most plausible to me."

I had my CRP checked and it was below 4 just before my HA. After taking care of myself for the last 30 years and always doing well in every aspect I really felt backed against the wall afterward. My numbers are very low now (pretty close to 60's across the board) but all of this is more complexed than just numbers.

Hi, Tuck--

That's great!

It reminds me of the USDA's request for public commentary on the food pyramid revision, prefaced by "We don't understand why, after we tell people to increase consumption of whole grains, they keep on gaining weight and becoming diabetic."

42--

Well said!

"eating right" and "taking care of myself" only tells me you were healthy by your standards or by the governments standards.  Most of the people I hear say "I eat healthy" means they eat lower fat but mostly trans fat when they do.

There has to be something causing your problem.  I would suspect what ever makes you extra hungry would be a possible cause.  Maybe it's too low cholesterol.  Agreed; very complicated.  Maybe it's just genetics.  Maybe there's something in the past 30 years that was not right but what?  A lot of maybes there.  Have you had a calcium score?

Tommy-

Do you have Lipoprotein(a)? You sound to me like a textbook Lp(a) case. Better get it checked and address it.

Trans fat? nooooooooo...lol.
No refined crap, no processed anything. Damn...I don't even eat ketchup(sugar)!! I consider AMA snobish about food intake. I had a conversation with a "heart healthy" dietitian from the hospital after my heart attack and she wanted me to have less than 50 g of fat per day (impossible). I told her I go by percentages of total calories consumed and explained it to her. She had no clue and didn't understand it in simplest terms. "Ok what if I wanted to consume more fat and just added non fat calories to my total intake....that would lower my percentage right? Uhhh....what? lol

@ David
I am thinking I may be LP(a) and I have been taking extra Vitamin D as well as a high dose of fish oil. Next cardiologist visit I will discuss Niacin as well as pattern B possibilities.

Tommy, what about stress and sleep?  Stress is a killer...

David, that is my suspicion. It's complicated because a lot of things happened at once at that time. Through July and August I was under stress from problems at work combined with personal family issues. In September i went on a cruise an ate up a storm as well as drank more than normal gaining 14 lbs. (my prior good blood labs gave me confidence ..ha ha ha.) Then I came home, worked out hard and lost all the weight in a week. Then my grand daughter got sick and I was very stressed out about it while my work issues were still mounting. In October I had an argument in the morning before leaving work (I had been switched to an overnight shift)and was stewing when I went to sleep. I woke up a few hours later having a heart attack. The rest is history.

Hi Dr. Davis.

These numbers are awful, but I think a point must be stressed regarding natural vs. industrial carbohydrate-rich foods. These numbers are not typical for normoglycemic folks who eat natural carbohydrate-rich foods.

Avoiding natural carbohydrate-rich foods in the absence of compromised glucose metabolism is unnecessary. Those foods do not “tire” the pancreas significantly more than protein-rich foods do.

Protein elicits an insulin response that is comparable to that of natural carbohydrate-rich foods, on a gram-adjusted basis (but significantly lower than that of refined carbohydrate-rich foods, like doughnuts and bagels).

http://healthcorrelator.blogspot.com/2010/04/insulin-responses-to-foods-rich-in.html

And nobody can live without protein. It is an essential nutrient. Usually protein does not lead to a measurable glucose response because glucagon is secreted together with insulin in response to ingestion of protein, preventing hypoglycemia.

I definitely get the whole low-carb thing, but I think you always use the extreme cases to make your point.  Even dietitians would not recommend that much starch.  In fact, many of the "top" dietitians limit starch quite drastically in their meal plans.  They are not as ignorant as you think.  However, because they have clinical experience (which I know you have too), they know that draconian, restrictive diets do not work.  Therefore, they work starches in the diet a bit, so people don't feel "deprived."  Still they choose "better" starch options like beans (OMG LECTINS!!!).

I do not believe for one second that the majority of people claiming to be eating according to the USDA guidelines are doing so within the correct caloric guidelines.  They are eating far too much and making terrible choices for starches to boot.  Portion control is tough obviously.  I think people who cannot master it may find low-carb useful because they eliminate starches/sugars outright and don't have to worry about serving sizes.  Plus, ketosis gives them a metabolic advantage allowing them to consume more calories and still lose weight.  It definitely is not an end all solution though.

Also, they don't bad mouth carbs in the press because people being people would start avoiding things like vegetables.

There is nothing inherently wrong with carbs.  We just have to eat them within reason.  Just like calcium for example.  Too much calcium is linked to heart attacks and prostate cancer.  But in moderate amounts, it is helpful.

Okay, I went my two weeks without wheat carbs. My results are purely non-scientific, but here goes. I lost 4 pounds, down to 156. I wasn't hungry at all. I didn't have any bread cravings like I thought I would. But I did have a hard time sleeping, for whatever reason.

After my two weeks I had angel hair pasta and a hamburger on a wheat roll. My stomach was slightly upset for a couple of days once I started eating wheat carbs again - probably just a coincidence though.

So I proved I could do it and I proved to myself that I wouldn't starve or go crazy without my bread. So, I think I'll be more careful about the wheat I put into my system. On the other hand, it looks like May needs to correct things and do it sooner than later.

Just goes to show ya. I'd *love* to weigh what Mary weighs - but it seems there is more involved that that. I just had an NMR test recently myself. Total LDL particle count was 2018. My doctor is freaked and says it's a horrible number. Every website I consult says it's a horrible number -though my small LDL is 212, only 10.6% of the total. But all the websites I consult say the total number is far more a risk factor than paticle size.

But what were the HDL and triglycerides of the people with high particle counts. High like Mary's? My own HDL (measured just last week) is 66 and my triglycerides 49.

But how do you get the particle number down? I've already been low-carb for four years, gluten-free for 18 months, avoid all sugars, take D3, magenesium, K2, 1500 mg niacin.

Might it go down if I can get my thyroid normalized? That's one issue I'm still trying to work through with my doctor. Sheesh, the older I get the harder it gets. So many things to consider I sometimes wonder how anyone manages to stay alive for a few weeks - let alone many years for most of us.

So for people with existing coronary artery issues and Small particle LDL is it true that increasing fat (especially saturated fat) only makes this worse? If you go low carb you need to also be low fat?
I read that "low fat" is bad for Pattern A but beneficial to pattern B.

Dr. Davis?

I am taking a yield of 1,000 mg of EPA from fish oil and my numbers still look bleak, so thanks for the encouragement to bump things up. I am also completely off sugar and wheat (not easy) for a year and still have these numbers.

Total cholesterol - 272
LDL-177
HDL -34
triglycerides- 300
VLDL- 60

Hi Dr. Davis,

I follow much of your advice.  On my NMR, I had an LDL of 50 and particle number of "less than 300".  Also, HDL was 82.  My LDL particle size was 21.1.  Large VLDL was 2.6 nmol/L (and the share of large VLDL was above the reference range), but I did the test postprandially.  My small LDL was "less than 90".  Interestingly, last year, my LDL particle number was 530 and small LDL was 120, but LDL size was larger at 22.3.  Is there anything to make of this?

I'd like to see a discussion of what you'd do for a patient who didn't eat wheat, was on a LC diet, ate a lot of fish, had high vitamin D levels, had normal thyroid tests and still had high LDL levels.

My father takes Lipitor.  He's also suffering from occasional short term memory loss (he's visiting a neurologist often to figure out why).  I'm damn sure it's because of the statins.  I've been on the "no wheat" & high good fat diet for a while and am in great shape.  I Can't get my father to ditch the drug and adopt my diet though (even if he does, I'm not sure if the memory issue will resolve itself).  Going against conventional wisdom is a constant uphill battle.

"...then the "need" and apparent benefits of Lipitor largely dissolve."

I was unaware that there was any research supporting statin use at all except maybe in one group (men under 65 with pre-existing conditions) which is still questionable. Could you further explain what this 'need' might actually be in abscence of such dietary intervention?

8 months ago my 91 year old mother was out of her mind in the hospital.  She had no idea where she was and was too weak to walk to the bathroom.  She was falling frequently.

Now that she's off lipitor she has a new lease on life.  She works in her flower garden and bathes herself.  

I'm now her caregiver and ensure that she takes 5 to 10 thousand iu of D3, Iodoral, 200 mg Ubiquinol, and a couple of grams of fishoil, but the biggest move, in my opinion, was taking her off Lipitor.

We have no family history of heart disease.

This advice works!

I know you intended "Life without Lipitor" to be for all your readers, Dr. Davis, but you might as well have written it for me (because of my earlier importunate and selfish request). Thank you.

Some things I still do not get, noted as they appear in your post:
1) Eliminate fruit?! Fruit, rich with nutrients, now is bad because fruit also comes packed with sugar (its complex carbs)? I respect the notion to eliminate carbs, especially wheat and other grains, but this notion seems rather... narrow. HELP!
2) "Conventional LDL of the sort obtained in your doctor's office": What test is this? Do you mean the phlebotomist (in the doctor's office) who sends the blood sample to Quest or LabCorp to obtain the calculated score?

Thank you for these, and all future clarifications. And for this site, of course.

Best wishes,

while you seem to recommend nuts be a part of the diet, what do you tell your patients who are allergic to nuts?  Peanuts ok?

Agree with much of the article but not sure about this:

"increasing healthy fat intake, such as the fats in lots of raw nuts, olive oil, and flaxseed oil reduce LDL."

All of these will contain unnaturally* large amounts of omega 6 (at least 9g/100g of almonds or olive oil, for example, or 12g/100 for flax oil). This will unquestionably drive up oxidised (atherogenic) LDL cholesterol. (See WholeHealthSource for details). Is there any reason at all to think that natural saturated fat isn't a far safer option (that will drive up HDL)? I can understand why one would worry at saturated fat increasing "cholesterol" back in the day before we could analyse lipid fractions, but what reason do we have to think it would have negative effects now?

Very good doc. I hope you come to the point that you will no longer subscribe statins at all.

DM Wrote:

All of these will contain unnaturally* large amounts of omega 6 (at least 9g/100g of almonds or olive oil, for example, or 12g/100 for flax oil). This will unquestionably drive up oxidised (atherogenic) LDL cholesterol. (See WholeHealthSource for details). Is there any reason at all to think that natural saturated fat isn't a far safer option (that will drive up HDL)? I can understand why one would worry at saturated fat increasing "cholesterol" back in the day before we could analyse lipid fractions, but what reason do we have to think it would have negative effects now?

----------------

Hi DM, I was the first anonymous up top.  I follow Dr. Davis' advice and eat lots of omega-6 rich nuts and, as you can see from the numbers above, my LDL and HDL look pretty good.  Also, my crp was .18 mg/L which is quite low and lp(a) was 2, so I doubt I have much inflammation/oxidation etc.

What are lipitors? Is there any substitute for lipitors?

What are lipitors? Is there any substitute for lipitors?

I've been taking off the shelf Red Yeast Rice instead of lipitor. Works great! My LDL cholesterol went down down down.

-- Boris

@ Anonymous-with-pretty-good-cholesterol.

That's good for you, but the studies show that across large groups, omega-6 will raise the amount of oxidised LDL, which is probably a *bad* thing for cardiovascular health. Stephan discusses this here: http://wholehealthsource.blogspot.com/2009/07/diet-heart-hypothesis-oxidized-ldl-part.html and here http://wholehealthsource.blogspot.com/2009/07/animal-models-of-atherosclerosis-ldl.html

Does anyone have a sample diet that they follow that is recommended from this website. I have recently eliminated all sugars from my diet and eat 7 small meals a day, but would like some help on seeing a recommended diet that is wheat free, also interested in what supplements people are taking. Thank you!

Heart  disease is one of the most  dangerous disease which takes thousands of life every years all over the world. If we know its symptoms and Treatment for heart disease. We can prevent is to large extent.

Speaking as someone with celiac, I wouldn't go NEAR einkorn and I don't understand why it continues to hold your interest. On the rare occasion that I really need a grain product of some kind, rice and corn are entirely adequate.

Have you heard of that study?  http://informahealthcare.com/doi/abs/10.1080/00365520600699983

The problem is that even if you mitigated the inflammatory effects of the gluten, you're still eating a (relatively) high glycemic, pre-masticated food. The pulverization and reconstitution of food, especially grain, is going to make the blood glucose response far greater. That then could be addressed, I suppose, with physical activity timed to coincide with the spike. At that point, however, it seems like you're going through great pains to eat something of no great nutritional value just for nostalgia's sake.

However, if we're talking about getting one's intractable relatives to save their lives through small steps, then this could be a legitimate option.

I have never been tested for celiac but can tell you within an hour if a food had gluten in it. Headache and abdominal pains as digestion starts followed by days near the bathroom. I have had the jovail pasta twice since your post about it. It was very nerve wracking to eat but ended up being very pleasant. The second time I checked my blood sugar before and every 15 min after eating.  89, 96, 109, 116,132, 116, 98, 92

I'm happy I read about it on your blog. On a side note now if I'm exposed to gluten by accident I take a product called gultenease and it seems to shorten the severity and duration.

Or declare grains not suitable for human consumption. After all, without fortification, it's not suitable for human consumption.

I go through periods of eating wheat and not eating it. My habits are very hard to break and I find bread products "comforting".

I have to say that when I eat a lot of breads, chips, etc., I find myself with a lot of belching, listlessness and bloating. I don't think I'm completely intolerant, just a little.

Oddly though, I can't eat oats. If I do, I get major cramping and all the fun that comes with that type of GI situation. My parents used to tell me I had a "nervous stomach". It turned out I ate too many Cheerios and granola cereal.

Can anyone tell me what's so bad about oats? Do they have similar affects as wheat?

I get no symptoms subsequent to eating bread or other wheat products.  But I do develop canker sores soon after a high-wheat meal.  That alone is enough motivation to avoid bread, pasta, etc.

kevin

I’m wondering if you’ve ever tried the Zone bread products and then measured your blood sugar with a glucose monitor. They claim that their products won’t raise your blood sugar more than a strawberry would. I couldn’t figure out if they used anything like Einkorn, but they say there’s a lot more protein in their products than normal bread products.

I am the first time on this site and am really enthusiastic about and so many good articles. I think it’s just very good.
Always yours

Your interest in einkorn as a via ingredient for an birthday cake is interesting.  I'm thinking that whatever is used to sweeten the birthday cake will have a bigger effect on glycemic response than the wheat.  No?

At any rate, the value of einkorn comes not only in the form of a lower glycemic impact(compared with normal wheat) but also it's nutritional qualities.

I was able to buy Jovial Einkorn Fusilli at WF.
My FBG this morning was 82.
I tested myself right before I ate dinner at 6PM..
My BG - non fasting - was 90.
The wife made pasta, with sweet sausage(2) and broccoli rabe.
I had three ounces of the pasta.
I also had a small piece - 2"x2" of home made corn bread afterwards.
My 1 hr BG was 142.
That's the highest BG reading I've ever had.
Back to no pasta and primal eating tomorrow.
For me that's a scary number.
Even if it's an abberation.

Dear Dr. Davis, I just bought your book and my spouse and I are trying gluten free to help with type 2 diabetes and BP-----we already had slashed carbs and sugar, and spouse has normal glucose if he stays on this strict lo carb diet, but we want to lose weight, lower my BP and reverse diabetes. IT is 6 weeks now and we are getting out of the detox.  We are noticing we are leaning toward low sugar foods to fell that 400  calorie gap, but we are wanting to try this way as long as we can, your book is great.  I also saw a new tv show on that frozen mummy from the alps, they did a second thing of exams on it and found einkorn wheat product in his stomach AND also calcification of the arteries, he is said to have been in his forties, this was 5 thousand years ago!  Looks like einkorn was affecting humankind even then???Thanks for your book.
Bill and Mary Wier in Chattanooga TN,

Hi, Bill and Mary--

Yes, I fear that, while einkorn is better, it may not be great. We don't want to repeat the flawed logic of the wheat lobby: replace something bad with something less bad, and the less bad thing must be good.

We don't have wheat every day, in fact, most days we do not.  Having the Jovial Einkorn makes things bearable for those days when we do have wheat.  We have their pasta about once per month.  I use the flour for baking cookies or other treats where I can't use almond meal or coconut flour.  It's a nice trade-off.  I'm never going to be as die-hard as some of you who never eat anything that isn't raw, or isn't whole, but it certainly makes making the changes better.  We really should try to be more loving about other's food choices, even if you don't find them to be the best for you.