I've been using the NatureMade fish oil because it's frequently 2-for-1 at Rite Aid. My VAP cholesterol test was excellent while on the product, but I suppose that doesn't ensure that the product is doing anything. Thanks for the info.

Fresh fish does not smell like fish. Only when the fish tissue starts to decompose does it start to smell like "fish".

First of all, Doc, thanks for taking the time to do this blog. It's great to have such an expert "in the trenches" practitioner helping ordinary people like me make much better decisions on keeping my heart going!
Specifically on this post, when you write these companies, I'd suggest writing a letter and sending it by post right to the CEO.
I've found that usually gets a better, more personalized response to my concerns.

What is a person with very low Vitamin D levels, but prone to kidney stones, to do?

I wonder if that letter was generated by a worker at an overseas customer service center who, as you suggested, just opened a file and inserted text.  How many hits does your blog get?

I've wondered if the USP seal on vitamins actually means anything -- apparently, it doesn't count for much.

I have had a company actually admit to a problem with their supplements once (Jarrow), where their Ubiquinol gelcaps were leaking (found goo at the bottom of my bottle). They admitted the capsules were faulty and they planned to change the manufacturer of their gels, and even sent me a replacement bottle. So... some companies will actually admit to problems and take care of them, but that is still probably the minority.

Hi Dr. Davis,

Have your patients had any experience with CostCo's 2000 IU vitamin D3 gelcaps?

In Italy, Vit D3 drugs are available over the counter at pharmacy. They are ultra cheap. I go for an injection every 2 months as 5 vial cost less than five €.
What prevent US consumers from going to a pharmacy and buy registered drugs instead of supplements?
Quality control for drug companies is surely a bit harsher than for supplement companies.
Then, regulation can be different.

good to know, I used to buy Nature Made all the time... now I am wondering if the "gummy bear" vitamins and vitamin D I give my kids actually are vitamins.  What if they are just candy.  How can you tell for sure?

Impudent--

Great idea.

Perhaps I will send future emails and say that there are thousands of people reading this blog who will await their response!

Gary--

Because we have only one Costco (i.e., only one store), we have had too few people buying this product to say with any confidence.

It never hurts to have your blood level checked.

You might consider me 'weird' but  I actually like to chew my fish oil capsules - I like the taste of the oil and the capsule itself. This has an added important benefit: I can taste if it's fresh BEFORE I swallow. I must say I've never had a rancid one yet. Presently am using Spring Valley from Walmart. I often do the same with my liquid vit D3 caps as well.

Dr. Davis, thank you so much for all the info you put out for us.

I am a fan of your blog, but honestly this is a very low standard of "proof" that you are using. If you feel strongly about it why not get a certificate of analysis done yourself?

I'm a psych NP. My patient took 7000iu Naturemade tabs with no effect on blood level after 2 months. Have heard tabs don't absorb, so have stearing people away from them. Thanks for the info on their softgels.

If I had to get a "certifcate of analysis" performed for every supplement I questioned, we'd go bankrupt just on the testing.

I'll be interested to see what organizations like Consumer Lab, who test a broad range of supplements, come up with.

I subscribe to Consumerlabs.

When they tested vitamin D3  (1/18/10) they only tested up to 1000iu/d capsules/tablet/liquid and also some combination products.

I'm sure readers here are all aware  1000iu/daily can, at best, only raise 25(OH)D 10ng/ml = 25nmol/l.
Most readers require significantly more than that to reach >50ng/ml+ ensuring their body has an emergency stored reserve supply of Vitamin D3.

People who are overweight or suffer diabetes, Celiac or any other inflammatory condition will generally require even more than 1000iu/daily/D3 per 25lbs weight.

The LEF report Startling Findings About Vitamin D Levels in Life Extension® Members By William Faloon shows IN PRACTICE 5000iu/daily/D3 averages only just above 42ng/ml so if we are trying to achieve a level that does more that just meet our daily requirements but also enables the body to store Vitamin D for emergencies, then we require MORE THAN just 5000iu daily/vitamin D3.

At latitude 52 with a BMI just under 25 I take 5000iu/daily + regular short full body prone uvb/winter/sun/summer exposure
My 25(OH)D stays @ 64ng/ml.

I am not convinced Consumerlabs testing of tablet formulations of 400iu or even up to 1000iu has any relevance to correcting vitamin D insufficiency.

Dr. Davis

My name is Douglas Jones, I am with in Corporate Communications at Pharmavite the makers of Nature Made Vitamins.  We take your comments very seriously and need the information that Marissa asked for in her e mail.

All of our products are tested fully before they are shipped to our customers.

Please feel free to contact me directly at djones@pharmavite.net

Thank you

Thank you, Mr. Jones.

Because I identify these cases one by one over months, I don't have my patients bring in their bottles.

I have to say that I am also impressed that I got beyond the girl in the cubicle on this one.

In future, I will ask patients to bring the bottles in. If I know this leads somewhere, then it's worth the extra effort.

However, I remain confident that there is a problem.

Do you recommend multivitamins and/ or Vitamin D brands?

I am 34 years old and at an ideal body weight but had moderately low HDL when blood work was done...Just following your blog and trying to figure out ways to raise my HDL and to help prevent heart disease (My mother is in her 50s and has been on statins for bad cholesterol, a path I don't want to follow).

heatherlbrandt(at) verizon (dot) net

I had been using NatureMade fish oils for years and no belchback. I got a batch that both my wife and I had bad belching with fish taste. Called the company and they said I had been using the enteric coated. I bought some of the enteric and they don't belch back, they also are not what we had been taking. Looks like I will be switching to a different company too.

My friends have been using NatureMade fish oil for over a year now. She told me that it is very effective. I think I am guess I will giving it a try.

Hi, nice post. I have been thinking about this topic,so thanks for sharing. I will likely be coming back to your blog. Keep up the good work
termpapers99@gmail.com

In Nature Made's defense, I've been using 2,000 Vitamin D from Nature Made for the past 6 months, and my Vitamin D levels have risen about 20 points.  I've been very happy with the result, so I just started using their fish oil. I'm sitting here with a brand new bottle of their fish oil enteric coating 1200 mg pills, and smell no odor at all.  This doesn't mean other people haven't had different experiences, but it might be very dependent on your individual body chemistry, and I would suggest doing blood tests every 6 months to determine if the Vit. D you are taking is working for you.  And no, I do not work for Nature Made, and have no connections to them

I just have to say that letter show what they think of customers and how they have made made their mind to deal with any complaints. They did not even bother to get a competent person who could write a letter. Forget that. They did not even bother to prepare a template response.

There is interesting research on omega 3 bioavailability.

After mixed results with various fish oil capsules resulting in low-tide burps or flatus, i moved to Coromega.  Wonderful product.

Re Costco 2,000 iu oil capsules, i've raised my serum levels to 88 ng/ml with them.

However, given the wide range of factors that affect D uptake/utilization, titrating to standard is the only useful methodology. Blind dosing, especially at very low serum levels, might not raise serum levels at all.

Omega-3 structure may affect bioavailability: Study

By Nathan Gray, 14-Jan-2011

Related topics: Research

The type of omega-3 we take may have a distinct affect on how much is actually absorbed, according to new research.


The study, published in the European Journal of Lipid Science and Technology, suggests that omega-3 concentrates – such as triacylglycerides – have much better bioavailability than purified fish oild

The team of Spanish researchers said that the study contributes to knowledge on the intestinal lipolysis of omega-3 sources, which can be found in many commercial forms, from purified fish oil to concentrates of free fatty acids and ethyl esters.

They said that despite differences regarding their intestinal metabolism, there is lack of information about the specific composition of the absorbable fraction from omega-3-TAG or omega-3-EE concentrates.

“This comparative study showed that the in vitro bioaccesibility of omega-3-polyunsaturated fatty acid (PUFA) seems to be better as omega-3-TAG concentrates than purified fish oils,” said the researchers, led by Dr. Diana Martin from the Universidad Autónoma de Madrid, Spain.

Fish oil

Consumption of fatty acids from the omega-3 family – particularly eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) – have been advised due to their beneficial role as anti-thrombotic, anti-inflamatory, and hypolipidemic fatty acids.

The authors noted, however, that in many populations consumption of fish is quite low and does not achieve levels adequate for reaching the minimal intake level of EPA and DHA. They added that because of this, an easy way of increasing omega-3-polyunsaturated fatty acids (PUFA) intake is by the fish oils supplements oils.

They said that recent studies have produced contradictory evidence for the in vitro metabolism of fish oils and omega-3-concentrates,

The new study compared the in vitro bioaccesibility of omega-3-oils from different sources. The researchers tested salmon oil, tuna oil, enriched-omega-3 oil as triacylglycerols (omega-3-TAG), and enriched-omega-3 oil as ethyl ester (omega-3-EE).

Study details

Dr Martin and colleagues reported the rate of hydrolysis of omega-3-TAG concentrates was continuous throughout the time of reaction, whereas the digestion of salmon oil and tuna oil was initially faster but stopped after 10 min.

They added that poor hydrolysis took place for the enriched-omega-3 oil as omega-3-EE.

The breakdown of omega-3-TAG oil, salmon oil, and tuna oil mainly consisted of free fatty acids (FFAs) and monoacylglycerides, whereas the breakdown from digested omega-3-EE oil consisted of free fatty acids and undigested ethyl esters.

“This comparative study showed that the in vitro intestinal digestion of omega-3 (EPA and DHA) sources as fish oil, triacylglycerides, or ethyl ester concentrates was different,” said Martin and colleagues.

“The highest degree of hydrolysis and inclusion of lipid products … was found for the omega-3-TAG oil, but compared to fish oils long times of digestion were required,” they added.

Source: European Journal of Lipid Science and Technology
Volume 112, Issue 12, pages 1315–1322, doi: 10.1002/ejlt.201000329
“Intestinal digestion of fish oils and ω-3 concentrates under in vitro conditions”
Authors: D. Martin, J.A. Nieto-Fuentes, F.J. Señoráns, G. Reglero, C. Soler-Rivas

http://www.adajournal.org/article/S0002-8223(09)00293-4/abstract

Re vitamin D uptake & utilization, diet (taking D with a meal doubles uptake), existing D levels (see Holick re substrate starvation), D form (D2 v D3), exposure, lifestyle, age (over 50 produce less in skin), obesity (excess bf sequesters D), co-factors (affect utilization), genes, bathing (bathing strips oils off skin), etc. affect D serum levels.

http://www.scribd.com/doc/38595990/D2-D3

http://www.scribd.com/doc/37319962/Vieth-Vit-D

http://www.scribd.com/doc/36940698/D-Test-and-Treat

http://www.scribd.com/doc/45004628/D-review

http://www.scribd.com/doc/49369766/Garland-021811

"Vitamin D has co-factors that the body needs in order to utilize vitamin D properly. They are:
magnesium
zinc
vitamin K2
boron
a tiny amount of vitamin A
Magnesium is the most important of these co-factors. In fact, it is common for rising vitamin D levels to exacerbate an underlying magnesium deficiency. If one is having problems supplementing with vitamin D, a magnesium deficiency could be the reason why."

Dr. I came across your site while looking for someone who was having the same problem w/ their Vitamin D levels and not finding a solution.  In fact, the brand you mentioned has done nothing for me in any of the vitamin area!  However I did come across a vitamin that has taken care of my Vit D problem and other problems.  Honestly I think the brand I am taking is the ONLY brand that is actually helping people.  Everyone I know who gets on them has had great results!  Rob Dillon - rdillon4@cox.net

Incidentally, I like the way you have structured your site, it is super and very easy to follow. I have bookmarked you and will be back regularly. Thank you

i too have suffered from kidney stones. i did a 24 hour urine test and my calcium urine level was 3 times normal. shock horror all round.
i began to take 5000iu of vitamin d3 daily and in a few weeks my calcium urine level was normal, my urologist was amazed that this had happened but i did not tell him why because english doctors do not believe in supplements and he would have had a hissy fit!!.
since then, no more stones!

My problem with Volek's study is that it's analogous to putting someone on a LC diet and then doing a GTT.

They kept people on a low-fat high-carb diet and put others on a high-fat, low-carb diet and then did a lipid tolerance test.

In both cases, your response to the nutrient (carbs in GTT and fat in lipid test) will be impaired because you stop producing enzymes you don't need.

The people on the low-fat diet didn't tolerate fat as well as people who had been on a high-fat diet when suddenly challenged with a tremendous amount of fat.

What I'd want to know would be the lipid responses *during* the 6 weeks on the two diets.

What his results show me is that eating a high-fat diet makes your body adapt to burning fats. This is what I would expect.

While these results are interesting, I wonder how relevant they are in a real life setting. The fat load that generated these results was 123 grams, which would be like eating 1.3 sticks of butter in a single meal, or like sitting down and drinking nearly 3 cups of heavy whipping cream all at once. Who does that?

Dr. Davis, I know you are encouraging 3 hour postprandial TG checks in the TYP program via CardioChek. Are you seeing these types of postprandial results (viz. results similar to Volek's) following meals with less exaggerated (i.e. normal) fat intake?

Here is prospective study done in Sweden with a follow up period of 12 years that shows a higher consumption of dairy fat like butter and cream is associated with a 45% reduction in risk for heart disease. "Nothing in biology must make sense except in the light of evolution"
http://www.mdpi.com/1660-4601/6/10/2626/pdf

After eating low-carb for over a year, my post-prandial triglycerides never go above 100.

I do agree with Gretchen on the adaptation process.  I shudder to think what an OGTT test would show.  Maybe some day, I'll drop $70 to find out if I can get someone to take me.  I'll be in no shape to drive after consuming that much sugar.

I agree Gretchen. There can be a long adaptation period. Dr. Davis's patients are blessed to have him as their doctor, but I suspect he can't quite kick the lipid hypothesis!

At least for me, I think Dr Ron Rosedale's diet is best.  Low carb, protein at 50 to 70 gms. No grain, mostly no dairy.  He says if you want to lose weight you need to avoid saturated fat because saturated fat keeps you insulin and leptin resistant.   Unless you drink olive oil, the diet winds up being low calorie.
Hmmmm.  Maybe that is the answer.

I have to wonder what the mechanism is for high triglycerides causing heart disease? High triglycerides in a high carb diet usually means high insulin, high glucose vs fat metabolism,and low hdl. Aren't high triglycerides in a low carb diet a slightly different picture?

Right or wrong, I admire your willingness to go against the tide (any tide) for what you see as right.

Absolutely!  What amazes me is, in spite of their adaptation to a high fat low carb metabolism, the patients still saw their OGTT triglyceride results improve over time!  This is my experience too.

There is no doubts, on a high animal fat diet or on a high fat diet of any kind, our tolerance to glucose is indeed reduced.  50g in one does is OK for me (I weigh ~65kg) but 100g in one go as sugar would still be too much and would make me feel sick (but the same amount of carbs in vegetables spread over a day would be ok).

It took a good few years to improve my tolerance.  Right after (2 weeks after) I went on a high animal fat LC nutrition (in 1999) I could not tolerate even a 50g of sugar in one shot! Even one bottle of beer (~20g of carbs) would make me feel stomach sick + give me a headache.   It took me more than 2 years to reach this tolerance to carbs, and I even noticed some steady improvement from year 2 to year 7 into this.

It is indeed totally illogical, although unsurprising given the present standards of medical science, to use big glucose shots to assert patients response under  predominantly ketogenic metabolism.

It is a curious lack of curiosity on behalf of the mainstream medicine that no nutrition research group seem interested in studying the exact effects (all beneficial for me), vitamin and nutrient requirements (very different!) and adaptation issues on the high fat low carb diets.

Stan

The last few posts have generated quite a few comments!!!


Anonymous said...
"The last sentence made me cry."


Alfred E. said...
"This is becoming more confusing by the minute. First, no carbs, only fats and protein. Now, no butter, no dairy, no, carbs, just a few drops of fat and protein. I am going to cry, like the previous poster."


Dana Law said...
"I've learned a lot but need some direct guidance. I find that making daily decisions on what to eat difficult. I want to eat healthy and have some variety. Here's the question. What do you eat? What did you have for breakfast this morning? What did you eat last night? What do you keep in the fridge and on the counter to make following your dictates easier. I don't want to over-think it but all this information is overwhelming."


Helen said...
"Again, with so many cautions of what not to eat, I'd love to see a Dr. Davis-approved diet plan. If I were just following all the Don'ts, I'd go crazy (and hungry)."


The bottom line is that Jimmy Moore, William Davis, Matt Stone, Kurt Harris, Stephan Guyenet, Don Matesz, Art Ayers, Billy E., B.G., T., Mark Sisson, Richard Nikoley, Michael Eades, Matt Metzger, Peter, Arthur De Vany, Chris, Ryan Koch, Chris Masterjohn, Jenny Ruhl, Richard Bernstein, Fred Hahn, Jonny Bowden, Larry McCleary, Mary Vernon, Dave Dixon, Mike O'Donnell, Scott Kustes, Gary Taubes, Rob Wolf, Seth Roberts, Loren Cordain, Sally Fallon, Mary Egin, Keith Thomas, Tom Naughton, PaleoDoc, Nora Gedgaudes, Barry Groves, John Briffa, Laura Dobson, Dana Carpender, Keith Norris, Rusty Moore, Doug McGuff, Martin Berkhan, Bryce Lane, Erwen Le Corre, Dan, Drew Baye, Uffe Ravnskov, Eric Westman, Lierre Keith, Brian Peskin, Steve Parker, Jeff Volek, Stephen Phinney, Diana Schwarzbien, Barry Sears, Nina Planck, Lyle McDonald, T.S. Wiley, James Carlson, Steven Gundry, Keith Berkowitz, Richard Feinmann, Jan Kwasniewski, Konstantin Monastyrsky, etc., etc., etc. cannot come to a cohesive way of eating that is workable for everyone. My guess is there are not two of these people whose diet is identical!!

Is it any wonder we are confused? Many folks are looking to emulate the diets of others - a method that will never provide personal optimal health.

Take the time to watch/listen to the following lecture by Dr. Bruce German from UC Davis. It will help to explain why we have this conundrum.

http://www.researchchannel.org/prog/displayevent.aspx?rID=29854&fID=567

Then read the writings of a Venetian gentleman who lived to be almost 100 yars of age (Born 1467 - Died 1566).

http://www.soilandhealth.org/02/0201hyglibcat/020105cornaro.html


Both of these together put nutrition and health in perspective for me.

Tom

Dr. Davis, please comment on the study released today by the Harvard medical School.  How does one avoid saturated fats and still get proteins if he is a low carber??   http://news.bbc.co.uk/2/hi/health/8580899.stm  Thanks!

Hi, David--

Studies are meant to make observations. That is the reason for the unnatural intake of fats.

People on the Track Your Plaque Diet approach rarely show such high levels because they've reduced or eliminated the foods that form the basis for high postprandial responses (wheat, cornstarch, and sugars) and do not indulge in high fat intakes that cause near-term surges of postprandial particles.

Hi, Gretchen--

I agree, but I believe that the observations are still relevant. It shows us that postprandial responses are sensitive to carbohydrate intake over time. It also shows us that average people have substantial surges postprandially with fat challenges on an average American diet.

While I advocate carbodrate restriction and weighing diet more heavily in fats and oils, you can see that the emerging conversation is that unlimited quantities of oils, low-carb or no, have the potential to generate extravagant postprandial responses.

I tested my postprandial triglycerides after having been on a LC diet for about 11 years and wheat-free even longer (because I discovered that it was wheat that was giving me acid reflux). With about 50 g of fat, the TGs went very high, over 400.

Someone else said his rarely went over 100 after only a year on a LC diet.

The author of "Life Without Bread" presented a graph showing that younger people reduced cholesterol on a LC diet but older people didn't.

We may all react slightly differently to different diets (as well as interpreting them differently, as someone else has pointed out; you can be on a LC diet that includes mostly LC junk food or a LC diet that includes a lot of greens and lean meat).

I have type 2 diabetes, and some people think that metabolic syndrome/type 2 diabetes is basically a disease of disturbed lipid metabolism.

So what worries me is that people with insulin resistance, who may not respond the same way as people without IR, are taking LC advice to eat a lot of fat that is based on the experiences of people without IR.

Here's an article that addresses this issue:

http://www.lipidworld.com/content/4/1/21

This is why some time ago I felt the "GO Diet" by Jack Goldberg and Karen O'Mara, which is LC but emphasizes monounsaturated fat, yogurt, and fiber, was the best solution and helped them rewrite it as "The Four Corners Diet."

Apparently very few people agreed with me, and the book bombed.

I still think LC with restrained fat intake, meaning restrained calorie intake, and real foods along with reasonable exercise is the best solution on the basis of today's evidence.

@Tom (anonymous)

Although there are many voices and styles of presentation, I can state, through frequent communication with them, that my approach at PaNu is a tent that fully covers the diets of Eades, Dr. Stephan, Peter at Hyperlipid, Sisson, Nikoley, and although I do not correspond with them, Bernstein and Groves. There is also significant overlap with the Weston A Price Foundation and even Matt Stone.

If you look for a common element in all of our approaches, and indeed the crux move in choosing a healthy alternative to the SAD, it is actually nothing to do with paleo so much as the simple and total rejection of Ancel Keys and the multiple versions of the lipid hypothesis he spawned 50 years ago.

This then allows the realization that humans are evolved to eat substantial calories from animal products, including animal fats, and further including (on purpose, and without limitation or fear) SATURATED FAT.

All versions of the lpid hypothesis have in common the belief that somehow, somewhere, there is a molecule that is fat, tastes like fat, is  kind of like fat, is associated with fat, or reminds us of fat, and that molecule is perversely designed to give us atherosclerosis and coronary heart disease.

Start to view all these dietary approaches through the filter of whether they reject the lipid hypothesis instead of "low carb" or "paleo" and the dividing line will start to look much much brighter.

So for someone that works out a lot and is suppost to gte something in the 3000-4000 calories per day... what would be the addecuate kind of food to use as high calories source?
I was taking unlimited almonds, but this post makes that look like way too much fats.

@ Dr. Harris,

You obviously did not read/listen to the two links that I provided in my comment.  I happen to believe every word you wrote in your response.   My contention is that personal optimal health and longevity is beyond the simplicity of following 12 simple steps (though I do think they are a huge step in the right direction).  Health is determined at the molecular level based upon an individuals genetics as affected by many factors, particularly, stress. Please Google nutrigenomics, epigenetics and metabolomics.

My apologies to Dr. Davis.

(I may have inadvertantly sent a another version of this comment previously.)

Tom

Isn't this just normal for a well adjusted human? I mean TGs are how fuel (free fatty acids) is transported through the blood from its sources (liver and fat cells) to the places where it is needed i.e. everywhere else.

@ Pythonic Avocado

Yup, eating fat raises TG levels temporarily.  I consume a high-fat diet with lots of nuts, and, based on results from a TG meter, do not see extraordinarily high TG levels (starting from a fasting level near 70).  I also spread meals out during the day, thereby reducing both BG and TG spikes.

The only time I saw a high TG spike was after consuming 2 raw egg yolks!  This influenced how I approach eggs (always cooked, one at a time, mixed with other foods).

btw, if you consume too much fat in one meal, a lot of the fat will end up in your stools, since there is a limit to the lipase that your pancreas can generate on short notice.  Another complication when trying to compare diets.

In other words, low-carb improves postprandial responses substantially--but postprandial phenomena still occur. Postprandial triglycerides of 88 mg/dl or greater are associated with greater heart attack risk because they signify the presence of greater quantities of atherogenic (plaque-causing) postprandial lipoproteins.

Great post, and painfully true for me; my father had to undergo his 2nd coronary bypass operation this past April 2007, and despite the strangely 'status-quo' or 'business as usual' attitude of both the surgeons and assisting doctors and nurses involved in my dad's procedure (yes, the whole thing seemed like such a regular day at the beach to them because Holy Cross in Fort Lauderdale performs so many of these operations on a daily basis, with success, of course) did nothing really to quell my family's fears of the severity of this operation; this is still a monstrous operation that not only takes a heavy toll on the patient, but on the family sitting in that waiting room as well.
I still cry at the memory of having to tell my dad, "hey Pop, you need another CABG" after an invasive angiogram revealed disaster after disaster in his arteries.
And this is why your message is so important, and why it needs to get out every day, and loudly.

I'm rooting for you. And I'm thankful you're here.

A few thoughts about this post:
The first is a question. What do you think about ultrasound screenings for carotid artery plaque, abdominal aortic aneurysm, and peripheral arterial disease? A company called Life Line offers these, saying that they show evidence of plaque build-up in the arteries. Are they useful in conjunction with a heart scan, or can they indicate risk similar to a heart scan? It sounds like they are intended to be early detectors of stroke risk. Are they worth the investment?

The second comment is an observation. Those of us not in the medical field tend to assume that anyone who is knows what he or she is talking about on the subject of the human body and illness. However it is apparent that those with M.D.'s can come to very different conclusions about what causes us to get sick and what we should do to prevent illness. Dr. Dean Ornish is an M.D. You are an M.D. Dr. Atkins was an M.D. Yet the dietary advice differs noticeably, so how do we know who is right and who to listen to? I've learned not to believe something just because a doctor says so, because when I followed the low-fat high-carb advice I got fat and felt horrible, but now that I am following a low-carb plan with plenty of protein and fat, I've lost 25 lbs. and feel great. My bloodwork also supports your claims: low triglycerides, high HDL, and low fasting blood sugar. It's kind of sad in a way that I actually get better medical advice from doctors whose blogs I read on the internet (I'm also a Dr. Eades fan) than from my personal physician. And finally, a thank-you: since reading your advice about Vitamin D, my flower garden is in the best shape it's been in in years, since I have a new knowledge about why it's so important spend some time in the sun and a new motivation, therefore, to be outside pulling the weeds.

And concerning your recent post  about breakfast cereals,congratulations are in order: I've broken my husband's cereal for breakfast habit. (I broke my own years ago.)

I have had good results with the Lifeline service, but only when used in conjunction with a heart scan. It cannot replace a heart scan. This is because, while atherosclerosis is a body-wide process, this disease does not perfectly track in parallel in all arteries of the body. You can, for instance, have lots of plaque in the carotid arteries while having only a modest amount of plaque in the coronary arteries, and vice versa.

I agree with your second comment. In fact, I have posted on this Blog about this.

We are all swimming in a sea of information and mis-information, and blind alleys along the way to the truth. We can only educate ourselves as best as possible and then come to our own judgements about the value of this or that argument.

I have a comment too: I think one reason there is so much confusion is because dietery connection with heart disease hasn't been sufficiently studied. We only saw some partial studies by Drs Ornish, Agatston, Atkins, Hayes but not much independent verification, AFAIK. For example there are some studies done by now on the effects of a high fat low carb nutrition in diabetes and epilepsy but virtually nothing that I know of for cardiac patients.  The only one such study I heard of was halted half way through (after showing very promising results) when the funding was cancelled, 27 years ago.
Stan (Heretic)

A somewhat updated comparison of old care versus new care: I was on American Airlines this week, and looked through their magazine. There was a full page ad from the Cooper Clinic in Texas; a 46 year old woman pictured said "I had no idea I had heart disease, but had a family history...an EBT scan and four stents later, with some lifestyle changes, I'm a new woman".

I understand you can't generalize from one case, and while this seems to represent cutting edge treatment, it also gives me the creeps thinking about the obvious drive for revenue here. Couldn't they have tried your approach for awhile before invading? Thanks.

I think that they tell the stories that have a "WOW!" factor. The Cooper Clinic does indeed engage in a low-level grade of preventive care (AKA Lipitor, etc.)

But I really hate those stories, too.

Saw a lady at shul today, she is convinced of Dr. Esselstein's more carbs- is- better method. Ornish, Esselstein.....hard to refute the drumbeat of eat carbs, cut meat and fat.