An EBT heart scan is also acceptabte, or equivalent to a CT scan?

So, Dr. Davis. Do you ever use carotid intimal medial thickness measurements in your practice? If so, how?  If not, why not?

instead of having to be exposed to radiation of a heart scan why wouln't a carotid IMT study be enought to indicate CAD since a narrowing of the carotid would preesent a high probability of CAD?

Well we are going to do the heart scan in Feb - thanks to your blog.
Check this out, our local place that does it is offering a two for one price! So me and the hubby can both get it done. I am nervous a bit but ready to do it.

I just came across your blog, but I really like it already!  I think you have a great topic, and you address it really well.  I look forward to being a new reader!

Visit my blog if you get a chance as well- http://asizableapple.blogspot.com

Any particular types of snacks helpful when taking niacin? I sometimes eat a handful of nuts, or an apple,  when taking niacin, hoping it will reduce the possibilty of flush -- just curious if some foods are better than others.

Also, since niacin can raise histamine, has any studies been done on taking an anti-histamine along with high dose niacin? Or how about some vitamin C (natural histamine reducer) at the same time as niacin?

And finally, any real differences between Niaspan, Slo-Niacin and Enduracin (besides cost)? The only difference I can find is that Slo-Niacin might tax the liver a bit more, since it takes longer to fully absorb. The others are absorbed within 6-8 hrs, I believe.

What about the use of Quercetin. There is a recent article showing it may inhibit the niacin flush. At least that was the result in rats. The study was published in the British Journal of Pharmocology Jan 2008
Anne

Dr Davis, the flush of Niacin has been of little bother to me. However each winter when I go to Florida from my cold north home, the Niacin itchy rash appears on my chest. This year I finaly found that Benadryl extra strength eliminated it after three applications. It has to be the increased sunshine that kicks it in. I hope others may find this helpful...Niacin is a life saver and still vastly under rated. Thanks for your informative blogs. Over&Out

I've noticed what seems to be a correlation between flushing and eating spicy foods -- foods that contain peppers containing capsaicin.  Has anyone else noticed this?

It seems that I can pretty much count on getting a flush response 30-60 minutes after eating spicy food.  

Dr. Davis, any thoughts?

Nice post - and I swear I don't know how doctors do it, repeating your self over and over.  I forward your blog wittings to family and friends.  And because of that I'm the one they naturally come to when looking for TYP advice.  

For what ever reason, no matter how many times I repeat myself, people forget two items with niacin:  1)hydrate to limit flush 2) avoid time release niacin as that can dangerously poison your liver - along with telling your doctor you are taking niacin. Grrrrr.........

Sorry, as a long-time niacin user I have to say the advice to increase hydration is good in general, but inadequate in itself to quickly eliminate a niacin flush. You can test this yourself. The next time you experience a big flush, go consume a large quantity of water...see if your flush quickly reduces.  It won't.

On those rare occasions when water by itself is insufficient, then an adult (325 mg), uncoated aspirin or 200 mg ibuprofen can also be used to accelerate relief.

"Sorry, as a long-time niacin user I have to say the advice to increase hydration is good in general, but inadequate in itself to quickly eliminate a niacin flush. You can test this yourself. The next time you experience a big flush, go consume a large quantity of water...see if your flush quickly reduces. It won't."

Okay. And as a long-term niacain user, myself, who just read this earlier tonight and who just tried drinking water when experiencing a flush, I will say that it does work. For me, at least.

Great factors…I would note that as someone who actually doesn’t comment to blogs a lot (in actual fact, this can be my first submit), I don’t suppose the time period “lurker” is very flattering to a non-posting reader. It’s not your fault at all, but maybe the blogosphere could give you a better, non-creepy name for the 90% of us that get pleasure from reading the posts.

Great factors…I would note that as someone who actually doesn’t comment to blogs a lot (in actual fact, this can be my first submit), I don’t suppose the time period “lurker” is very flattering to a non-posting reader. It’s not your fault at all, but maybe the blogosphere could give you a better, non-creepy name for the 90% of us that get pleasure from reading the posts.

Hey - good blog, simply wanting round some blogs, appears a fairly nice platform you're using. I’m currently using WordPress for a few of my websites however seeking to change considered one of them over to a platform just like yours as a trial run. Anything specifically you would recommend about it?

Wonderful put up from professional additionally it can probably be an exquisite know-easy methods to us and thank you a large number for posting this precious info with us all.

You no longer crave these foods.

It's true!  We've done it.  My husband and I stopped eating all grains and sugar in February.  At this point, we really don't miss them any more.  It was a huge change, but it's worth the effort.  I've lost over 20 pounds (10 to go)and my husband has lost 45 pounds (20 to go).  On top of it, our body shapes have changed drastically. It is really amazing.   I've got my waist back (and a whole wardrobe of clothes) - I'm thrilled.

I'm also very happy to be eating foods that I always loved like eggs, avocados, and meats - without feeling guilty that they're not good for me.

With the extremely hot weather this week in our area, we thought we'd "treat" ourselves to small ice cream cones.  To our surprise, it wasn't  that much of a treat. Didn't even taste as good as we'd anticipated. I know I would have been much more satisfied with a snack of smoked salmon with fresh dill, capers, chopped onion and drizzled with lemon juice.

Aside from weight changes, we both feel so much better in general - feel much more alert and move around with much greater flexibility, sleep well, never have any indigestion.  We're really enjoying this.  It's like feeling younger.  

It's not a diet for us.  This will be the way we eat from now on.  Actually, we think our food has become more interesting and varied since giving up all the "white stuff". I guess we felt compelled to get a little more creative.  

Eating out (or at other peoples' places) has probably been the hardest part of this adjustment.  But now we're getting pretty comfortable saying what we won't eat.  I'm starting to enjoy the reactions it produces.

Just wanted to share our experience with your readers.

BTW, Dr. Davis, we got the Carlson Vitamin D3 softgel caps and are each taking 4000 units a day.

That's fabulous!

Your post was so interesting that I read it to my two teenagers, who are both encountering great skepticism from their friends and grandparents and other relatives when they bring up this topic.

I hope it helps give them some perspective!  

One of my husband's favorite comments to people is "Grains are for birds". That slows them down a bit.  

I also just remembered a conversation I had a few months ago  with a neighbor who had invited us to dinner.  She asked if we had any food allergies or things we couldn't eat. She knew we were on some kind of diet.  I told her no food allergies to worry about and the diet is really simple: no grains, no potatoes and no sugars.  She was quiet for a minute and then replied "My goodness, that's just about our whole diet!"  It was hilarious.

It really is interesting that tobacco companies Phillip Morris & RJ Reynolds also sell processed foods that are responsible for so many life style disease problems effecting western society. My grandfather passed away undoubtedly by his life time of smoking.  Even after he had a heart attack he couldn't stop smoking for any length of time.  As soon as a stressful situation occurred, he was back using his pacifier, as we called his pipe.  I'm guessing the same reaction occurs with high glycemic, processed food.  

Another addiction that is worth mentioning is convenience.  In sales there is a saying that simply says "people are lazy."  It means, the more work a salesman does for a customer the less likely he/she will say no.  Fast, processed, food sellers are master salesmen at promoting their products such that it is hard to say no.  

I'm doing my part to promote healthy eating when outside the house.  A relative owns an award winning restaurant in St. Louis.  Talking to him about my new heart healthy diet, he mentioned that next time I'm in town he would like me to meet the chef.  The two of us will then create a couple heart healthy, TYP inspired, meals to be placed onto the menu.  I’m looking forward to this.  It will not only be fun to work in the kitchen with an accomplished chef but to also  have an easy place to visit for a healthy meal.

I agree.

Howeever, I do believe that we can maintain the convenience factor to some degree without too much sacrifice of health.

My kids and I were in a hurry recently to make a movie time. There wasn't enough time to squeeze in a healthy lunch, so we ended up at Trader Joe's and bought a bag of unsalted, dry roasted pistachios and mixed nuts (not roasted in oils). Not a perfectly well rounded meal, but lacking many of the negative effects of the overly processed, addictive foods.

Keep us posted on how your St. Louis menu turns out!

BarbaraW,

Keep it up, it's worth it and you won't look back!  I and my wife   went low carb high animal fat  (the "Optimal Diet") 8 years ago and we never felt better!

  Many things will improve, not just weight reduction:  you will think clearer, your reflexes will improve, your breathing rate will go down, your blood pressure will normalize.  You will never or rarely have a fever or viral infections like cold or flu.  You will become more resistant to cold temperature and you will rarely feel tired, ever!

Great results, Stan.

But let me make clear that I do NOT advocate high animal fat.

In my view, despite the results you've enjoyed, there are adverse health--and social--consequences of high intake of animal fat, including dramatic escalation of cancer risk.

There is no doubt that carbohydrate reduction alone achieves dramatic improvement in health and weight reduction. We've witnessed that on the Atkins' diet, for instance, a diet that is eminently effective for weight loss but is without question an unhealthy approach if followed for any more than a few weeks. (Bladder infections, constipation, higher colon cancer and other cancer risk, etc.)

So, in my view, please do not follow an unlimited animal fat approach.

Hi Stan and Dr. Davis,

We've been following the Eades' Protein Power plan for the most part and I don't think they advocate high fat. But we're not trying to go low fat, either. In any case, we've gravitated lately to eating more poultry and fish instead of red meats.  I think that has helped our weight loss a bit, along with cutting down on nuts and cheese.  We love red meat and do have it a couple of times a week, since we're fortunate to be in an area where we can easily get locally raised (grass-fed) beef and lamb, as well as free-range chickens and wonderful eggs. Quite different from what's typically sold in the grocery stores. Tastes much better.

On another note, over the last 6 months, we've noticed our meal portions have become somewhat smaller.  We're not consciously trying to cut them down, it's just happened.  I think because we're eating more satisfying food we don't need quite as much. We find a less frequent urge to snack in between meals, too.

We've already experienced a number of changes you mention, Stan, like blood pressure magically settling into perfect range and no colds/flu this past winter.

It's all quite amazing, isn't it!

Barbara

Is the problem wheat in and of itself?  or is it with the food processing that goes into almost everything nowadays.  I wonder if people would be having the same problems if they ate a steady diet of Grandma's homemade bread instead of stuff off the supermarket shelf.

Good point. In general, unprocessed is far better than processed. However, with wheat flour foods, I'm finding no difference. Both create weight gain, fatigue, increased blood sugar, small LDL etc.

I am wondering which is better to use butter vs. a non-hydrogenated "smart balance" type of margarine. Can you address this? I am on a statin and trying to reduce my weight and raise my HDL while normalizing my other numbers.I would like to get off this statin (lovastatin - generic I think)Thanks! Greg

PS- I use olive oil too and for awhile I was taking my local orgainic butter and mixing it half and half with organic olive oil for my own "blend" what do you think? That can also be done with organic canola oil for those who think olive oil is too strong of a tast.
Thanks again!

I wonder also if problems relate somewhat to modern forms of wheat, which has been adapted over the years for high yields, pest tolerance, etc. We have a daughter with celiac disease, and I read an article that maintained that the peptide chain implicated is not present in ancient forms of the grain, so they would be ok for celiacs. As far as processing goes, the article also suggested that the more time-consuming methods of making bread, like for sourdough, yield healthier bread. In short, it's what the modern world has done to wheat, not just wheat itself.

Here's the article I mentioned in my last comment:

http://www.westonaprice.org/moderndiseases/gluten-intolerance.html

I can certainly concur with the comments made here.

After a brief flirtation with wheat reduction i eliminated all grains from my diet and, almost effortlessly lost about 28lbs.  I also experienced an almost total elimination of bloating, tiredness and my bowell habits improved.

I do wonder if going one step further and eliminating any food that casues cravings might also be a good idea.  For me that seems to be the case with cheese and milk products, chocolate and cashew nuts (possibly containing lactose in the flavouring).  Its seems to be one of life's ironies that we crave foods for which we seem to have an intolerance.

Thanks for a generally excellent blog.

Interesting thought!

I believe those are very reasonable alternatives to butter. However, the real effect on LDL may depend on the size distribution of your LDL particles. Small, for instance, responds to carbohydrate restriction, not so much to saturated fat restriction.

Thanks for the butter response. I do have borderline small LDL. I had the test done last year at my suggestion after reading the South Beach Diet Heart Program. My physician knew nothing about it and of course said insurance would not pay.I had the test anyway.
The whole saturated fat/cholesterol in food theories are confusing; science seems to be changing on these long standing beliefs but it sure keeps me confused.
By the way - do you think the sprouted grain breads are better if one is to eat wheat? Does sprouted wheat behave diffently in the body and have a different effect on particle size of the LDL?
Thanks- Greg

Yes, the Ezekiel bread has a glycemic index of 35, fairly low, and seems to be a better choice than conventional breads.

I've ran accross another interesting effect of wheat. Dr. Loren Cordain, of Colorado State University has found that wheat contains a protein that diminishes vitamin D synthesis in the skin. Here's a link with the info.......
http://mylonglife.com/blog/index.php/2006/05/16/wheat_made_whites_whiter

VERY interesting!

Loren Cordain has truly been in the forefront of this argument.

anonymous, Doesn't heat denature lectins ... such as wheat germ agglutinin?  I'm wondering if there are other processes that inactivate these substances, such as fermentation?

Is a diet plan available today that suggests options for a whole wheat/grain free diet?

As I read Barbara W's comment, I wondered - what does she eat for breakfast? I have stopped eating cereal, and been eating oats instead. It's been working out for me. I have been able to lose 27 lbs and have another 20 lbs to go. But I do get hunger pangs every now and  then, and go offtrack. As Barbara says, eating out has been the biggest challenge.

I want to give the complete wheat/grain free diet a shot. Can you provide some recommendations on where I can refer for food options for breakfast, lunch and dinner? thanks.

Protein and fat rich foods like raw nuts, traditional fermented cheeses, and more liberal use of healthy oils like olive can provide feelings of prolonged satiety. Also, the Paleo Diet and South Beach diets both provide plenty of advice in this nutritional vein.

Also, watch for our new Track Your Plaque diet due to be out sometime this fall on the www.trackyourplaque.com website.

Readers here may be interested to listen to the presentation Loren Cordain gives entitled "Potential Therapeutic Characteristics of Pre-agricultural Diets in the Prevention and Treatment of Multiple Sclerosis"
http://wildhorse.insinc.com/directms03oct2007
While the talk is aimed at the MS audience it is interesting to understand the way diet may create autoimmune conditions.
Some, like the members of the audience may find the science a little difficult, if you click on the slides you can just watch the slides and listen to the talk without the distraction of audience activity.

Dr Atkins
www.atkinsdietbulletinboaaord.com
offers tons of great low carb recipes as does Dr Bernstein's Diabetic Sol'n board.

Looking forward to your new TYP diet, assuming sat fat won't be as much the enemy???

I'm really struggling with the saturated fat issue. I'm having trouble reconciling the "sat'd fat ain't so bad" argument, as skillfully articulated by Gary Taubes and Robert Atkins, with what I see in real life--ill-effects such as substantial hypertensive effects and pro-inflammatory effects.

Among the difficulties with saturated fat-rich diets, of course, is that they do not occur in isolation. Sat'd fat foods like sausage come along with wheat toast, syrup on pancakes, etc., a smorgasbord of food ingredients.

Nonethless, I'm going back to some of the old literature again and re-read.

However, sat fats for those reformed low carbers comes along with sausage, eggs, tomatoe and cuc slices......not pancakes.


.......cup of java with bit of real cream, not skim milk that zooms your bg and cravings.


My long term doc of 21 yrs asked me to run a group for her overweight diabetic patients and asked me why now could I do this when for the last 20 yr she put me on all these diets and sent me to not these weight loss programs and I couldnt do it then.....

why now...

( low low cal, low low fat, celery, apples, skim milk, grains grains grains, I was starved)

she asked.

I said:cause I had fats in my life and didn't get hungry. I cannot lose weight when I am hungry, when I don't have fats I am starved, most diabetics are starved as their bg are bouncing up and down all the time, low bg makes you want to eat a house and hi bg makes you want to  at a house.

.....having some fats makes you feel satiated and then you don't obsesses about food when you are not hungry.

Yet initially on Atkins I was eating 2000 cal a day and lost a ton of weight in a few months.

...not being hungry means you dont eat pancakes, and all that sugar as you know it will make you crave whereas at brekkie if you still feel hungry you can add an extra sausage, or extra egg and know you don't need to eat again for 5 hr or so as it holds you for the day, your bg don't move or move only a small amt.

Eventually you chol all comes down eating some sat fats and lots of good fats, so does it contribute that much to inflammation as does the hi carbs???

Dr A didn't promote sausage and bacon, in fact, he said not allot as it had nitrates,stay away from chemicals and eat whole foods.

Wish I was more scientific, I can only go by all the tons of material I read and how I feel and what my lab tests reflect.

I have had some of the tests you recommend but not all the advanced lipo protein.

Dr. Davis, I am a wheataholic.  But if I think back over the course of my life, there have been times in which my wheataholism has been in "remission." The remisions all occured on trips to the coast of Spain/Gibraltar, Haiti, Tucson (AZ), and Gulfport (MS). At the time, I certainly didn't realize what was happening, but after reflection, I can see something out of the ordinary occurred. In each location, I was with a group, so I had to eat what they ate (wheat products) while we all worked or hiked outside. During those times, I cannot remember one time after eating a wheat product did I have cravings, much less uncontrollable cravings. I thought the sun had something to do with it and that it must be the stimulation of Vit. D production in my skin. But then I had to rule that out because upon my return from these areas (and back to office work in Washington DC) I had to curtail my starches because of the resurgance of cravings. Now I have come to believe that the strengh of the sun's light boosted my seratonin levels creating the ability to view food, including wheat and other starches, in a reasonable manner. I know this topic has now past, but if you have any comments on this, it truly would be welcomed.

Even though the case against wheat and specifically gluten is so cut and dry, why is it that people have to jump so many hoops to be diagnosed as celiac and there is no real recognition that having gluten antibodies in your bloodstream might be bad - but instead have to rely on TTG tests that only pick up about 80% of celiacs and not gluten sensitvity at all?  
(I'm really struggling with this lassaiz faire attitude to something that is so toxic to so many people and BTW  thanks for blogging this. Wheat/gluten kills. And it's so insidious, it's in everything, and that can make it difficult for people to avoid it enough to get improved health effects.)