Addictive Foods

25. June 2007 William Davis (3)
Kraft Foods, Inc. is manufacturer of Kool Aid, Oscar Mayer, Kraft Macaroni and Cheese, Velveeta, Honey Maid Grahams, and hundreds of other processed food products. Post cereals also falls under the umbrella of Kraft with products like Raisin Bran, Post Toasties, and Fruity Pebbles. Annual revenues in 2006 for Kraft: $34.4 billion. A big operation with enormous influence over our eating habits.

Nabisco is manufacturer of Oreos, Ritz Crackers, Chips Ahoy and many others. Like Kraft/Post, it is also a big player.

While Nabisco was owned for several years by tobacco giant RJ Reynolds, in 2000 it was acquired by Philip Morris, another big tobacco manufacturer.

More recently in Spring, 2007, Philip Morris (now called Altria--you'd change your name, too, if it was synonymous with dirt) spun off its Kraft subsidiary for a big profit. However, the management structures remain intertwined.

In other words, despite the shuffling of shares, the two industries, big tobacco and big food, are in many respects one and the same.

Is it any surprise that the same industry that made billions of dollars pushing addictive nicotine products responsible for the deaths of hundreds of thousands of people is now intimately involved with addictive products produced and marketed by the processed food industry?

If you believe that food manufacturers are innocently and honestly conducting their businesses, simply think back to the testimony provided in front of Congress during the tobacco industry hearings. Broad deception, concealed truths, and outright lies were commonplace. There was no conscience involved. This was about money--and lots of it.

Why should the processed food industry, intimate with the tobacco industry, be any different?

If you want control over heart disease and your heart scan score, buy produce and buy local. Spend your time in the produce aisle, not the cereal or chip aisle. Unprocessed food, unadorned by bright labels, cartoon animals, American Heart Association endorsements, that's what we should seek.

Heart Scan Curiosities #7

25. June 2007 William Davis (1)



Here's a situation that crops up once in a while, occurring in perhaps 2% of heart scans.

The white within the circled area represents calcium, and thereby atherosclerotic plaque, situated immediately at the "mouth", or opening, of the the right coronary artery. What is somewhat unusual is that this plaque is not principally coronary, but aortic. That is, the plaque is mostly situated in the large vessel called the aorta. The three coronary arteries arise from the aorta.

In this instance, the aortic plaque involves the mouth of the right coronary artery. (In views not shown, the plaque also extends into the artery as well.) I call this a "double whammy" because the same plaque can post risk for heart attack and stroke.

Generally, aortic plaques pose risk for stroke. When aortic plaque fragments, little bits and pieces can travel upward to the brain and block an artery, thus a stroke.

In the coronaries, disrupted ("ruptured") plaques don't generally shower debris, but permit blood clot formation, resulting in heart attack.

This plaque, however, poses the theoretical risk of both heart attack and stroke because of its strategic location.

Should a plaque like this be handled any differently? I don't think so. But it does provide another reason to take atherosclerotic plaque in any artery seriously.

The nutrition counterculture

23. June 2007 William Davis (2)
When we look back over our American nutritional history over the last 50 years, it's hard not to come to the conclusion that much of the innovation in nutrition did not come from official agencies like the Food and Nutrition Board of the Institute of Medicine, the National Academy of Sciences, the FDA, the USDA, or the AMA.

Instead, it came from the popular culture. It came from bold, extravagant claims made by maverick figures like Ancel Keys, Nathan Pritikin, Dean Ornish, and Robert Atkins. Of course, some ideas have now fallen by the wayside, dismissed in a broad American "experiment" as ineffective, impractical, or kooky. But it permitted experimentation on an extraordinary scale with millions of people following a particular strategy at a time.

The advice of the official agencies tended to be reactionary. When nutritional deficiencies (remember those?) of the early 1900s were prevalent, they issued advice on food choices to help alleviate deficiencies. When deficiency transformed into excess after World War II, "smart" food choices from food groups and "sensible eating" became the theme.

Unfortunately, the advice was always adulterated by the enormous influence of various special interests, anxious to protect their national franchise. Powerful groups like the meat industry, wheat producers, and the dairy industry all made sure they had a big hand in crafting and influencing what was told to the American people.

The result: the advice offered by official groups has always represented the compromise of what some agency wished to convey to the people and the very powerful input of industry. What if the government decided to advise us what automobile to buy? Imagine the uproar in the auto industry when Washington tells us to buy Toyota for fuel economy and reliability. How long would that advice last?

That's why almost no knowledgeable adult follows the advice of the USDA, the National Academy of Sciences, or the Food Pyramid. I believe that we all intuitively recognize that the advice is watered-down, sometimes silly, sometimes downright unhealthy.

Nonetheless, the national experiment in diet that has taken place since 1950 has led to a collective wisdom of what is good and what is bad. The most productive conversations on nutrition therefore take place outside of the USDA and Washington. It occurs, instead, in places like bookstores, websites, and the media. Of course, there's lots of misinformation and profiteering in these sectors, as well. But like the enormous force unleashed by the collective wisdom of those contributing to the Wikipedia phemonenon, we've zig-zagged to something closer to the truth than ever uttered by an official agency.

Prescription vitamin D

23. June 2007 William Davis (32)
Niacin:

Over-the-counter: $2-5 per month
Prescription: $120 per month


Fish oil:

Over-the-counter: $3-6 per month
Prescription: $120 per month


Vitamin D:

Over-the-counter: $2 per month
Prescription: $70 per month



With vitamin D in particular, the prescription form is vastly inferior to the over-the-counter preparation. This is because the prescription form is ergocalciferol, or vitamin D2, not the effective human form, vitamin D3 or cholecalciferol.

When you're exposed to sun, what form of vitamin D is activated in the skin? It's all vitamin D3, no vitamin D2 whatsoever. Vitamin D3 is also far more effective than D2. People taking D3 (as long as it's oil-based) easily obtain healthy levels of vitamin D in the blood. People taking 50,000 units per day of D2 (the recommended quantity) remain miserably deficient, with minor increases in vitamin D blood levels. In short, D2 barely works at all. D3 works easily and effectively.

Moreover, D2 is the plant-based form. It is a form not found naturally in humans. D3 is the mammalian form, the same found in humans that exerts all its biologic benefits.

Then why is the prescription form of vitamin D2 (brand names Driscol and Calciferol) more expensive?

It's the same old pharmaceutical industry scam: Look for something patent protectable, regardless of whether it's superior to the non-patent protectable product, then sell it for exagerated profits. Though it is inferior and the science and clinical experience prove that it's inferior, you can still fool lots of people, including prescribing physicians. So what if you only make $50 or $100 million?

Don't fall for it. Prescription doesn't necessarily mean superior. In fact, the prescription form may be significantly inferior, as with vitamin D2. But the pharmaceutical industry carries such power and persuasion, who's going to know?

Nutrition activist Mike Adams

20. June 2007 William Davis (1)












I borrowed the above comic from the website of nutritionist, more properly nutrition activist and author, Mike Adams. His website, www.newstarget.com, was a pleasant surprise.

I was actually looking for some thoughts on pharmaceutical advertising and its pervasive and destructive effects and came across one of Adam's reports, Pharmaceutical television advertising is a grand hoax at http://www.newstarget.com/021526.html. The piece is a rant against the pharmaceutical industry's constant bombardment of the media, who have also been co-opted into their service, enticed by the enormous advertising revenues the drug industry brings.

But I was surprised to find an insightful, informative website on health issues, particularly healthy eating that rejects the manufactured food industry's intensive effort to persuade us to eat their products. While I don't agree with everything Adams has to say, his website provides some great food for thought. He also provides lots of downloadable information.

There's also some great laughs at his poke at the pharmaceutical industry with his Disease Mongering Engine at http://www.newstarget.com/disease-mongering-engine.asp, in which you get to create your own diseases. I got a real kick out of this.

CT scans and radiation exposure

19. June 2007 William Davis (8)


The NY Times ran an article called

With Rise in Radiation Exposure, Experts Urge Caution on Tests at

http://www.nytimes.com/2007/06/19/health/19cons.html?_r=1&adxnnl=1&oref=slogin&adxnnlx=1182254102-vQpytpx6W/Z9gvAaNPDZvA



“This is an absolutely sentinel event, a wake-up call,” said Dr. Fred A. Mettler Jr., principal investigator for the study, by the National Council on Radiation Protection. “Medical exposure now dwarfs that of all other sources.”


Where do CT heart scans fall?

Let's first take a look at exposure measured for different sorts of tests:



Typical effective radiation dose values

Computed tomography Milliseverts (mSv)

Head CT 1 – 2 mSv
Pelvis CT 3 – 4 mSv
Chest CT 5 – 7 mSv
Abdomen CT 5 – 7 mSv
Abdomen/pelvis CT 8 – 11 mSv
Coronary CT angiography 5 – 12 mSv

Non-CT Milliseverts (mSv)

Hand radiograph Less than 0.1 mSv
Chest radiograph Less than 0.1 mSv
Mammogram 0.3 – 0.6 mSv
Barium enema exam 3 – 6 mSv
Coronary angiogram 5 – 10 mSv
Sestamibi myocardial perfusion (per injection) 6 – 9 mSv
Thallium myocardial perfusion (per injection) 26 – 35 mSv

Source: Cynthia H. McCullough, Ph.D., Mayo Clinic, Rochester, MN


If you have a heart scan on an EBT device, then your exposure is 0.5-0.6 mSv, roughly the same as a mammogram or several standard chest x-rays.

A heart scan on a 16- or 64-slice multidetector device, your exposure is around 1.0-2.0 mSv, about the same as 2-3 mammograms, though dose can vary with this technology depending on how it is performed (gated to the EKG, device settings, etc.)

CT coronary angiography presents a different story. This is where radiation really escalates and puts the radiation exposure issue in the spotlight. As Dr. Cynthia McCullough's chart shows above, the radiation exposure with CT coronary angiograms is 5-12 mSv, the equivalent of 100 chest x-rays or 20 mammograms. Now that's a problem.

The exposure is about the same for a pelvic or abdominal CT. The problem is that some centers are using CT coronary angiograms as screening procedures and even advocating their use annually. This is where the alarm needs to be sounded. These tests, as wonderful as the information and image quality can be, are not screening tests. Just like a pelvic CT, they are diagnostic tests done for legimate medical questions. They are not screening tests to be applied broadly and used year after year.

Always be mindful of your radiation exposure, as the NY Times article rightly advises. However, don't be so frightened that you are kept from obtaining truly useful information from, for instance, a CT heart scan (not angiography) at a modest radiation cost.



Detail on radiation exposure with CT coronary angiograms on multidetector devices can be found at Hausleiter J, Meyer T, Hadamitzyky M et al. Radiation Dose Estimates From Cardiac Multislice Computed Tomography in Daily Practice: Impact of Different Scanning Protocols on Effective Dose Estimates. Circulation 2006;113:1305-1310, one of several studies on this issue.

Mediterranean diet vs. American Heart Association Diet

18. June 2007 William Davis (4)
In 1994, the Lyon Heart Study demonstrated a 50-70% reduction in coronary events in participants who followed a diet rich in vegetables, olive oil, fish, nuts, red wine, and enjoyed meals as a family activity. Various other studies have documented similar phenomena with less metabolic syndrome, better lipid patterns, less obesity with the Mediterranean lifestyle.

There are two fundamental differences between the Mediterranean diet and the diet advocated by the American Heart Association (AHA) for people with heart disease: the Mediterranean diet uses olive oil more liberally, such that fat calories can reach 40% of total; and, unlike the AHA diet, processed foods are not a part of the Mediterranean diet. Greeks, for instance, are far less likely to eat Count Chocula cereal for breakfast, or snack on Healthy Choice Premium Caramel Swirl Sandwich (ice cream sandwiches) or Malt-O-Meal Honey Nut Scooters. All three of these foods on listed on the AHA Heart-Check Mark heart-healthy program.

In other words, remove all the processed foods, and the AHA diet pretty closely resembles the Mediterranean diet. There are differences but they tend to be relatively small. If the only major difference is the presence of processed foods, wouldn't you therefore expect the AHA to embrace the Mediterranean diet?

Here's what their official stand on the Mediterranean diet states:

Does a Mediterranean-style diet follow American Heart Association dietary recommendations?

Mediterranean-style diets are often close to our dietary recommendations, but they don’t follow them exactly. In general, the diets of Mediterranean peoples contain a relatively high percentage of calories from fat. This is thought to contribute to the increasing obesity in these countries, which is becoming a concern.



The AHA is actually lukewarm towards the diet that was the first to show a dramatic decrease in heart attack and death. Why?

The answer is obvious, once cast in this light. To wholeheartedly endorse the Mediterranean diet might be seen as an indirect rejection of American processed foods. You know, the foods that have caused an extraordinary and unprecedented epidemic of obesity in the U.S., the foods that are manufactured by ConAgra, General Mills, Kelloggs--all also major financial contributors to the AHA, according to the AHA Annual Report.

I tell my patients: If you want heart disease, follow the American Heart Association diet. In my view, it is a diet founded on politics and money, not on health. How else could Cocoa Puffs be regarded as heart healthy?

Track Your Plaque in 50,000 BC

16. June 2007 William Davis (3)
Imagine we could send you back in a time machine to 50,000 BC.

However, our agreement: no modern tools or equipment. Just your brain, hands, and legs. And your landing spot will be tropical or semi-tropical, the same climate that humans spent much of their evolutionary time in.

Not only might you rub elbows with contemporaries like homo erectus and neanderthalensis, you'd also have to fend for your life and survival.

To eat, you will have to chase and kill wild game, all with your bare hands or crude tools crafted from sticks and stones. You will have to learn what wild berries, roots, and plants are edible and distingusih them from those that make you retch, make your bowels run, or kill you. You won't be able to cultivate grain, at least for a good long time, since you don't have a community that makes such an undertaking easier.

Instead, you are constantly on the run, from the moment you awake until you finally settle back as the sun sets, hopefully with a full stomach, but often empty and growling, anticipating the hunt and forage of tomorrow.

You are outdoors all day, except for the period when you hide in your cave or self-made shelter. You wear what little clothing you can make yourself from your kills, a skin or two. Your skin becomes a dark brown, a 5 foot 10 inch male will weigh 140 lbs, a 5 foot 5 inch woman 95 lbs. There are obvious downsides: your teeth will rot, you will be prone to infections, and predators view you as fair game.

But the result will be that many chronic diseases of modern life will no longer be worries for you. Heart disease? Highly unlikely. Do you need vitamin D? No, because you are outdoors virtually all day with most of your body surface area exposed to sun. Omega-3 fatty acids? You get those from the wild game you eat, since they have higher omega-3 content feeding in the wild, not eating corn like modern livestock. Since your body fat is minimal, just enough for survival, you don't need niacin.

In other words, many of the strategies of the Track Your Plaque program are modern necessities, responses to the "deficiencies" of modern life. Of course, I don't really have a time machine. I also doubt that you wish to hunt wild game every day, forage for plants and roots, run nearly-naked in the sun. You probably also have become accustomed to brushing your teeth and not viewing every animal as a potential threat to your life.

Nonetheless, I find this an interesting exercise for understanding the role of all the tools we use in the Track Your Plaque program for plaque control.

When pessimism wins

15. June 2007 William Davis (3)
When I first met Hank, I immediately sensed it: anger, hostility, fear. His heart scan score of 685 just made it worse.


He didn't want to be there talking to me. His wife was giving him a hard time. Work was a constant source of irritation. The receptionist at the front desk screwed up his paperwork. Our office charges were too much.


In short, Hank was a pessimist. A bad one.


All the nutrition information out there is bunk. Only he knew how he should eat right. It's stupid to take a lot of fish oil. "You want me to grow gills?"


Among the parameters we use in the Track Your Plaque program is blood pressure during exercise, which provides a surrogate measure of blood pressure during emotional stress, anxiety, etc. "No, I don't need that. I already exercise." No amount of justification could change his mind. "A guy at work had a stress test. They said everything was fine, then Bang! He drops dead. What good is that?"


Hank did go along with a few pieces of advice.


A repeat heart scan 12 months after the first: 870, a 27% per year rate of increase. That's about what would happen if Hank had done nothing, had taken no action to try and stop or reduce his heart scan score.


I don't know if Hank will ever succeed in dropping his score. In fact, I suspect that he will fail, meaning that plaque will grow and he will eventually, perhaps in a year, two or three, require several stents, heart bypass, or have a heart attack. In other words, Hank's pessimism is a self-fulfilling phenomenon: If he believes he will fail, he will. If he believes the world is a rotten place, it is.


Is it possible to "cure" someone like Hank of his deeply-rooted pessimistic attitudes? I don't know of any easy solutions for someone with attitudes as deeply-ingrained as Hank's. (See my prior post, "Cure for pessimism?" at http://heartscanblog.blogspot.com/2007_05_01_archive.html.)

I believe it does help to make someone aware of their attitudes and that it does indeed exert ill health-effects--if they will believe it. But this is a very tough nut to crack.

Bad news on CoQ10?

13. June 2007 William Davis (8)
A review of the effects of Coenzyme Q10 (CoQ10) on the muscle aches and weakness (myopathy) of statin drug therapy was just published in the Journal of the American College of Cardiology.

(Marcoff L, Thompson PD. The role of coenzyme Q10 in statin-associated myopathy. J Amer Coll Cardiol 2007;49(23):2231-2237.)

This is not a study, but a review of the existing scientific and clinical data available on this topic. The study authors conclude with a lukewarm statement:

". . .there is insufficient evidence to prove the etiologic [causal] role of CoQ10 deficiency in statin-associated myopathy and that large, well-designed clinical trials are required to address this issue. The routine use of CoQ10 cannot be recommended in statin-treated patients. Nevertheless, there are no known risks to this supplement and there is some anecdotal and preliminary trial evidence of its effectiveness. Consequently, CoQ10 can be tested in patients requiring statin treatment, who develop statin myalgia, and who cannot besatisfactorily treated with other agents. Some patients may respond, if only via placebo effect."

Should the media get hold of this report, be prepared for the usual "Nutritional supplement no help for drug toxicity" headlines, or "Yet another nutritional supplement shows no benefit" with parallels drawn to vitamin C or E.

There are several issue that need to be factored into the discussion:

1) This is not a study, just a review. Thus, any biases of the authors are more likely to exert themselves.

2) The understanding of CoQ10 absorption among different preparations may be an issue. I just received a mailing from Life Extension that made extravagant claims about the superior absorption of ubiquinol, to be distinguished from ubiquinone, the more common form. They claim that eight-fold increased absorption and blood levels of CoQ10 are achievable with ubiquinol. Unfortunately, virtually all the supportive data are unpublished, proprietary observations, i.e., generated by companies who make or sell it. This is as reliable as drug manufacturers who publish glowing reports on their own drugs--perhaps it's true, but it requires unbiased corroboration.

3) Despite the lack of a large, well-funded clinical trial (all are small), the issue continues to live and breathe because of the powerful anecdotal experience.

In our experience, CoQ10 does work. It doesn't work all of the time, perhaps just 80-90% of the time. It does generally require higher doses (100 mg per day, occasionally more). It very clearly must be an oil-based gelcap (just like vitamin D) to work; capsules containing powder do not work.

It's difficult to doubt when someone starts a statin drug, develops the muscle aches and weakness, begins CoQ10 and obtains distinct relief, stops CoQ10 and aches and weakness return, then only to go away again with resumption of CoQ10 . I've seen this countless times.

We do need better information on CoQ10. There's no doubt about it. For people who obtain benefit from statin therapy, I think CoQ10 remains a useful solution. A better solution would be to get rid of the offending drug. But that's not always possible--e.g., LDL cholesterol 190 mg/dl despite the best diet and "adjunctive" food effort. Then CoQ10 can be very useful.
The battle for asymptomatic disease

The battle for asymptomatic disease

31. October 2007 William Davis (10)
The heart disease revenue pie is shrinking. So is the "serving size" being shared by competing hospitals.

In other words, as more hospitals open heart programs, there is more competition for the same heart patient. Throw into the mix the drop in "acute" presentations of disease, probably due to the now widespread prescribing of statin drugs. When I first started cardiology practice 15 years ago, for instance, days and nights spent taking care of heart attacks coming through the emergency room was a common event. It still happens, but far less frequently. (I don't mean to suggest that the actual prevalence of coronary heart disease has decreased, just the acute, catastrophic version of it.)

Throw into this mix the results of the COURAGE Trial that has put a damper on the value of stents and angioplasty vs. "optimal" medical therapy in people with stable anginal symptoms, since there was little advantage of procedures. Though it has not stopped the practice, it has reduced the enthusiasm for procedures. Though data are hard to come by, I've heard talk of 10% or greater drops in total procedural volume over the past year.

It's not uncommon for hospitals to have overbuilt heart facilities in anticipation of continued growth of this--until recently--growth industry called heart disease. However, factors are converging that may provide a new profit opportunity for hospitals.

One such opportunity is CT coronary angiography. The usual scenario: Man or woman without symptoms is persuaded somehow--an ad, primary care physician, next door neighbor with a scary event, Dr. Mehmet Oz gushing about this sexy new technology on yet another Oprah episode--to undergo a CT coronary angiogram. A "severe" blockage is found, despite the lack of symptoms, and voila! A stent patient or bypass patient is created out of nothing! Do this repeatedly and systematically, and a hospital can regain its former high-procedural volume glory.

Heart scans, though I believe deeply in them and they are the basis for the Track Your Plaque prevention and reversal program, can also be used and abused this way. Asymptomatic person has a score 150. Concerned, they go to their physician who orders a nuclear stress test. An "inferior perfusion defect" is seen, presumably representing poor flow through the right coronary artery (but often just means that the diaphragm overlaps the heart muscle and yields this apparition, a "false positive" or misleading result). "But--wink--we've got to find out if there's a severe blockage, don't we? You don't want to end up in an early grave!"

Thus, the battle for new patients with asymptomatic disease is getting underway in earnest. The scramble for cardiologists to learn how to use CT coronary angiograms is proceeding at breakneck speed, with new training courses being offered nationwide several times and places every month. CT coronary angiography is a useful test, but it is also subject to enormous abuse. It also provides the ticket for the unscrupulous physician and the revenue-hungry hospital eager to expand its patient volume.

Many people believe that this cannot happen commonly in 2007, given scrutiny of practices, litigiousness, and the expectation of a moral sense in medicine. However, I've witnessed such incidents several times this month alone. If you need graphic proof of just how far this can go before action is taken, read Coronary, Stephen Klaidman's chilling tale of a cardiologist and cardiothoracic surgeon in small-town northern California who built an enormous heart center based on fabricated heart disease diagnoses. You'll also find their story in Shannon Brownlee's recently released Overtreated: Why Too Much Medicine Is Making Us Sicker and Poorer.





Of course, the Track Your Plaque program is meant principally for people without symptoms, also. But we are advocating that asymptomatic disease is a reason for prevention, not procedures. There's a difference.

By the way, the two practitioners who engineered the escapade detailed in these books, cardiologist Chae Hyun Moon and cardiac surgeon Fidel Realyvasquez, walked away with a monetary fine and suspension of their California medical licenses. It is likely that many people died because of their abusive practices, but the state struggled to make a sufficiently persuasive case for reasons that I still don't understand.
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Comments (10) -

  • G

    11/2/2007 6:36:00 AM |

    Poor Oprah, she's on the yellow brick road and doesn't even know it! I hope your results validating CT scans and dramatic primary CAD reduction bring on a revolution. It could not be soon enough. Personally, I find it so hard to teach my diabetes patients about wheat-elimination with the goal to improve their diabetes, reduce insulin doses and lose weight. (Not to mention, of course, other benefits like reducing early death -- esp the silent fatal heart attack kind) It's like trying to treat an obese child -- you look at the parents -- then realize you need to treat the parents first. To save lives from heart disease (which is increased five-fold in people with diabetes), I think the whole Western society needs to be educated and exposed to the TYP program!  i greatly think Oprah needs your help (at least get her out of the hands of M&M, you know, that sugar-coated pair Mehmet and Mike)  *ha haaa haa*  What a great help she would be if she was also convinced, and moved the TYP plan to the forefront?  PBS is good, but n-o-t-h-i-n-g is as good as Oprah ;)

    Your writings are mandatory reading for all my patients! Keep up the strong work!

  • Dr. Davis

    11/2/2007 10:41:00 AM |

    Thanks, G.

    Love your analogy of the obese and child and parents.

    I agree. It's a long uphill climb and one that runs against the winds of what the hospitals and powers that be tell us. Imagine how slow the climb would be without the information disseminating powers of the internet!

  • G

    11/2/2007 11:17:00 PM |

    Dr. D

    Thank God for the powers of the Internet!  I was researching estrogen (for a talk at a pharmacy school I teach at) and came across your blog under Sue Shellenbergers Wallstreet J article in March. What a fluke!! I went through all the archives almost as fast as I was hooked and addicted to watching Lord of the Rings.  You are undoubtedly the BEST health resource that I have come across -- including primary literature and cardiolgy texts.  I love your ex-interventionalist rhetoric and rants. You approach the whole body including mental health (LOVE the 'be happy' blog!) and emphasize heart prudent OPTIMAL nutrition.  Because I've lived it and I've seen health improvements with the basic low carb TYP rx on my DM patients (you know the 1-2% that actually aren't nonadherent), I know with 200% certainty IT works. Your explanations and references are always great in illustrating who they work for the heart and vasculature.

    I have faith that you will demonstrate compelling outcomes and data on how all these components work together (D replacement, nuts, vegetarianism, low GI foods, oat bran, fish oil, etc).  Without a doubht that seminal cardiology publication when it finally hits the stands will change e-v-e-r-y-t-h-i-n-g. (at least it will stir the establishment up a bit *what entertainment value THAT will have!!!* the suspense...)

    OK, i know you don't do individual consults, but I have a patient that I need help on...  his cardiologists have given up -- he's had multiple surgical interventions (s/p stents about 1-2 mos ago). I've implored him to read and study the TYP book and blog (he better be reading this).  Diffuse CAD still cause DOE and SOB. Within DAYS after the last stents were put in, the symptoms returned again. (drug-coated no less *YECK*)  He's doing the whole aggressive medical management thing (with me). he's eliminating all refined processed carbs (he misses his biscotti), we've added B3 (still titrating), D3 4000 Iu/d (baseline=37 ng/ml) and 3400mg EPA+DHA, oat bran and raw nuts. he's on Vytorin 10/80 for the heck of it. I hope to obtain 60/60/60/60 in 3-6mos. his a1c is almost < 6.5% (from 8.5%).

    My question for you is -- will he ever get off of the short or long acting nitrates? (at this point it's not apparently helping anyway) will the DOE always be there?!  what dramatic reversal in CAD have you seen?  he's a fit avid soccer player, but can't play at all right now.

    When you use Slo-niacin, can you get them to therapeutic doses faster? he's on short acting right now.  I am so grateful for your generosity in sharing your compelling and honest insights. You are totally making a difference...  

    Thank you in advance for your feedback.  Take care! G

  • Dr. Davis

    11/3/2007 1:24:00 AM |

    Hi, G--

    Thank you kindly!

    Interestingly, simply articulating the concept or philosophy of obtaining reversal, of at least setting that as a goal, can truly turn someone's view of themselves and their disease completely around.

    Some thoughts for the patient you discuss:

    1) Time is crucial. It may simply require several months.

    2) Consider using therapeutic fasting for the fastest means to resolution of symptoms. There is a report on this approach on the www.trackyourplaque.com website, or see Joel Fuhrman's book,
    Fasting and Eating for Health. (Ignore the low-fat eating comments in the book, however.)

    3) Consider l-arginine to accelerate anti-inflammatory and endothelial-normalizing effects.

    4) Unfortunately, I never use immediate release niacin, but I imagine that a 500 mg increase every two weeks could be tried, similar to the accelerated course we sometimes use with SloNiacin or Niaspan.

    5) Consider doxycycline for its matrix metalloproteinase-suppressing activity. See the associated report on the website, also.

    Nitrates in my view are just Band Aids that provide little genuine therapeutic benefit beyond temporary symptom relief.

  • G

    11/3/2007 4:17:00 AM |

    No matter what the results are, I'm eternally grateful (and he will be too). I'm going to approach his doc on Monday... THANK YOU VERY VERY VERY MUCH! G

  • Anonymous

    11/3/2007 1:38:00 PM |

    Boy G you are the first dietitian I know who promos low carb for diabetes, goodonya, do you read Dr Bernsteins Diabetic Solution. His book and webcasts and TYP are my bibles.

    Is Oprah's weight gain due to following Dr Oz.

    Here;s a story for you that is scary for a pateint with undiagnsoed chest pain:

    I had undiagnosed chest pain for several months, quit Actos ( it started around time I went on Actos)but it remained after quitting for 6 weeks actually, and they did a stress test and said nada but I know from your book I need another calcium score done so am pushing for that.

    In the meantime this Dr who is new to town told me I must stay on Actos no matter what the side effects are and sometimes you just have to take risks to stay on drugs!!  

    I actually only asked for Actos to try get my A1C to a 4.5 from a 5.4 as Dr Bernstein recommends that diabetics have the same rights to normal bg as non diabetics, so then I didn't see him again and saw his wife. They are both new Dr from South Africa.

    She put me on nitro spray, didn't even see me, called me out of the blue and said maybe I should use it,would aid in her diagnosis if it worked!! yet they won't give me a repeat Rx for metphormin which I have been on for 15 yr (over the phone)!!!!

    I didn't want to use it but the pain scares me as it is harsh, bends me over and I live out of town and fear if I am having a MI I am at higher risk, so the next time  I had the chest pain, I tried the nitro once and my bp dropped to 84/58 and I almost went into shock, so I dumped her and have a new young doc who tries to practise cardiology along with her caseload.

    My Dr of 21 yr moved so its been awful living rural in small town and not enough Dr, she seems intelligent, listens and I think I can bend her ear towards TYP.

    I am going to push for advanced lipid profile again,and another EBCT, my pain is lessening as my high stress job finished, I can't believe that crippling pain was due to stress and fear the Actos set me up for something.

    I am the therapist that got the referrals for those appearing in emerg thinking they are having a heart attack and they wern't, it was anxiety induced. I tried all the relaxation techniques I taught and it didn't help my chest pain so I was scared so used the nitro much against my better judgment and won't ever again.


    The stress test showed nothing wrong, good recovery, the ecg showed no heart attack.

    I had a Pulse Wave analysis test done at a conference I went to on menopause. This conference follows the programs of Dr John Lee who also thought outside the box like you do Dr D and he had good results and not the side effects from hormone trtment like oral drugs has.

    He suggests bio identical creams only so if you search out Jackie Harvey and the workshops she does called Heart to Heart for women and the medical profession, you will learn about menopause help that is also non traditional.

    This new doc I found supports her ideas, will support the saliva test and prescribe bio identical progesterone cream if your test suggests you need it as you have estrogen dominance, and it does seem to help.

    Tell me if you think this Pulse wave analysis is right on, they recommend a liquid L arginine as say it absorbs better but boy is it pricey.

    BTW I don't have a goggle acct and don't really know how to set one up so come under anonymous so it makes a few of us, sorry.


    Thank you for this siteSmile

  • Dr. Davis

    11/3/2007 7:06:00 PM |

    Reluctantly Anonymous via Google--

    Actually, what you are describing--chest pains around the menopausal years with some gauge of "endothelial dysfunction," i.e., abnormal coronary artery constriction--is how I first came to appreciate the power of l-arginine about 15 years ago.

    Back then, research from the NIH uncovered a poorly-named entity in perimenopausal women called "microvascular angina." It is wonderfully responsive to l-arginine. That's the situation in which I also learned that arginine only works when taken on an empty stomach.

  • gc

    11/3/2007 11:42:00 PM |

    Wow thank you for that info, Smile
    RA

  • Anonymous

    11/11/2007 2:31:00 AM |

    Thank you Dr. Davis for posting about the book "Coronary," which I ordered after reading about it on your website.

    It is one of the most chilling books I have read.  One would like to think that the unnecessary angioplasties and heart bypasses that the book described were anomalies, limited to two amoral out-of-control doctors in a small Northern California town.  But you write that you have seen it in your city in the Midwest.

    It makes me cynical about the entire medical profession.  By the way, I have seen the same amoral greediness from many so-called "alternative medicine" doctors in Los Angeles.  It may not be on the same scale as Drs. Moon and Realyvasquez, since these so-called anti-aging gurus are only pushing unnecessary supplements (which they sell at great markup in their offices) and unnecessary blood work and saliva tests (I have no doubt whatsoever that they are getting illegal kickbacks from the labs), not surgery and invasive procedures.  I guess it's the difference between a little shoplifting and armed bank robbery, but still it does make one cynical about the whole medical profession.

    Thank goodness for your blog, which at least helps laypeople have a fighting chance.

  • Dr. Davis

    11/11/2007 2:51:00 AM |

    I like your analogy: shoplifting vs. armed bank robbery.

    Legislating against such excesses is an impossible task. In my view, the solution is education.

    An informed, educated consumer is one who can make his/her own choice, whether it's to pursue acupuncture, chiropractic, take hawthorne, undergo coronary angioplasty, or some other path.

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