Track Your Plaque goes global

I don't use this space to toot my horn (at least I don't too often), but we were looking at the listings of our viewers and members. I was surprised to learn that we now have Track Your Plaque followers in 15 different countries around the world!

We have members from Europe including England, Ireland, Switzerland, Belgium, and the Czech Republic. We have members from as far away as South Africa, Australia, India, Singapore, Thailand, and China.

I see the entire Track Your Plaque process as a grand experiment. Never before in history has a system of health been delivered via a communication medium like the web. The internet provides more interactivity than television, it's more fluid than a book, it's more dynamic and evolves more rapidly than a face-to-face interaction. While we cannot be hands-on over the internet, we can still deliver all the crucial information and, hopefully, the knowledge on how to get it done.



Track Your Plaque is part of an even grander experiment: The movement to shift control over health away from the medical system, doctors, and hospitals and back to individuals. When you think about it, the idea that "health" (more acurately sickness) should be managed by people and institutions (e.g., hospitals and insurance companies) outside of the individual is a 20th century concept. I predict that this notion will also become a relic of the 20th century.

Someday, we will look back and laugh at the folly of the 20th century style of paternalistic health care. Perhaps it was a necessary step in the sequence to transform health to a better system that returns control to the individual. But it's clearly time for a change.

Track Your Plaque is an example of the extraordinary power that can be taken by a lone individual with only minimal assistance of a health care provider. I see Track Your Plaque members who understand heart disease (at least the coronary disease aspect) far better than 95% of my cardiology colleagues, 100% of my internal medicine and family practice colleagues. Physicians maintain a role, but their role has shrunk and receded. They should be facilitators of success in health, educators, a resource to turn to when we need help. It's not that way today. It will be in 50 years.

But, right now, we can get started on this wonderfully self-empowering--liberating-- movement by participating in this global experiment known as Track Your Plaque, the program with the goofy name that has the potential to usurp and unravel this enormous institutionalized system of health care the world has created.

Comments (3) -

  • J Phillip

    9/21/2007 1:01:00 PM |

    Bravo, Dr. Davis!  As always, you have hit the proverbial nail on the head. It is refreshing to see a medical professional who truly believes that cardiac (and overall medical) care should be the responsibility of the individual with guidance as necessary from their doctor.  Every time I see my doctor (part of a large hospital-based practice), he only wants to schedule a $5000 stress test, even though I have repeatedly 'stressed' to him that I feel great, have no symptoms and would much rather have a heart scan (alas his hosptal does not offer this test, so it is clearly not an option... I'll have to arrange for it on my own... taking care of my own health, I imagine!).  The doctor only rolls his eyes, I can only guess he doesn't understand the importance of the scan or views it as unimportant since his facility doesn't get to bill for it.  Who knows for sure, but it clearly is time for a new forward-thinking medical professional!
    I would like to tell you that I believe your blog is of immense value to those with current cardiac disease, as well likely as anyone over the age of 30 with a heart, and I look forward to every post... thanks!

  • J Phillip

    9/21/2007 1:02:00 PM |

    Bravo, Dr. Davis!  As always, you have hit the proverbial nail on the head. It is refreshing to see a medical professional who truly believes that cardiac (and overall medical) care should be the responsibility of the individual with guidance as necessary from their doctor.  Every time I see my doctor (part of a large hospital-based practice), he only wants to schedule a $5000 stress test, even though I have repeatedly 'stressed' to him that I feel great, have no symptoms and would much rather have a heart scan (alas his hosptal does not offer this test, so it is clearly not an option... I'll have to arrange for it on my own... taking care of my own health, I imagine!).  The doctor only rolls his eyes, I can only guess he doesn't understand the importance of the scan or views it as unimportant since his facility doesn't get to bill for it.  Who knows for sure, but it clearly is time for a new forward-thinking medical professional!
    I would like to tell you that I believe your blog is of immense value to those with current cardiac disease, as well likely as anyone over the age of 30 with a heart, and I look forward to every post... thanks!

  • wccaguy

    9/23/2007 2:56:00 AM |

    Kudos to you Dr. Davis for the work you've done to understand the various dimensions of dealing with coronary artery disease in preventative and crisis management situations.

    Thanks also for not sitting on that knowledge but instead establishing a vision and engaging in activity to assist those of us who suffer from the disease to make more informed and better choices to deal with it.

    I just found your work in the last 6 weeks or so and still have a lot to digest and implement.  Nevertheless, to be honest, I already consider you to be the best source for cardiology information and advice.

    My HMO has been great and I'm sure will be great as needed in my crisis situations but is virtually worthless for purposes of understanding prevention except to process my lipid medication prescriptions.

    I'm moving through your TrackYourPlaque book now.  It's great.

    Thanks.

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Appetite stimulants

Appetite stimulants

Ever have days when you just can't seem to get enough to eat, your stomach gnawing just a hour after a meal? We all get them, some more than others. Other days, you can be content with a few simple foods and hunger is subdued, temptation easy to control.

Why such contrasts on different days?

A major part of the reason can be the presence of appetite stimulants, factors that trigger appetite beyond rational control. The list of common appetite stimulants includes:

--Sleep deprivation--A very important factor. Lack of sleep drives tremendous appetite, and often for the wrong foods (processed carbohydrates). I personally have experienced my most shamefully indulgent days when sleep-deprived. The solution is obvious: Sleep. Another factor that is based purely on personal observation is that of waking mid-phase. In other words, waking up while you're still enjoying the deeper phases of sleep (e.g., phase 3,4, or REM). This can oddly disrupt your day and your impulse control. I usually try and time sleep to increments of 90 minutes to coincide with the average duration of the full cycle of sleep. For example, 7 1/2 hours is better than 8 hours, since the extra half hour puts your square into a deeper sleep cycle.

--Excessive caffeine--Caffeine stimulates stomach acid. This triggers the impulse to eat . . . and eat and eat.













Image courtesy Wikipedia

--Aspirin and other anti-inflammatory agents--If you take aspirin (as many of our Track Your Plaquers do), then beware of the gastritis that can develop. Like excessive caffeine, it also triggers the impulse to eat, likely a protective mechanism, since food sops up excess acid. I ask patients to take periodic breaks from aspirin, e.g., a week off every two or three months, to allow the stomach to heal. Alternatively, an occasional dose of acid-suppressing medication is a safe practice, e.g., Pepcid AC 10-20 mg; Prilosec 10-20 mg.

--Wheat-containing foods--Followers of The Heart Scan Blog know my feelings on this. Wheat is a potent appetite stimulant: Eat something containing wheat like a pretzel or whole wheat bagel, and you want more. You may want more immediately, or a little later when your blood sugar plunges after the wheat-driven insulin surge. Solution: Dump the wheat, one of the most unhealthy food groups around.

--Alcohol--Though perhaps not a direct appetite-stimulating effect, the loss of impulse-control with alcoholic drinks can lead to overindulgence, often in the worst foods. Just beware.

--Hanging around with heavy people. Remember peer pressure? It can be subliminal. People with poor eating habits provide the silent message that it's okay to yield to impulse, overeat, overindulge, and choose the wrong foods.

--Stress--Whether through cortisol stimulation or other means, stress triggers appetite in some people. If you experience this and must give in, reach for raw nuts or nuts, rather than wheat snacks or chips. The effect will be minimal, perhaps even beneficial, rather than the bloating, appetite-stimulating, fattening effect of crackers, chips, or pretzels. This may be the same phenomenon as taking prescription steroids like prednisone.

--Short dark days, long nights--In other words, winter. Though just an anecdotal observation, I am convinced that vitamin D supplementation is an effective antidote to this effect. The short, dark days just don't bother you as much, perhaps not at all, and there's no impulse for comfort foods.


How about appetite suppressants? In this list I would include 1) raw nuts--especially almonds, walnuts, pecans, and pistachios, the sort with a fibrous covering and rich in monounsaturates, 2) other sources of plentiful healthy oils, e.g, use more olive oil in your salad or add it to hummus for your veggie dip, 3) space-occupying fibers such as glucomannan, inulin (such as in Fiber Choice), and psyllium seed products. Counteracting the above appetite stimulants like sleep deprivation is, of course, important.

The coming wheat frenzy, otherwise known as the holidays, is an especially important time to be aware of these effects. Eat, drink, and be merry--but with rational impulse control not driven by subconscious appetite stimulants.

Comments (17) -

  • Nancy M.

    12/20/2007 4:16:00 PM |

    You didn't mention one of the biggest appetite stimulants ever.... insulin. They used to inject it directly into anorexics to get them to eat.  That pre-meal release of insulin where you get very, very hungry as you're about to sit down to your dinner.

    Actually, it probably isn't the insulin per se, but what the insulin does, drops your blood sugar.  This is why a low carb diet works so well on moderating appetite, insulin and blood sugar drops are much quieter.

  • Stan

    12/20/2007 6:28:00 PM |

    It is not surprising that you have listed nuts and seeds as appetite supressants.  In my experience the most powerful apetite controller (suppressants if you have eaten enough) are fats!   All fats work like that, especially butter, lard, egg yolks etc.  Typically, our digestive system produces a satiety feedback within 10-20 minutes from eating a meal containing a reasonable amount of fat (for me personally, "reasonable" means 60-80%).  It does not work for low fat high carb meals - then the only restraint is the bulk volume.

    Stan (Heretic)

  • HeartCipher

    12/20/2007 8:15:00 PM |

    Maybe I'm just imagining it but I could swear that I'm less hungry if I drink two large glasses of water as soon as I get up in the morning and then eat 2 or 3 hard boiled eggs for breakfast.

    That keeps me going through lunch as I also snack on almonds during the morning (while doing my 2 month "almond eating personal trial".

    If I manage to have a couple of more eggs for lunch then I'm good until dinner.

    Anyone else had this experience with eggs?

  • Anonymous

    12/20/2007 9:29:00 PM |

    Here's an odd one, but true: diet sodas cause tremendous hunger.  And they especially cause ravenous carb cravings before bedtime on any day a diet soda has been consumed.

  • Dr. Davis

    12/21/2007 2:41:00 AM |

    I have. The combined protein in the white and fat in the yolk are very filling.

  • Dr. Davis

    12/21/2007 2:42:00 AM |

    What an interesting observation!

    This would also be consistent with the recent study suggesting that diet sodas are no different than sugared sodas on long-term impact on weight.

  • chickadeenorth

    12/21/2007 7:09:00 AM |

    Yes I notice eggs can hold me till late aft and ground flaxseed only holds me for 2 or 3 hrs.

  • Anonymous

    12/21/2007 11:02:00 AM |

    It really is remarkable how a heart healthy diet has cut down on my appetite.  Going into it, I never thought this would happen.  I figured I'd have a feeling of starving all the time.  

    A little different question, but a topic that came up over dinner last night, some friends and I have been on a low carb diet for a few months, and have noticed that our hair that was formerly thinning has become thicker.  Have you noticed this yourself, or patients mention this before?

  • Dr. Davis

    12/21/2007 12:21:00 PM |

    Curious. No, I've never seen this effect before. I'll have to watch for it.

  • g

    12/22/2007 3:37:00 PM |

    Yes, I had a pt in his 60s (his 25(OH)D was already 60ng/ml in Nov naturally because he lives in Arizona) and after ONE-WEEK on the TYP meal plan, he reported more hair. a-m-a-z-i-n-g!
    he even smokes still 1/2-ppd.
    I think that TYP somehow magically synergizes things in the body. I wonder why? DR. Davis, you are truly like other talented artists like Emeril... you put things all in a pot *POW*  *BAM* and make them A-L-L.... HAPPY!

    BTW an interesting observation, I've been on Vit D and TYP now for 2mos and I'm getting hit on more than ever... and it aint the Victoria S Superbra *ha ha* ;)
    Keep trackin' and REVERSE-PLAQUIN,
    g

  • MAC

    12/22/2007 10:45:00 PM |

    Re: hair growth and low carb.

    There is a statement in the "Life w/o Bread" book by Christian Allan that too much insulin interferes with human growth hormone levels. Fingernails grow faster and hair growth increases on a low carb diet. This book is about Dr. Lutz who prescribed a low carb diet to his patients for 40+ years in Austria and Germany. The low carb diet puts the body back in balance between anabolic and catabolic processes.

  • Dr. Davis

    12/23/2007 12:39:00 AM |

    Hi, MAC--
    I wasn't aware of that. Thanks.

  • chickadeenorth

    12/23/2007 9:04:00 AM |

    Yes my nails grow like crazy as does my hair and lots on Atkins board said their hair grew and thickened.

  • Anonymous

    12/25/2007 9:57:00 AM |

    Hey g,

    Vitamin D must be an elixer huh?

    Very funny!

  • Anonymous

    1/18/2010 4:33:41 PM |

    Hanging around with heavy people can be bad for your health...?

    Comments like that are very hurtful and feed into the pressures in this country to be the perfect size 2.  Also, it assumes that only fat people eat a lot.  Thanks for that.  Appreciate it.

  • buy jeans

    11/2/2010 7:41:47 PM |

    --Hanging around with heavy people. Remember peer pressure? It can be subliminal. People with poor eating habits provide the silent message that it's okay to yield to impulse, overeat, overindulge, and choose the wrong foods.

  • pammi

    11/9/2010 11:32:04 AM |

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

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