For the sake of convenience: Commercial sources of prebiotic fibers

Our efforts to obtain prebiotic fibers/resistant starches, as discussed in the Cureality Digestive Health Track, to cultivate healthy bowel flora means recreating the eating behavior of primitive humans who dug in the dirt with sticks and bone fragments for underground roots and tubers, behaviors you can still observe in extant hunter-gatherer groups, such as the Hadza and Yanomamo. But, because this practice is inconvenient for us modern folk accustomed to sleek grocery stores, because many of us live in climates where the ground is frozen much of the year, and because we lack the wisdom passed from generation to generation that helps identify which roots and tubers are safe to eat and which are not, we rely on modern equivalents of primitive sources. Thus, green, unripe bananas, raw potatoes and other such fiber sources in the Cureality lifestyle.

There is therefore no need to purchase prebiotic fibers outside of your daily effort at including an unripe green banana, say, or inulin and fructooligosaccharides (FOS), or small servings of legumes as a means of cultivating healthy bowel flora. These are powerful strategies that change the number and species of bowel flora over time, thereby leading to beneficial health effects that include reduced blood sugar and blood pressure, reduction in triglycerides, reduced anxiety and improved sleep, and reduced colon cancer risk.

HOWEVER, convenience can be a struggle. Traveling by plane, for example, makes lugging around green bananas or raw potatoes inconvenient. Inulin and FOS already come as powders or capsules and they are among the options for a convenient, portable prebiotic fiber strategy. But there are others that can be purchased. This is a more costly way to get your prebiotic fibers and you do not need to purchase these products in order to succeed in your bowel flora management program. These products are therefore listed strictly as a strategy for convenience.

Most perspectives on the quality of human bowel flora composition suggest that diversity is an important feature, i.e., the greater the number of species, the better the health of the host. There may therefore be advantage in varying your prebiotic routine, e.g., green banana on Monday, inulin on Tuesday, PGX (below) on Wednesday, etc. Beyond providing convenience, these products may introduce an added level of diversity, as well.

Among the preparations available to us that can be used as prebiotic fibers:

PGX

While it is billed as a weight management and blood sugar-reducing product, the naturally occurring fiber--α-D-glucurono-α-D-manno-β-D-manno- β-D-gluco, α-L-gulurono-β-D mannurono, β-D-gluco-β- D-mannan--in PGX also exerts prebiotic effects (evidenced by increased fecal butyrate, the beneficial end-product of bacterial metabolism). PGX is available as capsules or granules. It also seems to exert prebiotic effects at lower doses than other prebiotic fibers. While I usually advise reaching 20 grams per day of fiber, PGX appears to exert substantial effects at a daily dose of half that quantity. As with all prebiotic fibers, it is best to build up slowly over weeks, e.g., start at 1.5 grams twice per day. It is also best taken in two or three divided doses. (Avoid the PGX bars, as they are too carb-rich for those of us trying to achieve ideal metaobolic health.)

Prebiotin

A combination of inulin and FOS available as powders and in portable Stick Pacs (2 gram and 4 gram packs). This preparation is quite costly, however, given the generally low cost of purchasing chicory inulin and FOS separately.

Acacia

Acacia fiber is another form of prebiotic fiber.  RenewLife and NOW are two reputable brands.

Isomalto-oligosaccharides

This fiber is used in Quest bars and in Paleo Protein Bars. With Quest bars, choose the flavors without sucralose, since it has been associated with undesirable changes in bowel flora.

There you go. It means that there are fewer and fewer reasons to not purposefully cultivate healthy bowel flora and obtain all the wonderful health benefits of doing so, from reduced blood pressure, to reduced triglycerides, to deeper sleep.

Disclaimer: I am not compensated in any way by discussing these products.

How Not To Have An Autoimmune Condition


Autoimmune conditions are becoming increasingly common. Estimates vary, but it appears that at least 8-9% of the population in North America and Western Europe have one of these conditions, with The American Autoimmune Related Diseases Association estimating that it’s even higher at 14% of the population.

The 200 or so autoimmune diseases that afflict modern people are conditions that involve an abnormal immune response directed against one or more organs of the body. If the misguided attack is against the thyroid gland, it can result in Hashimoto’s thyroiditis. If it is directed against pancreatic beta cells that produce insulin, it can result in type 1 diabetes or latent autoimmune diabetes of adults (LADA). If it involves tissue encasing joints (synovium) like the fingers or wrists, it can result in rheumatoid arthritis. It if involves the liver, it can result in autoimmune hepatitis, and so on. Nearly every organ of the body can be the target of such a misguided immune response.

While it requires a genetic predisposition towards autoimmunity that we have no control over (e.g., the HLA-B27 gene for ankylosing spondylitis), there are numerous environmental triggers of these diseases that we can do something about. Identifying and correcting these factors stacks the odds in your favor of reducing autoimmune inflammation, swelling, pain, organ dysfunction, and can even reverse an autoimmune condition altogether.

Among the most important factors to correct in order to minimize or reverse autoimmunity are:


Wheat and grain elimination

If you are reading this, you likely already know that the gliadin protein of wheat and related proteins in other grains (especially the secalin of rye, the hordein of barley, zein of corn, perhaps the avenin of oats) initiate the intestinal “leakiness” that begins the autoimmune process, an effect that occurs in over 90% of people who consume wheat and grains. The flood of foreign peptides/proteins, bacterial lipopolysaccharide, and grain proteins themselves cause immune responses to be launched against these foreign factors. If, for instance, an autoimmune response is triggered against wheat gliadin, the same antibodies can be aimed at the synapsin protein of the central nervous system/brain, resulting in dementia or cerebellar ataxia (destruction of the cerebellum resulting in incoordination and loss of bladder and bowel control). Wheat and grain elimination is by far the most important item on this list to reverse autoimmunity.

Correct vitamin D deficiency

It is clear that, across a spectrum of autoimmune diseases, vitamin D deficiency serves a permissive, not necessarily causative, role in allowing an autoimmune process to proceed. It is clear, for instance, that autoimmune conditions such as type 1 diabetes in children, rheumatoid arthritis, and Hashimoto’s thyroiditis are more common in those with low vitamin D status, much less common in those with higher vitamin D levels. For this and other reasons, I aim to achieve a blood level of 25-hydroxy vitamin D level of 60-70 ng/ml, a level that usually requires around 4000-8000 units per day of D3 (cholecalciferol) in gelcap or liquid form (never tablet due to poor or erratic absorption). In view of the serious nature of autoimmune diseases, it is well worth tracking occasional blood levels.

Supplement omega-3 fatty acids

While omega-3 fatty acids, EPA and DHA, from fish oil have proven only modestly helpful by themselves, when cast onto the background of wheat/grain elimination and vitamin D, omega-3 fatty acids compound anti-inflammatory benefits, such as those exerted via cyclooxygenase-2. This requires a daily EPA + DHA dose of around 3600 mg per day, divided in two. Don’t confuse EPA and DHA omega-3s with linolenic acid, another form of omega-3 obtained from meats, flaxseed, chia, and walnuts that does not not yield the same benefits. Nor can you use krill oil with its relatively trivial content of omega-3s.

Eliminate dairy

This is true in North America and most of Western Europe, less true in New Zealand and Australia. Autoimmunity can be triggered by the casein beta A1 form of casein widely expressed in dairy products, but not by casein beta A2 and other forms. Because it is so prevalent in North America and Western Europe, the most confident way to avoid this immunogenic form of casein is to avoid dairy altogether. You might be able to consume cheese, given the fermentation process that alters proteins and sugar, but that has not been fully explored.

Cultivate healthy bowel flora

People with autoimmune conditions have massively screwed up bowel flora with reduced species diversity and dominance of unhealthy species. We restore a healthier anti-inflammatory panel of bacterial species by “seeding” the colon with high-potency probiotics, then nourishing them with prebiotic fibers/resistant starches, a collection of strategies summarized in the Cureality Digestive Health discussions. People sometimes view bowel flora management as optional, just “fluff”–it is anything but. Properly managing bowel flora can be a make-it-or-break-it advantage; don’t neglect it.

There you go: a basic list to get started on if your interest is to begin a process of unraveling the processes of autoimmunity. In some conditions, such as rheumatoid arthritis and polymyalgia rheumatica, full recovery is possible. In other conditions, such as Hashimoto’s thyroiditis and the pancreatic beta cell destruction leading to type 1 diabetes, reversing the autoimmune inflammation does not restore organ function: hypothyroidism results after thyroiditis quiets down and type 1 diabetes and need for insulin persists after pancreatic beta cell damage. But note that the most powerful risk factor for an autoimmune disease is another autoimmune disease–this is why so many people have more than one autoimmune condition. People with Hashimoto’s, for instance, can develop rheumatoid arthritis or psoriasis. So the above menu is still worth following even if you cannot hope for full organ recovery

Five Powerful Ways to Reduce Blood Sugar

Left to conventional advice on diet and you will, more than likely, succumb to type 2 diabetes sooner or later. Follow your doctor’s advice to cut fat and eat more “healthy whole grains” and oral diabetes medication and insulin are almost certainly in your future. Despite this, had this scenario played out, you would be accused of laziness and gluttony, a weak specimen of human being who just gave into excess.

If you turn elsewhere for advice, however, and ignore the awful advice from “official” sources with cozy relationships with Big Pharma, you can reduce blood sugars sufficient to never become diabetic or to reverse an established diagnosis, and you can create a powerful collection of strategies that handily trump the worthless advice being passed off by the USDA, American Diabetes Association, the American Heart Association, or the Academy of Nutrition and Dietetics.

Among the most powerful and effective strategies to reduce blood sugar:

1) Eat no wheat nor grains

Recall that amylopectin A, the complex carbohydrate of grains, is highly digestible, unlike most of the other components of the seeds of grasses AKA “grains,” subject to digestion by the enzyme, amylase, in saliva and stomach. This explains why, ounce for ounce, grains raise blood sugar higher than table sugar. Eat no grains = remove the exceptional glycemic potential of amylopectin A.

2) Add no sugars, avoid high-fructose corn syrup

This should be pretty obvious, but note that the majority of processed foods contain sweeteners such as sucrose or high-fructose corn syrup, tailored to please the increased desire for sweetness among grain-consuming people. While fructose does not raise blood sugar acutely, it does so in delayed fashion, along with triggering other metabolic distortions such as increased triglycerides and fatty liver.

3) Vitamin D

Because vitamin D restores the body’s normal responsiveness to insulin, getting vitamin D right helps reduce blood sugar naturally while providing a range of other health benefits.

4) Restore bowel flora

As cultivation of several Lactobacillus and Bifidobacteria species in bowel flora yields fatty acids that restore insulin responsiveness, this leads to reductions in blood sugar over time. Minus the bowel flora-disrupting effects of grains and sugars, a purposeful program of bowel flora restoration is required (discussed at length in the Cureality Digestive Health section.)

5) Exercise

Blood sugar is reduced during and immediately following exercise, with the effect continuing for many hours afterwards, even into the next day.

Note that, aside from exercise, none of these powerful strategies are advocated by the American Diabetes Association or any other “official” agency purporting to provide dietary advice. As is happening more and more often as the tide of health information rises and is accessible to all, the best advice on health does not come from such agencies nor from your doctor but from your efforts to better understand the truths in health. This is our core mission in Cureality. A nice side benefit: information from Cureality is not accompanied by advertisements from Merck, Pfizer, Kelloggs, Kraft, or Cadbury Schweppes.

Cureality App Review: Breathe Sync



Biofeedback is a wonderful, natural way to gain control over multiple physiological phenomena, a means of tapping into your body’s internal resources. You can, for instance, use biofeedback to reduce anxiety, heart rate, and blood pressure, and achieve a sense of well-being that does not involve drugs, side-effects, or even much cost.

Biofeedback simply means that you are tracking some observable physiologic phenomenon—heart rate, skin temperature, blood pressure—and trying to consciously access control over it. One very successful method is that of bringing the beat-to-beat variation in heart rate into synchrony with the respiratory cycle. In day-to-day life, the heart beat is usually completely out of sync with respiration. Bring it into synchrony and interesting things happen: you experience a feeling of peace and calm, while many healthy phenomena develop.

A company called HeartMath has applied this principle through their personal computer-driven device that plugs into the USB port of your computer and monitors your heart rate with a device clipped on your earlobe. You then regulate breathing and follow the instructions provided and feedback is obtained on whether you are achieving synchrony, or what they call “coherence.” As the user becomes more effective in achieving coherence over time, positive physiological and emotional effects develop. HeartMath has been shown, for instance, to reduce systolic and diastolic blood pressure, morning cortisol levels (a stress hormone), and helps people deal with chronic pain. Downside of the HeartMath process: a $249 price tag for the earlobe-USB device.

But this is the age of emerging smartphone apps, including those applied to health. Smartphone apps are perfect for health monitoring. They are especially changing how we engage in biofeedback. An app called Breathe Sync is available that tracks heart rate using the camera’s flash on the phone. By tracking heart rate and providing visual instruction on breathing pattern, the program generates a Wellness Quotient, WQ, similar to HeartMath’s coherence scoring system. Difference: Breathe Sync is portable and a heck of a lot less costly. I paid $9.99, more than I’ve paid for any other mainstream smartphone application, but a bargain compared to the HeartMath device cost.

One glitch is that you need to not be running any other programs in the background, such as your GPS, else you will have pauses in the Breathe Sync program, negating the value of your WQ. Beyond this, the app functions reliably and can help you achieve the health goals of biofeedback with so much less hassle and greater effectiveness than the older methods.

If you are looking for a biofeedback system that provides advantage in gaining control over metabolic health, while also providing a wonderful method of relaxation, Breathe Sync, I believe, is the go-to app right now.

Amber’s Top 35 Health and Fitness Tips

This year I joined the 35 club!  And in honor of being fabulous and 35, I want to share 35 health and fitness tips with you! 

1.  Foam rolling is for everyone and should be done daily. 
2.  Cold showers are the best way to wake up and burn more body fat. 
3.  Stop locking your knees.  This will lead to lower back pain. 
4.  Avoid eating gluten at all costs. 
5.  Breath deep so that you can feel the sides or your lower back expand. 
6.  Swing a kettlebell for a stronger and great looking backside. 
7.  Fat is where it’s at!  Enjoy butter, ghee, coconut oil, palm oil, duck fat and many other fabulous saturated fats. 
8.  Don’t let your grip strength fade with age.  Farmer carries, kettlebells and hanging from a bar will help with that. 
9.  Runners, keep your long runs slow and easy and keep your interval runs hard.  Don’t fall in the chronic cardio range. 
10.  Drink high quality spring or reverse osmosis water. 
11.  Use high quality sea salt season food and as a mineral supplement. 
12.  Work your squat so that your butt can get down to the ground.  Can you sit in this position? How long?
13.  Lift heavy weights!  We were made for manual work,.   Simulate heavy labor in the weight room. 
14.  Meditate daily.  If you don’t go within, you will go with out.  We need quiet restorative time to balance the stress in our life. 
15.  Stand up and move for 10 minutes for every hour your sit at your computer. 
16. Eat a variety of whole, real foods. 
17.  Sleep 7 to 9 hours every night. 
18.  Pull ups are my favorite exercise.  Get a home pull up bar to practice. 
19.  Get out and spend a few minutes in nature.  Appreciate the world around you while taking in fresh air and natural beauty. 
20.  We all need to pull more in our workouts.  Add more pulling movements horizontally and vertically. 
21. Surround yourself with health minded people. 
22. Keep your room dark for deep sound sleep.  A sleep mask is great for that! 
23. Use chemical free cosmetics.  Your skin is the largest organ of your body and all chemicals will absorb into your blood stream. 
24. Unilateral movements will help improve symmetrical strength. 
25. Become more playful.  We take life too seriously, becoming stress and overwhelmed.  How can you play, smile and laugh more often?
26.  Choose foods that have one ingredient.  Keep your diet simple and clean. 
27.  Keep your joints mobile as you age.  Do exercises that take joints through a full range of motion. 
28. Go to sleep no later than 10:30pm.  This allows your body and brain to repair through the night. 
29. Take care of your health and needs before others.  This allows you to be the best spouse, parent, coworker, and person on the planet. 
30.  Always start your daily with a high fat, high protein meal.  This will encourage less sugar cravings later in the day. 
31. Approach the day with positive thinking!  Stinkin’ thinkin’ only leads to more stress and frustration. 
32. You are never “too old” to do something.  Stay young at heart and keep fitness a priority as the years go by. 
33. Dream big and go for it. 
34.  Lift weights 2 to 4 times every week.  Strong is the new sexy. 
35.  Love.  Love yourself unconditionally.  Love your life and live it to the fullest.  Love others compassionately. 

Amber B.
Cureality Exercise and Fitness Coach

To Change, You Need to Get Uncomfortable

Sitting on the couch is comfortable.  Going through the drive thru to pick up dinner is comfortable.  But when you notice that you’re out-of-shape, tired, sick and your clothes no longer fit, you realize that what makes you comfortable is not in align with what would make you happy.   

You want to see something different when you look in the mirror.  You want to fit into a certain size of jeans or just experience your day with more energy and excitement.  The current condition of your life causes you pain, be it physical, mental or emotional.  To escape the pain you are feeling, you know that you need to make changes to your habits that keep you stuck in your current state.  But why is it so hard to make the changes you know that will help you achieve what you want?  

I want to lose weight but….

I want a six pack but…

I want more energy but….

The statement that follows the “but” is often a situation or habit you are comfortable with.  You want to lose weight but don’t have time to cook healthy meals.  So it’s much more comfortable to go through the drive thru instead of trying some new recipes.   New habits often require a learning curve and a bit of extra time in the beginning.  It also takes courage and energy to establish new routines or seek out help.  

Setting out to achieve your goals requires change.  Making changes to establish new habits that support your goals and dreams can be uncomfortable.  Life, as you know it, will be different.  Knowing that fact can be scary, but so can staying in your current condition.  So I’m asking you to take a risk and get uncomfortable so that you can achieve your goals.  

Realize that it takes 21 days to develop a new habit.  I believe it takes triple that amount of time to really make a new habit stick for the long haul.  So for 21 days, you’ll experience some discomfort while you make changes to your old routine and habits.  Depending on what you are changing, discomfort could mean feeling tired, moody, or even withdrawal symptoms.  However, the longer you stick to your new habits the less uncomfortable you start to feel.  The first week is always the worst, but then it gets easier.

Making it through the uncomfortable times requires staying focused on your goals and not caving to your immediate feelings or desires.  I encourage clients to focus on why their goals important to them.  This reason or burning desire to change will help when old habits, cravings, or situations call you back to your old ways.
Use a tracking and a reward system to stay on track.  Grab a calendar, journal or index card to check off or note your daily successes.  Shoot for consistency and not perfection when trying to make changes.  I encourage my clients to use the 90/10 principle of change and apply that to their goal tracking system.  New clothes, a massage, or a day me-retreat are just a few examples of rewards you can use to sticking to your tracking system.  Pick something that really gets you excited.  

Getting support system in place can help you feel more comfortable with being uncomfortable.  Hiring a coach, joining an online support group, or recruiting family and friends can be very helpful when making big changes.  With a support system in place you are not alone in your discomfort.  You’re network is there for you to reach out for help, knowledge, accountability or camaraderie when you feel frustrated and isolated.  

I’ve helped hundreds of people change their bodies, health and lives of the eleven years I’ve worked as a trainer and coach.  I know it’s hard, but I also know that if they can do it, so can you.  You just need to step outside of your comfort zone and take a risk. Don’t let fear create uncomfortable feelings that keep you stuck in your old ways.  Take that first step and enjoy the journey of reaching your goals and dreams.  

Amber Budahn, B.S., CSCS, ACE PT, USATF 1, CHEK HLC 1, REIKI 1
Cureality Exercise Specialist

The 3 Best Grain Free Food Swaps to Boost Fat Burning

You can join others enjoying substantial improvements in their health, energy and pant size by making a few key, delicious substitutions to your eating habits.  This is possible with the Cureality nutrition approach, which rejects the idea that grains should form the cornerstone of the human diet.  

Grain products, which are seeds of grasses, are incompatible with human digestion.  Contrary to what we have been told for years, eating healthy whole grain is not the answer to whittle away our waists.  Consumption of all grain-based carbohydrates results in increased production of the fat storage hormone insulin.  Increased insulin levels create the perfect recipe for weight gain. By swapping out high carbohydrate grain foods that cause spikes in insulin with much lower carbohydrate foods, insulin release is subdued and allows the body to release fat.

1. Swap wheat-based flour with almond flour/meal

  • One of the most dubious grain offenders is modern wheat. Replace wheat flour with naturally wheat-free, lower carbohydrate almond flour.  
  • Almond flour contains a mere 12 net carbs per cup (carbohydrate minus the fiber) with 50% more filling protein than all-purpose flour.
  • Almond flour and almond meal also offer vitamin E, an important antioxidant to support immune function.

2. Swap potatoes and rice for cauliflower

  • Replace high carb potatoes and pasta with vitamin C packed cauliflower, which has an inconsequential 3 carbs per cup.  
  • Try this food swap: blend raw cauliflower in food processor to make “rice”. (A hand held grater can also be used).  Sautee the “riced” cauliflower in olive or coconut oil for 5 minutes with seasoning to taste.
  • Another food swap: enjoy mashed cauliflower in place of potatoes.  Cook cauliflower. Place in food processor with ½ a stick organic, grass-fed butter, ½ a package full-fat cream cheese and blend until smooth. Add optional minced garlic, chives or other herbs such as rosemary.
3. Swap pasta for shirataki noodles and zucchini

  • Swap out carb-rich white pasta containing 43 carbs per cup with Shirataki noodles that contain a few carbs per package. Shirataki noodles are made from konjac or yam root and are found in refrigerated section of supermarkets.
  • Another swap: zucchini contains about 4 carbs per cup. Make your own grain free, low-carb noodles from zucchini using a julienne peeler, mandolin or one of the various noodle tools on the market.  

Lisa Grudzielanek, MS,RDN,CD,CDE
Cureality Nutrition Specialist

Not so fast. Don’t make this mistake when going gluten free!

Beginning last month, the Food and Drug Administration began implementing its definition of “gluten-free” on packaged food labels.  The FDA determined that packaged food labeled gluten free (or similar claims such as "free of gluten") cannot contain more than 20 parts per million of gluten.

It has been years in the making for the FDA to define what “gluten free” means and hold food manufactures accountable, with respect to food labeling.  However, the story does not end there.

Yes, finding gluten-free food, that is now properly labeled, has become easier. So much so the market for gluten-free foods tops $6 billion last year.   However, finding truly healthy, commercially prepared, grain-free foods is still challenging.

A very common mistake made when jumping into the gluten-free lifestyle is piling everything labeled gluten-free in the shopping cart.  We don’t want to replace a problem: wheat, with another problem: gluten free products.

Typically gluten free products are made with rice flour (and brown rice flour), tapioca starch, cornstarch, and potato flour.  Of the few foods that raise blood sugar higher than wheat, these dried, powdered starches top the list.

 They provide a large surface area for digestion, thereby leading to sky-high blood sugar and all the consequences such as diabetes, hypertension, cataracts, arthritis, and heart disease. These products should be consumed very rarely consumed, if at all.  As Dr. Davis has stated, “100% gluten-free usually means 100% awful!”

There is an ugly side to the gluten-free boom taking place.  The Cureality approach to wellness recommends selecting gluten-free products wisely.  Do not making this misguided mistake and instead aim for elimination of ALL grains, as all seeds of grasses are related to wheat and therefore overlap in many effects.

Lisa Grudzielanek MS, RDN, CD, CDE
Cureality Health & Nutrition Coach

3 Foods to Add to Your Next Grocery List

Looking for some new foods to add to your diet? Look no further. Reach for these three mealtime superstars to encourage a leaner, healthier body.

Microgreens

Microgreens are simply the shoots of salad greens and herbs that are harvested just after the first leaves have developed, or in about 2 weeks.  Microgreen are not sprouts. Sprouts are germinated, in other words, sprouted seeds produced entirely in water. Microgreens are grown in soil, thereby absorbing the nutrients from the soil.

The nutritional profile of each microgreen depends greatly on the type of microgreen you are eating. Researchers found red cabbage microgreens had 40 times more vitamin E and six times more vitamin C than mature red cabbage. Cilantro microgreens had three times more beta-carotene than mature cilantro.

A few popular varieties of microgreens are arugula, kale, radish, pea, and watercress. Flavor can vary from mild to a more intense or spicy mix depending on the microgreens.  They can be added to salads, soup, omelets, stir fry and in place of lettuce.  

Cacao Powder

Cocoa and cacao are close enough in flavor not to make any difference. However, raw cacao powder has 3.6 times the antioxidant activity of roasted cocoa powder.  In short, raw cacao powder is definitely the healthiest, most beneficial of the powders, followed by 100% unsweetened cocoa.

Cacao has more antioxidant flavonoids than blueberries, red wine and black and green teas.  Cacao is one of the highest sources of magnesium, a great source of iron and vitamin C, as well as a good source of fiber for healthy bowel function.
Add cacao powder to milk for chocolate milk or real hot chocolate.  Consider adding to coffee for a little mocha magic or sprinkle on berries and yogurt.




Shallots


Shallots have a better nutrition profile than onions. On a weight per weight basis, they have more anti-oxidants, minerals, and vitamins than onions. Shallots have a milder, less pungent taste than onions, so people who do not care for onions may enjoy shallots.

Like onions, sulfur compounds in shallot are necessary for liver detoxification pathways.  The sulfur compound, allicin has been shown to be beneficial in reducing cholesterol.  Allicin is also noted to have anti-bacterial, anti-viral, and anti-fungal activities.

Diced then up and add to salads, on top of a bun less hamburger, soups, stews, or sauces.  Toss in an omelet or sauté to enhance a piece of chicken or steak, really the possibilities are endless.  

Lisa Grudzielanek,MS,RDN,CD,CDE
Cureality Nutrition & Health Coach

3 Band Exercises for Great Glutes

Bands and buns are a great combination.  (When I talk about glutes or a butt, I use the word buns)  When it comes to sculpting better buns, grab a band.   Bands are great for home workouts, at gym or when you travel.  Check out these 3 amazing exercises that will have your buns burning. 

Band Step Out

Grab a band and place it under the arch of each foot.  Then cross the band and rest your hands in your hip sockets.  The exercise starts with your feet hip width apart and weight in the heels.  Slightly bend the knees and step your right foot out to the side.  Step back in so that your foot is back in the starting position.  With each step, make sure your toes point straight ahead.  The tighter you pull the band, the more resistance you will have.    You will feel this exercise on the outside of your hips. 

Start with one set of 15 repetitions with each foot.  Work on increasing to 25 repetitions on each side and doing two to three sets.



Band Kick Back

This exercise is performed in the quadruped position with your knees under hips and hands under your shoulders.    Take the loop end of the band and put it around your right foot and place the two handles or ends of the band under your hands.  Without moving your body, kick your right leg straight back.  Return to the starting quadruped position.  Adjust the tension of the band to increase or decrease the difficulty of this exercise. 

Start with one set of 10 repetitions with each foot.  Work on increasing to 20 repetitions on each side and doing two to three sets. 



Band Resisted Hip Bridge

Start lying on your back with feet hip distance apart and knees bent at about a 45-degree angle.  Adjust your hips to a neutral position to alleviate any arching in your lower back.  Place the band across your hipbones.  Hold the band down with hands along the sides of your body.  Contract your abs and squeeze your glutes to lift your hips up off the ground.  Stop when your thighs, hips and stomach are in a straight line.  Lower you hips back down to the ground. 

Start with one set of 15 repetitions.  Work on increasing to 25 repetitions and doing two to three.  Another variation of this exercise is to hold the hip bridge position.  Start with a 30 second hold and work up to holding for 60 seconds.

Trains, planes, and heart scans

Trains, planes, and heart scans

A Heart Scan Blog reader posted the following question:

It is not clear to me why getting a cardiac scan is the necessary first step, if in fact the next step would be to bring down small LDL particles which is revealed on a NMR lipoprofile or VAP test. Why isn't the NMR or VAP test the first thing?

Good question. Think of it this way:

Lipoproteins, as measured via VAP (Vertical Auto Profile) or NMR (Nuclear Magnetic Resonance), provide a snapshot of risk from a metabolic viewpoint at that moment. Lipoproteins shift with the tides of age, menopause, weight changes, even what you ate last evening for dinner (especially small LDL). There are also other factors that cause coronary plaque, as well, not revealed through lipoprotein testing, such as vitamin D deficiency, smoking, high blood pressure, phosopholipase A2, lipoprotein(a), inflammatory factors, thyroid dysfunction, omega-3 fatty acid deficiency, etc.

A heart scan, providing a coronary calcium score, provides an indirect measure of coronary plaque that is the sum total of lipoprotein and other plaque-causing factors that have accumulated up to the time of your scan--regardless of the cause.

It means that two females, each 60 years old, with 70% small LDL, HDL 42 mg/dl, triglycerides 150 mg/dl, and mild hypertension, have identical markers for potential coronary risk, but can have widely different heart scan scores. One might have a score of zero, while the other might have a score of 300.

Why would the same panel of causes measured at one moment yield wildly different quantities of plaque? Several reasons:

1) The lifestyles, eating habits, and weight of each woman differed during their earlier years, not currently reflected in this moment's lipid or lipoprotein patterns. Perhpaps one experienced several years of extraordinary stress from a failed marriage, or suffered through two years of depression that caused her to smoke and overeat.

2) There are hidden factors that affect coronary plaque growth that we are presently not able to detect, e.g., vitamin D receptor genotype, cholesteryl-ester transfer protein variants, variation in inflammatory factors. If we can't measure it, we won't know whether it might influence coronary plaque risk.


With all the changes that occur over a person's life, with the uncertainties of yet-to-be-identified causes for coronary plaque, how can you possible know what your risk for heart disease truly is? Yup--a heart scan. Do it and you will know.

Comments (10) -

  • Anonymous

    9/6/2009 6:22:50 PM |

    So now the question is, how would your treatment differ for these two women?

    BTW I had thought the NMR/VAP were the lipoprotein equivalent of the HbA1c for blood sugar -- oh well!

  • Lou

    9/6/2009 10:38:43 PM |

    Hi Dr Davis

    I have just discovered your brilliant site.

    I saw on another post that you have some Track you plaque members from other countries. Do you have any idea if the blood tests you recommend are available to patients outside of the States (specifically in the UK or Europe)?

    Thanks
    Lou

  • Anonymous

    9/7/2009 1:45:12 AM |

    Hi Dr. Davis,

    Do you find an earlobe crease to be a reliable determinant of coronary calcium?  I have one and notice you have one as well (on your pic).

    Thanks,
    Dan

  • Heart Scan

    9/7/2009 6:12:51 AM |

    Isn’t it natural for us to believe we are healthy and not suffering from any disease? I had a similar thought process until my physician asked me to get a heart scan done after he found that my basic cardiograms were not perfect. I discovered that there were calcium deposits in my coronary arteries and I was at a serious risk of a heart attack. I was shocked and went ahead with the Cardiologist's suggestion of an advanced diagnostic scan. Though it’s always tough to undergo such experiences, I was not at any kind of discomfort at the Elitehealth.com advanced heart scan facility. I am not an expert in medical appliance and machines but could feel that the equipment was world-class and I was in safe hands. That feeling is really very important for me and that’s how it actually went on. The facilities for Full Body Scan were as good as they can get.

  • Dr. William Davis

    9/7/2009 2:13:21 PM |

    Anony--

    Easy. A woman with a zero score might make some efforts to correct her lipid/lipoprotein patterns to less strict endpoints, though she should still supplement vitamin D, iodine, and omega-3 fatty acids. The other woman should follow our Track Your Plaque endpoints if her goal is to stop plaque growth.


    Lou--

    Sorry, but I am not familiar with the availability of lipoproteins worldwide. I do know that people from outside the U.S. have managed, but it differs in every country. Please let us know if you have any success.

  • Anonymous

    9/7/2009 3:21:15 PM |

    I had a heart scan 7 years ago at  Hopkins, how often should it be done? I didn't have any calcium- I  was 49 at the time but I have high levels of small particle LDL and HDL.

    Incidentally they called a week after reporting the results of the heart scan and said I had a bunch of 'spots' on my liver which requires CAT scans and Ultra sounds to further investigate. Turned out to be something rather normal- I forget what they are called- just it involved a bunch of tests during a four week period and a lot of worrying.

    Anytime you do a body scan be prepared to find other stuff- which may or may not be a good thing depending on your frame of mind and it you are the type of person who needs to know everything.

    C'est la vie

  • Anonymous

    9/9/2009 1:42:12 PM |

    Actually, I can think of at least one scenario where getting a VAP or similar test WOULD be the first step... youth.


    I am inelligible for a heart scan because of my age (female under 40), yet I have a strong family hx of heart disease and have already presented with some signs of risk.  IMO, a VAP test would be the best thing for someone under 40 who is concerned about heart disease.

  • Materialguy

    9/15/2009 5:21:02 PM |

    I'm looking at "The New Heart Disease Handbook" by Christopher Cannon MD and Elizabeth Vierck 2009. They mention calcium score and calcium scan a few times. Their wording focuses on the calcium scan being useful in identifying areas of plaque buildup. There are probably only a total of 300 words on the subject all totaled. Sounds like progress slowly inching along.

  • Carolyn

    9/23/2009 6:11:03 PM |

    Wheat bran and any other dry whole grain puts my digestive tract in acid overdrive.

  • Female heart attack

    9/24/2009 10:06:31 AM |

    We all have heard of heart attacks. Among women, menopausal women are more prone to heart attacks due to lower levels of estrogen. Some symptoms of female heart attacks are: pressure felt in the chest area, feeling weak, low energy, uncommon symptoms are: nauseous sensation, giddiness, etc. Women often put themselves in the last list because they have many responsibilities, but as soon as any women notice such symptoms, should go for checking.

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Calcium chaos

Calcium chaos


Imagine that I'm planning to build a wall of bricks. I start by throwing cement at a pile of bricks, hoping that it forms a nice, orderly brick wall.

Fat chance, you say.

I believe that is what appears to be emerging as the situation with calcium supplementation.

A recent study from New Zealand reported an experience with 1,471 postmenopausal women, mean age of 74 years, who were randomized to treatment with either calcium supplements or placebo. Calcium was supplied as calcium citrate (Citrical) to provide 1000 mg of (elemental) calcium per day (400 mg morning, 600 mg evening).

(Bolland MJ, Barber PA, Doughty RN et al. Vascular events in healthy older women receiving calcium supplementation: randomised controlled trial. Brit Med J BMJ, doi:10.1136/bmj.39440.525752.BE; published 15 January 2008)

Over 5 years, women taking calcium had twice the risk of having a heart attack compared with women taking the placebo; women taking calcium had a 47 percent higher risk of having any one of three "events" (heart attack, stroke or sudden death) than women in the placebo group.

The findings of this study run counter to what we've been telling people all these years: Calcium supplementation, usually taken to halt deteriorating bone health and osteoporosis, modestly reduces blood pressure, reduces LDL and raises HDL cholesterol. At first blush, we might thereby presume that it also reduces cardiovascular events.

This study suggests that calcium supplementation does not result in reduction of cardiovascular events, perhaps even increases risk.

Certainly, this new finding will serve to confuse the public even more than it is already, particularly when it comes to strategies that modify risk for heart attack. However, this may make more sense once we stop and think for a moment.

Calcium supplementation inarguably slows, occasionally halts, calcium resorption from bone (through suppression of parathyroid hormone). Calcium also accumulates as part of atherosclerotic plaque in coronary and other arteries.

How does oral calcium know where to go--bones, not arteries or kidneys, in addition to serving all its other crucial functions?

Keep in mind that, in many roles, calcium is passive, something that responds to control exerted by some other factor. Vitamin D is that factor. Vitamin D controls the absorption of calcium in the intestinal tract (calcium aborption quadruples when vitamin D is restored to normal), it controls whether calcium is deposited in bone or extracted from arteries. It is the master control over the fate of calcium. Calcium just goes along for the ride.

Bone and arterial health do indeed intersect via calcium, but not through calcium supplementation. Instead, the control exerted by vitamin D (and vitamin K2, another conversation) connects the seemingly unrelated processes.

At what calcium dose threshold do the benefits stop and the adverse effects begin? That remains unanswered, particularly in light of this new study. However, this study calls into serious question the wisdom of supplementing calcium at a dose of 1000 mg, particularly when taken without normalization of vitamin D.

Calcium is therefore emerging as an important player in artery health. But just taking calcium makes no more sense than our brick wall and cement analogy. You might regard vitamin D as the mason that skillfully lays down both brick and cement in a neat, orderly way.

Comments (30) -

  • Anne

    1/23/2008 7:47:00 AM |

    Dear Dr Davis,

    Sometimes I think I must be living in the Matrix - I thought this article so interesting as I have been prescribed calcium supplements for osteoporosis, but just a few weeks ago I had to stop taking them because I discovered they were the cause of severe diarrhoea I had been having for nearly a year. Stopping the calcium supplements halted the diarrhoea straight away, trying it again, even a different make, brought it back even on low dose. Anyway, it was just then that I read a lot about vitamin D3 on your blog and Dr Eades, just at that very time, so I upped my D3 intake to 5,000iu in the hopes it will help me absorb as much of my dietary calcium as possible. I cannot take dairy products so I get my calcium from leafy green veggies, nuts, seeds and fish. And now you wrote on your blog to look at vitamin D3 for aortic valves (I'm the one with bicuspid aortic valve) too. The Matrix ! Or I've found the best doctors on the internet Smile

    all the best,
    Anne

  • Anonymous

    1/23/2008 5:23:00 PM |

    I'm taking Vit D3 in gel form for my bones, heart, and to help prevent cancer, until it warms up here so I can get some sun. I'll be getting plenty of direct sun while gardening and bike riding, but the rest of the time outside, I'll sit in the the shade so I won't get too much UVA, since my family had a few skin cancers (caught early).

    I'm going to look for natto when I finally make it to the Asian store. I've heard it tastes pretty bad for people that have never eaten it, so I'll have to try to mix it in with something else probably. I've also read that some people compare it to blue cheese, so maybe I'll start with blue cheese recipes to try to mellow the natto taste.

    S

  • Red Sphynx

    1/23/2008 6:50:00 PM |

    Granted, calcium supplements leave a lot to be desired.

    But this article didn't cast any light on the problem.  Read Sandy Szwarc' excellent Fisking of this study over at JunkFoodScience.

    Adam Becker Sr

  • Anonymous

    1/23/2008 8:53:00 PM |

    Doesn't calcium compete with magnesium for absorption from the gut?  In which case, supplemental magnesium in addition to the calcium would be indicated

  • Anonymous

    1/24/2008 12:49:00 AM |

    I am so confused about this whole chotesterol/ heart attack risk argument. I've been reading your blog for months now and follow everything you say because it sounds like it all makes great sense. So whats the problem? We keep hearing more and more that total cholesterol, as was once thought, is not a very good indcator of impending heart attack. So how come Dr.William Castelli, the one time director of the famous Framingham Study says in over 60 years following thousands of people, they have NEVER had a heart attack in ANYONE with a total cholesterol below 150 regardless of what the HDL may be? If that doesn't indicate that total cholesterol CAN be a strong indicator I don't know what can. I understand if your cholesterol is higher than 150 this may not tell you anything, but for those of us below doesn't it? Or does no heart attacks in a 60 year period with thousands of people tell us nothing?

  • Dr. Davis

    1/24/2008 2:44:00 AM |

    I do not agree with Dr. Castelli's observation. I have seen MANY heart attacks with total cholesterols <150 mg/dl. I do not understand the discrepancy.

    For instance, an HDL of 23 mg/dl--very high risk--can easily be concealed within a low total cholesterol, as can smoking, diabetes, and Lp(a).

  • Peter

    1/24/2008 9:05:00 AM |

    Anonymous, even the most cursory glance at any of the aggressive LDL-C lowering trials will give you the information about the accuracy of Dr Castelli's statement. Let's not be too explicit.

    Peter

  • donnyrosart

    1/24/2008 1:33:00 PM |

    It looks like going into the study, the authors suspected the opposite (calcium prevents heart disease) was true. They mention speculation that calcium supplementation might be heart healthy by increasing malabsorption of fat, and quote a study where calcium supplementation doubled fecal fat and bile. Personally, I try to eat things I'd like to absorb.
    The first study they reference to (I think it's their own study) showed calcium supplementation increased Hdl, and decreased ldl, but had no effect on triglycerides. If ldl decreases, but triglycerides remain the same, does that suggest anything about ldl particle size?
    Really like your blog.

  • Dr. Davis

    1/24/2008 4:19:00 PM |

    Good question.

    I've not looked specifically for a LDL size effect from calcium, nor am I aware of any specific literature to this effect. However, I do believe that many of us are trending towards less and less calcium supplementation, particularly in light of vit D supplementation.

  • Anonymous

    1/24/2008 7:59:00 PM |

    I apologise maybe I worded my question incorrectly. Dr. Castelli doesn't claim that if you have a total cholesterol under 150 you will not have a heart attack, he says in The Framingham study ( involving 3 generations and over 10,000 people ) there has never been one. I suppose we could blow this off and claim he's lying ( I doubt it ) or try to learn something from it. Thats a VERY large long lasting study and once again he has said "under 150 REGARDLESS of HDL score" there HAS to be a reason for this, I was just wondering if anyone had a guess.

  • brittany lady

    1/24/2008 10:59:00 PM |

    This now has me totally confused.  My doctor recommended I take 1,000 mg. of Calcium in supplement form every day, and to make sure I get 800 mg. of Vitamin D.  I have done so faithfully plus drinking about 10 oz. of calcium added Lactaid fat free milk. I also learned after an x-ray, stress test and heart imaging that I have calcification at the base of my aorta, but my heart is not enlarged.  This has happened since 1999, and I have only been taking Vitamin D for the past year and a half. Now I wonder if large doses of Calcium before having my vitamin D levels tested might have caused this. On another note, I had very high triglycerides and started taking 2000 mg. of fish oil capsules daily.  My triglycerides dropped from 375 to 160 in 6 months.  That might be a solution to someone with these concerns.

  • Anne

    1/25/2008 8:23:00 AM |

    Since being diagnosed with osteoporosis last year I have done a lot of research on it and on various therapies. I am, btw, only 54 so it was a big shock. Anyway, looking at things logically, there is no way that someone my age would have got osteoporosis from lack of calcium, so why do they prescribe it ? It seems based on research done on elderly ladies in nursing homes. I've got osteoporosis because of health issues when I was younger yet, I was still told the usual to take 1000mg calcium and 800iu vitamin D. I refused bisphosphonates and have been prescribed Strontium Ranelate instead. I hope Strontium doesn't cause calcification, I don't think they know enough about it so I feel rather a guinea pig. Now that I can't tolerate calcium and have stopped taking it and upped the Vitamin D3 to 5000iu I feel more confident that this will help not only my bones but also my heart health. I also take 2,000mg of fish oil.....my triglycerides are currently 0.6 (53).

    Anne

  • Anne

    1/25/2008 1:39:00 PM |

    Something else to make one realise that calcium may not be as important as we have been told - if you look at countries in Africa where some people have sub-optimal diets and low in calcium, you usually don't often find osteoporosis ! I would hazard a guess that the reason they don't get osteoporosis is because they have plenty of Vitamin D from the sunshine and they probably do a lot of physical work.

    Anne

  • Dr. Davis

    1/25/2008 1:51:00 PM |

    Great thought.

    I am impressed that many of the "holes" in our thinking about health and nutrients is filling in with greater understanding of the role of vitamin D.

  • Rick

    1/25/2008 5:19:00 PM |

    Dr. Castelli also made the following observation:

    "For example, in Framingham, Mass, the more saturated fat one ate, the more cholesterol one ate, the more calories one ate, the lower the person’s serum cholesterol."

    For Dr. Eades's typically insightful take on the issue, go here:

    http://tinyurl.com/2d7bzw

    and here:

    http://tinyurl.com/24uqj2

  • Dr. Davis

    1/26/2008 5:05:00 AM |

    I couldn't agree more.

    Cholesterol (total and LDL) are lousy predictors of heart disease. They are, indeed, factors. But in the long list of factors causing heart disease, cholesterol is way down.

    But cholesterol is, no doubt, the most profitable. Revenues for statin drugs topped $27 billion last year.

  • Anonymous

    1/26/2008 3:05:00 PM |

    Great articles Rick, read them both and found them quite interesting however a little disappointed neither had anything to do with why after 60 years and following over 10,000 people NOT ONE of them with a total cholesterol under 150 ever had a heart attack. I eat low carb, loved Taubes book explaining the myths about eating fat, big proponent of Track your plaque and think Dr. Davis is brilliant and well ahead of his time. And yet either we think Dr. Castelli is a liar or anybody with ANY interest in preventive cardiology would want to know why no heart attacks in anyone with tot cholesterol under 150 in over 60 years in such a large group of people. My god we hear all the time about the stunning results of the HATS Trial which included a grand total of 161 people.

  • MAC

    1/26/2008 5:38:00 PM |

    Dr. Davis,
        Found this study while perusing Science daily today. Not sure how or if this intersects at all with the good results you get with Vit D.

    Vitamin D Deficiency May be a Sympton of Disease: Supplementations may make it worse:

    http://www.sciencedaily.com/releases
    /2008/01/080125223302.htm

    "Low blood levels of vitamin D have long been associated with disease, and the assumption has been that vitamin D supplements may protect against disease. However, this new research demonstrates that ingested vitamin D is immunosuppressive and that low blood levels of vitamin D may be actually a result of the disease process. Supplementation may make the disease worse."

  • Dr. Davis

    1/27/2008 2:18:00 AM |

    It refers to the so-called "Marshall Protocol." Having read his arguments, he mixes science with conjecture and enormous leaps of speculation, all with zero experience in real, live humans. (He's a "bench" researcher with experience that doesn't extend beyond mice and cell cultures.)

    It reminds me an awful lot of the pseudo-scientific tangent that misled Linus Pauling and Mathias Rath.

  • Rick

    1/27/2008 7:40:00 AM |

    Anonymous,

    No need to be disappointed.  Here's the relevance.  Dr. Eades quoted Dr. Kannel, who preceded Castelli as director of the Framinham study as saying:

    "...it is not possible to select a critical lipid value that separates potential CHD candidates from the rest of the population."

    That appears to contradict the implications of Castelli's quote.

    Dr. Eades also made the case that sometimes the pronouncement of the researchers is not supported by the evidence.

    What percent of the population had cholesterol lower than 150?  What was their age distribution?  These would be important things to know.

    In looking at a graph of the distribution, it appears that less than 5% of the population were in that category.  

    BTW, can you you provide a citation for your quote of Dr. Castelli?  Thanks.

  • Stan

    1/27/2008 3:32:00 PM |

    anonymous,

    Castelli said that there was no heart attack at all in the sub-population below 150mg/dl of cholesterol, and he said also
    that, quote:

    "For example, in Framingham, Mass, the more saturated fat one ate, the more cholesterol one ate, the more calories one ate, the lower the person’s serum cholesterol."

    This is a speculation but one possible explanation behind those two seemingly contradictory informations is that the
    subpopulation of people who had naturally low cholesterol in Framingham, were all young and/or  were all eating more animal fat and less carbohydrates than the other groups!  Younger people are more active and eat more calories too. Both factors (young age and a higher animal fat lower carbohydrate nutrition) tend to associate with low cholesterol
    and are simultanously cardioprotective.

    Is it improbable? I dont' think so. Dr. Davis's own results on vitamin D3 and essential fatty acids supplementation (naturally present in animal food, dairy, eggs, meat and fish!) also seem to point in the same direction.

    It would also fit another observation: I remember some published data on Masai population who also have or had very low total cholesterol (I think about 160 mg/dl on average), follow a high fat low carbohydrate nutrition and have very little heart disease!

    Stan (Heretic)

  • Anonymous

    1/28/2008 3:38:00 PM |

    http://tinyurl.com/24uqj2, Rick try this one but any search on google brings many citataions.

  • Anonymous

    1/28/2008 3:41:00 PM |

    Rick heres another better one.http://findarticles.com/p/articles/mi_qa3987/is_20070409/ai_n19031299/pg_2

  • Rick

    1/29/2008 12:32:00 AM |

    Anon,

    Thanks for the links, but the first one is the link I gave you, and the second is truncated.  

    If it's the article by the chiropracter, I've already seen that, but was hoping for  a primary source so I could read the context.  I've done a fair amount of googling but haven't been able to find it.

    Your quote speaks of 60 years of research, yet the artcle you cite (at least I think it's the same artcle) speaks of 40 years and the Framingham website is proudly celebrating 50 years of research.

    This is not to nitpick but it does make me wonder if this isn't one of those internet quotes that takes on a life of its own.

    I agree with you that it is confusing because so much of what I have read, along with my own experience renders his observation, whether true or not, meaningless.

  • Anonymous

    1/29/2008 12:51:00 AM |

    http://findarticles.com/p/articles/mi_qa3987/is_20070409/ai_n19031299/pg_2
    This article explains Dr. Castelli's position well.

  • Anonymous

    1/29/2008 12:55:00 AM |

    http://findarticles.com/p/articles/mi_qa3987/is_20070409/ai_n19031299
    Read this one Rick.

  • Anonymous

    1/30/2008 3:07:00 PM |

    The Framingham Study was begun in 1948. That seems to be the one point that is a fact.

  • Rick

    1/30/2008 7:14:00 PM |

    Thanks for the link.  That is one of the articles I'd already seen. ( Not to put too fine a point on it, but he does refer to 40 years, not 60 as in your quote.)

    The data I've seen confirms his statement.  People whose TC was below 150 didn't evidence CHD.  But, as I mentioned above, the number of those people was extremely small, less than 5% of the population. It may be true the nobody who's run a sub 2:10 marathon has suffered a heart attack, but so what?

    For the vast majority of the population in the study, those between 150 and 370, some did have CHD, some didn't.  The correlation was not strong except on the edges.  

    So what can we take away from this?  Get your TC below 150 and you're immune from CHD?  The same research shows correlation with low levels of TC and all cause mortality.  So choose your poison.

    And if, despite your best efforts, your numbers creep up above 150, are all bets off?  My TC over the years, has ranged from 140 to 180, most recently 160, yet my plaque burden put me in the 50th percentile for my peer group.  So the importance of Dr. Castelli's observation is lost on me.

    As pointed out by Dr. Davis, and many others, total cholesterol alone is not a very useful indicator. Check out the post on the Vytorin study. Those whose cholesterol dropped the most experienced a greater increase in plaque.

    So, while Castelli's statement is based in fact, there is a lot of room for interpretation.  And most of the rest of what is attributed to him in that article is speculation.

    Yes, Framingham was begun in 1948, but I doubt the data is available instantaneously.

  • Anonymous

    6/4/2008 1:31:00 PM |

    My sister and I got in argument at a picnic about whether calcium supplements are a good idea.  Afterward she sent me an article in favor, and I sent her one against.  Then I realized you wrote both articles!

  • ccruby

    8/17/2008 1:30:00 AM |

    Mayo Clinic diagnosed me with fluid around my heart.  I could feel it sloshing around.  Stopped calcium/mag and estrogen supplements and I could no longer feel it; I also kept telling it to go away.  Went back a couple of months later for MRI--Mayo said I had fat around my heart.  I know the original diagnosis was correct.

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