The Plavix Scam

Periodically, I'll see a flurry of TV ads for Plavix. It comes with a polished computer-animated cartoon that shows how platelets clump and form a blood clot, causing heart attack.

Imagine there's a pile of oil-soaked rags in a corner of your garage. I come by and tell you to get a good fire extinguisher to keep next to the rag pile in case they spontaneously ignite.

Does that make sense to you?

Wouldn't it be better to get rid of the oily rags and forget about the fire extinguisher?

Plavix is the fire extinguisher. The oil rags are your coronary plaque. The solution is to gain control over plaque behavior. Unfortunately, the TV ads (intentionally, I suspect) give the impression that blood clots just form out of the blue for no reason. Of course that's not true. It requires active, growing, inflamed atheroslcerotic plaque that ruptures, uncovering the "angry" and platelet-adhering material underneath the thin covering or endothelial lining.

Urging everybody to take Plavix is absurd. The TV ads urge many people who have no business taking the drug to take it. There are, without a doubt, groups of people who are better off taking Plavix and aspirin: people who are in the midst of heart attack, people who have unstable plaque, people with recent stents or bypass. Perhaps people at high risk for plaque rupture, e.g., extensive coronary plaque that has continued to grow.

These tactics are consistent with the experiences I've had with the sales representatives from the company (when I used to actually talk to sales reps; my office is now barred from them). The reps very aggressively would urge me to consider having everyone take Plavix. No kidding.


For us, i.e., for people who just have a heart scan score but interested in engaging in a powerful program of prevention and reversal, Plavix rarely provides any advantage. The answer is, just like our oily rag analogy, control the plaque, not put out the fire.

Comments (3) -

  • Moderator Mike

    4/12/2007 11:23:00 PM |

    Fantastic blog!  Just what I was searching for when I found you via a blog directory (BlogFlux).

    Question though....where is the "Track Your Placque" website that accompanies this blog?

    Thanks.

  • Dr. Davis

    4/12/2007 11:44:00 PM |

    Mike--

    The website address is:

    www.trackyourplaque.com

    Dr. Davis

  • buy jeans

    11/2/2010 7:38:35 PM |

    These tactics are consistent with the experiences I've had with the sales representatives from the company (when I used to actually talk to sales reps; my office is now barred from them). The reps very aggressively would urge me to consider having everyone take Plavix. No kidding.

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Can you say "sugar"?

Can you say "sugar"?

All of these products bear the American Heart Association Check Mark of approval emblem, signifying that they are "heart healthy":


Kellogg's Frosted Mini-Wheats cereal

Ingredients:WHOLE GRAIN WHEAT, SUGAR, STRAWBERRY FLAVORED CRUNCHLETS (SUGAR, CORN CEREAL, CORN SYRUP, MODIFIED CORN STARCH, PARTIALLY HYDROGENATED COTTONSEED AND/OR SOYBEAN OIL, CITRIC ACID, GLYCERIN, NATURAL AND ARTIFICIAL FLAVOR, RED #40, BLUE #2), NATURAL AND ARTIFICIAL STRAWBERRY AND CREME FLAVOR, SORBITOL, GELATIN, REDUCED IRON, NIACINAMIDE, ZINC OXIDE, RED #40, PYRIDOXINE HYDROCHLORIDE (VITAMIN B6), RIBOFLAVIN (VITAMIN B2), THIAMIN HYDROCHLORIDE (VITAMIN B1), FOLIC ACID, BLUE #1, AND VITAMIN B12. TO MAINTAIN QUALITY, BHT HAS BEEN ADDED TO THE PACKAGING.










Orville Redenbacher popcorns









Dora the Explorer Cereal
























Cheerios
























The following requirements must be met to gain approval of the Check Mark program:

1) total fat 3.0 grams or less per serving

2) saturated fat 1.0 gram or less per serving

3) 20 grams or less cholesterol per serving

4) 480 mg or less sodium per serving

5) "Jelly Bean Rule": 10% of the Daily Value of 6 nutrients (e.g., fiber, vitamins A and C, etc.) must also be contained in each serving.


Had the Check Mark program focused on genuine nutrition and rated products by:

1) Healthy oil content

2) Sugar content or sugar-equivalents, i.e., glycemic index or load

3) Impact on HDL, small LDL, triglycerides

none of these products would have made the list, not even close.

Comments (11) -

  • Anna

    4/20/2008 4:14:00 PM |

    A measured bowl of Cheerios and a bit of milk (whole, because it's what I had), equal to 75 grams of  carbohydrate, gave me the highest ever blood glucose reading from a food (not counting glucose solution from a Glucose Tolerance Test).  I was attempting a "homemade" version of a 3 hr GTT before going to my doctor with my concerns about my BG.  

    My BG started to rise very fast within 15 minutes after eating the cereal, peaked at about 250 mg/dL at 45 minutes, then slowly dropped.  By about 60-75 minutes, I experienced strong hunger and carb cravings as the BG began to slowly drop, and by about 2.5 hours after eating, my BG had suddenly dropped quite low (in the low 70s) and I had developed  a nasty hypoglycemic feeling (shaky, irritable, craving sugary foods, headache, etc.).

    It's hard for me to see "heart healthy" Cheerios (or any other highly processed breakfast cereal) as anything other than a bowl of pre-digested sugar that contributes to roller coaster blood glucose and insulin levels, which a great way to start anyone's day.  Certainly, I don't do well with Cheerios because I clearly have a damaged glucose regulatory system (probably a diminished or absent first phase insulin response, but I can't imagine that it is doing any good for people with healthy glucose regulation, either.  

    I banned prepared cold cereals from our house.  If my 9 yr old son gets cereal at all at home, it's whole groats (not even rolled or steel cut because those aren't truly "whole grain" anymore), soaked overnight in some water and a tsp of plain yogurt  (soaking neutralizes phytates and reduces cooking time), then cooked about 8-10 minutes (water added as necessary).  Sometimes I add a bit of quinoa or almond meal prior to soaking to boost the protein content a bit.  I garnish with a pat of butter, some heavy cream, and a dusting of cinnamon.  If I'm feeling *really* indulgent, I drizzle about 1 tsp of Grade B maple syrup on top (Grade B is stronger in flavor and so less can be used).  I don't eat this cereal myself, and truthfully, I'd rather my son not, either, but he sometimes wants cereal.  It's the least damaging compromise I can come up with that we can both live with.

  • Jenny

    4/20/2008 7:18:00 PM |

    The sugar is ridiculous. But what about those TRANS FATS?

    You're a cardiologist, why don't you write to JAMA or some other prestigious journal and and demand other cardiologists put a stop to the marketing of dangerous foods to children as "healthy?"

  • Anonymous

    4/20/2008 10:30:00 PM |

    Last week there were food riots in several locations around the world.  The protests were over the steep rise in price for grains in particular.  Papers blamed several areas for the rise in price, the main two being the use of biofuels and also the economic growth in Asia.  The "problem" papers said is that in Asia people are "upgrading" their diet to a western, sugary diet.  Having work with Chinese companies since the early 90s, I've seen the western food growth in that country.  I have a Chinese friend that will sometimes e-mail me about his visits with his son to a local KFC.  Good American eating he tells me.  

    Unlike the AHA, which remains silent, I hope Asian health agencies catch onto the health problems western sugar foods like pop, bread, fried potatoes, etc can cause and warn their peoples soon.               The old traditional Asian diet of  vegetables, beans and fruits is better than the new.  

    I don't mind seeing sugar burnt as fuel.

  • Dr. William Davis

    4/21/2008 12:33:00 AM |

    Anna--

    Your comments are so telling that I'd like to feature them in a post. Thanks!

  • Anna

    4/21/2008 6:51:00 PM |

    Be my guest!

  • Dr. William Davis

    4/22/2008 12:39:00 AM |

    Hi, Jenny--

    I've voiced my objections only by phone. I will indeed be more vocal to the people in charge of the Heart Check Mark program. I've been planning to do so for some time.

  • Anonymous

    4/22/2008 1:56:00 PM |

    Call me confused.  According to the nutritional information listed on the Cheerios package the total amount of sugar is 1 gram.  Isn't that minimal?  It seems as though the overwhelming bulk of the product is whole oats.  Why would oats (even if pulverized into tiny little shapes) cause such a rise in BG levels?  Something doesn't add up.

    FYI, hard to imagine that any cereal with partially hydrogenated oil can be called heart healthy - that is crazy!

  • Anna

    4/23/2008 9:08:00 PM |

    anonymous,

    You're making a common label reading mistake.  

    You can't just look at the "sugar" content on the label, which only measures simple sugars.  

    You have to look at the total carbohydrate content (though some people subtract the indigestible fiber content) to see how much starch is in the product, too.  That starch is simply chains of simple sugars bonded together, and when broken down by digestive enzymes, yields simple sugar.  Starch in a pulverized grain, will break down into simple sugars super fast, nearly as fast as eating plain table sugar.   All the sugars and starches (carbohydrates) end up as glucose in the blood stream eventually, and enough insulin has to be secreted to handle it.  

    This business of "whole grain" is a big marketing ploy, a wolf in sheep's clothing.  The grain isn't "whole" and intact anymore if it is processed into flour or extruded (like Cheerios), even if the fiber is left in the flour.    I consider it "pre-chewed" or "predigested" Smile.

    Your own saliva has the enzyme to break starch into simple sugar, too, amylase, so digestion starts right in the mouth while chewing.  When I was in junior high school biology one of the experiments was chewing a saltine cracker very well and holding it in our mouths a few moments, well mixed with saliva.  Within a very short time, it began to taste sweet from the starch broken down into sugar.  That's how fast the starch in Cheerios becomes glucose.

    The slowest and lowest rise in BG I have seen with *any* oat cereal (using a glucose meter) is with cooked whole groats (bought from the bulk bin at the natural foods store).  Whole, not rolled, not steel cut.   Cooked whole groats are very nutty in texture, each groat kernal remains distinct, and they takes a lot more chewing than cooked oatmeal - rolled oats or steel cut.   The body still has to cover all the glucose those groats eventually become, but it will be much slower and easier for the body to manage it (assuming healthy insulin production).  For those of us with impaired insulin production, even whole groats might be too much of a burden on the system.

  • Red Sphynx

    4/23/2008 10:42:00 PM |

    You may have left out the most important thing!
    > The following requirements must be met to gain approval of the Check Mark program ...

    Isn't there a fee to the American Heart Association involved?

  • Helen Kopp

    3/5/2009 5:52:00 PM |

    How can I find healthy whole grains?  Aside from true whole wheat pasta (not the fake whole wheat pasta), brown rice, plain oatmeal... whole grains are so hard to find.  I've yet to find a bread or cereal without all kinds of sugar and additives.  I'm a runner, and cereal with milk is such a convinient snack or even meal for me, but what kind of cereal is actually healthy for me? And what kind of bread can I use to make a sandwich? Suggestions?

  • Megan

    5/14/2009 2:20:00 AM |

    Helen- most reading this blog are probably pretty careful about carbs, including me - but many won't have any bread or cereal go near their mouths!  I occasionally (a couple times a week) will have a slice of Light bread (containing 8 grams of carbs a slice or less) to put my peanut butter on, or fold in half and stuff with turkey or whatever.  Another choice would be one of those Toufayan (spelling?) low carb pitas that have 11 grams of protein!  Protein helps slow those carbs down.  Also, the only cereal I occasionally will eat is Special K-PROTEIN PLUS cereal; it has 9 net grams of carbs and 10 grams of protein/ serving.  I only eat 1 serving when I do have it.

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