Heart scan curiosities 1

Heart scans often reveal more than coronary plaque. From time to time, I'll show some curious findings that people have displayed during routine heart scans.

This 65-year old man had a relatively low heart scan score of 73, but showed an impressive quantity of calcification of his pericardium, the usually soft-tissue sack that encases the heart. The calcified pericardium is the white arcs that surround the heart in the center of the image.



Thankfully, because he's without any symptoms of breathlessness, excessive fatigue, or leg swelling, he won't need to have it surgically corrected. When the pericardium becomes rigid and encircles the heart, it can literally squeeze the heart, a condition called "constrictive pericarditis". The surgery is pretty awful.

This man's calcified pericardium likely resulted from one or more viral infections over his lifetime.

Annual physical

A judge who lives in my neighborhood was found dead in his bed this week from a heart attack. He was 49 years old. His teenage kids found him and performed CPR, but he was cold and long-gone by then.

A close friend of the judge told me that he'd passed an annual physical just weeks before.

This sort of tragedy shouldn't happen. It is easily--easily--preventable. Had this man undergone a heart scan, a score of at least 400 if not >1000 would have been uncovered, and appropriate preventive action could have been taken. The conversation could have centered around the strategies to correct the patterns that triggered his plaque and how he could reduce his score.

Of course, hospitals make use of stories like this to fuel fear that brings hordes to their wards for procedures. Would the judge have required a procedure to save his life, had his heart disease been diagnosed at his annual physical? Not necessarily. Hospitals and cardiologists would try to persuade you that procedures have an impact on mortality. This is simply not true. In fact, the mortality benefits of procedures are questionable except in the midst of acute illness (e.g., unstable chest pain symptoms or heart attack).

Don't be falsely reassured by passing a physical. A physical does nothing to screen you for heart disease. An EKG and stress test, if included, is a lame excuse for heart disease screening. Remember that a stress test is a test of coronary blood flow, not for the presence of coronary plaque. The unfortunate judge most likely had a 30% "blockage" that did not block flow, but ruptured and closed an artery off sometime in the night when he died. A stress test even on the day of his death would not have predicted this.

A CT heart scan would have uncovered it easily, unequivocally, safely.

A curious case of regression

Randi came to me at age 43. Before I'd met her, she'd undergone two heart scans about one year apart. The initial score was 57--not terribly high, but very high for a 41-year old, pre-menopausal female. Recall that rarely do women have any heart scan score above zero before age 50. Randi's 2nd scan had yielded a score of 72, a 27% increase.

Randi even had her lipoproteins assessed and she had the dreaded Lp(a). So when I met her, we discussed the possible choices in Lp(a) treatment: niacin and estrogens as primary treatment, along with LDL reduction to rock-bottom numbers, along with adjunctive DHEA, almonds, ground flaxseed, and fish oil. Sandi was okay with the adjunctive treatments and was already slender and active (BMI <25), and did not show Lp(a)'s evil partner, small LDL. But Randi had no interest in estrogens, even bio-identical preparations, because of the usual uncertainties associated with estrogen replacement. She also proved to be one of the people truly intolerant to anything but the most minute dose of niacin, experiencing prolonged flushing and abdominal cramps with any dose >250 mg.

Randi even attempted a trial of the Mathias Rath concoction of high-dose vitamin C, lysine, and proline as treatment for Lp(a), but we saw no effect on Lp(a).

Unfortunately, this left Randi's Lp(a) essentially uncorrected. Another scan one year later: 90, another 25% increase. 18 months after that, another scan: 120, a 30% increase.

Now 47-years old, Randi had resigned herself to not being able to control her plaque. We'd run out of options. At that point, I'd started to have everyone's vitamin D blood level assessed and then replaced with vitamin D. I did this with Randi, too.

A year after her last scan, she underwent another. The score: 92, a 23% reduction--substantial reversal following a course of unrelenting progression.

Randi and I, of course, both rejoiced with this unexpected success. But it raised some interesting questions: How important is Lp(a) when vitamin D is normalized and small LDL is not a part of the picture? How consistent with regression be with this strategy over time? Would normalization of vitamin D have stopped plaque from becoming established in the first place?

I hope these issues will clarify over time. For now, I'm thrilled with Randi's success. She remains on her present, "incomplete", though successful program.

Note: I would not ordinarily advise a young woman to undergo serial heart scanning with this frequency. Randi had unusual access to a scan center through a relationship with the staff. I am nonetheless grateful for the lessons her experience have taught us.

Fortune teller

Whenever your doctor uses your cholesterol values--total, LDL, HDL, triglycerides--to judge your heart disease risk, he/she is trying to act as your fortune teller.

In some states, fortune telling is illegal, a misdemeanor. The New York State lawbooks say:

A person is guilty of fortune telling when, for a fee or compensation which he directly or indirectly solicits or receives, he claims or pretends to tell fortunes, or holds himself out as being able, by claimed or pretended use of occult powers, to answer questions or give advice on personal matters or to exorcise, influence or affect evil spirits or curses; except that this section does not apply to a person who engages in the aforedescribed conduct as part of a show or exhibition solely for the purpose of entertainment or amusement.
(Source : Wikipedia)

Rather than occult powers, your physician claims to use "medical judgement" to tell your fortune. Except for that distinction, it might be construed as a misdemeanor.


Let's take three typical examples:

58-year old Laura has a high LDL of 195 mg/dl. Her HDL is 52 mg/dl, triglycerides 197 mg/dl. Does she have heart disease?

51-year old Jonathan has an LDL of 174 mg/dl, HDL 34 mg/dl, triglycerides 156 mg/dl. Does Jonathan have heart disease?

71-year old Marian has an LDL cholesterol of 135 mg/dl, HDL 84 mg/dl, triglycerides of 67 mg/dl.

None of the three have symptoms. They all feel well. Nobody is taking a statin cholesterol drug or other agent that would modify the numbers. Jonathan is around 30 lbs overweight. Nobody has an impressive family history of heart disease.

Can you tell who has heart disease and who doesn't? If you can, you're smarter than I am, because I certainly can't tell. But your doctor tries to divine your future by looking at these numbers.

Do they know something that we don't know? No. It's a crude odds game, a guessing game. A guessing game that frequently comes up on the losing end.

These are three real people. Laura, despite her high LDL, has no identifiable coronary heart disease. Jonathan has advanced coronary disease. These were his numbers just prior to his stent. Marian has a moderate quantity revealed by a CT heart scan score of 419.

Don't even try predicting your future from your cholesterol numbers--it simply can't be done. Every day, I see patients and physicians beating their heads over this dilemma. Telling your fortune using pretended occult powers is illegal. Telling your fortune using cholesterol numbers should be, too.

If you want to know if you have coronary plaque, that's the role of the CT heart scan. Plain and simple.

Heart scan score drops like a stone

Matt was dumbfounded when he found out about his heart scan score of 317 in the summer of 2005.

Earlier that year he'd unintentionally lost 20 lbs. in the space of two months and was feeling awful. He was diagnosed with diabetes and put on several medications. He told me that the heart scan score was just adding insult to injury.

As you'd expect in someone with diabetes, Matt had a low HDL, increased triglycerides, and small LDL. Blood pressure and inflammation (C-reactive protein) were issues as well.

Matt's primary care physician had put him on a statin cholesterol drug as soon as he heard about Matt's heart scan score, so we kept this going. What Matt's primary care physician didn't know was that his "true" LDL had been much higher than the conventional calculated LDL had suggested, so the statin agent was a reasonable solution. (Matt was also not terribly motivated to make dramatic changes in lifestyle or food choices. The statin drug was a compromise.)

We added fish oil and vitamin D to his regimen. Though recent data have cast doubt on the value of treating homocysteine levels of around 12.5, Matt's much higher value of 28 was treated with vitamins B6, B12, and folic acid, with a resultant homocysteine of 7.6.

17 months into the Track Your Plaque approach, and Matt's repeat heart scan score: 244, a 23% reduction.

How's that for an early Christmas gift?

"You don't have a uterus. You don't need progesterone"

I was talking with a hospital nurse recently who told me about her lack of energy, blue moods, and other assorted complaints. At age 49, she was exasperated. So I suggested that she ask her gynecologist about progesterone cream.

The gynecologist advised her, "You don't have a uterus. You don't need progesterone." He went on to explain that the only reason to take progesterone was to prevent uterine cancer caused by estrogen.

Then what about progesterone's weight loss benefits? It's effects on increased energy, improved mood, deeper sleep? These benefits, of course, have nothing to do with the uterus.

I've witnessed these benefits in women many times, both in the peri-menopausal period (which starts around your late 30's) and menopause.

Why talk about progesterone when our focus is heart disease and reduction of heart scan scores? Because if progesterone in a woman helps her feel better, more upbeat, and accelerates weight loss, she's more likely to succeed in her plaque-control program.

For additional comments on progesterone, read the Track Your Plaque interview with women's hormone expert, Dr. Nisha Jackson, Females, hormones, and weight control:
An interview with Dr. Nisha Jackson
found at http://www.cureality.com/library/fl_04-008njacksonhormones.asp. Dr. Jackson also has a book available called "The Hormone Survival Guide to Perimenopause".







Or, read Dr. John Lee's pioneering books, What Your Doctor May Not Tell You About Menopause: The Breakthrough Book on Natural Hormone Balance and What Your Doctor May Not Tell You About Premenopause: Balance Your Hormones and Your Life from Thirty to Fifty . (An edition that combines the two books is available, also.)

Take a niacin "vacation"

I've been seeing a curious niacin phenomenon that has not, to my knowledge, been reported anywhere in the medical literature.

People with lipoprotein(a), or Lp(a), are best treated with niacin, particularly given the relative lack of other effective therapies. I now have seen approximately 10 people with great initial responses to niacin, only to observe Lp(a) levels slowly drift back up to the starting level over a period of 2-3 years.

In other words, if starting Lp(a) is 200 nmol/l (approximately 80 mg/dl), drops to 70 nmol/l on niacin. Then, over 2-3 years of treatment, it drifts back to 200 nmol/l. Very frustrating.

Somehow, your body's Lp(a) manufacturing mechanism circumvents the niacin, sort of like antibiotic resistance (without the bacteria, of course).

My response to this, though untested, is to have people take an occasional "niacin vacation". I don't mean take a trip to the Bahamas while on niacin. I mean take 2 weeks off from niacin every three months or so. My hope is that the occasional vacation from niacin will allow the body to continue to respond and suppress "resistance". When resuming niacin, you may have to escalate the dose gradually to avoid re-provoking the "flush".

The same "resistance" seems to develop to testosterone in males: an initial drop followed by a gradual increase. Curiously, I've not seen this in females with estrogens, which seems to generate a durable Lp(a) suppressing effect. For this reason, an occasional testosterone "vacation" might also be considered.

So far, I've advised several people to try this. The long-term success or failure, however, is uncertain. I know of no other solutions, however.

If you have Lp(a) and are on long-term niacin, you should consider talking about this issue with your physician. Like many aspects of Lp(a), while fascinating in its complexity, much remains uncertain. Stay tuned.

When LDL is more than meets the eye

Jerry wanted to know what to do with his LDL cholesterol of 112 mg/dl. "My doctor said that it's not high but it could be better."

So I asked him what the other numbers on his lipid panel showed. He pulled out the results:

LDL cholesterol 112 mg/dl

HDL 32 mg/dl

Triglycerides 159 mg/dl


I pointed out to Jerry that, given the low HDL and high triglycerides, his calculated LDL of 112 was likely inaccurate. In fact, if measured, LDL was probably more like 140-180 mg/dl. LDL particles were also virtually guaranteed to be small, since low HDL and small LDL usually go hand-in-hand (though small LDL can still occur with a good HDL).

So Jerry's LDL is really much higher than it appears. To prove it, Jerry will require an additional test, preferably one in which LDL is measured, such as LDL particle number (NMR), apoprotein B, or "direct" LDL.

It's really quite simple. Jerry likely has a high number of LDL particles that are too small. This pattern confers a three- to six-fold increased risk for heart disease.

Treatment requires more than just reducing LDL. Small LDL--an important component of this pattern, responds, for instance, to a reduction in processed carbohydrates like wheat products (breads, breakfast cereals, pretzels, etc.), NOT to a low-fat diet. Weight loss to ideal weight, especially loss of abdominal fat, will yield huge improvements in these numbers. Niacin may be a necessary component of Jerry's treatment program, since it increases LDL size and raises HDL.

For more discussion on measures superior to LDL cholesterol, see my upcoming editorial, Let Dr. Friedewald Lie in Peace (an expansion of a previous Heart Scan Blog). It will be posted on the Cardiologist on Call column on the Track Your Plaque website within the next week.)

Oil-based vitamin D


As time passes, I gain greater and greater respect for the power of restoring vitamin D blood levels to normal, i.e. 50-70 ng/ml. Just yesterday, I saw several people with blood levels of <10 ng/ml--severe deficiency.

Vitamin D deficiency this severe poses long-term risk for osteoporosis, arthritis, colon cancer, prostate cancer, inflammatory diseases, diabetes, and heart disease. Vitamin D appears to make coronary plaque reversal--reduction of your heart scan score--easier and faster.

But it is important that you take the right kind of vitamin D. Several of the people I saw yesterday with vitamin D levels of somebody living in total darkness were taking vitamin D, but they were taking tablets. Tablets are the wrong form. Powder-based tablets, in my experience, yield little or no rise in blood levels. Some preparations generate a small rise but the dose required is huge.

If you're going to take vitamin D, take a preparation that yields genuine and substantial rises in blood levels. This requires an oil-based capsule. I commonly see blood levels of 25-OH-vitamin D3 rise from, say, 10 ng/dl to 60 ng/ml when oil-based capsules are taken.

The most common dose I prescribe to patients is 2000 units per day to females, 3000-4000 units per day to males in non-sun exposed months. Ideally, your dose is adjusted to blood levels.

The Vitamin Shoppe preparation pictured here is one I've used successfully and generates bona fide rises in blood levels. And it costs around $5. Just be sure the preparation you buy is oil-based.

For rapid success, try the "fast" track

Have you tried fasting?

Before your eyes glaze over, let me tell you what I mean. I don't mean a water-only fast for two weeks while you drool over all the temptations around you and you feel sorry for yourself.

I also don't mean the juice fasts that some people use that turn into fruit juice fasts of pure sugar.

Here's another way to do it. Usually, 48 hours of doing this will yield several benefits:

--Weight loss of 1 lb. You will likely experience an even greater weight loss of 2-4 lbs, but much of this will be water loss.

--If you're like me and share a heightened sensitivity to sugars and carbohydrates (like wheat), you may find out just how awful you feel when you eat certain foods. Many people tell me they feel absolutely wonderful when they fast--clearer thinking, increased energy, improved mood. Not the constant gnawing urge to eat they expected.

--After your fast is over, you look back and realize just what large portions of food you were eating. You'll be content with smaller quantities--and enjoy it more.


The "fast" I've used successfully includes two foods:

1) Vegetable juices--that you either juice yourself or purchase. V8 or its equivalent works pretty well. Though purchased V8 is not the best, it's better than nothing and does work reasonably well. If you juice your own vegetable juices, watch out for the diarrhea if you're unaccustomed to vegetable juices. Four 8 oz glasses per day works well.

2) Soy milk--for a source of protein and modest quantity of sugar and fat. I like the Light Silk Soymilk (Vanilla) which contains 80 calories, 2 g fat (0.5 g monounsaturated), 7 g sugar, 6 g protein per 8 oz glass. Four 8 oz glasses of soymilk also work well. In my neighborhood, 8th Continent is another good choice.


Sip both of these throughout the day. Of course, drink water in unrestricted amounts.

What can you expect in your coronary plaque control/heart scan score reversal program? When the fast is over, a rise in HDL, reduction in small LDL, reduction in triglycerides, reduction in blood sugar and insulin, and a smaller tummy. This strategy can be useful to kick-start weight loss efforts or as a periodic way to maintain control over weight and lipid/lipoprotein patterns.


Nutritional Composition Silk Soymilk--Vanilla

Nutrition Facts
Serving Size 1 cup (240mL)
Servings per container 8 H/G OR 4 QT

Amount per Serving

Calories 70
Calories from Fat 20

% Daily Value
Total Fat 2g 3%
Saturated Fat 0g 0%
Trans Fat 0g
Polyunsaturated Fat 1g
Monounsaturated Fat 0.5g

Cholesterol 0mg 0%
Sodium 120mg 5%
Potassium 300mg 8%
Total Carbohydrates 8g 3%
Dietary Fiber 1g 4%
Sugars 6g
Protein 6g
Vitamin A 10%
Vitamin C 0%
Calcium 30%
Iron 6%
Vitamin D 30%
Riboflavin 30%
Folate 6%
Vitamin B12 50%
Magnesium 10%
Zinc 4%
Selenium 8%
Wheat addiction: 140 lbs lost

Wheat addiction: 140 lbs lost

Here is detailed comment from a reader who figured out the wheat (and dairy) issue on her own with impressive results.

Though it seems an unpardonable over-simplification of diet, this concept of eliminating wheat-based products (along with obvious unhealthy foods like candy and soda) yields unexpectedly large results, as our reader relates.


Hi Dr. Davis,

Several years ago, chronic untreated asthma infections hospitalized me. I thought it was recurring bronchitis as I'd never had asthma in my life. Killed much of the alveoli... took awhile to de-crap the lungs and regrow the alveoli. Got assigned a cardiologist sort-of by accident while in the hospital for that (couple days of constant heated steroid, stress, a pain + situation combined, elevated my heart rate to 298 for a brief time). When I went to see him, he wrote me a prescription for the Eades' PPLP [Protein Power LifePlan] book.

It's taken awhile, since it's required radical gradual changes in most aspects of my overly Type-A life, but I'm now about 140 lbs lighter, and hopefully much more in the future.

Miraculously, after 10 days on a hard meat-eggs-cheese-veggie-berry approach (which I sadly confess was mostly pepperoni & mozz nuked... I was busy! ;-)), all my medical symptoms disappeared too. Acid reflux, acne, brain-fog, rashes, 'severe asthma', allergies, etc. etc. By trial and error I realized I wrongly attributed that to lowcarbing when it was getting off gluten that actually did it for me. Which since I'm lowcarb also means all the crap my celiac boyfriend can eat, I can't. Lowcarb does many great things for me (just dropping all the bloating and increasing the energy level are awesome), but getting off wheat was critical.

I've since found that a single tablespoon of "milk" in the morning, or something with wheat (say a tortilla), will make me ravenous *specifically for milk and wheat* all day. Conversely, I can be eating lowcarb and then eat total junk--but something without gluten--and not have it bother me much at all. But one pumpernickel slice at Outback and I am DOOMED. It doesn't always happen that instant; will-power has some sway; but the odds of my making a 'poor decision that leads to cascade failure and totally abandoning my eating plan' in the next 48 hours is astronomically higher if milk or wheat were involved. Oddly, cheese does not seem to affect me this way.

When I was younger (I'm 42 now) I had to stop drinking milk. If I drank some I wanted more. If I drank more I needed more. If I drank more, that was it: I'd be stumbling to the kitchen in the dark at 3am, drinking out of the carton, falling gasping against the refrigerator after several long gulps, like a heroin addict who just got a fix. I finally realized that since I'd lived on a ton of milk my whole life, maybe this was a milk problem; so I usually stayed away from it. So then it turned out wheat/gluten were an issue too. Which made me realize how much of my life was filled with not-eating most of the time (very busy, workaholic, but very sedentary), but when I did eat, ingesting amazing amounts of wheat products. I'm astounded that my whole life I mostly ate things I am apparently intolerant to "or something." Sometimes I wonder how much different even my brain would be if it'd been different.

This might contribute to my ending up weighing 500# at one point. The only amazing thing is that I didn't get a disease. (Well I did--obesity--but I mean any others.) I'm from a family of people who are mostly fat, mostly alcoholic, and mostly dead of cancer. I'm just fat, worse than the others but otherwise seemingly ok. Now I'm starting to think that maybe my whole family may have some 'issue' with the primary foods of our culture.

I tell friends that my horrible chronic acid reflux was solved merely by getting off gluten. They nearly all say, "I could never give up bread!" (Isn't it funny, you never hear people say, "Oh man, I could never give up broccoli!") I tried to convince one young friend to try it; her doctor told her eating more protein and fat was unhealthy, and gave her a prescription (this is lifetime--it doesn't cure it, merely treats the symptom) to a drug to help with acid reflux. I said you're kidding me, you think taking a drug the rest of your life is healthier than trading your pasta for a steak?? Go figure.

I still haven't figured out the milk connection (or why I seem ok with cheese for some reason; maybe there is a dosage-difference, or the sugar combined with it has some effect), but I think it's pretty clear that dropping milk and wheat has very radically changed my life for the better. I may actually live, which being a single mom to an awesome 11 year old girl, is a good thing.

Best,
P.

Comments (14) -

  • Anonymous

    5/27/2008 6:15:00 PM |

    Dr. Davis,

    What a great story to share!

    Just an aside, most people have no idea the impact of particular foods or the excess of foods on their blood sugar. Still we go about our daily lives, some of us with very high blood sugar after a meal on a daily basis. I think if non-diabetics (the general population) were encouraged to learn to use a glucose meter (that you don't have to be a diagnosed diabetic to use one), some chronic health ailments would diminish.

  • Brian

    5/27/2008 9:35:00 PM |

    I find it interesting when wheat and dairy get mentioned at the same time when talking of food addiction. Some years ago I came across information on the opiate- like nature of gluten and casein (proteins in wheat and milk). A quick web search will return lots of leads.

  • Angela Coppola

    5/27/2008 10:00:00 PM |

    So why is it that cheese seems ok to some people? What about yogurt? Is it the lactose or something else? I have always wondered about these things.

  • Anne

    5/28/2008 1:37:00 AM |

    One reason that you may be able to tolerate cheese but not milk is because milk contains lactose and hard cheeses are almost lactose free. Lactose intolerance is caused by the lack of the enzyme to digest this milk sugar.

    Cheese is high in casein, a major protein in dairy.

    Both lactose intolerance and/or casein intolerance are often associated with gluten intolerance.

    I am glad that you turned your health around with lifestyle eating changes.

  • Anonymous

    5/28/2008 3:35:00 PM |

    I had a major gut episode yesterday after eating rice cereal with milk. I've previously tolerated milk, and cheese as well. But I've read that a gluten-sensitive gut can be sensitive to other foods until the gut heals (by avoiding gluten). I'm not sure if it's the casein or lactose, but I'm leaning towards lactose since I've been able to tolerate fermented cheese.

    The lady in this post, and your last post mentioned strong cravings for wheat after eating some. I've read theories (at alternative sites) about most people having at least a small amount of candidiasis. I wonder if that might be part of the reason for the strong cravings. I don't crave wheat anymore, but if something causes severe pain enough times, one tends to get over it quickly.

    S

  • Nyn

    5/28/2008 4:10:00 PM |

    Very inspiring to read. I would have to know more about how this 'Type A' personality managed to eat so low-carb and eliminate wheat long enough to lose that kind of weight. I am at a loss as to what to eat in place of wheat, and while it seems like an easy answer, I have almost zero time for meal prep. I eat 2 of 3 meals a day at my office or in the car, and some days even all 3. No way to slow down my schedule either. Anyone know of a elimination-wheat-blog/diary I can follow to get some ideas? Still a wonderful story, and glad you shared it.

  • PJ

    5/28/2008 11:35:00 PM |

    Wow, thanks for posting my email comments doc. When I gave permission I didn't realize it'd be front page news. Though I noticed you did leave out my ravings about how wonderful you and my cardiologist are I noticed... very humble of you!

    I'm no expert on anything, and my blog isn't a nutrition blog, but I'm at The Divine Lowcarb for anybody who likes layman blogs.

    PJ

  • Sue

    5/29/2008 1:25:00 AM |

    Just eat a green salad or low-carb vegies in place of wheat.  Salad and vegies easy to prepare if you get them packaged - already washed and cut.

  • Gyan

    5/30/2008 11:48:00 AM |

    Is that so that carbs are less harmful to physically active people and more harmful to sedentary people?

    Since the active muscles of physically active people with tend to utilize glucose more efficiently than not-so-active muscles of sedentary people.

    Also does it make any difference if one consumes freshly milled flour of 100% extraction
    (the way our ancestors used to eat) with plenty of butter?
    (By fresh I mean less than one week old).

  • jpatti

    6/4/2008 10:28:00 PM |

    Carbs are more harmful to people with the genetic propensity for metabolic syndrome, whether they are active or not!  

    Of course, exercise helps whether someone is perfectly normal or flatout diabetic.  

    As for wheat, I don't personally think if you're not diabetic and don't have gluten intolerance that it is necessarily bad.  But as far as grains go, it's relatively nutritionally bankrupt.  Barley or buckwheat are the best grain choices.  I think even rice or oats are better choices than wheat.

    And, of course, veggies are better bang for your carb buck than any of the grains.

    I really think that those who tolerate wheat and choose to eat it should prefer whole wheat berries (they cook up to a nice hot cereal overnight in a crockpot with some apples and cinnamon).  Second best choice is bread or pasta made from freshly ground flour - you can grind it yourself with either a dedicated grinder or some appliances can grind wheat like the Vitamix.  Far behind those choices is freshly baked bread made from preground whole wheat flour.

  • jpatti

    6/6/2008 10:40:00 AM |

    I just want to add - even for those who have no problems with wheat and eat it as a whole grain... the problem is it's a staple in people's diets.  Same problem with corn.

    There's not enough nutrition in wheat or corn foods to make them worthwhile as a significant part of your diet.  Even if you tolerate them just fine now and then, you just don't need them to be at the base of your food pyramid.  Vegetables should be at the base, whether you eat grains or not.  

    And if you eat grains regularly, there's so many better choices than wheat or corn.  Barley and buckwheat are the best.  But even oats or whole grain rice are way better than wheat or corn.

    Wheat and corn are pretty much "filler" foods at best - they mostly provide calories.  In places  and times where there are food shortages, they're very useful foods cause they prevent starvation pretty well.  They're cheap, store well, and fill bellies, but that's really the best you can say for them.

    But in the western world today where we have a wide variety of foods available to us, the primary benefit of wheat and corn is to food manufacturers who make a fortune out of processing such cheapo ingredients into forms that tempt us to pay big bucks for them.

    I don't agree that wheat is somehow worse than all other carby foods, but realistically, cutting wheat out of your diet *mostly* results in a much healthier diet cause most folks eat so much crap made from wheat.  

    Personally, if I had to give *one* piece of diet advice to *everyone*, it wouldn't be to avoid wheat.  Rather, it would be to eat at least half of your food intake as fresh vegetables.  

    Eating loads of veggies provides a wide range of nutrients, probably ones we haven't discovered yet too.  And it also crowds most of the worst foods out of your diet, regardless of what they are.

  • Anonymous

    6/3/2009 4:45:37 PM |

    A recent study using Italian cheese made from ewes milk showed some very strong heart health benefits.

    The cheese mentioned in this study is an Italian cheese called Pecerino.
    The most popular type in the US is called Pecerino Romano,an aged cheese with a salty taste.

    CLA-rich cheese may boost heart health: Study


    Quote:
    Consuming cheese from ewe’s milk, rich in conjugated linoleic acid (CLA), may reduce markers linked to heart disease, suggest results from a small Italian study.

    Researchers from the University of Florence report that ewe’s milk rich in cis-9, trans-11 CLA produced favourable changes in inflammatory cytokines and platelet aggregation, both of which are associated with atherosclerosis, or hardening of the arteries due to the build-up of fatty deposits on artery walls.

    Atherosclerosis is the primary cause of coronary heart disease (CHD), which costs the British public health system more than €5bn per year.

    “These observations, although preliminary and obtained in a limited study group, seem to be of relevance for the practical implications in terms of nutrition and health of the general population,” wrote the researchers in Nutrition, Metabolism and Cardiovascular Diseases.

    “If the effects of dairy products naturally enriched for their contents of cis-9, trans-11 CLA are confirmed by further examinations, this will likely have important implications for human nutrition and food industry.”

    Cheese – ewe decide

    Researchers, led by Francesco Sofi, recruited 10 subjects with an average age of 51.5 and randomly assigned them to consume a diet containing 200 grams per week of cheese from ewe’s milk (pecorino cheese), naturally rich in CLA, or cheese from cow’s milk (placebo), for 10 weeks.

    Sofi and his co-workers report that consumption of the CLA-rich ewe’s cheese produced significant reductions in inflammatory markers, including a 43 per cent reduction in interleukin-6 (IL-6), a 36 per cent reduction in IL-8, and a 40 per cent reduction in tumour necrosis factor-alpha (TNF-alpha). No significant changes were observed following 10 weeks of placebo, they added.

    Furthermore, a 10 per cent reduction in the extent of platelet aggregation, induced by arachidonic acid, was observed for the CLA-cheese group, compared to placebo.

    “CLAs have been previously reported to attenuate inflammatory cytokine expression in animals and humans, and it has been recently reported that they are able to inhibit the expression of cytokine-induced adhesion molecules on endothelial and smooth muscle cells,” wrote the researchers.

    “Thus, it is conceivable to hypothesise that CLAs are able to attenuate the atherosclerotic process through inhibition of the initiating inflammatory cytokines, such as those measured in our study, as well as through inhibition of the stress signalling cascades these cytokines elicit,” they added.

    Source: Nutrition, Metabolism and Cardiovascular Diseases
    Published online ahead of print, doi: 10.1016/j.numecd.2009.03.004
    “Effects of a dairy product (pecorino cheese) naturally rich in cis-9, trans-11 conjugated linoleic acid on lipid, inflammatory and haemorheological variables: A dietary intervention study”
    Authors: F. Sofi, A. Buccioni, F. Cesari, A.M. Gori, S. Minieri, L. Mannini, A. Casini, G.F. Gensini, R. Abbate, M. Antongiovanni

  • Chrissy

    7/6/2010 9:55:19 PM |

    I wanted to lose weight so I decided to keep it simple.  cut out wheat is the only rule.  However I am not in the obese category, and don't drink soda's or much sugar, most of the sugar I eat is in with the wheat foods (eg: cake).  I also eat fruits ad vegetables every day and very little fast food (now and again when travelling for example)  by day three and four of the no wheat diet, I am WAY less hungry and eat less.  But I am having cravings for toast - previously my staple food.  I used to eat up to six slices of toast a day, plus other wheat based foods, biscuits and such.
    The reason I know it's a craving for wheat, is because I look at other foods I like, and I have no appetite for them whatsoever, because I am not ACTUALLY HUNGRY.  It's easy to over-eat on wheat based products, but if you're not allowed them, you just don't want to eat anything.  so your appetite becomes regulated.

  • buy jeans

    11/3/2010 7:29:34 PM |

    Just an aside, most people have no idea the impact of particular foods or the excess of foods on their blood sugar. Still we go about our daily lives, some of us with very high blood sugar after a meal on a daily basis. I think if non-diabetics (the general population) were encouraged to learn to use a glucose meter (that you don't have to be a diagnosed diabetic to use one), some chronic health ailments would diminish.

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