Watch your weight plummet:Be a super vegetarian

Here's a neat trick for losing weight: Become a strict vegetarian for 3 days.

Before you yawn or say "Yecchhhh!", let me elaborate.

Pick some time period. It doesn't have to be 3 days. It could be 2 days, or 5 days, or two weeks. But, for the period you choose, eat only vegetables. No meat, cereals, breads, milk, cookies, etc.

Vegetables alone could get monotonous, so make them interesting. Possibilities include:


--Hummus--add a little bit of olive-oil, chopped garlic, paprika, red pepper.

--Tabouleh--I get mine from Trader Joe's and it's delicious.

--Salsa--Low in calories, rich in lycopene and other flavonoids, with no nutritional downside. Also, pico de gallo--chopped tomatoes, onions, jalapeno chiles, cilantro, cucumbers.

--Mustards--hot, yellow, brown, spicy, gourmet, horseradish, etc.

--Cocktail sauce--i.e., ketchup and horseradish. Use the low-carb ketchup made without high fructose corn syrup.

--Tapenades--e.g., olive tapenade made with chopped olives, capers, and olive oil.
--Pesto-made with basil, garlic, and olive oil.

--Spices and herbs--basil, arugula, peppers, mustard powder, garlic, cilantro, ginger, etc.

--Vinegars--wine, Balsamic, rice, apple cider.

--Infused olive oils--infused with garlic is especially delicious,e.g., added to hummus.

--Bean dips--white bean dip, roasted bean dip, etc.





With the varieties of ways to jazz up your vegetables, you couldn't possibly be bored.

For example, for breakfast on day 1, eat sliced cucumbers and green peppers dipped in garlic-infused olive oil hummus and a handful of almonds. For a snack, some walnuts, sunflower seeds, sliced zucchini dipped in salsa. For lunch, a salad with an olive oil and balsamic vinegar dressing. For dinner, tablouleh, a cucumber and tomato salad, celery sticks dipped in pico de gallo.

All vegetables can be eaten without restricting portion size, since calorie content of vegetables are so low compared to other calorie-dense foods. (See The Heart Scan Blog from a few days back, "One bit or many mouthfuls?" at http://heartscanblog.blogspot.com/2007/01/one-bite-or-many-mouthfuls.html.)

This approach works nearly as well as fasting. A half-pound per day weight loss or more is common and painless. You'll also feel great living on low glycemic index foods.

(Photos courtesy Wikipedia.)

Dr. Agatston to the rescue


Dr. Arthur Agatston, author of wildly successful South Beach Diet, has just released a new book titled The South Beach Heart Program. Dr. Agatston has started on a media speaking circuit to promote his book and concepts.


A reporter from Time, who interviewed Dr. Agatston, commented:

". . .not enough doctors prescribe niacin for their heart patients, even though the medicine is a proven treatment for raising 'good' cholesterol. Physicians are reluctant, Agatston suggests, because niacin requires diligent follow-up to watch for side effects, taking time that most primary-care practices cannot afford. On the other hand, he says, too many doctors are performing heart operations that represent a financial windfall for hospitals. Bottom line: there isn't as much money to be made in prevention as in treatment."

Amen.

Dr. Agatston echoes many of the concepts that the Track Your Plaque program advocates. His notoriety is going to help disseminate the idea that 1) CT heart scans are the #1 method to identify hidden atherosclerotic coronary plaque, 2) taking control of your heart scan score is the best way to seize hold of your future, and 3) the present-day popularity of heart procedures like stents and bypass is intolerable, inexcusable, and needs to be reined back.

Agatston also brings great credibility and fairness to the conversation and his comments will gain tremendous attention in the press and with the public.

When is a vitamin not a vitamin?

When it's a hormone.

That's the stand that several researchers in vitamin D have taken and I think they're right. Dr. John Cannell has made a fuss over this in his www.vitamindcouncil.com website.

Structurally, vitamin D is most closely related to testosterone, estrogen, and cortisol. You wouldn't call testosterone vitamin T, would you?

Vitamins are also meant to be obtained from food. Yes, vitamin D is in milk but only because humans are required to put it there to prevent childhood rickets. Otherwise, the only substantial food source of vitamin D is in oily fish like salmon and then only a modest quantity.

Vitamin D is cholecalciferol, a hormone. Deficiencies of hormones can have catastrophic consequences. Imagine that every winter your thyroid gland shuts down and produced no thyroid hormone. You'd get very ill, gain 30 lbs, lose your hair, feel awful.

That's what happens when you're sun deprived and thereby deficient in cholecalciferol--you're deficient in a hormone. And it happens to most of us every year for many months.

I continue to witness spectacular effects by bringing 25-OH-vitamin D3 blood levels to 50 ng/ml with supplementation, including an apparent surge in success dropping heart scan scores.

An epidemic of heart disease reversal

Heart disease reversal is nothing new in my office. However, I have to admit that it's not something that generally happens each and every day.

As our approach is refined, we are witnessing an unprecedented frequency of plaque reversal. Since Monday (today is Tuesday), I've seen four people who have regressed their coronary plaque and dropped their heart scan score.

Pat was the most recent addition to this list. At age 53, I was honestly surprised at the ease of dropping her heart scan score from 128 to 42 in the space of a year. I was surprised because among her lipoprotein patterns was the dreaded combination of lipoprotein(a) and small LDL, probably the most aggressive risk for heart disease I know of and also among the most difficult to gain control over. She also suffered a deep personal tragedy in her family, an emotional convulsion that can sometimes wipe out any hope of plaque reversal.

I'm hopeful that this virtual epidemic of heart disease reversal continues. And I hope that you participate in it.

Second heart scan and heart attack risk

At first, Joe felt disappointed, defeated, and frightened. After his heart scan, a radiologist at the center told him that his score of 264 was moderately high. He told Joe that he was at moderate risk for heart attack and that a nuclear stress test was going to be required.

This left Joe feeling confused. After all he'd had a heart scan 18 months earlier and his score was 278, 5% higher.

I reassured Joe that the radiologist had not been aware that Joe had a prior heart scan. The radiologist didn't know that Joe's heart scan score had actually been reduced.

In fact, Joe's risk for heart attack was not moderate--it is now very low, since his score was 5% lower. While growing plaque is active plaque, shrinking plaque is inactive plaque and thereby at far less risk for heart attack.

I wrote about this phemonenon in a previous Blog: When is a heart scan score of 400 better than 200? at http://heartscanblog.blogspot.com/2006_09_01_archive.html. When you've had more than one scan, the risk for heart attack suggested by the score takes a back seat to the rate of change of your score. In other words, even though Joe's score of 264 represented a moderate risk (of approximately 3% per year, roughly 30% over 10 years), this no longer held true, since it actually represented a 5% decrease over a previous score.

Joe's risk for heart attack is probably close to zero. ALWAYS view your second (or any subsequent) heart scan score in the context of your previous score, not in isolation.

Track Your Plaque newsletter subscribers: We will detail more of Joe's story in the coming January 2007 newsletter. If you'd like to read or subscribe to the newsletter, go to http://www.cureality.com/f_scanshow.asp.

Heart scan curiosities #5

Despite the controversy over drug-coated stents, I maintain that the best stent is no stent at all.

Yes, there are indeed times when such things are necessary, but not with the frequency that they are implanted nowadays.

Another reason why stents are an undesirable phenemenon is that they muck up your heart scan. Take a look:





The long white object in the center is a stent in the left anterior descending artery of this 60 year old man. Just beyond the stent (at about 1 o'clock from the stent) is a plaque that could be scored. However, you can see that, with the presence of the stent, the bulk of this artery is no longer "scorable". If this man wishes to "track his plaque", he will have to be content with tracking only the circumflex and right coronary arteries, the other two arteries without stents.

The stainless steel or similar metallic materials of current stents simply prevent us from seeing through them for plaque scoring purposes. It's best if you can simply avoid getting one for this and other reasons.

Track Your Plaque Members: Watch for the upcoming editorial by our Heart Hawk on drug-eluting stents.

One bite or many mouthfuls

A reader brought this beautiful series of food photos to my attention:

http://www.wisegeek.com/what-does-200-calories-look-like.htm

It's simply a graphic display of what 200 calories of various foods look like. You'll note that vegetables and fruits permit large servings to yield 200 calories. Processed foods, on the other hand, require very little to tally up the same calorie load. In particularly, look how little in the way of wheat products are required to match that amount.

Heart scan curiosities #4

Here's an interesting example of a 63-year old man with a heart scan score of 112. However, his aortic valve was also severely calcified (loaded with calcium). In other words, the normally flexible and mobile "leaflets" of the aortic valve were coated with calcium and other tissues that interfere with its free motion. The aortic valve is the starburst white in the center of the heart.








This is what the aortic valve should look like on a CT heart scan--you shouldn't see it at all.

The first man with the calcified valve will unfortunately require a new prosthetic aortic valve sometime in his future. This is usually determined with the help of an ultrasound, or echocardiogram, a better test for assessment of the aortic valve (though useless for detection of coronary plaque).

It's my suspicion that chronic and longstanding deficiency of vitamin D is among the factors that contribute to the abnormal deposition of calcium on the aortic valve. We desperately need more data on this. Nonetheless, perhaps this adds yet another reason to 1)get a CT heart scan, and 2) bring your vitamin D blood level to normal. (We aim for 50 ng/ml year round.)

Fish oil and the perverse logic of hospitals

Hospitals are now starting to carry prescription fish oil, known as Omacor, on their formularies. It's used by some thoracic surgeons after bypass surgery, since fish oil has been shown to reduce the likelihood of atrial fibrillation (a common rhythm after heart surgery).

Why now? The data confirming the benefits of fish oil on atrial fibrillation has been available for several years.

It's now available in hospitals because it's FDA-approved. In other words, when fish oil was just a supplement, it was not available in most hospitals. Whenever I've tried to get fish oil for my patients while in hospital, you'd think I was trying to smuggle Osama Bin Laden into the place. The resistance was incredible.

Now that FDA-approved Omacor is available, costing $130 dollars per month for two capsules, $195 for the three capsule per day dose for after surgery, all of a sudden it becomes available. Why would this irrational state of affairs occur in hospitals?

Several reasons, most of which revolve around the great suspicion my colleagues have towards nutritional supplements. In addition, there's the litigation risk: If something has been approved by the FDA, their stamp of endorsement provides some layer of legal protection.

However, I regard those as pretty weak reasons. I am, indeed, grateful that fish oil is gaining a wider audience. But I think it's absurd that it requires a prescription to get it in many hospitals. Imagine, as the drug companies would love, vitamin C became a prescription agent. Instead of $3, it would cost far more. Does that make it better, safer, more effective?

Of course, no drug sales representative is promoting the nutritional supplement fish oil to physicians nor to hospitals. I now see people adding the extraordinary expense of prescription fish oil to their presription bills.

In my view, it's unnecessary, irrational, and driven more by politics and greed than actual need. Take a look at the website for Omacor (www.omacorrx.com). Among the claims:

"OMACOR is the only omega-3 that, along with diet, has been proven and approved to dramatically reduce very high triglycerides..."

This is a bald lie. Dozens of studies have used nutritional supplement fish oil and shown spectacular triglyceride-reducing effects.

Their argument against fish oil supplements:

"Dietary supplements are not FDA-approved for the treatment of any specific disease or medical condition. Get the Facts: nonprescription, dietary supplement omega-3 is not a substitute for prescription OMACOR."

Does that make any sense to you? Should you buy a GM car because only GM makes genuine GM cars? This is the silly logic being offered by these people to justify their ridiculous pricing.

How about: "The unique manufacturing process for OMACOR helps to eliminate worries about mercury and other pollution from the environment."

Funny...mercury in fish tends to be sequestered in the meat, not the oil. Independent reports by both Consumer Reports and Consumer Lab found no mercury, nor PCB's, in nutritional supplement fish oil. But just suggesting a difference without proving it may be enough to scare some people.

Just because something is used by a hospital does not make it better. The adoption of fish oil is hospitals is a good thing. Too bad it has to add to already bloated health care costs to enrich some drug manufacturer.

Repent for past sins

If the food temptations of the holidays got the best of you, and you're now 5, 10, 15 lbs or more over your pre-holiday weight (our record is 18lbs!), then it's time for serious action.

One easy method to regain the control you may have lost is to pick some period, say, 3 days. During those three days, eat nothing but vegetables--no breads, meats, dairy products, certainly no cookies, cakes, pasta, etc., not even fruit. Follow this routine and weight drops rapidly. Vegetables are wonderful but sometimes boring, so use healthy condiments to spice them up: mustards (hot, brown, yellow, horseradish); healthy salad dressings, which are olive or canola oil-based; salsas, a fabulous garnish with no nutritional downside whatsoever; pesto; tapenades; horseradish added to other condiments or even by itself (wasabi).

Of course, fasting in one of its several variations is another rapid method to regain control. My favorite is to use soy milk in a modified fast, usually 4-6 glasses of a low-fat, low-sugar soy milk per day, along with plenty of water. (Please refer to the precautions detailed in the recent Track Your Plaque Special Report, Fasting: Fast Track to Control Plaque , particularly if you fast 5 days or longer or take blood pressure or diabetic medication.)

Of course, yo-yoing your weight--up during the holidays, down after their conclusion--is not good for you. It does raise the likelihood of diabetes, not to mention cultivate the patterns that contribute to coronary plaque growth, especially small LDL. But if temptation got out of control and you need to regain lost ground, these two strategies work fabulously well for most people.

If you've gained, say, 10 lbs during the holidays, but simply resume your usual habits, chances are you won't lose the weight. Year after year, this can add up to an enormous weight gain. The time to act is now. It's easier to lose the 10 lbs of weight you gained recently, rather than the 50 lbs you've stacked up over the past 5 years.
Kitchen sink approach for Lp(a)

Kitchen sink approach for Lp(a)


Lipoprotein(a), Lp(a), can be a tough nut to crack.

Having struggled and wrestled with this genetic pattern for the last 12 years or so in hundreds of patients, I have gained great respect for this difficult to control pattern.

I regard lipoprotein(a) as the number one most aggressive cause for heart disease and coronary plaque known. It can account for heart attacks in men in their 40s, women in their 50s. It can cause heart disease and heart attacks in even the ultra-fit like marathon runners. It accounts for both excessive coronary risk and misleading cholesterol values in slender, healthy-appearing people.

Niacin is the number one treatment choice for Lp(a), followed by testosterone for men, estrogens (preferably human, not horse or other non-human mammal) for women. I then often resort to DHEA, along with adjunctive nutritional agents like raw almonds, ground flaxseed, and others.

Our most recent addition to the Lp(a) treatment list is high-dose fish oil, which appears to exert a significant effect in about 40% of people with Lp(a).

Even with this multi-agent approach, not everybody gains control over Lp(a).

That makes me wonder if someone has Lp(a) at a substantial level of, say, 200 nmol/L or 70 mg/dl (values can differ tremendously, depending on the method of measurement), should we throw everything but the kitchen sink at Lp(a) from the start? Right now, by adding an agent one at a time, it often takes two years to gain control over Lp(a) (if we are going to get it at all).

While many people might find this unpalatable and overwhelming from the starting gate of their program, I do believe it may be a strategy we should consider adopting for full and more immediate plaque control in the Track Your Plaque program. Something to chew on.

Clearly, we need better answers for Lp(a). A "kitchen sink," full-frontal assault might be a way to gain faster control, though not necessarily a superior approach with regards to efficacy and potency.

There are a number of unique, potentially effective therapies for Lp(a) that are worth examining. Given the difficulty of performing clinical trials with non-drug agents (largely a lack of financial support, since nobody gets a financial return with non-patent-protectable agents), I am anxious to put these potential treatments to a test in the Track Your Plaque program Virtual Clinical Trail (VCT). The VCT gives us a quick and relatively easy method to test various potential treatments, with feedback generated in months, rather than years.

Any suggestions on promising agents to test? Of course, they must be widely available nutritional agents, not drugs.

Comments (12) -

  • Anonymous

    8/29/2008 4:45:00 PM |

    Dr. Davis, first, thanks for one of the best blogs on the net.

    I'd suggest testing krill oil to see if it offers an advantage over plain fish oil.

    I'd also consider testing the rather extreme diet followed by the guy who does the Hyperlipid blog.  (Extreme high fat, moderate protein, essentially zero carb.)

    (By the way, he has an interesting post where he argues that in the presence of dietary sugar and/or excess alcohol intake, that fish oil is actually very dangerous.
    http://high-fat-nutrition.blogspot.com/2008/08/familial-hypercholesterolaemia-and.html

  • donny

    8/29/2008 7:18:00 PM |

    http://www.ajcn.org/cgi/content/full/69/3/419

    I got this from the Wikipedia page on Lp(a). Subjects were fed casein, safflower oil, and cornstarch, or the same but with soy replacing the casein. With soy, Lp(a) levels were slightly decreased, with casein, they were radically decreased. (By as much as 65 percent.)

    Those fish-eating Bantu Islanders from the Kitiva study--they weren't just eating more omega 3's, they were also eating a lot more protein, and better quality protein at that.

  • Anonymous

    8/31/2008 3:57:00 AM |

    Hi Dr. Davis,

    Doxycycline works to reduce Lp(a) in some patients...

    Doxycycline inhibits the production of Leukotrienes produced through the 5-Lipoxygenase inflammatory pathway.

    I think you've hit the nail on the head here with the question of whether it would be better to hit Lp(a) with every weapon in the arsenal right from the start...

    So, all the inhibitors of the 5-LO pathwy would be used from the start including High dose EPA/DHA, Boswellia, Curcumin, Pycnogenol, Resveratrol, Quercetin, etc.

    Hit it with everything right from the start...

    wccaguy

  • Anonymous

    8/31/2008 4:06:00 AM |

    Forgot another possibly significant angle on this "kitchen sink" idea...

    Include the new software tools/devices in the Virtual Clinical Trial to increase Heart Rate Variability to reduce the inflammation that most likely drives Lp(a) level.

    Re: the concept of the kitchen sink...

    It can take years to cycle through all the potential supplement and other solutions to high Lp(a) in the difficult cases.

    Why not throw the kitchen sink right from the start for the TYP program "high risk" members?

    8-)

    wccaguy

  • Anonymous

    8/31/2008 4:10:00 AM |

    Regarding diet....

    I am increasingly more impressed with the essential argument of the PaleoDiet that G keeps bringing up...

    Why is it that study after study finds the "nuts, berries, leaves, bark, and meat" which are central to the paleo diet to reduce risk?

    It seems to me that the essential argument of the paleo diet makes scientific sense and that the detailed studies of the nuts, berries, bark, and meat are supportive as well.

    wccaguy

  • JohnN

    9/1/2008 7:16:00 AM |

    Dr. Davis,
    My two-cent suggestion for a full-frontal assault would include the followings:
    1. Drastically lower basal and total insulin production through ketogenic diet (the anabolic hormone that promotes inflammation). In this context, intermittent fasting and/or a high-fat diet is a component of this approach.
    2. Promote cell membrane flexibility/suppleness with fish-oil and simultaneously cut back on omega-6 intake.
    3. L-Arginine and/or nasal-breathing aerobic/anaerobic physical activities to promote nitric oxide production by the endothelial cells - vasodilation
    4. Potassium supplement from spices, vegetables and fruits (low fructose) to help lower blood pressure.
    5. Correct other nutritional deficiencies (vitamins D, A, niacin, magnesium, etc.)
    6. Treating the root cause of Lp(a) production. I'm partial to the Pauling's hypothesis which asserts that (a) the small, dense and sticky Lp(a) is the body's first response to patch the cracked coronary arteries that break down due to constant high pumping pressure; and (b) Lp(a) production is unique to primates who have lost the ability to synthesize ascorbic acid. Therefore, high dose vitamin C to cure scurvy of the heart and Lysine and Proline to bind to and remove Lp(a) that forms plaque.

    If all of that fail to produce the desire outcome after 6 months or so then it's time to get naked and carry a sharpened stick to the woods to did up some tubers and kill your own meat.

  • Anonymous

    9/3/2008 3:06:00 AM |

    Dr. Davis, thanks for an a great blog.

    I'd suggest testing the following:


    After one year, arterial plaque decreased 30% for those patients who consumed 8oz Pomegranate Juice daily, compared to a 9% worsening for patients who drank a placebo:

    Blood flow to the heart improved approximately 17% for those patients who consumed 8oz Pomegranate Juice daily but worsened approximately 18% in the comparison group:

    http://tinylink.com/?OUFOIe3yo6  
    same as:
    http://www.pompills.com/health_benefits/health_heart.aspx

    Statin dosage may need to be reduced because pomegranate acts like grapefruit.


    Seaweed sushi wrap for increased iodine.

    Daily Japanese iodine consumption vary from 5,280 mcg to 13,800 mcg; by comparison the average U.S. daily consumption is 167 mcg. It has been hypothesized the amount of iodine in the Japanese diet has a protective effect for breast and thyroid disease:

    http://tinylink.com/?Q1Gfu8LFxO  
    same as:
    http://findarticles.com/p/articles/mi_m0FDN/is_2_13/ai_n27943644/pg_

    HeartHawk (blog) thinks his hypothyroidism has caused some of his Lp(a) problems.


    Matt W

  • scatman75

    9/11/2008 3:37:00 PM |

    Apparently some people in the Netherlands believe in Doxy as well, enough to warrant a trial.

    The effects of doxycycline treatment on inflammation and endothelial function in advanced atherosclerosis

    My mother-in-law has fibromyalgia and host of viral infections, one bacterial, along with Lpa around 240, and of course elevated CRP. She is starting on Doxy for the bacterial infection.  Maybe we can hit two birds???

    Thanks Dr Davis for an excellent blog.  Hopefully with info from you blog we can slow down her PAD (100% blocked carotid + 4 blocked arteries below the knee) and keep her legs!

  • Heather

    9/18/2009 3:08:11 AM |

    Matt made a mention of Iodine.

    Dr. Guy Abraham has been doing all sorts of studies with and Iodine/Iodide combination. It has proven to be very effective in treating fibrocystic breast/ovarian disease, which are also responsive to estrogen. From looking at many of the studies he's published (http://www.optimox.com/pics/Iodine/opt_Research_I.shtml) he seems to like to collaborate with physicians with a clinical practice. Perhaps he would be interested in working with you to look at the Lp(a) problem and see if iodine/iodide has any affect.

  • katty

    7/22/2010 3:59:57 PM |

    I love my kitchen,when i bought my house through costa rica homes for sale i expected to have a big kitchen and now i am really happy.

  • katty

    7/22/2010 4:00:41 PM |

    I love my kitchen,when i bought my house through costa rica homes for sale i expected to have a big kitchen and now i am really happy.

  • buy jeans

    11/3/2010 6:19:34 PM |

    While many people might find this unpalatable and overwhelming from the starting gate of their program, I do believe it may be a strategy we should consider adopting for full and more immediate plaque control in the Track Your Plaque program. Something to chew on.

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