In search of wheat

Many people ask: "How can wheat be bad if it's in the Bible?"

Wheat is indeed mentioned many times in the Bible, sometimes literally as bread, sometimes metaphorically for times of plenty or freedom from starvation. Moses declared the Promised Land "a land of wheat, and barley, and vines, and fig trees, and pomegranates; a land of oil olive, and honey" (Deuteronomy 8:8).

Wheat is a fixture of religious ceremony: sacramental bread in the Eucharist of the Christian church, the host of the Holy Communion in the Catholic church, matzoh for Jewish Passover, barbari and sangak are often part of Muslim ritual. Wheat products have played such roles for millenia.

So how can wheat be bad?

What we call wheat today is quite different from the wheat of Biblical times. Emmer and einkorn wheat were the original grains harvested from wild growths, then cultivated. Triticum aestivum, the natural hybrid of emmer and goatgrass, also entered the picture, gradually replacing emmer and einkorn.

The 25,000+ wheat strains now populating the farmlands of the world are considerably different from the bread wheat of Egyptians, different in gluten content, different in gluten structure, different in dozens of other non-gluten proteins, different in carbohydrate content. Modern wheat has been hybridized, introgressed, and back-bred to increase yield, make a shorter stalk in order to hold up to greater seed yield, along with many other characteristics. Much of the genetic work to create modern wheat strains are well-intended to feed the world, as well as to provide patent-protected seeds for agribusiness.

What is not clear to me is whether original emmer, einkorn, and Triticum aestivum share the adverse health effects of modern wheat.

Make no mistake about it: Modern wheat underlies an incredible range of modern illnesses. But do these primitive wheats, especially the granddaddy of them all, einkorn, also share these effects or is it a safe alternative--if you can get it?

I've ordered 2 lb of einkorn grain, unground, from Massachusetts organic farmer, Eli Rogosa, who obtained einkorn seed from the Golan Heights in the Middle East. We will be hand-grinding the wheat and making einkorn bread. We will eat it and see what happens.

Comments (43) -

  • Narda

    5/26/2010 3:53:55 PM |

    Wow! Thank you, so much for that link! That farm is only a few towns from us! We'll be sure to check it out! Smile

  • Matt Stone

    5/26/2010 4:00:20 PM |

    Interesting experiment.  I certainly know that wheat was held in very high regard by Robert McCarrison, Weston A. Price, and others that witnessed entire populations thriving off of wheat.  The Maycoba of Northern Mexico (Mexican Pima) would be another example.  

    This has always left me with some cognitive dissonance about the wheat issue, and a strong feeling that wheat intolerance in the modern world was a result of weak intestinal strucure and altered gut flora caused by non-wheat factors (such as refined sugar, nutrient-poor food, etc.).

  • Shady Lady

    5/26/2010 4:32:21 PM |

    Just curious if you plan to sprout it first. Can einkorn be tolerate by people with Celiac?

    I'm looking forward to the results.

  • Catherine

    5/26/2010 4:34:36 PM |

    Is this a religious or Christian blog? (Serious question.) I don't follow the reasoning that if something is mentioned in the Bible it wouldn't be unhealthy. Lots of things that people ate or practiced in the ancient world were very unhealthy.

  • StephenB

    5/26/2010 4:49:18 PM |

    Nothing like a little hands-on experimentation -- I like the spirit.

  • Anna

    5/26/2010 4:50:34 PM |

    Being in the Bible isn't much of a recommendation, IMO.

  • Anonymous

    5/26/2010 5:31:54 PM |

    It'd be interesting to see the results of your wheat test there.

    What about the other ancient wheat, Emmer? I think it can be found in Italian  pasta form, called Farro.

  • Helena

    5/26/2010 6:08:35 PM |

    Very interesting and important angle to speak about since those questions comes up very often... especially the "but we have been eating wheat for millenniums"... now we have a good answer! Thank you!

  • Richard A.

    5/26/2010 6:29:26 PM |

    Recently, I have discovered bread that is made from sprouted grain. How healthy this bread is relative to whole grain bread I do not know. The only store I can find this bread at is Trader Joe's.

  • Rob

    5/26/2010 6:29:26 PM |

    Short of growing and milling your own eikorn wheat, is there a viable option for the rest of us?  Is there an acceptable commercially-available (i.e. found at larger grocery stores) product like hard red spring or buckwheat that would be a better alternative with fewer of the downsides of the more traditional wheat flours?

  • Michael

    5/26/2010 6:58:24 PM |

    Looking forward to the results!  Thanks for the great content.

    MH

  • Ghost

    5/26/2010 7:02:26 PM |

    I look forward to the report, both on how the bread turns out, and how you react to eating it.

  • Thomas

    5/26/2010 7:26:06 PM |

    Fascinating. I will be very interested to hear what your experiences with this experiment will be.

  • babblefrog

    5/26/2010 8:10:47 PM |

    A quote from http://www.hort.purdue.edu/newcrop/proceedings1996/v3-156.html

    "The gluten of the einkorn accession had a gliadin to glutenin ratio of 2:1 compared to 0.8:1 for durum and hard red wheat."

    If that means anything.

  • Stan Ness

    5/26/2010 8:43:43 PM |

    Our preliminary studies have not determined that all types of einkorn can be universally tolerated by those with gluten intolerance.  Please use caution if you have celiac or some form of gluten intolerance.  On the plus side, Einkorn is one tasty, healthy grain…it just doesn’t yield as much as modern (hexaploid) bread wheat, so agribusiness is reluctant to plant it.  I'm posting studies about the health benefits of einkorn and including all findings on my website at einkorn.com.  I'm very interested to see how you like the taste Smile

  • Dr. William Davis

    5/26/2010 9:05:36 PM |

    Hi, Catherine--

    No, this is not a religious blog.

    I raise this issue because I hear this from patients.

  • Dr. William Davis

    5/26/2010 9:08:26 PM |

    Stan said exactly what I was going to say: There are insufficient experiences to know whether the gluten sequences in einkorn will activate the celiac response.

    Eli Rogosa tells me that she also has seen several celiac people tolerate einkorn.

    However, none of this should be construed as a clinical study.

  • nonzero

    5/26/2010 10:59:29 PM |

    Stoning people to death and slavery are in the bible, how can they be bad?

    *rolls eyes*

    Lately this blog has really become hit and miss.

  • Thrasymachus

    5/27/2010 12:08:30 AM |

    To neolithic humans wheat must have seemed to be a miracle food. It could be stored for long periods and transported long distances. They could grow it, store it, or trade for it. No longer did they need to worry every day about finding something to eat. They could wait out the winter with full stomachs and calm minds, and some small portion of the population could freed from food production. To do what? As it turned out art, culture, religion, scholarship, everything we think of as civilization.

    They may have even noticed that their primitive neighbors, who still hunted and gathered wild plants to eat, were larger and healthier. If they did, they probably regarded the greatly reduced fear of starvation and the ability of at least some to have some leisure probably seemed like very worthwhile tradeoffs.

    It is only very recently- this century, even for advanced civilizations- that worrying about what you eat has been an option.

  • Dr. William Davis

    5/27/2010 12:41:22 AM |

    Thrasy--

    Excellent perspective.

    No doubt: Agriculture permitted specialization of occupation and the trappings of culture to develop. Wheat facilitated this cultural evolution.

    Did it come at a price?

  • Rick

    5/27/2010 1:03:04 AM |

    Great post. Thanks for the open-minded approach. Nonzero, I think you're missing the point. Dr Davis isn't saying that something must be good because it's in the Bible, but he's saying that some people do ask that question, so it's appropriate that he should try to answer it.

    For you and me, perhaps he could just as easily ask: "Wheat has been used for millennia and has been the foundation of great civilizations; perhaps we shouldn't be too hasty to conclude that it's bad?"

  • HSL

    5/27/2010 3:36:07 AM |

    Weston A Price also observed that traditional cultures that consumed wheat did so after the wheat was soaked & sprouted or fermented in some way.  These processes are rarely used anymore and certainly not on a large commercial scale so the question isn't simply whether wheat has good or bad effects, but what has been done to it as well.

  • Anonymous

    5/27/2010 4:55:23 AM |

    Would you please clarify what exactly you mean by "we will eat it and see what happens"? Are you going to do a blood test after consuming the bread?

  • Anonymous

    5/27/2010 7:11:03 AM |

    The things one finds in the bible...Check this:

    In  Genesis  , Chapter Four, Eve bears Cain and Abel. 'And Abel was a keeper of sheep, but Cain was a tiller of the ground.' That 'but' in the middle of the sentence is the first clue to disapproval. This disapproval is confirmed by verses three to five. Abel and Cain bring offerings to God: Abel of his sheep and Cain, the fruits of the ground. God, we are told, had respect for Abel's carnivorous offering, but He had no respect for Cain's vegetarian one.

  • Abe

    5/27/2010 12:30:16 PM |

    Thrasy - I believe you're incorrect about the leisure comment.  Hunter/gatherers have been shown to have had far more leisure time than agriculturalists - it's just that they didn't need the trappings of society, since they did not produce anything that required customers.  And the oldest art in the world definitely existed before farming did...

  • DiegoCenteno

    5/27/2010 4:34:40 PM |

    My biggest concern with wheat is we are eating the seed and not the product of the seed. If you take a look and think about what a seed it makes sense.
    The seed is a body shield/ armor to protect the information inside to ensure the plant continues to survice. Now we are taking that very complex material made up of many proteins such as Lectin that they body simply can not digest, so it aggravates the lining of your digestive system.
    Not only does it not get absorb, but it also creates a auto-immune response as well as prevents nutrients the body is trying to absorb.

  • Anonymous

    5/27/2010 4:41:54 PM |

    regardless if you can tolerate ancient strains of wheat over current strains, what is the value add that you can't get from a normal diet of meats, veges, and some fruits eaten seasonally?? what is so special that u think u need to have wheat in ur diet in the first place?

  • girl

    5/27/2010 5:05:13 PM |

    The good and bad aspects of grain as a product of agriculture are thematic in the early Old Testament. Remember that Cain and Abel are one generation out of the Garden of Eden. Adam and Eve were gatherers until the fall; the first sin is plucking the forbidden fruit. At the time of the fall, God is the first to kill an animal, and at the same time, institutes agriculture through a curse upon the ground.

    When Cain kills Abel, it's the first murder. Why can't the farmer and the cowboy be friends? Because the farmer always wins.

    It's grain that saves Jacob's family of herdsmen when Joseph convinces the Egyptian pharaoh to stockpile reserves for times of famine. After the Egyptian enslavement, the Israelites are gatherers during the Exodus, but gathering manna doesn't satisfy them, so God later sends quail. But their goal is the land of milk and honey, an agricultural land -- a land that is only wrested from the Canaanites through violent, genocidal warfare.

    The food cleanliness restrictions of the Mosaic law center on avoiding foods contaminated by the cursed ground (i.e., cloven hoofs exposed an animal to the ground, but chewing cud is cleansing, so cows are okay but not pigs; similar distinctions apply to seafood).

    The association of the adoption of agriculture with war and oppression is an aspect of the story of the fall as well as the Exodus story (even later, King David is a shepherd) -- the writers of the Old Testament side with agricultural development, urbanization, and the advance of civilization, but they also show a deep cultural awareness of the cost.

    The theme never goes away; in the Christian New Testament, Jesus is both the Lamb of God, and the Bread of Life: the sacrifice of Cain as well as the sacrifice of Abel. In short, there many reasons to think that the Biblical story isn't simply that wheat is the best thing since sliced bread, even if Biblical wheat had a better effect on blood sugar.

  • Robert

    5/27/2010 5:40:27 PM |

    Judging by the number and severity of Western diseases ancient Egyptians had, I would not be in any hurry to mimic any of their dietary patterns. That said, I encourage patients to give up the grains altogether. Without any nutritional pros and quite a number of cons, the continued use of grains is only a matter of custom and addiction; neither of which contribute to health or longevity.

    Dr. C

  • Anonymous

    5/27/2010 7:02:10 PM |

    myths are often centered around varying methods of food production and often change as methods change.  A hunter gatherers religious myths will be much different than an agricultural society's myths. I think that bread is mentioned in the bible because it is primarily a collection of myths of an agricultural society.

  • Anonymous

    5/27/2010 7:56:43 PM |

    After decades of worsening hip pain, I stopped eating any wheat about five days ago, and am now pain-free.  Before, I could barely rise from my chair and could barely walk!  Now I rise up quickly and stride off with no thought of restriction.  I had abandoned weekly hard sprints last year due to the hip pain, but I may try again.  I had been eating two slices of sprouted, fermented whole wheat, and about two or three additional servings of other whole wheat products such as muffins, etc, each day.  I dropped the wheat after reading the recent post about a 25-year old man who gave up wheat with similar results.

  • Hoste

    5/27/2010 8:34:27 PM |

    "I don't follow the reasoning that if something is mentioned in the Bible it wouldn't be unhealthy. Lots of things that people ate or practiced in the ancient world were very unhealthy."

    Can you cite any examples staple foods of that time that were unhealthy? Wheat, maybe, but the awful foods of our modern times were not invented yet. I doubt we'd have the Diabetes and heart-disease epidemic if people stuck to a Biblical diet from a young age onward. Lentils too are a food that is mentioned in the Bible and (unlike Wheat) it has a negligible effect on my blood glucose.

    "
    And Jacob gave Esau bread and pottage of lentils. And he did eat and drink, and rose up, and went his way.  Genesis 25:34"

    I wonder if the large amount of fiber in the lentils might have reduced the hyperglycemic effect of the bread.

  • Chuck

    5/28/2010 1:13:40 PM |

    Genesis is one of our oldest history accounts written down from oral history that is much older. In summing up the large trends of the sweep of history as they knew it then, you can see them refer to the primal world and the original tribe in the garden of Eden and supported by nature but man, who decided to live in cities and who embraced knowledge and rules of society and agriculture, was considered to be "cast out" and God condemns them saying that Childbirth would now be painful etc.

    Now match that with what we know about the skeletal degradation of the Egyptians compared to the people a few hundred mile up the Nile still living Paleo and it fits.
    The story of Cain and Abel with God accepting meat and rejecting grains is consistent.

    These are our oldest stories, and as an likely Atheist, I think they correlate in an interesting way.
    http://www.amazon.com/Book-Genesis-Illustrated-R-Crumb/dp/0393061027

  • Murray

    5/28/2010 1:15:17 PM |

    Dr Davis,
    It's sad that you have patients that ask such inane questions. I can't believe there are people living in this century with such outdated belief systems. It must be difficult to deal with.

  • Meredith

    5/28/2010 2:00:00 PM |

    Hi Dr. Davis,  I can't wait to hear about your results from the einkorn grain you plan to make into bread!  I sure do hope it turns out well!  If it does then I will buy some and make bread at home and also turn it into  pastry floor to make deserts since I am a baker as well.

    Looking forward in great anticipation to the results of you experiments!  Thanks so much for your efforts in locating it!!!

    Sincerely,  Meredith

  • Bobber

    5/28/2010 2:26:24 PM |

    As Thrasy pointed out, clearly there were bad effects of the early grains.  The stature changed for one thing.  And longevity for another.  I guess I don't understand the primes of your research here.

  • Joe D

    5/28/2010 3:37:26 PM |

    Ya know what? I like you; you're a scientist/scholar in the classical sense. You dig into an issue and keep digging and searching until you find the answers, no matter how complex or simple.

    In the 1950's-60's the highest compliment we could pay someone was to say "You're cool". Well, you are. hehe. (Don't blush, we know you're old as the hills, just like me.) Keep up the good work Doc.

  • Dr. William Davis

    5/28/2010 5:30:42 PM |

    The question I'd to find answers for are:

    Is all wheat bad, ancient einkorn and emmer included? Or, is modern wheat that emerged in the last 40 years bad, while its predecessors were no worse than other carbohydrates like rice and potatoes?

    Because wheat is a readily-digested carbohydrate source, it is at least on a par with other carbohydrates. The question is where, how, and why it accumulated these other potential adverse characteristics.

  • Anonymous

    5/30/2010 1:24:52 PM |

    well it might not be an issue according to this news about wheat fungus;

    http://www.scientificamerican.com/article.cfm?id=virulent-wheat-fungus-africa

    Trev

  • Andy

    6/2/2010 11:46:16 AM |

    homemade bread? Sounds good!

  • Eli Rogosa

    6/4/2010 11:20:12 PM |

    Fascinating comments. Bill's research is exciting for all.  Thank you Bill!

    Years ago I found wild wheat growing in the Galilee when I was hiking. As an artisan baker and seed-saver, I began collecting, growing and baking with the vast biodiversity of heritage wheats, most of which are on the verge of extinction!

    Modern wheat is bred to be dependent on agrochemicals,  an empty harvest. In contrast, ancient and heritage wheats have evolved over millennia to have high nutritional value, are well-adapted to organic systems, have deep roots that absorb organic nutrients and are tall for good photysynthetic activity.  

    As for baking methods, sprouted, sourdough einkorn bread is delicious and full of life. I offer baking workshops and sell small amts of heritage grains so folks can grow your own.   Folks are welcome to visit our 12 acre seed conservation farm and bakery.   Email: growseed@yahoo.com

    Green Blessings,
    Eli Rogosa

  • Anna

    6/10/2010 3:52:24 PM |

    I used to buy TJ sprouted "flourless" bread, too, thinking it was a good choice for my grade school aged son, who was the only person in our family still eating bread.  I only bought 1 or 2 loaves a month for him, which he would consume within a few days (bread *is* an easy to prepare item for kids), so some weeks he had no bread or wheat at all.   I began to notice there was a marked difference in his behavior and moods when he ate bread vs the weeks when he didn't.  He had difficulty concentrating and quickly became frustrated with difficult tasks (whether schoolwork or something fun, but difficult,  like building a complex Lego structure).  I paid attention to his behavior and moods and other factors and determined the "sprouted" bread was a significant trigger.  

    Nearly all TJs whole grain breads have added gluten to boost dough performance and (rising and softer texture).   Truly fermented sourdough breads (with a long fermentation) are probably a better choice that simply "sprouted" wheat (who knows what "sprouted"  means with commercial bread anyway?), because long fermentation partially breaks down the gluten protein, which is difficult for humans to digest.  Sprouting merely neutralizes the phytate/phytic acid anti-nutrient content, but does nothing to the high gluten content of the wheat and added gluten ingredients (which are added to nearly any "soft" whole wheat bread as a dough enhancer).      

    My son didn't exhibit the negative behaviors when he ate a true sourdough bread that was long fermented  (many sourdoughs are imposters with sourdough flavoring or only weakly fermented for a short time).  I purchased that locally made bread at another "natural food store", not TJs.

    Nonetheless, for the past year+ we are a wheat and gluten-free family now, after my son and I tested positive with Enterolab for anti-gluten antibodies and other indications that gluten was provoking an undesirable immune response (as well as two copies of HLA genes that predispose to gluten intolerance and/or celiac and in my son's case, also fat malabsorption).

    I used to buy a lot of our food from Trader Joe's.  I still shop there regularly, but mostly for simple foods and ingredients for meals I prepare at home with local CSA subscription produce, meat puchased in bulk (or wild game from my sister the hunter), and "back yard"  eggs I buy direct from the producers.  Too much of TJ fare is still highly processed food that is little better than the stuff at the conventional supermarkets.  

    Also, someone mentioned Weston A. Price valuing wheat as a food.  True enough, but again, the point is that wheat has changed dramatically in just the past few decades.  The wheat of Price's time is not what is commonly available now.  Also, Price advocated freshly ground whole wheat.  Is commercial bread likely to be made with freshly ground wheat, or warehoused, fumigated, long-distance trucked stale flour that was ground who-knows when?

  • buy jeans

    11/3/2010 12:26:04 PM |

    think of the healing humans, but not of blogging

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Why do the Japanese have less heart disease?

We should look to the Japanese to teach us a few lessons about preventing heart disease. A Japanese male has only 65% of the risk of an American male (despite 40% of Japanese men being smokers), while a Japanese woman has 80% less risk than an American woman. While the U.S. is near the top of the list of nations with highest cardiovascular risk, Japan is the lowest.

What are they doing right?

There is no one explanation, but several. Genetics probably does not play a substantial role, by the way, as demonstrated by observations of Japanese people who emigrate to Western cultures. People of Japanese heritage living in Hawaii, for instance, develop the same cardiovascular risk as non-Japanese living in Hawaii. They also develop obesity and diabetes.

Among the factors that likely contribute to reduced risk in Japanese people:

--A style of eating that does not include a lot of sweet foods. No breakfast cereal or donuts for breakfast, for instance, but miso soup with tofu, fish, green onions, and daikon (as takuan, or pickled radish).
--Seaweed--It's probably a combination of the green phytonutrients and iodine. Typical daily iodine intake is in the neighborhood of 5000 mcg per day from nori, kombu, wakame, and other seaweed forms. (The average American obtains 125 mcg per day of iodine from diet.)
--Seafood--Fish in many forms not seen in the U.S. are popular.
--Green tea--Consumption of green tea has been confidently linked to reduced cardiovascular risk, probably via visceral fat-reducing, anti-oxidative, and anti-inflammatory effects. Although tea in Japan is often the less flavonoid-rich oolong tea, softer benefits from this form are likely.
--Soy--Tofu, miso, and soy sauce are staples. It's not clear to me whether soy is intrinsically beneficial or whether it is beneficial because it serves to replace unhealthy alternatives. (Genetic modification may change this effect.)
--Reduced exposure to cooked animal products (except seafood). This is not a saturated fat issue, but probably an advanced glycation end-product/lipoxidation issue that result from cooking.
--The lack of a "eat more healthy whole grain" mentality, the advice that has plunged the entire U.S. into the depths of a diabetes and obesity crisis (along with high-fructose corn syrup and sugar). Noodles like udon and ramen do have a place in their diet, as do some dessert foods. But the overall wheat exposure is less--no bagels, sandwiches, and breakfast cereals.
--Less overweight and obesity--The above eating style leads to less weight gain.

Japanese foods have a unique taste, consistency, and mouth-feel that go well with saltiness, thus the downside of their diet: salt consumption. On a broad scale, high salt consumption has been associated with hypertension and gastric cancer. But the tradeoff has, on the whole, been a favorable one.


One study trying to find some answers:

Dietary patterns and cardiovascular disease mortality in Japan: a prospective cohort study.

Shimazu T, Kuriyama S, Hozawa A et al.
Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine, Japan.


We prospectively assessed the association between dietary patterns among the Japanese and CVD mortality. Dietary information was collected from 40 547 Japanese men and women aged 40-79 years without a history of diabetes, stroke, myocardial infarction or cancer at the baseline in 1994.
During 7 years of follow-up, 801 participants died of CVD.

Factor analysis (principal component) based on a validated food frequency questionnaire identified three dietary patterns: (i) a Japanese dietary pattern highly correlated with soybean products, fish, seaweeds, vegetables, fruits and green tea, (ii) an 'animal food' dietary pattern and (iii) a high-dairy, high-fruit-and-vegetable, low-alcohol (DFA) dietary pattern. The Japanese dietary pattern was related to high sodium intake and high prevalence of hypertension. After adjustment for potential confounders, the Japanese dietary pattern score was associated with a lower risk of CVD mortality (hazard ratio of the highest quartile vs the lowest, 0.73; 95% confidence interval: 0.59-0.90; P for trend = 0.003). The 'animal food' dietary pattern was associated with an increased risk of CVD, but the DFA dietary pattern was not.

The Japanese dietary pattern was associated with a decreased risk of CVD mortality, despite its relation to sodium intake and hypertension.

Niacin: What forms are safe?

Niacin, or vitamin B3, remains a confusing issue for many people. It shouldn't be.

It doesn't help that most physicians and many pharmacists also do not understand the basic issues surrounding niacin. The only reason why there is any level of prevailing knowledge about niacin is that Kos Pharmaceuticals managed to "pharmaceuticalize" a niacin preparation, prescription Niaspan, that provided the revenue to fund professional "education."

Niacin can be helpful to increase HDL, reduce small LDL particles and shift them towards the more benign large particles, reduce triglycerides, and reduce lipoprotein(a).

So here's a brief description of the various forms that you will find niacin:

Immediate-release niacin--Also called crystalline niacin or just niacin. This is the original niacin that releases within minutes of ingestion. Because it releases rapidly, it triggers the most intense "hot flush." While this form of niacin works wonderfully well, is the safest, and is dirt cheap, the majority of people are simply unable to tolerate the intense flush. It also works best taken twice a day, generating two intolerable flushes per day.

Slow-release niacin--These preparations were popular in the 1980s, since the slow 12 to 24 hour pattern of release minimized the annoying hot flush. But, with prolonged use, it also became apparent that an unnaceptable frequency of liver toxicity developed. Unfortunately, this means that any niacin preparation that trickles niacin out over an extended period, including many of the slow-release preparations now sold in health food stores and pharmacies, have potential for liver toxicity. These preparations should be avoided.

6-hour release niacin--Releasing niacin more slowly than immediate-release niacin but more rapidly than slow-release niacin, 6-hour release (or what the Niaspan people call "extended-release" niacin) is nearly as effective as immediate-release niacin with approximately the same low potential for liver toxicity. It is far less liver toxic than slow-release niacin. 6-hour release niacin therefore offers the best balance between effectiveness and safety. Preparations that show this pattern of release include Niaspan ($180 per month), the poorly-named Sloniacin (about $8 per month), and Enduracin (about $7 per month) for 1000 mg per day. (Some Track Your Plaque Members have also determined that several other over-the-counter preparations have been demonstrated to share a similar pattern of release.)

Then there are the scam products that have no useful effect at all:

Flush-free or no-flush niacin--Inositol hexaniacinate, or 6 niacin molecules bound to the sugar, inositol, has no effect in humans, at least not with the dozen or so preparations that I've seen used. Nor are there any data to document the effectiveness of flush-free niacin. It's also more expensive.

Nicotinamide--This niacin derivative likewise has no effect on the usual targets for niacin treatment.

While I used to prescribe Niaspan, the ridiculous pricing and aggressive marketing really turned me off. I now advise my patients and our online followers to use only Sloniacin or Enduracin, unless you can tolerate immediate-release niacin.

Introduction to the New Track Your Plaque book, version 2.0


Out with the old,
in with the new  



“I believe that you are suffering from what is called a fatty degeneration of the heart.”

Dr. Tertius Lydgate to Mr. Casaubon on making a diagnosis with the new medical device, the stethoscope.

George Elliot
Middlemarch, 1871





Old notions in medicine have a peculiar way of lingering.

In 1882, Dr. Robert Koch discovered the tubercle bacillus in tissues of people with “consumption.” By connecting a bacterium with the disease, he usurped the long held notion that tuberculosis was a degenerative disease caused by lack of fresh air. But, for decades after Dr. Koch’s revelation, the “bad air” belief persisted. Surgical collapse of the lung, a painful and barbaric treatment for tuberculosis, persisted well into the 1960s, years after effective antibiotics were discovered in 1947.

The medical community of the 19th century viewed mental illness as the hereditary end-product of ancestral nervousness, alcoholism, prostitution and criminal behavior, a bias that remained widespread well into the mid-20th century. Nazi physicians invoked the theory of heritable “mental degeneration” to justify wholesale extermination of schizophrenics. Electro-convulsive therapy (ECT, or “electroshock therapy”) was widely applied to treat schizophrenia, depression, homosexuality, and criminal behavior for over 30 years, gradually abandoned (at least in its original form) after years of abusive application to subdue patients, demonized in the 1975 movie, “One Flew Over the Cuckoo’s Nest,” depicting the author’s real-life experience with ECT.

Long after a theory or practice has been discredited, it can persist, refusing to die. The new and improved may not be adopted into mainstream practice for years, even decades.

Back to the 21st century: What if you realized that, by quirks of human nature and the uneven adoption of health information, your doctor practiced medicine appropriate for 1985? 1975?

While digital information nowadays is transmitted at the speed of light, disseminating as fast as it takes the next juicy tidbit to be “virally” reproduced via social networking websites, it’s the human factor that still operates with the inertia of human behavior. Habits and attitudes slow the adoption of new information in time measured not in seconds, but in years or decades.

A century ago, 20 years were required for the new technology of blood pressure measurement to be adopted after its introduction in the U.S. in 1910, since physicians were long comfortable with the practice of “pulse palpation” (feeling the pulse). (The arcane language of pulse palpation persists to this day, terms like “pulsus parvus et tardus,” the slow rising pulse of a stiff aortic valve; and the "water-hammer" pulse of a leaking aortic valve.)

The discovery of new, health-changing information today in the 21st century disseminates through the ranks of modern healthcare providers at much the same pace as measuring blood pressure did in the early 20th century.

It’s also tempting to paint American medicine as a fiefdom intent on maintaining exclusive rein over health information. Look back over the hierarchical relationship of medicine over nursing in the past century: When blood pressure measurement was adopted on a broad scale in the 1930s, it was practiced only by physicians, since nurses were deemed incapable. (Modern-day nurses should surely have a hearty laugh over this.) Stethoscopes, around even longer than blood pressure cuffs, weren’t permitted to fall into the hands of nurses until the 1960s, since the medical community feared that nurses might command too much control over patient care. Even after nurses were permitted to have their own stethoscopes, great pains were taken to be certain the nurses’ version was readily distinguishable from the “real” tool wielded by physicians; nurses’ stethoscopes were therefore labeled “nurse-o-scopes,” or “assistoscopes,” and were required to be smaller and flimsier.

Old and ineffective doesn’t always give way to new and better at once; it is slowed by habit as well as an unwillingness to relinquish control.

Somehow technology marches on. But it does so unevenly, sweeping some along in its first wave, others in its wake, some never at all.

Just as effective antibiotics to cure tuberculosis were available for 20 years while surgeons continued to remove patients’ lungs, so better solutions to heart disease are already available but not yet employed by your neighborhood physician. The primary care physician may have heard about some of the newest means to prevent heart disease, but is too overwhelmed with the day-to-day of sore throats, diarrhea, and rashes. Cardiologists, intent on inserting the next best stent or defibrillator, have little but passing interest in strategies that might halt or reverse the heart disease that can be “managed,” no matter how imperfectly, with procedural solutions like angioplasty and bypass surgery. We should bear these flawed human tendencies in mind as we explore the world of heart disease prevention.

We need look no farther than the front page of the newspaper to find evidence of the failure of present-day heart disease detection and management. Over the past several years, headlines have carried the likes of Tim Russert, Bill Clinton, Larry King, Dick Cheney, David Letterman, Tommy Lasorda, Ed Bradley, Mike Ditka, Walter Cronkite, Alberto Salazar, all heart disease sufferers. Some, like talk show host David Letterman, survived their brush with heart catastrophe and underwent successful bypass surgery. Others, like marathoners Fixx and Salazar, raised none of the conventional red flags for heart disease. All received standard, “modern” medical care . . . all the way up to their heart attack, bypass surgery, or untimely death.

Like the sphygnomanometer (blood pressure) cuffs of 1910, Track Your Plaque represents an example of the new. But, unlike the simple practice of taking blood pressure in the early 20th century, Track Your Plaque represents an entirely new way to look at coronary heart disease: a new way to measure it, a new way to identify its causes, and a new way to seize control over it, often to the point of achieving reversal of the process. It also puts control over much of this process into your hands and away from hospitals, cardiologists, and heart procedures. 

I could speak of revealing “secrets,” but that’s not true. In Track Your Plaque, I simply convey information about heart disease that you were likely unaware existed, strategies that doctors fail to discuss. I assemble them into a “package” that, together, create an enormously empowering unique approach to prevent heart disease and heart attack.

Track Your Plaque also challenges the high-tech status quo, practices that occupy exalted places in the enormous cardiovascular healthcare machine that has dominated American healthcare for the past 40 years. I propose that high-tech hospital procedures should join the practice of ECT for homosexuality and insanity¾and become yet another relic of the past.

What are "normal" triglycerides?

Among the most neglected yet enormously helpful values on any standard cholesterol panel is the triglyceride value.

Triglycerides traverse the bloodstream by hitching a ride on water (serum)-soluble lipoproteins, or lipid-carrying proteins. We measure triglycerides as an indirect index of triglyceride-containing lipoproteins.

Triglycerides are a basic currency of energy. While the average American ingests around 300 mg of cholesterol per day, he or she also ingests 60,000-120,000 mg (60-120 grams) of triglycerides, i.e., 200 to 400 times greater amounts, from fat intake. Zero triglycerides in the diet or in the bloodstream is not an option.

But what represents too much triglycerides in the bloodstream? There are several observations to help us make this determination:

1) When fasting triglycerides are 133 mg/dl or greater, 80% of people will show show at least some degree of small LDL particles.

2) When fasting triglycerides are 60 mg/dl or less, most (though not all, since genetic factors enter into the picture) people will show little to no small LDL particles.

3) When fasting triglycerides are 200 mg/dl or greater, small LDL particles will dominate and large LDL particles will be in the minority or be gone entirely.

4) When triglycerides are 88 mg/dl or greater after eating, then risk for heart attack is doubled. Non-fasting triglycerides in the 400+ mg/dl range are associated with 17-fold greater risk for heart attack.



From Austin et al 1990. "Phenotype A" means that large LDL particles dominate; "phenotype B" means that small LDL particles dominate.

Note that conventional "wisdom" (i.e., NCEP ATP-3 guidelines) is that triglycerides of up to 150 mg/dl are okay, a level that virtually guarantees expression of small LDL particles and increased cardiovascular risk.

Based on observations like these, in the Track Your Plaque program we aim for fasting triglycerides of no higher than 60 mg/dl and postprandial (after-meal) triglycerides of no more than 90 mg/dl.

Curiously, while fat intake (i.e., triglyceride intake) plays a role in determining postprandial triglyceride blood levels, it's carbohydrate intake that plays a much larger role. That will be an issue for another day.

1985: The Year of Whole Grains

In 1985, the National Cholesterol Education Panel delivered its Adult Treatment Panel guidelines to Americans, advice to cut cholesterol intake, reduce saturated fat, and increase "healthy whole grains" to reduce the incidence of heart attack and other cardiovascular events.

Per capita wheat consumption increased accordingly. Wheat consumption today is 26 lbs per year greater than in 1970 and now totals 133 lbs per person per year. (Because infants and children are lumped together with adults, average adult consumption is likely greater than 200 lbs per year, or the equivalent of approximately 300 loaves of bread per year.) Another twist: The mid- and late-1980s also marks the widespread adoption of the genetically-altered dwarf variants of wheat to replace standard-height wheat.

In 1985, the Centers for Disease Control also began to track multiple health conditions, including diabetes. Here is the curve for diabetes:


Note that, from 1958 until 1985, the curve was climbing slowly. After 1985, the curve shifted sharply upward. (Not shown is the data point for 2010, an even steeper upward ascent.) Now diabetes is skyrocketing, projected to afflict 1 in 3 adults in the coming decades.

You think there's a relationship?

Have some more

Wheat, via exorphin effects, is an appetite stimulant. Eat a whole wheat bagel or bran muffin, you want another. You also want more of other foods. You also want something to eat every two hours due to widely-swinging insulin-glucose responses: blood sugar high followed by a sharp downturn that triggers a powerful impulse to eat (thus the cravings for a snack at 9 and 11 a.m. after a 7 a.m. breakfast).

If wheat is a stimulant of appetite, then removing it should yield reduced appetite and reduced calorie intake. That is precisely what happens.

When wheat products are removed from the diet--without calorie restriction, without counting fat or carbohydrate grams, no exercise program, no cleansing regimen, no skipping meals . . . nothing--calorie intake drops 350 to 400 calories per day. This calorie figure remains curiously consistent across multiple studies in which wheat was eliminated.

400 calories per day results in 21 lbs lost over 6 months, based just on calories. (3500 calories per pound lost.) That is what happens in wheat elimination diets: 21-26 lbs lost over 6 months.

Wheat is the processed food industry's nicotine, a means of ensuring repeat food purchases. It's also low-cost (subsidized by the U.S. government), high-yield, an ingredient that even has its very own withdrawal syndrome should you miss a "hit."

When MIGHT statins be helpful?

I spend a lot of my day bashing statin drugs and helping people get rid of them.

But are there instances in which statin drugs do indeed provide real advantage? If someone follows the diet I've articulated in these posts and in the Track Your Plaque program, supplements omega-3 fatty acids and vitamin D, normalizes thyroid measures, and identifies and corrects hidden genetic sources of cardiovascular risk (e.g., Lp(a)), then are there any people who obtain incremental benefit from use of a statin drug?

I believe there are some groups of people who do indeed do better with statin drugs. These include:

Apoprotein E4 homozygotes

Apoprotein E2 homozygotes

Familial combined hyperlipidemia (apoprotein B overproduction and/or defective degradation)

Cholesteryl ester transfer protein homozygotes (though occasionally manageable strictly with diet)

Familial heterozygous hypercholesterolemia, familial homozygous hypercholesterolemia

Other rare variants, e.g., apo B and C variants

The vast majority of people now taking statin drugs do NOT have the above genetic diagnoses. The majority either have increased LDL from the absurd "cut your fat, eat more healthy whole grains" diet that introduces grotesque distortions into metabolism (like skyrocketing apo B/VLDL and small LDL particles) or have misleading calculated LDL cholesterol values (since conventional LDL is calculated, not measured).

As time passes, we are witnessing more and more people slow, stop, or reverse coronary plaque using no statin drugs.

Like antibiotics and other drugs, there may be an appropriate time and situation in which they are helpful, but not for every sneeze, runny nose, or chill. Same with statin drugs: There may be an occasional person who, for genetically-determined reasons, is unable to, for example, clear postprandial (after-eating) lipoproteins from the bloodstream and thereby develops coronary atherosclerotic plaque and heart attack at age 40. But these people are the exception.

Advanced topics in nutrition

Nutrition in the modern world has become an increasingly problematic topic. From genetic modification to commercialized methods of mass production, we are having to navigate all manner of complex issues in food choices, particularly if ideal health, including maximal control over coronary plaque, is among our goals.

We will therefore be releasing a series of discussions on the Track Your Plaque website in the coming months, a series I call "Track Your Plaque Advanced Topics in Nutrition." These will be, as the series title suggests, discussions for anyone interested in more than the "eat a balanced diet" nonsense that issues from "official" sources. Among the topics to be covered:

1)Advanced Glycation End-products--both endogenous and exogenous, including peripheral issues like lipoxidation and acrylamides.

2)Dietary influences on LDL oxidation--including the concept of "glycoxidation." Protection from oxidative phenomena is not just about taking antioxidants.

3) Foods you MUST eat--We've talked a lot about foods that you shouldn't eat. How about foods you should eat?

The New Track Your Plaque Guide now available

The New Track Your Plaque Guide is now available!

The Track Your Plaque program has evolved over its 8 year history. While the original Track Your Plaque book reflected the program details that got the program started back in 2003-2004, plenty has changed.

This new version of the book, what I call the program Guide, represents version 2.0 of Track Your Plaque and includes:

--Updated lipoprotein treatment strategies--including new and expanded treatment choices for small LDL and lipoprotein(a).

--An entire chapter on vitamin D and its crucial role in cardiovascular health and plaque control.

--A new and expanded diet--All the reasons why the New Track Your Plaque Diet can achieve spectacular improvement in lipids/lipoproteins, reversal of insulin resistance/pre-diabetes/diabetes, weight loss, reduction in blood pressure, etc. are discussed in considerable detail. The diet is crafted to achieve maximum control over both metabolic responses and coronary plaque.

--An entire chapter on the role of omega-3 fatty acids is included.

--A detailed discussion on the role of iodine and thyroid health--One of the newest additions to the Track Your Plaque menu of strategies is to achieve and maintain ideal thyroid health. This tips the scales in your favor for improved control over lipids/lipoproteins, weight, blood sugar, and coronary plaque.


The new guide, as well as our new Member kits that include the new Track Your Plaque Recipe Book, At-Home Lab Test kits, and nutritional supplements, are all available in the Track Your Plaque Marketplace.

Don't wet yourself

While there is more to wheat's adverse effects on human health than celiac disease, studying celiac disease provides important insights into why and how wheat--the gluten component of wheat, in this case--is so destructive to human health.

Modern wheat, in particular, is capable of causing "celiac disease" without intestinal symptoms---no cramping or diarrhea--but instead shows itself as brain injury (ataxia, dementia), peripheral nervous system damage (peripheral neuropathy), joint and muscle inflammation (rheumatoid arthritis, polymyalgia rheumatica and others), and gastrointestinal cancers.

One neurological manifestation of wheat's effect on the human brain is a condition called cerebellar ataxia. This is a condition that can affect adults (average age 48 years) and children and consists of incoordination, falls, and incontinence.

Because brain tissue has limited capacity for healing and regeneration, symptoms of cerebellar ataxia usually improve slowly and modestly with meticulous elimination of wheat and other gluten sources.

Such observations are relevant even to people without celiac disease. Celiac disease sufferers are more susceptible to such extra-intestinal phenomena, but it can also happen in people without positive celiac antibodies.



Some references:

Neurological symptoms in patients with biopsy proven celiac disease

A total of 72 patients with biopsy proven celiac disease (CD) (mean age 51 +/- 15 years, mean disease duration 8 +/- 11 years) were recruited through advertisements. All participants adhered to a gluten-free diet. Patients were interviewed following a standard questionnaire and examined clinically for neurological symptoms. Medical history revealed neurological disorders such as migraine (28%), carpal tunnel syndrome (20%), vestibular dysfunction (8%), seizures (6%), and myelitis (3%). Interestingly, 35% of patients with CD reported of a history of psychiatric disease including depression, personality changes, or even psychosis. Physical examination yielded stance and gait problems in about one third of patients that could be attributed to afferent ataxia in 26%, vestibular dysfunction in 6%, and cerebellar ataxia in 6%. Other motor features such as basal ganglia symptoms, pyramidal tract signs, tics, and myoclonus were infrequent. 35% of patients with CD showed deep sensory loss and reduced ankle reflexes in 14%. Gait disturbances in CD do not only result from cerebellar ataxia but also from proprioceptive or vestibular impairment.



Gluten ataxia in perspective: epidemiology, genetic susceptibility and clinical characteristics

Two hundred and twenty-four patients with various causes of ataxia from North Trent (59 familial and/or positive testing for spinocerebellar ataxias 1, 2, 3, 6 and 7, and Friedreich's ataxia, 132 sporadic idiopathic and 33 clinically probable cerebellar variant of multiple system atrophy MSA-C) and 44 patients with sporadic idiopathic ataxia from The Institute of Neurology, London, were screened for the presence of antigliadin antibodies. A total of 1200 volunteers were screened as normal controls. The prevalence of antigliadin antibodies in the familial group was eight out of 59 (14%), 54 out of 132 (41%) in the sporadic idiopathic group, five out of 33 (15%) in the MSA-C group and 149 out of 1200 (12%) in the normal controls. The prevalence in the sporadic idiopathic group from London was 14 out of 44 (32%). The difference in prevalence between the idiopathic sporadic groups and the other groups was highly significant (P < 0.0001 and P < 0.003, respectively). The clinical characteristics of 68 patients with gluten ataxia were as follows: the mean age at onset of the ataxia was 48 years (range 14-81 years) with a mean duration of the ataxia of 9.7 years (range 1-40 years). Ocular signs were observed in 84% and dysarthria in 66%. Upper limb ataxia was evident in 75%, lower limb ataxia in 90% and gait ataxia in 100% of patients. Gastrointestinal symptoms were present in only 13%. MRI revealed atrophy of the cerebellum in 79% and white matter hyperintensities in 19%. Forty-five percent of patients had neurophysiological evidence of a sensorimotor axonal neuropathy. Gluten-sensitive enteropathy was found in 24%. HLA DQ2 was present in 72% of patients. Gluten ataxia is therefore the single most common cause of sporadic idiopathic ataxia.
Track Your Plaque Program Data Tracking Tools

Track Your Plaque Program Data Tracking Tools

At last: After talking about the new Track Your Plaque community tools for the last year, our data tracking software is now available!



Track Your Plaque is, admittedly, somewhat data-intensive. The basic concept relies on the fact that we track heart scan scores, cholesterol values, lipoprotein values like percent small LDL and Lp(a), vitamin D blood levels, intake of omega-3 fatty acids, etc. Our new data tracking tools will help Members track their data over time.

Even more interesting, you can allow other Members (not required) to view your data for comments and feedback. You can also view the program data of other Members (if they choose to make their data "public") to learn how they are going about stopping and reversing their coronary plaque.

In other words, our graphic data tracking tools are yet another way we are using to acquire a collective wisdom on how to put a stop to coronary heart disease, heart attack, and perverse "let's make money with heart procedures" hospital solutions.

One of the aspects that helps make this work is the sharing of data. So far, the people who have begun to enter their data have all made their information "public." It's not truly "public," but viewable only by other Track Your Plaque Members. Also, Members can, in effect, anonymize their data simply by using a nickname, e.g., heartprotection or hearthawk.

The data tracking tools are in beta-test version, so there are bound to be a few glitches. But we're eager to hear from our Members' experiences on how to improve these tools. Report any problems or make your suggestions on the Track Your Plaque Member Forum--Technical Support.

Comments (3) -

  • Anonymous

    12/9/2008 7:32:00 PM |

    How do we access it?
    Do we have to have had a heart scan or can we start with our lipid measurements?

    Jeanne

  • Dr. William Davis

    12/10/2008 1:08:00 AM |

    This blog is meant to supplement the Track Your Plaque program, a membership website.

    Please go to www.trackyourplaque.com to decide if this is appropriate for you.

  • lala

    11/17/2010 3:22:40 AM |

    Thanks for your post and welcome to check: here.

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