Who lost weight?

The results of the latest Heart Scan Blog poll are in.


I went wheat-free and I . . .


Gained weight 6 (3%)

Lost no weight 41 (21%)

Lost less than 10 lbs 28 (14%)

Lost more than 10 lbs 34 (17%)

Lost more than 20 lbs 22 (11%)

Lost more than 30 lbs 28 (14%)

I'm still losing weight! 30 (15%)

(189 respondents)


This means that, by eliminating wheat:

24% had no success

31% had moderate success (less than 10 lbs or more than 10 lbs)

25% had extravagant results with 20 lbs or more lost


It would be interesting to know where along the weight-loss spectrum the last category, "I'm still losing weight," group falls. (Anyone with a good story please speak up!)

I believe we can conclude from this casual exercise that, as a simple strategy, wheat elimination is surprisingly effective.

Why would 3% gain weight? Well, without knowing the details, there are several possible explanations:

1) Weight gain developed through other foods. For instance, I've had people eliminate wheat only to replace it with fattening gluten-free alternatives. Remember: wheat-free is not gluten-free. Others load up on the wrong foods, e.g., Craisins and other dried fruit; overdo dairy; or snack on wheat-free but unhealthy foods like ice cream and chips.

2) Too much alcohol

3) Hypothyroidism--A lot more common than you'd think. In fact, this has been the case with a majority of people who have done everything right, yet either failed to lose weight or gained weight.

Those are the biggies.

I'd like to hear your personal stories of wheat elimination--the ups and downs, your success or failure, how you felt during the process, how easy or difficult, your eventual results. Just post them as a response to this blog post.

A niacin primer

A reader of Life Extension reminded me of a piece I wrote about niacin a couple of years back.

Anyone desiring a primer on how and why to use niacin to correct lipid and lipoprotein patterns might find this useful.

While some people, no matter what they do, cannot tolerate niacin (about 10% of people), many others enjoy spectacular benefits.


Q: I recently had a cholesterol profile blood test and learned that I may be at risk of heart disease because my levels of beneficial HDL (high-density lipoprotein) are too low. I read that niacin could help increase my HDL, but my doctor said niacin is dangerous. Whom should I believe?

A: Your doctor would be right—if we were still living in 1985. Since then, however, we have learned how to use niacin (vitamin B3) safely and effectively. Unfortunately, many physicians have not yet caught up, or are still trapped by the idea that cholesterol-lowering statin drugs are the only way to decrease cardiovascular disease risk. I have personally prescribed niacin for thousands of patients as part of our program to reverse coronary disease. In fact, niacin is the closest thing we have available to a perfect treatment that corrects most of the causes of coronary heart disease.

Continued here.

What would life be like . . . ?

What if coronary heart disease could be prevented--no eliminated--applying methods that were accessible, easy, and cheap?

What if coronary heart disease and, thereby, angina, heart attack, sudden cardiac death, ventricular tachycardia, heart failure, and the cerebrovascular equivalent, stroke, could be eliminated using readily available tools available to virtually everyone in the U.S.? And, over a year, it cost less than a once-a-week latte at Starbucks?

How would the healthcare landscape change? What would become of hospitals, manufacturers of the billions of dollars of hospital equipment necessary to supply the cardiovascular hospital industry (e.g., stent manufacturers, catheter manufacturers, defibrillator and pacemaker manufacturers, pharmaceutical manufacturers who no longer have to produce the volume of antiplatelet agents, inotropic drugs, antiarrhythmic agents, etc.)?

How would our lives change? What would the end of life look like if people stopped dying of heart attack, sudden cardiac death, congestive heart failure at age 55, 65, or 75, but lived out their lives to die of something unrelated?

What if the solution had little or nothing to do with drugs but evolved from simple nutritional strategies, supplements meant to correct the deficiencies that accompany modern lifestyles, and a few unique strategies targeted towards the genetic predispositions that lead to heart disease?

What if all this were possible at a cost of a few hundred dollars per year?

It would certainly be a cataclysmic change. Hospitals would shrink to a small remnant of their current gargantuan, dozens-per-city presence. The need for hospital staff would be slashed by over half. The rare cardiologist would tend to congenital heart disease sufferers and other unusual forms of heart disease and he or she might have a colleague or two in all of a major city.

Healthcare costs would plummet, no longer having to sustain the enormous cardiovascular healthcare machine of hospitals, staff, industry, and long-term care. Health insurance, private or public, would drop by 50%.

It would free up nearly a trillion dollars that could be redirected towards other pursuits, like schools and research. Extraordinary leaps forward in quality of life and science would emerge, given that magnitude of funding.

It's not as grand a thought experiment as Alan Weisman's The World Without Us, in which he imagines what the world would be like without humans altogether.

How long would it take to recover lost ground and restore Eden to the way it must have gleamed and smelled the day before Adam, or Homo habilis, appeared? Could nature ever obliterate all our traces? How would it undo our monumental cities and public works, and reduce our myriad plastics and toxic synthetics back to benign, basic elements?

But I believe this thought experiment--what would life be like without heart disease because it was eliminated using inexpensive tools-- is more plausible, more likely to occur. In fact, it has already begun to occur.

See those vines growing up the side of the hospital?

Are jelly beans heart healthy?

Total Fat

3 g or less

Less than 6.5 g





Saturated Fat



1 g or less

1 g or less





Cholesterol

20 mg or less

20 mg or less





Sodium

480 mg or less per RACC* & labeled serving

480 mg or less per RACC* & labeled serving





Nutrients

Contain 10 percent or more of the daily value of 1 of 6 nutrients; vitamin A, vitamin C, iron, calcium, protein or dietary fiber



Contain 10 percent or more of the daily value of 1of 6 nutrients; vitamin A, vitamin C, iron, calcium, protein or dietary fiber





Trans fat

Less than 0.5 g per RACC* and labeled serving



Less than 0.5 g per RACC* and labeled serving





Whole Grain

N/A



51 percent by weight/RACC*







Minimum Dietary Fiber



N/A

1.7 g/RACC of 30 g

2.5 g/RACC of 45 g

2.8 g/RACC of 50 g

3.0 g/RACC of 55 g





(RACC=Reference Amount Customarily Consumed)

Thyroid correction: The woeful prevailing standard

Rich has been taking Synthroid or levothyroxine for many years.

When Rich came to my office for continuing management 10 years after his bypass surgery, I checked his thyroid panel:

TSH 7.44 uIU/L

Free T4 1.88 ng/dl (Ref range 0.80-1.90 ng/dl)

Free T3 2.0 pg/ml (Ref range 2.3-4.2 pg/ml)


Rich's thyroid hormone distortions--high TSH, low T3--are sufficient to account for a tripling of heart attack risk long-term.

As Richs' thyroid was being managed by his primary care physician, I notified this doctor of Rich's panel. He therefore increased Rich's levothyroxine from 75 mcg per day to 100 mcg per day. Another thyroid panel several months later showed:

TSH 0.98 uIU/L

Free T4 2.38 ng/dl

Free T3 2.0 pg/ml



As you would expect, increasing the intake of the T4 hormone (levothyroxine) increased free T4 and suppressed TSH.

But what about T3? It's unchanged.

Indeed, Rich says that he feels no better and, in fact, wakes up in the morning foggy and requires a nap in the afternoon.

In my experience, the majority (approximately 70%, but not 100%) experience subjective improvement when T3 is added in some form and the free T3 level is increased. While the data (summarized here) are conflicted on whether there is objective benefit to T3 management and supplementation, there seems to be a poorly-quantified subjective improvement.

Rich's increased levothyroxine dose decreased (calculated) LDL cholesterol by 10 mg/dl. Based on my experience, I'll bet that his lipid panel would likely be further improved with T3 correction.

What I find incredible is the absolutely rabid resistance waged by primary care physicians and endocrinologists against this notion of T3, mostly due to fears of the remote likelihood of inducing atrial fibrillation and osteoporosis, while they are ready to prescribe lifelong statin drugs without a moment's hesitation.

Launch of new Track Your Plaque newsletter: Cardiac Confidential

Track Your Plaque has just launched a new version of our newsletter. We call it Cardiac Confidential.

Cardiac Confidential is meant to be a no-holds-barred, go-for-the-throat exposé of the world of heart disease. We will expose the dishonest, reveal what we view as the underlying truth. We'll even have an occasional "undercover" report of what goes on in hospitals and the go-for-the-money world of heart procedures.

Read the first issue here (open to everyone) in which "Laurie" describes her encounter with a sleazy, profiteering cardiologist. She survives, but not without paying a dear price.

Thyroid: Be a perfectionist

If you'd like to reduce LDL cholesterol with nearly as much power as a statin drug, think thyroid.

When thyroid is corrected to ideal levels, LDL cholesterol drops 20, 30, 40 mg/dl or more, depending on how poor thyroid function and how high LDL are at the start. The poorer the thyroid function (the higher the TSH or the lower the T3 and T4) and the higher the LDL cholesterol, the more LDL drops with thyroid correction.

(For those of you minding LDL particle size, such as Track Your Plaque Members, the "dominant" LDL species will drop: If you are genetic small LDL, small LDL will drop. If you have mostly large LDL because of being wheat-free and sugar-free, then large LDL will drop.)

One of the problems is that many healthcare providers blindly follow what the laboratory says is "normal" or the "reference range," which is usually nothing more than a population average (actually the mean +/- 2 standard deviations, a common method of developing references ranges). In other words, a substantial degree of low thyroid function, or hypothyroidism, can be present when your doctor adheres to the reference range provided by the laboratory.

What does it mean to achieve ideal thyroid status? My list includes:

--Normal oral temperature of 97.3 F first upon arising. (The thyroid is the body's thermoregulatory organ.)
--TSH 1.0 mIU/L or less
--Free T3 upper half "normal" range
--Free T4 upper half "normal" range
--You feel good: mental clarity, energy, upbeat mood. You lose weight when you try.

Iodine replacement should be part of any thyroid health effort. Iodine is not an optional trace mineral, no more than vitamin C is optional (else your teeth fall out). The only dangers to iodine replacement are to those who have been starved of iodine for many years; increase iodine and the thyroid can over-respond. I've seen this happen in 2 of the last 300 people who have supplemented iodine.

In my view, neglecting T3 replacement is absurd. While it is not clear to me why many otherwise healthy people have low T3 at the low range of "normal" or even in the below-normal range, people feel better and have better health--faster weight loss, reduced LDL, reduced triglycerides, they are happier and enjoy more energy--when T3 is increased to the upper half of the reference range. (Crucial question: Why is the 5'-deiodinase enzyme that converts T4 to T3 inhibited, resulting in reduced free T3? What is in our diets or environment that is exerting this effect? I don't have answer, but we sorely need one.)

It pays to be a perfectionist when it comes to thyroid. Not only do you feel better, but LDL cholesterol can drop with a statin-like magnitude, but with none of the adverse effects.

If interested, Track Your Plaque offers fingerstick blood spot testing that you can perform in your own home. Each test kit will test for: TSH, free T3, free T4, along with a thyroid peroxidase antibody (a marker for Hashimoto's thyroiditis, an autoimmune inflammatory condition of the thyroid).

Nutrition Syllogism

What do you think of these chains of logic?

Cyanide is a potent lethal poison; carbon monoxide is a less lethal poison.
Therefore: plenty of carbon monoxide is good.




Having uterine cancer is a bad thing. Having uterine fibroids is a less bad thing.
Therefore: plenty of uterine fibroids are good.



These are obvious examples of seriously flawed logic. Students of logic and philosophy will recognize the above erroneous sequences as examples of the twisted arguments often used to persuade an argumentative opponent of the logic of a premise. As long ago as 335 B.C., Greek philosopher, Aristotle, recognized the pitfalls of thinking in such arguments. You think we’d know better by now.

Try this one:

White enriched flour is a bad for health; whole grains are less bad for health.
Therefore: plenty of whole grains are good for health.



Ouch!

In the 1960s, we all ate hot dogs on white buns, white flour Wonder Bread® sandwiches, Mom made cookies and cupcakes with white flour. Then, during the 1970s and 1980s, clinical studies were performed demonstrating that whole wheat and whole grains reduced colon cancer, high blood pressure, diabetes, and heart disease compared to white flour. In other words, add back fiber and B vitamins and health benefits develop: No argument here.

Therefore: whole grains must be good for health. Further, lots of whole grains?unlimited quantities of whole grains many times per day, every day?must be even better. Even the USDA says so on their nutrition pyramid, with 8-11 servings of grains per day, 4 of which should be whole grains, at the widest portion of the pyramid.

But what happens when you follow this logic through and fill your diet with whole grains?

Look around you and it’s easy to see: Appetite increases, people become obese, blood sugar increases, diabetes develops, HDL cholesterol plummets, triglycerides skyrocket, inflammatory patterns (e.g., c-reactive protein, or CRP) increase, small LDL (the number one cause for heart disease in the obese U.S.!) shoots through the roof.

I would no more fill my diet with “healthy whole grains” than I would close my garage door with the car running.

Is pomegranate juice healthy?


Pomegranate juice, 8 oz:

Sugars, total 31.50 g

Sucrose 0.00 g

Glucose (dextrose) 15.64 g

Fructose 15.86 g




In your quest to increase the flavonoids in your diet, do you overexpose yourself to fructose?

Remember: Fructose increases LDL cholesterol, apoprotein B, small LDL, triglycerides, and substantially increases deposition of visceral fat (fructose belly?). How about a slice of whole grain bread with that glass of pomegranate juice? The Heart Association says it's all low-fat!


(Coming on the Track Your Plaque website: A full in-depth Special Report on fructose in all its glorious forms and whether this is truly an issue for your health. Fructose tables and the scientific data to establish a safe "threshold" value will be included.)

Image courtesy Wikipedia

Honeydew melon


Honeydew melon:

Sugars, total 51.97 g

Sucrose 15.87 g

Glucose 17.15 g

Fructose 18.94 g

Because sucrose is half fructose (the other half is glucose), there are approximately 26 grams of fructose per one-half honeydew melon.



Image courtesy Wikipedia
Fructose is a coronary risk factor

Fructose is a coronary risk factor

As discussed in a previous Heart Scan Blog post, Say Goodbye to Fructose, a carefully-conducted University of California study demonstrated that, compared to glucose, fructose induces:

1) Four-fold greater intra-abdominal fat accumulation

2) 13.9% increase in LDL cholesterol, doubled Apoprotein B

3) 44.9% increase in small LDL, 3-fold more than glucose

4) Increased postprandial triglycerides 99.2%.


Other studies have shown that fructose:

--Increases uric acid--No longer is red meat the cause for increased uric acid; fructose has taken its place. Uric acid may act as an independent coronary risk factor and increases high blood pressure and kidney disease.

--Induces insulin resistance, the situation that creates diabetes

--Increases glycation (fructose linked to proteins) and protein cross-linking, processes that underlie atherosclerosis, liver disease, and cataracts.


Make no mistake: Fructose is a powerful coronary risk factor.
There is no doubt whatsoever that a diet rich in fructose from fruit drinks, honey, raisins and other dried fruit like cranberries, sucrose (table sugar), and high-fructose corn syrup is a high-risk path to heart disease.

Also note that many foods labeled "heart healthy" because of low-fat, low saturated fat, addition of sterol esters, or fiber, also contain fructose sources, especially high-fructose corn syrup.

Comments (21) -

  • Anonymous

    8/4/2009 5:03:13 PM |

    I'd love to see more studies looking at glycated hemoglobin and heart disease risk. Many of the changes Dr. Davis recommends, limiting fructose  & glucose, wheat elimination,  and even correction of vitamin D levels can reduce a person's glycated hemoglobin levels.

  • Marc

    8/4/2009 7:59:39 PM |

    Stanhope et al is a very interesting study. I'd love to see it repeated with a larger group of subjects as well as with different percentages of fructose consumption and in diets with different macronutrient composition. I'm assuming fructose sweetened drinks were used rather than actual fruit as they are directly comparable with glucose sweetened drinks?

  • norse_monster

    8/4/2009 8:26:44 PM |

    So I guess I've got to give up all fruit now. What is the acceptable level of fructose per day?

  • Berner

    8/5/2009 2:31:44 AM |

    "a diet rich in fructose"

    OK avoiding ALL wheat seems to be a good idea.  But avoid all/virtually all fructose?  Do you really think that for a healthy active person i.e. someone exercising, that say 1 cup of berries and an apple or 2 per day is too much fructose?

  • pmpctek

    8/5/2009 2:48:46 AM |

    Okay, you make a clear case against fructose and sucrose... and I thank you for making it clear to us, but...

    Fructose is in almost everything, including some of the most antioxidant rich, nutrient dense fruits and vegetables.  I'm sure your not advocating we all stop eating fresh pomegranates, apples, berries, tomatoes, peppers, lettuce, cabbage, etc.

    We await your guidance on what would be a safe upper daily limit for fructose consumption that would help us avoid its coronary risk factors while we may continue to enjoy the numerous benefits that reside in the same foods.

  • Zbig

    8/5/2009 6:47:01 AM |

    So it's clear that what is proposed eg in the popular in Europe Montignac diet - use fructose in place of sugar due to its low GI - may be a harmful bs. But if I keep my carbs under 100g, do you think it makes much difference if it's fruit, honey, veggies or just a handful of pure fructose powder?

  • Anonymous

    8/5/2009 8:55:34 AM |

    After watching the u-tube video "Sugar the Bitter Truth" by Dr. Lustig, I concluded that fructose is more a direct cause of heart disease rather than just another risk factor like cholesterol. Fructose actually causes the arteries to become inflamed and inflammation is the beginning of heart disease, right?
    Josephine
    Hawaii

  • JC

    8/5/2009 11:30:36 AM |

    Can you comment on the role of fresh fruits like apples,oranges,berries,etc?Do they also raise the risk factors?

  • TedHutchinson

    8/5/2009 2:25:12 PM |

    Sugar Is a Poison, Says UCSF Obesity Expert
    This article highlights the main points of Lustig's 80 minute video
    Sugar: The Bitter Truth

    This is what Lustig has to say on fruit.
    Fruit is fine but we should think twice before drinking juice or feeding it to our kids. The fiber in whole fruit contributes to a sense of fullness. It is rare to see a child eat more than one orange, but it is common for kids to consume much more sugar and calories as orange juice.

    Eating fiber also results in less carbohydrate being absorbed in the gut, Lustig notes. In addition, he says, fiber consumption allows the brain to receive a satiety signal sooner than it would otherwise, so we stop eating sooner.


    The video goes into the biochemistry of fructose metabolism in some detail. I urge you to stick with it although it is quite complex. It gets a bit clearer when you reach the summary slides at the end.

  • billye

    8/5/2009 3:33:54 PM |

    As an answer to your many inquiries in todays comments. You can never go wrong following the lead of our ancient ancestors.  Yes they ate some fruit, mostly berries that were seasonaly availlable only,  very small and not very sweeet by todays standards.  I eat a cup or less of only berries, combined with 2 tablespoons of high antioxident cacao nibs and a tablespoon of ground flax seeds for breakfasy wvwry morning.  This keeps my blood sugar below <100 mg/dl and my A1c levels below 5.  This is a work in progress, because, I am on a constant experimental path of reversing my metabolic syndrom diseases.  As an asside, there is a Dr. Bernstein who wrote several books relative to diabetes, who said that he hasn't had a piece of fruit in 30 years, all without ersity what so ever.  

    The few doctors who's advice I follow without question are You Dr. Davis along with Dr. Kenneth Tourgeman M.D. "nephropal.blogspot.com"

  • billye

    8/5/2009 4:31:03 PM |

    For health reasons, I strictly try to mimic the eating patterns of our early ancestors where possible.  Yes they ate fruit, limited by seasonal requirements.  However, the fruit they ate was very small and not very sweet, not like today's farm engineered varieties. Therefore, I limit what fruit I eat to one cup or less daily.  I combine this with 2 tablespoons of the antioxidant rich super food cacao nibs (dark chocolate), and 1 tablespoon of ground flax seeds.  When in doubt I ask myself the question, "what would my caveman ancestors have eaten?"  I live by this health supporting guide.  I find the food delicious and very satisfying.  

    Of course, I would not do any of this without the sage advice of a few brave doctors who care only about reversing or curing disease and do not give a whit about following some outdated and wrong dogma. More valiant doctors must step up.  

    I have become healthy because of you Dr. Davis, through your fine blog, and the direct care and supervision of Dr. Kenneth Tourgeman  "nephropal.blogspot.com"

  • StephenB

    8/5/2009 8:38:20 PM |

    The best types of fruit and berries are those with the highest nutrition to fructose ratio, like blueberries and strawberries. If eating an apple, consider just eating the skin and a little farther in; no need to eat all the way to the core.

  • Dr. William Davis

    8/5/2009 10:09:58 PM |

    Billye and StephenB--

    Excellent insights into how to keep fruit in the diet without suffering its adverse effects.

    Anon--

    Yes, Dr. Lustig does an absolutely bang-up job of describing the rationale behind the destructive effects of fructose. It is the best presentation on this topic--and from the principal investigator, no less.

    It is a must-see. I watched it last night.

  • David

    8/6/2009 5:44:13 PM |

    Dr. Lustig's lecture is incredible-- I just finished watching it.

    I think he overstates the case for fiber, and is too accepting of glucose in the diet, however. I agree that glucose is much better than fructose, and isn't a huge problem for a healthy person, but given that most Americans are metabolically "crippled" and teetering on the edge of diabetes, heart disease, etc., it would seem wise to me not to go pushing glucose as a great thing.

    My quibbles with Dr. Lustig are minor, however. Overall it's a fantastic presentation.

  • Anonymous

    8/12/2009 11:08:25 PM |

    How would you explain the evolution of primate frugivores in relation to human health, and why a diet probably greater than 50% fructose is obviously benign for them?

    (Yes, I know current fruit varieties have more fructose.)

  • Susan

    8/18/2009 8:00:14 PM |

    My daughter (who is Canadian) is currently in the US doing some research at the National Archives. She mentioned to me that she finds the fruit juice she's had too sweet to drink (she's staying at a hotel, so fresh fruit is hard to come by and the breakfast is all wheat). This was not only some anonymous apple juice, but also a bottle of Tropicana (she didn't check the label to see if there was added fructose), so she has switched to water. She also commented on how ridiculously large the portions were in restaurants.

    It's no wonder that Americans are getting larger and larger (Canadians are too, but not as quickly.)

  • buy jeans

    11/3/2010 8:27:02 PM |

    Also note that many foods labeled "heart healthy" because of low-fat, low saturated fat, addition of sterol esters, or fiber, also contain fructose sources, especially high-fructose corn syrup.

  • Anonymous

    1/9/2011 3:09:37 PM |

    Hilarious Billye!

    "For health reasons, I strictly try to mimic the eating patterns of our early ancestors where possible. Yes they ate fruit, limited by seasonal requirements. However, the fruit they ate was very small and not very sweet, not like today's farm engineered varieties. Therefore, I limit what fruit I eat to one cup or less daily. I combine this with 2 tablespoons of the antioxidant rich super food cacao nibs (dark chocolate), and 1 tablespoon of ground flax seeds. "

    And did our ancient ancestor blend powdered cacao nibs and flax with their berries? SO much for strictly following cavemen.

  • bodylift

    3/18/2011 11:00:19 AM |

    This is fact. Hepatic metabolism of fructose also differs greatly from that of glucose. Fructose-induced hyperlipidemia has also been hypothesized to be of intestinal origin. That can be risky.

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