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.
My experience with the omega-3 index

My experience with the omega-3 index

I just got back my own results from the Gene Smart laboratory reporting my omega-3 index and omega-6:omega-3 ratio.

My results:

Omega-3 index: 8.2%

Omega-6:omega-3 index: 3.2 to 1

Not too bad, but not as good as I'd expected. Hmmm.

Although the omega-3 index of 8.2% puts me in the lower risk category for sudden cardiac death, I was hoping for a level of 10% or slightly greater, the level that I believe is more likely to be related to plaque inactivation or reversal. I obtained this level of omega-3 averaging an intake of EPA and DHA of about 2500 mg per day.

I was somewhat disappointed by the omega-6:omega-3 index. Although it's clearly better than the American average range of 20:1, it is short of the ideal of 2:1 or even 1:1. Since I purposely avoid omega-6-rich sources like corn oil, vegetable oils, sunflower or safflower oils, I wonder if I've overdone the nuts. The two ways to improve the omega-6:omega-3 ratio are to 1) decrease omega-6, or 2) increase omega-3. I'm going to do both.

So I thought I was doing pretty well. But there's clearly room for improvement.

Remember: If just reduction of cardiovascular risk is your interest, then a lackadaisical attitude towards these issues might work. But if your interest is elimination of risk and reversal of atherosclerotic plaque, then it pays to go the extra mile. In this case, knowing your omega-3 index and omega-6:omega-3 ratio might tighten up your program.

Comments (23) -

  • Stephan Guyenet

    10/8/2009 10:28:18 PM |

    Hi Dr. Davis,

    Adipose tissue also stores a lot of LA (proportional to long-term diet) and that will influence blood lipids.  The half-life of adipose LA is about 2 years, so changing that contribution is a long-term process.

  • William Trumbower

    10/9/2009 12:13:12 AM |

    I used the omega profile thru YFH.com.  My AA/EPA ratio was 1.39 on 7.5gm EPA+DHA (1 TBS EicoRx)daily  This dose also cured my asthma and almost eliminated my seasonal allergies.  EicoRx has GLA added, which pushes eicosanoid synthesis more toward the "Good Side".  One of the best basic fish oils is available thru the life extension foundation.  It is 60% pure (600mg EPA+DHA per 1000mg capsule) and contains sesame lignans and olive extract.  It is certified thru IFOS.  I got it on sale for under $10 for a bottle of 120!

  • karl

    10/9/2009 3:45:21 AM |

    I wonder if taking 6G of EPA+DHA/day - split as three separate dosages has any advantage over a single dose?

  • Dr. B G

    10/9/2009 3:57:37 AM |

    Dr. Davis!

    I like your n=1 experiment!

    Thank you for sharing your results. In all honesty, I think your Japanese blood demands more omega-3's.  That might in fact be genetic!!
      
    -G

  • Dr. B G

    10/9/2009 3:57:37 AM |

    Dr. Davis!

    I like your n=1 experiment!

    Thank you for sharing your results. In all honesty, I think your Japanese blood demands more omega-3's.  That might in fact be genetic!!
      
    -G

  • Anonymous

    10/9/2009 4:30:18 AM |

    What about the studies that Harvard's nutrition webpage cites that omega-3 and omega-6 were both beneficial and that they are not competition with each other?

    http://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/omega-3-fats/index.html

    The studies have citation numbers of 4 and 5 but i'll link them here anyway

    http://www.ncbi.nlm.nih.gov/pubmed/17876199?dopt=Citation

    "Adequate intakes of both n-6 and n-3 fatty acids are essential for good health and low rates of cardiovascular disease and type 2 diabetes, but the ratio of these fatty acids is not useful. Reductions of linoleic acid to "improve" this ratio would likely increase rates of cardiovascular disease and diabetes."

    http://www.ncbi.nlm.nih.gov/pubmed/15630029?dopt=Citation

    "n-3 PUFAs from both seafood and plant sources may reduce CHD risk, with little apparent influence from background n-6 PUFA intake."

  • Nameless

    10/9/2009 5:04:21 AM |

    I wonder if there are any other commercial labs doing Omega3/6 testing? Ideally, I'd like to get it a regular lab, through insurance, as I see enough doctors that I can get one to write a script.

    Any concerns about GeneSmart also selling Omega 3 supplements? It seems like a conflict of interest to me somehow. I would look at a VAP test differently if the same company sold statins direct to the consumer, for instance.

  • Jim Purdy

    10/9/2009 7:29:28 AM |

    Aw, shucks! Since dark chocolate is supposed to have good antioxidants, and nuts are supposed to have good fats, I thought that peanut or almond M&Ms would be the perfect health food.

  • Anonymous

    10/9/2009 12:32:33 PM |

    I'm currently taking 3600 mg EPA-DHA in 5 gels of PurPride fish oil at $.04 per gel...while equiv LEF fish oil would be 3 at $.17 per.

    I'm sure the LEF quality is better.

    Was wondering if 5 gels (3600 mg) was too much...looks like it might not be.

  • Roman

    10/9/2009 4:31:49 PM |

    Omega6s are one of the reasons I cut back on most nuts. Walnuts are the worst. The lowest amounts of omega6s are in macadamia nuts, so I still eat few of those. For this same reason I rarely eat avocados any more - they were throwing off my omega6/omega3 balance way too much, despite all the fish and supplements. Compared to most nuts and avocadoes even grain-fed beef is pretty benign from omega6 point of view.

  • PacRim Jim

    10/9/2009 4:54:06 PM |

    I wonder if any progress is being made in evaluating each person as a unique system. The same levels for everyone may not be appropriate.

  • Dave in Ohio

    10/10/2009 10:05:33 AM |

    I don't know how many nuts you're eating a week Doc, but 8 oz. of mixed nuts has about 25 g. 18:2 n-6 (LA).  Most nuts are high in LA, except for macadamia nuts.  Walnuts are the highest, with 38 g. LA per 100 g. of nuts.  Pecans are next at 20, peanuts at 15, almonds and pistachios at about 13.5, and cashews at 8.5. Macadamias have only 1.3 g. LA per 100 g. of nuts.

  • Anonymous

    10/10/2009 5:01:40 PM |

    Hello,

    I just purchased the omega 3/omega 3/6 ration test -

    what does the omega ratio test cover? The ratio in tissue? Blood? My understanding is that the ratio in tissue is what is the best identifier, but I believe it says that blood is tested?

    *confused*

  • Anonymous

    10/10/2009 5:26:45 PM |

    All the evidence suggests that dietary linoleic acid (plant-based omega 6) is perfectly healthy - it's the dietary arachidinoic acid (animal-based omega 6) that's problematic.

  • Dr. William Davis

    10/11/2009 12:09:36 AM |

    Omega-6 intake seems to be a tripping point. We'll discuss that in a future post.

  • Rick

    10/11/2009 9:25:18 AM |

    Dr Davis,
    If we order test kits from overseas, even if the kit arrives OK I'm worried about customs problems when sending back my own blood in order to get the results. Any idea how likely this is to be a problem?

  • Dr. William Davis

    10/11/2009 11:52:43 PM |

    Hi, Rick--

    To my knowledge, there should be no problem with international orders.

  • Anonymous

    10/12/2009 10:37:04 AM |

    I remember one of the marketing points made by krill sellers is that krill EPA/ DHA is absorbed better into the cell membrane verses regular fish oil.  It would be interesting to see if that is true.

  • Nameless

    10/13/2009 4:41:12 PM |

    Interesting comment about the krill, although to do a fair comparison the Omega 3 intakes would need to be equal (or in the same ballpark) for both fish and krill.

    To get to 1-2 grams of Omega 3s/daily from krill, it'd probably bankrupt you.

    I think krill may do a better job than fish oil as to  reducing c-reactive protein and probably does absorb better. But it's not so cost effective at large doses.

  • Sue

    10/14/2009 10:14:29 AM |

    Are you a vegetarian?  I think I read somewhere you don't like meat.  Perhaps this is contributing to your omega 3 index.

  • MarciaBrady

    10/15/2009 6:21:39 PM |

    Hi.  I just recently saw something on WebMD that said Fish Oil has been shown to worsen your risk of heart disease.  What do you think about that?

  • Anonymous

    10/15/2009 6:23:39 PM |

    I previously posted that I was taking 3600 mg O3s...when it is actually 1500 mgs...
    will be increasing to around 2900 mgs.

    Do have a question as far as the interaction of a pomegranate extract which I take...where this is also supposed to help clear plaque...any such thing as too much arterial clearing?

  • Rhino

    2/1/2011 2:01:53 PM |

    These companies that sell supplements and omega 3 index tests dont do the analysis.  
    The lab that created the Index, OmegaQuant, does the lab work and is blinded to patient information.

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