Man walks after removing wheat

9. May 2010 William Davis (27)
No, this isn't some National Enquirer headline like "Woman delivers alien baby."

Tom is a 26-year old man with a complex medical condition, a malformation he was born with and has had reconstructed. Aside from this, he leads a normal life: works, is married, and is, in fact, quite intelligent.

He came to me for an opinion regarding his overall health. Tom was worried that his congenital condition would impair his long-term health and longevity prospects, so he wanted to optimize all other aspects of his health.

But, when I examined Tom, he could barely get himself up on the exam table without wincing in pain. When I asked him to walk, he hobbled a few steps, again clearly in pain. When I asked him what hurt, he said "everything." He said that all his joints hurt just to move.

He told me that his several doctors over the years didn't know why he was in such pain: It wasn't rheumatoid arthritis, gout, pseudogout, or any of the other inflammatory joint diseases that might account for virtually incapacitating this 26-year old man. Even the rheumatologists were stumped. It was also unrelated to his repaired congenital condition. So Tom went on with his life, barely able to even go for a walk with his wife without pain, slowing him down to the pace of an 80-year old.

So I suggested that he eliminate all wheat products. "I don't know for a fact whether it will work, Tom. But the only way to find out is to give it a try. Why not try a 4-week period of meticulously avoiding wheat? Nothing bad will come of it."

He and his wife look perplexed, but were so desperate for a solution that they agreed to give it a try.

Tom returned 6 weeks later. He walked into the room briskly, then bounded up on the exam table. He told me that, within days, all his joint pains had completely disappeared. He could walk, stretch, do all the normal physical things with none of the pain he had suffered previously.

Tom told me, "I didn't think it could be true. I thought it was just a coincidence. So I had a sandwich about 2 weeks into it. In about 5 minutes, I got about half my pains back."

Tom now remains wheat-free and pain-free, thankfully with no discernible joint impairment.

So, yes, Tom walked freely and without pain simply by eliminating wheat from his life.

Is it an immune phenomenon? Does wheat gluten trigger some inflammatory reaction in some people? There is surely something like this underlying experiences like Tom.

Wheat contains far more than gluten. Modern wheat is a collection of hundreds of different proteins, though gluten is the most plentiful, the one that confers the "viscoelasticity" of dough. But there's plenty more to wheat than gluten or celiac disease.

AGEing gracefully

5. May 2010 William Davis (32)
Advanced Glycation End-products, or AGEs, have the potential to change our entire conversation about diet.

AGEs come from two principal sources:

1) Endogenous--Glucose-protein interactions that arise from high blood glucose levels

2) Exogenous--From diet

The first is sensitive to glucose levels: the higher the glucose level, the greater the AGE formation. The second depends on the quantity of AGE in the food consumed.

A compelling body of evidence points towards AGEs as an agent of aging, as well as kidney dysfunction, dementia, and atherosclerosis. Some of the observations made include:

--If AGEs are infused into an experimental animal, it develops atherosclerosis, kidney disease, and other "diseases of senescence" within weeks to months.

--In endothelial cells (cells lining arteries), AGE induces expression of adhesion molecules and inflammatory signals. In fibroblasts, AGE provokes collagen production. In smooth muscle cells, AGE triggers migration and proliferation. In monocytes and macrophages, AGEs induce chemotaxis and release of inflammation mediators. In short, AGEs have been implicated in just about every step leading to atherosclerosis.

--In humans, greater quantities of AGEs are present in diabetics, pre-diabetics and people with insulin resistance. We all know that these people develop atherosclerosis, kidney disease, cataracts, and other conditions at an accelerated rate.

--Foods containing greater quantities of AGEs cause endothelial dysfunction, i.e., artery constriction via blockade of nitric oxide and other mechanisms.

Short of taking agents that block AGE activity, how can you minimize the absorption or production of AGEs? There are two general strategies:

1) Keep blood glucose low--The Whitehall study demonstrated increased cardiovascular mortality with a postprandial (actually 2-hour post- 50-gram glucose challenge) blood sugar of 83 mg/dl. Lower blood glucose, less glycation. Less carbohydrates in the diet, the lower the blood sugar, the less the glycation. Studies like Whitehall demonstrate that glycation begins with glucose values within the normal range. Thus, aging occurs even with normal glucose levels. It occurs faster with higher glucose levels.

2) Choose and prepare foods with lower AGE content. Food content of AGEs is a major determinant of blood AGE levels. Fats and meats are the primary dietary source of AGEs, particularly if cooked at high temperature (broiling, frying). While this does not mean that meats and fats need to be avoided, it can mean that limiting serving size of meats and fats, while being selective in how they are prepared, are important. This can mean cutting your meats in thinner slices or smaller pieces to permit faster cooking, eating rare when possible (not poultry, of course), avoiding cooking with sauces that contain sugar (which enhances AGE formation). Is this an argument in favor of sashimi?

Minimizing exposure to AGEs, endogenous or exogenous, has the potential to slow the aging process, or at least to lessen the likelihood of many of the phenomena of aging.

More on this to come.

Small LDL: Simple vs. complex carbohydrates

4. May 2010 William Davis (17)
Joseph is a whip-smart corporate attorney, but one who accepts advice at his own pace. He likes to explore and consider each step of the advice I give him.

Starting (NMR) lipoprotein panel on no treatment or diet change:

LDL particle number 2620 nmol/L (which I would equate to 262 mg/dl LDL cholesterol)
Small LDL 2331 nmol/L--representing 89% of LDL particle number, a severe dominance of small LDL

I advised him to eliminate wheat, cornstarch, and sugars, while limiting other carbohydrate sources, as well. Joseph didn't like this idea very much, concerned that it would be impractical, given his busy schedule. He also did a lot of reading of the sort that suggested that replacing white flour with whole grains provided health advantages. So that's what he did: Replaced all sugar and refined flour products with whole grains, but did not restrict his intake of grains.

Next lipoprotein panel with whole grains replacing white refined flour:

LDL particle number 2451 nmol/L
Small LDL 1998 nmol/L--representing 81.5% of LDL particle number.

In other words, replacing white flour products with whole grain products reduced small LDL by 14%--a modest improvement, but hardly great.

I explained to Joseph that any grain, complex, refined, or simple--will, just like other sugars and carbohydrates, still provoke small LDL. Given the severity of his patterns, I suggested trying again, this time with full elimination of grains.

Next lipoprotein panel with elimination of whole grains:

LDL particle number 1320 nmol/L
Small LDL 646 nmol/L--48.9% of total LDL particle number, but a much lower absolute number, a reduction of 67.6%.

This is typical of the LDL responses I see with elimination of wheat products on the background of an overall carbohydrate restriction: Big drops in precisely measured LDL as LDL particle number (i.e., an actual count of LDL particles, not LDL cholesterol) and big drops in the number of small LDL particles.

You might say that wheat elimination and limitation of carbohydrate intake can yield statin-like values . . . without the statin.

Is Cocoa Puffs no longer heart healthy?

29. April 2010 William Davis (17)
Until recently, Cocoa Puffs enjoyed the endorsement of the American Heart Association (AHA) as a heart-healthy food.

For a price, the AHA will allow food manufacturers to affix a heart "check mark" signifying endorsement by the AHA as conforming to some basic "heart healthy" requirements.

Odd thing: The list of breakfast cereals on the check mark program has shrunk dramatically. When I last posted about this, there were around 50-some breakfast cereals, from Cocoa Puffs to Frosted Mini Wheats. Now, the list has been trimmed down to 17:

Berry Burst Cheerios-Triple Berry
Cheerios
Cheerios Crunch
Honey Nut Cheerios
Kashi Heart to Heart Honey Toasted Oat Cereal
Kashi Heart to Heart Oat Flakes & Wild Blueberry Clusters
Kashi Heart to Heart Warm Cinnamon Oat Cereal
Multi Grain Cheerios
Oatmeal Crisp Crunchy Almond
Oatmeal Crisp Hearty Raisin
Quaker Cinnamon Life
Quaker Heart Health
Quaker Life
Quaker Life Maple & Brown Sugar
Quaker Oat Bran
Quaker Oatmeal Squares - Brown Sugar
Quaker Oatmeal Squares - Cinnamon


According to sales material targeted to food manufacturers, the American Heart Association boasts that "The American Heart Association’s heart-check mark is the most recognized and trusted food icon today . . . Eighty-three percent of consumers are aware of the heart-check mark. Sixty-six percent of primary grocery shoppers say the heart-check mark has a strong/moderate influence on their choices when shopping."

So, is Cocoa Puffs no longer heart healthy?

I suspect that agencies like the AHA, the USDA, the American Diabetes Association as starting to understand that they have blundered big time by pushing low-fat, having contributed to the nationwide epidemic of obesity and diabetes, and that it is time to quietly start backpedaling.

While it's a step in the right direction, judging from the above list of breakfast cereal "survivors" of the check mark program, the criteria may have been tightened . . . but not that much.

Fractures and vitamin D

27. April 2010 William Davis (25)
This is a bit off topic, but it's such an interesting observation that I'd like to pass it on.

Over the past several years, there have been inevitable bone fractures: People slip on ice, for instance, and fracture a wrist or elbow. Or miss a step and fracture a foot, fall off a ladder and fracture a leg.

People will come to my office and tell me that their orthopedist commented that they healed faster than usual, often faster than anyone else they've seen before. My son was told this after he shattered his hand getting slammed against the boards in hockey; his orthopedist took the screws and cast off much sooner than usual since he judged that healing had occured early. (My son was taking 8000 units vitamin D in gelcap form; I also had him take 20,000 units for several days early after his injury to be absolutely sure he had sufficient levels.)

My suspicion is that people taking vitamin D sufficient to enjoy desirable blood levels (I aim for a 25-hydroxy vitamin D level of 60-70 ng/ml) heal fractures much faster, abbreviating healing time (crudely estimated) by at least 30%.

For any interested orthopedist, it would be an easy clinical study: Enroll people with traumatic fractures, randomize to vitamin D at, say, 10,000 units per day vs. placebo, watch who heals faster gauged by, for instance, x-ray. My prediction: Vitamin D will win hands down with faster healing and perhaps more assured fusion of the fracture site.

T3 for accelerating weight loss

25. April 2010 William Davis (57)
Supplementation of the thyroid hormone, T3, is an underappreciated means to lose weight.

Thyroid health, in general, is extremely important for weight control, since even subtle low thyroid hormone levels can result in weight gain. The first step in achieving thyroid health is to be sure you are obtaining sufficient iodine. (See Iodine deficiency is real and Healthy people are the most iodine deficient) But, after iodine replacement has been undertaken, the next step is to consider your T3 status.

I've seen T3 ignite weight loss or boost someone out of a weight loss "plateau" many times.

Endocrinologists cringe at this notion of using T3. They claim that you will develop atrial fibrillation (an abnormal heart rhythm) and osteoporosis by doing this. I have yet to see this happen.

Adding T3 revs up metabolic rate at low doses. The idea is to push free T3 hormone levels to the upper limit of normal, but not to the hyperthyroid range. While an occasional person feels a little "hyper" like they've had a pot of coffee, most people just feel energized, clear-headed, and happier. And weight trends down much more readily.

Taking T3 by itself with no effort at weight loss generally yields only a modest weight reduction. However, T3 added to other weight reducing efforts, such as wheat elimination and exercise, accelerates the weight loss effect considerably. 5 lbs lost will likely be more like 8 to 10 lbs lost; 10 lbs lost will likely be more like 15 to 20 lbs, etc.

It's also my suspicion that more and more people are developing a selective impairment of T3, making it all the more important. I believe that you and I are being exposed to something (perchlorates, bisphenol A, perflurooctanoic acid, and others?) that may be impairing the 5'-deiodinase enzyme that converts the T4 thyroid hormone to the active T3. Relative lack of T3 leads to slowed metabolism, weight gain, and depressed mood. While avoiding or removing the toxin impairing 5'-deiodinase would be ideal, until we find out how to do this, taking T3 is a second best.

The tough part: Finding a prescriber for your T3.

The world according to the Wheat Foods Council and the Whole Grains Council

23. April 2010 William Davis (26)

You might get a kick out of what the Wheat Foods Council and the Whole Grains Council recommend for a sample meal plan:

Breakfast: Whole grain raisin toast
Lunch: Sandwich on whole grain
Snack: Rye bread crackers
Dinner: Whole grain pasta with your favorite sauce

Breakfast: Whole grain waffles 
Lunch: Hamburger on whole grain bun
Snack: Graham crackers
Dinner: Whole grain homemade pizza on whole grain pita crust

Remember Morgon Spurlock's documentary movie, Super Size Me? (If you haven't already seen it, Super Size Me is viewable for free on Hulu.) Spurlock conducts a self-inflicted 30-day experiment of eating at McDonald's fast food restaurants every day. In short, the results on Spurlock's weight and health are disastrous. 

How about Wheat Belly: The Movie? We would chronicle our star through a 30-day course of meals served up by the Wheat Foods and Whole Grains Councils, all featuring wonderful wheat products in every meal. We could measure blood sugar, triglycerides, LDL, small LDL, weight, etc.


Any predictions?

Why bananas increase cholesterol

21. April 2010 William Davis (0)
Anything that increases postprandial (after-eating) blood sugar will increase the number of LDL particles in the blood.

An increase in LDL particles is an important factor in causing heart disease: The greater the number of LDL particles, the more opportunity they have to interact with the walls of arteries, contributing to atherosclerosis.

Carbohydrates increase small LDL, especially if postprandial sugar is increased. Here's another way carbohydrates increase LDL particles: The duration of time LDL particles hang around in the blood stream is doubled.

When blood sugar increases, such as after the 30 grams carbohydrates in a medium-sized banana, glycation of LDL particles occurs. This means that a gglucose (sugar) molecule reacts with a lysine residue in the apoprotein B of the LDL particle. This induces a change in conformation that makes it less readily recognized by the LDL receptor. Thus, the glycated LDL particle persists for a longer period of time in the blood stream.

LDL particles are therefore cleared less efficiently, numbers of LDL particles increase.

Plant-based or animal-based?

19. April 2010 William Davis (78)
The ideal diet for heart and overall health restricts carbohydrate intake. I say this because carbohydrates:

Make you fat--Carbohydrates increase visceral fat, in particular.
Increase triglycerides
Reduce HDL
Increase small LDL particles
Increase glycation of LDL
Increase blood pressure
Increase c-reactive protein

Reducing carbohydrates reverses all the above.

But here's a common mistake many people make when following a low-carbohydrate diet: Converting to a low-carb, high-animal product diet.

It accounts for a breakfast of a 3-egg omelette with cheese and butter, 4 strips of bacon, 2 sausages, cream in coffee. Low-carb? It certainly is. But it is a purely high-animal product, no-plant-based meal.

I believe a strong argument can be made that a low-carbohydrate but plant-based diet with animal products as the side dish is a better way to go.

Consider that:

1) Animal products have little to no fiber, while plant-based products like spinach, avocado, and walnuts and other raw nuts have substantial quantities.

2) Plant products are a source of polyphenols and flavonoids--This encompasses a large universe of nutrients, from epigallocatechins in tea, polymeric procyanidins from cocoa, to hydroxytyrosol from olives, and anthocyanins from red wine and eggplant. The inflow of these beneficial compounds needs to be frequent and generous, not piddly amounts taken infrequently.

3) Vitamin C--While it's easy to obtain, the fact that you and I need to obtain vitamin C from frequent ingestion of plant sources suggests that humans were meant to eat lots of plants. While it may require a few months of deficiency before your teeth fall out, imagine what low-grade deficiency can do over a long period.

4) Vitamin K1--Rich in green vegetables, vitamin K1 is virtually absent in animal products.

5) Tocotrienols--I've been watching the data on this fascinating family of powerful oil-soluble antioxidants unfold for 20 years. Tocotrienols come only from plants. (I recently had an extended conversation with the brilliant biochemist, Dr. Barrie Tan, who is incredibly knowledgeable about tocotrienols, having developed several methods of extraction from plants, including his discovery of the highly concentrated source, annatto. Be sure to watch for future conversations about tocotrienols.)

6) Meats and dairy yield a net acid load--While plant foods are net basic. At the very least, this yields risk for osteoporosis, since acids are ultimately buffered by basic calcium salts from the bones. Tissue and blood pH is a tightly regulated system; veering off just a teensy-weensy bit from the normal pH of 7.4 to an acidic pH of, say, 7.2, leads to . . . death. In short, pH control is very important. A net acid challenge from animal products is a lot like drinking carbonated soda, a huge acid challenge that leads to osteoporosis and other health issues.

Conversely, a pure plant-based diet has its own set of problems. Eating a pure plant-based diet can lead to deficiencies of vitamin B12, omega-3 fatty acids (no, linolenic acid from flaxseed will NOT cut it), vitamin K2, carnitine, and coenzyme Q10.

So, rather than a breakfast of 3-egg omelet with bacon, sausage, cream, and cheese, how about a handful of pecans, some blueberries, and a 2-egg omelet made with basil-olive oil pesto? Or a spinach salad with walnuts, feta cheese, and lots of olive oil?

Fat is not the demon

16. April 2010 William Davis (36)
So my patient, Dane, generously volunteered to be on the Dr. Oz show, as I discussed previously.

What we didn't know, nor did the producer who contacted us mention, that Dane would be counseled by low-fat guru Dr. Dean Ornish on a strict low-fat diet. The teaser introduction essentially tells the entire story.

Ironically, that is the exact opposite of the dietary program that I advocate. I rejected the 10% fat diet long ago after I became a type II diabetic, gained 30 lbs, and suffered miserable deterioration of my cholesterol values on this diet. I also witnessed similar results in many hundreds of people, all following a strict low-fat diet. In fact, elimination of wheat--whole, white, or otherwise--along with limitation or elimination of all other grains has been among the most powerful health strategies I have ever witnessed.

I now regret having subjected my patient to this theatrical misinformation. Dane is a smart cookie--That's probably why he was not allowed more than a "yes" or "no" during Dr. Oz's monologue, else Dane might have pitched in about some ideas that would have tripped Oz and Ornish up.

In their defense, if we took 100 Americans all following a typical 21st century diet of fast food, white bread buns, Coca Cola and other soft drinks, chips, barbecue sauce, and French fries, converting to a plant-based, high-carbohydrate, grain-rich diet is indeed an improvement. People will, at first, lose weight and enjoy an initial response. (The occasional person with the Apo E4 genetic pattern, heterozygote or homozygote, may even enjoy long-term benefits, a topic for another day.)

But the majority of people, in my experience, after an initial positive response to an Ornish-like low-fat, high-carbohydrate diet will either plateau (stay overweight, have low HDL, high triglycerides, plenty of small LDL, and high blood sugars) or deteriorate, much as I did.

Thankfully, Dane has been a good sport about this, understanding that this is essentially show business. I believe he understands that the information was all well-intended and, after all, we are all working towards the same goal: reduction of heart disease risk.

By the way, regardless of which diet you follow, it is, in my view, absurd to believe that diet alone will do it. What about vitamin D normalization, thyroid normalization (thyroid disease is incredibly common), omega-3 fatty acids from fish oil, identification of hidden sources of risk (something that is unlikely in Ornish, since small LDL particles skyrocket on a low-fat diet), postprandial glucoses, etc., all the pieces we focus on to gain control over coronary plaque? Eating green peppers and barley soup alone is not going to do it.
Track Your Plaque challenges

Track Your Plaque challenges

1. December 2009 William Davis (31)
Of all the various factors we correct in the Track Your Plaque program in the name of achieving reversal of coronary plaque, there are two factors that are proving to be our greatest challenges:

1) Genetic small LDL

2) Lipoprotein(a)

More and more people are enjoying at least marked slowing, if not zero change or reduction, in heart scan scores following the Track Your Plaque program. We achieve this by correcting a number of factors. Some factors, like vitamin D deficiency, are easily corrected to perfection--supplement sufficient vitamin D to achieve a blood level of 25-hydroxy vitamin D of 60-70 ng/ml. Correcting standard lipid values--LDL cholesterol, HDL cholesterol, and triglycerides--child's play, even to our strict targets of 60-60-60.

However, what I call "genetic small LDL" and a subset of lipoprotein(a) are proving to be the most resistant of all.

Let's first consider genetic small LDL. Small LDL is generally the pattern of the carbohydrate-ingesting, overweight person. It has exploded in severity over the past decade due to overconsumption of carbohydrates due to the ridiculous low-fat notion. Reduce or eliminate carbohydrates, especially wheat, which permits weight loss, and small LDL drops like a stone. But there is a unique subset of people who express the small LDL pattern who start at or near ideal weight. Take Chad, for instance. At 6' 2" and 152 lbs and BMI of 19.6, there's no way excess weight could be triggering his small LDL. Yet he starts with 100% small LDL particles. All efforts to reduce small LDL, such as wheat, cornstarch, and sugar elimination; niacin; vitamin D normalization; thyroid normalization; and several supplements that yield variable effects, such as phosphatidylcholine, all leave Chad with more than 90% small LDL.

Lipoprotein(a) is a bit different. Over the past 5 years, our choices in ways to reduce Lp(a) expression have improved dramatically. Beyond niacin, we now have high-dose EPA + DHA, thyroid normalization that includes use of T3, and hormonal manipulation. In the Track Your Plaque experience, approximately 70% of people with Lp(a) respond with a reduction in Lp(a). (In fact, the 4 out of the 5 record holders for reduction of heart scan scores have Lp(a) that was successfully treated.) But about 30% of people with Lp(a) prove resistant to all these treatments--they begin with a Lp(a) of, say, 260 nmol/L and, despite niacin, high-dose EPA + DHA, and various hormones, stay at 260 nmol/L. It can be frustrating and frightening.

So these are the two true problem areas for the Track Your Plaque program, genetic small LDL and a subset of Lp(a).

We are actively searching for better options for these two problem areas. Given the collective exploration and wisdom that develops from such collaborative efforts as the Track Your Plaque Forum, I am optimistic that we will have better answers for these two stumbling blocks to plaque reversal in the future.
Tags :

Comments (31) -

  • Nigel Kinbrum BSc(Hons)Eng

    12/1/2009 5:19:32 PM |

    As LDL-c is produced by the liver (I don't know where Lp(a) is produced but I'd hazard a guess that it's the liver), could the secret lie in the liver?

    See Cirrhosis and corn oil.

    Has the effect of beef fat & MCT's on small LDL-c percentage & Lp(a) been investigated?

  • David

    12/1/2009 5:30:54 PM |

    Dr. Davis,

    Could some of the non-response be be caused by underlying food sensitivities (other than wheat), without acute allergic reactions, that contribute to underlying chronic inflammation?  I.e., a gluten like effect but specific to another food in their diet.

    -David

  • bender645

    12/1/2009 6:02:29 PM |

    Hello Dr.

    I have read elsewhere (LA Vida Low Carb, Free the Animal, Hyperlipid)that saturated animal fat intake can positively impact LPa and LDL particle size.  Particularly that of pastured-grass fed animals.  

    I am not 100% familiar with your program or dietary recommendations, but it might be worth investigating.

  • Dr. William Davis

    12/1/2009 10:30:38 PM |

    Hi, Nigel--

    To my knowledge, not beef fat specifically but various fatty acid fractions, such as stearic acid, and percent fat intake have been examined; MCTs I believe have not been investigated.

    However, the effects of adding fats to the existing strategies in the Track Your Plaque program tend to be small, since the diet is not fat restricted.

  • Dr. William Davis

    12/1/2009 10:31:34 PM |

    Hi, David--

    Don't know for certain.

    However, these are generally slender, athletic types with no bowel symptoms, arthritis, etc. So I suspect an allergic theme does not tie them together.

  • Anonymous

    12/2/2009 3:06:57 AM |

    Consider an epigenetic effect as a possible cause for the resistant patients' failure to respond.

  • Dr. William Davis

    12/2/2009 3:18:03 AM |

    Anon--

    Please elaborate.

  • Anonymous

    12/2/2009 10:02:48 AM |

    If the idea is to reduce plaque...

    http://www.lef.org/LEFCMS/aspx/PrintVersionMagic.aspx?CmsID=115645

    After one year, the group receiving the drugs, but not pomegranate showed a significant 9% increase in intima-media thickness. In contrast, the group receiving the pomegranate plus drugs showed a reduction in carotid intima-media thickness as follows:

    After three months: 13%

    After six months: 22%

    After nine months: 26%

    After one year: 35%

    Carotid artery blood flow (as measured by end diastolic velocity) improved in the pomegranate plus drugs group as follows:

    After three months: 16%

    After six months: 20%

    After nine months: 31%

    After one year: 44%

  • P

    12/2/2009 3:00:03 PM |

    hmmm, interesting.
    Such epigenetic effects have resulted in reducing diabetic moratality during famine times previously. Should be interesting if someone studied similar gene expression for your Lpa problem.

  • Scott Miller

    12/2/2009 9:56:25 PM |

    Dr. Davis, I think your diligent quest to reverse heart disease needs to embrace two important additions:

    [1] Have your patients seriously reduce inflammation-causing polyunsaturated fats (primarily, any oil with a poly content greater than 10 percent, which means olive oil barely ducks under the bar, but not many other vegetable oils do, including the oft touted as healthy canola oil).

    [2] Have them consume more saturated fat, especially coconut oil. In effect, low HDL is a symptom of saturated fat deficiency. A great source of coconut oil is cold-processed virgin coconut oil (should smell like coconuts), and full-fat coconut milk (an excellent base for sauces, and smoothies mixed with frozen berries and whey protein powder).

    The main key, IMO, is to reduce processed vegetable oils, a highly inflammatory food ingredient that has a half-life in the body of 2-4 years, so the effects of reduction may take a while to notice.

  • Peter

    12/2/2009 11:11:50 PM |

    Dr Davis,
    Since hormones have such a profound effect on lipoproteins, could there be a connection between DHT levels and resistance to treatment here?  I recently read that early baldness is a risk factor for heart disease, and that DHT opposes estrogen much more strongly than testosterone.  Since estrogen is so heart protective, is it possible that this would be another avenue of attack?  If a person had high levels of the 5 alpha reductase enzymes, testosterone normalization as a treatment avenue might be neutralized in these cases (I am assuming that all hormones have been optimized in your resistant patients).
    I was thinking about this recently as I just came across a patent application for the use of finasteride in heart disease.  You had also mentioned the use of tamoxifen in one of your earlier posts, which would obviously relate here as tomaxifin binds estrogen receptors.

  • Anonymous

    12/3/2009 3:50:01 AM |

    It's so funny that Cheerios has targeted your site for its google ads.

    Cheerios® Cereal
    Improve Your Heart's Health With Cheerios® Cereal Today
    www.Cheerios.com

  • Nigel Kinbrum BSc(Hons)Eng

    12/3/2009 4:05:09 AM |

    Dr William Davis said "However, the effects of adding fats to the existing strategies in the Track Your Plaque program tend to be small, since the diet is not fat restricted."

    I was thinking more along the lines of substituting MCTs for omega-6 fats rather than adding fats.

  • Francis

    12/3/2009 5:22:29 AM |

    I may be wrong but there seems to be an emphasis on treating potentially benign lab values in your post.

    What do the heart scan scores show for the patients you mention? Isn't reversing their plaque the ultimate heart-goal of the program? If their plaque is reversing, so what if some lab values aren't perfect?

    The interesting question is what happens to the risk of having a heart attack or a stroke when plaque is under control, but small LDL or Lp(a) are not.

  • András

    12/3/2009 10:59:53 AM |

    Dr Davis,

    What about Pauling's old protocol for Lp(a) that involves Vitamin C and Lysine? Is it good?

  • Dr. William Davis

    12/3/2009 1:45:48 PM |

    Andras--

    I WISH the Pauling/Rath protocol worked.

    We've tried it and I've had a number of patients try it on their own. I have never witnessed any effect whatsoever on Lp(a), though diarrhea is a predictable result (from the high-dose vitamin C).

  • Kent

    12/3/2009 6:48:29 PM |

    In January of 09 I started out with LP(a) of 198 nmol/L. After finding Dr Davis and reading his book, I started applying his principles by bumping my Niacin from 1500mg to 2000mg, fish oil dosage of 7200mg to 9600mg combined EPA and DHA, Coq10, flaxseed, oatbran, little to no wheat diet, etc.

    However, with Dr Davis suggestions, I also followed the Pauling Therapy of 6g of Vitamin C and L-Lysine along with 2g of l-proline daily. In 3 months my LP(a) went from 198nmol/L to 105nmol/L. In 9 months my LP(a) was down to 45nmol/L, A 77% reduction from January! If you look on Dr Mercola's site, he also states that kind of documented results from the Pauling Therapy.

    I give credit to both Dr Davis and Linus Pauling, but most of all my Lord and Saviour Jesus Christ for answered prayer.

  • Anonymous

    12/3/2009 11:34:16 PM |

    Dr. Davis,

    thats interesting. How long did you try?

    As I understood him, he didn't recommend vitamin C and L-Lysin in isolation, but together with a Multivitamin, additional vit A, Bs, D, E, K, amino-acids arginine, carnitine, taurine, magnesium,..

    I myself started Pauling's protocol against a PAD - and within a half year my walking distance doubled from below a km.

    Short before this improvement I also got to experience the 'predictable' result of diarrhea, due to increasing from the usual 6 grams of vit C daily by titrating up to bowel tolerance (which, with 50 grams, proved quite high).

    Beside that, I experienced some other unexpected effects:

    # a rush on my back I had for a year healed right away
    # my seasonal strong hay fever ceased
    # a strong chest pain, for which I've been to hospital for one week 3 years ago without any diagnosis or treatment - particularly painful in physical or mental stressful situation - is gone now too.

    So already these 'minor' side-effects make me very grateful. Not to talk how glad I am about being able to walk faster than a snail again..
    However, in this respect there's still much improvement potential for me.

    Therefore, any clarifications - why it could have failed in your case - would be highly appreciated.

    Kind regards..

  • Dr. William Davis

    12/3/2009 11:53:19 PM |

    Hi, Kent--

    I'm glad it worked for you. Perhaps there are subsets of Lp(a) that respond, as Lp(a) is subject to great individual variation in behavior.

    It's also possible that it's the high-dose fish oil. We've seen such delayed responses to high-doses of EPA + DHA that take over a year to develop.

  • Dr. William Davis

    12/3/2009 11:55:44 PM |

    Hi, Anon--

    The experiences have been scattered, but all involved only C, lysine, and proline, though everyone here takes fish oil and vitamin D. Many also take magnesium. Most tried for about 6 months.

    So it's hardly a systematic study. But any hint of an effect would have been encouraging, but I have yet to see it.

  • David

    12/4/2009 2:24:47 AM |

    Hi Dr. Davis,

    What about exercise-induced hypertension? Do you still find that to be a persistent problem when all other biomarkers are optimal?

    Thanks,
    David

  • David

    12/4/2009 2:27:26 AM |

    Also, is there a way to know one has exercise-induced hypertension? Would one get headaches?

  • Dr. William Davis

    12/4/2009 3:14:39 AM |

    Hi, David--

    Yes and no. Following all the components of the program will reduce blood pressure. However, some people just don't respond as readily and hypertension with exercise and emotional stress persists. A simple stress test remains the best way to assess this.

  • Kent

    12/4/2009 6:20:49 PM |

    Dr. Davis,

    I've thought about that concerning the high dose of fish oil. I'm wondering possibly if it's a synergizing effect of all the supplements, including the C, Lysine and Proline.

    I also wanted to mention that I split the doses up throughout the day. I've been informed that Vit C and L-Lysine only stay in the system for a short time, therefore, if you take it only once or twice a day, it's not going to have near the effect as splitting it up. I take 2g of the proline, lysine and C in the morning, then take the remaining amounts of C and Lysine throughout the day every 2 hours or so at 1g each, with my last dose at 5:00pm. I try to take my last dose a couple of hours before taking my Niacin, as I've heard the C can sometimes have a negative effect on the Niacin.

    My brother has high LP(a) as well, without seeing it go down. He was taking pretty much everything I was, with the exception of proline and only 4-5g of fish oil. And he was only taking the lysine and C twice a day. He has altered it to match more of what I'm doing, so we're anxious to see what his next blood test reveal.

    By the way, thanks to applying the principles you laid out in the book and here on your site, my other blood levels have been improved drastically. For that I am extremely greatful!

  • Anonymous

    12/4/2009 11:30:22 PM |

    Dr. Davis,

    thanks for your clarification. I appreciate that you remain open to possibly more positive results with Pauling's protocol in the future..


    Hi Kent,

    what is the negative effect of vit C to Niacin you heard of? I'm aren't aware of any, though I too take the biggest part of vit C separate from meals, during which I use the Niacin.

    thanks..

  • StephenB

    12/6/2009 5:11:30 AM |

    For non-responders doing everything correctly but still holding on to lots of small LDL, what's happening to their heart scan scores?

    I was wondering if there were any possibility that small LDL is more associative of heart disease than causative.

  • Kent

    12/7/2009 4:11:09 PM |

    Hi Anon..

    The negative effects I've heard about Vit C to Niacin are spotty. What I've heard is that there is a possibility of any anti-oxident to diminish some possitive effects of Niacin, such as reducing it's HDL raising ability a bit. I don't know anyone personally that has experienced this, I just try not to the two together if possible.

  • Anonymous

    12/8/2009 3:08:01 AM |

    I try to filter out the "faith" based claims and stick with scientifically backed information.  Niacin improved my very low HDL by 30% but complete elimination of the exercise induced angina I had suffered disappeared for me when I subjected myself to high dose K2 for 6 months.  Nothing I have tried (including wheat elimination) enables me to stay off reasonably high dose statins

  • Anonymous

    12/8/2009 11:33:01 AM |

    Thanks for the reply, Kent. Though my HDL did raise about 18% within one year of 1.5 gram Niacin use, at 33 now it's still much too low.

    On your suggestion I'll try to take them more separated, beside raising the dose of Niacin. Which I think is advisable in my case due to Lp(a) anyway (57).

    What is the advised upper limit of the daily dose of Niacin at TYP?

  • Kent

    12/9/2009 6:17:13 PM |

    Anon..

    I really noticed a huge jump in my HDL, when I bumped Niacin from 1.5g to 2g, introduced high intake of fish oil, at least 7200mg to 9600mg, got vitamin D levels up, and alomost eleminated wheat. I went from HDL's of 40's/50's to 86.

    I believe the upper limit of Niacin depends on the type, wheter it be immediate, sustained, or slow release. Perhaps Dr. Davis could address that.

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