Self-directed health: At-home lab testing

29. March 2009 William Davis (20)
I have a prediction.

I predict that more and more healthcare can and will be obtained directly by the individual--without doctors, without hospitals, without the corrupt profit-at-any-costs modus operandi of the pharmaceutical industry. I predict that, given the right tools, Joe or Jane Q. Public will have the choice to manage his or her own health using tools that are directly accessible, tools that include direct-to-consumer medical imaging (CT scans, ultrasound, MRI, etc.), nutritional supplements (a loosely-defined term, to our advantage), and direct-to-consumer laboratory testing.

Done responsibly, self-directed healthcare is superior to healthcare from your doctor. While no one expects you to remove your own gallbladder, you can manage cholesterol, blood sugar issues, vitamin D, low thyroid, and others--better than your doctor.

As everyone becomes more comfortable with the notion of self-directed health, you will see new services appear that help individuals manage their health. You will see prices for direct-to-consumer medical imaging and lab testing drop due to competition, something that doesn't happen in current insurance-based healthcare delivery. People are being exposed to larger deductibles and/or draw money from a medical savings account and will seek more cost advantages. Such direct-to-consumer competitive pricing will meet those needs. Overall, the presently unsustainable cost of healthcare will decline.

To help accelerate the shift of human healthcare away from conventional paths and divert it towards the individual, we have launched a panel of direct-to-consumer at-home laboratory tests that we are making available on the Track Your Plaque website.

On your own (except in California, which requires a doctor's order or prescription; and NY, the only state in the nation that prohibits entirely), you can now test, in the comfort of your own home with no laboratory blood draw required, parameters including:

--Thyroid tests--Free T3, free T4, TSH
--Lipids
--C-reactive protein
--Vitamin D
--Testosterone
--Progesterone

and others.

As the technology improves, more tests will become available for testing at home. (Lipoproteins are not yet available, but will probably be available within the next few years. That would be an enormous boon to those of us interested in supercharged heart disease prevention and reversal.)

Anyone interested in our at-home testing can just go to the Track Your Plaque lab test Marketplace.

When I first began the Track Your Plaque program around 8 years ago, I saw it as a way for people to learn how to control or reverse coronary atherosclerotic plaque, and I'd hoped that physicians would begin to see the light and become patient advocates in this process. But I have lost hope that most of my colleagues are interested in becoming your advocate in health. They are too locked into the "call me when you hurt" mentality. I now see Track Your Plaque as a way for people to seize control over coronary plaque with minimal assistance from their doctors. Indeed, some of our Members have achieved reduction of their plaque in spite of their doctors.

This is just the tip of the iceberg of what's to come. Brace yourself for a cataclysmic shift in returning health to you and away from those who would profit from your misfortune.

Vitamin D for Peter, Paul, and Mary

27. March 2009 William Davis (15)
Why is it that vitamin D deficiency can manifest in so many different ways in different people? One big reason is something called vitamin D receptor (VDR) genotypes, the variation in the receptor for vitamin D.

It means that vitamin D deficiency sustained over many years in:

Peter yields prostate cancer

Paul yields coronary heart disease and diabetes

Mary yields osteoporosis and knee arthritis.


Same deficiency, different diseases.

VDR genotype-determined susceptibility to numerous conditions have been identified, including Graves' thyroiditis, osteoporosis and related bone demineralization diseases, prostate cancer (Fok1 ffI genotype), ovarian cancer, rheumatoid arthritis, breast cancer (Fok1 ff), birth weight of newborns, melanoma and non-melanoma skin cancers, insulin resistance and metabolic syndrome, susceptibility to type I diabetes, Crohn's disease, and neurological or musculoskeletal deterioration with aging that leads to falls, respiratory infections, kidney cancer, even periodontal disease.


Why is it that the dose of vitamin D necessary to reach a specific level differs so widely from one person to the next? VDR genotype, again. Variation in blood levels of 25-hydroxy vitamin D from a specific dose of vitamin D can vary three-fold, as shown by a University of Toronto study. In other words, a dose of 4000 units per day may yield a 25-hydroxy vitamin D blood level of 30 ng/ml in Mary, 60 ng/ml in Paul, and 90 ng/ml in Pete--same dose, different blood levels.

Should we all run out and get our VDR genotypes assessed? So far the data have not progressed far enough to tell us. If, for instance, you prove to have the high-risk Fok1 ff genotype, would you do anything different? Would vitamin D supplementation be conducted any differently? I don't believe so.

Virtually all of us should be supplementing vitamin D at a dose that generates healthy blood levels, regardless of VDR genotype. For those of us following the Track Your Plaque program for coronary plaque control and reversal, that means maintaining serum 25-hydroxy vitamin D levels between 60-70 ng/ml.

As the fascinating research behind VDR genotype susceptibility to disease unfolds, perhaps it will suggest that specific genotypes be somehow managed differently. Until then, take your vitamin D.

Blowup at Milwaukee Heart Scan

26. March 2009 William Davis (20)
A local TV investigative news report just ran a critical report of the goings-on at Milwaukee Heart Scan:

Andy Smith went to Milwaukee Heart Scan. "It passed the smell test like a road kill skunk. I mean it was bad," Smith explained.

Our hidden cameras went inside the high pressure sales pitch. "On a good day I sell eight, nine, 10 people. On a bad day probably three," sales manager Angelo Callegari told us.


What the heck happened?

Let me tell you a story.

Back in 1996, I learned of a new technology called UltraFast CT scanning, or electron-beam tomography (EBT), a variation on the standard CT technology that permitted very rapid scanning, sufficiently rapid to allow visualization of the coronary arteries. Back then, only a few dozen devices had been established nationwide.

But the technology was so promising and the initial data so powerful that I lobbied several hospital systems in town to consider purchasing one of the $1.8 million devices. I was interested in applying this exciting technology for early detection of coronary heart disease in Milwaukee. While administrators from several hospitals listened, they quickly lost interest when they figured out that the scanner was primarily a tool for prevention, and would not be directly useful to increase revenue-generating hospital procedures.

I floundered about for a year, trying to drum up support for obtaining a scanner. The manufacturer of the device, Imatron, put me in touch with a couple from Indiana who were also interested in setting up a scanner and had actually obtained the investment capital to do it. We met and, over the next year, got Milwaukee Heart Scan up and running. I served as Medical Director (but never an investor or owner).

Milwaukee Heart Scan was busy from day one, performing EBT heart scans, as well as CT coronary angiograms as long ago as the late 1990s, virtual colonoscopies, and other imaging tests. We all spent a great deal of time educating the public and physicians on what this technology meant for detection and prevention of disease.

Despite the public's perception that the owners, Nancy and Steve Burlingame, were making a bundle of money, in reality they could barely pay their expenses. As price competition heated up in Milwaukee with the lower-cost competing multidetector scanners cropping up, the Burlingames often did not pay themselves.

My interest was to keep this device afloat. I therefore told the Burlingames that they should pay their bills first--their staff, overhead, the scanner costs, and pay themselves--and not worry about reimbursing me for the (very modest) heart scan interpretation fees. For several years, I read thousands of scans without any compensation. But that was okay with me--I just wanted to be sure this device remained available.

But in 2008, some business people from Chicago contacted Steve Burlingame with prospects of applying a contract model of long-term scanning to patients,i.e.,getting people to sign a several-year contract for discounted imaging. They proposed that Milwaukee Heart Scan offer heart scans for free to get people in the door.

What was peculiar about all this is that none of the four physicians on staff at Milwaukee Heart Scan had any knowledge of these discussions at all, including myself. Personally, I figured something was afoot when I came in to read scans in the summer of 2008. While, ordinarily, there is a single stack of scans to read from the preceding few days, this time there were numerous stacks of scans, hundreds of scans in all. Not a word had been said to me or my colleagues. I quickly figured out (thanks to the staff filling me in) that they had been offering scans for free. Not surprisingly, many people took them up on the offer.

Up until then, I had been readily willing to read heart scans without compensation, provided I could perform scan readings in a modest time commitment every week on the weeks it was my responsibility. But work several hours every day for free? Impossible.

My colleagues and I were deeply upset and concerned and insisted on a meeting with all the people involved, including the Burlingames, who had engineered this new sales program. We expressed serious reservations about what they were doing and insisted that they dramatically scale back the promises being made to people. I personally asked that they fire several of the people they had hired as sales people, given what we thought was unprofessional appearance and behavior.

The Burlingames and their new business partners essentially thumbed their noses at the physicians and ignored our advice. So, of the four physicians (one radiologist, three cardiologists), three of us resigned. (The one remaining cardiologist, I believe, didn't really understand what was going on.)

Apparently, after we left, the hard sales tactics continued. The news media got hold of the story through some understandably disgruntled people, and you know the rest.

The tragedy in all this is that, as wonderful as heart scans are, they don't make money for the people who invest in the technology. In the sad case of Milwaukee Heart Scan, it meant that my former friends, the Burlingames, turned to questionable tactics to make this technology pay.

Make no mistake: Heart scans remain a wonderful medical imaging modality. EBT, in particular, remains a fabulous technology that would--even today--remain the pre-eminent means to image coronary arteries, except that GE (who acquired Imatron some years ago) decided that a more direct path to bigger revenues was to purchase Imatron, then promptly scrap the entire operation, choosing to focus on multidetector technology exclusively.

Don't let the spotty past and petty ambitions cloud the fact that heart scans remain the best way to identify and track coronary plaque. Just don't get tempted by the offer of any free scans "without obligation."

Do you work for the pharmaceutical industry?

24. March 2009 William Davis (30)
In response to my post, Lovaza Rip-off, I received this angry comment:


Very high triglycerides, as you all know, is a very serious and life-threatening condition. Therefore, it is very important that any medication you take for treatment must be FDA proven and scientifically backed. This is true for a few reasons. First, there have been zero studies done to show the effects of Costco brand fish oil pills on patients with high triglycerides. So, you cannot assume, simply because the pills you are taking "claim" to have a certain amount of Omega 3 in the them, that they actually do (supplement labeling is self-submitted by the company, and not regulated by any external or 3rd party agency).

Secondly, the other components in fish oil, and maybe in Costco brand (no one knows because it isn't on the label) can actually inhibit the bioavailablity of Omega 3, most notably, Omega 6. And, nowhere on the Costco label does it tell you how much Omega 6 is in it. We also cannot underestimate the importance of purity with these compounds: a top selling brand of fish oil found stores like CVS was recently recalled because it was found to have large amounts of fire retardant in it! These supplements are NOT regulated by the FDA.

Thirdly, be careful when you compare costs. The cost of hospitalization due to acute pancreatitis (a risk of very high triglycerides) far outweighs the cost of taking Lovaza for even several years. If you have a real disease, you need a real drug. And, until Costco does a prospective long-term clinical trial to show that it lowers triglycerides, it should not be used in place of Lovaza.

Finally, I am a living example of how taking a high-potency supplement form of Omega 3 barely lowered my triglycerides, yet within 2 weeks of being on Lovaza there was a significant difference. I am now at my goal. So, before you knock a company, that, in my opinion, has saved my life, please do your research and do not mislead people into thinking that an Omega 3 is an Omega 3 is an Omega 3. If your insurance covers the most potent, the most pure, and the ONLY proven Omega 3 pill on the market, you should be thankful.


The comment was posted anonymously, so I don't know who it came from. But I can tell who I think it is: Someone who works for the drug industry.

This is a common phenomenon: Large corporations are fearful of the comments that are generated on internet conversations and other media. On the internet, there are actually people whose job it is to do "damage control." I suspect this came from one of them.

Why bother? Surely there are better things to do? Well, that's easy. There are billions of dollars at stake. Lovaza, in particular, is sold on the perception that it is somehow superior. If word gets out that maybe you can achieve the same results at a fraction of the cost . . .

Perhaps the "commenter" should also question whether omega-3 fatty acids can come from eating fish.

As part of my cardiology practice, I provide consultation on complex hyperlipidemias, or unusual lipid abnormalities. I have many patients with something called familial hypertriglyceridemia, a genetic condition that permits triglyceride levels of 500, 1000, even many thousands of mg/dl, levels that, as the anonymous commenter points out, can be dangerous.

I virtually never prescribe Lovaza for these people. In their treatment program, I use simple fish oil supplements, such as that from Costco, Sam's Club, or other retailers. I have not witnessed a single failure in treating these people and reducing triglycerides. People with lesser triglyceride abnormalities likewise respond very nicely to inexpensive fish oil that we can buy at the health food store. (I do rely on useful services like Consumer Reports and www.consumerlab.com to reassure us that no pesticide residues, mercury, or other contaminants are in the brands we use.) Excellent, high-quality fish oil supplements are sold by Carlson, Life Extension, Barlean's, even the Members' Mark brand from Sam's Club.

So, the notion that only prescription fish oil is capable of reducing triglycerides is, in a word, nonsense.

Take that back to your CEO.

Cholesterol effects of carbohydrates

24. March 2009 William Davis (31)
Let's take a hypothetical person, say, a 50-year old male. 5 ft 10 inches, 160 lbs, BMI 23.0. He's slender and in good health.

Our hypothetical man eats a simple diet of vegetables, some fruit, nuts, and meats but avoids processed industrial foods. By macronutrient composition, his diet is approximately 30% protein, 40-50% fat, 20-30% carbohydrate. His starting lipid panel:

Total cholesterol 149 mg/dl
LDL cholesterol 80 mg/dl
HDL 60 mg/dl
Triglycerides 45 mg/dl

His starting lipids are quite favorable (though I don't often see this kind of starting panel nowadays except in athletes). We begin here because this hypothetical man is going to serve as our test subject.

We ask our hypothetical man to load his diet up on "healthy whole grains." He complies by eating whole grain cereals for breakfast, whole wheat toast; sandwiches made with whole grain bread; dinners of whole wheat pasta; snacks of granola bars, whole wheat pretzels and crackers.

Three months later, his lipids show:

Total cholesterol 175 mg/dl
LDL cholesterol 130 mg/dl
HDL 45 mg/dl
Triglycerides 150 mg/dl


You can see that LDL cholesterol has increased, HDL has dropped, and triglycerides have increased. This wave of change is the hallmark of carbohydrate excess, but more specifically of overreliance on wheat products. Beyond his lipid panel, the man has gained 10 lbs, all concentrated in a soft roll around his abdomen, his blood sugar is now in the "borderline range" of between 110 and 126 mg/dl, i.e., pre-diabetic.

If we were to examine this man's advanced lipoproteins (e.g., NMR from Liposcience, or VAP from Atherotech), we would see that there has been an explosive increase in small LDL particles, along with a shift of large HDL to small, and the appearance of multiple abnormal classes of particles called VLDL and IDL (signalling abnormally slowed clearance of dietary by-products from the blood).

Familiar scenario? The "after-carbohydrate" situation is the rule among the people who I first meet who claim to be eating a "healthy" diet, though their patterns are usually much worse, with higher LDL, lower HDL, and much higher triglycerides, an exaggeration of our hypothetical man's abnormalities.

What if our hypothetical man now goes to his conventionally thinking (read "taught medicine by the pharmaceutical industry") physician? What will likely be the advice he receives? Reduce his saturated fat intake, eat plenty of healthy whole grains, take a statin drug.

Although my illustrative man is hypothetical, I've seen this scenario play out many thousands of times. It happens in real life all the time. It is predictable, it is highly manipulable. Sadly, it is rarely recognized for what it is: the result of excess carbohydrates, or what I call "Carbohydrate Intolerance Syndrome."

The misinterpretation of this condition has created 1) an epidemic of diabetes and pre-diabetes, 2) a nation of frustrated obese Americans, 3) a $27 billion per year statin industry, 4) another growth opportunity for the drug industry in diabetes drugs.

Wheat Belly Revisited

23. March 2009 William Davis (24)
Do you have a wheat belly?

When I first coined this phrase back in July, 2007, I had witnessed the phenomenal health effects of wheat elimination in several hundred patients.

In the nearly two years that have passed since my original post, I have witnessed hundreds more people who have done the same: eliminate pretzels, crackers, breads of all sorts, bagels, pasta, muffins, waffles, pancakes, etc.

If anything, I am convinced now more than ever that wheat is among the most destructive foods in the human diet. At least 70% of people who eliminate wheat from their diet obtain at least one, if not several, substantial health benefits.

Now, if I were trying to sell you something, say, an alternative to wheat, then you should be skeptical. If I tell you that drug or nutritional supplement X is great and you should take it, only to follow it with a sales pitch, you should be skeptical.

What am I selling? Nothing. I gain nothing by telling everyone to avoid wheat. In fact, I wish it wasn't true. Wheat foods taste good. Wheat flour makes great comfort foods. In years past, I spent many hours sitting at the bagel shop reviewing papers over a cup of coffee and a bagel. No longer.

So here, back by popular demand, the original Wheat Belly post:



Wheat Belly

You've heard of "beer bellies," the protuberant, sagging abdomen of someone who drinks excessive quantities of beer.

How about "wheat belly"?

That's the same protuberant, sagging abdomen that develops when you overindulge in processed wheat products like pretzels, crackers, breads, waffles, pancakes, breakfast cereals and pasta.



(By the way, this image, borrowed from the wonderful people at Wikipedia, is that of a teenager, who supplied a photo of himself.)

It represents the excessive visceral fat that laces the intestines and triggers a drop in HDL, rise in triglycerides, inflames small LDL particles, C-reactive protein, raises blood sugar, raises blood pressure, creates poor insulin responsiveness, etc.

How common is it? Just look around you and you'll quickly recognize it in dozens or hundreds of people in the next few minutes. It's everywhere.

Wheat bellies are created and propagated by the sea of mis-information that is delivered to your door every day by food manufacturers. It's the same campaign of mis-information that caused the wife of a patient of mine who was in the hospital (one of my rare hospitalizations) to balk in disbelief when I told her that her husband's 18 lb weight gain over the past 6 months was due to the Shredded Wheat Cereal for breakfast, turkey sandwiches for lunch, and whole wheat pasta for dinner.

"But that's what they told us to eat after Dan left the hospital after his last stent!"

Dan, at 260 lbs with a typical wheat belly, had small LDL, low HDL, high triglycerides, etc.

I hold the food companies responsible for this state of affairs, selling foods that are clearly causing enormous weight gain nationwide. Unfortunately, the idiocy that emits from Nabisco, Kraft, and Post (AKA Philip Morris); General Mills; Kelloggs; and their kind is aided and abetted by organizations like the American Heart Association, with the AHA stamp of approval on Cocoa Puffs, Cookie Crisp Cereal, and Berry Kix; and the American Diabetes Association, whose number one corporate sponsor is Cadbury Schweppes, the biggest soft drink and candy manufacturer in the world.

As I've said many times before, if you don't believe it, try this experiment: Eliminate all forms of wheat for a 4 week period--no breakfast cereals, no breads of any sort, no pasta, no crackers, no pretzels, etc. Instead, increase your vegetables, healthy oils, lean proteins (raw nuts, seeds, lean red meats, chicken, fish, turkey, eggs, Egg Beaters, low-fat yogurt and cottage cheese), fruits. Of course, avoid fruit drinks, candy, and other garbage foods, even if they're wheat-free.

Most people will report that a cloud has been lifted from their brains. Thinking is clearer, you have more energy, you don't poop out in the afternoon, you sleep more deeply, some rashes disappear. You will also notice that hunger ratchets down substantially. Most people lose the insatiable hunger pangs that occur 2-3 hours after a wheat-containing meal. Instead, hunger is a soft signal that gently prods you that it's time to consider eating again.

You will also make considerable gains towards gaining control over your risk for heart disease and your heart scan score, a crucial step in the Track Your Plaque program.

Thank you, Crestor

20. March 2009 William Davis (9)
I'm sure everyone by now has seen the Crestor ads run by drugmaker, AstraZeneca. TV ads, magazine ads, and the Crestor website all echoing the same message:

"While I was busy building my life, something else was busy building in my arteries: dangerous plaque."

While previous drug trials with Mevacor, Pravachol, Zocor, and Lipitor have focused mostly on examining whether the drugs reduced incidence of cardiovascular events, Crestor studies have also focused on effects on atherosclerotic plaque volume. The best example is the ASTEROID trial that demonstrated approximately 7% reduction in plaque volume by intracoronary ultrasound.

So the AstraZeneca decision makers took the leap from cholesterol reduction to plaque reduction.

I'm sure this switch wasn't taken lightly, but was the topic of discussion at many meetings before the decision to make plaque reduction the focus of hundreds of millions of dollars of advertising. After all, billions of dollars are at stake in this bloated statin market.

Ordinarily, I couldn't care less about how the drug manufacturers conduct their advertising campaigns. But this one I paid attention to because the Crestor ads are helping fuel a new way of thinking about coronary heart disease: It's not about the cholesterol; it's about the atherosclerotic plaque that accumulates in arteries.

It's not cholesterol that grows, limits coronary blood flow, and causes angina. It's not cholesterol that "ruptures" its internal contents to the surface within the interior of the blood vessel and causes blood clot and heart attack. It's not cholesterol that fragments from the carotid arteries and showers debris to the brain, causing stroke. It's all plaque.

I took the same leap years ago, though not backed by hundreds of millions of dollars of marketing money. When I first called my book Track Your Plaque, some of the feedback I got from editors included comments like "I thought this was a book about teeth!" Even now, the word "plaque" in the book title and website is responsible for confusion.

But AstraZeneca is helping me clear up the confusion. As the word plaque gains hold in public consciousness, it will become increasingly clear that cholesterol reduction is not what we're after. We are looking for reduction of plaque.

If you are trying to develop an effective means to reduce or reverse coronary heart disease, then there are two simple equations to keep in mind:


Plaque = coronary heart disease

Cholesterol ? coronary heart disease


Plaque is the disease, cholesterol is not. Cholesterol is simply a crude risk for plaque.

While I'm no friend to the drug industry nor to AstraZeneca, some good will come of their efforts.

Supermarkets and buggy whips

17. March 2009 William Davis (17)
Will supermarkets eventually phase out, joining the history books as a phenomenon of the past? Or are supermarkets here to stay, an emblem of the industrialization of our food--easy access to foods that are convenient, suit the undiscriminating masses, stripped of nutritional value despite the prominent health claim on the package front?

Anna left an insightful comment on the last Heart Scan Blog post, Sterols should be outlawed, along with some useful advice on how to avoid this trap for poor health called a supermarket:


I rarely shop in regular supermarkets anymore (farm subscription for veggies, meat bought in bulk for the freezer, eggs from a local individual, fish from a fish market, freshly roasted coffee from a local coffee place, etc.). What little else I need comes from quirky Trader Joe's (dark chocolate!), the fish market, farmer's markets, a small natural foods store, or mail order.

When I do need to go into one of the many huge supermarkets near me, not being a regular shopper there, I never know where anything is, so I have to ramble a bit around the aisles before I find what I'm looking for (and I almost always can grab a hand basket, instead of a trolley cart).

It's almost like being on another planet! There's always so many new products (most of them I hesitate to even call food). It's really a shock to the senses now to see how much stuff supermarkets sell that I wouldn't even pick up to read the label, let alone put in a cart or want to taste. I'm not even tempted by 99% of the tasting samples handed out by the sweet senior ladies in at Costco anymore (only thing I remember tasting at Costco in at least 6 mos was the Kerrygold Irish cheese, because I know their cows have pasture access and it's real food).

What's really shocking to me is how large some sections of the markets have become in recent years. While Americans got larger, so did some sections of the supermarket (hint - good idea to limit the consumption of products from those areas). Meat and seafood counters have shrunk, though. Produce areas seem to be about the same size as always (but more of it is pre-prepped and RTE in packaging.

But the chilled juice section is h-u-g-e! And no, I don't think there is a Florida orange grove behind the cases. Come on, how much juice do people need? Juice glasses used to be teeny tiny, for a good reason. To me it looks like a long wall stocked full of sugar water. Avoiding that section will put a nice dent in the grocery expenses.

The yogurt case is also e-n-o-r-m-o-u-s! Your 115 yo Bulgarian "grandmother" wouldn't know what to make of all these "pseudo-yogurts"! Chock full of every possible variety, but very little fit to eat. The only yogurts I'll look at are made with plain whole milk, without added gums, emulsifiers, or non-fat milk solids, and live cultures (I mostly buy yogurt now and then to refresh my starter culture at home). I can flavor them at home if needed. The sterols are showing up in processed yogurts, too, along with patented new strains of probiotic cultures (I'll stick to my old fashioned, but time-proven homemade lacto-cultured veggies and yogurt instead).

I found the same "cooler spread" in the butter & "spread" section. The spread options were just grotesque sounding. Actually, the butter options weren't much better, as many were blended with other ingredients to increase spreadability, reduce calories or cholesterol/saturated fat, etc. A few plain butters were enhanced with "butter flavor" - say what? And on no package could it be determined if the butter came from cows that were naturally fed on pasture or on grain in confined pens.


Well said, Anna.

There's a huge supermarket about 1 mile away from my house similar to the one Anna describes with aisle after aisle of eye-catching cellophane-wrapped foods. I go there about every 3 or 4 months, and then I only go to get something I need in a pinch. Every time I go, I too am reminded just how many products there are that look more like junk food than real food.

But there's no real money in real food. Who gets rich off of selling green peppers, tomatoes, and eggs?

Supermarkets sell these modern industrial foods because people buy it: Look around you. You don't get to be a 250 lb 5 ft 2 inch-woman by eating too many cucumbers.

Like Anna, I drive an additional several miles to Trader Joes', buy at farmers' markets whenever possible, buy some odds and ends like wine and cheese and raw nuts at specialty stores. I grow my own basil in a big pot I keep in the kitchen and we are just about to start turning over the soil in the back yard for our vegetable garden. I don't need nor do I miss having the choice among 40 different chips, 25 brands of ready-made microwavable dinners, an entire aisle of breakfast cereasl (all of which are virtually the same with different names and labels), or 75 varieties of salad dressing.

The supermarket for me--and I hope for many of you--has become a place rarely frequented, and only for the odd forgotten item. Oh, I forgot the dog chewies the grocery does have--my dogs love them. So perhaps they are good for something after all.

Sterols should be outlawed

14. March 2009 William Davis (10)
While sterols occur naturally in small quantities in food (nuts, vegetables, oils), food manufacturers are adding them to processed foods in order to earn a "heart healthy" claim.

The FDA approved a cholesterol-reducing indication for sterols , the American Heart Association recommends 200 mg per day as part of its Therapeutic Lifestyle Change diet, and WebMD gushes about the LDL-reducing benefits of sterols added to foods.


Sterols--the same substance that, when absorbed to high levels into the blood in a genetic disorder called "sitosterolemia"--causes extravagant atherosclerosis in young people.

The case against sterols, studies documenting its coronary disease- and valve disease-promoting effects, is building:

Higher blood levels of sterols increase cardiovascular events:
Plasma sitosterol elevations are associated with an increased incidence of coronary events in men: results of a nested case-control analysis of the Prospective Cardiovascular Münster (PROCAM) study.

Sterols can be recovered from diseased aortic valves:
Accumulation of cholesterol precursors and plant sterols in human stenotic aortic valves.

Sterols are incorporated into carotid atherosclerotic plaque:
Plant sterols in serum and in atherosclerotic plaques of patients undergoing carotid endarterectomy.




Though the data are mixed:

Moderately elevated plant sterol levels are associated with reduced cardiovascular risk--the LASA study.

No association between plasma levels of plant sterols and atherosclerosis in mice and men.




The food industry has vigorously pursued the sterol-as-heart-healthy strategy, based on studies conclusively demonstrating LDL-reducing effects. But do sterols that gain entry into the blood increase atherosclerosis regardless of LDL reduction? That's the huge unanswered question.

Despite the uncertainties, the list of sterol-supplemented foods is expanding rapidly:




Each Nature Valley Healthy Heart Bar contains 400 mg sterols.












HeartWise orange juice contains 1000 mg sterols per 8 oz serving.













Promise SuperShots contains 400 mg sterols per container.














Corozonas has an entire line of chips that contain added sterols, 400 mg per 1 oz serving.














MonaVie Acai juice, "Pulse," contains 400 mg sterols per 2 oz serving.














Kardea olive oil has 500 mg sterols per 14 gram serving.










WebMD has a table that they say can help you choose "foods" that are sterol-rich.

In my view, sterols should not have been approved without more extensive safety data. Just as Vioxx's potential for increasing heart attack did not become apparent until after FDA approval and widespread use, I fear the same may be ahead for sterols: dissemination throughout the processed food supply, people using large, unnatural quantities from multiple products, eventually . . . increased heart attacks, strokes, aortic valve disease.

Until there is clarification on this issue, I would urge everyone to avoid sterol-added "heart healthy" products.


Some more info on sterols in a previous Heart Scan Blog post: Are sterols the new trans fat? .

Texas today, tomorrow . . . the world?

10. March 2009 William Davis (0)
Texas state representative, Rene Oliveira, has introduced legislation that mandates heart scans for adults in the state of Texas.

Rep. Oliveira

A press release from the SHAPE Society ( Society for Heart Attack Prevention and Eradication) reads:

Assessment of heart attack risk on the basis of traditional risk factors alone such as high cholesterol and high blood pressure and so forth, while useful, misses many who are at high risk and also incorrectly flags some for high risk who are in fact at very low risk of near term heart attack; on the other hand detection of atherosclerosis by non-invasive imaging, as suggested by the SHAPE group, accurately identifies plaque and improves the ability to identify at-risk individuals who could benefit from aggressive preventive intervention while sparing low-risk subjects from unnecessary aggressive medical therapy," said Dr. P.K. Shah, Director of Cardiology at Cedars Sinai Heart Institute in Los Angeles, a leading member of the SHAPE Task Force who is also an active member of the American Heart Association. "Sadly, these vulnerable patients go undetected until struck by a heart attack, because insurance companies don't cover the newer heart attack screening imaging tests."


Rep. Oliveira, whose coronary disease was first uncovered by a heart scan and prompted a bypass operation, states:

"It is about time that we cover preventive screening for the number one killer in Texas, and take action to reduce healthcare costs through preventive healthcare. Right now, we are extending the lives of those who can afford the procedure while hundreds of thousands of Texans with hidden heart disease go undetected because of antiquated thinking. The time has come for this change."


Is this what we've come to? Since practicing physicians are either so entranced by the drug and procedural solutions to heart disease, do we need to resort to heart scan by legislation?

It does indeed appear that we've come to this point. Should this trend catch on, it will surely mean an upfront increase in healthcare costs to cover the expense of heart scans. But in the long run, it will mean reduction in healthcare costs--dramatic reduction--if heart scans prompt effective preventive action.
Overweight, hungry, diabetic, and fat-free

Overweight, hungry, diabetic, and fat-free

15. December 2009 William Davis (52)
Let me tell you about my low-fat experience from 20 years ago.

At the time, I was living in Cleveland, Ohio, and served on the faculty at a large metropolitan university-affiliated hospital, supervising fellows-in-training and developing high-tech cath lab procedures like directional athererectomy and excimer laser coronary angioplasty. (Yes, another life.)

I was concerned about personal heart disease risk, though I knew next to nothing about lipids and coronary risk prediction outside of the little I learned in training and what the drug industry promoted.

I heard Dr. Dean Ornish talk while attending the American College of Cardiology meetings in Atlanta. Dr. Ornish spoke persuasively about the dangers of fat in the diet and how he "reversed" coronary disease using a low-fat, no added oils, no meat, vegetarian diet that included plenty of whole grains. So I thought I'd give it a try.

I eliminated all oils; I removed all meat, eggs, and fish from my diet. I shunned all nuts. I ate only low-fat products like low-fat yogurt and cottage cheese; and focused on vegetables, fruit, and whole grains. Beans and brown or wild rice were a frequent staple. I loved oatmeal cookies--low-fat, of course!

After one year of this low-fat program, I had gained a total of 31 lbs, going from 155 lbs to 186 lbs. I reassessed some basic labs:

HDL 28 mg/dl
Triglycerides 336 mg/dl
Blood sugar 151 mg/dl (fasting)


I became a diabetic. All through this time, I was also jogging. I ran on the beautiful paths along the Chagrin River in suburban Cleveland for miles north and south. I ran 5 miles per day most days of the week.

It was diabetes that hit me alongside the head: I was eating low-fat meticulously, exercising more than 90% of the population, yet I got fat and diabetic!

I have since changed course in diet. Last time I checked, my lipid values on NO statin agent:

HDL 67 mg/dl
Triglycerides 57 mg/dl
Blood sugar 91 mg/dl

That was my lesson that fat restriction is a destructive, misguided notion. The data since then have confirmed that restricting total fat is unnecessary, even undesirable, when fat calories are replaced by carbohydrate calories.
Tags :

Comments (52) -

  • dave schy

    12/15/2009 1:55:11 PM |

    Not sure exactly what you were eating. As a chef for the last 30 years here is what I eat now.
    Maybe worth taking a look.

    http://www.newtaste.com

  • Peter

    12/15/2009 2:02:55 PM |

    I've read that Ornish scored zero on the heart scan.  As long as we're speculating about anecdotal evidence, I have to wonder if that's because of his stance against sugar and flour.

  • Christian

    12/15/2009 2:21:42 PM |

    But obviously Dean Ornish's program seems to work in order to reverse heart desease. Of course it consists of more than just a change in your diet, so my question is: Do you think that if Dean Ornish would apply a diet that is high in fat and low in CHO - in addition to his stress management program and exercise and so on - it would work to  heart desease?

  • Vivian

    12/15/2009 3:52:04 PM |

    Ditto this.  Exactly.

  • Anonymous

    12/15/2009 4:13:03 PM |

    Huh? For a minute, I thought you were writing about my exact experience. Yup, I was a vegetarian all my life until a year ago. Followed Dean Ornish's advice and saw my glucose and lipids behave exactly like yours. In the last one year, I have started eating eggs, fish and fat (butter, olive oil) and my blood sugar is normal and lipids are 110 total and 66 LDL. However, I am on statins and my doctor doesn't want to take me off of it yet. I wish my HDL was as high as yours but it's hovering around 35 and 40.

    I keep wondering how many people's health is affected by all the quackery that goes in the name of medical research and science.

  • JPB

    12/15/2009 4:18:42 PM |

    Oh yes, I can relate to that.  I followed my then doctor's advice on diet (yes, it was low-fat, high carb).  In a year, I gained 12 pounds effortlessly and 50 points total cholesterol plus my blood glucose was inching up....
    When is the truth about low-fat going to come out?  There seem to be too many well-entrenched powers out there!!

  • DrStrange

    12/15/2009 4:35:37 PM |

    "I ate only low-fat products like low-fat yogurt and cottage cheese..."

    I would love to know actual percentage of calories from fat in the diet.  "Low-fat" dairy can really add to quite a bit!  I know that Ornish now has a "spectrum" of diets depending on how healthy you want to be, to coax people on board, but his original diet (and his sort of ultimate one on the spectrum) is around 10% total fat calories.  Many or most who use the term "low-fat" really mean closer to 20% or even 30% calories from fat....

  • Anonymous

    12/15/2009 5:11:24 PM |

    so how does your diet look now? great results after you switched!

  • Peter

    12/15/2009 5:27:50 PM |

    If it were the case that a low fat/high carb diet causes obesity and diabetes in most people, the Japanese would be fat and diabetic, but they have far less obesity and diabetes than we do.  Probably other factors besides the ratio of fats and carbs are more decisive in determining who gets sick and who doesn't.

  • Anonymous

    12/15/2009 7:05:28 PM |

    Thanks for sharing your personal experience Dr. Davis.  Very interesting.

  • Chloe

    12/15/2009 9:18:00 PM |

    My theory confirmed.  Once the "community standard of care" or even the experts in traditional medicine fail in treating a doctor-patient's concerns and that doctor-patient has to self-treat then we lay folks get the benefit of their learning how to take care of themselves.  Love it and am grateful you found a way to treat yourself so we all could benefit from that knowledge.

  • Gretchen

    12/15/2009 9:39:00 PM |

    ". . . he "reversed" coronary disease using a low-fat, no added oils, no meat, vegetarian diet"

    This is often stated, but in fact even Ornish never "reversed" CVD by diet alone. He did what he did with a complete program that included diet, stress reduction, I think smoking cessation, and immense peer support.

  • billye

    12/15/2009 10:37:19 PM |

    Hi DR. Davis,

    You certainly had a horrifying experience.  But, your end result was very positive.  You are lucky that you did not continue longer, because, your out come might have mirrored mine.  I too went to a Dean Ornish lecture and bought in to his program.  I didn't stop with that, I followed many other Doctors programs over a 30 year period.  They all failed. I too had diabetes type 2, hypertension, Lipid problems, and last but not least chronic kidney disease. Of course, I ballooned up to 240 pounds.

    What we had in common, as all of those with diseases of the metabolic syndrome do, is the fact that every program was locked into
    the so called "healthy eating" dogma first presented and proselytized by Dr. Ancel Keys and his low fat and high carbohydrate hypothesis.  It still pervades medicine,even today.


    It took me 50 years to finally get it.  My awakening came when I read Garry Taubes best seller, Good Calories Bad Calories.  I then followed on with Barry Groves Trick and Treat.  These two books educated me as to what a health supporting program could be, and started me on the way to recovery.  I also followed up with your fine blog along with some others.  

    I am happy to report that my diabetes type 2 is now cured, without medication, and always <100mg/dl.  While I know that CKD can not be cured, my nephrologist Dr. Tourgeman says "he is amazed that there is a huge improvement in my kidney function".  My latest VAP test HDL 63, TRIG 63, LDL 154, all without statens.  But, my Real LDL size are pattern A large bouyant and fluffy, which is a huge change from what they used to be 11 months ago.  I am taking SLO-NIACIN to reverse my high LDL.  My diabetes induced hypertension is a problem, but we will see, because I have about 40 pounds to lose yet.  I am now 185 pounds.  All of this because I listened to my doctor who told me to switch to high saturated fat and low carbohydrate.  What a miracle this is.  I also supplement with vitamin D3, 8000IU, and high dose fish oil.
    Billy E nephropal.com

  • Dr. William Davis

    12/15/2009 11:38:05 PM |

    Gretchen is correct: The Ornish program consists of more than a low-fat diet. However, the diet is a crucial component of the program, one that cannot be ignored given its potentially destructive effects in a large proportion of people, especially those who are non-ApoE4.

    Also, I would argue that Dr. Ornish NEVER showed reversal of coronary atherosclerosis. He showed reversal of ENDOTHELIAL DYSFUNCTION, which, by the methods used, provide the appearance of reversal of disease. They are two different things.

    As a non-cardiologist and using 20th century technology, perhaps we can forgive him this faux pas.

  • Gyan

    12/16/2009 5:12:55 AM |

    Dr Davis,
    What was your blood sugar prior to going on low-jfat diet?

  • Myron

    12/16/2009 8:22:06 AM |

    "Dr. it's not the red meat that's bad for you it's the green meat", one carnivore commented. "HaHa", he said.

    It's not the no fat it's the no bad fats that count.   Cancer is a cell membrane disease and a disease of the mitochondria cell membrane.   Feed the membrane, feed the mitochondria and Cancer can go away.
    Live longer feel better eat live leaf juices foods.    Sure you should get your vitamins from food--that's what I'm talking about--solar powered leaf juice.

  • Kurt

    12/16/2009 1:04:29 PM |

    I began on the Ornish diet after my heart scan almost a year ago. In four months, I went from 183 to 167 lbs, and my LDL cholesterol dropped 40%. Triglycerides and fasting blood sugar remained unchanged. My HDL did drop about 10%, to 50. I've since increased my intake of healthy fats, but my experience with the Ornish diet was very positive, especially as it showed me that I could control my cholesterol with diet, something my doctor didn't believe was possible.

    I do think genetics are involved, especially given the discrepancy between our results.

  • Adolfo David

    12/16/2009 2:06:27 PM |

    Dr Ornish is a public danger. Be sure.

    I dont know how a doctor who recommends so terrible diet is 'famous'.

    He has to use exercise and meditation in order to balance the disaster of his diet in his patients. So sad.

  • Dr. William Davis

    12/16/2009 3:17:33 PM |

    Kurt's different response might be explained by being an ApoE4 homo- or heterozygote. I am an ApoE3 homozygote. In addition, there are genetic variants in CETP, hepatic lipase, lipoprotein lipase, and others that can modify the response.

    My point here is that, with extreme unnatural limitation of fat, a substantial proportion of people (probably 70% or more) will experience adverse effects.

    Also, the initial response is determined to a large degree by the diet PRIOR to the diet change.

  • PJNOIR

    12/16/2009 3:27:20 PM |

    I am diabetic- I was over weight and my sugars ran high. I followed the ADA diet (much like Ornish program)- low fat with moderate to high carbs- certainly high at the end of the day's tally I took all the meds and insulin prescribed – did cardio and some gym work.  Rarely snacked and always hungry. Gained 40 lbs in three months.  Discovered Atkins- then other low carb diets. Added high fat – lose 70 lbs  this last year.  Cholesterol fell to 130- Trigs are better then perfect. No more meds for diabetes. Blood pressure under control for the first time. I do NO cardio just strength training I am never hungry and avoid all grains and starches. Soy is a major never no-no.  I’m so glad I read Taubes  and Bernstein and did a little research on my own.  High fat and Low carb saved my life.

  • Diana

    12/16/2009 3:57:30 PM |

    It reminds me of a Vogue (a highly scientific publication, I know) article I read a few days ago. A woman went on a "cleansing" grapes-only diet promoted by yuppie-type Frenchwomen. She lost 1 lb each of water and muscle...and gained a pound of fat. Unfortunately the epiphany eluded her...

  • steve

    12/16/2009 3:59:14 PM |

    Ornish may be modifying his views: he now recommends daily consumption of fish oil!

  • White Zombie

    12/16/2009 8:56:24 PM |

    Dr. Davis,

    Its interesting you posted this. I am a Indian vegetarian before and now also, I used to run 7 days a week for nearly 15yrs. I was a pretty fast runner too keep 7-8min per mile competing in races until I got a heel spur and couldn't run at all but I got it fixed with homeopathic medicine but I digress. I used to be low fat, high carb, whole grain diet which lead a cholesterol profile of which I have records for 15yrs:

    HDL: ranges 50-58
    TriG: lowest was 130 to 275
    LDL: lowest was 130 to 250

    My most recent reading a 9months back:

    HDL: 58
    LDL: 158
    TriG: 250

    My latest reading 2 weeks old:

    HDL: 63
    LDL: 114
    TriG: 90

    What did I do ? For one I stopped doing any form of aerobics do only weight training 4 times a week for 15-20mins of intense weight training. I lost few pounds not much, lost a fat percentage points, I started eating a lots of salads, lots & lots of walnuts, pecans, fish oil, vitamin d supplement. My take I think the weight training improves insulin sensitivity along fish oil, walnuts and vit-d supplementation do the trick.

    My eye opener was Gary Taubes book the chapter on Cholesterol where he talks about Dr. John Gofman research on cholesterol and trigs. I am no longer afraid of fat, I consume a lot, no fat free milk, lots of walnuts, lots of olive oil and I don't see myself gaining any weight at all.

    I have to give thanks to Art Devany Evolutionary Fitness and your advice in this blog for my achievement.

    -White

  • FMJ

    12/16/2009 9:45:33 PM |

    Dr Davis:

    Thanks for this eye opener experience. What is your opinion of supplements like r-alpha lipoic acid, pycnogenol and acetyl L-carnitine for the treatment of glucose metabolization problems ?

    Thanks

    FMJ

  • Anonymous

    12/17/2009 2:10:07 AM |

    Is your 91 blood sugar level optimal?  Mine dropped from 95 or 96 down to 71 when I eliminated wheat.

  • Dr Matti Tolonen

    12/17/2009 2:52:53 PM |

    A new large, 90,000 people comprising European 10-yrs follow-up study EPIC (European Prospective Investigation into Cancer and Nutrition)does not support the use of low-fat diets to prevent weight gain.
    http://www.ajcn.org/cgi/content/abstract/90/6/1632

  • DrStrange

    12/18/2009 12:52:17 AM |

    from:  http://www.ajcn.org/cgi/content/abstract/90/6/1632

    "Mean total fat intake as a percentage of energy intake ranged between 31.5% and 36.5%"

    Sorry, that is not a low fat diet!  Low fat means approx 10% calories from fat.

  • Anonymous

    12/18/2009 2:06:11 AM |

    I'm confused.  I thought diabetes was a permanent condition that could not be cured or reversed?

  • DrStrange

    12/19/2009 1:32:29 AM |

    Type 1 diabetes is indeed permanent.  Type 2 is often completely reversible with appropriate diet and exercise.  If it is too far advanced in destroying the beta cells via high sugar and high insulin inflammation then the person may still need to supplement insulin but much lower amounts w/ above diet and exercise.

  • karl

    12/19/2009 1:51:31 AM |

    I had a similar experience to Dr. Davis - I followed AHA low fat diet - still didn't lose weight - so I cut the fat even further - and gained weight. I would go to bed hungry as it was better than feeling the hunger in the day.  

    As soon as I read Taubes book, I went low carb and quickly lost weight - switching to mostly non saturated fat - I lost even more weight - and it wasn't hard. I'm now at 14% body fat.

  • Anonymous

    12/19/2009 4:39:46 AM |

    ok already. i will give an animal/fish, low grain diet another try...... I need to count calories this time as the last time I eliminated wheat and went Paleo, I put on 10lbs

    more mechanisms please.  I find that helps me believe

  • Anonymous

    12/20/2009 6:12:10 AM |

    I have a friend who said he did Ornish religiously. The few times they had us over for dinner, they had what appeared to be pure Ornish type dishes. The man lost an enormous amount of weight (which was one of the strongest motivations for his wanting to do the  diet).

    However, lab tests confirmed that his cholesterol was moving in the wrong direction (triglycerides were in the 4 digits) and his doctor told him to start eating more meat and to cut back on the carbs!

    The quote from his doctor? "We tend to see this with people doing Ornish; your case is not unique."

    Yikes.

  • Mac

    12/21/2009 11:58:45 PM |

    Can you devote some posts to the dietary modifications needed for an ApoE 4... I know that fat has more of an effect, but is it saturated and trans fat only, or all fat.  Should ApoE 4 still take fish oil?

  • clevelander

    12/28/2009 1:34:47 PM |

    I'm a 55 year old woman.  I reversed a bad lipid profile by researching and then creating my own diet based on what, how, and why I eat.

    My before lipids
    LDL < 100
    HDL < 50
    TRIG > 300
    Blood sugar fasting 107
    weight, close to 180 lbs (I'm 5'3")
    waist 40"



    I set a goal, to consume 1500 calories a day, allowing for 1800 2000 on high activity days(>1 hr bicycling or salsa dancing, for example), with the calorie distribution 30% fats, 50% carbs, 20% protein.  Trans fats were never an issue, I don't eat fast food or much processed food.

    I kept a rigorous food diary (note: nutritiondata.com is a great place to get info), and for the 1st 6 weeks eliminated every added sugar I could think of - no cookies, candy, soda, etc.  I developed a list of "go to" foods: oat bran, 1% cottage or ricotta cheese, a serving of legumes every day, low-sodium V8 juice, almonds, and all the green vegetables my heart desired.  I supplemented with 6 caps of fish oil (~ 6 gm), and 4 inulin fiber tablets aday, which had the advantage of tasting like giant Sweetarts.  I included 30 minutes minimum of exercise/high activity a day, and weights 15 minutes 4 times a week.

    After 6 weeks my doc was stunned:

    LDL < 93
    HDL 63
    TriG 98!
    Blood sugar 96
    weight:163
    waist: 37"

    Th thing is, i can stick to this diet because it didn't depart that far from my usual cooking.eating preferences.  I had always eaten the good stuff; trouble was I topped it with dessert all too often.

    I now allow myself a little added sugar in the form of 1 oz 70% dark chocolate (5-9 gm depending on brand), and an occaisional Stella D'Oro anisette toast - while their serving size is 3 pieces I have one with my coffee, all of 4 gms sugar!

    My carb choices are whole grains, mostly not wheat: oat bran, hulled (not pearled) barley, quinoa, as well as beans and yellow/orange vegs like sweet potato & squash.  Here's the thing: I keep a measureing cup on my counter and limit myself to 1/2 cup servings, maximum twice a day.

    Proteins: fish at least twice a week, ricotta and cottage cheese, eggs, whole and whites.  Limited meat and poultry, which is just a preference.  Bison when I can get it.  Legumes.

    Fruit: twice a day, mostly whole
    Vegs; plan my meals around them.  Unlimited of green leafy, tomatoes, cukes, mushrooms, summer squash, cruciferous/ I love a good salad, and always measure the dressing - 1 Tb max commercial (no low fats - yecch!), or 1 tsp olive oil plus lemon juice or vinegar.  Again, the measuring spoon is always within reach.



    My motto; have that, but halve that.  I enjoy small portions of high fat dairy, for instance.

    Snacking:  I put out 1/4 cup of nuts in a dish, along with my daily chocolate or a bit of dried fruit. That is what I nibble on.

    I am headed to my goal of keeping the lipids/blood sugar good, 140 lbs, < 35" waist.


    Hope this is helpful.

  • Anonymous

    12/28/2009 3:23:35 PM |

    Well, not to knock the approach advocated here, but  I've had a very different experience on Ornish.  I've been following the original Ornish recommendations which are closer to what Dr. Esselstyn promotes as a result of his 20 year study.  I lost 50 pounds effortlessly, lowered total TC from 160 to 90, and TG steady at 80 and have stayed there for over three years.  

    Perhaps the difference is in the details.  I see a lot of people here saying they followed Ornish and ate low fat cookies, low fat dairy and such, but Esselstyn shows that that you really need to cut out all processed foods, all animal products, and watch those small amounts of oil.  It's a very different diet I suspect than many of you tried.  Esselstyn did show reversal of disease, as well as mortality, not just endothylium function, by the way.  I haven't seen published comparable results from Dr. Davis' regime here.

    If Ornish was such a horrible diet, you'd see terrible disease rates in Okinawa, other parts of Asia, or in many of the other societies, Seventh day adventists for that matter, around the world where they essentially eat the same diet.  But, of course you don't.  It's very easy to slam a diet that you're not really following, and anyone who says they were following the ADA diet and thinks it's the same as the original Ornish diet clearly doesn't know what the Ornish diet is.  ADA is 30% fat, Ornish is 10% fat, for starters, and as I mentioned, if you really want to do it right, Esselstyn has the details down.

    I do wonder about the heavy use of the calcium score here when you have recent studies questioning the value of these scores such as this:

    http://www.theheart.org/article/1035927.do

    Coronary calcification progression doubted as a CV diagnostic
    DECEMBER 17, 2009 | Reed Miller
    Editor's note: The headline for this story has been revised to more accurately reflect study findings.
    Royal Oak, MI - Coronary artery calcification (CAC) progression is not a suitable end point for trials of cardiovascular-disease therapies, and the usefulness of tracking CAC progression over time is still in doubt, according to researchers who analyzed previous randomized trials that tracked CAC for at least a year [1].

  • Anonymous

    12/30/2009 5:15:48 PM |

    I got fat by eating low-fat/high-carb for years starting in my teens into my early 30's.  Weight loss programs like Weight Watcher's only made me more obese and made me clinically sicker (low HDL and very high triglycerides).  

    Following Atkins way of eating (now moving to PaNu) has completely turned everything around for me.  I have lost over 100lbs and kept it off and my labratory results are, in my doctor's words, "enviable."  My diet is < 10% carbs and > 60% healthy fat (mostly saturated).  I started a vitD and Omega-3 regiment as well and I will get lab results from that in about 2 weeks.

    The lab results are great, but the feeling of complete control over my eating is even better.  When I an hungry it is because my stomach is empty, and the feeling can be sustained until I can grab something to eat.  When I was low-fat/high-carb, I was constantly hungry and food-obsessed and the only way I could lose any weight was from sheer deprivation which is unsustainable.

  • DrStrange

    1/1/2010 1:19:12 AM |

    Just eating "low fat/high carb" can easily be a terrible diet.  CocaCola and Entenmann's fat free pasteries would qualify here.  What McDougall, Ornish, etc are recommending is low fat/high carb consisting ONLY of minimally processed, whole foods, from plants.  That means the green "plants" not the factories "plants". AND it is crucial for the diet to work that you aren't sneaking in little bits here and there of junk food and highly processed foods that claim to be low fat but have a lot of fat hidden by labeling claims.

    If you only eat from the produce section, whole/intact grains, whole legumes, and moderate fruit, maybe an ounce of flax or walnuts per day the diet will work wonders!

  • B.K.

    1/1/2010 5:20:56 PM |

    I tried reducing fats as well. Rice, baked vegetables, potatoes, salads with fat-free dressing, you name it. At 5'8" tall, I got up to 210 lbs. and a 38" waist. Fat was the "bad guy". Diet soda, diet foods, water, walking...then the numb fingers, blurry vision, and even peeing my pants hit me because I could not get out of the bathroom. The Dr. said diabetes; it took 2 weeks to get in to him. In the meantime, my boss was on Atkins and dropping weight and feeling GOOD. In just 2 weeks, when I was tested, my urine was still "a disaster area" but BG after fasting and walking several blocks in was 75. Now it is usually always below 100. I dropped about 60 lbs. in less than 6 months! My last A1C was 5.4. I do not take meds of any kind. I have a 'safe list' of carbs to eat, all of them low GI and avoid corn syrup, flour, and sugar. I eat a LOT of nice, red, fat meat. Pretty much, if it's a "dead animal", I'll eat it. If it's green or colorful, I eat it. Nothing "white" or high GI. That was 3.5 years ago. I do not have a need for statins, insulin, nothing. Grandpa is fat-free, high carb, etc. - oats, rice, you name it. He's not obese, but his cholesterol is over the moon and I can't get him to get a BS test.

  • Ned Kock

    1/2/2010 3:24:43 PM |

    My experience was very similar in terms of the numbers, although I followed a slightly different diet modification path:

    Before: LDL: 156, HDL: 38, triglycerides: 188.

    After: LDL: 123, HDL: 66, triglycerides: 46.

    I included more details on the post below, if you are interested:

    http://healthcorrelator.blogspot.com/2009/12/refined-carbs-sugar-and-cholesterol-my.html

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  • Term Paper

    2/18/2010 7:08:16 AM |

    This is often stated, but in fact even Ornish never "reversed" CVD by diet alone. He did what he did with a complete program that included diet, stress reduction, I think smoking cessation, and immense peer support.

  • jea

    5/24/2010 6:38:48 PM |

    I have lost 51 pounds on the Ornish low fat diet, avoiding most sweets, and exercising 6 days a week, that included weights and cardio.

    Slamming Ornish is easy but it seems some do because the diet fails because it is not followed properly.

    Eating sugars such as cookies and carbs such as white flour will make you gain weight. I only eat whole grains and measure my portion.

    Its also interesting that Ornish does say that blood levels such as HDL will increase on a high fat diet because your body needs more protection.

    But the diet is not a cure all. As he has pointed out, even people with lower cholesterol can die if they dont change their attitude and habits.

  • Max

    6/3/2010 6:01:53 AM |

    i eat a lot & never exercise  and i am 22 yrs, no disease has dared to touch me..

  • DrStrange

    6/6/2010 5:51:12 PM |

    Max   At  22 no disease has had time to develop.  It is quite natural to have a fairly distorted sense of time and lack of awareness of your own mortality.  Most everyone can do as you have been doing and feel fine and not "see" damage.  Yet. But continue as you are and it is almost guaranteed you will end up w/ either diabetes, some form of cardiovascular disease, or both.  By the time you are in your 40's you will be a fat, old man, panting to walk up a flight of stairs, with high blood pressure, high blood sugar, and dyslipidemia.  You can pretty much take that to the bank!

  • Term papers

    6/8/2010 2:00:27 PM |

    Posts like this will teach me to take a long weekend offline, and off of the newsreader.

  • error fix

    8/22/2010 10:44:51 PM |

    Do you think that if Dean Ornish would apply a diet that is high in fat and low in CHO - in addition to his stress management program and exercise and so on - it would work to heart desease? b

  • buy jeans

    11/3/2010 10:17:48 PM |

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