For the sake of convenience: Commercial sources of prebiotic fibers

Our efforts to obtain prebiotic fibers/resistant starches, as discussed in the Cureality Digestive Health Track, to cultivate healthy bowel flora means recreating the eating behavior of primitive humans who dug in the dirt with sticks and bone fragments for underground roots and tubers, behaviors you can still observe in extant hunter-gatherer groups, such as the Hadza and Yanomamo. But, because this practice is inconvenient for us modern folk accustomed to sleek grocery stores, because many of us live in climates where the ground is frozen much of the year, and because we lack the wisdom passed from generation to generation that helps identify which roots and tubers are safe to eat and which are not, we rely on modern equivalents of primitive sources. Thus, green, unripe bananas, raw potatoes and other such fiber sources in the Cureality lifestyle.

There is therefore no need to purchase prebiotic fibers outside of your daily effort at including an unripe green banana, say, or inulin and fructooligosaccharides (FOS), or small servings of legumes as a means of cultivating healthy bowel flora. These are powerful strategies that change the number and species of bowel flora over time, thereby leading to beneficial health effects that include reduced blood sugar and blood pressure, reduction in triglycerides, reduced anxiety and improved sleep, and reduced colon cancer risk.

HOWEVER, convenience can be a struggle. Traveling by plane, for example, makes lugging around green bananas or raw potatoes inconvenient. Inulin and FOS already come as powders or capsules and they are among the options for a convenient, portable prebiotic fiber strategy. But there are others that can be purchased. This is a more costly way to get your prebiotic fibers and you do not need to purchase these products in order to succeed in your bowel flora management program. These products are therefore listed strictly as a strategy for convenience.

Most perspectives on the quality of human bowel flora composition suggest that diversity is an important feature, i.e., the greater the number of species, the better the health of the host. There may therefore be advantage in varying your prebiotic routine, e.g., green banana on Monday, inulin on Tuesday, PGX (below) on Wednesday, etc. Beyond providing convenience, these products may introduce an added level of diversity, as well.

Among the preparations available to us that can be used as prebiotic fibers:

PGX

While it is billed as a weight management and blood sugar-reducing product, the naturally occurring fiber--α-D-glucurono-α-D-manno-β-D-manno- β-D-gluco, α-L-gulurono-β-D mannurono, β-D-gluco-β- D-mannan--in PGX also exerts prebiotic effects (evidenced by increased fecal butyrate, the beneficial end-product of bacterial metabolism). PGX is available as capsules or granules. It also seems to exert prebiotic effects at lower doses than other prebiotic fibers. While I usually advise reaching 20 grams per day of fiber, PGX appears to exert substantial effects at a daily dose of half that quantity. As with all prebiotic fibers, it is best to build up slowly over weeks, e.g., start at 1.5 grams twice per day. It is also best taken in two or three divided doses. (Avoid the PGX bars, as they are too carb-rich for those of us trying to achieve ideal metaobolic health.)

Prebiotin

A combination of inulin and FOS available as powders and in portable Stick Pacs (2 gram and 4 gram packs). This preparation is quite costly, however, given the generally low cost of purchasing chicory inulin and FOS separately.

Acacia

Acacia fiber is another form of prebiotic fiber.  RenewLife and NOW are two reputable brands.

Isomalto-oligosaccharides

This fiber is used in Quest bars and in Paleo Protein Bars. With Quest bars, choose the flavors without sucralose, since it has been associated with undesirable changes in bowel flora.

There you go. It means that there are fewer and fewer reasons to not purposefully cultivate healthy bowel flora and obtain all the wonderful health benefits of doing so, from reduced blood pressure, to reduced triglycerides, to deeper sleep.

Disclaimer: I am not compensated in any way by discussing these products.

How Not To Have An Autoimmune Condition


Autoimmune conditions are becoming increasingly common. Estimates vary, but it appears that at least 8-9% of the population in North America and Western Europe have one of these conditions, with The American Autoimmune Related Diseases Association estimating that it’s even higher at 14% of the population.

The 200 or so autoimmune diseases that afflict modern people are conditions that involve an abnormal immune response directed against one or more organs of the body. If the misguided attack is against the thyroid gland, it can result in Hashimoto’s thyroiditis. If it is directed against pancreatic beta cells that produce insulin, it can result in type 1 diabetes or latent autoimmune diabetes of adults (LADA). If it involves tissue encasing joints (synovium) like the fingers or wrists, it can result in rheumatoid arthritis. It if involves the liver, it can result in autoimmune hepatitis, and so on. Nearly every organ of the body can be the target of such a misguided immune response.

While it requires a genetic predisposition towards autoimmunity that we have no control over (e.g., the HLA-B27 gene for ankylosing spondylitis), there are numerous environmental triggers of these diseases that we can do something about. Identifying and correcting these factors stacks the odds in your favor of reducing autoimmune inflammation, swelling, pain, organ dysfunction, and can even reverse an autoimmune condition altogether.

Among the most important factors to correct in order to minimize or reverse autoimmunity are:


Wheat and grain elimination

If you are reading this, you likely already know that the gliadin protein of wheat and related proteins in other grains (especially the secalin of rye, the hordein of barley, zein of corn, perhaps the avenin of oats) initiate the intestinal “leakiness” that begins the autoimmune process, an effect that occurs in over 90% of people who consume wheat and grains. The flood of foreign peptides/proteins, bacterial lipopolysaccharide, and grain proteins themselves cause immune responses to be launched against these foreign factors. If, for instance, an autoimmune response is triggered against wheat gliadin, the same antibodies can be aimed at the synapsin protein of the central nervous system/brain, resulting in dementia or cerebellar ataxia (destruction of the cerebellum resulting in incoordination and loss of bladder and bowel control). Wheat and grain elimination is by far the most important item on this list to reverse autoimmunity.

Correct vitamin D deficiency

It is clear that, across a spectrum of autoimmune diseases, vitamin D deficiency serves a permissive, not necessarily causative, role in allowing an autoimmune process to proceed. It is clear, for instance, that autoimmune conditions such as type 1 diabetes in children, rheumatoid arthritis, and Hashimoto’s thyroiditis are more common in those with low vitamin D status, much less common in those with higher vitamin D levels. For this and other reasons, I aim to achieve a blood level of 25-hydroxy vitamin D level of 60-70 ng/ml, a level that usually requires around 4000-8000 units per day of D3 (cholecalciferol) in gelcap or liquid form (never tablet due to poor or erratic absorption). In view of the serious nature of autoimmune diseases, it is well worth tracking occasional blood levels.

Supplement omega-3 fatty acids

While omega-3 fatty acids, EPA and DHA, from fish oil have proven only modestly helpful by themselves, when cast onto the background of wheat/grain elimination and vitamin D, omega-3 fatty acids compound anti-inflammatory benefits, such as those exerted via cyclooxygenase-2. This requires a daily EPA + DHA dose of around 3600 mg per day, divided in two. Don’t confuse EPA and DHA omega-3s with linolenic acid, another form of omega-3 obtained from meats, flaxseed, chia, and walnuts that does not not yield the same benefits. Nor can you use krill oil with its relatively trivial content of omega-3s.

Eliminate dairy

This is true in North America and most of Western Europe, less true in New Zealand and Australia. Autoimmunity can be triggered by the casein beta A1 form of casein widely expressed in dairy products, but not by casein beta A2 and other forms. Because it is so prevalent in North America and Western Europe, the most confident way to avoid this immunogenic form of casein is to avoid dairy altogether. You might be able to consume cheese, given the fermentation process that alters proteins and sugar, but that has not been fully explored.

Cultivate healthy bowel flora

People with autoimmune conditions have massively screwed up bowel flora with reduced species diversity and dominance of unhealthy species. We restore a healthier anti-inflammatory panel of bacterial species by “seeding” the colon with high-potency probiotics, then nourishing them with prebiotic fibers/resistant starches, a collection of strategies summarized in the Cureality Digestive Health discussions. People sometimes view bowel flora management as optional, just “fluff”–it is anything but. Properly managing bowel flora can be a make-it-or-break-it advantage; don’t neglect it.

There you go: a basic list to get started on if your interest is to begin a process of unraveling the processes of autoimmunity. In some conditions, such as rheumatoid arthritis and polymyalgia rheumatica, full recovery is possible. In other conditions, such as Hashimoto’s thyroiditis and the pancreatic beta cell destruction leading to type 1 diabetes, reversing the autoimmune inflammation does not restore organ function: hypothyroidism results after thyroiditis quiets down and type 1 diabetes and need for insulin persists after pancreatic beta cell damage. But note that the most powerful risk factor for an autoimmune disease is another autoimmune disease–this is why so many people have more than one autoimmune condition. People with Hashimoto’s, for instance, can develop rheumatoid arthritis or psoriasis. So the above menu is still worth following even if you cannot hope for full organ recovery

Five Powerful Ways to Reduce Blood Sugar

Left to conventional advice on diet and you will, more than likely, succumb to type 2 diabetes sooner or later. Follow your doctor’s advice to cut fat and eat more “healthy whole grains” and oral diabetes medication and insulin are almost certainly in your future. Despite this, had this scenario played out, you would be accused of laziness and gluttony, a weak specimen of human being who just gave into excess.

If you turn elsewhere for advice, however, and ignore the awful advice from “official” sources with cozy relationships with Big Pharma, you can reduce blood sugars sufficient to never become diabetic or to reverse an established diagnosis, and you can create a powerful collection of strategies that handily trump the worthless advice being passed off by the USDA, American Diabetes Association, the American Heart Association, or the Academy of Nutrition and Dietetics.

Among the most powerful and effective strategies to reduce blood sugar:

1) Eat no wheat nor grains

Recall that amylopectin A, the complex carbohydrate of grains, is highly digestible, unlike most of the other components of the seeds of grasses AKA “grains,” subject to digestion by the enzyme, amylase, in saliva and stomach. This explains why, ounce for ounce, grains raise blood sugar higher than table sugar. Eat no grains = remove the exceptional glycemic potential of amylopectin A.

2) Add no sugars, avoid high-fructose corn syrup

This should be pretty obvious, but note that the majority of processed foods contain sweeteners such as sucrose or high-fructose corn syrup, tailored to please the increased desire for sweetness among grain-consuming people. While fructose does not raise blood sugar acutely, it does so in delayed fashion, along with triggering other metabolic distortions such as increased triglycerides and fatty liver.

3) Vitamin D

Because vitamin D restores the body’s normal responsiveness to insulin, getting vitamin D right helps reduce blood sugar naturally while providing a range of other health benefits.

4) Restore bowel flora

As cultivation of several Lactobacillus and Bifidobacteria species in bowel flora yields fatty acids that restore insulin responsiveness, this leads to reductions in blood sugar over time. Minus the bowel flora-disrupting effects of grains and sugars, a purposeful program of bowel flora restoration is required (discussed at length in the Cureality Digestive Health section.)

5) Exercise

Blood sugar is reduced during and immediately following exercise, with the effect continuing for many hours afterwards, even into the next day.

Note that, aside from exercise, none of these powerful strategies are advocated by the American Diabetes Association or any other “official” agency purporting to provide dietary advice. As is happening more and more often as the tide of health information rises and is accessible to all, the best advice on health does not come from such agencies nor from your doctor but from your efforts to better understand the truths in health. This is our core mission in Cureality. A nice side benefit: information from Cureality is not accompanied by advertisements from Merck, Pfizer, Kelloggs, Kraft, or Cadbury Schweppes.

Cureality App Review: Breathe Sync



Biofeedback is a wonderful, natural way to gain control over multiple physiological phenomena, a means of tapping into your body’s internal resources. You can, for instance, use biofeedback to reduce anxiety, heart rate, and blood pressure, and achieve a sense of well-being that does not involve drugs, side-effects, or even much cost.

Biofeedback simply means that you are tracking some observable physiologic phenomenon—heart rate, skin temperature, blood pressure—and trying to consciously access control over it. One very successful method is that of bringing the beat-to-beat variation in heart rate into synchrony with the respiratory cycle. In day-to-day life, the heart beat is usually completely out of sync with respiration. Bring it into synchrony and interesting things happen: you experience a feeling of peace and calm, while many healthy phenomena develop.

A company called HeartMath has applied this principle through their personal computer-driven device that plugs into the USB port of your computer and monitors your heart rate with a device clipped on your earlobe. You then regulate breathing and follow the instructions provided and feedback is obtained on whether you are achieving synchrony, or what they call “coherence.” As the user becomes more effective in achieving coherence over time, positive physiological and emotional effects develop. HeartMath has been shown, for instance, to reduce systolic and diastolic blood pressure, morning cortisol levels (a stress hormone), and helps people deal with chronic pain. Downside of the HeartMath process: a $249 price tag for the earlobe-USB device.

But this is the age of emerging smartphone apps, including those applied to health. Smartphone apps are perfect for health monitoring. They are especially changing how we engage in biofeedback. An app called Breathe Sync is available that tracks heart rate using the camera’s flash on the phone. By tracking heart rate and providing visual instruction on breathing pattern, the program generates a Wellness Quotient, WQ, similar to HeartMath’s coherence scoring system. Difference: Breathe Sync is portable and a heck of a lot less costly. I paid $9.99, more than I’ve paid for any other mainstream smartphone application, but a bargain compared to the HeartMath device cost.

One glitch is that you need to not be running any other programs in the background, such as your GPS, else you will have pauses in the Breathe Sync program, negating the value of your WQ. Beyond this, the app functions reliably and can help you achieve the health goals of biofeedback with so much less hassle and greater effectiveness than the older methods.

If you are looking for a biofeedback system that provides advantage in gaining control over metabolic health, while also providing a wonderful method of relaxation, Breathe Sync, I believe, is the go-to app right now.

Amber’s Top 35 Health and Fitness Tips

This year I joined the 35 club!  And in honor of being fabulous and 35, I want to share 35 health and fitness tips with you! 

1.  Foam rolling is for everyone and should be done daily. 
2.  Cold showers are the best way to wake up and burn more body fat. 
3.  Stop locking your knees.  This will lead to lower back pain. 
4.  Avoid eating gluten at all costs. 
5.  Breath deep so that you can feel the sides or your lower back expand. 
6.  Swing a kettlebell for a stronger and great looking backside. 
7.  Fat is where it’s at!  Enjoy butter, ghee, coconut oil, palm oil, duck fat and many other fabulous saturated fats. 
8.  Don’t let your grip strength fade with age.  Farmer carries, kettlebells and hanging from a bar will help with that. 
9.  Runners, keep your long runs slow and easy and keep your interval runs hard.  Don’t fall in the chronic cardio range. 
10.  Drink high quality spring or reverse osmosis water. 
11.  Use high quality sea salt season food and as a mineral supplement. 
12.  Work your squat so that your butt can get down to the ground.  Can you sit in this position? How long?
13.  Lift heavy weights!  We were made for manual work,.   Simulate heavy labor in the weight room. 
14.  Meditate daily.  If you don’t go within, you will go with out.  We need quiet restorative time to balance the stress in our life. 
15.  Stand up and move for 10 minutes for every hour your sit at your computer. 
16. Eat a variety of whole, real foods. 
17.  Sleep 7 to 9 hours every night. 
18.  Pull ups are my favorite exercise.  Get a home pull up bar to practice. 
19.  Get out and spend a few minutes in nature.  Appreciate the world around you while taking in fresh air and natural beauty. 
20.  We all need to pull more in our workouts.  Add more pulling movements horizontally and vertically. 
21. Surround yourself with health minded people. 
22. Keep your room dark for deep sound sleep.  A sleep mask is great for that! 
23. Use chemical free cosmetics.  Your skin is the largest organ of your body and all chemicals will absorb into your blood stream. 
24. Unilateral movements will help improve symmetrical strength. 
25. Become more playful.  We take life too seriously, becoming stress and overwhelmed.  How can you play, smile and laugh more often?
26.  Choose foods that have one ingredient.  Keep your diet simple and clean. 
27.  Keep your joints mobile as you age.  Do exercises that take joints through a full range of motion. 
28. Go to sleep no later than 10:30pm.  This allows your body and brain to repair through the night. 
29. Take care of your health and needs before others.  This allows you to be the best spouse, parent, coworker, and person on the planet. 
30.  Always start your daily with a high fat, high protein meal.  This will encourage less sugar cravings later in the day. 
31. Approach the day with positive thinking!  Stinkin’ thinkin’ only leads to more stress and frustration. 
32. You are never “too old” to do something.  Stay young at heart and keep fitness a priority as the years go by. 
33. Dream big and go for it. 
34.  Lift weights 2 to 4 times every week.  Strong is the new sexy. 
35.  Love.  Love yourself unconditionally.  Love your life and live it to the fullest.  Love others compassionately. 

Amber B.
Cureality Exercise and Fitness Coach

To Change, You Need to Get Uncomfortable

Sitting on the couch is comfortable.  Going through the drive thru to pick up dinner is comfortable.  But when you notice that you’re out-of-shape, tired, sick and your clothes no longer fit, you realize that what makes you comfortable is not in align with what would make you happy.   

You want to see something different when you look in the mirror.  You want to fit into a certain size of jeans or just experience your day with more energy and excitement.  The current condition of your life causes you pain, be it physical, mental or emotional.  To escape the pain you are feeling, you know that you need to make changes to your habits that keep you stuck in your current state.  But why is it so hard to make the changes you know that will help you achieve what you want?  

I want to lose weight but….

I want a six pack but…

I want more energy but….

The statement that follows the “but” is often a situation or habit you are comfortable with.  You want to lose weight but don’t have time to cook healthy meals.  So it’s much more comfortable to go through the drive thru instead of trying some new recipes.   New habits often require a learning curve and a bit of extra time in the beginning.  It also takes courage and energy to establish new routines or seek out help.  

Setting out to achieve your goals requires change.  Making changes to establish new habits that support your goals and dreams can be uncomfortable.  Life, as you know it, will be different.  Knowing that fact can be scary, but so can staying in your current condition.  So I’m asking you to take a risk and get uncomfortable so that you can achieve your goals.  

Realize that it takes 21 days to develop a new habit.  I believe it takes triple that amount of time to really make a new habit stick for the long haul.  So for 21 days, you’ll experience some discomfort while you make changes to your old routine and habits.  Depending on what you are changing, discomfort could mean feeling tired, moody, or even withdrawal symptoms.  However, the longer you stick to your new habits the less uncomfortable you start to feel.  The first week is always the worst, but then it gets easier.

Making it through the uncomfortable times requires staying focused on your goals and not caving to your immediate feelings or desires.  I encourage clients to focus on why their goals important to them.  This reason or burning desire to change will help when old habits, cravings, or situations call you back to your old ways.
Use a tracking and a reward system to stay on track.  Grab a calendar, journal or index card to check off or note your daily successes.  Shoot for consistency and not perfection when trying to make changes.  I encourage my clients to use the 90/10 principle of change and apply that to their goal tracking system.  New clothes, a massage, or a day me-retreat are just a few examples of rewards you can use to sticking to your tracking system.  Pick something that really gets you excited.  

Getting support system in place can help you feel more comfortable with being uncomfortable.  Hiring a coach, joining an online support group, or recruiting family and friends can be very helpful when making big changes.  With a support system in place you are not alone in your discomfort.  You’re network is there for you to reach out for help, knowledge, accountability or camaraderie when you feel frustrated and isolated.  

I’ve helped hundreds of people change their bodies, health and lives of the eleven years I’ve worked as a trainer and coach.  I know it’s hard, but I also know that if they can do it, so can you.  You just need to step outside of your comfort zone and take a risk. Don’t let fear create uncomfortable feelings that keep you stuck in your old ways.  Take that first step and enjoy the journey of reaching your goals and dreams.  

Amber Budahn, B.S., CSCS, ACE PT, USATF 1, CHEK HLC 1, REIKI 1
Cureality Exercise Specialist

The 3 Best Grain Free Food Swaps to Boost Fat Burning

You can join others enjoying substantial improvements in their health, energy and pant size by making a few key, delicious substitutions to your eating habits.  This is possible with the Cureality nutrition approach, which rejects the idea that grains should form the cornerstone of the human diet.  

Grain products, which are seeds of grasses, are incompatible with human digestion.  Contrary to what we have been told for years, eating healthy whole grain is not the answer to whittle away our waists.  Consumption of all grain-based carbohydrates results in increased production of the fat storage hormone insulin.  Increased insulin levels create the perfect recipe for weight gain. By swapping out high carbohydrate grain foods that cause spikes in insulin with much lower carbohydrate foods, insulin release is subdued and allows the body to release fat.

1. Swap wheat-based flour with almond flour/meal

  • One of the most dubious grain offenders is modern wheat. Replace wheat flour with naturally wheat-free, lower carbohydrate almond flour.  
  • Almond flour contains a mere 12 net carbs per cup (carbohydrate minus the fiber) with 50% more filling protein than all-purpose flour.
  • Almond flour and almond meal also offer vitamin E, an important antioxidant to support immune function.

2. Swap potatoes and rice for cauliflower

  • Replace high carb potatoes and pasta with vitamin C packed cauliflower, which has an inconsequential 3 carbs per cup.  
  • Try this food swap: blend raw cauliflower in food processor to make “rice”. (A hand held grater can also be used).  Sautee the “riced” cauliflower in olive or coconut oil for 5 minutes with seasoning to taste.
  • Another food swap: enjoy mashed cauliflower in place of potatoes.  Cook cauliflower. Place in food processor with ½ a stick organic, grass-fed butter, ½ a package full-fat cream cheese and blend until smooth. Add optional minced garlic, chives or other herbs such as rosemary.
3. Swap pasta for shirataki noodles and zucchini

  • Swap out carb-rich white pasta containing 43 carbs per cup with Shirataki noodles that contain a few carbs per package. Shirataki noodles are made from konjac or yam root and are found in refrigerated section of supermarkets.
  • Another swap: zucchini contains about 4 carbs per cup. Make your own grain free, low-carb noodles from zucchini using a julienne peeler, mandolin or one of the various noodle tools on the market.  

Lisa Grudzielanek, MS,RDN,CD,CDE
Cureality Nutrition Specialist

Not so fast. Don’t make this mistake when going gluten free!

Beginning last month, the Food and Drug Administration began implementing its definition of “gluten-free” on packaged food labels.  The FDA determined that packaged food labeled gluten free (or similar claims such as "free of gluten") cannot contain more than 20 parts per million of gluten.

It has been years in the making for the FDA to define what “gluten free” means and hold food manufactures accountable, with respect to food labeling.  However, the story does not end there.

Yes, finding gluten-free food, that is now properly labeled, has become easier. So much so the market for gluten-free foods tops $6 billion last year.   However, finding truly healthy, commercially prepared, grain-free foods is still challenging.

A very common mistake made when jumping into the gluten-free lifestyle is piling everything labeled gluten-free in the shopping cart.  We don’t want to replace a problem: wheat, with another problem: gluten free products.

Typically gluten free products are made with rice flour (and brown rice flour), tapioca starch, cornstarch, and potato flour.  Of the few foods that raise blood sugar higher than wheat, these dried, powdered starches top the list.

 They provide a large surface area for digestion, thereby leading to sky-high blood sugar and all the consequences such as diabetes, hypertension, cataracts, arthritis, and heart disease. These products should be consumed very rarely consumed, if at all.  As Dr. Davis has stated, “100% gluten-free usually means 100% awful!”

There is an ugly side to the gluten-free boom taking place.  The Cureality approach to wellness recommends selecting gluten-free products wisely.  Do not making this misguided mistake and instead aim for elimination of ALL grains, as all seeds of grasses are related to wheat and therefore overlap in many effects.

Lisa Grudzielanek MS, RDN, CD, CDE
Cureality Health & Nutrition Coach

3 Foods to Add to Your Next Grocery List

Looking for some new foods to add to your diet? Look no further. Reach for these three mealtime superstars to encourage a leaner, healthier body.

Microgreens

Microgreens are simply the shoots of salad greens and herbs that are harvested just after the first leaves have developed, or in about 2 weeks.  Microgreen are not sprouts. Sprouts are germinated, in other words, sprouted seeds produced entirely in water. Microgreens are grown in soil, thereby absorbing the nutrients from the soil.

The nutritional profile of each microgreen depends greatly on the type of microgreen you are eating. Researchers found red cabbage microgreens had 40 times more vitamin E and six times more vitamin C than mature red cabbage. Cilantro microgreens had three times more beta-carotene than mature cilantro.

A few popular varieties of microgreens are arugula, kale, radish, pea, and watercress. Flavor can vary from mild to a more intense or spicy mix depending on the microgreens.  They can be added to salads, soup, omelets, stir fry and in place of lettuce.  

Cacao Powder

Cocoa and cacao are close enough in flavor not to make any difference. However, raw cacao powder has 3.6 times the antioxidant activity of roasted cocoa powder.  In short, raw cacao powder is definitely the healthiest, most beneficial of the powders, followed by 100% unsweetened cocoa.

Cacao has more antioxidant flavonoids than blueberries, red wine and black and green teas.  Cacao is one of the highest sources of magnesium, a great source of iron and vitamin C, as well as a good source of fiber for healthy bowel function.
Add cacao powder to milk for chocolate milk or real hot chocolate.  Consider adding to coffee for a little mocha magic or sprinkle on berries and yogurt.




Shallots


Shallots have a better nutrition profile than onions. On a weight per weight basis, they have more anti-oxidants, minerals, and vitamins than onions. Shallots have a milder, less pungent taste than onions, so people who do not care for onions may enjoy shallots.

Like onions, sulfur compounds in shallot are necessary for liver detoxification pathways.  The sulfur compound, allicin has been shown to be beneficial in reducing cholesterol.  Allicin is also noted to have anti-bacterial, anti-viral, and anti-fungal activities.

Diced then up and add to salads, on top of a bun less hamburger, soups, stews, or sauces.  Toss in an omelet or sauté to enhance a piece of chicken or steak, really the possibilities are endless.  

Lisa Grudzielanek,MS,RDN,CD,CDE
Cureality Nutrition & Health Coach

3 Band Exercises for Great Glutes

Bands and buns are a great combination.  (When I talk about glutes or a butt, I use the word buns)  When it comes to sculpting better buns, grab a band.   Bands are great for home workouts, at gym or when you travel.  Check out these 3 amazing exercises that will have your buns burning. 

Band Step Out

Grab a band and place it under the arch of each foot.  Then cross the band and rest your hands in your hip sockets.  The exercise starts with your feet hip width apart and weight in the heels.  Slightly bend the knees and step your right foot out to the side.  Step back in so that your foot is back in the starting position.  With each step, make sure your toes point straight ahead.  The tighter you pull the band, the more resistance you will have.    You will feel this exercise on the outside of your hips. 

Start with one set of 15 repetitions with each foot.  Work on increasing to 25 repetitions on each side and doing two to three sets.



Band Kick Back

This exercise is performed in the quadruped position with your knees under hips and hands under your shoulders.    Take the loop end of the band and put it around your right foot and place the two handles or ends of the band under your hands.  Without moving your body, kick your right leg straight back.  Return to the starting quadruped position.  Adjust the tension of the band to increase or decrease the difficulty of this exercise. 

Start with one set of 10 repetitions with each foot.  Work on increasing to 20 repetitions on each side and doing two to three sets. 



Band Resisted Hip Bridge

Start lying on your back with feet hip distance apart and knees bent at about a 45-degree angle.  Adjust your hips to a neutral position to alleviate any arching in your lower back.  Place the band across your hipbones.  Hold the band down with hands along the sides of your body.  Contract your abs and squeeze your glutes to lift your hips up off the ground.  Stop when your thighs, hips and stomach are in a straight line.  Lower you hips back down to the ground. 

Start with one set of 15 repetitions.  Work on increasing to 25 repetitions and doing two to three.  Another variation of this exercise is to hold the hip bridge position.  Start with a 30 second hold and work up to holding for 60 seconds.

Study review: cerivastatin

Study review: cerivastatin

I'd like to start an occasional series of blog posts on The Heart Scan Blog in which I review studies relevant to the whole heart scan score reversal experience.

In a previous post, Don't be satisfied with "deceleration,"I discussed the BELLES Trial (Beyond Endorsed Lipid Lowering with EBT Scanning (BELLES)), in which either atorvastatin (Lipitor), 80 mg, or pravastatin (Pravachol),40 mg, was given to 615 women. Both groups showed an average of 15% annual plaque growth, regardless of which agent was taken and regardless of the amount of LDL cholesterol reduction.

I cited another study in which 471 participants received either Lipitor, 80 mg, or Lipitor, 10 mg. The rate of annual score increase was 25-27%, regardless of drug dose or LDL lowering.

Here's yet another study, a small German experience in 66 patients, with a curious design and using the now-defunct statin drug, cerivastatin (Bayccol, pulled in 2001, nearly simultaneous with the publication of this study, due to greater risk of muscle damage, particularly when used in combination with gemfibrozil). Achenbach et al in Influence of lipid-lowering therapy on the progression of coronary artery calcification: A prospective evaluation reported on this trial in which all participants underwent heart scanning to obtain a heart scan score; no treatment was initiated based on the score. A second scan was obtained after the no treatment period, followed by treatment with cerivastatin, 0.3 mg per day. A third scan was finally obtained.

In year one without treatment, the average increase in heart scan scores was 25%. In year two with cerivastatin, the average increase in heart scan score was 8.8%. In 32 participants who achieved LDL<100 mg/dl on the drug, there was an average modest reduction in heart scan scores of 3.7% (i.e., -3.7%).

Now, that was eye-opening. Why did this small study achieve such startlingly different results from the other two studies that showed relentless progression despite even high doses of Lipitor? That remains unanswered. Was cerivastatin unique among statins? Did the unique two-phase trial design somehow change the outcome by triggering participants to change lifestyle habits after their first scan (since most exhibited an increase in score; they were not "blinded" to their scores). Those questions will remain unanswered, since the drug has been made unavailable. This smal l study had actually been intended to be larger, but was prematurely terminated because of cerivastatin's withdrawal.

This experience is unique, as you can see, compared to the two other studies. But it was also smaller. The results are also different than what I have seen in day-to-day practice when I've seen people treated with statin drugs alone (not cerivastatin, of course): rarely do heart scan scores stop increasing. While slowing does usually occur (18-24% per year rates of annual score increase are very common in people who do nothing but take a statin drug and make modest lifestyle changes), I have personally seen only two people stop their score with this strategy alone. Nobody has ever dropped their score taking a statin alone, in my experience.

You can also see the nature of clinical studies: single or limited interventions instituted in order to control for unexpected or complex effects. If three different treatments are used, then what desirable or undesirable effects, or lack of an effect, is due to which treatment agent?

My experience is that no single treatment stops or reduces heart scan scores. It requires a more rational effort that includes 1) identification of all causes of coronary plaque (e.g., low HDL, high triglycerides, Lp(a), small LDL, deficiency of vitamin D, etc, none of which are substantially affected by statin drugs), and 2) correction of all causes. That simple concept has served us well.

Comments (10) -

  • G

    11/27/2007 3:21:00 AM |

    Baychol ('gorilla'-statin when it came out) had a halogenated side group, which means biologically, this gave it 'super' powers.  Other drugs with halogens are also stronger as well (ie topical steroid Clobetasol). Unfortunately, Baychol also had 'super' strong side effects as well! including death from rhabodmyolysis (breakdown of muscle fibers which then leads to 'clogging up' the kidneys when the myoglobins are released into the blood stream, leading to multiple organ failure). Car accident, trauma and marathon runners can get the condition as well.
    I like your scientific method of accurately assessing various dysfunctions of the lipoprotein patterns and correcting with modifications in various strategies (D3, B3, monounsaturated nut oils, etc). Tying this in with tracking the size of shrinking calcium deposits in plaque make a lot of sense (and of course backed up with data, like the one you just posted!)...

    BTW, with erectile dysfunction associated with atherosclerosis, do you also see symptom reversal with the TYP plan? at what level of CAC reversal?  Do you see less use of Viagra later?
    Do you have a cure for white hair too (* ha ha haaaa *)? Global warming?  Amazon de-forestation? You're so humble!
    THANK YOU! G

  • Dr. Davis

    11/27/2007 12:12:00 PM |

    Hi, G--

    As always, thanks for the insights.

    Because 99% of the people who participate in the program begin with asymptomatic coronary plaque, it's not possible to say if symptoms are relieved. The occasional person who chooses this program but has anginal chest pain has indeed experienced complete elimination of symptoms.

    Re: erectile dysfunction. Also, no systematic tracking, so I don't know. Also, I have to admit not purposefully looking for it in men well into the program. But a great thought! It would indeed make sense that restoration of endothelial function and erectile capacity would accompany plaque control and/regression.

  • Anonymous

    11/27/2007 6:00:00 PM |

    Geez Doc, I wish you would have put the last paragraph first on your Blog. I was just about to throw up my hands in despair and call in for a double cheese all meat pizza on wheat, thinking all was lost. I was greatly releived to see I might still make it a while with low dose(10mg)lipitor, 1500 Niacin, Aspirin, and 2000IU D3. With exercise & diet I have worked hard to get LDL,Trigs,LP(a) all in the 30,s. With HDL at 68 I now see hope...don't do that again please!  Over&Out

  • Dr. Davis

    11/27/2007 10:39:00 PM |

    Well, my motivation for posting these occasional summaries of prior clinical studies is to provide, bit by bit, some of the rationale behind the Track Your Plaque program and to show why the simple-minded "take your statin and shut up" approach simply doesn't work.

  • G

    11/28/2007 11:19:00 PM |

    Theoretically, ED and peripheral vascular disease should regress ('cured' perhaps?) if sufficient plaque reversal occurred and original blood flow were restored... wouldn't you think?  ED is frequently common in T2DM and pre-CAD (I made that up) individuals.

    I customarily ask about ED because I use it as a motivating 'factor' in my strategy to get individuals to comply with changes to improve T2DM (yes, I just gave all my secrets now!).  You'd be surprised how effective this strategy is (of course only men -- I use a diff one for females)! Often people will not make necessary changes for 'health' reasons as you know.  The justifications are typically everything-but!  

    You know, I can tell that you're not in the business of selling books, eh?  You're strength is as an innovator imparting knowledge/power...saving lives... preventing unnecessary tragedies...  (THANK YOU FOR ALL YOU DO!)  if you notice improvement in ED, I'd suggest you change your book title to... you know to reach greater target audiences! (well, you'll get the men then you'll have to trust they'll share with their partners)
    'TYP -- Reverses ED and Heart Disease'
    'Don't Live with ED or Coronary Heart Disease'
    'Erectile Dysfunction can be erased, just like your CAD'
    'Better in bed, greater longevity'

    *ha haa haaa* i'm j/k... who is your marketing person?!! not very sexy or splashy... (pardon, if it is you!)

  • bobb

    11/30/2007 6:05:00 AM |

    Dr Davis,

    Two years ago my calcium score was 145.  I am 58 and my score is 294!
    I am very fit, work out 4 times a week with weights and cardio and have for years.  I take 80 mg of vitorin, fish oil, folic acid, nacin, and 2 baby asprin a day. My cholesterol is 142, Hdl 79, LDL 54 and triglycerides 47!  I am 5 9 and 165 lb.  

    Given this I can not seem to stop the increases in calcium.  What else can I do.

    Bill Blanchet is my Doctor!

    Thanks!!

  • Dr. Davis

    11/30/2007 12:38:00 PM |

    Bobb--

    Clearly you can get no more benefit out of squeezing more out of  cholesterol values. I would propose that you and Dr. Blanchet (a refreshingly open-minded physician who I'm going to invite to become a panel member on Track Your Plaque) consider several issues:

    1) Have all causes beyond cholesterol (HDL, LDL, etc.) been identified?

    2) Have you addressed vitamin D? Vitamin D is a huge effect.

    I would invite you to look at our website, www.trackyourplaque.com, for much more information. There is no 10 cent answer to your question. A comprehensive approach that corrects all causes is usually necessary.

  • Neelesh

    12/8/2007 4:30:00 AM |

    I accidentally bumped in to this study about the connection between vitamin D3 and ApoA-I, observing that ApoA-I levels are reduced by Vitamin D3.

    http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=pubmed&dopt=AbstractPlus&list_uids=16236546

    As far as I know, ApoA-I is a good lipoprotein.

    I tried to find some more material on this topic, but to no avail.

    Is this something that you have seen, Dr Davis?

    Thanks!
    -Neelesh
    http://www.recoverytrail.com/blog/

  • Dr. Davis

    12/8/2007 2:00:00 PM |

    Hi, Neeleesh--

    I don't know what to make of this study. It is clearly counter to what I am seeing in real live humans.

    I see the total HDL and the large HDL subclass (richer in ApoA1) increase, often substantially. So I see the exact opposite.

    My observations on this phenomena are informal. Formalizing this observation is part of a future research project.

  • buy jeans

    11/2/2010 8:22:46 PM |

    Those questions will remain unanswered, since the drug has been made unavailable. This smal l study had actually been intended to be larger, but was prematurely terminated because of cerivastatin's withdrawal.

Loading
Genetic vs. lifestyle small LDL

Genetic vs. lifestyle small LDL

Let me explain what I mean by "genetic small LDL." I think it helps to illustrate with two common examples.

Ollie is 50 years old, 5 ft 10 inches tall, and weighs 253 lbs. BMI = 36.4 (obese). Starting lipoproteins (NMR):

LDL particle number 2310 nmol/L
Small LDL: 1893 nmol/L
(1893/2310 = 81.9% of total, a severe small LDL pattern)


Stan is 50 years old, also, 5 ft 10 inches tall, and weighs 148 lbs. BMI = 21.3. Starting lipoproteins:

LDL particle number 1424 nmol/L
Small LDL 1288 nmol/L
(1288/1424 = 90.4% of total, also severe)


Both Ollie and Stan go on the New Track Your Plaque diet and eliminate wheat, cornstarch, and sugars, while increasing oils, meats and fish, unlimited raw nuts, and vegetables. They add fish oil and vitamin D and achieve perfect levels of both. Six months later, Ollie has lost 55 lbs, Stan has lost 4 lbs. A second round of lipoproteins:

Ollie:

LDL particle number 1810 nmol/L
Small LDL: 193 nmol/L
(193/1810 = 10.6% of total)


Stan:

LDL particle number 1113 nmol/L
Small LDL 729 nmool/L
(729/1113 = 65.4% of total)


Ollie has reduced, nearly eliminated, small LDL through elimination of wheat, cornstarch, and sugars, along with weight loss, fish oil, and vitamin D.

Stan, beginning at a much more favorable weight, reduced both total and small LDL with the same efforts, but retains a substantial proportion (65.4%) of small LDL.

Stan's pattern is what I call "genetic small LDL." Of course, this is a presumptive designation, since we've not identified the specific gene(s) that allow this (e.g., gene for variants of cholesteryl ester transfer protein, hepatic lipase, lipoprotein lipase, and others). But it is such a sharp distinction that I am convinced that people like Stan have this persistent pattern as a genetically-determined trait.

Comments (59) -

  • Onschedule

    2/18/2010 8:25:54 PM |

    Your blog entry appears to have been truncated.

  • Anonymous

    2/18/2010 8:29:46 PM |

    How are Stan's blood sugars?

  • zach

    2/18/2010 8:59:48 PM |

    Sounds like Stan is screwed. Of course, there may be other factors mitigating his lipid pattern because he avoids the neolithic agents. Stan would be more susceptible to heart disease than ollie on the SAD, but not when they both have good diets?

  • Jeff

    2/18/2010 10:23:31 PM |

    Is it possible that a different diet might work for Stan? I don't know what it would be, I just wonder if it's possible.

  • Kurt G. Harris MD

    2/18/2010 10:29:07 PM |

    So Ollie and Stan BOTH show substantial improvement on their LC diets.

    The difference between them may well be due to genetics, but where is the evidence that Stan needs to avoid saturated fat?

    Did you advise Stan to increase sat fat and then watch his sdLDL get worse?

    If they accomplished this with "oils" at the expense of saturated fats (oils are liquid due to the paucity of saturated fats in them), then it looks like they both have a saturated fat deficiency, and one could speculate that Stan is even more deficient than Ollie.

    Swap out the nasty oils for more butter and beef fat and coconut fat and maybe Ollie will have sdLDL of 0 (like I do on 35% of calories from sat fat) and Stan will improve even further.

  • Peter

    2/18/2010 10:44:33 PM |

    Hi Dr Davis,

    You describe a fascinating scenario.

    Ollie has clearly lost weight. He has lost 55 lb in 6 months. That is nearly 10 pounds of "lard-equivalents" each month. This has not evaporated. It is exactly what he has been running his metabolism on. Whatever nuts and vegetables he has eaten can have been nothing in comparison to the 4 times half pound blocks of lard he has "eaten" from his own adipose tissue, every week. Result: Metabolism runs on lard and sdLDL plummet.

    Stan has lost minimal weight so has run his metabolism on  his food alone. If this is low in lard he may well be running his metabolism on vegetable derived carbohydrate and nut derived omega 6 PUFA. It's possible he has NOT been eating 2lb of lard a week in his diet, because obviously this might raise his LDL. So he has NOT used lard to fuel his metabolism, he has used nuts and vegetables when Ollie has used lard from his adipose stores.

    Before I would blame genetics I would get rid of the nuts and unlimited vegetables from Stan's diet and replace them with exactly the same the adipose tissue derived fuel that Ollie was using. If Stan cannot spare it from his butt (he certainly cannot at BMI 21), it's going to have to go on his plate. Two pounds of lard a week.

    Then compare sdLDL values, when you have similar metabolic situations... Until then Stan just has nut and vegetable poisoning showing as sdLDL.

    There do not have to be any genetics involved. There might be, but let's keep it simple for the time being... Ollie is on lard while he is losing weight. Mimic that.

    Peter

  • Sue

    2/18/2010 11:16:15 PM |

    Stan did improve.  Maybe he will improve further, the longer on diet?

  • Anonymous

    2/18/2010 11:52:16 PM |

    I think it's somewhat telling that you advise your patients to eat "oils."  What kind of "oils" are they eating?  Why are your patients eating unlimited nuts?

    Until you get off the Omega-6-loaded "heatlhy" polyunstaturated fats bandwagon, it's hard to take your clinical observations on "fats" very seriously.

  • stcrim

    2/19/2010 12:15:07 AM |

    Dr. Davis,

    Help me understand the part about not eliminating meats or fats.  First, here is my blood work 15 days apart.

    Total cholesterol 295 - 15 days later 156
    LDL 200 - 15 days later 102
    HDL   46 - 15 days later  32  (have added 1500mg of niacin since then)
    Triglycerides   242 - 15 days later 109
    VLDL  49 - 15 days later 22
    Vitamin D was 28 – 15 days later it’s 56 (using 10,000 of Carlson’s D3)

    FYI my heart scan was 899 (54 year old male)

    I started on all the main nutrients you recommend here plus a few.  I dropped dairy like a hot potato including 6 or more ounces of cheese a day.  During those 15 days I ate only plant based foods (have since added some salmon and egg whites)

    The only oil I use now (sparingly) is olive.  I have a couple of gallons of coconut oil I assumed would have to be tossed sooner or later.

    Guess you could say I became fat paranoid and downright phobic about any saturated fat.

    Am I understanding I could add back Grass-fed beef (omega-3) pastured chicken and Omega-3 whole eggs?  Coconut oil?   If so, is there some safe percentage of a person’s diet to include those proteins/fats?

    By the way, my doctor wouldn’t let me out of his office without a copy of your book.  He’s one in a million as are you!

    Steve

  • Daddy

    2/19/2010 1:05:49 AM |

    Doc, would you say family history could be a clue towards small-particle tendencies?   I have zero family members with heart issues yet I was given pause by your recent post on saturated fats having a disproportionate affect on these genetically challenged folks.  I ask because I eat a ton of rib eyes and bacon.

  • Dr. William Davis

    2/19/2010 3:08:19 AM |

    I have indeed had many people with presumed "genetic small LDL" load their diets with oils and fats with only minor improvement. Loaded with saturated fat, however, and there seems to be deterioration.

    I know this flies in the face of the "saturated fat is great" dogma, but I don't make this stuff up. Just as I don't make up the deterioration of postprandial triglycerides and chylomicron remnant effect when saturated fats are loaded heavily in the diet.

    The persistence of small LDL is also long-term, i.e., it persists for years despite continuing efforts.

  • Dr. William Davis

    2/19/2010 3:09:48 AM |

    Oils = olive oil, flaxseed oil, canola oil (yes, yes, I know), avocado, almond, oils from raw nuts and meats.

    No polyunsaturates here. You've go the wrong guy.

  • Richard A.

    2/19/2010 3:41:23 AM |

    On Doctor's orders, Ollie did indeed lose a massive amount of weight.
    http://www.youtube.com/watch?v=IYAeYj8-G4w

  • LynP

    2/19/2010 3:41:52 AM |

    @Peter, fascinating...eat lard when slim in attempt to reduce sdLDL.  Doc D thanks for 'splaining 'genetic' tendency to sdLDL & why numbers not reduced on sat fat & only reduced mildly on mono sats.  Great info guys!

  • Kurt G. Harris MD

    2/19/2010 3:52:12 AM |

    "Oils = olive oil, flaxseed oil, canola oil (yes, yes, I know), avocado, almond, oils from raw nuts and meats.

    No polyunsaturates here. You've got the wrong guy."

    But Dr. Davis, those all chock full of PUFAs

    Linseed oil (flax oil) is 71% LA and ALA

    Rapeseed oil (Canola oil) is 33%  LA and ALA

    Almond oil is about 25% PUFA

    Even olive oil can be up to 20% PUFA

    And all of these are mostly Linoleic acid.

    All best left as industrial lubricants and paint additives rather than eaten.

  • LeenaS

    2/19/2010 4:10:32 AM |

    So, you have a fat guy, who has been living on (his own) saturated animal fats, and he has improved a lot.

    Then you have a skinny guy, who has been living on "healthy vegetable fats" with surprisingly much LA in them, and he has not improved that much.

    So, it seems to tell that without saturated fats LDL improvement is much harder in LC, to say it kindly.

    And it sounds as if butter and saturated animal fats would be advantageous for the latter guy, too. Have they ever tried this, under your coucelling?

    With regards,
    LeenaS

  • Anonymous

    2/19/2010 4:30:07 AM |

    Dr. Davis,

    While body composition certainly isn't a prerequisite for being part of a classic comedy team, I couldn't help but notice that Stan had the makings of a skinny-fat bean pole checking in at 5' 10" and only 148 pounds. Those stats make him sound like a diehard distance runner or a chain smoker.

    While it was clearly just for illustrative purposes, I couldn't help but think that, if "Stan" exercises at all, he must not be exerting himself very much. I'm not advocating that every older gentleman suddenly attempt to impersonate Mr. Olympia, but I have to wonder seeing such a lightweight. That's not to say that I think sufficiently intense exercise would remove the problem that is genetically-based small LDL, but it is enough to make me raise an eyebrow when I see that type of weight for a male listed as 5'10".

  • Anonymous

    2/19/2010 4:32:12 AM |

    Dr. Davis,

    Would a take-home point simply be to let the numbers from proper testing be the guide versus what we "think" is right based upon generally-sound dietary advice that may apply to many, but not all, situations?

    Bill Lindvall

  • Anonymous

    2/19/2010 7:25:27 AM |

    Olive oil is monounsaturated but flaxseed oil, canola oil, avocado oil, almond oil, and oils from raw nuts are all polyunsaturated oils!  Yes, flax oil is omega 3 and canola has more omega 3 than omega 6, but both omega 3 and omega 6 are polyunsaturated.

  • Sue

    2/19/2010 8:10:06 AM |

    Do you know how much saturated fat was eaten?

  • Sue

    2/19/2010 8:28:08 AM |

    Maybe too much mono-unsaturates?

  • Anonymous

    2/19/2010 11:18:48 AM |

    In another post, you said that blood sugars parallel small LDL.  Do Stan's blood sugars follow the pattern you would predict for someone with a lot of small LDL?

    http://heartscanblog.blogspot.com/2009/12/to-track-small-ldl-track-blood-sugar.html

  • lightcan

    2/19/2010 12:46:27 PM |

    No polyunsaturates?
    Because olive, flax, canola oils, nuts have no polyunsaturated fats?
    I found something different.
    Even avocados have 10 % PUFAs.
    http://curezone.com/foods/fatspercent.asp

  • Anonymous

    2/19/2010 2:01:52 PM |

    So what about epigenetics? Any way to modify this unknown gene or set of genes?  Pomegranate, etc?

  • Adolfo David

    2/19/2010 2:27:14 PM |

    Please guys, find so other monounsaturated (MUFA) fats with less PUFA..

    I eat almonds, walnuts, extra virgin olive oil as fats and my diet is low in Omega 6, 10% or 20% of Omega 6 PUFA is nothing compared with 70 or 85% of MUFA.

    My experience taking a lot of saturated fats with low carbs is bad, I prefer a diet high in MUFA and low carb.

  • Anonymous

    2/19/2010 3:18:19 PM |

    Maybe the mental stress of having to worry about what to eat is a factor.
    I do find my self stressing about that often and wonder if just enjoying the food would give me a longer nicer life quality which is in then end what matters.

    Which reminds me somehting I have never read in this blog is about cortisol.
    Have you ever tracked cortisol levels in your patients?

  • ET

    2/19/2010 5:37:36 PM |

    A yea ago, i went off niacin and zocor due to elevated liver enzymes.  Before I restarted niacin, an NMR lipoprotein analysis showed:
    LDL particle number - 2197
    Small LDL-P - 1614
    LDL Particle size - 20.3
    Saturated fat (% of calories) - 21%

    Six months later, after radically increasing the amount of coconut oil I consumed, the results were:
    LDL particle number - 896
    Small LDL-P - 466
    LDL Particle size - 21.6
    Saturated fat (% of calories) - 45%


    Five months after that:
    LDL particle number - 946
    Small LDL-P - 120
    LDL Particle size - 21.1
    Saturated fat (% of calories) - 52%

    Carbohydrate consumption has held fairly steady at 10% of calories.

  • Vladimir

    2/19/2010 5:41:33 PM |

    I agree 100% with these comments.  Not a drop of dogma in them; pure science.  Yes, omega-6 is evil; avoid foods with any of it. No nuts, no seeds. Soy -- dangerous.  Milk -- cavemen didn't drink it and it's possibly dangerous too.  Vegetables -- no, no, goodness no, they're mostly made of dreaded carbohydrates, have little fat, an fiber isn't important!  Saturated fat?  I don't know about you, but I'm too scared to go hog wild on it.

    I know, I know!  Let's not eat at all.  That would drive small LDL to 0!  That would end heart disease -- and everything else -- in a flash.

    Or, just maybe, we could be moderate and sensible.  Take some fish oil to balance whatever omega-6 you get in the olive & canola oils and in nuts.  Eat some, but not too much, animal protein, and mostly fish and lean meats at that, because saturated fat isn't out of the woods yet. (Just because saturated fat's risks have been over-hyped doesn't mean that we should eat all meat all the time, because the evidence is not in yet that saturated fat is a panacea.) Eat some, but not tons, of fruits, because they have antioxidants.  And for goodness sake, eat your vegatables -- lots of them, and all kinds of them -- because your mother was right to make sit at the table until you finished them.

  • Anonymous

    2/19/2010 5:51:09 PM |

    "I couldn't help but notice that Stan had the makings of a skinny-fat bean pole checking in at 5' 10" and only 148 pounds. Those stats make him sound like a diehard distance runner or a chain smoker."

    I'm 5'10" and under 145 lbs., and I'm neither.

  • Anonymous

    2/19/2010 6:15:07 PM |

    Kurt G & Lightcan,

    I think when Dr. D said no "No polyunsaturates here. You've got the wrong guy."...he probably meant to say "No (high omega 6) polyunsaturates here.".

    Lastly...I have a question for Dr. Davis:

    Dr. D., is this "genetic small LDL" the same as when you talked about people with ApoE4 in your November 17, 2008 post? If so, do you think it would be helpful to test ApoE before experimenting with diet??

    Thanx!

    John M.

  • zach

    2/19/2010 6:20:59 PM |

    Aren't most nuts full of N-6 PUFA?

  • Rainer

    2/19/2010 6:23:53 PM |

    Hi Dr. Davis,

    and what is happend with the triclycerides of Stan. Are they high too?

  • Anonymous

    2/19/2010 7:14:40 PM |

    This is usually when the good doctor stops answering comments.

    Come on, Dr. D, prove me wrong!

  • Anonymous

    2/19/2010 7:24:49 PM |

    You have really great taste on catch article titles, even when you are not interested in this topic you push to read it

  • Donny

    2/19/2010 7:33:02 PM |

    I'm going to steal a page from T. Colin Campbell here (yechh!)

    Dr Davis, you say that

    "I have indeed had many people with presumed "genetic small LDL" load their diets with oils and fats with only minor improvement. Loaded with saturated fat, however, and there seems to be deterioration."

    Campbell makes the contention that studies showing that low saturated fat intake is beneficial (never mind whether they actually exist or not, just for the sake of argument here) might actually have nothing to do with the type of fat in the diet, and everything to do with the protein which accompanies the fat; most animal fat in our culture comes attached to meat (protein.)

    Adding plant fats and oils to the diet, including nuts, would tend to increase total percentage fat in the diet at the expense of both carbohydrate and protein. Adding animal fat, attached to meat might increase total protein percentage even as it increases total saturated fat.

    Understand, I'm not saying "protein bad," I guess I'm just echoing Peter, really, Stan may be trying to live off of a protein/fat mix that's too rich in protein, entirely aside from the whole issue of saturation.

  • Jeanie Campbell

    2/19/2010 7:57:39 PM |

    Don't tell me no one picked up on the Laurel and Hardy reference! Brilliant!

  • Anonymous

    2/19/2010 10:16:49 PM |

    Could all you saturated fat mafia people please stop polluting the comments section?

  • Sue

    2/20/2010 12:48:15 AM |

    Maybe recommend Stan use only sat fats and no poly oils and then see if there is a change.

  • Anonymous

    2/20/2010 2:29:41 AM |

    Drs. Davis and Harris,

    Googlemaps indicate you two practice your medicinal arts about 154 miles away from each other.

    May I respectfully suggest a summit meeting in Manitowoc to resolve these matters?

  • Scott Miller

    2/20/2010 3:31:43 AM |

    Flax oil, canola oil, any nut oil (except macadamia nut oil), and all of those nuts -- these are all rich with polyunsaturated fats. I never eat these oils, and my Lp(a) is 2, as last measured a few months ago.

    I always recommend nuts as a very moderate snack because of their high PUFA content.  Macadamia nuts are the ONE exception, with a fatty acid profile similar to olive oil.  Basically, I never recommend any food with a PUFA content greater that 12 percent.  That means canola oil is right out!

    Dr. Davis, perhaps try putting a few of these presumed "genetic small LDL" people on a real low PUFA diet for a while (with more coconut oil and butter--but no nuts during this period) and see if there's improvement.

    I'd bet there is.  Nothing really to lose by giving this a shot.

    If it works to your satisfaction, I'll donate $1000 to your Track-the-Plaque program, or a charity of your choice.

  • Dr. William Davis

    2/20/2010 1:58:33 PM |

    Some other features of the presumptive "genetic small LDL" pattern:

    1) It occurs in the minority of people with small LDL, likely less than 20% of people who start with substantial small LDL.

    2) It is associated with insulin resistance and a tendency towards diabetes

    3) It can occur independent of ApoE genotype. However, if it occurs with ApoE2, it means a very potent carb-sensitivity/diabetic tendency.

    4) The "floor" of 600 nmol/L can be broken. We've had success achieving really low body weight and inconsistently with several supplements, e.g., phosphatidylcholine.

    This area is fascinating, though very poorly explored. "Genetic small LDL" is truly one of the problem areas in gaining control over heart disease risk.

  • Henry North London

    2/20/2010 2:23:56 PM |

    I currently consume coconut oil and butter  I do not use any lard or pufas  I consume a moderate amount of almonds a day ( nine) and some ground almonds as a meal replacement about 10-20gs as a meal about two or three times a week

    I eat avocados maybe twice a week  about two-three

    I have started to show my abdominal muscles after two months where before I looked as if I were pregnant of about a 5 month pregnancy

    I have dropped half a stone  My BP is controlled by a sartan

    I consume a moderate amount of frozen blueberries and raspberries May be about 1 kg of each a month

    or less

    I am living on saturated fat and loving it

    My body works better on it but then I have blood group B

    You have to eat right for your blood type perhaps?

  • Miki

    2/20/2010 3:17:30 PM |

    I would like to add support to Dr. Harris' hypothesis. LDL (no NMR in our country) and TG both rise on low carb, high sat fat diet. No weight problem ever. No high protein no high PUFA for me. Pre-diabetic fasting glucose (110-120). Only complication is I had my gallbladder removed (but my brother didn't). Will increase coconut oil and olive oil on account of double cream. Feel so good on low carb it can't be wrong. Also wonder if under healthy low carb diet LDL and TG have atherogenic effect (My calcium score is low)
    In summary I think Dr. Davis is onto something but I would love to know if LDL status corresponded to increased calcium score in the said patients.

  • Donny

    2/20/2010 3:41:44 PM |

    Choline deficiency can lessen hyperglycemia in rodents with fatty livers. Maybe the inconsistent effects of phosphatidylcholine have something to do with that?

    To the person who mentioned the saturated-fat mafia; we have limited information going in here. Trying to guess at alternate explanations isn't the same as insisting that saturated fat is good in all situations for everybody, no matter what. Proper skepticism demands that we question even the most respected sources.

  • Anonymous

    2/20/2010 8:12:29 PM |

    Dr. Davis, this recent article seems congruent with some of your observations:

    http://jn.nutrition.org/cgi/content/abstract/jn.109.115964v1

  • Anonymous

    2/20/2010 8:16:01 PM |

    To all these nutty omega-6 fatphobes - I eat lots of nuts of all sorts, probably 40% of calories, including... peanuts, which I am aware are a legume.  I have no small LDL, undetectable CRP, and lp(a) of 4, high hdl and low homocysteine, HbA1C of 5.2.

  • Anonymous

    2/20/2010 9:06:44 PM |

    Dr. Davis,
    You said "Some other features of the presumptive "genetic small LDL" pattern:

    1) It occurs in the minority of people with small LDL, likely less than 20% of people who start with substantial small LDL."


    So, based on a minority of people with small LDL, you are recommending the same diet to everyone?

  • Dr. William Davis

    2/21/2010 2:28:39 AM |

    Please don't misunderstand: I am NOT saying that saturated fat increases small LDL in most people.

    What I am suggesting is that there is a genetic minority in which saturated fat increases small LDL. These people seem to be the unusually slender, high HDL, low triglycerides, yet diabetes-prone who show apparently intractable small LDL.

    I don't know for a fact why this happens, but I speculate that it is a genetically-determined trait.

    This pattern responds best to a high-protein, high-fat, very low-carbohydrate diet. But saturated fat is the exception in this group.

  • Kurt G. Harris MD

    2/21/2010 3:25:37 AM |

    Hello Dr Davis

    I am only persisting in this as the implications might be important.

    I asked, "Did you advise Stan to increase sat fat and then watch his sdLDL get worse?"

    You later said, "Loaded with saturated fat, however, and there seems to be deterioration."  and ..

    "What I am suggesting is that there is a genetic minority in which saturated fat increases small LDL."

    and...

    "This pattern responds best to a high-protein, high-fat, very low-carbohydrate diet. But saturated fat is the exception in this group."

    Can I assume when you say "seems to be deterioration" and "there is a suggestion that saturated fat increases small LDL" and "saturated fat is the exception" that this is based on the observation of  serially increased sdLDL NMR values after increasing only saturated fat intake in these 100 or so patients?

    If this is what you have, serial NMRs that show increased sdLDL with increased saturated fat intake, why not say so explicitly?

    Or is it just a reasoned (perhaps correct, perhaps not) guess of what would happen to sdLDL in those 100 or so who have this presumed genetic pattern of persistent sdLDL?

  • Rick

    2/21/2010 3:24:07 PM |

    Dr. Davis wrote:

    "I know this flies in the face of the 'saturated fat is great' dogma, but I don't make this stuff up."


    The way that Peter described the scenario you presented, it seems to support the health benefits of saturated fat rather than deride them

    Ollie is mainlining saturated fat from his gut.  Stan is not.  Ollie's sdLDL drops like a rock.  Stan's doesn't.  

    It seems like if this phenomenon of high sdLDL specifically affects low BMI people, their lack of saturated fat intake, whether through their mouths or from their love handles, could be the culprit.

  • kilton9

    2/24/2010 10:45:35 PM |

    Dr. Harris,

    I'm a fan of your blog, but I can't help but notice that you have completely ignored Dr. Harris's questions in this entry as well as the other recent entry about saturdated fat and LDL.  I find his questions to be pertinent.

  • bovinedefenestration

    2/27/2010 7:26:50 AM |

    I'm actually a little surprised no one's brought up this blog, that indicates polyunsaturate consumption over 4% of calories can be detrimental:

    http://wholehealthsource.blogspot.com/2009/05/eicosanoids-and-ischemic-heart-diseas.html

    Eh. Took me long enough to find. At any rate, 10-20% polyunsaturates, especially if they come from omega-6, is a huge amount for a human.

    Imma going to go away and let you argue now.

  • Henry North London

    2/27/2010 7:07:21 PM |

    Hear Hear throwing cows out of windows...  It blows the polyunsaturates out  of the window

    I have the printout of the Rose et al Paper..

    Corn oil increased the death rate

  • Janet -Mich

    2/28/2010 11:16:20 PM |

    My family has a history of high colestral and plaque build-up in the blood.  Should I stay on my Lipator and stay on a low-carb diet ?  Your article brings up some red flags for me.  Maybe I should talk to my Doctor, but my low-carb friends tell me the doctor will tell me to get off the diet !  I would like some advice.

  • dining table

    7/9/2010 9:52:12 AM |

    How did that happen? Is it possible? Different diet will work to Stan? I am curious about that. I will visit this blog again. I am hoping for an update.

  • Derek Weiss

    8/4/2010 9:49:11 PM |

    Obviously another great blog about eating and living right, but at some point we have to take a step back and live.  Food avoidance and constant stressing about food seems it could negate any benefits of just eating a sensible, well balanced, moderately low carb diet.  

    To me, all these nutrition blogs are fun to read at work. But have you ever noticed the incredible difference in opinion from one to the next?  I take all that with a large grain of salt, pun intended.

    Oh my god, I ate a walnut, surely I will be in the cath lab tomorrow getting my LAD stented;)

    You might not find yourself in the cath lab from eating the random 1/2 cup of oatmeal, but you might find yourself there from stressing about it too much.

    Read all the blogs, use all the information to help guide you.  But don't get in line with the zombies and wander off the deep end too far.

    Just a thought.

  • Liz Stanley

    9/16/2010 8:32:32 PM |

    Here's a stumper. I just had my VAP done and the results surprised me. Some background: I'm not on any medication and never have been. Never had a weight problem, body fat below 20%. I exercise regularly (CrossFit 4x/week). Never smoked. Rarely drink. I eat mostly a primal diet w/plenty of grass-fed/organic/cage-free/wild-caught meat/fish and lots of fresh veggies. Some dairy, but only hormone and antibiotic free. Hardly any grains or processed foods. Low fasting blood sugar (76 as of two weeks ago.) Here are my VAP results:

    Total cholesterol: 200
    HDL : 79
    LDL: 106
    VLDL: 14
    Lp(a): 7
    Triglycerides: 43

    With all that I'd expect to have Pattern A LDL. Yet the VAP test says I have Pattern B! I'm not aware of any history of heart disease on either side of my family. But if it's true that my LDL is small and dense, all I can figure is that it must be genetic. I'm not really sure what to make of it! Any ideas?

  • Anonymous

    9/24/2010 10:26:37 PM |

    Liz Stanley - while my HDL and LDL aren't as good as yours (63 and 185 respectively), I also just received VAP results that stumped me for a similar reason.  I exercise frequently, am not overweight, don't smoke or drink, eat low carb, etc., yet I have pattern B as well.  To add to the confusion, my cCRP is 0.7, which my doctor said was excellent and basically renders my test results a wash as I have zero other risk factors.  I don't know what to make of any of this when you put it all together, and I stumbled upon this post because I'm hoping to find some answers online.

  • buy jeans

    11/3/2010 6:33:42 PM |

    While body composition certainly isn't a prerequisite for being part of a classic comedy team, I couldn't help but notice that Stan had the makings of a skinny-fat bean pole checking in at 5' 10" and only 148 pounds. Those stats make him sound like a diehard distance runner or a chain smoker.

Loading