Beware the "false positive" stress test

4. March 2007 William Davis (11)
There's a widely-known (among cardiologists) problem with nuclear stress tests. It's called the "false positive." (Nuclear stress tests are known as stress Cardiolites, stress thalliums, stress Myoviews, persantine stress tests, adenosine stress tests)

Stress tests, nuclear and otherwise, are helpful for identifying areas of poor blood flow. If an area of poor blood flow is detected and the area is substantial, then there may be greater risk of heart attack and other undesirable events in the relatively near future.

What "false positive" means is a stress test that shows an abnormality but it's not true--it is falsely abnormal. There are a number of reasons why this can happen. The problem is that this phenomenon is very common. Up to 20% of nuclear stress tests are false positives.

There are indeed situations where there may an abnormality and it is not clear whether it is true or false. This may lead to a justifiable heart catheterization or CT coronary angiogram. But, given the extraordinary number of false positives, there's a lot of gray in interpreting these tests. Hospital staff, in fact, call nuclear medicine "unclear" medicine. It's common knowledge that you can often see just about anything you want to see on a nuclear image of the heart. Abnormalities in the bottom of the heart, the "inferior" wall, are especially common due to the overlap of the diaphragm with the heart muscle, yielding the appearance of reduced blood flow. Defects in the front of the heart heart are common in females with large breasts for the same reasons.

The problem: The uncertainty inherent in nuclear stress tests opens the door to the unscrupulous or lazy practitioner. Any blip, tick, or imperfection on the nuclear images serve as carte blanche to drag you into the hospital for procedures.

This abusive practice is, in my experience, shockingly common for two reasons: 1) It pays better to do heart catheterizations, and 2) Defensive medicine.

What's the disincentive? Only doing the right thing and maintaining a clear conscience. Slim reasons for many of my colleagues--and a lot less money.

If you are without symptoms and feel fine, and a nuclear stress test is advised by your doctor, followed by a discussion of an abnormality, insist on a discussion of exactly what is abnormal, just how abnormal, and what the alternatives might be. If you receive unsatisfactory or incomplete answers despite your best effort, it's time for another opinion.

Don't neglect your magnesium

3. March 2007 William Davis (3)
Magnesium is kind of boring. So most people don't pay too much attention to it.

Magnesium can be important, however. I saw an interesting phenomenon recently. A type I diabetic patient of mine (that is, an adult who developed diabetes as a child), Mitch, was experiencing wide swings in blood sugar: low low's and very high high's (300-400 mg/dl). Mitch's magnesium was only marginally low at 2.0 mEq/L. (Ranges for normal magnesium blood levels are usually 1.3–2.1 mEq/L or 0.65–1.05 mmol/L.) Note that Mitch's blood levels fall within "normal." I do not agree with these "normal" ranges. I shoot for 2.1 to 2.4 mEq/L, which I think is the truly normal range.

In addition to eating plenty of raw nuts and green vegetables, Mitch began supplementing magnesium with magnesium citrate, 200 mg twice a day (our preferred supplement form). He reported that the wide swings in blood sugar were nearly eliminated.

Mitch's dramatic benefit is just a great illustration of how magnesium can help control blood sugar metabolism. A type I diabetic is more sensitive to the effects, but anyone with type II (adult) diabetes, metabolic syndrome, or just a slightly high blood sugar could benefit from magnesium supplementation.

There's a number of ways to accomplish getting sufficient magnesium in your daily regimen. Track Your Plaque members, Be sure to read:


Your water may be killing you at
http://www.cureality.com/library/fl_03-002magnesium.asp

Magnesium: Water to the rescue! at http://www.cureality.com/library/fl_03-010magnesium2.asp

Third heart scan a charm

1. March 2007 William Davis (0)
It struck me recently that, for many people, it's not the second but the third heart scan that more commonly shows a reduction in score.

I think this is because many people's reaction to their first heart scan is "This can't be. There's no way my arteries have that much plaque." They then follow a half-hearted program to correct their patterns.

When the second heart scan shows a significantly higher score, that really catches their attention. This is when they finally buckle down and give it their all.

Only the occasional person will, after the first heart scan, seize full control and take their program very seriously. These tend to be highly motivated people.

Don't feel too bad if your second heart scan score shows an increase. Look at it for what it represents: feedback on the adequacy of your program.

Metabolic syndrome--cured

27. February 2007 William Davis (0)
Peter started out at age 59 at 248 lbs, standing 6 ft tall (BMI = 33.6!).

Along with his weight, Peter had the entire panel of phenemena of the so-called "metabolic syndrome", or pre-diabetes:

--Triglycerides 238 mg/dl and associated with extremes of excess VLDL and IDL
--High blood pressure
--Blood sugar 115 mg/dl
--High c-reactive protein
--Small LDL particles 99% of total LDL

Interestingly, Peter's HDL was a surprisingly favorable 58 mg/dl (HDL is usually low in this syndrome). However, when broken down by size, he had nearly zero large, healthy HDL (sometimes called HDL2b). Though total HDL was favorable, most of it was simply ineffective.

Peter eliminated snacks and processed foods, particularly bread; increased his reliance on healthy oils and lean proteins; incorporated soy protein; increased vegetables. He added 30 minutes of a rapid walk on a treadmill every day. He added vitamin D to achieve a blood level of 50 ng/dml. He added a magnesium supplement.

Peter has lost 31 lbs. in the last year. Weight 207 lbs., BMI 28.1 (desirable <25). Blood sugar: 96 mg/dl; triglycerides: 56 mg/dl; HDL 71 mg/dl with 35% in the large fraction; small LDL 45% of total. Not perfect, but a damn site better.

Control of metabolic syndrome is an achievable goal for over 90% of people, just with these simple efforts. We haven't yet had a chance to assess the effect on the progression or regression of Peter's heart scan score, but he has, at the very least, spared himself a future of diabetes and all its complications.

Heart Scan Curiosities #6

27. February 2007 William Davis (0)















This is a "slice" from a normal heart scan in a 58 year old woman. Heart scan score zero. Look at the lungs, the dark areas left and right of the heart in the center. The lungs are also normal. Black represents normal density, healthy lung tissue. The white streaking is just normal lung blood vessels. This person doesn't smoke.


















This woman smokes a pack of cigarettes a day and has done so for 45 years ("45 pack-years"). She had a surprisingly low heart scan score (at age 64) of only 71, despite the smoking. However, look at this woman's lungs. It's a little tough to make out, since the computer graphics loses some of the resolution. But you can see the near absence of lung tissue on both sides. This is an advanced phase of the destructive lung disease, emphysema, from smoking. Even if she quit smoking today, the destroyed lung tissue never grows back. She literally has huge gaps or holes in her lungs where lung tissue used to be.

Smoking is among the most destructive, terrible things you can do to your body, short of swallowing strychnine or jumping off a building. Stay as far the heck away from cigarettes as you possibly can. If you are exposed to "secondary" smoke, insist that the person never smoke in your presence. It's not the smell that destroys your lungs or causes coronary plaque (though it is indeed foul), it's the actual smoke.

Should you become a vegetarian?

24. February 2007 William Davis (0)
Do you need to become a vegetarian in order to reduce your heart scan score?

No. Plain and simple. We’ve had many non-vegetarians drop their scores.

That said, are there still advantages to following a vegetarian diet, or some variation on the vegetarian theme?

Yes, there are. Let’s put aside the moral or religious arguments in favor of not eating animals—the need to eliminate killing animals for food, elimination of suffering common in modern livestock practices, Kosher considerations, etc. (Not that there aren’t real arguments here. Our focus for this conversation is not, however, the moral dilemma, but the health argument.)

Some of the most unhealthy people I’ve ever met, mostly males, are proud carnivores who boast of their prodigious capacities to eat meat. Unfortunately, it’s hard to tease out the ill-effects of excessive meat eating, since these same men also tend to be substantially overweight, smoke, drink excessively, and fail to get exercise unless their job is physically demanding. You know the type.

What advantages does a vegetarian obtain? A number of studies have suggested that the reduced saturated fat, reduced exposure to parasites, as well as reduced exposure to the antibiotics and hormones now used routinely in livestock-raising practices, do indeed provide benefits to the vegetarian. Thus, vegetarians tend to be substantially thinner, experience less bowel cancer, have less diabetes and heart disease, and live longer.

(If you are interested in reading or seeing more about just how inhumane modern livestock practices are, take a look at the video, "Meet Your Meat" at meat.org. Be sure not to view this after dinner.)

Of course, some of the disadvantages of eating animal products diminish when free-range livestock are eaten, i.e., livestock not raised in the inhumane cramped, filthy conditions of livestock factories, but in the open, grazing or rooting freely. These animals tend to have different fat compositions and taste different.

The advantages of vegetarianism, however, have blurred in recent years, since many so-called vegetarians have failed to maintain the distinction between naturally-occurring foods and processed foods. So, Ritz Crackers, Oreo cookies, whole wheat bread, and Raisin Bran fit into a vegetarian program, but they’re awful for your health. I’ll occasionally meet a self-proclaimed vegetarian who looks every bit as unhealthy as a conventionally eating American, that is, overweight, pre-diabetic person with a developing heart scan score.

So it is not necessary to be vegetarian to reduce your score. You might consider vegetarianism for other reasons, such as moral considerations, or to reduce your risk for cancer. But it is not necessary to drop your heart scan score. A non-processed food diet? Now that's is worth giving serious consideration.

Let's make it a lot easier

24. February 2007 William Davis (0)
The American Heart Association just released a new set of consensus guidelines on heart disease prevention in women: Evidence-Based Guidelines for Cardiovascular Disease Prevention in Women: 2007 Update

For those of you following the Heart Scan Blog and the Track Your Plaque program, there will be little new in the guidelines. In fact, you'll wonder if the date on the front of the report should be 1987, rather than 2007. Did you know that you should exercise and eat healthy?

Take a look at the list of risk factors for coronary vascular disease (CVD) listed in the report:

Major risk factors for CVD, including:
Cigarette smoking
Poor diet
Physical inactivity
Obesity, especially central adiposity
Family history of premature CVD (CVD at <55>

Progress: You'll notice that buried inside the list is "Evidence of subclinical vascular disease (e.g., coronary calcification)". Just a few short years ago that wouldn't have even been included.

The Track Your Plaque contention is that, for the great majority of women, this list could be shortened to one item: coronary calcification. As time goes on, the people who argue and draft these guidelines will come to the realization that coronary calcification is the disease--it's not a risk for the disease, a predictor of the disease. Coronary calcification is the disease itself. The other items on the list recede way into the background when you know whether or not coronary atherosclerosis is present, i.e., you know your heart scan score (of coronary calcium).

The report goes to say such things as taking a little bit of fish oil is a good idea, maintaining a normal blood pressure is desirable. . . yada yada yada. You've heard this all before.

A major part of the treatment guidelines are devoted to LDL cholesterol reduction with statin agents. You shouldn't be surprised. It's amazing what $22 billion dollars in revenues will buy.

A closing paragraph reads:

'Population-wide strategies are necessary to combat the
pandemic of CVD in women, because individually tailored
interventions alone are likely insufficient to maximally prevent
and control CVD. Public policy as an intervention to
reduce gender-based disparities in CVD preventive care and
improve cardiovascular outcomes among women must become
an integral strategy to reduce the global burden of
CVD.'

Say that again? If you understood that bit of gobbledygook, you're a lot smarter than me.

Don't look to the American Heart Association report for any new ideas. It reminds me of the politician who reminds everybody of what a devoted family man he is: It has nothing to do with his policies. It just makes him look good. If compared to prior report, the 2007 report does indeed represent progress--but just oh so little.

No wonder nobody talks about real prevention

23. February 2007 William Davis (0)
Take a look at this eye-opening statement taken from a well-written NY Times article about Dr. Arthur Agatston, the South Beach Diet and now South Beach Heart Program books:


'We have made major improvements in prevention,” Dr. Gregg W. Stone, the director of cardiovascular research at Columbia University, says. “But it’s difficult. It takes frequent visits, a close relationship between a physician and a patient and a very committed patient.'

Which is exactly the atmosphere Dr. Agatston’s practice tries to create. Nurses there give patients specific cholesterol goals to meet and help them deal with the side effects of the drugs they are taking. A nutritionist, Marie Almon, meets with patients frequently enough to discuss real-life issues like how to stick to a high-fiber Mediterranean diet even on a cruise or a business trip.

There is only one problem with this shining example of a medical practice: it is losing money.


From NY Times, January 24, 2007. What’s a Pound of Prevention Really Worth? (Find the full text at http://www.nytimes.com/2007/01/24/business/24leonhardt.html?ex=1172379600&en=4268a738e82857da&ei=5070.)

It gets at one of the fundamental reasons why your cardiologist will probably never talk to you about an intense approach to prevention: it doesn't pay. Because John Q. Cardiologist focuses, instead, on how to increase procedural volume, train how to put in the next best defibrillator, etc., there is little consciousness about preventive issues. Just the simple matter of taking fish oil causes their eyes to glaze over.

That's why the Track Your Plaque program exists: it is a portal for the kind of information you cannot get. Of course, you could read all the scientific studies, attempt years of trial and error, and try to gain a sense of how to do this yourself. Or you could follow this program. We are proud to not worry about generating procedural profits. We ar unbiased by drug or medical device money. We say exactly what we mean.

By the way, we are on a current push to really "beef-up" our online discussions via real-time chat. Long-term, we'd like to be able to offer chat with our staff many hours every day. Be patient. It will happen, but not today.

HDL and vitamin D

22. February 2007 William Davis (5)
I know of no published reports on this question, but I've now seen numerous people experience significant jumps in HDL with raising blood vitamin D to 25-OH-vitamin D3.

Last week, for example, I had a man who had struggled with raising HDL from a starting level of 28 mg/dl. On niacin, exercise, weight loss, fish oil, red wine, and cilostazol (a prescription agent that I use occasionally that raises HDL), his HDL rose to 41 mg/dl--better, but hardly to our goal.

I added vitamin D, 4000 units, and raised his 25-OH-vitamin D3 level from 22 ng/ml to 53 ng/ml. Next HDL: 73 mg/dl! Small LDL improves along with a rise in HDL.

Not everybody's response is this dramatic. I see more typical rises of 5 to 10 mg/dl every day. I'm uncertain of why the response is inconsistent, though people who begin with lower vitamin D levels seem to experience a larger HDL increase. I wonder if the partial normalization of insulin and glucose responses is at work, or some anti-inflammatory effect.

Vitamin D provides so many other benefits, as well as HDL-raising. I hope you've gone to the effort to have your blood level checked to determine your replacement need. If not, now's the time. February represents your nadir (lowest point) for 25-OH-vitamin D3 blood levels.

Even more Michael Pollan

20. February 2007 William Davis (0)
"Eat food. Not too much. Mostly plants.

That, more or less, is the short answer to the supposedly incredibly complicated and confusing question of what we humans should eat in order to be maximally healthy. I hate to give away the game right here at the beginning of a long essay, and I confess that I’m tempted to complicate matters in the interest of keeping things going for a few thousand more words. I’ll try to resist but will go ahead and add a couple more details to flesh out the advice. Like: A little meat won’t kill you, though it’s better approached as a side dish than as a main. And you’re much better off eating whole fresh foods than processed food products. That’s what I mean by the recommendation to eat “food.” Once, food was all you could eat, but today there are lots of other edible foodlike substances in the supermarket. These novel products of food science often come in packages festooned with health claims, which brings me to a related rule of thumb: if you’re concerned about your health, you should probably avoid food products that make health claims. Why? Because a health claim on a food product is a good indication that it’s not really food, and food is what you want to eat."

Michael Pollan, author of my latest favorite book, The Omnivore's Dilemma, wrote a wonderful piece for the New York Times entitled "Unhappy Meals". You can find the full text at http://www.nytimes.com/2007/01/28/magazine/28nutritionism.t.html?ex=1172120400&en=a78c20f4da0cdc7b&ei=5070. (Another favorite read of mine, The Fanatic Cook's Blog at , alerted me to Pollan's article. Incidentally, take a look at the Fanatic Cook's latest posts--very entertaining and informative. She's got incisive insight into foods as well as a great sense of humor.)

Pollan goes on to say that...

"...typical real food has more trouble competing under the rules of nutritionism, if only because something like a banana or an avocado can’t easily change its nutritional stripes (though rest assured the genetic engineers are hard at work on the problem). So far, at least, you can’t put oat bran in a banana. So depending on the reigning nutritional orthodoxy, the avocado might be either a high-fat food to be avoided (Old Think) or a food high in monounsaturated fat to be embraced (New Think). The fate of each whole food rises and falls with every change in the nutritional weather, while the processed foods are simply reformulated. That’s why when the Atkins mania hit the food industry, bread and pasta were given a quick redesign (dialing back the carbs; boosting the protein), while the poor unreconstructed potatoes and carrots were left out in the cold.

Of course it’s also a lot easier to slap a health claim on a box of sugary cereal than on a potato or carrot, with the perverse result that the most healthful foods in the supermarket sit there quietly in the produce section, silent as stroke victims, while a few aisles over, the Cocoa Puffs and Lucky Charms are screaming about their newfound whole-grain goodness."

Not everything Pollan says is new, but he says it so eloquently and cleverly that he's worth reading. If you haven't yet read Omnivore's Dilemma, or just want a condensed version of the book, the New York Times piece is a great piece of the world according to Michael Pollan.

The Track Your Plaque guide to getting grotesquely overweight

15. August 2006 William Davis (0)
If you'd like to gain huge quantities of weight, here's a number of helpful tips:

1) Follow the advice of food manufacturers and eat the products they label "healthy", or "heart healthy", or "part of a nutritious breakfast" etc., like Shredded Wheat cereal, pretzels ("a low-fat snack"!), low- or non-fat salad dressings.

2) Cut your morning calorie intake by skipping breakfast.

3) Hang around with other heavy people. They will confirm that it's okay to be overweight.

4) Call walking your dog "exercise".

5) Get a sedentary desk job. Use your swivel desk chair to scoot about whenever possible, rather than getting up to do things.

6) Say "I've worked hard all week long. Weekends are for relaxing, not for physical activities. I deserve a rest."

7) Eat foods without thinking about it: Eat chips while watching football, eat while on the phone, daydream over the sink.

8) Eat to provide comfort when stressed.

9) Eat foods that have sentimental value, whether or not they're good for you: Freshly-baked cakes that remind you of Mom, Pop Tarts that you used to carry in your lunchbox when you were a kid, hot dogs just like Dad would buy at the baseball stadium.

10) Cut back on sleep and generate insatiable starch cravings.

11) Stack your shelves at home with great variety. That way, you'll always have something to suit your mood.

12) Say to your spouse: "It's none of your damn business what I eat! I'm a grown man/woman!" Prove it by over-indulging in obviously unhealthy foods.

13) Tell yourself that you're just too busy to pay attention to food choices. Just grab whatever you can out of a convenience store or vending machine.

See, it's easy! And that just a start.

Of course, I don't really want you to do any of these things. But if you see yourself in any of the above, and you're struggling with weight, you should seriously rethink your approach.

Your heart scan is just a "false positive"

15. August 2006 William Davis (0)
I've seen this happen many times. Despite the great media exposure and the growing acceptance of my colleagues, heart scans still trigger wrong advice. I had another example in the office today.

Henry got a CT heart scan in 2004. His score: 574. In his mid-50s, this placed him in the 90th percentile, with a heart attack risk of 4% per year. Henry was advised to see a cardiologist.

The cardiologist advised Henry, "Oh, that's just a 'false positive'. It's not true. You don't have any heart disease. Sometimes calcium just accumulates on the outside of the arteries and gives you these misleading tests. I wish they'd stop doing them." He then proceeded to advise Henry that he needed a nuclear stress test every two years ($4000 each time, by the way). No attempt was made to question why his heart scan score was high, since the entire process was outright dismissed as nonsense.

I'm still shocked when I hear this, despite having heard these inane responses for the past decade. Of course, Henry's heart scan was not a false positive, it was a completely true positive. I'm grateful that nothing bad happened to Henry through two years of negligence, though his heart scan score is likely around 970, given the expected, untreated rate of increase of 30%.

The cardiologist did a grave disservice to Henry: He misled him due to his ignorance and lack of understanding. I wish Henry had asked the cardiologist whether he had read any of the thousands of studies now available validating CT heart scans. I doubt he's bothered to read more than the title. The cardiologist is lucky (as is Henry) that nothing bad happened in those two years.

Do false positives occur as the cardiologist suggested? They do, but they're very rare. There's a rare phenomenon of "medial calcification" that occurs in smokers and others, but it is quite unusual. >99% of the time, coronary calcium means you have coronary plaque--even if the doctor is too poorly informed to recognize it.

What's better than a heart scan?

13. August 2006 William Davis (0)

Do you know what's better than a heart scan?

Two heart scans. No other method can provide better feedback on the results of your program.

Say you've made efforts to correct high LDL; lost weight to raise HDL and reduce small LDL; added soluble fibers, nuts, and dramatically reduced wheat products; take fish oil, vitamin D, and follow a flavonoid-rich diet. Has it worked?

After a year or so of your program, that's when another heart scan can give you invaluable feedback on whether it's been successful. I tell my patients that it's relatively easy to correct lipid and lipoprotein abnormalities. The difficult part is to know when it's good enough. Is your LDL of 67 mg/dl and HDL of 50 mg/dl good enough? Another heart scan score is the best way I know of to find out.

Variation in plaque growth differs hugely from one person to another, even at equivalent lipoprotein values. Why? Lots of reasons. Humans are inconsistent day to day. Lipoproteins, being a snapshot in time and not a cumulative value, change somewhat from day to day. There's also the possibility of unmeasured, unrecognized factors that influence coronary plaque growth. We may not be smart enough to identify these hidden factors yet. But your heart scan score will incorporate the effects of these hidden factors.

Ideally, we aim for zero growth in plaque (no change in score) or a reduction. But, particularly in the first year, 10% or less plaque growth is still a good result that predicts much reduced risk of heart attack. More than 20% per year and your program needs more work--or else you know what's ahead.

Lipids are snapshots in time; heart scans are cumulative

12. August 2006 William Davis (0)
Let me paint a picture. It's fictional, though a very real portrait of how things truly happen in life.

Michael is an unsuspecting 40-year old man. He hasn't undergone any testing: no heart scan, no lipids or lipoproteins. But we have x-ray vision, and we can see what's going on inside of him. (We can't, of course, but we're just pretending.) Average build, average lifestyle habits, nothing extraordinary about him. His lipids/lipoproteins at age 40:

--LDL cholesterol 150 mg/dl
--HDL cholesterol 38 mg/dl
--Triglycerides 160 mg/dl
--Small LDL 70% of all LDL

At age 40, with this panel, his heart scan score is 100. That's high for a 40-year old male.

Fast forward 10 years. Michael is now 50 years old. Michael prides himself on the fact that, over the past 10 years, he's felt fine, hasn't gained a single pound, and remains as active at 50 as he did in 40. In other words, nothing has changed except that he's 10 years older. His lipids and lipoproteins:

--LDL cholesterol 150 mg/dl
--HDL cholesterol 38 mg/dl
--Triglycerides 160 mg/dl
--Small LDL 70% of all LDL

Some of you might correctly point out that just simple aging can cause some deterioration in lipids and lipoproteins, but we're going to ignore these relatively modest issues for now.)

Lipids and lipoproteins are, therefore, unchanged. Michael's heart scan score: 1380, or an approximate 30% annual increase in score. (Since Michael didn't know about his score, he took no corrective/preventive action.)

My point: If we were to make our judgment about Michael's heart disease risk by looking at lipids or lipoproteins, they would'nt tell us where he stood with regards to heart disease risk. His lipids and lipoproteins were, in fact, the same at age 50 as they were at age 40. That's because measures of risk like this are snapshots in time.

In contrast, the heart scan score reflects the cumulative effects of life and lipids/lipoproteins up until the day you got your scan.

Which measure do you think is a better gauge of heart attack risk? I think the answer's obvious.

11. August 2006 William Davis (0)
The recognition of the metabolic syndrome as a distinct collection of factors that raise heart disease risk has been a great step forward in helping us understand many of the causes behind heart disease.

Curiously, there's not complete agreement on precisely how to define metabolic syndrome. The American Heart Association and the National Heart, Lung, and Blood Institute issued a concensus statement in 2005 that "defined" metabolic syndrome as anyone having any 3 of the 5 following signs:





Waist size 40 inches or greater in men; 35 inches or greater in women

Triglycerides 150 mg/dL or greater (or treatment for high triglycerides)

HDL-C <40 mg/dL in men; <50 mg/dL in women (or treatment for reduced HDL-C)

Blood Pressure >130 mmHg systolic; or >85 mmHg diastolic (or drug treatment for hypertension)

Glucose (fasting) >100 mg/dL (or drug treatment for elevated glucose)


Using this definition, it has become clear that meeting these criteria triple your risk of heart attack.

But can you have the risk of metabolic syndrome even without meeting the criteria? What if your waste size (male) is, 36 inches, not the 40 inches required to meet that criterion; and your triglycerides are 160, but you meet none of the other requirements?

In our experience, you certainly can carry the same risk. Why? The crude criteria developed for the primary practitioner tries to employ pedestrian, everyday measures.

We see people every day who do not meet the criteria of the metabolic syndrome yet have hidden factors that still confer the same risk. This includes small LDL; a lack of healthy large HDL despite a normal total HDL; postprandial IDL; exercise-induced high blood pressure; and inflammation. These are all associated with the metabolic syndrome, too, but they are not part of the standard definition.

I take issue in particular with the waist requirement. This one measure has, in fact, gotten lots of press lately. Some people have even claimed that waist size is the only requirement necessary to diagnose metabolic syndrome.

Our experience is that features of the metabolic syndrome can occur at any waist size, though it increases in likelihood and severity the larger the waist size. I have seen hundreds of instances in which waist size was 32-38 inches in a male, far less than 35 inches in a female, yet small LDL is wildly out of control, IDL is sky high, and C-reactive protein is markedly increased. These people obtain substantial risk from these patterns, though they don't meet the standard definition.

To me, having to meet the waist requirement for recogition of metabolic syndrome is like finally accepting that you have breast cancer when you feel the two-inch mass in your breast--it's too late.

Recognize that the standard definition when you seen it is a crude tool meant for broad consumption. You and I can do far better.

What role DHEA?

9. August 2006 William Davis (2)



DHEA, the adrenal gland hormone, has suffered its share of ups and downs over the years.

Initially, DHEA was held up as the fountain of youth with hopes of turning back the clock 20 years. Such extravagant dreams have not held up. But DHEA can still be helpful for your program.

All of us had oodles of DHEA in our bodies when we were in our 20s and 30s. Gradually diminishing levels usually reach nearly blood levels of around zero by age 70.



In our heart disease prevention program, of course, we aim to stop or reduce your CT heart scan score. Does DHEA reduce your score? No, it most certainly does not. But it can be helpful for gaining control over some of the causes behind coronary plaque.

For instance, DHEA can:

--Help reduce abdominal fat and increase muscle mass (slightly)
--Provide more physical stamina.
--Boost mood.
--It may modestly reduce some of the phenomena associated with the metabolic syndrome (high blood pressure, high blood sugar, high insulin, low HDL, small LDL, etc.)

In my experience, people who feel better do better on their overall program. If you're always tired and run down and run out of steam by 3 pm, I won't see you riding your bicycle outdoors or at the aerobics class. But if you're bursting with energy until you put your head on the pillow, you're more inclined to walk, bike, dance, play with the kids, dance, take Tai Chi, etc.

Some downsides to DHEA: Some people experience aggression. Backing off on the dose usually relieves it. Also, sleeplessness. Taking your DHEA in the morning usually fixes it.



The dose is best tailored to your age and blood levels. People less than 40 years old should not take DHEA. The older you are, the higher the dose, though we rarely ever have to exceed 50 mg per day. If you've never had a blood level and your doctor refuses to obtain one, 25 mg per day is a reasonable dose (10-15 mg in women 40-50 years old). It's always best to discuss your supplement use, particularly agents like DHEA, with your doctor.

Track Your Plaque Members: Stay tuned to the www.cureality.com website for a Special Report more completely detailing the hows and whys behind DHEA.

Brainwashed!

9. August 2006 William Davis (0)
At a social gathering this weekend, as we humans like to do, someone asked me what I did for a living. I told him I was a cardiologist.

"What hospital do you work at?" he asked.

This is invariably the response I get whenever I tell people what I do. I wouldn't make much of it except that it happens just about every time.

This indicates to me just how successful hospitals, my colleagues, cardiac device manufacturers, and others supporting the status quo in heart care, have been in persuading us that the place for heart disease is the hospital--period.

Tense families, drama, high-tech...It all takes place in the hospital.

Yet the people destined to be the fodder for hospital heart care are presently well, mostly unaware of what the future holds. Also unaware that heart disease is readily, easily, inexpensively, and accurately identifiable. Ask anyone in the Track Your Plaque program who's had a CT heart scan.

We all need to rid ourselves of the idea that the hospital is the place for heart disease. If the coronary plaque behind heart attack is easy to detect and controllable, there's little or no need for the hospital for the vast majority of us.

In the majority of instances of coronary disease, the hospital should be the place for the non-compliant and the ill-informed, and not for those of us sufficiently motivated to know and do better. The formula is simple: 1) Quantify plaque with a CT heart scan, 2) Identify the causes, then 3) Correct the causes.

The Fanatic Cook: A fabulous Blog about food and nutrition

7. August 2006 William Davis (0)
I came across this Blog authored by a nutritionist when it was highlighted on Blogger as an interesting site:

The Fanatic Cook at http://fanaticcook.blogspot.com/

I was thoroughly impressed with the insightful and entertaining commentary. I'd highly recommend this site to you for reading on nutrition. In particular, her coenzyme Q10 column was exceptionally well written and clear.(http://fanaticcook.blogspot.com/2005/02/statins-and-not-well-publicized-side.html)

Also read her column, Super NonFoods at http://fanaticcook.blogspot.com/2005/07/super-nonfoods.html.

There's also oodles of recipes, all for the taking.

Eggs: Good, bad, or indifferent?

5. August 2006 William Davis (3)
Eggs have been in the center of the cholesterol controversy almost from the very start.

The traditional argument against eggs went that eggs, high in cholesterol (210-275 mg per egg)and with some saturated fat (1.5-2.5 grams per egg), raised blood cholesterol (and LDL). Out went the daily fried, scrambled, poached eggs that many Americans indulged in most mornings. (We replaced it with more breakfast cereals and other carbohydrate conveniences, then got enormously overweight.)





A large Harvard epidemiologic study in 1999 called this observation into question. They tracked the fate of 117,000 thousand people and then compared the rate of heart attack, death, and other cardiovascular events among various people correlated to the "dose" of eggs they ate. Egg intake varied from none to 7 or more per week. Lo and behold, people who ate more eggs appeared to not suffer more events.

This study, large and well-conducted by an internationally respected group of investigators, seem to reopen the gates for more egg consumption, though most Americans still consume eggs cautiously.

Deeper down in this study, however, was another observation: People with diabetes who ate 1 egg per day had double the risk of heart attack. Because this study was observational, no specific conclusion as to why could be drawn.

A new study conducted by a Brazilian group may shed some light. Healthy (non-diabetic) men were fed an emulsion of several eggs. Inclusion of plentiful yolks caused a dramatic slowing of fat clearance from the blood. Specifically, "chylomicron remnants" were abnormally persistent in the blood. Chylomicron remnants are potent causes of coronary plaque. (Chylomicron remnants can be measured fairly well by intermediate-density lipoprotein and VLDL by NMR, or IDL by VAP.)

Diabetics are know to have substantial disorders of after-meal fat clearance, including an excess of chylomicron remnants. Could the Brazilian observation be the explanation for the increased event rate in diabetics in the Harvard study? Interesting to speculate.

We continue to tell our patients that eating eggs in moderation is probably safe. After all, there are good things in eggs: the high protein in the egg white, lecithin in the yolk. It is the yolk's contents that are in question, not the white. Thus, you and I can eat all the egg whites (e.g., Egg Beaters) we want. It's the safety of yolks that are uncertain.

The abnormal after-eating effect suggested by the Brazilians opens up some very interesting questions and confirms that we should still be cautious in our intake of egg yolks. One yolk per day is clearly too much. What is safe? The exisitng information would suggest that, if you have diabetes, pre-diabetes, or a postprandial disorder (IDL, VLDL), you should minimize your egg yolk use, perhaps no more than 3 or so per week, preferably not all at one but spaced out to avoid the after-eating effect.

Others without postprandial disorders may safely eat more, perhaps 5 per week, but also not all at one but spaced out.

Track Your Plaque Members: Be sure to read our upcoming Special Report on Postprandial Disorders. It contains lots of info on what this important pattern is all about. Postprandial disorders are largely unexplored territory that hold great promise for tools to inhibit coronary plaque growth and drop your heart scan score. The Brazilian study is just one of many future studies that are likely to be released in future about this very fascinating area.




Hu FB, Stampfer MJ, Rimm EB, Manson JE, Ascherio A, Colditz GA, Rosner BA, Spiegelman D, Speizer FE, Sacks FM, Hennekens CH, Willett WC.A prospective study of egg consumption and risk of cardiovascular disease in men and women. JAMA 1999 Apr 21;281(15):1387-94.

Cesar TB, Oliveira MR, Mesquita CH, Maranhao RC. High cholesterol intake modifies chylomicron metabolism in normolipidemic young men. J Nutr. 2006 Apr;136(4):971-6.

Diabetes is Track Your Plaque's Kryptonite!

3. August 2006 William Davis (0)

If there's one thing I truly fear from a heart scan score reduction/coronary plaque regression standpoint, it's diabetes.

I saw a graphic illustration of this today. Roy came into the office after his 2nd heart scan. His first scan 14 months ago showed a score of 162. Roy started out weighing well over 300 lbs and with newly-diagnosed adult diabetes.

Roy put extraordinary effort into his program. He lost nearly 70 lbs by walking; cutting processed carbohydrates, greasy foods, and slashing overall calories. His lipoproteins, disastrous in the beginning, were falling into line, though HDL was still lagging in the low 40s, as Roy remains around 60 lbs overweight, even after the initial 70 lb loss.

Unfortunately, despite the huge loss in weight, Roy remains diabetic. On a drug called Actos, which enhances sensitivity to insulin, along with vitamin D to also enhance insulin response, his blood sugars remained in the overtly diabetic range.

Roy's repeat heart scan showed a score of 482--a tripling of his original score.

Obviously, major changes in Roy's program are going to be required to keep this rate of growth from continuing. But I tell Roy's story to illustrate the frightening power of diabetes to trigger coronary plaque growth.

Like Kryptonite to Superman (remember George Reeves crumbling and falling to his knees when the bad guys got a hold of some?), diabetes is the one thing I fear greatly when it comes to reducing your heart scan score. As you see with Roy's case, diabetes can be responsible for explosive plaque growth, more than anything else I know.

The best protection from diabetes is to never get it in the first place. (See my earlier Blog, "Diabetes is a choice you make".)
What increases blood sugar more than wheat?

What increases blood sugar more than wheat?

15. July 2010 William Davis (38)
Take a look at these glycemic indexes (GI):


White bread 69
Whole wheat bread 72
Sucrose 59
Mars bar 68
White rice 72
Brown rice 66


I've made issue in past of whole wheat's high GI--higher than white bread. Roughly in the same glycemic league as bread are shredded wheat cereal, brown rice, and a Mars candy bar.

With few exceptions, wheat products have among the highest GIs compared to the majority of other foods. For instance:


Kidney beans 29
Chick peas 36
Apple 39
Ice cream 36
Snickers Bar 40


Yes, by the crazy logic of glycemic index, Snickers is a low-glycemic index food.

While I do not believe that low GI makes a food good or desirable, since low GI foods still provoke high blood sugars, small LDL particles, trigger glycation, and other abnormal phenomena, they are clearly less obnoxious than the items in the first list.

Take a look at this list:

Cornflakes 80
Rice cakes 80
Rice Krispies 82
Rice pasta, 92
Instant potatoes 83
Tapioca 81



Starches that are dried and/or pulverized, such as cornstarch, potato starch, rice starch, and tapioca starch (cassava root) will increase blood sugar even more than wheat. Foods with these starches have GI's of 80-100.

Cornstarch, potato starch, rice starch, and tapioca starch: Sound familiar? These are the main starches used in "gluten-free" foods. A hint of the high GI behavior of these dried starches is seen in the GI for cornflakes of 80.

So remember: Wheat-free is not the same as gluten-free. Gluten-free identifies junk carbohydrates masquerading as healthy because they don't contain one unhealthy ingredient, i.e. wheat.
Tags :

Comments (38) -

  • Anonymous

    7/15/2010 3:20:49 PM |

    These are the reasons to go grain-free, except for flaxseed.

  • Suzan

    7/15/2010 3:46:32 PM |

    As a gluten intolerant person, I can say that those gluten-free foods make me ill. I favor a grain-free Primal diet.

  • Anonymous

    7/15/2010 3:48:19 PM |

    Is it also accurate to say that high glycemic index only applies to wheat, and not unrefined WHOLE wheat, or wheat KERNELS?

    Aaccording to this, wheat kernels's GI is less than 50:
    http://www.southbeach-diet-plan.com/glycemicfoodchart.htm

    Also, eating whole wheat makes you feel fuller longer, which is a benefit, no?

  • Peter

    7/15/2010 3:48:30 PM |

    I wonder why many traditional diets in Africa are mainly composed of starch, yet don't seem to lead to heart disease.  I 'm assuming manioc and other starches also raise their blood sugar, yet that doesn't translate into heart disease and diabetes.  anyone have a theory?

  • DrStrange

    7/15/2010 4:01:44 PM |

    "I wonder why many traditional diets in Africa are mainly composed of starch, yet don't seem to lead to heart disease. I 'm assuming manioc and other starches also raise their blood sugar, yet that doesn't translate into heart disease and diabetes. anyone have a theory?"

    There seems a stubborn tendency on this site to confound refined carbs ie flour products w/ intact, whole grain carbs.  They do behave differently in the body. Also, significant differences in some people's physiologies, individual, personal, differences that must be accounted for.  And probably most importantly, for the Africa etc question, total calorie intake is a huge factor.  If you eat more than your body needs, calories become excess blood sugar; spikes, triglycerides, etc.  US and western Europe, esp US, people just eat way to many calories because they are eating nutrient poor, manufactured, refined, imitation foods that do not satisfy the body's needs for nutrition in terms of micronutrients and oversupply calories.  If you only eat starches/carbs in the form of whole intact grains and starchy veg IN THE CONTEXT of a diet emphasizing micronutrient rich, nonstarchy veg, then you just will not have all the problems.

  • Jenny

    7/15/2010 5:47:17 PM |

    The glycemic index is a poor guide to carbohydrate impact because it is based on the fallacy that carbs that don't raise blood sugar at 1 hour after eating don't matter.

    They do.

    The carbs in many supposedly low glycemic foods WILL metabolise into glucose over a period of anywhere from 1.5 to 5 hours (Pasta) and when they do, they require insulin secretion to be dispersed.

    Also, "Glycemic Index" values for identical foods vary from study to study because the reading depends on the blood sugar status of the subjects used to test the foods. It is a junk measurement created by the food companies to fight the success of the low carb movement.

    Count the non-fiber carbs in your food, rather than the glycemic index values and you'll get a MUCH better idea of what impact foods will have on your health.

  • Pallav

    7/15/2010 6:19:28 PM |

    Dr Davis

    Dont be so stubborn. Get a hold of cooking practises as practised outside of your country too. If america is consuming wheat the wrong way, or you are consuming wheat in a wrong way don't implicate wheat in its entirety.

  • Pallav

    7/15/2010 6:21:32 PM |

    Imagine if i consume fish day and night cooked in hydrogenated vegetable oils and then implicate fish for my health problems. How stupid would that be?

  • John

    7/15/2010 6:51:53 PM |

    Hello, what happens if you consume bread with a fat or protein e.g. butter or cottage cheese.

    Will the bread contribute too much to insulin pike or will it be buffered by the fat/protein in the same serving?

    Thanks.

  • Carl

    7/15/2010 9:58:41 PM |

    Glycemic index if flawed in that it counts fructose as a carb for the denominator but uses glucose as the numerator -- at least as I understand it.

    Fructose follows a different metabolic path, but it is more destructive when in the blood than glucose -- which is probably why the liver does all the fructose metabolism.


    I revised glycemic index which used glucose and glucose based starches only in the denominator would be a better index to determine which foods slowly feed glucose into the body.

    Or, you can use glycemic index and just not look at fructose and sucrose containing foods.

  • Matt Stone

    7/15/2010 10:05:33 PM |

    Peter-

    Starches do not raise blood sugar or cause hyperinsulinemia in people on traditional diets because they are not insulin resistant like modern man on low-nutrient, refined-carbohydrate, vegetable and trans fat laden fare with a vast array of other complications.  

    Kitavans for example ate 69% of their food as unrefined carbohydrate, most of it as starch, yet the average fasting glucose is less than 70 mg/dl with zero documented cases of hyperglycemia or type 2 diabetes...

    http://180degreehealth.blogspot.com/2010/06/staffan-lindeberg.html

  • Dr. William Davis

    7/15/2010 10:10:58 PM |

    I have yet to meet a wheat product I liked.

    In my experience, they ALL increase blood sugar to one extravagant degree or another.

    Wheat also triggers inflammatory phenomenon more than any other food known. Celiac disease just one manifestation of wheat-triggered diseases.

  • Dr. William Davis

    7/15/2010 10:13:55 PM |

    Hi, Jenny--

    I agree wholeheartedly.

    We do the exact same thing as you: Count carbohydrate grams or check 1-hour postprandial glucoses. Works far better than the misleading glycemic index or glycemic load.

  • Anne

    7/15/2010 10:54:28 PM |

    After going gluten free I quickly discovered I felt better if I avoided all grains. I became very serious about eliminating grains after I found they all raised my blood glucose even if I ate them with fat and protein. I am now on a fairly simple primal-like diet.

    I run a support group for gluten intolerance and I tell people that the gluten free diet can be a healthy or as unhealthy as they want to make it. Sadly, many people who go gluten free don't want to change their diet other than to substitute gluten free products for their favorite wheat products. The market for gluten free foods has exploded and still growing. The most recent addition is Gluten Free Bisquick.

  • Lori Miller

    7/16/2010 12:42:56 AM |

    When I cut out wheat in January, my appetite ratcheted down and my bloating went away. That's reason enough for me to leave wheat alone.

    Since I cut way down on carbs in late February (probably less than 50g per day), a lot of aches and pains suddenly disappeared. The one in my left shoulder returns if I eat quite a bit of carb. For me, at least, it's carbs in general that seem to be inflammatory.

  • Lori Miller

    7/16/2010 12:51:06 AM |

    Jenny said, "Count the non-fiber carbs in your food, rather than the glycemic index values and you'll get a MUCH better idea of what impact foods will have on your health."

    This is what my mother and I have been doing for the past few months since we went low-carb. It's worked for us. (She's diabetic and I'm prone to acid reflux, so non-fiber carbs give us a smackdown very quickly if we eat too many of them.) It's easy, too, since it just involves looking at a label and doing a bit of subtraction. I never quite understood how the index worked--maybe because it doesn't?

  • Lori Miller

    7/16/2010 1:41:39 AM |

    For a thickener, I use xanthan gum. All the carbs in it are fiber. It's expensive, but a little goes a long way. I use half a teaspoon to thicken my protein/peanut butter shake, which is around 12 ounces.

  • julianne

    7/16/2010 3:20:33 AM |

    I have followed a low Glycemic load diet (always with protein and moderate carbs at each meal, plus a little good fat) in two different ways, for 12 years I used small amounts of grains including wheat (Zone Diet). 14 months ago I removed grains and legumes (but kept to Zone ratio as it works well for me) after reading this outstanding paper by Loren Cordain.
    "Cereal Grains: Humanities double edged sword"
    http://www.thepaleodiet.com/articles/Cereal%20article.pdf

    The difference was amazing - no more PMS breast pain, no more menstrual cramps, no more joint swelling, some fat loss, ganglion cyst that I'd had for 10 years shrank, no more constipation, all I can say is: try it - grain free is a cut above managing glycemic load with grains.
    Even fruit and it's fructose content is fine in moderate amounts (2 -3 serves day)

  • Anonymous

    7/16/2010 3:58:51 AM |

    I have celiac and type II diabetes, the fastest way to get my blood sugar in the danger zone is to eat "gluten-free" foods.  1/2 of a gluten free 6 inch pizza on a recent camping trip when we stopped in town for lunch sent me over 200. The only answer is to stick with real food, and skip anything with tapioca starch!

  • Bilal Shanti

    7/16/2010 10:18:01 AM |

    For people who respond well to low-carb diets, it’s important to sort out the nutritional value of a food from its affect on blood sugar. For someone who is (take your pick as they mean similar things): sensitive to sugar, prediabetic, Type 2 diabetic, insulin resistant, or has metabolic syndrome, keeping blood glucose stable is an important priority for health. In that way, it’s not much different from any condition that is treated by diet tradeoffs must be made. Someone who is allergic to wheat, for example, can still eat a balanced, healthy diet without harming their body. So can someone who strives for stable, normal levels of blood sugar.

    My Social Bookmarks: Bilal Shanti Facebook, Dr. Bilal Shanti Wordpress, Bilal Shanti MD Vitals, Dr. Bilal Shanti MD SiliconIndia, Bilal Shanti 123people, Bilal Shanti MD LinkedIn

  • Food, flora and felines

    7/16/2010 1:36:51 PM |

    @ Peter: Maybe it's the letcins? I came across a bit on how lectins may promote obesity (and so metabolic syndrome) in the whole food health source recently;

    http://wholehealthsource.blogspot.com/2008/04/leptin-and-lectins.html

    http://wholehealthsource.blogspot.com/2008/04/leptin-and-lectins-part-ii.html

  • DrStrange

    7/16/2010 3:50:39 PM |

    anonymous: "The only answer is to stick with real food...!"

    ALWAYS!!!

  • help to stop smoking

    7/16/2010 6:22:54 PM |

    For most people, this is just interesting, albeit, a little confusing. It is for me anyway. I don't pay attention to anything I eat, except I try to avoid desserts (when possible).

    I'm curious, are there simple guidelines for those who are gluten intolerant or have similar food "issues". Also, don't most people who "feel" they are gluten allergic, not?

    I read somewhere that it takes an endoscopic biopsy to officially diagnosis someone as gluten intolerant? For instance, a family member thinks she is because she thinks bread gives her gas. Weird, huh? Last time I checked, EVERYTHING gave her gas! Smile

    But apparently the internet has many sites just waiting to fill her head with crazy ideas.

  • Dr. William Davis

    7/16/2010 6:42:37 PM |

    Hi, Help to stop--

    My personal view is that all humans should stop consuming wheat. There is more to wheat intolerance than celiac disease, the conventionally accepted health problem provoked by wheat gluten.

    But there are so many other expressions of wheat intolerance that are rarely diagnosed, from childhood behavioral disorders to unexplained ataxias (imbalances due to neurologic deterioration) to peripheral neuropathies to diabetes to heart disease . . . and the list goes on and on.

    The difficult thing is that the majority of these people with non-celiac wheat intolerances test negative for celiac markers like anti-endomysial antibodies and anti-gliadin IgG.

  • Anonymous

    7/16/2010 10:24:18 PM |

    As I understand it the glycemic index was set using only slender healthy college age men, hardly a model for me!

  • Lori Miller

    7/17/2010 12:22:13 AM |

    @Help to Stop, according to Norm Robillard, a microbiologist, carbohydrates produce gas in the digestive tract. Fat and protein, not so much. In my case, wheat--especially whole wheat--made me so bloated I looked like I was pregnant. (Look up "wheat belly" on this site.) Since cutting out almost all the starchy, sugary carbs, I no longer have this problem. I recommend your family member with the gas problem try a low carb diet and avoid dairy products.

  • Pallav

    7/17/2010 4:50:20 PM |

    Dr. Davis.

    "wheat is not for human consumption"
    .
    knock knock! anyone home?
    cooking styles? perhaps?
    .
    Hydrolysis and depolymerization of gluten proteins during sourdough fermentation
    http://pubs.acs.org/doi/abs/10.1021/jf034470z
    .
    Sourdough Bread Made from Wheat and Nontoxic Flours and Started with Selected Lactobacilli Is Tolerated in Celiac Sprue Patients http://aem.asm.org/cgi/content/abstract/70/2/1088
    .
    Potential of sourdough for healthier cereal products http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6VHY-4F6CRDT-2&_user=10&_coverDate=03%2F31%2F2005&_rdoc=1&_fmt=high&_orig=search&_sort=d&_docanchor=&view=c&_searchStrId=1403383360&_rerunOrigin=scholar.google&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=c744a61e5abbed1ed60c4a079ff39fb5.
    .
    Prolonged Fermentation of Whole Wheat Sourdough Reduces Phytate Level and Increases Soluble Magnesium http://pubs.acs.org/doi/abs/10.1021/jf001255z
    .
    Phytase activity in sourdough lactic acid bacteria: purification and characterization of a phytase from Lactobacillus sanfranciscensis  CB1
    http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T7K-4846KTT-11&_user=10&_coverDate=11%2F01%2F2003&_rdoc=1&_fmt=high&_orig=search&_sort=d&_docanchor=&view=c&_searchStrId=1403383734&_rerunOrigin=scholar.google&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=b30d3245227db0269ca748da5d73c62f
    .
    Article
    Moderate Decrease of pH by Sourdough Fermentation Is Sufficient To Reduce Phytate Content of Whole Wheat Flour through Endogenous Phytase Activity http://pubs.acs.org/doi/abs/10.1021/jf049193q

    i'm curious why wheat is still unsuitable after neutralizing gluten and phytic acid?

    kindly explain the science dr. davis!

  • TomF

    7/17/2010 9:23:30 PM |

    Can you successfully build muscle mass on a grain free/low-carb diet?  I am eating to gain weight, but I'm concerned my diet is not optimal (i.e. heavy in carbs).  However, I'm afraid that if I drop the carbs down I could end up doing myself a disservice in terms of building muscle mass.

  • Lori Miller

    7/18/2010 1:41:41 PM |

    Tom F, I was a Body-for-Lifer for six years. For health reasons, I traded the low-fat, high carb diet for a high-fat, low-carb one. It took me a few weeks to get back the energy to sprint across the street, for example, but for ordinary, day-to-day stuff, I had more get-up-and-go.

    Recently, I started the Slow Burn program by Fred Hahn. It's a strength training program. Having done weightlifting for six years, I was fairly strong, but I've found these exercises very challenging--especially the one-legged squats. With the BFL exercises, I was at the limit of what my joints, not muscles, would take. With Slow Burn, the exercises are easier on your joints, so my muscles are getting more of a workout.

    A few people have written about the Slow Burn program: Dr. Michael Eades (he's a co-author of the book: http://www.proteinpower.com/drmike/uncategorized/slow-burn-fitness-for-boomers/

    Tom Naughton: http://www.fathead-movie.com/index.php/2009/10/01/taking-the-6-week-cure-almost/

    and me (see comments too, Fred Hahn was kind enough to make some suggestions).
    http://relievemypain.blogspot.com/2010/07/exercise-without-joint-pain.html

  • DrStrange

    7/18/2010 3:16:59 PM |

    "For health reasons, I traded the low-fat, high carb diet for a high-fat, low-carb one. It took me a few weeks to get back the energy to sprint across the street, for example, but for ordinary, day-to-day stuff, I had more get-up-and-go. "

    It's all about individual physiology and uniqueness.  I basically had the opposite reaction when I did this, going from moderate fat fairly high carb "health food "diet. After about 9 months on low carb (approx 30 grams/day total) high fat diet, I felt like I was dragging an anchor all day every day. Gradually worse as time passed. If I did even mild exercise ie Nordic Walking for a couple miles, I would be totally wasted to the point I would almost have to sleep for a couple hours then continue to feel exhausted for another 24 hours or so.  Finally got smart and went the other way first McDougall and got my energy back then "upgraded" to Fuhrman and finally stabilized blood sugar etc.

  • Dr. William Davis

    7/18/2010 4:47:52 PM |

    Pallav-

    Please read the past posts in this blog.

    Wheat is not just about gluten, though gluten proteins are indeed a major part of the adverse reaction to wheat.

    We also have neurologic phenomena attributable to wheat, only some of which may be gluten-mediated. We have amylopectin A, among the most highly digestible starches known, accounting for wheat ability to increase blood sugar more than just about all other carbohydrates.

  • rmarie

    7/19/2010 3:50:35 AM |

    @ Dr. Strange
    We know each other from the McDougall forum. I left, because I couldn't take the constant hunger any more, even though I ate practically all day long. I lost so much weight that my BMI was down to 17.5. I did McD for almost 1 1/2 years. At the end I weighed 3 pounds less than when I was 17 - which was 50 years ago!

    (note to others, I'm 4'11" started McDougall weighing 93 lbs and within 3 months was down to 88 and then actually went down to 85lbs. That's when I said 'no more' and went over to the low(er) carb community (60-80g).

    Unlike most people I have never had any aches or pains, joint problems or digestive problems in my life.
    And I've always been very active with lots of energy both with low-fat/high carb or low-carb/high fat. I see no difference except that I can now often go 3-4 hours between meals before I get hungry.

    But I did not adopt the american way of eating (junkfood and sodas) after coming here from Europe. I started McDougall starch based diet because of its promise to lower blood sugar (he does have many success stories, helped change people's lives in more than 30 years and offers many well researched science based articles to support his position). It is so confusing when each side is certain they have the answer WITH STUDIES TO PROVE IT.

    I have been pre-diabetic for at least 10 years that I know of. Doc never said much because the cut off number was 126 and I was well below that.

    Low-fat, high carb surprisingly did not change my BS much either way. I certainly did NOT have the reaction Dr. Davis talks about.

    Everyone reacts differently (maybe there is something to the metabolic typing after all?

  • Pallav

    7/19/2010 9:05:31 AM |

    Dr davis

    Thanks for your reply. what wheat contains is probably not entirely known, ill give it to you because of the clinical results coming through but wheats culpibility in the crime is quite interesting and certainly whether some component of wheat is responsible for the results you are observing or whether it is just a matter of preparation would certainly call for further investigation.

  • JTownsend

    7/21/2010 10:07:28 PM |

    Inspired by the good doctor I have essentially eliminated all grains from my diet, particularily wheat, with positive results. But I must admit that I do still enjoy a cold beer and am loath to
    forsake this one precious pleasure. Where does beer fit in I wonder? It is a grain product I guess just like bread or cereal. So is it on the banned list for cardiac health?

  • Anonymous

    7/23/2010 3:41:22 PM |

    Is there a safe sandwich bread out there in most local stores?  I eat sandwiches most every day and I'm trying to figure out how to follow your advice re wheat.

  • Anonymous

    8/26/2010 4:23:10 PM |

    Try Glucose Level by Sprunk-Jansen.

    GLUCOSE LEVEL helps to support glucose metabolism and to maintain insulin levels already within the normal range. GLUCOSE LEVEL uses four plant extracts - nettle, salt bush, walnut and olive - which work together to help bring your blood sugar levels into alignment.

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