Indian buffet

24. February 2011 William Davis (56)
I took my family to a local all-you-can-eat Indian buffet. It was delicious.

I confined my food choices mostly to vegetables and soups. Within about 30 minutes, I started to get that odd buzz in my head that usually signals a high blood sugar.

When I got home, my fingerstick blood glucose: 173 mg/dl. Darn it! Must have been cornstarch or other sugars in the sauces.

I got on my supine stationary bike and pedaled for 40 minutes at a moderate pace while I played Modern Warfare on XBox. (A great way, by the way, to fit in some low- to moderate-intensity exercise while occupying your brain. My wife often has to yell at me to get off, it's so much fun.)

Blood glucose at the conclusion of exercise: 93 mg/dl-- a nice 80 mg/dl drop.

This is a useful strategy to use in a pinch when you've either been inadvertently exposed to more carbohydrate than you can tolerate, or if you'd like to blunt the adverse glucose effects of a bowl of ice cream or other carbohydrate indulgence.

Should we explore the idea of a "morning-after" pill, or actually a "meal-after" pill, a supplement pill or liquid that blunts or eliminates the blood glucose rise after a meal? I've considered such an idea, but have been fearful that people would start to use it habitually. Thoughts?

American Heart Association diet makes a monkey out of you

21. February 2011 William Davis (38)
Heart Scan Blog reader, Roger, brought this New York Times article to my attention.

In an effort to develop a better experimental model for obesity than mice, scientists have turned to monkeys and other primates. The emerging observations are eerily reminiscent of what you and I witness just by going to the local grocery store or fast food outlet:

"'It wasn’t until we added those carbs that we got all those other changes, including those changes in body fat,' said Anthony G. Comuzzie, who helped create an obese baboon colony at the Southwest National Primate Research Center in San Antonio."

"Fat Albert, one of her monkeys who she said was at one time the world’s heaviest rhesus, at 70 pounds, ate “nothing but American Heart Association-recommended diet,” she said."

Yes, indeed: The American Heart Association diet makes monkeys fat. Extrapolate this a little higher on the evolutionary ladder and guess what?

This is one of the many reasons why, when I have a patient who is counseled by the hospital dietitian on the American Heart Association diet, I advise them to 1) ignore everything the dietitian told them, and then 2) follow the wheat-free, cornstarch-free, sugar-free, whole food diet I advocate.

Not unexpectedly, much of this primate research is not being devoted to just manipulating diet to achieve weight loss and health, but to develop new drugs to "treat" obesity.

Would you like a banana?

Construct your glucose curve

19. February 2011 William Davis (24)
In a previous Heart Scan Blog post, I discussed how to make use of postprandial (after-meal) blood sugars to reduce triglycerides, reduce small LDL, increase HDL, reduce blood pressure and inflammatory measures, and accelerate weight loss.

In that post, I suggested checking blood glucose one hour after finishing a meal. However, this is a bit of an oversimplification. Let me explain.

A number of factors influence the magnitude of blood glucose rise after a meal:

--Quantity of carbohydrates
--Digestibility of carbohydrates--The amylopectin A of wheat, for example, is among the most digestible of all, increasing blood sugar higher and faster.
--Fat and protein, both of which blunt the glucose rise (though only modestly).
--Inclusion of foods that slow gastric emptying, such as vinegar and fibers.
--Body weight, age, recent exercise

Just to name a few. Even if 10 people are fed identical meals, each person will have a somewhat different blood glucose pattern.

So it can be helpful to not just assume that 60 minutes will be your peak, but to establish your individual peak. It will vary from meal-to-meal, day-to-day, but you can get a pretty good sense of blood glucose behavior by constructing your own postprandial glucose curve.

Say I have a breakfast of oatmeal: slow-cooked, stoneground oatmeal with skim milk, a few walnuts, blueberries. Blood glucose prior: 95 mg/dl. Blood glucose one-hour postprandial: 160 mg/dl.

Rather than taking a one-hour blood glucose, let's instead take it every 15 minutes after you finish eating your oatmeal:


In this instance, the glucose peak occurred at 90-minutes after eating. 90-minute postprandial checks may therefore better reflect postprandial glucose peaks for this theoretical individual.

I previously picked 60-minutes postprandial to approximate the peak. You have the option of going a step better by, at least one time, performing your own every-15-minute glucose check to establish your own curve.

Why is type 1 diabetes on the rise?

16. February 2011 William Davis (43)
Type 1 diabetes, also called "childhood" or "insulin-dependent" diabetes, is on the rise.

Type 2 diabetes, or "adult," diabetes, is also sharply escalating. But the causes for this are easy-to-identify: overconsumption of carbohydrates and resultant weight gain/obesity, inactivity, as well as genetic predisposition. A formerly rare disease is rapidly becoming the scourge of the century, expected to affect 1 in 3 adults within the next several decades.

Type 1 diabetes, on the other hand, generally occurs in young children, not uncommonly age 3 or 4. Type 1 diabetes also shares a genetic basis to some degree. But the genetic predisposition should be a constant. Obviously, lifestyle issues cannot be blamed in young children.
Then why would type 1 diabetes be on the rise?

For instance, this study by Vehik et al from the University of Colorado documents the approximate 3% per year increase in incidence in children with type 1 diabetes between 1978 and 2004:


(From Vehik 2007)

(For an excellent discussion of the increase in type 1 diabetes in the 20th century, see this review.)

This is no small matter. Just ask any parent of a child diagnosed with type 1 diabetes who, after recovering from hearing the devastating diagnosis, then has to stick her child's fingers to check glucose several times per day, mind carefully what he or she eats or doesn't eat, watch carefully for signs of life-threatening hypoglycemic episodes, not to mention worry about her child's long-term health. Type 1 diabetes is a life-changing diagnosis for both child and parents.

Various explanations have been offered to account for this disturbing trend. Some attribute it to the increase in breast feeding since 1980 (highly unlikely), exposure to some unidentified virus, or other exposures.

I'd like to offer another explanation: wheat.

Lest you accuse me of becoming obsessed with this issue, let me point out the four observations that lead me to even consider such an association:

1) Children diagnosed with celiac disease, i.e., the immune disease of wheat gluten exposure, have 10-fold greater likelihood of developing type 1 diabetes.

2) Children diagnosed with type 1 diabetes are 10-fold more likely to have abnormal levels of antibodies (e.g., transglutaminase antibodies) to wheat gluten.

3) Experimental models, such as in these mice genetically susceptible to type 1 diabetes, showed a reduction of type 1 diabetes from 64% to 15% with avoidance of wheat.

4) The increase in type 1 diabetes corresponds to the introduction of new strains of wheat that resulted from the extensive genetics research and hybridizations carried out on this plant in the 1960s. In particular, unique protein antigens (immune-provoking sequences) were introduced with the dwarf variant attributable to alterations in the "D" genome of modern Triticum aestivum.

Proving the point is tough: Would you enroll your newborn in a study of wheat-containing diet versus no wheat, then watch for 10 years to see which group develops more type 1 diabetes? It is a doable study, just a logistical nightmare. Perhaps the point will be settled as more and more people catch onto the fact that modern wheat--or this thing we are being sold called "wheat"--is a corrupt and destructive "foodstuff" and eliminate it from their lives and the lives of their young children from birth onwards. Then a comparison of wheat-consuming versus non-wheat-consuming populations could be made. But it will be many years before this crucial question is settled.

Yet again, however, the footprints in the sand seem to lead back to wheat as potentially underlying an incredible amount of human illness and suffering. Yes, the stuff our USDA puts at the bottom, widest part of the food pyramid.

Apo E4 and sterols: Lethal combination?

11. February 2011 William Davis (24)
Phytosterols, or just "sterols" to its friends and neighbors, are a group of cholesterol-like compounds that are abundant in the plant world. Lately, however, sterols have proliferated in the processed food supply, thanks to the observation that sterols reduce LDL cholesterol when ingested by humans.

This must mean that sterols are good for you.

Uh oh. Wait a minute: There is a rare disease called sitosterolemia in which there is unimpeded intestinal absorption of all sterols ingested through diet. They must have really low LDL cholesterols! Nope. They develop coronary disease--heart attacks, angina, etc.--in their late teens and 20s. In other words, if sterols gain access to your bloodstream, they are bad. Very bad.

Conventional thinking is that only a modest quantity of dietary sterols gain access to the bloodstream. But there are two potentially fatal flaws in this overly simplistic line of thinking:

1) What happens when you load up your diet with "heart healthy" sterols, such as those in "heart healthy" margarines, mayonnaise, and yogurt, effectively increasing sterol intake 10-fold?

2) What happens in people with the genetic pattern, apo E4, that is carried by 25% of the general population that permits much greater intestinal absorption of sterols?

My prediction: Despite the fact that sterols reduce LDL, they may, in certain genetically-susceptible people, such as those with apo E4, increase risk for heart disease: heart unhealthy.

Here are two studies that suggest that greater sterol absorption in people without sitosterolemia are at higher risk for heart disease:

Alterations in cholesterol absorption/synthesis markers characterize Framingham offspring study participants with CHD

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

Glucomania

8. February 2011 William Davis (52)
As I suggested in a previous Heart Scan Blog post, a glucose meter is your best tool to:

1) Lose weight
2) Cure diabetes
3) Reduce or eliminate small LDL particles
4) Achieve anti-aging or age-slowing effects

But it means getting hold of a glucose meter and applying it in a very different way.

Diabetics typically check fasting morning glucose and again several times during the day to assess medication effects. But you and I can measure blood glucose to assess the immediate effects of food choices--two very different approaches.

The concept is simple: Check a blood glucose just prior to a food or meal of interest, then one hour after finishing.

Let's take two hypothetical breakfasts. First, oatmeal, a so-called "low-glycemic index" food. Slow-cooked, stone ground oatmeal with skim milk, a handful of walnuts, just a few blueberries.

Blood glucose just prior: 95 mg/dl
Blood glucose one hour after finish: 175 mg/dl

I made those numbers up, but this is a fairly typical response for many adults. (This is why "low-glycemic index" is an absurd notion.) This kind of response causes 1) glycation, the adverse effects of glucose modification of proteins that leads to cataracts, kidney disease, cartilage damage and arthritis, atherosclerosis, skin wrinkles, etc., 2) high insulin response that cascades into fat deposition, especially visceral fat ("wheat belly"), and 3) glucotoxicity, i.e., direct damage to the pancreas that can, over years, lead to diabetes.

Next day, let's try a breakfast of 3-egg omelet made with green peppers, sundried tomatoes, and olive oil.

Blood glucose just prior: 95 mg/dl
Blood glucose one hour after finish: 93 mg/dl

This is a meal of virtually zero-glycemic index. This kind of response triggers none of the effects experienced following the oatmeal. Repeated over time and you fail to trigger glycation, you stop provoking insulin, and visceral fat mobilizes rather than accumulates: you lose weight, particularly around the middle.

We therefore aim to keep the one-hour blood glucose 100 mg/dl or less. If you start with a high fasting blood glucose of, say, 118 mg/dl, then we aim to keep the one-hour after-eating blood glucose no higher than the pre-meal.

It works. Plain and simple.

This makes the primary care docs crazy: "How dare you check your blood sugar! You're not diabetic." In truth, blood glucose meters are relatively simple devices to use. The test strips and lancets will cost a few bucks. (The meters themselves are either low-cost or free, just like Gillette sometimes sends you a beautiful new razor for free but expects you to buy the blades). These are direct-to-consumer products. While a prescription written by your doctor for a glucose meter and supplies helps insurance cover the costs, you can easily get these devices without a prescription. Some stores, like Target, keep their devices out on the shelves with the shampoo and bath soap.

Warning: Anyone taking diabetes drugs will have to consult with their doctors about the safety of such an approach. Because this approach can actually cure diabetes in some people, if you are taking some diabetes drugs, especially glyburide, glipidize, and glimepiride, you can experience dangerously low blood sugars, just as any non-diabetic taking these drugs would.

Diarrhea, runny noses, and rage: Poll results

6. February 2011 William Davis (19)
Here are the results of the week-long poll asking the question:

Have you experienced a wheat re-exposure syndrome?
Yes, undesirable gastrointestinal effects 223 (41%)
Yes, asthma or sinus problems 51 (9%)

Yes, joint pains and/or swelling 85 (15%)

Yes, emotional or other nervous system effects 59 (10%)
No, nothing, nada  107 (19%)

No. Wheat is sacred and you're all nuts  13 (2%)


There are several interesting observations to make from this informal poll. First, as I have observed, the most common wheat re-exposure syndrome is gastrointestinal, usually involving cramps, diarrhea, and lame explanations to your dinner partner.

Second most common: joint pains and/or swelling.

Third: asthma or sinus congestion.

The incidence of emotional or nervous system effects surprised me a bit. I didn't expect 10% of people to share this effect. This is an effect I also experience personally, along with the gastrointestinal consequences.

To be sure, this is a skewed poll, since many people likely come to this blog in the first place because of such issues. But I was nonetheless impressed with the relatively modest proportion of people who did not share such a re-exposure syndrome: only 19%.

Beyond the interesting numbers provided by readers, a good many also provided some fascinating and graphic comments. Here's a sample:




Sassy said:

Reflux -- starts a day later and goes for up to a week. And Bloat:2-5 inches on my waistline in a day, lasting up to three. Miserable. And why, having experienced this once, have I done it often enough to verify the connection with certainty? I am working on that one.
Anonymous said:
Wheat increased hunger with even with only a small amount. Crackers in soup was enough to set it off.

Also, when I was trying to get off wheat, I noticed that 2 eggs and 2 bacon and I could go 5 hours before hunger, or 2 eggs and 2 bacon and toast was good for three hours before hunger. That was the final step to giving up wheat. Now three years and 59 Kg [130 lbs!] loss later, there is no doubt in my mind that wheat is evil, and I do not regard it as suitable for human food. I speculate that it increases ghrelin or cortisol.

Anna said:
For me, in the two years since I began eating Gluten-Free (Low Carb for 6 years), the few times I've had re-exposure to wheat, I've experienced fast onset and intense abdominal pain (known exposure during the daytime) and heartburn, indigestion, intense nausea, and disrupted sleep (exposures during evening meal not discovered until the next day).

My husband wants to think he's fine with wheat (though I know that he has at least one gene that predisposes to celiac), but IMO, he isn't. He eats no wheat at home because that's the default, and he's OK with that. But if he goes out to dinner at a restaurant that serves "good" artisan bread, he will indulge in a few bites (he does restrict his carb intake, so it's still a limited amount). More often than not, he will sleep fitfully on those nights, snore more, and wake in the night with indigestion. He wants to bury his head in the sand and will only acknowledge the discomfort being due to eating too many carbs, not the wheat itself. I notice he sleeps fine if he eats a small amount of potato or rice. Go figure.

Our 12 yo son has been eating GF for two years also. About 6 months into GF, he unknowingly ate wheat a number of times (licorice candy laces at a friend's house), which resulted in outbreaks of canker sores in his mouth each time. He also exhibits mood and behavior changes when he eats wheat, which is what prompted me to test him for gluten intolerance in the first place.

Mark said:
If I go for 3-4 days without wheat, grains or sugar and then go out and binge on a pizza and ice cream or something like that I become explosive within 20 minutes to an hour. It's like a wheat and sugar rage.(I'm not saying this is an excuse for rage, I'm saying it has happened to me and I believe partly do to re-exposure) It seems the combination of the wheat plus sugar can be the worst.

I get red rashes around my neck sometimes right away and sometimes up to a day or later and sometimes get bad diarrhea. 
I think it can be almost dangerous to cut things like gluten and sugar suddenly out of the diet without being very serious about keeping them out. I have found it very hard to cut out wheat without binging on it later after 4 or 5 days. I don't believe that my symptoms are just psychological either.
I was also diagnosed with ADHD as a young kid and then rediagnosed with adult ADHD by 3 different doctors. I also have bouts of mania at times too. I am considering trying to go completely gluten/refined carbohydrate free to see if it helps with the symptoms and gives me some relief.

I have never been tested for celiac or gluten intolerance but I would like to be. I think it would help explain to my girlfriend, family and friends why I can't go out and eat pizza or have a beer or ice cream. Right now they all think I'm a hypochondriac. At times I have experienced an intense fatigue the next day like I can't wake up and also sharp pains in my body and headaches.
Anonymous said:
I ditched wheat a year ago after my wife was diagnosed celiac. I immediately experienced a number of health improvements (blood lipids, sleep, allergies, etc.).

Fast forward: We all suffered some inadvertent wheat exposure yesterday via some chocolate covered Brazil nuts (of all things). This accidental A-B-A experimental design resulted in the following:

1. My celiac wife experienced what she calls "the flip" within an hour of exposure (i.e., intense GI distress).
2. My five-year old son went to bed with some wicked reflux.
3. I woke up with some twinges in my lower back and an ache in my football-weary left shoulder. I was also complaining to my wife about fuzzy-headedness that refused to respond to caffeine or hydration. I could only describe it as "carb flu"...

And then I read your post!

Anne said:
Depression, agitation and brain fog if I get glutened. Some times this comes with abdominal pain and a rash on my back - I think it is dose dependent. Cross contamination with wheat is a big issue when eating out. Needless to say, I eat out infrequently and then try to stick with the restaurants that are the most aware of gluten issues.
Terrence said:
Several weeks ago, I started Robb Wolf's 30 day challenge.

The first two weeks were brutal - calling it a withdrawal flu was a massive understatement. So, I thought I would try some wheat and see what happened (could not be worse, I thought). Well, it was.

I still felt extremely crappy, but I was now MASSIVELY GASSY - AMAZINGLY GASSY, for about 48 hours - flatulence on wheels, in spades. I did not go out at all in those 48 hours - when the gas came on, it went out, LONG, and QUICKLY and LOUDLY.

I am easing back into wheat and grain free. I am gluten free today and tomorrow (Sunday and Monday). I expect to try a small amount of wheat on Thursday, then maybe a little more the following Thursday.

Donald said:
I have limited wheat consumption severely over the last 8 months. I have lost 120 pounds, no longer have bouts of illness, asthma, depression, or low energy. I also take vitamin D and other supplements that have helped (many are from your blog recommendations).

Last week I ate a small piece of cake and dessert pizza. Shortly thereafter I started sneezing, had a scratchy throat, and runny nose. I called off sick the next day for fear of being contagious. My symptoms subsided quickly and I am now attributing them to the processed flour eaten at my work luncheon. I think it was an allergic reaction since I recall having much more severe symptoms fairly regularly in my wheat eating days. Those were attributed to an "allergy" of unknown origin back then.

John said:
I suffered from Ankylosing Spondylitis, Iritis, Plantar Fasciits, etc for a number of years. I restricted carbs, especially wheat and I've been symptom free for the past two years now.
Lori said:
I found wheat to be one of the worst things for giving me gas bloating and acid reflux, and I'd had sinus and nasal congestion my whole life. When I ate that cookie, it just re-introduced old problems. I can occasionally eat a gluten-free, grainy goody at my party place without any side effects. I also have a little sprouted rice protein powder every day.

Another odd thing about wheat: it was hard for me to stop eating it once I started. I could go through a whole box of cookies in one sitting, even though I wasn't a binge eater. But I can have a couple of gluten-free cookies and stop.

Paul said:
Except for one slip up this recently past holiday season, I've been sugar-grain-starch free since July 2008. Mental fog was the most noticable re-exposure symptom I had.

My mom has had the worst acid-reflux for 40-plus years. It had become so bad that she was on three medications just to deal with the symptoms. After much training and coaxing, I finally got across to her  how to totally get off wheat. Not at all to my surprise, after being wheat free for a few weeks, she lost weight and her acid reflux was GONE!

But she had been addicted to wheat for so long, she relapsed, and the reflux fire soon returned. Wheat must be akin to heroin with some people. Even though they know it's very bad for them, they can't help themselves.

Onschedule said:
Re-exposure often leads to diarrhea for me, or such a heavy feeling of tiredness that all I can do is lay down and pass out. A local pizzeria makes a darn good pie, but since I started practicing wheat-avoidance, I can't keep my eyes open after eating there. I can't say for sure that it's the wheat causing it, but definitely something in the crust. Diarrhea, on the other hand, is definitely triggered by the wheat for me.

My mom complained of gastric reflux for years, but never filled the prescriptions that her doctors would give her. I suggested wheat-avoidance- gastric reflux disappeared within 3 days and hasn't returned (has been 6 months now). I've already commented elsewhere on this blog about how much weight and bloating she has lost...

Steve said:
Interesting that I should sit down, turn on my computer and find your poll. Having gone several weeks, maybe months, avoiding gluten, I took my daughter and her boyfriend out to eat because my wife has been working late at the office lately. Although I was thinking I would just eat my steak and chicken, I succumbed to the temptation of eating about a dozen greasy, breaded shrimp that my daughter and her boyfriend ordered. It's 1:39am and I still do not feel sleepy. My left nostril is completely blocked, my stomach feels bloated, really, really full and I've been burping. In your poll I checked sinus problems but could have chose gastrointestinal or nervous problems just as well. 
A few weeks ago my daughter brought home a pizza and, once again, despite my knowing that I shouldn't, I ate a couple of pieces. I was sick for two days. The pain in what I think was my transverse colon was so bad I thought I might have to go to ther emergency room. Before I ate the pizza I had never gone grain-free that long before. I did this after reading Robb Wolf's book. 
I AM CONVINCED. No more wheat for me! Please, Lord, give me strength.
LV said:
What don't I experience! I typically avoid wheat (and gluten for that matter) as I'm pretty sure it makes me sick, but when I slip (or someone else slips me some) I end up with massive amounts of joint swelling and tenderness, diarhea, cramping, gas, bloating and brain fog. I'm absolutely miserable. Just that alone is enough to keep me off gluten. I have RA, so if I have repeated exposures I'll have a flare which SUCKS!

The perfect Frankengrain

4. February 2011 William Davis (25)
Pretend I'm a mad food scientist. I'd like to create a food that:

1) Wreaks gastrointestinal havoc and cause intractable diarrhea, cramps, and anemia.
2) Kills some people who consume it after a long, painful course of illness.
3) Damages the brain and nervous system such that some people wet their pants, lose balance, and lose the ability to feel their feet and legs.
4) Brings out the mania of bipolar illness.
5) Amplifies auditory hallucinations in people with paranoid schizophrenia.
6) Makes people diabetic by increasing blood sugars.
7) Worsens arthritis, such as osteoarthritis and rheumatoid arthritis.
8) Triggers addictive eating behavior.
9) Punishes you with a withdrawal process if you try to remove it from your diet.

I will develop a strain that is exceptionally hardy and tolerates diverse conditions so that it can grow in just about any climate. It should also be an exceptionally high yield crop, so that I can sell it cheaply to the masses.

Now, if my evil scheme goes as planned, I will then persuade the USDA that not only is my food harmless, but it is good for health. If they really take the bait, they might even endorse it, create a diet program around it.

Dag nabit! Such a plan has already been implemented. Another evil food scientist already beat me to the punch. The food is called wheat.

Diabetes: A study in aging

3. February 2011 William Davis (0)
Diabetics experience long-term health difficulties, including atherosclerosis/heart attacks, peripheral vascular disease, hypertension, cataracts, kidney disease, neuropathies, male erectile dysfunction, osteoarthritis, and colorectal cancer. They also die, on average, 10 years earlier than non-diabetics.

In effect, diabetics compress their lives into a shorter period of time. They experience all the "complications" of aging at a younger age. People without diabetes, of course, can develop atherosclerosis, cataracts, kidney disease, etc., but they tend to do so later in life compared to diabetics.

One index of the rate of aging (but not chronologic age itself) is hemoglobin A1c, or HbA1c, a "moving average" of glycated hemoglobin, i.e., glucose-modified hemoglobin. Blood glucose glycates hemoglobin linearly and irreversibly; measuring HbA1c thereby provides an index of the last 60 or so days average blood glucose.

To put HbA1c values into perspective:

Average HbA1c of hunter-gatherers: 4.5%
Average HbA1c for Americans: 5.6%
American Diabetes Association definition of diabetes: 6.5% or greater
American Diabetes Association definition of adequate control of diabetes: 7.0% or less

Why do diabetics age faster? There are likely several reasons. One important reason is glycation, as indexed by HbA1c. Glycated proteins in the lens of the eye causes cataracts. Glycated proteins in cartilage leads to arthritis. Glycated LDL particles (apo B) leads to atherosclerosis. Glycated nerve cells causes neuropathy. And so on.

If glycation underlies many of the phenomena of aging, then we might surmise that:

1) The less you glycate, the slower you age.
2) The more you glycate, the faster you age.

Therefore, the higher the HbA1c, the faster you are aging.

What foods increase HbA1c? Carbohydrates. That bowl of slow-cooked, stone ground oatmeal? A one-hour after-eating blood sugar of 170 mg/dl is common. Your doctor says that's okay because it's below 200 mg/dl and you don't "need" medication yet.

Self-empowerment is coming!

11. June 2006 William Davis (0)
I've discussed this before: The coming wave of self-empowerment in health. Health that is driven by you, not a hospital, not a doctor, not by procedures, but by information and access to tools that are powerful and effective.

The seeds are being planted right now and won't take full root for many years or decades. But it's going to happen.

I previously cited several broad trends that are examples of this emerging wave:

--The nutritional supplement movement. Contrary to the media's ill-informed bashing, nutritional supplements are getting better: improved quality, better substantiation of when/how to use them, new agents that appear rapidly, since introduction is not slowed by the molasses of the FDA.

--Medications moving to over-the-counter status. Health insurers are driving this one. OTC means not paid for by insurance. That also means access to you.

--What I call "retail imaging", i.e. screening ultrasound, heart scans, full body scans, etc. that are available in most states without a doctor's order.

--The Internet. The mind-boggling rapidity and depth of information available on the Internet today is fueling the self-empowerment movement by providing sophisticated information to health care consumers. Information here is uneven at present. But, as consumer sophistication increases and the system of checks and balances evolves, internet-driven information will be often superior to what you get from a doctor or other health professional.

--High-deductible health insurance plans. If health care consumers bear more and more of the costs of health care, they will seize greater responsibility for early identification and prevention and minimize long-term costs.

This trend does not mean treating your own infection, taking out your own gall bladder, repairing your own broken leg. It means that conventional routes of health delivery will recede into providing only catastrophic care.

It means that you and your family will take a larger role in learning how to eat and exercise properly, use foods to maintain and promote health (the "designer food" and "nutraceutical" movement), take supplements that have real benefits, use medications for treatment of many everyday ailments.

It also means seizing control of diseases that previously were only treated in hospitals, like coronary heart disease. This, of course, is where our program, Track Your Plaque, is an example of how you can have a powerful and effective role in your heart health. Track Your Plaque goes so far beyond the "eat low-fat, exercise, and know your numbers" media mantra that it's like comparing a brand-new Mercedes to a rusted, run-down '87 Ford Escort. There truly is no comparison. (Sorry if you're an Escort driver!) But you get the idea.

Another option for lipoprotein testing

9. June 2006 William Davis (0)

For those of you who have been frustrated in trying to get your lipoprotein analysis performed, here's another option.

The Life Extension Foundation at www.lef.org provides access to the VAP test, or Vertical Auto Profiler. This is the lipoprotein test run by the Atherotech company in Birmingham, Alabama. The name refers to the method used, a form of centrifugation, or high-speed spinning of your blood (plasma) to separate the various components by density.

This is a fine technique that works well. Though our preferred method is NMR (www.Lipoprofile.com, Liposcience Inc.), the Atherotech VAP is a reasonable alternative.

If you go through the Life Extension process, they will direct you to blood draw sites in your area. They charge $185 for Life Extension members, $247 for non-members. (Membership in Life Extension costs $75.) Drawback: No billing for health insurance reimbursement.

A full description of the significance of lipoproteins can also be found in my article posted on-line at the www.lef.org website at http://www.lef.org/magazine/mag2006/may2006_report_heart_01.htm

Weight and lipoproteins

8. June 2006 William Davis (0)
Tom, an accountant, came into the office eager to know what his 2nd heart scan score showed.

A year ago, Tom's view of himself as a healthy, middle-aged man was shattered when he found out his heart scan score: 1236. Tom had severe coronary plaque with a heart attack risk of 25% per year (without intensive preventive action).

In the way of lipoprotein abnormalities, he had several: low HDL, deficient large HDL, small LDL, high triglycerides, IDL (the after-eating inability to clear dietary fats), and a high blood sugar in the pre-diabetic range. In addition, Tom was hypertensive, with blood pressure so high it even landed him in the emergency room last winter.

In addition to our approach to correct all these patterns, Tom was urged to lose a significant quantity of weight. Starting at 225 lb., at 5 ft 7 inches, Tom was clearly at least 40 lbs over his ideal weight.

I stressed to Tom that the entire spectrum of causes of coronary plaque were weight-related. I likened his patterns to throwing gasoline on a fire: As weight increased, his lipoprotein and other abnormalties flared dramatically.

But each time Tom came back to the office over the ensuing year, he'd gained another 3 to 6 lbs. And each time he had an explanation. "My daughter just got married. I couldn't turn down wedding cake, now could I?" Or, I just survived another tax season. I was working day and night--no time for exercise!" "It's getting too hot to walk anymore."

Well, despite multiple treatments, Tom's repeat heart scan showed a score of 1677, a 35% increase. That's a dangerous rate of growth that virtually guarantees that plaque is building up momentum to "rupture", which results in heart attack.

I therefore stressed to Tom that weight loss was crucial. Control of coronary plaque was simply not going to occur without weight loss to our target. Alternatively, we could add several new prescription medicines and hope that they could achieve the same effect, though at a price (side-effects, expense).

I tell Tom's story to highlight again just how important weight loss can be for a number of lipoprotein abnormalities.

What measures specifically are sensitive to weight? They are:

--HDL cholesterol
--Triglycerides
--Small LDL
--VLDL
--Blood pressure
--Blood sugar and insulin
--C-reactive protein
--LDL

Weight exerts profound influence on these patterns. In Tom and people like him, weight can be a "make it or break it" issue.

If you, like Tom, have any of the above patterns, consider weight loss as a potent tool you can use to gain control of coronary plaque.

Variation in vitamin D requirements

7. June 2006 William Davis (0)

For Track Your Plaque followers, you know we are very concerned about vitamin D blood levels. My prediction is that, in 10 years, vitamin D will be regarded as an important item on the list of coronary artery disease risk factors.

In our experience of trying to stop or reverse heart scan scores, restoration of vitamin D to a blood level of 50 ng/ml appears to have increased our success rate dramatically.

As we've talked about before, on the bell curve of vitamin D dosing in a northern climate, the majority of women require 2000 units per day, men require 3000 units per day to achieve a level of 50 ng. However, there are "outliers" on this bell curve, i.e., people who require much more or much less.

This week, I saw two people who were very instructive cases of extreme requirements on the high end of vitamin D dosing. Both started with unmeasurable blood levels, i.e., essentially zero ng/ml. On 5000 units of vitamin D per day, both raised their blood levels to around 17-18 ng/ml--in the range of severe deficiency (defined as <20 ng/ml). I advised both to increase their oral dose of vitamin D to 8000 units per day.

Notably, both people avoided sunlight and lived in Wisconsin, a terribly sun-deprived locale 10 months a year. Both were also substantially overweight (around 300 lbs each).

The vitamin D issue continues to be endlessly fascinating in all its nuances and twists.

Heart attacks in your own backyard

7. June 2006 William Davis (0)
Two men from my community just died of heart attacks. Both were in their 40s.

What bothers me most about these all too frequent stories is that it is so preventable. You can bet that both had little or no symptoms prior to their deaths. You can also bet that they've had cholesterol panels taken by their doctors.

Followers of the Track Your Plaque program know that these are sure-fire paths to failure. The absence of heart disease symptoms should provide no reassurance whatsoever. High cholesterol, in-between cholesterol, low cholesterol--none are confident indicators in a specific individual.

Stress test? How about the patient I saw today who, until I met him, had been undergoing stress test after stress test, every year--all while the quantity of coronary plaque tripled. False reassurances provided by his cardiologist led him to believe that all was well--while this stack of oily rags was just waiting for the spark to ignite.

Too little time, too much money, too far away--there's a hundred excuses for not getting a heart scan. Or, you've had a heart scan and no one can tell you what to do about it. If you're reading this, however, you've found the most intensive source of information available on how your heart scan can serve as the start of a program of heart attack prevention for a life free of dangers.

It's not that tough. But it won't just go away on its own. I just have to look around me in my own community, watch the local news, talk to friends, and I'll heart about all the people just in my neighborhood who should be learning these lessons. I rant and rave about this but some people need to hear it from a friend, colleague, neighbor, rather than some crazy doctor bucking the standard line.

You, too, should be telling anyone who will listen about how heart disease can be identified and controlled.

Pilot lands safely after heart attack, then dies

6. June 2006 William Davis (1)
That was the disturbing headline on a report from MSNBC, also reported nationally on all the major news networks.

The story goes on:

"A pilot suffering a heart attack made an emergency landing on a highway, saving his three passengers shortly before he died...He landed the single-engine Cessna 185 on Utah 30 near Park Valley and was taken to Bear River Hospital in Tremonton, where he died."

We track these sorts of stories and it's frightening just how common they are. A school bus driver recently had a heart attack while driving 30 children; the bus crashed but no one was hurt. A 52-year old commercial bus driver suffered a heart attack while transporting 49 conference attendees; the bus plunged 400 feet down a ravine. Remarkably, 17 passengers suffered only minor injuries and there were no deaths.

There have even been incidents where the pilot of a jet liner suffered a heart attack in-flight. In 2000, the 53-year old pilot of a Northwest Airlines DC-10 died while in-flight from a heart attack while landing in Minneapolis. The 290 passengers were landed safely by co-pilot.

Most incidents where the driver or pilot has been incapacitated or died resulted in the deaths of only a handful of people. No major catastrophe has yet occured. But--mark my words--it will. These incidents just happen too frequently.

Virtually all of these and similar incidents could have been prevented. If the FAA, for instance, would insist that all pilots have a simple CT heart scan, it would become immediately obvious which pilots should be grounded and who should fly. Similar requirements could easily be applied to persons in charge of the welfare of many people, most notably school bus drivers.

It's not that tough! The FAA currently requires stress testing and cholesterol testing. Well, guess what? Followers of the Track Your Plaque program know that these tests do not effectively identify the person at risk for heart attack in the majority of individuals. Just ask former President Bill Clinton how helpful his stress tests (five in a row!) were. Or how valuable his cholesterol monitoring was--all prior to his emergency bypass surgery.

Large new clinical study launched to study. . .niacin

5. June 2006 William Davis (3)

Oxford University has issued a press release announcing plans for a new clinical trial to raise HDL cholesterol and reduce heart attack risk. 20,000 participants will be enrolled in this substantial effort. The agent? Niacin.

How is that new? Well, this time niacin comes with a new spin.

Dr. Jane Armitage, formerly with the Heart Protection Study that showed that simvastatin (Zocor) reduced heart attack risk regardless of starting LDL, is lead investigator. She hopes to prove that niacin raises HDL cholesterol and thereby reduces heart attack risk. But, this time, niacin will be combined with an inhibitor of prostaglandins that blocks the notorious "flushing" effect of niacin.

The majority of Track Your Plaque participants hoping to control or reverse coronary plaque take niacin. Recall that niacin (vitamin B3)is an extremely effect agent that raises HDL, dramatically reduces small LDL, shifts HDL particles into the effective large fraction, reduces triglycerides and triglyceride-containing particles like IDL and VLDL. Several studies have shown that niacin dramatically reduces heart attack. The HATS Study showed that niacin combined with Zocor yielded an 85-90% reduction in heart attack risk and achieved regression of coronary plaque in many participants.

In our experience, approximately 1 in 20 people will really struggle using niacin. Flushes for these occasional people will be difficult or even intolerable. Should Dr. Armitage's study demonstrate that this new combination agent does provide advantages in minimizing the hot flush effect, that will be a boon for the occasional Track Your Plaque participant who finds conventional niacin intolerable.

But you already have access to niacin, an agent with an impressive track record even without this new study. And you have a reasonably effective prostaglandin inhibitor, as well: aspirin. Good old aspirin is very useful, particularly in the first few months of your niacin initiation to blunt the flush.

Although this study is likely to further popularize niacin and allow its broader use, it's also a method for the drug companies to profit from an agent they know works but is cheap and available.

You don't have to wait. You already have niacin and aspirin available to you.

The dark side of CT heart scans

4. June 2006 William Davis (0)
"I just got a heart scan!" declared Eric to his doctor. He handed the report to him.

"Oh my. Your score is 154." The doctor paused, then looked at Eric with a serious look on his face. "If we're going to understand whether or not you're in danger, you'll need a heart catheterization."


I've seen this happen countless times. How can I say this diplomatically? THIS IS WRONG!! In my view, it's absolutely criminal for this to happen. Physician ignorance, profiteering, whatever--it is wrong.

There's very few reasons why someone who has no symptoms should go directly to the cath lab for a procedure. (A rare exception might be an exceptional quantity of plaque in the left mainstem artery, e.g., >100. This is highly unusual.)

Even a nuclear stress test (e.g., thallium) at this level of scoring is only 10-15% likely to be abnormal. That means 85-90% likelihood of being normal. There's rare reasons to perform a heart catheterization in a person with no symptoms and an entirely normal stress test. The vast majority of people like Eric do not need a heart catheterization to discern risk.

If Eric's doctor had been up-to-date on the published literature on the prognostic value of heart scans, he could have advised Eric what the risks were--without a catheterization. Many doctors simply don't want to be bothered. Or, they opt for the more profitable method--a hospital procedure.

Always discuss your heart scan with your doctor--but be armed with information in case your doctor is uninformed or unscrupulous. Unfortunately, that's not uncommon. The Track Your Plaque program is your advocate, a source for unbiased information.

The dirty little secret about aneurysms

2. June 2006 William Davis (1)
Jake had an abdominal aneurysm identified--by accident.

While getting a CT scan of his abdomen for unexplained abdominal pain, a 4.4 cm aneurysm was discovered. Jake's abdominal pain eventually passed without explanation, but he was left with this aneurysm.

Jake's primary care doctor referred him to a surgeon. "It's too small to require surgery right now. Wait a few years and it'll probably get bigger. When it gets to around 5.5 cm, that'll be the time to operate. Let's schedule an abdominal ultrasound or CT scan every 6 months."

Jake then got himself a heart scan. His high score of 879 then led him to my office. Lipoprotein testing, a stress test, correction of his lipoprotein patterns, changes in lifestyle followed. One year later, Jake's heart scan score was unchanged.

How about his abdominal aneurysm? 4.2 cm--a modest quantity of regression. When Jake's surgeon learned of the change, he just shrugged. "Okay, we'll just watch it from here."

Shockingly, the conversation surrounding aneurysms is just like the one Jake received: Let's just watch it grow until you need surgery.

If you've every seen anyone have abdominal aneurysm surgery, you know it is an awful, painful, barbaric process with high risk for major complications like kidney failure and loss of the legs. Waiting for an aneurysm to grow is a lousy solution. Surgeons point out that, although surgery is imperfect, it's better than the alternative: rupture, which is catastrophic with a 50% chance of dying.

But what about stopping the growth of the aneurysm? Or even reversing, or shrinking, it?

Surgeons say it can't be done. Yet we've done it--many times. And it's not that difficult.

The steps to take are very similar to that in the Track Your Plaque program for coronary plaque regression, with a few different strategies. Suppression of inflammation, for instance, plays a more important role and blood pressure must be abolutely normal, even during exercise.

More to come on this important topic in the future, including an upcoming Special Report on the www.cureality.com membership website.

Heart scan scores dropping like stones!!

1. June 2006 William Davis (0)
I saw two instances of dramatic coronary plaque regression today.

John, a 53-years old mechanical lift operator, dropped his heart scan score from 479 to 323--a 32% regression of coronary plaque volume!

Eric, a 50-year consulting engineer, dropped his heart scan score from 668 to 580--a 13% reduction.

Both men did nothing special beyond the principles advocated in the Track Your Plaque program. Recall that, without preventive efforts, your heart scan score is expected to increase by 30% per year. Both men are well on their way to freedom from risk of coronary "events".

Two less people to feed the revenue-hungry hospital procedure system! We need many more like them.
What's for breakfast? Egg bake

What's for breakfast? Egg bake

20. August 2010 William Davis (42)
Heart Scan Blog reader and dietitian, Lisa Grudzielanek, provided this recipe in response to the post, What's for breakfast?

Lisa, by the way, is one of the rare dietitians who understands that organizations like the American Dietetic Association have made themselves irrelevant. She therefore advocates diet principles that work, not just echoing the idiocy that emanates from such organizations, often driven by economics more than science. Lisa works in the Milwaukee area and has proven a useful resource person for my patients who have required extra coaching in the Track Your Plaque diet principles.

Egg Bake
My favorite breakfast is what I call an "egg bake." Others may refer to it as a "quiche."

Take a variety of fresh vegetables. This time of year is great for farmers' markets.

I typically use fresh chopped organic spinach, bell peppers, red & white onions, scallions, broccoli, mushrooms, cherry tomatoes halved and, if desired, meat (nitrite-free ham or leftover chicken breasts).

1) Chop veggies and place in casserole dish.
2) Add meat and handful of cheese of your choice.
3) Scramble 8 eggs & little bit of milk & pepper.
4) Add to casserole dish and mix/coat veggies with egg mixture.
5) Put in oven at 450 degress for 30 minutes.

Yummy, ready to eat breakfast that is so easy for the work week.
Tags :

Comments (42) -

  • Jonathan

    8/20/2010 3:17:30 PM |

    I took 7 eggs, spinach leaves torn up small, cut up green and blond peppers, and dropped them all in my cast iron pan on the stove top with some bacon grease.  It would have got some sausage, bacon, ham, and/or onion but I didn't have any.  I called it an omelet but I think it would taste a lot like the quiche here.  (ate it all by myself so needless to say, i'm not hungry and wont be eating lunch)

  • Matt B

    8/20/2010 6:02:55 PM |

    I always shy away from this type of thing, thinking of the oxidation that is occurring with the cholesterol in the eggs.   Is this unreasonable to consider, when contemplating eggs that have been in my fridge, scrambled, for days?   Same reason, I don't eat scrambled eggs on hotel buffet lines - also with those there is a higher likelihood that the eggs were made from powdered, also oxidized, fats.

  • n

    8/20/2010 7:07:04 PM |

    I'm with Jonathan. fried eggs > baked eggs. baking eggs makes them spongy.

    Matt B - I'm not sure I follow. Surely sealing the eggs away from the air in a tight container fixes this.

  • DogwoodTree05

    8/20/2010 10:00:00 PM |

    My favorite breakfast: deconstructed omelet

    1-2 eggs
    finely diced veggies
    spices
    butter or lard
    water or broth

    Melt 2T butter or lard in a fry pan on medium heat.
    Add spices and let cook for a couple minutes to bring out the flavor.  If you have minced onion or garlic, add these now.
    Add enough water or broth to cover the bottom of the pan, about 1/8 to 1/4 cup.  
    Add the veggies and cook for 2-5 minutes, until just softened and the color bright.
    Push the veggies to the side of the pan, add a little water, broth, or cooking fat if necessary and drop 1-2 eggs in the middle of the pan.  Cover and the eggs should set in 2-4 minutes.  
    Layer the veggies on the bottom of a plate and top with the eggs or serve them side by side.

    If you don't want to bother with veggies, eggs cooked in chicken broth and/or lard are delicious!  The egg whites soak up the flavor of the cooking liquid.

  • Anonymous

    8/21/2010 2:37:51 PM |

    Eggs got a bad rap in the 80s and 90s for having too much cholesterol. Should we not worry about ingestion of cholesterol as much as creation of cholesterol in the liver? I could eat eggs 4x a day, and lots of them each time if it doesn't spike my numbers.

    -- Boris

  • Matt B

    8/21/2010 6:11:56 PM |

    @n, I believe some oxidation would occur with the exposed yolks.  It's never going to be air tight.  Are my concerns totally unfounded?  

    http://www.cheeseslave.com/2009/08/28/what-passes-for-food-in-america/  

    @Boris, I am all for consuming cholesterol, just not oxidized cholesterol.  My breakfast many days is 3 hard boiled eggs with butter Smile

    If I pre-cook eggs, I only do it hard boiled.   fried eggs >>>>> baked eggs, but when I'm trying to get out the door by 5:30, fried don't work so well Smile

  • Tom

    8/21/2010 6:29:02 PM |

    Hi,
    Would someone please explain the "oxidation" your speaking of?
    Thank you.
    Tom

  • Tom

    8/21/2010 6:32:09 PM |

    I just tried the recipe with most of the same ingredients .... delicious!
    I think this will work with most any veggies.  I'm looking forward to experimenting.
    One note: I baked it in an uncovered dish.  It was just a bit watery on the bottom.  I think it would have been more so in a covered dish.

  • PAl

    8/21/2010 7:20:26 PM |

    hi dr davis.

    you've done amazing coverage for wheat. would you consider exploring the murky world of milk as well?

    it will be great to have some clarification on that too!

  • Anonymous

    8/22/2010 12:55:54 AM |

    For convenience, we bake them in mini-muffin pans and freeze them in single serving bags.

  • Anonymous

    8/22/2010 5:29:31 AM |

    has this turned into a recipies site?

  • Anonymous

    8/22/2010 11:54:26 AM |

    Sally Fallon says scrambling eggs does NOT oxidize the cholesterol:

    http://kellythekitchenkop.com/2009/05/oxidized-cholesterol-sally-fallon-answers-a-reader-question.html

  • Anonymous

    8/22/2010 3:12:19 PM |

    According to F. Guadiola et el in the book "Cholesterol and Phytoisterol Oxidation Products: Analysis Occurance, and Biological Effects." pg 129, Eggs that are fried and boiled have been reported to have oxidized cholesterol.

    You can preview this in google books.

  • Anonymous

    8/22/2010 7:48:44 PM |

    I guess I'm a little lost.  I just signed up for TYP to read articles and forum posts, with many of the articles alluding that it is best to keep saturated fat low, but these blog posts seem to contradict that?

    Changing or evolution of ideas?

  • Jonathan

    8/22/2010 10:23:27 PM |

    Most health advice says to lower Sat. fat intake.  That was based on some really crappy science and number fudging.  Books such as ones by Uffe Ravnskov and many others tear that science to bits.  The more cholesterol and Sat. fat you eat, the less the body makes.  It's pretty well regulated.  The reason it goes up in the first place is because it is protective.  It's used to repair the body.  It went up because wheat consumption and too many carbs raised the abrasive sugar in you veins and caused inflammation for which the cholesterol has to fix.  Fixing the inflammation lowers the cholesterol.
    Eating sat fat (most of the fats we use as replacements are high in inflammation causing Omega 6) also helps raise you HDL while the LDL will go down or at least change to a fluffy pattern.  Totals shouldn't be 200 or less like they say now.  240 is quite normal and people with 600 live really long normal lives.

    I think baking them doesn't make them spongy as much as the whisking them before you put them in there.  I still prefer them skillet scrambled.

  • Anonymous

    8/23/2010 12:00:51 AM |

    Thanks for the insight Jonathan.  I'm an ER/ICU nurse of 15 years with a few years of Nutrition studies before I went to nursing school.  Unfortunately, my brain is now just ridding itself of it's current dogma as I research this new 'trend' and approach.  

    I've been spending about 7 hours a day (I'm working in a slow ER;)) reading this site, and others like it.  Great resource and amazing how we got lead down the wrong path for the last 30 some odd years.

  • Anonymous

    8/23/2010 12:03:43 AM |

    I've been eating low carb for the last months, and I started experiencing realy bad muscle aches teh day after workouts. Like I feel my triceps and chest are burning under the skin.
    So after last workout I added some extra carbs and aches are gone.
    so the question is... how do you deal with muscle aches on a low carb diet?

  • kellgy

    8/23/2010 5:54:54 AM |

    The Egg bake looks like an interesting recipe. I just bought two dozen eggs and am readying the kitchen. Can't wait to try it. Thanks for the post and Lisa for the idea!

  • Anonymous

    8/23/2010 9:45:19 AM |

    Dear Dr. Davis,

    This blog is full of statements and advice that seem to seek to debunk conventional, established thinking about heart issues. Given that we are talking about extremely serious matters, do you not think that the least you can do is to let us know whether:

    1. You have published research backing the advice you give on your blog,
    2. Your work has been peer reviewed and
    3. Where to find them.

    By not doing so, every reader of your blog will feel entitled to utter totally unsubstantiated statements such  as these two in this post: "That was based on some really crappy science and number fudging" (Jonathan) or "my brain is now just ridding itself of it's current dogma" (Anonymous).

  • Pal

    8/23/2010 10:48:00 AM |

    ^^^^

    we are all the peers of each other here and have reviewd this advise by testing it on ourselves.

    you are welcome to be a 'peer reviewer' yourself and 'report' your 'findings' through a simple comment on this blog.

    lets keep the bureaucracy and red tape out, and figure out for ourselves what works.

    learn to listen to your body, that is the best peer review!

  • Jonathan

    8/23/2010 2:31:33 PM |

    Muscle aches.  Hmm...  I get sore after HIT but always though I was supposed to.  I only lift once a week though so I have plenty of time to replenish stores of glucose.  You my want to add some fruit like a peach or apple post work out (shouldn't need much) along with some post workout protein.

    Conventional thinking has to be right because it is conventional.  So a drug manufacturer sponsors a trial, they work the numbers to match what they thought it should say, hand this screwed up data to a peer panel that never tested this stuff themselves, and now it is accurate "peer reviewed" advice to give to 100% of the people on this planet.
    I'll stick to thought that God knew what he was doing when we were created and that our bodies have cholesterol for a reason.  If saying I believe in God makes me unscientific, I don't care.  I know what works for me (lost 70 lbs and counting, sugar is under control, can do 5+ mile hikes in the mountains even though I'm still 285 lbs, no longer take Prilosec at all, and feel strong as an ox).
    If it was two of us low-carbers finding improvements in health then maybe there would be room for dispute but we are thousands strong.
    Why is it the people how actually find what works have to prove themselves and the people who push ideas that haven't worked in 40 years get to stand and point fingers.  I believe in what I learn myself, not what is forced upon me.

  • Anonymous

    8/23/2010 3:21:15 PM |

    Really!...Do you subscribe to Pal & Jonathan statements, Dr. Davis?

  • Dr. William Davis

    8/23/2010 3:42:10 PM |

    I find it odd that requests for publications and references comes in a recipe post.

    Point taken. This is also a blog, not an encyclopedia. While I try to point out the science where it exists and is appropriate, much of what I say here is based on personal observations, not always quantified. That's why I call it The Heart Scan Blog, not The Heart Scan Encyclopedia.

  • n

    8/23/2010 4:03:54 PM |

    The Guadiola book from 2002 referred to by anon above is very interesting.

    From the table on p125 of cholesterol oxidation product in egg products:

    pasturized, uncooked egg - 3 ug/g
    fried 1 min - 84
    fried 3 min - 124
    boiled 3 min - 128
    boiled 10 min - 203

    I wonder what effect temp has on these numbers. That is, cooking at a temp lower that boiling or what you'd trypically fry an egg at.

  • Anonymous

    8/23/2010 5:11:07 PM |

    My point exactly, Dr. Davis. If your blog were about recipes and cookery, I wouldn't have even bothered to raise the issue. As far as I know, cookery has not reached the status of science ...not yet anyway!

    According to your own profile in this blog, you practise cardiology, and so one imagines that both your writings and opinions are informed by scientific methods. And when that is not the case, and when what you are providing is an opinion, even if it is an informed opinion, it is your professional duty to let your readers know that what you are saying is, in your own words, based on personal observations.

    And that is perfectly legitimate, you are of course entitled to your own opinions. But when what you write about and the comments you make might have a impact on the health of those readers who trust your opinions, because you are a practising cardiologist, then your opinions must adhere to scientific principles. And if what you say and write about has not been scientifically demonstrated, then you should expressed it unambiguously.

    I have a serious heart condition, and believe you me, when it comes to life or death matters, I do not consult the cookery pages. Nor do I seek advice from an astrologer either.

  • Pal

    8/23/2010 5:36:36 PM |

    ^^^

    you have a serious heart condition because of your trust in 'scientific principles' which is how it should be.

    but sir what do you mean by that phrase? just complex sounding gibberish stretched and distorted through endless loops of political and monetary  interets called the 'peer review' process?

    you are welcome to unravel the heart mysteries here yourself but do let Dr Davis share his observations without choking this channel for others by your demands for your version of the 'peer review' process!

    i like the simple and effective approach here!

    Thanks!

  • n

    8/23/2010 5:46:11 PM |

    Anon said "I have a serious heart condition, and believe you me, when it comes to life or death matters, I do not consult the cookery pages. Nor do I seek advice from an astrologer either."

    Last time I checked this wasn't the doctor's office.

    Either you're a troll or you haven't grasped the concept of a blog.

  • Tom

    8/23/2010 7:45:56 PM |

    @Anonymous:

    You obviously have a need for "authoritarian" documentation to sooth your inability to think for yourself.  Why do you continue to post here other than to stir up contoversy and post snide Ad Hominums?
    Clearly you are trolling, and that says all that needs be said about your pompous and officious personality.
    I for one will now ignore you and I hope that everyone else will also.
    Take your pathetic and disengenuous comments somewhere with your own kind where you can all feed on each other's tiny egos, and mean and nasy outlooks on everything.
    No one asked you to come here, so leave.  You bring nothing of value to the discussions here.

  • Anonymous

    8/23/2010 9:47:29 PM |

    I have nothing against the blog. You are free to think whatever you want and your beliefs are not my concern. Just do not try to present as a fact what is just an opinion. At least Jonathan, one of your neighbours a couple of comments before yours, is more candid when he says: "I'll stick to thought that God knew what he was doing when we were created and that our bodies have cholesterol for a reason." I rest my case.

  • Tommy

    8/24/2010 2:24:04 AM |

    Jonathan said:
    "Eating sat fat (most of the fats we use as replacements are high in inflammation causing Omega 6) also helps raise you HDL while the LDL will go down or at least change to a fluffy pattern. Totals shouldn't be 200 or less like they say now. 240 is quite normal and people with 600 live really long normal lives."

    Dr. Davis said in an older post:

    "If, on the other hand, your small LDL is genetically programmed, then saturated fat will increase small LDL.  In other words, saturated fat tends to increase the dominant or genetically-determined form of LDL. If your dominant genetically-determined form is small, then saturated fat increases small LDL particles."

    Dr Davis also mentioned somewhere (can't find it at the moment) that saturated fat causes inflammation.

    So I'd say that there is still conflicting reports out there and moderation again wins the day.

    Meanwhile in this post we have the suggestion to consume large amounts of eggs which contain saturated fat. Safe for everyone?

  • Kristen B

    8/24/2010 3:02:50 AM |

    I am curious: just what consists of a typical day of  meals for you? And what is causes "oxidized ldl"?

  • Anonymous

    8/24/2010 12:34:28 PM |

    About the muscle aches...

    A little bit of soreness is to be expected, especially after a hard workout, change of routine, or starting a routine after a long break.  That said, if you're not consuming adequate calories, your body will use the protein for fuel instead of for repairing/rebuilding your muscles.  Carbohydrate will spare the protein (again, assuming adequate calories are consumed) as well as replace glycogen stores.  Try just bumping up your calories, but if you want to continue the carbs just make sure you consume a carb/protein snack within an hour of your workout and don't overtrain.

  • Jonathan

    8/24/2010 2:36:03 PM |

    First off, LDL is not the horrible guy everybody thinks of it as.  You have to have it.  It has a job to do.  LDL helps fight infections as well as transport needed fuel through the blood.  You just want the bigger size pattern so it doesn't oxidize as quickly.
    Sat fat consumption doesn't fix the pattern directly.  It allows for less calories from carbs which helps fix the pattern.  It does seem to help raise HDL no matter how the person's genetics create LDL.  Along with the less carbs causing lower Trig, the HDL to Trig ratio is much improved.
    Your body stores excess as a high % of sat fat to burn later.  Which means in order to use those stores, you have to release it into the blood stream.  What's the difference in that and eating it?
    As for inflammatory, I've not seen anything on it.  Doesn't mean it doesn't exist.  It might not be scientific and I'm just a layman, but if you put sugar on your tongue and rub it around it will get real sore.  Put some coconut oil on there and rub it around it will feel better.  So my opinion is that fat/cholesterol didn't cause the inflammation in the arteries, it's responding to it to fix it.

    Dr. Davis is just one man with an opinion too.  He blogs those current thoughts.  They may change.  This site isn't a medical text book (and I still wouldn't 100% trust it if it were).  We can take away from him what we want to learn and believe.  We can read other people's opinions.  We can discuss; don't have to agree.  Knowledge only advances through disagreement.

    If you want to attack my religion, fine by me.  Only tells me you have nothing to dispute my ideas with so you grasp at anything discrediting instead.  Why not call me fatty or dumb?  Bet you would think Albert Einstein as a good scientist but how many discredited him in their minds because he was weird or had strange hair.  Believe what you want to believe but think for yourself.

  • LynneC

    8/24/2010 3:16:01 PM |

    Well, I don't think Dr Davis was recommmending that you eat the entire 8 egg casserole at one sitting! Here's a link to eggs as it relates to heart disease.  You will need to copy and paste the link into your browser.  Full PDF available for free...
    http://www.jacn.org/cgi/content/full/23/suppl_6/596S

  • Jonathan

    8/24/2010 3:24:52 PM |

    Thanks for the link.  I got stuck on this part:
    "However, population-based studies examining the association between egg consumption and serum cholesterol levels show either no association, or, paradoxically, an inverse association"

  • Anonymous

    8/24/2010 6:21:19 PM |

    Jonathan, Jonathan. Your logic beggars belief. Now that you mention Einstein, he once said that there are two things that are infinite: the universe and human stupidity, and that he wasn't sure about the universe.

  • Tom

    8/24/2010 6:45:32 PM |

    Is it possible to have this troll who calls himself "anonymous" removed?
    He's here only to stirr up trouble.

  • Tommy

    8/24/2010 7:06:07 PM |

    Jonathan, I'm not being argumentative, This is a serious inquiry. I learn a lot from this blog but I also learn a lot from sites and blogs that are in complete opposition, I take from everything. Personally the more information I get from all sides the more I end up middle of the road on my own path.

    You said:
    Sat fat consumption doesn't fix the pattern directly. It allows for less calories from carbs which helps fix the pattern.

    Is this because the more fat/sat fat you consume the more satiated you become and it's just less room for carbs due to lack of hunger? If so then that doesn't work for everyone. I am at a good weight....maybe even thin...but I have a huge appetite. A person like me would could eat loads of sat fat and still consume a lot of carbs. What about a huge plate of pasta smothered in high fat meat sauce? Finish that meal with Italian pastries (nice cannolis) and fruit and I'd say that's a high fat and high carb disaster. The fat in that meal doesn't squeeze out the carbs then....does it?

    I don't buy into the whole saturated fat nonsense and personally don't run and hide from saturated fat. I drink whole fat milk, I have Olive oil, I don't buy non fat products etc but at the same time I don't go crazy eating too much either. What is too much? I don't know but I just try not to get too crazy. But I also don't consume any processed refined carbs. No bread, wheat or sugar, no flour. Actually it would be hard for me to think of a food I eat that even has an ingredient label!! But I do eat brown rice and quinoa. Not huge amounts, but I eat them.

    Thanks

  • Jonathan

    8/24/2010 8:47:41 PM |

    Awesome.  Anonymous called me stupid.  

    Tommy, I'm not meaning to attack you either.  I think you a prime example of why the government has no business giving dietary guidelines.  No one diet plan can fit 100% of the people.  You have to do what works for you.
    What I meant is that if you drop calories in carbs you'll replace them in protein and fat.  I simply choose to eat more sat and the rest in mono and not increase protein.  The first time I tried Atkins I just focused on lowering carbs and I didn't make it too long.  This time around, I focused on low to now carb and increasing natural sat fat and trying to keep protein moderate.  I feel great now and have for the last 8 months.
    Your high metabolism is interesting.  It's like you are very active athlete who may need some extra carbs to keep going.  Not saying grains are a good place to get them.  I would be curious how active you really are and I would be curious what a 70-80% fat content over a few weeks would do for your hunger (say your body releases insulin faster than others to protein or something).  Have you tried checking your blood sugar on an interval for a day?  Once my sugar stabilized (too me a couple of months to get real stable) my hunger when way down.  I guess I'm just mentally stuck on insulin being the normal culprit for messing with fat and sugar storage/usage and ultimately hunger causing.  I guess I should add my idea of high fat would be a day like: 4 eggs and bacon for breakfast and a cup of coffee with heavy cream, a salad with olive oil or left over pork chops or 4 hotdogs or fasting for lunch, and an untrimmed 7-9oz steak with butter on top and broccoli or asparagus sauteed in butter/coconut oil for supper.  I feel extra hungry sometimes and will have some cheese or more steak or something at supper.  I also try to vary the amount I eat like fasting some days and gorging others.  Eating carbs makes me more and more hungry (sometime delayed an hour); fat at the least doesn't make me more hungry.
    Just my observations of what is working for me.

  • Tommy

    8/24/2010 9:22:40 PM |

    Here's the funny thing. If not for reading things on the internet I'd probably keep going thinking I was doing fine. I mean, basically I am. My weight is excellent. My bodyfat is good. I feel good, I'm in shape. My bloodwork is good and all is well. I could just leave it at that and keep going but the internet leaves me with questions all the time.  You know, I can get someone looking to lose weight and probably ask them "how they would like to do it." "Do you like carbs? There is a site that is very successful in their members losing weight consuming high carbs (Matt Stone). Do you like meat? There is a site that has huge numbers of followers losing weight eating lots of meat and animal fat (Mark Sisson). Do you like low fat? there are low fat diets that some swear by also.  How about high protein? (Michael Eades), What about traditional and middle road? (Sally Fallon)."
    Then you have Atkins and like minded and McDougal and like minded. Everyone has followers who claim all the same beifits as the next guy on the opposite end. Weight loss, better numbers in bloodwork, more energy, less cavities, no joint aches and on and on.

    There really are a lot of choices out there and a lot of conflicting information. I think my worst move was to gain a little knowledge...lol.

    Thanks...interesting info.

  • Vicki Huckabee Dixon

    8/25/2010 4:34:09 PM |

    I for one eat LOTS of saturated fat and my labs are all the proof I need to know they don't cause inflammation.  In fat, they definitely seem to lower it.  I don't follow anything on blind faith. "The proof is in the pudding".  And I dear friends, have never been healthier in my life.  Nor has my cholesterol and inflammation been lower.  Nay say all you want, but try it out and have a good hard look at your labs for the proof you need.

  • Laura

    8/30/2010 7:25:35 PM |

    Thank you, Dr. Davis for reposting this so we can all view it more easily.

Add comment

Loading