Rerun: To let low-carb right, you must check POSTPRANDIAL blood sugars

2. April 2010 William Davis (12)
Checking postprandial (after-eating) blood sugars yields extraordinary advantage in creating better diets for many people.

This idea has proven so powerful that I am running a previous Heart Scan Blog post on this practice to bring any newcomers up-to-date on this powerful way to improve diet, lose weight, reduce small LDL, reduce triglycerides, and reduce blood pressure.



To get low-carb right, you need to check blood sugars

Reducing your carbohydrate exposure, particularly to wheat, cornstarch, and sucrose (table sugar), helps with weight loss; reduction of triglycerides, small LDL, and c-reactive protein; increases HDL; reduces blood pressure. There should be no remaining doubt on these effects.

However, I am going to propose that you cannot truly get your low-carb diet right without checking blood sugars. Let me explain.

Carbohydrates are the dominant driver of blood sugar (glucose) after eating. But it's clear that we also obtain some wonderfully healthy nutrients from carbohydrate sources: Think anthocyanins from blueberries and pomegranates, vitamin C from citrus, and soluble fiber from beans. There are many good things in carbohydrate foods.

How do we weigh the need to reduce carbohydrates with their benefits?

Blood sugar after eating ("postprandial") is the best index of carbohydrate metabolism we have (not fasting blood sugar). It also provides an indirect gauge of small LDL. Checking your blood sugar (glucose) has become an easy and relatively inexpensive tool that just about anybody can incorporate into health habits. More often than not, it can also provide you with some unexpected insights about your response to diet.

If you’re not a diabetic, why bother checking blood sugar? New studies have documented the increased likelihood of cardiovascular events with increased postprandial blood sugars well below the ranges regarded as diabetic. A blood sugar level of 140 mg/dl after a meal carries 30-60% increased (relative) risk for heart attack and other events. The increase in risk begins at even lower levels, perhaps 110 mg/dl or lower after-eating.

We use a one-hour after eating blood sugar to gauge the effects of a meal. If, for instance, your dinner of baked chicken, asparagus brushed with olive oil, sauteed mushrooms, mashed potatoes, and a piece of Italian bread yields a one-hour blood sugar of 155 mg/dl, you know that something is wrong. (This is far more common than most people think.)

Doing this myself, I have been shocked at the times I've had an unexpectedly high blood sugar from seemingly "safe' foods, or when a store- or restaurant-bought meal had some concealed source of sugar or carbohydrate. (I recently had a restaurant meal of a turkey burger with cheese, mixed salad with balsamic vinegar dressing, along with a few bites of my wife's veggie omelet. Blood sugar one hour later: 127 mg/dl. I believe sugar added to the salad dressing was the culprit.)

You can now purchase your own blood glucose monitor at stores like Walmart and Walgreens for $10-20. You will also need to purchase the fingerstick lancets and test strips; the test strips are the most costly part of the picture, usually running $0.50 to $1.00 per test strip. But since people without diabetes check their blood sugar only occasionally, the cost of the test strips is, over time, modest. I've had several devices over the years, but my current favorite for ease-of-use is the LifeScan OneTouch UltraMini that cost me $18.99 at Walgreens.

Checking after-meal blood sugars is, in my view, a powerful means of managing diet when reducing carbohydrate exposure is your goal. It provides immediate feedback on the carbohydrate aspect of your diet, allowing you to adjust and tweak carbohydrate intake to your individual metabolism.

LDL glycation

1. April 2010 William Davis (11)
The proteins of the body are subject to the process of glycation, modification of protein structures by glucose (blood sugar). In the last Heart Scan Blog post, I discussed how glycated hemoglobin, available as a common test called HbA1c, can serve as a reflection of protein glycation (though it does not indicate actual Advanced Glycation End-products, or AGEs, just a surrogate indicator).

There is one very important protein that is subject to glycation: Apoprotein B.

Apoprotein B, or Apo B, is the principal protein of VLDL and LDL particles. Because there is one Apo B molecule per VLDL or LDL particle, Apo B can serve as a virtual VLDL/LDL particle count. The higher the Apo B, the greater the number of VLDL and LDL particles.

Because Apo B is a protein, it too is subject to the process of glycation. The interesting thing about the glycation of Apo B is that its "glycatability" depends on LDL particle size: The smaller the LDL particle, the more glycation-prone the Apo B contained within.

Younis et al have documented an extraordinary variation in glycatability between large and small LDL, with small LDL showing an 8-fold increased potential.

Think about it: Carbohydrates in the diet, such as wheat products and sugars, trigger formation of small LDL particles. Small LDL particles are then more glycation-prone by up to a factor of 8. Interestingly, HbA1c is tightly correlated with glycation of Apo B. Diabetics with high HbA1c, in particular, have the greatest quantity of glycated Apo B. They are also the group most likely to develop coronary atherosclerosis, as well as other consequences of excessive AGEs.

No matter how you spin it, the story of carbohydrates is getting uglier and uglier. Carbohydrates, such as those in your whole grain bagel, drive small LDL up, while making them prone to a glycating process that makes them more likely to contribute to formation of coronary atherosclerotic plaque.

High HbA1c: You're getting older . . . faster

28. March 2010 William Davis (16)
Over the years, we all accumulate Advanced Glycation End-products, or AGEs.

AGEs are part of aging; they are part of human disease. AGEs are the result of modification of proteins by glucose. AGEs form the basis for many disease conditions.

Accumulated AGEs have been associated with aging, dementia, cataracts, osteoporosis, deafness, cancer, and atherosclerosis. Most of the complications of diabetes have been attributable to AGEs.

There's one readily available method to assess your recent AGE status: HbA1c.

Hemoglobin is the oxygen-carrying protein of red blood cells. Like other proteins, hemoglobin becomes glycated in the presence of glucose. Hemoglobin glycation increases linearly with glucose: The higher the serum or tissue glucose level, the more glycation of hemoglobin develops. Glycated hemoglobin is available as the common test, HbA1c.

Ideal HbA1c is 4.5% or less, i.e., 4.5% of hemoglobin molecules are glycated. Diabetics typically have HbA1c 7.0% or greater, not uncommonly greater than 10%.

In other words, repetitive and sustained high blood glucose leads to greater hemoglobin glycation, higher HbA1c, and indicates greater glycation of proteins in nerve cells, the lens of your eye, proteins lining arteries, and apoprotein B in LDL cholesterol particles.

If AGEs accumulate as a sign of aging, and high blood sugars lead to greater degrees of glycation, it only follows that higher HbA1c marks a tendency for accelerated aging and disease.

Indeed, that is what plays out in real life. People with diabetes, for instance, have kidney failure, heart disease, stroke, cataracts, etc. at a much higher rate than people without diabetes. People with pre-diabetes likewise.

The higher your HbA1c, the greater the degree of glycation of other proteins beyond hemoglobin, the faster you are aging and subject to all the phenomena that accompany aging. So that blood glucose of 175 mg/dl you experience after oatmeal is not a good idea. 

The lesson: Keep HbA1c really low. First, slash carbohydrates, the only foods that substantially increase blood glucose. Second, maintain ideal weight, since normal insulin responsiveness requires normal body weight. Third, stay physically active, since exercise and physical activity exerts a powerful glucose-reducing effect. Fourth, consider use of glucose-reducing supplements, an issue for another day.

While HbA1c cannot indicate cumulative AGE status, it can reflect your recent (preceding 60 to 90 days) exposure to this age-accelerating thing called glucose.

If your doctor refuses to accommodate your request for a HbA1c test, you can perform your own fingerstick test.

Slash carbs . . . What happens?

26. March 2010 William Davis (20)
Cut the carbohydrates in your diet and what sorts of results can you expect?

Carbohydrate reduction results in:

Reduced small LDL--This effect is profound. Carbohydrates increase small LDL; reduction of carbohydrates reduce small LDL. People are often confused by this because the effect will not be evident in the crude, calculated (Friedewald) LDL that your doctor provides.

Increased HDL--The HDL-increasing effect of carbohydrate reduction may require 1-2 years. In fact, in the first 2 months, HDL will drop, only to be followed by a slow, gradual increase. This is the reason why, in a number of low-carb diet studies, HDL was shown to be reduced.--Had the timeline been longer, HDL would show a significant increase.

Decreased triglycerides--Like reduction of small LDL, the effect is substantial. Triglyceride reductions of several hundred milligrams are not at all uncommon. In people with familial hypertriglyceridemia with triglyceride levels in the thousands of milligrams per deciliter, triglyceride levels will plummet with carbohydrate restriction. (Ironically, conventional treatment for familial hypertriglyceridemia is fat restriction, a practice that can reduce triglycerides modestly in these people, but not anywhere near as effectively as carbohydrate restriction.) Triglyceride reduction is crucial, because triglycerides are required by the process to make small LDL--less triglycerides, less small LDL.

Decreased inflammation--This will be reflected in the crude surface marker, c-reactive protein--Yes, the test that the drug industry has tried to convince you to take statins drugs to reduce. In my view, it is an absurd notion that you need to take a drug like Crestor to reduce risk associated with increased CRP. If you want to reduce CRP to the floor, eliminate wheat and other junk carbohydrates. (You should also add vitamin D, another potent CRP-reducing strategy.)

Reduced blood pressure--Like HDL, blood pressure will respond over an extended period of months to years, not days or weeks. The blood pressure reduction will be proportion to the amount of reduction in your "wheat belly."

Reduced blood sugar--Whether you watch fasting blood sugar, postprandial (after-meal) blood sugars, or HbA1c, you will witness dramatic reductions by eliminating or reducing the foods that generate the high blood sugar responses in the first place. Diabetics, in particular, will see the biggest reductions, despite the fact that the American Diabetes Association persists in advising diabetics to eat all the carbohydrates they want. Reductions in postprandial (after-eating) blood sugars, in particular, will reduce the process of LDL glycation, the modification of LDL particles by glucose that makes them more plaque-causing.


You may notice that the above list corresponds to the list of common plagues targeted by the pharmaceutical industry: blood pressure, diabetes (diabetes being the growth industry of the 21st century), high cholesterol. In other words, high-carbohydrate, low-fat foods from the food industry create the list of problems; the pharmaceutical industry steps in to treat the consequences.

In the Track Your Plaque approach, we focus specifically on elimination of wheat, cornstarch, and sugars, the most offensive among the carbohydrates. The need to avoid other carbohydrates, e.g., barley, oats, quinoa, spelt, etc., depends on individual carbohydrate sensitivty, though I tend to suggest minimal exposure.

Normal fasting glucose with high HbA1c

23. March 2010 William Davis (24)
Jonathan's fasting glucose: 85 mg/dl
His HbA1c: 6.7%

Jonathan's high HbA1c reflects blood glucose fluctuations over the preceding 60-90 days and can be used to calculate an estimated average glucose (eAG) with the following equation:

eAG = 28.7 X A1c – 46.7

(For glucose in mmol/L, the equation is eAG = 1.59 × A1C - 2.59)

Jonathan's HbA1c therefore equates to an eAG of 145.59 mg/dl--yet his fasting glucose value is 85 mg/dl. 

This is a common situation: Normal fasting glucose, high HbA1c. It comes from high postprandial glucose values, high values after meals. 

It suggests that, despite having normal glucose while fasting, Jonathan experiences high postprandial glucose values after many or most of his meals. After a breakfast of oatmeal, for instance, he likely has a blood glucose of 150 mg/dl or greater. After breakfast cereal, blood glucose likely exceeds 180 mg/dl. With two slices of whole wheat bread, glucose likewise likely runs 150-180 mg/dl. 

The best measure of all is a postprandial glucose one hour after the completion of a meal, a measure you can easily obtain yourself with a home glucose meter. Second best: fasting glucose with HbA1c.

Gain control over this phenomenon and you 1) reduce fasting blood sugar, 2) reduce expression of small LDL particles, and 3) lose weight.  

Can you handle fat?

21. March 2010 William Davis (19)
No question: Low-carbohydrate diets generate improved postprandial lipoprotein responses.

Here's a graph from one of Jeff Volek's great studies:



Participants followed a low-carb diet of less than 50 g per day carbohydrate ("ketogenic") with 61% fat.   The curves were generated by administering a 123 g fat challenge with triglyceride levels assessed postprandially. The solid line represents the postprandial response at the start; dotted line after the 6-week low-carb effort.

Note that:

1) The postprandial triglyceride (area-under-the-curve) response was reduced by 29% in the low-carb diet.  That's a good thing.

2) The large fat challenge generated high triglycerides of greater than 160 mg/dl even in the low-carb group. That's a bad thing. 

In other words, low-carb improves postprandial responses substantially--but postprandial phenomena still occur. Postprandial triglycerides of 88 mg/dl or greater are associated with greater heart attack risk because they signify the presence of greater quantities of atherogenic (plaque-causing) postprandial lipoproteins.

A full discussion of these phenomena can be found in the Track Your Plaque Special Report, Postprandial Responses: The Storm After the Quiet!, part of a 3-part series on postprandial phenomena.

Statin stupid

19. March 2010 William Davis (0)
If we followed the lead of the pharmaceutical industry and my cardiology colleagues, we would all subscribe to the "statins for all" philosophy. There is now $2 billion of clinical "research" to back up this "evidence-based" practice.

I do not endorse this "statins for all" philosophy. I believe it is a product of the raw profiteering of the pharmaceutical industry, who are adept at recruiting physicians to their cause.

But lost in the confusion of tainted studies and over-the-top media saturation is the fact that there are small groups of people who likely do obtain benefit from statin drugs. They would certainly benefit from better informed scrutiny of their lipoprotein and metabolic abnormalities. But treatment may involve statins.

This is entirely distinct from the "statins for all" argument, the simpleminded rule that primary care physicians and cardiologist are told to follow.

Groups who may indeed benefit from statin therapy include:

Homozygous or heterozygous familial hypercholesterolemia--Lacking a receptor for LDL particles, LDL piles up to very high levels in these people. LDLs of 300+ are common and lead to heart disease and stroke at relatively young ages.

Combined mixed hyperlipidemia--Among the one or more genetic defects underlying this condition involves excessive production of apoprotein B and VLDL particles. This leads to high risk for heart disease.

People unable to follow a diet to correct their lipid disorder--I have 80+-year old patients, for instance, who say, "I've eaten this way for 82 years. I'm not going to change now!" In the absence of diet and other efforts (e.g., omega-3 fatty acids from fish oil), drugs may be the answer.

In other words, of the $27 billion annual bill for statin drugs, perhaps a tiny fraction is truly necessary. The majority of people taking statin drugs would not really need them if they had the real answers. But don't let that confuse us: There are some people who do indeed benefit.

Butter and insulin

19. March 2010 William Davis (83)
In a previous post, Atkins Diet: Common Errors, I commented on butter's unusual ability to provoke insulin responses. I offer this as a possible reason why, after a period of effective weight loss on a low-carbohydrate program, inclusion of some foods, such as butter, will trigger weight gain or stall weight loss efforts.

This develops because of butter's insulin-triggering effect, doubling or tripling insulin responses (postprandial area-under-the-curve). If insulin is triggered, fat gain follows.

Here's one such study documenting this effect: Distinctive postprandial modulation of ß cell function and insulin sensitivity by dietary fats: monounsaturated compared with saturated fatty acids

López et al 2008


From Lopez et al 2008. Mean (± SD) plasma glucose, insulin, triglyceride, and free fatty acid (FFA) concentrations during glucose and triglyceride tolerance test meal (GTTTM) with no fat (control), enriched in monounsaturated fatty acids (MUFAs) from refined olive oil (ROO meal), with added butter, with a mixture of vegetable and fish oils (VEFO) or with high-palmitic sunflower oil (HPSO). N = 14.

The postprandial (after-eating) area-under-the-curve is substantially greater when butter is included in the mixed composition meal. This effect is not unique to butter, but is shared by most other dairy products.

Fat, in general, does not make you fat. But butter makes you fat.

Vitamin D as a cardiovascular risk factor gains ground

18. March 2010 William Davis (0)
If you were reading The Heart Scan Blog back in 2007, or read my Life Extension article on vitamin D deficiency as a cardiovascular risk factor, you already knew that vitamin D deficiency is rampant and adds to cardiovascular risk.

Results of a study from the Intermountain Medical Center Heart Institute in Utah bolster the concept that vitamin D deficiency is a cardiovascular risk factor, vitamin D normalization/supplementation reduces cardiovascular risk.

Science Daily reported:

For the first study, researchers followed two groups of patients for an average of one year each. In the first study group, over 9,400 patients, mostly female, reported low initial vitamin D levels, and had at least one follow up exam during that time period. Researchers found that 47 percent of the patients who increased their levels of vitamin D between the two visits showed a reduced risk for cardiovascular disease.


In the second study, researchers placed over 31,000 patients into three categories based on their levels of vitamin D. The patients in each category who increased their vitamin D levels to 43 nanograms per milliliter of blood or higher had lower rates of death, diabetes, cardiovascular disease, myocardial infarction, heart failure, high blood pressure, depression, and kidney failure. Currently, a level of 30 nanograms per milliliter is considered "normal."


Over the past 4 years, people in our program have been enjoying the extravagant benefits of vitamin D restoration. Cardiovascular benefits are becoming better documented and the bone health, cancer-preventing, insulin-normalizing, mood-adjusting, and anti-inflammatory effects likewise.

Atkins Diet: Common errors

18. March 2010 William Davis (74)
No doubt: The diet approach advocated by the late Dr. Robert Atkins was a heck of a lot closer to an ideal diet than the knuckleheaded advice emitting from the USDA, American Heart Association, American Diabetes Association, and the Surgeon General's office.

But having just spent a week with Atkins low-carbers, here are some common errors that I see many make, errors that I believe have long-term health consequences, including impairment of weight loss.

Excessive consumption of animal products--Non-restriction of fat often leads to over-reliance on animal products. Higher intakes of red meats (heme proteins?) have been strongly associated with increased risk for colon and other gastrointestinal tract cancers. It is not a fat issue; it is an animal product issue. We should consume less meat, more vegetables and other plant-sourced foods.

Consumption of cured meats--Cured, processed meats, such as sausage, hot dogs, salami, bologna, and bacon, have a color fixative called sodium nitrite, an additive that has been confidently linked to gastrointestinal cancers. Risk is likely dose-dependent: The more you ingest, the greater the long-term risk.

Overconsumption of dairy products--Dairy products, especially milk, yogurt, cottage cheese, and butter, are potent insulinotropic foods, i.e., foods that trigger insulin release. There can be up to a tripling of insulin (area-under-the-curve) levels. This is not good in a world populated with tired, overworked pancreases, exhausted from a lifetime of high-carbohydrate eating.

Too many calories--While I agree that "a calorie is a calorie" and "calories in, calories out" are faulty concepts, I have anecdotally observed that long-time low-carbers often trend towards unlimited consumption of food, a phenomenon that seems to result in weight gain, especially in the sedentary. I wonder if this is a reflection of the insulinotropic action of dairy products and other proteins, compounded by the poor insulin responsiveness that develops with lack of physical activity. Factor into this conversation that lower calorie intake extends life, probably substantially (Sirt-2 activation and related phenomena, a la resveratrol). If lower calorie intake extends life, unlimited calorie intake likely shortens life.

Please don't hear this as low-carb bashing--it is not. It is a call to improve diets and not stumble into common traps that can impair heart health, weight loss, and longevity.
Homegrown osteoporosis prevention and reversal

Homegrown osteoporosis prevention and reversal

1. September 2010 William Davis (58)
I don't like to stray too far off course from discussions of heart disease and related issues in this blog. But the question of bone health comes up so often that I thought I'd discuss the strategies available to everybody to stop, even reverse, osteoporosis.

Coronary atherosclerotic plaque and bone health are intimately interwoven. People who have coronary plaque usually have osteoporosis; people who have osteoporosis usually have coronary plaque. (The association is strongest in females.) The worse the osteoporosis, the greater the quantity of coronary plaque, and vice versa. The two seemingly unconnected conditions share common causes and thereby respond to similar treatments.

Incredibly, rarely will your doctor tell you about these strategies. Your doctor orders a bone density test, the value shows osteopenia or osteoporosis, and a drug like Fosamax or Boniva is prescribed. As many people are learning, drugs like this can be associated with severe side-effects, such as jaw necrosis (death of the jaw bone), a dangerous and disfiguring condition that leads to loss of teeth and disfigurement, followed by reconstructive surgery of the jaw and face. These are not trivial effects.

Note that drugs are approved by the FDA based on assessment of efficacy and safety, NOT proven equivalence or superiority to natural treatments.

In order of importance (greatest to least), here are strategies that I believe are important to regain or maintain bone health. Indeed, I have seen many women increase bone density using these strategies . . . without drugs of any sort.

1) Vitamin D restoration--Vitamin D is the most important control factor over bone calcium metabolism, as well as parathyroid function. As readers of this blog already know, gelcap forms of vitamin D work best, aiming for a 25-hydroxy vitamin level of 60-70 ng/ml. This usually requires 6000 units per day, though there is great individual variation in need.

2) Vitamin K2--If you lived in Japan, you would be prescribed vitamin K2. While it's odd that K2 is a "drug" in Japan, it means that it enjoys the validation required for approval through their FDA-equivalent. Prescription K2 (as MK-4 or menatetranone) at doses of 15,000-45,000 mcg per day (15-45 mg), improves bone architecture, even when administered by itself. However, K2 works best when part of a broader program of bone health. I advise 1000 mcg per day, preferably a mixture of the short-acting MK-4 and long-acting MK-7. (Emerging data measuring bone resorption markers suggest that lower doses may work nearly as well as the high-dose prescription.)

3) Magnesium--I generally advise supplementation with the well-absorbed forms, magnesium glycinate (400 mg twice per day) or magnesium malate (1200 mg twice per day). Because they are well-absorbed, they are least likely to lead to diarrhea (as magnesium oxide commonly does).

4) Alkaline potassium salts--Potassium as the bicarbonate or the citrate, i.e., alkalinizing forms, are wonderfully effective for preservation or reversal of bone density. Because potassium in large doses is potentially fatal, over-the-counter supplements contain only 99 mg potassium per capsule. I have patients take two capsules twice per day, provided kidney function is normal and there is no history of high potassium.

5) An alkalinizing diet--Animal products are acidic, vegetables and fruits are alkaline. Put them together and you should obtain a slightly net alkaline body pH that preserves bone health. Throw grains like wheat, carbonated soft drinks, or other acids into the mix and you shift the pH balance towards net acid. This powerfully erodes bone. Therefore, avoid grains and never consume carbonated soft drinks. (Readers of this blog know that "healthy, whole grains" should be included in the list of Scams of the Century, along with Bernie Madoff and mortgage-backed securities.)

6) Strength training--Bone density follows muscle mass. Restoring youthful muscle mass with strength training can increase bone density over time. The time and energy needs are modest, e.g., 20 minutes twice per week.

Note that calcium may or may not be on the list. If on the list at all, it is dead last. When vitamin D has been restored, intestinal absorption of calcium is as much as quadrupled. The era of force-feeding high-doses of calcium are long-gone. In fact, calcium supplementation in the age of vitamin D can lead to abnormal high calcium blood levels and increased heart attack risk.

These are benign and easily incorporated strategies. They are also inexpensive. I challenge any drug to match or exceed the benefits of this combination of strategies. Keep in mind that strategies like vitamin D restoration provide an extensive panel of health benefits that range far beyond bone health, an effect definitely NOT shared by prescription drugs.
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Comments (58) -

  • Luming Zhou

    9/1/2010 5:09:06 AM |

    Great article. I especially liked the emphasis on potassium poisoning. This is no joke.

    I nearly died from potassium poisoning. I bought 99mg supplements and I once took several a day, along many pounds of potatoes. I then suffered from hyperventilation, muscle cramps, tingling on my extremities, and delirium. I was on a salt restricted diet back then. That was an idiotic move. But I saved myself by adding back salt to my diet.

    I don't particularly like potassium supplementation. If I overdosed potassium on potatoes, then potatoes will taste disgusting to me. But if I relied on supplementation, then I might overdose because I can't taste it.

    Hope this helps.

  • Anonymous

    9/1/2010 11:23:22 AM |

    on the spot again! any role of GMOs here ?

  • Anne

    9/1/2010 1:06:10 PM |

    What about Strontium as part of the drive to reverse established osteoporosis ? Strontium Ranelate is prescribed in the UK as an alternative to Fosamax or Boniva type drugs.

    I have osteoporosis but I do not have any coronary atherosclerotic plaque I'm happy to say. I had scan to show my coronary arteries are clear.

    I take a high dose vitamin D - current 25(OH)D is 78 ng/ml (195 nmol/L) and do strength training Smile  Can't get vitamin K2 but eat an alkalizing diet with lots of veggies high in K such as kale which, I understand help intestinal bacteria make K2.

  • Anonymous

    9/1/2010 1:23:44 PM |

    I jumped down from my kids trampoline back in 2003 with immense pain.  I thought I had jarred my back but after an x-ray, it turns out I had crushed 3 vertebra. The year before, I had an angiogram after suffering shortness of breath and jaw pains on moderate exercise. Surgeon told me he could not stent because the artery was fully blocked. the good news was it had happened over time so collateral had formed, so no heart attack. My recovery has been more due to self education and action than the medical establishment.

    For some time I still had occasional angina, but for the last 18months I have been taking K2 together with VitaminD3, fish oil and Niacin. I have no angina, no muscle aches (ok, maybe that was the statin), bike long distances, kayak, hike....yada yada.

    This is what has worked for me.  I sincerely hope people with either low bone density or plaque problems give the K2/D3 route a try.

  • Kathy

    9/1/2010 2:13:32 PM |

    I sure would LOVE for Dr. Davis
    to weigh in on Strontium.  I took
    Strontium 680 MG following everything I learned about it and had a nice improvement in my Bone Density.  However, my primary care doc insisted on a strontium level of my blood and of course it was off the wall, and
    my doc asked me to discontinue because there have never really been any long term trials on it.  I take D as Dr. Davis suggests, and only half the calcium I used to as he suggests and fish oil etc.  Will add K too!  Kathy

  • Kathy

    9/1/2010 2:18:49 PM |

    PS  As per Doctor Davis instructions, I too had a heart scan and had
    Zero plaque.  I am 61 years old and
    have improved from Osteoporosis to
    Osteopenia in my bone density, mostly from the strontium.....Kathy

  • Jessica

    9/1/2010 2:19:25 PM |

    Whenever I see Sally Field's Boniva commericals on TV in which she proclaims, "I thought taking Vitamin D and calcium were enough to stop my bone loss, come to find out, they weren't enough," I can't help but ask (aloud), "yea? How much D were you taking?"

    I get embarrassed for her.

    Docs in our area (FPs and specialists), while now starting to pay more attention to Vitamin D, still take shots at us for recommending Vitamin D over fosomax, boniva, etc. They feel it's unethical.

    We press right on, though.

  • Kathy

    9/1/2010 2:22:09 PM |

    @ Jessica, I truly want to throw something at the TV when I see her
    commercials!  LOL
    As "they say"
    KNOWLEDGE is POWER!  Kathy

  • malpaz

    9/1/2010 2:49:06 PM |

    "Coronary atherosclerotic plaque and bone health are intimately interwoven. People who have coronary plaque usually have osteoporosis; people who have osteoporosis usually have coronary plaque. (The association is strongest in females.) The worse the osteoporosis, the greater the quantity of coronary plaque, and vice versa. The two seemingly unconnected conditions share common causes and thereby respond to similar treatments. "


    mmmkay you just scared the lving bee--geeez out of me. i have osteoporosis and am only 24 yrs old, recovering anorexic now weight restored Smile

    i do have joint bone pain and problms however. i do take D, mag and my K is way over 100% DV eveyday(gimme my greens). not sure where my potassium falls

    so is a hih fat high meat diet goodfor osteoporosis or not? i am no very 'schooled' about acid-alkaline stuff

  • malpaz

    9/1/2010 2:49:43 PM |

    "Coronary atherosclerotic plaque and bone health are intimately interwoven. People who have coronary plaque usually have osteoporosis; people who have osteoporosis usually have coronary plaque. (The association is strongest in females.) The worse the osteoporosis, the greater the quantity of coronary plaque, and vice versa. The two seemingly unconnected conditions share common causes and thereby respond to similar treatments. "


    mmmkay you just scared the lving bee--geeez out of me. i have osteoporosis and am only 24 yrs old, recovering anorexic now weight restored Smile

    i do have joint bone pain and problms however. i do take D, mag and my K is way over 100% DV eveyday(gimme my greens). not sure where my potassium falls

    so is a hih fat high meat diet goodfor osteoporosis or not? i am no very 'schooled' about acid-alkaline stuff

  • Kathy

    9/1/2010 3:03:00 PM |

    Malpaz, I am so proud of you I can't STAND it!  You go girl!
    I've been told once DX'd with Osteoporosis- it will ALWAYS show up in your records, but you CAN reverse it!  Read everything you can get your hands on including everything Dr.
    Davis told us here.  Weight training
    should be a #1 goal.  It is my
    understanding that high fat, ADEQUATE
    protein does NOT promote bone loss,
    as long as you are eating lots of
    non acidic foods too! Make sure you K vitamins, and magnesium and D3
    are what Dr. Davis recommends AND
    FISH OIL!!!  Kathy

  • Anne

    9/1/2010 3:15:03 PM |

    Kathy - I am in my 50s and have osteoporosis. Here in the UK I have been prescribed Strontium Ranelate for over three and a half years now. No side effects and bone density increasing. The company that make it tell me that they are following women prescribed it for over eight years now - so long term studies are done on it.

  • Catherine/Santa Fe

    9/1/2010 3:39:55 PM |

    I have great news!

    I belong to an osteoporosis forum, and a large group of us has been committed to reversing our osteoporosis without using drugs. We have compiled all the credible research we could find on reducing bone loss while also forming strong new healthy bone architecture and started our own bone-health programs---much of what Dr. Davis advocates here plus some other protocols such as the Prune Study and osteo-specific exercises.

    These programs ARE WORKING! at least 40 of us in just this one year have reversed our bone loss without drugs, and actually made increases in our BMD.  (I had a 10-year documented continual loss of BMD and this year gained 3%!!)

    Here is the link to our success stories and the protocols we have been using.  Some are adding strontium citrate, but others  such as myself have had success without the strontium. As Dr. Davis states, achieving optimum D levels played a big part. You will need to click on the Part ! link to read all the back stories--- Part 2 is the current new updated thread just started.
    http://www.inspire.com/groups/national-osteoporosis-foundation/discussion/success-stories-w-o-drugs-part-2/

    A while back, Dr. Davis advised me to try magnesium for my long-standing arrhythmia, which worked magnificently in stopping it, but also was a big part to reversing my bone loss--magnesium, K2, vitamin D, and calcium all have an intricate relationship in transporting calcium and bone minerals safely and effectively to where they belong instead of in tissues, joints, and heart valves.
    Warm regards,  Catherine/Santa Fe

  • Anonymous

    9/1/2010 3:41:56 PM |

    Kathy, you are so correct about reading everything you can get your hands on. I have osteopenia (strong family history) and have been taking Boniva for over two years. I upped my vitamin D, and added 5-10 mgs of Vitamin K2 earlier in the year, along with 400 magnesium and fish oil.

    I get a bone scan next week, and am very nervous about it. I am hoping I have improvement so I can get off the Boniva and maintain bone density with the vitamins.

    By the way Dr. Davis, I am fairly certain I have a polymophism of my Vitamin D receptor. Do you know if that could play a role? Chris Kessler did an excellent post on it a few weeks ago.
                -Melissa

  • Anonymous

    9/1/2010 3:47:08 PM |

    Catherine, thank you for posting that information, what great news! Would you mind telling me how much K and magnesium you take? Do you take the potassium that Dr. Davis recommends also?
                -Melissa

  • Kathy

    9/1/2010 3:58:18 PM |

    Melissa don't expect your doc
    to tell you to stop taking the Boniva!
    My OB/GYN was content to let me die on the stuff it was my primary care
    doc that said she wanted me off of it!
    (Course she was the same one that
    did not want me on the strontium) :-(
    Listen to your heart- if your bone
    density has improved get off the stuff
    and use the new tools your are acquiring!  Smile)  Kathy

  • Anonymous

    9/1/2010 4:04:23 PM |

    Kathy, thanks for the feedback. I'm not sure about my gyn who prescribed it, but my internist did say that if bone density returned to normal, it would be possible to go off. While not horrible, I do have side effects. And then there's possible long term side effects...
               -Melissa

  • Catherine/Santa Fe

    9/1/2010 5:06:13 PM |

    Dr. Davis,

    I can't tell you how encouraging this is that YOU TOO are seeing reversal of bone loss with these protocols. As I mentioned in my post above, we are trying to assemble these success stories which are plentiful but spread out all over the internet and not easily accessible in any sort of organized way.

    It would be so helpful if you would encourage any of your patients who've had success reversing their bone loss on these protocols to post their stories on the thread I posted above, which is from the National Osteoporosis Foundation's osteo forum---where most osteo patients end up when looking for good info.
    I know there are tons of these success stories that are just not getting reported. And regular doctors don't even seem interested in these successes (mine wasn't-but was VERY interested on putting me on  osteo drugs).
    Thank God their are a few doctors like yourself who are actually awake at the wheel.
    Warm regards, Catherine/Sante Fe

  • malpaz

    9/1/2010 5:15:44 PM |

    wow kathy, thanks for the encouragement! that means a lot. i will get to reading... i do keep my diet high fat but i am currently stressing about fertility as it has been a LONG while since i have menstruated(6-7 years)

    i cant afford a bone scan, hormone tests, thyroid or blood work like i need so i am hoping keeping paleo/primal and lots of adequate food is going to help me. glad to know at least ONE part of this is reversible as i am now left with alot of baggage

  • Dr. William Davis

    9/1/2010 5:18:05 PM |

    Hi, Anne and Kathy--

    There are indeed solid data on the use of the trace mineral, strontium, as a means to increase bone density.

    However, since my focus is heart disease, this is the one agent I've had no experience using.

    If anyone chooses to use strontium, please let come back and let us know how your experience goes.

  • Dr. William Davis

    9/1/2010 5:21:22 PM |

    Catherine from Santa Fe--

    Thanks for the links to the osteoporosis forums. It's great to hear others are witnessing similar results!


    Luming--

    Thanks for highlighting how important it is to be careful with potassium.

    In fact, it is wise to occasionally have a potassium and a creatinine level checked to be sure that potassium is not accumulating.

    The dose I recommended is very modest. Accumulation is highly unlikely unless kidney disease or some other uncommon conditions are present.

  • Kathy

    9/1/2010 7:04:43 PM |

    Malpaz you didn't pack those "bags" overnight and you won't unpack them
    that fast either.  One day at a time and you will get where you want to go!
    Be patient with yourself! Smile  Kathy

  • adam

    9/1/2010 8:25:01 PM |

    Hi Dr. Davis,

    Another great post, educating as always--my mother kind of freaked out when I showed her this, but once she realized she's taking everything you've suggested to combat her osteoporosis, she was able to breathe again (LOL)

    Here's my slightly off-topic question for you: In your experience in your practice, have you ever seen a patient's problem parathyroid (hypo or hyper) resolve with the addition of vitamin D to his/her diet?  Have you ever had a patient one step away from a parathyroid surgery, only to have the problem clear up when proper vitamin D levels were obtained?  I'm wondering if alot of patients suffer with above normal calcium reading in their blood work because of this?

    Thanks again for all you do,
    Adam Wilk

  • Stephen

    9/1/2010 10:13:16 PM |

    Perhaps the fear of potassium poisoning is overblown? One serving of low sodium V-8 contains 800 mg of potassium from potassium chloride.

    I've been experimenting with topical magnesium lately (Mg sulfate cream and MgCl2 brine aka magnesium oil). It seems to be working. One thing I've noticed since starting taking magnesium (oral and topical) is about a 50 point drop in total cholesterol from 240 to 190.

  • Anonymous

    9/1/2010 11:22:36 PM |

    You forgot to mention, for those new to this site, that not all vitamin D is the same. They ONLY want D3 (cholecalciferol) gelcaps, not the nearly useless D2 (ergocalciferol) that gets added to milk.

  • Geoffrey Levens

    9/2/2010 1:44:45 AM |

    tI have seen jaw necrosis up close and in person and believe me, you do not want it!

    No need to have "normal"t bone density to get off Boniva, very few doctors will tell you to stop.  You can just stop whenever you want to!

    There is little to no correlation between bone density and fracture rate anyway, it is a scam to sell the drugs.  Quality bone is what you want so alkaline diet and supps as outlined and plenty of weight bearing exercise, esp pumping iron.  No coffee, no sodas, no smoking...t

  • Paul

    9/2/2010 3:21:34 AM |

    It should also be noted that calcium supplementation can significantly compete with magnesium in absorption and utilization.

    There really should be no reason to supplement calcium if you eat plenty of vegetables, especially the dark green leafy kind, or if dairy is part of your regular diet.

    If you find that you need to supplement calcium, try to take it in the middle of the day, and take the magnesium in the morning and at bed time.

  • Stephen

    9/2/2010 2:21:28 PM |

    @malpaz: You wrote "i do have joint bone pain and problms however. i do take D, mag and my K is way over 100% DV eveyday(gimme my greens)."

    The K in greens is K1 and not K2, not the same thing. The Japanese studies were done with the MK4 form of K2 (as used in the Thorne drops or Carlson Labs products).

  • Kathy

    9/2/2010 5:03:26 PM |

    @ Steven!  What brand of transdermal
    magnesium are you using?  I am interested for my husband who I FINALLY convinced to get off statins!
    He had a zero heart scan score score and yet his doc
    STILL had him on statins!  Thanks!
    Kathy

  • kris

    9/2/2010 5:36:52 PM |

    Dr. Davis - I love your blog.  Thank you for providing it for us. I have read the comment regarding carbonation and bone loss several times. I always wondered if it is the carbonation in particular that is the culprit, or the sugars, additives etc. that exist in most soft drinks. There seems to be some confusion regarding this. I love carbonated waters, flavored seltzers with no sugar, artificial or otherwise. Are they included in the carbonated beverages you mention as being detrimental?

  • Dr. William Davis

    9/2/2010 8:15:30 PM |

    Hi, Adam--

    I have indeed seen mild hyperparathyroidism (high PTH) improve or resolve entirely with vitamin D supplementation.


    Kris-

    This applies to all carbonated beverages, since they are all rich in carbonic acid.

  • Paul Rise

    9/3/2010 4:00:30 AM |

    Hi Dr. Davis - Wanted to share my story of calcium overdose. Was told to take 2000 vitamin D but my doctor didn't mention to avoid the D+Calcium brands. I took in a lot of calcium for about 2 weeks and then had painful digestive symptoms and off and on paralyzing pain in my right leg and neck. My doctor's RN was the one who figured it out. After I searched online about calcium supplements and found your blog. I read on and  have cut out 75% of carbs from my diet. Feeling great for a month now. Thanks for what you do.

  • David M Gordon

    9/3/2010 10:17:58 AM |

    Dr Mercola Finally Starts to Catch on to Gluten Free

    http://articles.mercola.com/sites/articles/archive/2010/09/03/media-finally-starts-to-catch-on-to-gluten-free.aspx

  • Anonymous

    9/3/2010 8:16:12 PM |

    My mother took Fosamax for years.  She developed acute myeloid leukemia and her bone marrow was shot.  On reading your latest post, Dr Davis, I've begun to wonder if side effects of the drug could go deeper than the bone.

    Nina

  • Anonymous

    9/3/2010 8:21:08 PM |

    Well I've answered my own question with a Google search:

    http://www.topix.com/forum/drug/fosamax/TSK1OBBDLMJ0EJSQ9

    It never occurred to me that Fosamax could cause such devastation until your comment about jaw disintegration, Dr Davis.

    Nina

  • Anonymous

    9/3/2010 9:10:33 PM |

    In today's news is a British study of standard osteoporosis drugs and esophogeal cancers:

    http://www.reuters.com/article/idUSTRE6816HF20100902

    Nina

  • Drs. Cynthia and David

    9/3/2010 9:45:45 PM |

    I don't believe there is any truth to the concept that an acidifying diet promotes osteoporesis, at least as far as protein intake is concerned (I won't go so far as to defend the drinking of phosphoric acid, i.e., sodas).  Numerous studies have shown that increased calcium excretion in urine (observed on higher protein diets) is not due to calcium loss from bone, but rather due to increased calcium absorption.  See http://www.ncbi.nlm.nih.gov/pubmed/20717017 "Contrary to the supposed detrimental effect of protein, the majority of epidemiological studies have shown that long-term high-protein intake increases bone mineral density and reduces bone fracture incidence. The beneficial effects of protein such as increasing intestinal calcium absorption and circulating IGF-I whereas lowering serum parathyroid hormone sufficiently offset any negative effects of the acid load of protein on bone health."

    Cynthia

  • Pal

    9/3/2010 9:47:11 PM |

    still waiting for doctors to catch onto vaccine free life after the gluten free diet! Wink

  • Mark

    9/3/2010 10:14:03 PM |

    Does plain carbonated water (soda water) have an effect on pH or just carbonated soft drinks?

  • Raphael

    9/4/2010 2:06:48 PM |

    Hello, I'm from Brazil.
    I found your website and wanted to ask, please, for that added the link to my blog for disclosure in order to be partners.
    Already added your on my list of partners, ok?
    My blog is about technology, science and health: http://www.biomedicinaunip.blogspot.com
    Thanks!

  • Stargazey

    9/4/2010 6:09:22 PM |

    Dr. Davis, how can the foods we eat shift our body's pH balance toward net acid?

    As I understand it, if our blood strays very far from pH 7.4 ("a slightly net alkaline body pH") we will not be osteopenic. We will be dead.

    If I'm remembering my physiology correctly, acidic food may affect our tooth enamel, but once the digested food reaches our blood and tissues, the body is well able to buffer it to a very tight pH range regardless of the pH it may have had in its original form.

  • Rick

    9/8/2010 11:38:06 PM |

    Dr Davis,

    One of the many sports drink-type beverages in Japan is called Dakara. It contains no sodium, but 180 mg of calcium, 60 mg of magnesium, and 500 mg of potassium per liter.

    I took potassium tablets for a while a few years ago but found that, even on a full stomach, they messed with my digestion and I gave them up. As an alternative, do you think this Dakara, maybe a 500 mg bottle a day, might be OK? (It does contain sucralose, which might present other problems, though.)

    Any other ways to take potassium?

  • The Naked Carnivore

    9/11/2010 12:58:19 AM |

    Osteoporosis is another disease of civilization caused by insulin interference with calcium metabolism.

    Whatever else you do, you're pushing a rock uphill unless you kick the carb habit.

  • Dr. William Davis

    9/20/2010 12:36:31 AM |

    Hi, Cynthia--

    I believe that you are correct: Protein sources, such as meats, have complex effects beyond acidification. That's why meats consumers have greater bone density because of some bone growth-enhancing effect, e.g., insulin-like growth factor.

    I believe that it's the grains that upset the dietary pH apple cart, providing an acid load that must be buffered but lacking the bone density enhancing effects of animal proteins.

  • Anonymous

    9/22/2010 12:00:01 AM |

    Dr Davis,  Didn't really understand your statement about protein.  Should I be limiting my protein intake due to my osteoporosis or not?  

    The endocrinologist today told me that she doubts that I can totally reverse my osteoporosis.  She thinks I can make a small reversal.  Do you think it's possible to totally reverse osteo?  Thank you!

  • Treatment for heart disease

    9/27/2010 12:32:46 PM |

    Heart  disease is one of the most  dangerous disease which takes thousands of life every years all over the world. If we know its symptoms and Treatment for heart disease. We can prevent is to large extent.

  • Treatment for heart disease

    9/27/2010 12:32:54 PM |

    Heart  disease is one of the most  dangerous disease which takes thousands of life every years all over the world. If we know its symptoms and Treatment for heart disease. We can prevent is to large extent.

  • Bernice

    9/30/2010 6:57:09 AM |

    Your article is truly informative. Many women today suffer from osteoporosis. I've read some articles about preventing it by taking enough calcium so our bones will get stronger.

    Back pain is also one of the common ailments of aged people. Causes of back pain are Lumbar Muscle Strain, Ruptured Disc, Discogenic Back Pain, etc. Some people who suffer back pain visit a chiropractor. Brooklyn Center (MN) is one of areas known for good chiropractic treatments. Just last year, my mom had back pain. She went to a chiropractic (Brooklyn Center MN) clinic to have some consultations. After her sessions, she started feeling the improvements.

  • purity12lover

    10/19/2010 2:59:16 PM |

    I’ve been a regular face at the hospital to get treatment for my condition. After a very long time, I kind of almost gave up. Then one of my friends introduced me to Purity 12 products. I said to myself, how can this be a solution to my problems? He encouraged me to try it first and that there’s no harm in trying anyway, and he told me that he’s been using their products and made a business out of it.  As a friend, he bought some products for me as a gift so I could try them. Now, I’m really thankful that I received this gift. It’s been the best gift I have ever received since. I feel better, a lot more energetic and like I’m a totally new person! It’s really important to me to be able to share my story with you because I also want people like me to make this discovery and make their lives finally better!  If you want to know more about them, everything is on their website. Learn More

  • Anonymous

    10/29/2010 11:40:01 PM |

    If someone can't get enough magnesium from their diet, then they should change their diet. I just don't think supplemental magnesium is wise if someone has a basically normal diet. Besides, magnesium chelate is not food magnesium. I do think D3 and MK-7 are a good idea for many people.

  • Anonymous

    12/19/2010 4:57:52 PM |

    I am late reading this blog and want to know if taking vitamin K2 would interfer with taking the occassional asprin - 81mg which I do take from time to time but not daily.

    I did not see you mention anything about that in your blog.

  • Anonymous

    12/29/2010 8:29:08 AM |

    you said: "Animal products are acidic, vegetables and fruits are alkaline."

    Now I have read this for the last 20 years - but have never found any scientific research about it. Maybe you could enlighten me with some links - or facts?

    Many thanks - by the way I love your blog - as does my doctor Smile

  • Breast Augmentation Los Angeles

    1/27/2011 1:38:07 PM |

    Good to know what is going to help the body recover and heal.A healthy body is more than a gift of nature and no ones knows it more than the ailing.Vitamins are present in various fruits and vegetable so we must pay attention to what exactly we are eating.

  • Anonymous

    1/27/2011 9:36:12 PM |

    @ Melissa,
    I'm really late jumping in here and you may not even check this but I have to tell you this. I have osopenia and NOT one of my doctors ever suggested putting me on any type of meds. I was to supplement with cal, and vit D. The ironically, they also didn't bother to tell me how to take the dosage. I didn't know your body can only absorb 500 mg at a time. I was advised to go to a endocrinologist and did. your doc they put you on it to begin with.I would highly recommend going to an endocrinologist..
    Julie

  • Jack

    2/23/2011 5:32:46 PM |

    The AlgaeCal Bone Health Program is a natural <a href="http://www.algaecal.com/osteoporosis-treatment.html>osteoporosis treatment</a> that combines all of the above advice.This natural osteoporosis treatment consists of AlgaeCal Plus, Strontium Boost and weight bearing exercise.

    AlgaeCal Plus is the world's only plant source calcium and It also includes magnesium, trace minerals, vitamin D3 and vitamin k2. Strontium Boost is a supplement consisting of strontium citrate, learn more about strontium, a powerful bone building mineral.

  • Olivia

    5/11/2011 8:04:54 PM |

    Would anyone be able to tell me where I can get the vitamins and supplements Dr Davis suggests? I live in the UK and have done an internet search with no success. I have just been diagnosed with osteoporosis and don't like the sound of most of the treatment drugs available.

  • Magnesium Oxide

    12/20/2011 6:05:45 AM |

    Nice post about vitamins and minerals . Magnesium oxide is also very good for our body's healthy functionality.

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