One bite or many mouthfuls

6. January 2007 William Davis (0)
A reader brought this beautiful series of food photos to my attention:

http://www.wisegeek.com/what-does-200-calories-look-like.htm

It's simply a graphic display of what 200 calories of various foods look like. You'll note that vegetables and fruits permit large servings to yield 200 calories. Processed foods, on the other hand, require very little to tally up the same calorie load. In particularly, look how little in the way of wheat products are required to match that amount.

Heart scan curiosities #4

5. January 2007 William Davis (2)
Here's an interesting example of a 63-year old man with a heart scan score of 112. However, his aortic valve was also severely calcified (loaded with calcium). In other words, the normally flexible and mobile "leaflets" of the aortic valve were coated with calcium and other tissues that interfere with its free motion. The aortic valve is the starburst white in the center of the heart.








This is what the aortic valve should look like on a CT heart scan--you shouldn't see it at all.

The first man with the calcified valve will unfortunately require a new prosthetic aortic valve sometime in his future. This is usually determined with the help of an ultrasound, or echocardiogram, a better test for assessment of the aortic valve (though useless for detection of coronary plaque).

It's my suspicion that chronic and longstanding deficiency of vitamin D is among the factors that contribute to the abnormal deposition of calcium on the aortic valve. We desperately need more data on this. Nonetheless, perhaps this adds yet another reason to 1)get a CT heart scan, and 2) bring your vitamin D blood level to normal. (We aim for 50 ng/ml year round.)

Fish oil and the perverse logic of hospitals

4. January 2007 William Davis (6)
Hospitals are now starting to carry prescription fish oil, known as Omacor, on their formularies. It's used by some thoracic surgeons after bypass surgery, since fish oil has been shown to reduce the likelihood of atrial fibrillation (a common rhythm after heart surgery).

Why now? The data confirming the benefits of fish oil on atrial fibrillation has been available for several years.

It's now available in hospitals because it's FDA-approved. In other words, when fish oil was just a supplement, it was not available in most hospitals. Whenever I've tried to get fish oil for my patients while in hospital, you'd think I was trying to smuggle Osama Bin Laden into the place. The resistance was incredible.

Now that FDA-approved Omacor is available, costing $130 dollars per month for two capsules, $195 for the three capsule per day dose for after surgery, all of a sudden it becomes available. Why would this irrational state of affairs occur in hospitals?

Several reasons, most of which revolve around the great suspicion my colleagues have towards nutritional supplements. In addition, there's the litigation risk: If something has been approved by the FDA, their stamp of endorsement provides some layer of legal protection.

However, I regard those as pretty weak reasons. I am, indeed, grateful that fish oil is gaining a wider audience. But I think it's absurd that it requires a prescription to get it in many hospitals. Imagine, as the drug companies would love, vitamin C became a prescription agent. Instead of $3, it would cost far more. Does that make it better, safer, more effective?

Of course, no drug sales representative is promoting the nutritional supplement fish oil to physicians nor to hospitals. I now see people adding the extraordinary expense of prescription fish oil to their presription bills.

In my view, it's unnecessary, irrational, and driven more by politics and greed than actual need. Take a look at the website for Omacor (www.omacorrx.com). Among the claims:

"OMACOR is the only omega-3 that, along with diet, has been proven and approved to dramatically reduce very high triglycerides..."

This is a bald lie. Dozens of studies have used nutritional supplement fish oil and shown spectacular triglyceride-reducing effects.

Their argument against fish oil supplements:

"Dietary supplements are not FDA-approved for the treatment of any specific disease or medical condition. Get the Facts: nonprescription, dietary supplement omega-3 is not a substitute for prescription OMACOR."

Does that make any sense to you? Should you buy a GM car because only GM makes genuine GM cars? This is the silly logic being offered by these people to justify their ridiculous pricing.

How about: "The unique manufacturing process for OMACOR helps to eliminate worries about mercury and other pollution from the environment."

Funny...mercury in fish tends to be sequestered in the meat, not the oil. Independent reports by both Consumer Reports and Consumer Lab found no mercury, nor PCB's, in nutritional supplement fish oil. But just suggesting a difference without proving it may be enough to scare some people.

Just because something is used by a hospital does not make it better. The adoption of fish oil is hospitals is a good thing. Too bad it has to add to already bloated health care costs to enrich some drug manufacturer.

Repent for past sins

2. January 2007 William Davis (0)
If the food temptations of the holidays got the best of you, and you're now 5, 10, 15 lbs or more over your pre-holiday weight (our record is 18lbs!), then it's time for serious action.

One easy method to regain the control you may have lost is to pick some period, say, 3 days. During those three days, eat nothing but vegetables--no breads, meats, dairy products, certainly no cookies, cakes, pasta, etc., not even fruit. Follow this routine and weight drops rapidly. Vegetables are wonderful but sometimes boring, so use healthy condiments to spice them up: mustards (hot, brown, yellow, horseradish); healthy salad dressings, which are olive or canola oil-based; salsas, a fabulous garnish with no nutritional downside whatsoever; pesto; tapenades; horseradish added to other condiments or even by itself (wasabi).

Of course, fasting in one of its several variations is another rapid method to regain control. My favorite is to use soy milk in a modified fast, usually 4-6 glasses of a low-fat, low-sugar soy milk per day, along with plenty of water. (Please refer to the precautions detailed in the recent Track Your Plaque Special Report, Fasting: Fast Track to Control Plaque , particularly if you fast 5 days or longer or take blood pressure or diabetic medication.)

Of course, yo-yoing your weight--up during the holidays, down after their conclusion--is not good for you. It does raise the likelihood of diabetes, not to mention cultivate the patterns that contribute to coronary plaque growth, especially small LDL. But if temptation got out of control and you need to regain lost ground, these two strategies work fabulously well for most people.

If you've gained, say, 10 lbs during the holidays, but simply resume your usual habits, chances are you won't lose the weight. Year after year, this can add up to an enormous weight gain. The time to act is now. It's easier to lose the 10 lbs of weight you gained recently, rather than the 50 lbs you've stacked up over the past 5 years.

Wheat-free 2007

1. January 2007 William Davis (4)

Long ago, most of us made the change of reducing saturated fat in our diet. Few people now rely on butter (despite the idiotic butter vs. margarine controversy), full-fat dairy products, fried foods, and greasy meats. That's a healthy change, since saturated fat has conclusively been tied to various cancers, high blood pressure, rise in LDL, and is calorie-dense.

But if there were just one change you were to make beyond a reduction in saturated fat, a change that would translate into dramatic health benefits, it would be a drastic reduction, even elimination, of wheat products.

People do indeed eat enormous quantities of wheat flour-containing products. U.S. per capita consumption of wheat flour was 110 pounds in the early 1970s, and rose to 141 pounds in 1991. It's even higher now. 20% or more of most people's caloric intake every day is provided by wheat flour products.

Wheat containing foods are tasty and convenient. Witness the popularity of bagel shops, the goodie counter at Starbuck's, the proliferation of crackers, breads, and breakfast cereals at the grocery store. Patients are horrified when I suggest that they find a substitute for the sandwiches they eat every day. Even Mom said they were okay!

You're unlikely to hear much about this from the popular press. The wheat industry is enormous and exerts extraordinary clout, just like the drug industry. Texas alone farms 6 million acres of wheat, yielding over $2 billion for the state's economy. The "wheat chain" is complex and far-reaching: growers, processors, food manufacturers, the transportation industry, retailers, chemical producers, and on and on. Wheat futures are traded on the Chicago Board of Trade. Wheat is a major export industry for the U.S.

Of course, these are not evil people, intent on corrupting your health. In fact, most of them are probably working under the perception that they are raising a healthy product. The point is that the notion that wheat is healthy is deeply entrenched in the minds and economy of the U.S. Don't expect to hear unbiased commentary on the health effects of wheat products from most media sources.

What can you expect if you sharply reduce or eliminate wheat? The majority of people:

--Feel like a cloud has been lifted from their thinking.
--Don't experience the afternoon blah or tired feeling after lunch.
--Lose weight, sometimes substantial quantities.
--Raise HDL.
--Reduce small LDL.
--Reduce triglycerides, particularly if they start >100 mg/dl.
--Reduce blood sugar.

The reduction in small LDL can be especially impressive.

For most people, reducing or eliminating wheat is a sacrifice, a major change in food choices and even a loss of convenience. But the health benefits for most people can be dramatic.

Is vitamin D a "vitamin"?

29. December 2006 William Davis (5)
Vitamins are crucial participants in the body's reactions and are obtainable from food. Vitamin C, for example, comes from citrus fruits and vegetables. Vitamin K comes from green vegetables. The B vitamins are found in meats, soy, dairy products, and grains. Vitamin A comes from carrots, squash, and other orange and green colored vegetables.

How about vitamin D? What foods contain vitamin D? The list includes:


Food International Units(IU) vitamin D per serving

Cod liver oil, 1 Tablespoon 1,360
Salmon, cooked, 3½ ounces 360
Mackerel, cooked, 3½ ounces 345
Tuna fish, canned in oil, 3 ounces 200
Sardines, canned in oil, drained, 1¾ ounces 250

Milk, nonfat, reduced fat, and whole, vitamin D fortified, 1 cup 98
Margarine, fortified, 1 Tablespoon 60
Pudding, prepared from mix and made with vitamin D fortified milk, ½ cup 50
Cheese, Swiss, 1 ounce 12

Ready-to-eat cereals fortified with 10% of the DV for vitamin D, ¾ cup to 1 cup servings (servings vary according to the brand) 40

Egg, 1 whole (vitamin D is found in egg yolk) 20
Liver, beef, cooked, 3½ ounces 15

(Modified from the Office of Dietary Supplements, National Institutes of Health)


You'll note that the only naturally-occurring food sources of vitamin D are the modest quantities in fish, egg yolks, and liver. All the other vitamin D-containing foods like cereal, milk, and other dairy products have vitamin D only because humans add it.

It takes me (personally) 6000 units of vitamin D per day to bring my blood level to an acceptable 50 ng/ml. To obtain this from eating salmon, I would have to eat 58 ounces, or 3 1/2 pounds of salmon--every day. Or, I could eat 30 cans of tuna fish.

If I didn't want to eat loads of fish every day, I could drink 60 glasses of milk every day. After I recovered from the diarrhea, my vitamin D might be adequate, provided the milk indeed contained the amount stated on the label (which it often does not when scrutinized by the USDA).

If vitamin D is a vitamin, how are humans supposed to get sufficient quantities? I don't know anybody who can eat 3 1/2 lbs of salmon per day, nor drink 60 glasses of milk per day. But aren't vitamins supposed to come from food?




The problem is that vitamin D is not really a vitamin, it's a hormone. If your thyroid hormone level was low, you'd gain 20, 30, or more pounds in weight, your blood pressure would skyrocket, you'd lose your hair, become constipated, develop blood clots, be terribly fatigued. In other words, you'd suffer profound changes. Likewise, if thyroid hormone levels are corrected by giving you thyroid hormone, you'd experience profound correction of these phenomena.

That's what I'm seeing with vitamin D: restoration of this hormone to normal blood levels (25-OH-vitamin D3 50 ng/ml) yields profound changes in the body.

If there's one thing that I've come across lately that packs extraordinary potential to help us in reducing heart scan scores, it's the vitamin--sorry, the hormone--cholecalciferol, or D3.

Heart scan curiosities 3

28. December 2006 William Davis (0)

Note the shape of the chest in this 64-year old man. The front of his chest (upper portion of scan) is concave. In other words, if you were looking at this man (shirtless, of course) face to face, his chest would bow inward, rather than the usual outward configuration. The official name for this is "pectus excavatum".





Compare this to the normal chest in the second image, in which the chest is convex. Face to face, the chest would bow slightly outward.















What does it matter? The pectus excavatum in and of itself has no importance, just a curiousity. (I personally find this surprising, given the fact that the heart actually appears squashed by the sternum, or chest wall.) However, it is commonly associated with a "floppy" mitral valve (also called mitral valve prolapse), a common congenital disorder of the mitral valve often accompanied by a slender build, loose joints, and even a nervous disposition. Occasionally, in its more severe forms, the aorta is also enlarged. (This man's aorta is not enlarged.)

So, while we can't actually visualize the mitral valve by a CT heart scan, we can surmise that he likely has a floppy mitral valve, is slender, is probably a nervous sort, and has long limbs with loose joints. He probably required braces as a child, since many people have a phenemenon of "crowded teeth". The roof of his mouth, or hard palate, probably unusually high up in the mouth. He probably has a "weak chin", meaning a less prominent protuberance of his chin. His fingers and toes are likely unusually long and slender.

It could mean that some attention and exploration of how floppy his mitral valve might be could be useful, e.g., an ultrasound or echocardiogram. He might even require oral antibiotics at the time of any oral or some gastrointestinal procedures, since floppy valve are more susceptible to blood infections when potentially "dirty" orifices are instrumented.

All that from a heart scan!

Gratitude

24. December 2006 William Davis (2)
The holidays and the end of the year may be a good time to reflect on how grateful we should be for having the freedom to discuss the ideas we share on this Blog, the Track Your Plaque website, online and offline.

Although I rant and rave against the status quo in heart disease, the shameful profiteering of my colleagues and hospitals, the cut-throat marketing practices of drug and device manufacturers, I am truly grateful that, in the U.S., I have the extraordinary freedom to say these things. You have the freedom to agree or disagree and none of us pays a price for truth.

I've been reflecting myself a great deal on this idea of happiness and gratitude being a critical component of coronary plaque regression and dropping your heart scan score. (See The Heart Scan Blog from earlier this week.) The more I think about this, the more I think that it is indeed true: Harboring anger and resentment, regrets, irritability, all those petty emotions that most of us know are not good for us, erode our chances for success in dropping your heart scan score.

We could rationalize it this way: Anger and other negative emotions are adrenaline-driven states, also characterized by activation of the "sympathetic" nervous system. (Despite its name, the sympathetic system is not sympathetic, as in compassionate; its the "fight-or-flight" activator that accelerates heart rate and blood pressure.)

Happiness, contentment, and gratitude are "parasympathetic" states characterized by slower heart rates, deeper respiration, greater variation in beat-to-beat heart rates (a powerful predictor for health and the basis for the HeartMath program of Lew Childre), lower blood pressure, and even a subtle change in brain waves. In other words, happiness is not just a mental and emotional state, it is a constellation of physical phenomena.

Even though I pick on Dr. Dean Ornish for his stubborn adherence to the outdated low-fat mantra, I do agree with him on the value of happiness. His book, Love and Survival, articulates this concept. Ornish has even said on several occasions that it wasn't the diet that was most important but the connection and warmth that was created by the comraderie created by participation in the Ornish Program group sessions.

I am personally grateful that the concepts I promote are gaining a following and that I can say so without fear of prosecution. I am grateful that Track Your Plaque followers are not just sharing our concepts, but obtaining genuine and powerful health advice that will help keep them home and healthy, away from hospitals, procedures, and the dangers of heart disease.

I hope you share in my gratitude and are thankful for all the truly wonderful things that surround us. I wish you all a wonderful holiday and long, healthy life filled with gratitude.

A Track Your Plaque failure

23. December 2006 William Davis (0)
We recently had a man suffer a heart attack after beginning the program. Let me tell you the details.

Jerry's heart scan score 781, age 53. Multiple lipoprotein abnormalities: HDL 32 mg/dl, triglycerides 279 mg/dl, nearly all of his LDL was in small particles with an "effective" LDL (LDL particle number), and very high IDL. So Jerry added fish oil 6000 mg per day, niacin, and vitamin D to the statin drug prescribed by his primary physician. Jerry added oat bran, ground flaxseed, and tried to eat fish at least once per week.

However, Jerry continued to smoke. He'd smoked for 40 years (!), up to 2 packs per day, and just reasoned that it was too late to quit. He also continued to indulge in the packaged, processed foods that were part of his convenience story business.

Jerry's stress test was normal--no chest pain, normal EKG, normal images of blood flow, though he was somewhat breathless, likely from his lung disease from smoking.

Two months into his program, he abruptly experienced severe crushing pain in his chest. Because he was traveling, he ended up in a small local hospital. A failed angioplasty led to urgent coronary bypass surgery.

Jerry's alive. Now he's a non-smoker. He's got the pursed lips and peculiar breathing pattern that smokers get, but he's breathing.

Lesson: In the face of the most powerful program for heart disease known, it can still be overpowered by Twinkies, Hoho's, pretzels, chips--and cigarettes.

The new year is approaching. Be grateful for another year of healthy life and commit to a new year of even greater health. If you're a smoker, there's no choice: you've got to quit.

Are you more like a dog or a rabbit?

20. December 2006 William Davis (11)
Dr. William Roberts, editor of the American Journal of Cardiology and cardiovascular pathologist, is a perennial source of clever ideas on heart disease.
In a recent editorial, Dr. Roberts comments:








"Because humans get atherosclerosis, and atherosclerosis is a disease only of herbivorers, humans also must be herbivores. Most humans, of course, eat flesh, but that act does not make us carnivores. Carnivores and herbivores have different characteristics. (1) The teeth of carnivores are sharp; those of herbivores, flat (humans have some sharp teeth but most are flat for grinding the fruits, vegetables, and grains we are built to eat). (2) The intestinal tract of carnivores is short (about 3 times body length); that of herbivores, long (about 12 times body length). (Since I am 6 feet tall my intestinal tract should be about 60 feet long. As a consequence, if I eat bovine muscle [steak], it could take 5 days to course through those 20 yards.) (3) Body cooling for carnivores is done by panting because they have no ability to seat; although herbivores also can pant, they cool their bodies mainly by sweating. (4) Drinking fluids is by lapping them for the carnivore; it is by sipping them for the herbivore. (5) Vitamin C is made by the carnivore's own body; herbivores obtain their ascorbic acid only from their diet. Thus, although most human beings think we are carnivores or at least conduct their lives as if we were, basically humans are herbivores. If we could decrease our flesh intake to as few as 5 to 7 meals a week our health would improve substantially."



You can always count on Dr. Bill Roberts to come up with some clever observations.

I think he's right. Some of the most unhealthy people I've known have been serious meat eaters. Most of the vegetarians have been among the healthiest. (I say most because if a vegetarian still indulges in plenty of junk foods like chips, crackers, breakfast cereals, breads, etc., then they can be every bit as unhealthy as a meat eater.)

Should you become a vegetarian to gain control over coronary plaque and other aspects of health? I don't believe you have to. However, modern livestock raising practices have substantially modified the composition of meats. A steak in 2006, for instance, is not the same thing as a steak in 1896. The saturated and monounsaturated fat content are different, the pattern of fat "marbling" is different, the lean protein content is different. Meat is less healthy today than 100 years ago.

Take a lesson from Dr. Roberts' tongue-in-cheek but nonetheless provocative thoughts. Pardon me while I chew on some carrots.

Wheat brain

30. March 2011 William Davis (52)
Among the most common effects of wheat are those on the brain.

Consume wheat and susceptible individuals will experience a subtle euphoria. Others experience mental cloudiness or sleepiness. (This is what I personally get.)

It gets worse. Children with ADHD and autism have difficulty concentrating on a task and have behavioral outbursts after a cookie. Schizophrenics experience paranoid delusions, auditory hallucinations, and worsening of social detachment. People with bipolar disorder can have the manic phase triggered by a breadcrumb. All these effects are blocked by administering drugs that block the brain's opiate receptors. (This is why, by the way, a drug company is planning to release an oral agent, naltrexone, formerly administered to heroin addicts to help control addiction, for weight loss: block the euphoric effect, take away the temptation, lose weight.)

Here is Heart Scan Blog reader, Nicole's, mental fog story:

I have been grain-free (no gluten free grains either) for quite a long time (about a year and a half). Earlier this week, I decided to try white bread and pasta. The experiment only lasted two days. I had horrible terminal insomnia both nights, causing me on the second night to wake up at 2:30 am unable to get back to sleep at all. I felt drugged and in a mind-fog all the next day and even dozed off a few times! Luckily I had the day off work.

I had very bad forgetfulness also. I forgot that I left my bag and groceries at work, so I had to go back for them. Then I had to use my husband's keys to get in because I thought my keys were in my bag, but it turns out they were in my pocket. Then I got my bag, set the alarm, locked the door and then realized I forgot my groceries. So I had to re-open the door, unset the alarm, and go back for the groceries. Then I locked the door, forgetting to set the alarm, so I had to unlock it, open up and set the alarm. It was just ridiculous, I am NEVER like that!

In addition to the insomnia and forgetfulness, I also had horrible anxiety and paranoia, almost to the point of panic. Which I NEVER have, I am usually very easy-going, even-tempered, and worry-free. But this was horrible, I really was quite paranoid and anxious about everything. Weird!

And the worst, was that in just two days of eating wheat, I gained 4 lbs and 2% bodyfat!! It's two days wheat-free now, and it's finally going back down, but wow. Just two days of wheat-eating caused that much weight and fat gain!

Anyway, I've learned my lesson and will continue to avoid grains (including gluten free grains) entirely.

Eat more "healthy whole grains"? Modern dwarf Triticum aestivum, perverted even further by agricultural geneticists and modern agribusiness, subsidized by the U.S. government to permit $5 pizza, is better than any terrorist plot to discombobulate the health and performance of the American people.

The Westman Diet

27. March 2011 William Davis (71)
Dr. Eric Westman has been a vocal proponent of carbohydrate restriction to gain control over diabetes, as have Drs. Richard Bernstein, Mary Vernon, Richard Feinman, and Jeff Volek.

Several studies over the years have demonstrated that reductions in carbohydrate content of the diet yield reductions in weight and HbA1c (glycated hemoglobin, a reflection of average blood glucose over the preceding 60-90 days).

Among the more important recent clinical studies is a small experience from Duke University's Dr. Eric Westman. In this study, obese type 2 diabetics reduced carbohydrate intake to 20 grams per day or less: no wheat, oats, cornstarch, or sugars. Participants ate nuts, cheese, meats, eggs, and non-starchy vegetables.

After 6 months, average weight loss was 24.4 lbs, BMI was reduced from 37.8 to 34.4. At the end of the study, 95% of participants on this severe carbohydrate restriction reduced or eliminated their diabetes medications.

That was only after 6 months. Note that the ending BMI was still quite well into the obese range. Imagine what another 6-12 months would do, or achieving BMI somewhere closer to ideal.

Curiously, this idea of severe low-carbohydrate restriction to cure or minimize diabetes is not new. Sir William Osler, one of the founders of Johns Hopkins Hospital and author of the longstanding authoritative text, Principles and Practice of Medicine, advocated an diet identical to Dr. Westman's diet. So did Dr. Frederick Banting, discoverer of the pancreatic extract, insulin, to treat childhood diabetics. Before insulin, Banting and his colleagues at the University of Toronto used carbohydrate elimination (less than 10 g per day) to prolong the lives of children with diabetes.

This lesson was also learned many times during war time, when staples like bread were unavailable. The Siege of Paris in 1870 yielded cures for diabetes in many (or at least they stopped passing urine that tasted--yes, tasted--sweet and attracted flies), only to have it recur after the siege was over.

These are lessons we will have to relearn. As long as the American Diabetes Association and most physicians continue to advocate a diet of reduced fat, increased carbohydrate that includes plenty of "healthy whole grains," diabetics will continue to be diabetics, taking their insulin and multiple medications while developing neuropathy (nervous system degeneration), nephropathy (kidney disease and failure), atherosclerosis and heart attack, cataracts, and die 8 to 10 years earlier than non-diabetics.

All the while, we've had the combined wisdom from antiquity onwards: Carbohydrates cause diabetes; elimination of carbohydrates cures diabetes.

(This applies, of course, only to adult overweight type 2 diabetics, not type 1 or some of the other variants.)

Handy dandy carb index

25. March 2011 William Davis (21)
There are a number of ways to gauge your dietary carbohydrate exposure and its physiologic consequences.

One of my favorite ways is to do fingerstick blood sugars for a one-hour postprandial glucose. I like this because it provides real-time feedback on the glucose consequences of your last meal. This can pinpoint problem areas in your diet.

Another way is to measure small LDL particles. Because small LDL particles are created through a cascade that begins with carbohydrate consumption, measuring them provides an index of both carbohydrate exposure and sensitivity. Drawback: Getting access to the test.

For many people, the most practical and widely available gauge of carbohydrate intake and sensitivity is your hemoglobin A1c, or HbA1c.

HbA1c reflects the previous 60 to 90 days blood sugar fluctuations, since hemoglobin is irreversibly glycated by blood glucose. (Glycation is also the phenomenon responsible for formation of cataracts from glycation of lens proteins, kidney disease, arthritis from glycation of cartilage proteins, atherosclerosis from LDL glycation and components of the arterial wall, and many other conditions.)

HbA1c of a primitive hunter-gatherer foraging for leaves, roots, berries, and hunting for elk, ibex, wild boar, reptiles, and fish: 4.5% or less.

HbA1c of an average American: 5.2% (In the population I see, however, it is typically 5.6%, with many 6.0% and higher.)

HbA1c of diabetics: 6.5% or greater.

Don't be falsely reassured by not having a HbA1c that meets "official" criteria for diabetes. A HbA1c of 5.8%, for example, means that many of the complications suffered by diabetics--kidney disease, heightened risk for atherosclerosis, osteoarthritis, cataracts--are experienced at nearly the same rate as diabetics.

With our wheat-free, cornstarch-free, sugar-free diet, we have been aiming to reduce HbA1c to 4.8% or less, much as if you spent your days tracking wild boar.

Battery acid and oatmeal

23. March 2011 William Davis (38)
Ever notice the warnings on your car's battery? "Danger: Sulfuric acid. Protective eyewear advised. Serious injury possible."

Sulfuric acid is among the most powerful and potentially harmful acids known. Get even a dilute quantity in your eyes and you will suffer serious burns and possibly loss of eyesight. Ingest it and you can sustain fatal injury to the mouth and esophagus. Sulfuric acid's potent tendency to react with other compounds is one of the reasons that it is used in industrial processes like petroleum refining. Sulfuric acid is also a component of the harsh atmosphere of Venus.

Know what food is the most potent source of sulfuric acid in the body? Oats.

Yes: Oatmeal, oat bran, and foods made from oats (you know what breakfast cereal I'm talking about) are the most potent sources of sulfuric acid in the human diet.

Why is this important? In the transition made by humans from net-alkaline hunter-gatherer diet to net-acid modern overloaded-with-grains diet, oats tip the scales heavily towards a drop in pH, i.e., more acidic.

The more acidic your diet, the more likely it is you develop osteoporosis and other bone diseases, oxalate kidney stones, and possibly other diseases.

Here's one reference for this effect.

What'll it be: Olive oil or bread?

21. March 2011 William Davis (0)
We frequently discuss the advisability of consuming fats, carbohydrates, and various types within each category.

But what's the worst of all? Combining fats with carbohydrates.

Putting aside the wheat-is-worst form of carbohydrate issue and treating bread as a prototypical carbohydrate, let's play out a typical scenario, a make-believe feeding study in which a theoretical person is fed specific foods.

John is our test person, a 40-year old, 5 ft 10 inch, 210 lb, BMI 27.7 (roughly the mean for the U.S.) He starts with an average American diet of approximately 55% carbohydrates and 30% fat. Starting lipoproteins (NMR):

LDL particle number 1800 nmol/L
Small LDL 923 nmol/L


(The LDL particle number of 1800 nmol/L translates to measured LDL cholesterol of 180 mg/dl, i.e., drop last digit or divide by 10.)

Also, calculated LDL cholesterol is 167 mg/dl (yes, underestimating "true" measured LDL), HDL 42 mg/dl, triglycerides 170 mg/dl.

We feed him a diet increased in carbohydrates and reduced in fat, especially saturated fat, with more breakfast cereals, breads and other wheat products, pasta, fruit juices and fruit, and potatoes. After four weeks:

LDL particle number 2200 nmol/L
Small LDL 1378 nmol/L

Note that LDL particle number has increased by 400 nmol/L due entirely to the increase in small LDL particles triggered by carbohydrate consumption. Lipids show calculated LDL cholesterol 159 mg/dl--yes, a decrease, HDL 40 mg/dl, triglycerides 189 mg/dl. (At this point, if John's primary care doctor saw these numbers, he would congratulate John on reducing his LDL cholesterol and/or suggest a fibrate drug to reduce triglycerides.)

John takes a rest for four weeks during which his lipoproteins revert back to their starting values. We then repeat the process, this time replacing most carbohydrate calories with fats, weighed heavily in favor of saturated fats like fatty red meats, butter and other full-fat dairy products. After four weeks:

LDL particle number 2400 nmol/L


Let's

Chocolate peanut butter cup smoothie

19. March 2011 William Davis (18)
Here's a simple recipe for chocolate peanut butter cup smoothie.

The coconut milk, nut butter, and flaxseed make this smoothie exceptionally filling. If you are a fan of cocoa flavonoids for reducing blood pressure, then this provides a wallop. Approximately 10% of cocoa by weight consists of the various cocoa flavonoids, like procyanidins (polymers of catechin and epicatechin) and quercetin, the components like responsible for many of the health benefits of cocoa.


Ingredients:
1/2 cup coconut milk
1 cup unsweetened almond milk
2 tablespoons cocoa powder (without alkali)
2 tablespoons shredded coconut (unsweetened)
1 tablespoon ground flaxseed
1 teaspoon almond extract
1 1/2 tablespoons natural peanut, almond, or sunflower seed butter
Non-nutritive sweetener to taste (stevia, Truvia, sucralose, xylitol, erythritol)
4 ice cubes

Combine ingredients in blender. Blend and serve.

If you plan to set any of the smoothie aside, then leave out the flaxseed, as it absorbs water and will expand and solidify if left to stand.

For an easy variation, try adding vanilla extract or 1/4 cup of sugar-free (sucralose) vanilla or coconut syrup from Torani or DaVinci and leave out the added sweetener.

The compromise I draw here is the use of non-nutritive sweeteners. Beware that they can increase appetite, since they likely trigger insulin release. However, this smoothie is so filling that I don't believe you will experience this effect with this recipe.

Letter from the insurance company

18. March 2011 William Davis (24)
Claudia got this letter from her health insurance company:

Dear Ms. ------,

Based on a recent review of your cholesterol panel of January 12, 2011, we feel that you should strongly consider speaking to your doctor about cholesterol treatment.

Reducing cholesterol values to healthy levels has been shown to reduce heart attack risk . . .

Okay. So the health insurer wants Claudia to take a cholesterol drug in the hopes that it will reduce their exposure to the costs for her future heart catheterization, angioplasty and stent, or bypass surgery. This is understandable, given the extraordinary costs of such hospital services, typically running from $40,000 for a several hour-long outpatient catheterization procedure, to as much as $200,000 for a several day long stay for coronary bypass surgery.

So what's the problem?

Here are Claudia's most recent lipid values:

LDL cholesterol 196 mg/dl
HDL 88 mg/dl
Triglycerides 37 mg/dl
Total cholesterol 291 mg/dl

By the criteria followed by her health insurer, both total and LDL cholesterol are much too high. Note, of course, that LDL cholesterol was a calculated value, not measured.

Here are Claudia's lipoproteins, drawn simultaneously with her lipids:

LDL particle number 898 nmol/L
Small LDL particle number less than 90 nmol/L (Values less than 90 are not reported by Liposcience)

LDL particle number is, by far and away, the best measure of LDL particles, an actual count of particles, rather than a guesstimate of LDL particles gauged by measuring cholesterol in the low-density fraction of lipoproteins (i.e., LDL cholesterol). It is also measured and is highly reproducible.

To convert LDL particle number in nmol/L to an LDL cholesterol-like value in mg/dl, divide by ten (or just drop the last digit).

Claudia's measured LDL is therefore 89 mg/dl--54% lower than the crude calculated LDL suggests.

This is because virtually all of Claudia's LDL particles are large, with little or no small. This situation throws off the crude assumptions built into the LDL calculation, making it appear that she has very high LDL cholesterol.

Do you think that Big Pharma advertises this phenomenon?

Healthy smoothies

15. March 2011 William Davis (51)
I've now seen several people who have either caused themselves to be diabetic or to have other phenomena associated with excessive consumption of carbohydrates, all by innocently indulging in a carbohydrate-packed smoothie every morning.

Kay, for instance, has a smoothie of a half-pint blueberries, a banana, a scoop of whey, low-fat yogurt, a cup of milk every morning. The rest of her diet was fairly healthy: salads with oil-based dressing for lunch, salmon and asparagus for dinner, only an occasional carbohydrate indulgence outside of her morning smoothie ritual. Yet she had a HbA1c (a reflection of prior 60 to 90 days average blood sugar) at the near-diabetic range of 5.9%.

The mistake most people make when making smoothies is relying too heavily on carbohydrates like fruit. A smoothie like the one made by Kay can easily top 50, 60, or 70 grams carbohydrates per serving, more than sufficient to send blood sugars up to 150 mg/dl or more.

So what can you put in your smoothie and not send you over the edge to diabetes, small LDL, and all the other undesirable phenomena of excessive carbohydrates? Here's a list:

--coconut milk, unsweetened almond milk. Less desirable: milk, full-fat soymilk
--ground flaxseed
--oils: flaxseed oil, coconut oil (melted), extra-light olive oil, walnut oil
--dried coconut
--extracts: vanilla, almond, coconut, cherry, hazelnut
--spices: cinnamon, nutmeg, ginger
--herbs: mint leaves, cilantro
--cocoa powder (unsweetened)
--nut or seed butters (peanut butter, almond butter, sunflower seed butter)
--tofu
--exotic ingredients (ingredients you wouldn't expect in a smoothie): spinach, kale, cucumber

How do you sweeten a smoothie? This is what trips up most people. If you resort to fruit like bananas, pineapple, or apple, you will readily send your blood sugar skyward. Honey, agave syrup, and sugar, of course, all increase blood sugar and/or have the adverse effects of fructose. Be careful of yogurt, also, for similar reasons.

Therefore, to sweeten your smoothie, consider:

--Small servings of berries, e.g., 8-10 blueberries, 2 strawberries, a few wedges of apple, half a kiwi
--Non-nutritive sweeteners like stevia, Truvia, sucralose, xylitol, erythritol. Also, sugar-free (sucralose-based) syrups like those from DaVinci and Torani are useful. (Just be aware that non-nutritive sweeteners can increase appetite--use sparingly.)

Also, note that, if you have divorced yourself from wheat, cornstarch, and sugars, your desire for sweet should be much reduced. Foods other people find just right will taste sickeningly sweet to you. You might therefore find that foods like peanut butter or coconut milk have a mild natural sweetness; added sweetness is only minimally necessary.

Coming next: I'll share a smoothie recipe or two of mine. Anyone want to share a recipe?

Insulin secretagogue

14. March 2011 William Davis (34)
Dairy products have the peculiar property of triggering pancreatic release of insulin. The research group at Lund University in Sweden have contributed the most to documenting this phenomenon:




Mean (±SEM) incremental changes (?) in serum insulin in response to equal amounts of carbohydrate from a white-wheat-bread reference meal (x) and test meals of whey (?), milk (?), cheese (?), cod (?), gluten-low (?), and gluten-high (?) meals. From Nilsson 2004.

Note that it is the area under the curve (AUC), not the peak value, that assumes greatest importance.

Dairy products, especially milk, whey, and yogurt, are insulin secretagogues: they stimulate pancreatic release of insulin. The effect is likely due to amino acids and/or polypeptides in dairy products. (The effect is less prominent with cheese. Also see this study.)

By conventional wisdom, this may be a good thing, since the excess insulin will blunt the glucose rise after consumption. However, in my book, this is not such a good thing, since most of us have tired, beaten, overworked pancreatic beta cells from our decades of carbohydrate overconsumption. I fear that the effect of dairy products just take us a bit closer to beta cell failure: diabetes.

Good news: The effect is least with cheese.

Be gluten-free without "gluten-free"

9. March 2011 William Davis (23)
While I've discussed this before, it is such a confusing issue that I'd like to discuss it again.

I advocate wheat elimination because consumption of products made from modern dwarf Triticum aestivum:

--Triggers formation of extravagant quantities of small LDL and LDL particle number (or apoprotein B)
--Triggers inflammatory phenomena like c-reactive protein, increases leptin resistance, and reduction of the protective adipocytokine, adiponectin.
--Encourages accumulation of deep visceral fat ("wheat belly") that is inflammatory and causes resistance to insulin
--Increases blood sugar more than nearly all other foods--higher than a Milky Way bar, higher than a Snickers bar, higher than table sugar.
--Is being linked to a growing number of immune-mediated diseases, including celiac disease (quadrupled over past 50 years), type 1 diabetes in children, and cerebellar ataxia and peripheral neuropathies.

This last group of wheat-related phenomena are primarily due to gluten, the collection of 50+ proteins found in each wheat plant. For this reason, people diagnosed with celiac disease are advised to eliminate gluten from wheat and other sources (barley, rye, triticale, bulgur) and to eat gluten-free foods.

Gluten-free has therefore come to be viewed as wheat-free and problem-free. It ain't so.

Among the few foods that increase blood glucose higher than wheat: cornstarch, rice starch, potato starch, and tapioca starch--Yup: the ingredients commonly used to replace wheat in gluten-free foods. They are also flagrant triggers of the small LDL pattern, along with increased triglycerides, reduced HDL, increased visceral fat, increased blood pressure. In short, gluten-free foods lack the immune and brain effects of wheat gluten, but still make you fat, hypertensive, and diabetic.

I tell patients to view gluten-free foods like jelly beans: Gluten-free pancakes, muffins, breads, etc. are indulgences, not healthy replacements for wheat. It's okay to have a few jelly beans now and then. But they should not be part of a frequent or daily routine. Same with gluten-free foods.
Why do morphine-blocking drugs make you lose weight?

Why do morphine-blocking drugs make you lose weight?

10. November 2010 William Davis (24)
Naloxone (IV) and naltrexone (oral) are drugs that block the action of morphine.

If you were an inner city heroine addict and got knifed during a drug deal, you'd be dragged into the local emergency room. You're high, irrational, and combative. The ER staff restrain you, inject you with naloxone and you are instantly not high. Or, if you overdosed on morphine and stopped breathing, an injection of naloxone would reverse the effect immediately, making you sit bolt upright and wondering what the heck was going on.

So what do morphine-blocking drugs have to do with weight loss?

An odd series of clinical studies conducted over the past 40 years has demonstrated that foods can have opiate-like properties. Opiate blockers, like naloxone, can thereby block appetite. One such study demonstrated 28% reduction in caloric intake after naloxone administration. But opiate blocking drugs don't block desire for all foods, just some.

What food is known to be broken down into opiate-like polypeptides?

Wheat. On digestion in the gastrointestinal tract, wheat gluten is broken down into a collection of polypeptides that are released into the bloodstream. These gluten-derived polypeptides are able to cross the blood-brain barrier and enter the brain. Their binding to brain cells can be blocked by naloxone or naltrexone administration. These polypeptides have been named exorphins, since they exert morphine-like activity on the brain. While you may not be "high," many people experience a subtle reward, a low-grade pleasure or euphoria.

For the same reasons, 30% of people who stop consuming wheat experience withdrawal, i.e., sadness, mental fog, and fatigue.

Wouldn't you know that the pharmaceutical industry would eventually catch on? Drug company startup, Orexigen, will be making FDA application for its drug, Contrave, a combination of naltrexone and the antidepressant, buproprion. It is billed as a blocker of the "mesolimbic reward system" that enhances weight loss.

Step back a moment and think about this: We are urged by the USDA and other "official" sources of nutritional advice to eat more "healthy whole grains." Such advice creates a nation of obese Americans, many the unwitting victims of the new generation of exorphin-generating, high-yield dwarf mutant wheat. A desperate, obese public now turns to the drug industry to provide drugs that can turn off the addictive behavior of the USDA-endorsed food.

There is no question that wheat has addictive properties. You will soon be able to take a drug to block its effects. That way, the food industry profits, the drug industry profits, and you pay for it all.
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Comments (24) -

  • praguestepchild

    11/10/2010 3:49:28 PM |

    A doctor friend of mine was telling me about this, junkies hate it because it makes them instantly sober. Interesting that it would block the same receptors involved in wheat addiction.

  • Anonymous

    11/10/2010 4:29:57 PM |

    Thank you for explaining/exposing this.  For years I've wondered how food addictions work, especially wheat.  That our representative government is serving profit seeking corporate interests no longer surprises me though.

  • Anonymous

    11/10/2010 4:30:30 PM |

    Thesis + antithesis = synthesis.

  • arnoud

    11/10/2010 7:12:13 PM |

    Thank you for these interesting insights.  

    Now I also know why I couldn't just eat one cookie - - had to continue and eat the whole box.

    Now, without that first cookie, I totally don't care about them at all.

  • Anonymous

    11/10/2010 7:32:04 PM |

    BTW, naltrexone is also used to treat alcoholism in protocol known as The Sinclair Method.  You take the naltrexone an hour before drinking and then drink normally.  The naltrexone blocks the opoid receptors in the brain and the endorphins released by the drinking find no room at the inn.  Over time, the addiction is extinguished.

  • terrence

    11/10/2010 7:35:08 PM |

    I do not think I could have made up something like this! If I could I would be very rich, and maybe own a Big Pharma company or two.

    BTW, awhile ago, I read about a clinical study done in the UK. It had three groups of heron addicts - one group stayed on heroin, another was given methadone, the third was given a placebo (that they were told was methadone).

    Not surprisingly, the first group remained addicted to heroin, and the second group remained addicted to Methadone. The third group ALL got over their previous addiction to heroin, and with NO withdrawal symptoms, NONE, not one of them.

    Some commentators pointed out that The Heroin Establishment has a very large financial interest in keeping the story alive that heroin is hard to stop.

    I also know someone who was addicted to heroin. But, he realized that he was messing up his life (lost his wife, kids, etc). So, just stopped taking it - NO withdrawal issues, NONE.

  • Steve Cooksey

    11/10/2010 7:59:52 PM |

    Smile

    I love it when you rant against the MACHINE!!!  (in a dignified manner of course) Smile

    I'm a Type 2 Diabetic, with normal blood sugar and I take -0- drugs , -0- insulin.

    I follow a Very Low Carb, Gluten Free "Primal" meal plan....and I LOVE IT!

  • Dr. William Davis

    11/10/2010 11:04:21 PM |

    It's not clear to me how much of this is intentional, i.e., is wheat now a ubiquitous component of processed food precisely because of its addictive potential?

    Regardless, wheat stands apart from all other foods for this effect on humans.

  • mrfreddy

    11/11/2010 12:41:41 PM |

    interesting!

    and to think, the Ornishes, Furhmans, and Campbells of the world would have us believe that meat is addictive. Ha!

  • Anonymous

    11/11/2010 2:52:43 PM |

    Naltrexone..really?  Do some research on this drug and you will find that used over a long period of time it will cause changes to the receptors so that we feel no euphoria ever!  Bad Bad news.

  • Chet

    11/11/2010 6:13:47 PM |

    Eating wheat bread by itself is not very addicting but if sugar is thrown in the mix, you can get a nice mood lift.  This is because sugar(along with the wheat) spike insulin which drives tryptophan into the brain, where it converts to serotonin, the feel good neurotransmitter.

  • Kevin

    11/11/2010 9:58:03 PM |

    I may experiment.  I have some naltrexone that is about to expire.  I might give myself an injection and see if it makes me less interested in bread.  At the most I might eat two slices of whole wheat once or twice a week.  Would it work for other carbs like potatoes?

  • Dr. William Davis

    11/12/2010 1:32:06 AM |

    HI, Kevin--

    I'm impressed that you've got naltrexone! Please let us know what becomes of the experiment.

    Wheat stands apart for this effect. The only other foods that have been shown to exert a morphine-like effect are dairy products ("caseomorphin"), though the potency is many times less than that exerted by wheat.

  • Anonymous

    11/12/2010 3:09:49 AM |

    I eliminated grains, switched to Almond milk, cut out coffee and all artificial sweeteners.

    I started LDN in June and have easily lost 23 pounds, a feat almost unheard of in a Hashimoto's patient.

    Just a small amount of some protein and veggies will satisfy me but so could a handful of unsalted nuts.
    My appetite is no longer an issue.
    I would say I don't really have an interest in food anymore.
    I no longer have any blood sugar swings but those disappeared when I eliminated grains. I just feel LDN was helping in the appetite area, now your post confirms what I had been feeling.

    Now that my thyroid medication has been switched ( Armour to Synthroid due to manufacturing issues) and adding Cytomel plus LDN, I feel better.

    I am waiting of lab results to see where my Vit. D level is ( was at 42 aiming for 60) and to see what impact 6 months of no grains has done to my cholesterol.
    I am hopeful!  And that's another thing about LDN, depression is a thing of the past.
      
    My holistic MD thinks because the dosage is so small, LDN is acting in a homeopathic manner.  
    Many Hashimoto's patients have to decrease the amount of hormone they take because of LDN's effect on the thyroid.  
    I should know if my thyroid is happier by the end of the month. It might even be too happy.

  • Anne

    11/12/2010 3:28:40 AM |

    Chet - you say wheat is not addicting. My experience is not proof but when I gave up wheat I had about 3 days of withdrawal symptoms.  I felt really terrible and I was still eating sugar and high carb foods. A few years later I gave up the sugars. Although it took a while to lose the cravings for sweets, I did not have a period of feeling ill like I did when I gave up wheat.  

    Giving up wheat eliminated my depression. The tiniest amount of accidental wheat causes my mood to drop for a few days.

  • Anonymous

    11/12/2010 6:22:05 AM |

    Wrong explanation. By antagonizing opioid receptors, naltrexone disrupts flow in reward circuit. Which we know is central to the development of addiction. Wheat or no wheat. The weight loss appears to be at least in part something else. In combination with buproprion (AKA Zyban, an effective quit smoking drug) it significantly reduces food intake (by blocking hunger signal and reducing cravings). Again, wheat or no wheat.

  • Peter

    11/12/2010 5:40:16 PM |

    I'm trying to understand trade-offs.  Since quitting meat my weight hasn't changed, my blood sugar has improved, and my LDL is worse.

  • Kevin

    11/12/2010 7:35:40 PM |

    I took a closer look.  It's naloxone, not naltrexone.  Very rarely I see a dog that's ingested opiates.  That's why I have it but as I said, the dozen vials have reached the expiration date.

    kevin

  • Sue

    11/13/2010 3:22:52 AM |

    Sorry, completely off topic but did you see the article in HeartWire re reducing LDL even more.
    http://www.theheart.org/article/1145175.do

  • ilaçlama

    11/13/2010 11:03:45 AM |

    Thanx For subject

  • Anonymous

    11/13/2010 1:55:04 PM |

    ANNE
    I suffer from depression and would like to know more about how giving up wheat has helped you. Do u mind emailing me? If you don't scooby43215@yahoo.com. Thanks in advance.

  • Denny Barnes

    11/17/2010 8:50:40 AM |

    The diabetes guru Dr. Bernstein has written about low dose naltrexone therapy (LDN) to help diabetics lose weight.  Have you used LDN with your patients?  I understand that a low dose of naltrexone taken at night at first inhibits endorphin release and then stimulates it.  Presumably, increased endorphins eliminates the need for addictive foods and lowers inflammation.  Your thoughts?

  • elpi

    11/18/2010 1:30:57 AM |

    I just need to exercise and a healthy diet for me to lose weight. .That's all

  • Rene Sugar

    11/29/2010 6:25:35 PM |

    There is a Scientific American article that says negative emotions and pain-induced negative emotion are processed in the same brain areas so pain medication also relieves emotional pain.

    If wheat has opiate like effects, it might explain "emotional eating".

    http://www.scientificamerican.com/article.cfm?id=how-pain-can-make-you-fee

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