Followers of the Track Your Plaque program already know that maintaining an optimistic viewpoint is important in gaining control over coronary plaque.

In fact, I believe that, in many cases, a sense of optimism may make or break your CT heart scan score-reducing efforts. Pessimists rarely drop their score, while optimists do so all the time.

This week posed a challenge to my optimism. I spent the last week on jury duty hearing the details of a murder case. For four days, I listened to blow-by-blow testimony about the totally pointless, unprovoked death of a young man by a drug-dealing thug. Much of the witness testimony was from people who shared the hopeless, violent world of the defendant.

I was, however, completely impressed by the dedication of the prosecuting attorney, a 50-some year old man who was clearly deeply dedicated to his mission and didn't once provide any indication that he was grandstanding or looking for some personal glory. He was doing his job and trying to obtain justice for the fallen victim. I was equally impressed by the judge, who seemed unfazed by the events but carefully explained why the system worked the way it did. After the trial, he provided some further insights to us jury members and I saw him as a human being who, like the prosecutor, was trying to make a small contribution to making the world better.

Though many of the witnesses who testified against the defendant shared his world, I was impressed with their courage in coming forward. They face the threat of reprisals, I'm sure, for coming forward to the law and testifying against a known career criminal. Several of them said that they were not after any reward, but simply wished to do the right thing and provide testimony that proved damning against the defendant.

I acted as the jury foreman and I was proud of how the jury members listened carefully, asked intelligent and probing questions, and then helped us render a confident and expeditious sentence: guilty.

If anything, despite the tragic circumstances, I was much heartened at how all the participants in this process played their part and justice (at least in the legal sense) was served.

Let optimism prevail, even in dire circumstances.

I seem to be repeating myself lately, but I think this does bear repeating:

There's no need to re-invent the wheel when it comes to gaining control over your heart scan score.

The Track Your Plaque program is the most powerful approach known to help you gain control over your coronary atherosclerotic plaque and CT heart scan score, bar none. While 100% of people do not drop their score, more and more people every week are doing so. (One of the admitted weaknesses of the Track Your Plaque website is our failure to list more success stories; we're working on it.)

The basic program is quite simple:

--The Rule of 60 for lipids (LDL 60 mg/dl; HDL 60 mg/dl or greater; triglycerides 60 mg/dl or less)

--Identify hidden causes of plaque, esp. small LDL, Lp(a), and IDL, followed by specific corrective action

--Fish oil--minimum 1200 mg per day of EPA + DHA

--Normal vitamin D3 blood levels (We aim for 25-OH-vitamin D3 of 50-60 ng/ml)

--Normal blood sugar (<100 mg/dl)

--Normal blood pressure (<130/80)

--An optimistic attitude

Much of the other stuff--vitamin K, matrix metalloproteinase reducing strategies, flavonoid strategies, exercise-induced hypertension, etc.--are, for the majority, fluff. Their real role is in people who may have failed in stopping the rise of their heart scan score just doing the basics of the program.

If you neglect the basics, hoping to find some magic potion, I'm afraid the overwhelming likelihood is that you will fail. I've seen it happen time and again. Someone will come to my office with an extraordinary list of supplements--hawthorne, dozens of anti-oxidants, EDTA, concentrated flavonoid preparations, and on and on. Not only is it shockingly expensive to do this, it's also unnecessary and foolhardy. This kind of unfocused, hocus-pocus in the hopes of getting it right fail time after time.

The Track Your Plaque program, while not foolproof, is the best I know of. Stick to the basics and wander off when the basics fail. But there's extraordinary power in just achieving the basics.

I was shocked recently when someone accused me and the Track Your Plaque website of being nothing more than a front for the drug industry, that we are promoting concepts with the hidden pharmacuetical agenda behind us.

Don't make me laugh. How in the world that kind of impression could be gotten from either the Heart Scan Blog or the Track Your Plaque website is beyond me.

But I occasionally do need to state explicity: We do not promote drugs, neither this Blog nor the Track Your Plaque website has ever sought nor been backed by pharmaceutical money. The only money that supports this website is our own and that from paying Track Your Plaque members.

In fact, I am quite proud of the unbiased content and commentary on both venues. I challenge anyone to point out how and where there is any suggested relationship to a hidden source of commercial backing. I assure you, there is none.

If I say a drug is worth you and your doctor considering, then I say so with a true belief in it, not because somebody or some company paid me to say so. If I say a drug stinks, I believe that too. If we use a specific supplement in the program, it's because we believe it truly adds value to a plaque-reversal program. We receive no money from drug, supplement, or other commercial interests to promote their products. Period.

When it comes to laboratory values and medical testing, a common dilemma is knowing what is "normal." Let me explain.

First of all, when you receive a laboratory result for a test, a "reference range" or "normal range" is usually provided. Where did that range come from?

It varies from test to test. For instance, a low potassium is easy, because low potassium levels can lead to life threatening consequences, e.g., dangerous heart rhythms. High potassium likewise, because dangerous phenomena develop when potassium generally exceeds 5.5 mg/dl or so.

But what about something like HDL or LDL. Here's where confusion reigns. Often, "normal" is obtained by taking the average and saying that any value plus or minus two standard deviations (remember that painful class?) represents normal or reference range.

If that were true, what if we applied that principle to body weight. If we weighed several thousand adult women, the average would be in the neighborhood of 172 lbs (no kidding). Does that mean that 172 lbs plus or minus two standard deviations is normal? No, of course not.

There is therefore a distinction between "normal" and "desirable". For HDL cholesterol, your laboratory report might say that an HDL cholesterol of 40-60 mg/dl is normal. But is it desirable? I don't think so. The most frequent HDL level for a male with a heart attack is 42 mg/dl--hardly desirable.

Let's take triglycerides. The average triglyceride level in the U.S. is somewhere around 140 mg/dl. For those of us who do a lot of lipoprotein testing, we can tell you that triglycerides at this level, though generally regarded as being within the normal range, are associated with flagrant and obvious excesses of several abnormal lipoprotein particles that contribute to coronary plaque growth (VLDL and often IDL; small LDL; drop in HDL and shift towards small HDL).

So, always take the so-called "normal" or "reference" values on a lab report as crude guidelines that often have little or nothing to do with health or desirability. Unfortunately, many physicians are not aware of this and will declare any value within the normal or reference range as okay. An HDL of 40 mg is not okay. A triglyceride level of 140 mg is also not okay.

What is okay? What is desirable? That depends on the parameter being examined. From a basic lipid standpoint, of course, we regard desirable as 60-60-60. Desirability from a lipoprotein standpoint we will cover in a more thorough Track Your Plaque Special Report in future.

My sister sent me these quotes:

"We don't like their sound, and guitar music is on the way out."

Decca Recording Co. rejecting the Beatles, 1962

"Stocks have reached what looks like a permanently high plateau."

Irving Fisher, Professor of Economics, Yale University, 1929

"Airplanes are interesting toys but of no military value."

Marechal Ferdinand Foch, Professor of Strategy, Ecole Superieure de Guerre, France

"Everything that can be invented has been invented."

Charles H. Duell, Commissioner, US Office of Patents, 1899

No doubt, conventional wisdom can often be laughably (tragically?) wrong. The problem is that, as absurd as all the above sentiments seem to us now and in retrospect, they represented the view of many people years ago. These views were held by many, including many people in positions of power and decision-making responsibility.

A more relevant but nonetheless laughable and widely held belief in 2007: coronary heart disease should be treated with hospital procedures.

Why is a disease that requires 30 years to develop treated only at the final moments with a procedure? Do you only change your car's oil when the engine is on its last legs? Or, do periodic, relatively effortless oil changes during the life of the car make better sense?

I witness just how brainwashed the public has become with this crazed notion when I meet someone socially at, say a fundraiser or cocktail party. When they ask what I do, I tell them I'm a cardiologist. The invariable response: "Oh, what hospital do you work out of?"

I tell them I don't, that I take care of the majority of heart disease right from the office. 99% of the time I get a puzzled look. If we had comic bubbles above our heads revealing our internal thoughts, it would read "Yeah, right. What a kook."

The notion that coronary heart disease is something that is manageable with simple tools for the majority of us in the early stages is entirely foreign to almost everybody. The hospitals and the medical industry have so succeeded in dazzling the public with images of staff in scrubs, rushing from emergency to emergency, lights flashing, scalpels flying. . . how can you possibly accomplish this at home or anywhere outside of the high-tech world of the hospital?

Well, I'm a cardiologist and I do it every day. We all need a figurative dose of electroshock therapy to shake ourselves of this crazy notion.

Perhaps more than any other supplement, l-arginine causes frustration and confusion. It’s difficult to find, sometimes quite expensive, and some preparations cause loose stools.

Just how necessary is it?

L-arginine, you’ll recall, is a source of nitric oxide, or NO. Though it’s the same stuff as in car exhaust, NO provides a critical signaling role in your body’s cells that regulate a multitude of functions. Among the important roles of NO is to powerfully dilate, or relax, arteries. A constant flow of NO is required for health, particularly since each molecule persists only a few seconds.

L-arginine is the body’s source of nitric oxide. In addition, a peculiar but very effective blocker of l-arginine called asymmetric dimethylarginine, or ASDM, has recently been discovered to prevent the production of NO. Varied conditions like hypertension, diabetes, high cholesterol, excessive saturated fat or processed carbohydrate intake all lead to heightened levels of ASDM, often several-fold greater levels, and thereby effectively blocking NO production.

The “Arginine Paradox” is the name that some researchers in this field have given to the unusual property of l-arginine supplementation to “overpower” the blocking effects of ASDM. This is somewhat unusual in biologic systems in that an agent that blocks a receptor cannot usually be outmuscled by providing excess material for a reaction. Kind of like hoping that your car runs faster simply by topping up the gas tank.

Concrete observable benefits have been made for l-arginine in clinical trials, such as arterial relaxation that results in arterial enlargement (which can actually be seen in the cath lab); anti-inflammatory effects; reduction of blood pressure; enhancement of insulin responses, etc. All of these effects can be connected to beneficial properties that may facilitate atherosclerotic plaque regression and, indeed, there are limited data to document that this is true.

Drug companies may be greedy, but they’re not stupid. They’ve been vigorously pursuing this line of research for some years, a research path that led inadvertently to the erectile dysfunction agent, sildenafil (Viagra), and all its subsequent competitors. (Erectile dysfunction is another expression of endothelial dysfunction, since male erections are driven by the ability to dilate penile arteries.) The wonderful properties of NO enhancement continue to occupy research labs around the world.

Wow. So what’s the reluctance? In the early years of the Track Your Plaque program (meaning just a short 7-8 years ago), I was thoroughly convinced that l-arginine was a crucial, necessary part of a plaque regression program. Without it, you would rarely succeed. With it, the odds were tipped in your favor.

However, something curious has emerged recently. I’ve seen more and more people dropping their heart scan scores. Not just a little bit, but a huge amount. Witness our most recent record holder, Neal, who dropped his score 51% in 15 months. Just five years ago, this magnitude of reversal was unimaginable. Granted, Neal is our record holder, but others are obtaining 10, 18, 24, 30% drops in scores all the time. Many have done it without l-arginine.

Now, how about the people who have failed to stop a rising score? Would they do better with l-arginine as part of the mix? I believe so, but sometimes we never quite know except in retrospect. It has been a great dilemma for us trying to predict from the starting gate who will or who won’t drop their heart scan score.

My view from the trenches is that l-arginine packs its greatest atherosclerosis-fighting punch in the first year or two of use, when “endothelial dysfunction” is likely to be present (abnormal artery constriction). But as all other strategies take hold—fish oil, correction of lipid and lipoprotein abnormalities, weight loss (big effect), vitamin D (another very big effect), etc.—endothelial behavior improves over time. Perhaps l-arginine becomes a less necessary component over time.

There’s no doubt that uncertainty still surrounds the use and science surrounding l-arginine. However, if you’re interested in stacking the odds in your favor, particularly during the first year or two of your plaque-reducing efforts, I think that l-arginine is worth considering. It is cumbersome, it can be expensive, some preparations may even be foul. But in the big picture of life, with hospitals trying every possible ploy to get your body on a table for a procedure, doctors perverting their mission by signing employment contracts with hospitals and agreeing to usher you into the hospital as a paying patient whenever possible, and drug companies viewing you and me as a market for medications which may or may not be helpful, l-arginine is surely not that big a burden.

If you're a Track Your Plaque Member or viewer, you may know that we have resisted outside commercial involvement. We do not run advertising on the site, we do not allow drug companies to post ads, we do not covertly sponsor supplements. We do this to main the unbiased content of the site.

We've seen too many sites be tempted by the money offered by a drug company only to see content gradually drift towards providing nothing more than cleverly concealed drug advertising. I personally find this deceptive and disgusting. Ads are ads and everyone knows it. But when you subvert content, secretly driven by a commercial agenda, that I find abhorrent.

That said, however, I do wonder if we need the participation of some outside commercial interests to help our members. In other words, many (over half) of the questions and conversations we have with people is about what supplement to take, or what medication to take. While we cannot offer direct medical advice online (nor should we) because of legal and ethical restrictions, I wonder if could facilitate access to products.

Many people struggle, for instance, with trusted sources for l-arginine, vitamin D, fish oil. Other people struggle with finding a heart scan center because of the changing landscape of the CT scanning industry. Could we somehow provide a clear-cut segment of the website that clearly demarcates what is commercial and non-Track Your Plaque-originated, yet at least provides a starting place for more info?

Ideally, we would have personally tried and investigated everything there is out there applicable to the program. But that's simply impossible at this stage.

I feel strongly that we will never run conventional ads on the site. Nor will we ever permit any outside commercial interest to dictate what and how we say something. The internet world is full of places like that. Look at WebMD. I find the site embarassing in the degree of commercial bias there. We will NEVER sell out like that, regardless of the temptation. People with heart disease are all conducting a war with the commercial forces working to profit from them--hospitals, cardiologists, drug companies, medical device companies (yes, even they advertise to the public, e.g., implantable defibrillators--no kidding). Genuine, honest, unbiased information is sorely needed and not from some kook who either knows nothing about real people with real disease, or has a hidden agenda like selling you chelation.

I'd welcome any feedback either through this Blog or through the contact@cureality.com.

A conversation about vitamin K2 commonly leads to confusion. Several people have asked about something called nattokinase.

The scientific data on the potential role of vitamin K2 deficiency in causing both osteoporosis and vascular calcification is fascinating. Along with vitamin D3, vitamin K2 may be an important factor in regulation of calcium metabolism. Supplementation may prove to be a major strategy for inhibition of vascular calcification.

Obtaining K2 in the diet is tricky, since it's present in just a handful of foods: egg yolks, liver, traditional cheeses, and natto. This is where the confusion starts.

Natto is a Japanese fermented soy product. I've had it and it's quite disgusting. Nonetheless, Japanese who eat natto experience less fracture. (A parallel study in heart disease has not been performed.) Natto is also a source of another substance called nattokinase.

Advocates (otherwise often known as supplement distributors) claim that nattokinase is a "fibrinolytic", or blood clot-dissolving, preparation that "improves blood flow, protects from blood clots, and prevents heart attacks and strokes."

Don't you believe it. This is patent nonsense. There are several problems with this rationale:

--Any oral fibrinolytic agent is promptly degraded in the highly acid environment of the stomach. That's why all medically used fibrinolytics are given intravenously. Drug companies have struggled for years to encapsulate, modify, or somehow protect protein (or polypeptide) products taken orally from degrading this way. They've never succeeded. That's why, for instance, growth hormone (a polypeptide) remains an injection, not an oral agent. An oral growth hormone, by the way, would sell like mad, so the drug companies would very much like to figure out how to bypass the degradative effects of stomach acid. One of the "researchers" behind the nattokinase claims boasts that he has single-handedly figured out how to protect the nattokinase molecule in the gastrointestinal tract. However, he won't tell anybody how he does it. Right.

--Fibrinolytic agents are extremely dangerous. In years past, we used to treat heart attacks with intravenous fibrinolytic agents like tissue plasminogen activator, urokinase, streptokinase, and others. They have fallen by the wayside, for the most part, because of limited effectiveness and the unavoidable dangers of their use. Fibrinolytics are "dumb": they dissolve blood clots in both good places and bad. While they might dissolve the blood clot causing your heart attack, they also degrade the tiny clot in your cerebral (brain) circulation that was protective. That's why fatal brain hemorrhages, bleeding stomach ulcers, and blood oozing from strange places can also occur with fibrinolytic administration. Believe me, I've seen it happen, and I've watched people die from them.

The idea that a small dose taken orally is healthy is ridiculous. Even if nattokinase worked, why the heck would you take an agent that has known dangerous and very real consequences?

Don't let this idiocy reflect poorly on the K2 conversation, which, I believe, holds real merit and is backed by legitimate science. This is symptomatic of a larger difficulty with the supplement industry: Insane and unfounded claims about one supplement erodes credibility for the entire industry. It gives regulation-crazed people like the FDA ammunition to go after supplements, something none of us need. You and I have to sift through the nonsense to uncover the real gems in this rockpile, real gems like vitamin D3, omega-3 fatty acids from fish oil, and, perhaps, vitamin K2. But not nattokinase.

Here's a frequently neglected cause for an increasing CT heart scan score: High blood pressure with exercise. Let me explain.

Paul's blood pressure at rest, sitting in the office or on arising in the morning, or at other relatively peaceful moments: 110/75 to 130/80--all in the conventional normal range.

We put Paul on the treadmill for a stress test. At 10 mets of effort (on the protocol used, this means 3.4 mph treadmill speed at 14 degree incline), Paul's blood pressure skyrockets to 220/105. That's really high.

Now, blood pressure is expected to increase with exercise. If it doesn't rise, that's abnormal and may, in fact, be a sign of danger. Normally, blood pressure should rise gradually in a stepwise fashion with increasing levels of exercise. But any blood pressure exceeding 170/90 is clearly too high with exercise. (Not to be confused with high blood pressures not involving exercise.) A handful of studies have suggested that a "breakpoint" of 170/90 also predicts heightened risk of heart attack over a long period.)

I see this phenomenon frequently--normal blood pressure at rest, high with exercise. This also suggests that when Paul is stressed, upset, in traffic congestion, under pressure at work, etc., his blood pressure is high during those periods, as well. I wouldn't be surprised to see other phenomena of underappreciated high blood pressure, like abnormally thick heart muscle (left ventricular hypertrophy), an enlarged thoracic aorta (visible on your heart scan), left atrium, perhaps even an abnormal EKG or abnormal kidney function (evidenced by an elevated creatinine on a standard blood panel).

Unfortunately, the treatments that reduce blood pressure are "stupid," i.e., they have no appreciation for what you are doing and they reduce blood pressure all the time, whether or not you're stressed, exercising, or sleeping.

Blood pressure reduction should begin with weight loss, exercise, reduction of saturated fats and processed carbohydrates (esp. wheat), magnesium replacement, vitamin D replacement. Think about CoQ10. After this, blood pressure medication might be necessary.

The message: Watch out for the blood pressures when you have a stress test. Or, if you have a friend who is adept at getting blood pressures, get a blood pressure immediately upon ceasing exercise. It should be no higher than 170/90.

An interesting question came up on the Track Your Plaque Member Forum about vitamin D2 vs. vitamin D3. This often comes up among our patients, as well.

Vitamin D is measured in the blood as 25-OH-vitamin D and is distinct from 1,25-diOH-vitamin D, a kidney measure, a test you do not need unless you have kidney failure.

The human form of vitamin D is cholecalciferol and is usually obtained via activation of a precursor molecule in the skin on activation by the sun. You can also take cholecalciferol and it increases blood levels of 25-hydroxy vitamin D reliably.

However, there is a cheap, plant-sourced, alternative to vitamin D3, called vitamin D2, or ergocalciferol. D2 has far less effect in the body. Taking D2 or ergocalciferol orally is an extremely inefficient way to get D. Unfortunately, it's the form often used in milk and many supplements, even the prescription form of D. About half the multivitamins and calcium supplements I've looked at contain ergocalciferol rather than cholecalciferol.

Taking vitamin D2 yields very little conversion to the effective D3. This particular issues is maddening, as the USDA requires dairy farmers to add 100 units of vitamin D to milk, and D2 is often used. In other words, the D in many dairy products barely works at all. There are many children who rely on D from dairy products who are at risk for rickets and are not getting the D they need from dairy products because of this cost-saving switch. Do not rely on milk for vitamin D for your children.

D2 or ergocalciferol is often included in the blood measures of vitamin D along with vitamin D3. The only reason it's checked with blood work is to ensure "compliance,", i.e., see whether or not you're taking a prescribed ergocalciferol. Beyond this, it has no usefulness.

25-OH-vitamin D3, or cholecalciferol, is both the blood measure and the supplement you need. This is the one that packs all the punch. Keep in mind also that it is the oil-based gelcap you want, with more consistent and efficient absorption. Tablets usually barely work at all, even if it contains cholecalciferol. Most people who take calcium tablets with D, or multivitamin with D, not only are getting a powdered form of D, but also in trivial doses. It's the pure vitamin D3, cholecalciferol, in gelcap form you want if you desire all the spectacular benefits of vitamin D.

At a presentation at the American College of Cardiology meetings in New Orleans yesterday (March 27, 2007), Dr. Arthur Agatston declared "I have been doing CT for many years, and I have never seen regression."

Whooooaaaa. Wait a minute here. I have great respect for the work Dr. Agatston has done over the years. He is, after the originator of the scoring algorithm that allows us to score CT heart scans (though a more accurate measure, the volumetric score, is the one we often use behind closed doors because of modestly increased accuracy and reproducibility). His diet program, the South Beach Diet, has achieved enormous success and is indeed an effective approach for both weight loss and correction of many weight-related causes of heart disease.

But he has never seen regression? Why would this be when we see it all the time? When we see heart scan scores drop 30%, it's hard to believe that with some savvy he has never seen regression (drop in score).

I can only attribute the difference to the more intensive endpoints we advocate (e.g., 60-60-60 for lipid values); the incorporation of adjuncts like fish oil, vitamin D, l-arginine; attention to non-cholesterol issues and intensified treatments for each. I doubt that the populations we see differ substantially.

As much as I admire Dr. Agatston's accomplishments, I believe that he is behind the times on this issue. No regression is so starkly different from the Track Your Plaque experience. I believe that relying only on statin drugs and diet will slow but will not stop plaque growth. It will also rarely, if ever, drop your score.

Attention to detail and a little insight into better preventive strategies really pays off. While not everyone in the Track Your Plaque experience will drop their score, a substantial number do. Many more slow plaque growth dramatically. And, as time goes on, our track record gets stronger and stronger.

The results of the long-awaited COURAGE Trial were announced today at the American College of Cardiology meetings in New Orleans.

In this trial, 2200 participants with stable coronary disease (i.e., not unstable, in which heart attack or death is imminent) were randomly assigned ("randomized") to either angioplassty/stent or "maximal medical therapy." Medical therapy means such things as aspirin, beta blocker drugs, and statin cholesterol drugs. There was virtually no difference between the groups in rate of heart attack and death from heart disease over a period of up to 7 years.

These results have caused a stir in the media and my colleagues, trying to sort out of the implications. However, I think there's one observation in particular worth making for those of us who tend to scoff at the conventional approach to coronary disease. That is, 1 of 5 people had a heart attack or died from heart disease in both groups. That's a lot. Even more ended up with a procedure (angioplasty, stent, or bypass). In other words, the "maximal medical therapy" instituted in participants was hardly a success. Though angioplasty and stenting failed to prove superiority, both really stunk. Both permitted a lot of catastrophes to occur.

"Maximal medical therapy," in other words, is a laughable concept. It doesn't include raising HDL, suppressing small LDL, reducing Lipoprotein(a), addressing inflammatory issues. It does not include omega-3 fatty acids from fish oil, nor does it address the severe degrees of vitamin D deficiency that are proving, in the Track Your Plaque experience, to be among the most potent causes of atherosclerotic plaque known. It includes a sad attempt at diet, as advocated by the American Heart Association, a diet that, in my view, causes heart disease and is distorted by the powerful political and financial influence of food manufacturers.

If the trial were to be done again, I'd like to see the "maximal medical therapy" arm be represented by a more effective program like the Track Your Plaque approach.

Margaret is 73. She's a very good 73. She loves children and works full-time in a daycare. She manages her own household, goes to dinner at least once each week with one or more of her adult children. She is slender and has never been in the hospital--until she developed an abnormal heart rhythm called atrial fibrillation.

Most people who develop atrial fibrillation do so with no immediate identifiable cause. However, Margaret has been a widow since her husband died 15 years ago of a heart attack. She was therefore especially frightened of any heart issues in her own health. Her doctor also raised the question of whether atrial fibrillation might represent the first hint of future heart attack.

So we advised a CT heart scan. Score: zero, or no detectable plaque whatsoever. This put Margaret's risk for heart attack as close to zero as humanly possible. (Nobody is truly at zero risk for heart attack for a number of reasons. One reason is that people do irrational things like take cocaine or amphetamines, or they take too much decongestant medication, all of which can trigger heart attack.)

The heart scan settled it. Margaret has the sort of atrial fibrillation which likely simply develops as a result of "wear and tear" on the heart's electrical impulse conducting system and it has nothing to do with coronary heart disease or heart attack.

As that MasterCard commercial goes: Cost of a heart scan: About $200. Peace of mind: priceless.

If you're a participant in the Track Your Plaque program for atherosclerotic plaque regression, you are at the cutting edge of health.

Few physicians give this issue any thought. Chances are, for instance, that if you were to bring up the subject of reversal of heart disease to your primary care physician, you'd get a dismissive "it's not possible," or " Yeah, it's possible but it's rare."

Ask a cardiologist and you might make a little more progress. He/she might tell you that Lipitor 80 mg per day or Crestor 40 mg per day might achieve a halt in plaque growth or a modest reduction of up to 5-6%. If they've tried this strategy, they would likely also tell you that hardly anybody can tolerate these doses for long due to muscle aches. I'd estimate that 1 of 10 of my colleagues would even be aware of these studies.

Both groups are, however, reasonably adept at diagnosing chest pain, an everyday occurrence in hospitals and offices. Chest pain, for them, is a whole lot more interesting. It holds the promise of acute catastrophe and all its excitement. It also holds the key to lots of hospital revenues. Did you know that 80% of all internal medicine physicians are now employees of hospitals? They're also commonly paid on an incentive basis. More revenues, more money.

Ask Drs. Dean Ornish or Caldwell Esselstyn about reversal of heart disease and they will tell you that a very low-fat diet (<10% of calories)can do it. That's true if you use a flawed test of coronary disease like heart catheterization (angiograms) or nuclear stress tests (Ornish calls them "SPECT"). It would be like judging the health of the plumbing in your house by the volume of water flowing out the spigot. It flows even when the pipes are loaded with rust.

In the Track Your Plaque experience, extreme low-fat diets (i.e., high wheat, corn, and rice diets) grotesquely exagerrate the small LDL particle size pattern, among the most potent triggers for coronary plaque growth. This approach also makes your abdomen get fatter and fatter and inches you closer to diabetes. Triglycerides go up, inflammation increases.

If you were able to measure the rust in the pipes, that would be a superior test. You can measure the "rust" in your "pipes," the atherosclerotic plaque in your coronary arteries, using two methods: CT heart scans or intracoronary ultrasound. Take your pick. I'd choose a heart scan. It's safe, accurate, inexpensive. I've performed many intracoronary ultrasounds for people in the midst of heart attacks or some other reason to go to the catheterization laboratory. But for well people, without symptoms, who are interested in identifying and tracking plaque? That's the place for heart scans.

In our program, 18-30% reductions in heart scan scores are common.

Burt came to me last week. He'd received a stent a few months earlier. He'd been feeling fine except for some fatigue. A nuclear stress test proved equivocal, with the question of an abnormal area of blood flow in the bottom (inferior wall) of the heart.

"The doctor said I had a 50% blockage. Even though it wasn't really severe, he said I'd be better off with a stent, just in case."

Just in case what? What justification could there be for implanting a stent "just in case"? (The artery that was stented did not correspond to the area of questionable poor blood flow on the nuclear stress test.)

Just in case of heart attack? If that's the case, what about the several 20 and 30% blockages Burt showed in other arteries? The cardiologist was apparently trying to prevent the plaque "rupture" that results in heart attack by covering it with a stent. Why stent just one when there were at least 7 other plaques with potential for rupture?

That's the problem. And that's why stents do not prevent heart attack (unless the stent is implanted in the midst of heart attack, when the rupturing plaque declares itself.) Of course, when no plaque is in the midst of rupturing, as with Burt, there's no way to predict which plaque will do so in future. Since only one plaque was stented, there is a 7 out of 8 chance (87.5%) that the wrong plaque was chosen. And that's assuming that there aren't plaques not detected by catheterization angiogram; there commonly are. The odds that the right plaque was chosen would be even lower.

In other words, stenting one blockage that is slightly more "severely blocked" in the hopes of preventing heart attack is folly. If it's not resulting in symptoms and blood flow is not clearly reduced, a stent can not be used to prevent plaque rupture. A stent is not a device to be used prophylactically. It is especially silly when an approach like ours is followed, since plague progession is a stoppable process.

Note: This issue is distinct from the one in which symptoms and/or an abnormal stress test show clearly reduced blood flow and flow is restored by implantation of a stent. While some controversies exist here, as well, a stent implanted under these circumstances may indeed provide some benefit.

This issue came up twice this week.

Bill is a busy accountant. Two years ago, just after the tumult of the 2005 tax season was over, he got a CT heart scan. His score: 398. At age 53, this was a significant score. His internist did the usual: prescribed a statin (Zocor), told him to cut the fat in his diet, and be sure to exercise. (Yawn.)

Since then, Bill quit preparing tax returns and migrated to a less harried job in corporate accounting. It took two years since his heart scan for Bill to start thinking that perhaps his doctor's advice wasn't enough. If it was, he realized, everyone on a statin drug who made these minimal lifestyle changes would be cured of heart attack risk. Clearly not the case.

So Bill enrolled in the Track Your Plaque program. Our first step: Get another heart scan.

Bill was surprised. "Why another scan? I already had one!"

I explained to Bill that atherosclerotic plaque is like money: it grows in percentages, just like money in a bank account or in a mutual fund. If, for instance, you deposit $500 in a mutual fund and it yields 5% return, then after one year you will have $550. One year later, you will have 5% x $550, or $605. Another year: $665. In other words, growth is not 10% of the original amount you deposited. Growth is compounded, year over year. That's why money, when compounded, can grow so quickly.

Atherosclerotic plaque and your CT heart scan score do the same thing: they grow by a percentage of the current plaque quantity. In fact, we use the compound interest equation to calculate the annualized rate of plaque growth. But plaque grows at the extraordinary rate of 30% per year, on average. Imagine that was the rate of return on your money. You'd be the richest man or woman on earth.

Back to Bill. Now Bill, in his defense, was on a statin drug and did make modest efforts towards a (mis-guided) low-fat diet and walking four days per week. If, on a second CT heart scan, his score was:

398--No change. That's a success, since the expected rate of increase of 30% has been stopped. However, on his current program, this is highly unlikely. (I've seen it happen just once ever out of about 2000 people.)

250--Pop the cork on your champagne, because Bill needs to celebrate. He has substantially reversed his plaque. Highly unlikely on the current effort.

525 --The score is higher by 30%, so it has slowed, but it surely hasn't stopped. This is the most typical result on the sort of program Bill is following.

The message: Don't delay after your first heart scan score. It plaque grows like money with a huge return, there's no time like the present to take the steps to regain control.

Firefighters are twice as likely to die from a heart attack in the line of duty than are policemen, and three times more likely than EMTs.

That's among the headlines run today because of a report in the New England Journal of Medicine documenting a dramatically higher risk for heart attack for fire fighters putting out fires. The above headline is from an excellent report run on NPR radio. You can listen to the webcast at http://www.npr.org/templates/story/story.php?storyId=9047656.

The story sparked comments from experts insisting that all fire fighters should have physicals, should be in better physical condition, should be covered by health insurance (the NPR report said that 1 out of 4 fire fighters lack health insurance). Judging from the indisputable risk firefighters encounter, these are all good ideas.

But if you've been following my blog or the Track Your Plaque program, you know that physicals alone are hopeless exercises for identifying hidden heart disease. Among the solutions: identify whether or not heart disease is present in the first place--do a CT heart scan.

In fact, several local fire companies in my area have done just that: insisting that all firefighters undergo a heart scan. When groups of people like firefighters arrange for heart scans, they gain the advantage of doing so en masse, thereby allowing many scan centers to offer a dramatically reduced price to the city, town, or village that is paying for them. I've even seen many firefighters scanned at no cost.

It would also help to have health insurance, be physically fit, and have a stress test (an exception to my view that stress tests are also useless to screen asymptomatic people for heart disease). But a CT heart scan would settle the question quickly, easily, undeniably, and inexpensively.

This question comes up around once a week:

My CT heart scan score is ____. Wouldn't I be better off just getting a bypass (or stent, etc.) and getting it over with? If I know that heart attack is in my future, why not just get it over with?

The most recent source of this question was the wife of a patient. Jack had a heart scan score of 92 in 2005. He made very little effort to correct his causes, permitting pre-diabetic patterns to persist, failed to correct vitamin D, etc. and a repeat heart scan score showed a dramatic rise to 264.

Jack's wife asked whether he should just have a bypass.

There are several problems with this line of reasoning:

1) Bypass surgery does not reduce the long term risk for heart attack.

2) The risk of bypass surgery often outweighs the risk of an asymptomatic heart scan score.

3) Bypass surgery is a temporary "fix," a fancy Band Aid for a disease that progresses after the procedure. One bypass typically prompts another, and another...

4) Bypassing arteries that have vigorous blood flow often causes the bypass graft to not "take" and close within the first few days.

Thankfully, nobody in his right mind has proposed that we perform prophylactic bypass operations.

Of course, hospitals and surgeons would jump at the chance to perform procedures in anybody with some threshhold heart scan score. It would double or triple their business overnight. At $70,000 or more per procedure, they would dance in glee. Of course, you and I would pay for their new burst of wealth by a sharp increase in our health insurance premiums. Not only that, the people who underwent the procedure would not benefit.

I'm seeing more and more people taking 80 mg of Lipitor per day. For the most part, these are people who come in for another opinion after a stent or heart attack and are prescribed the drug during their hospitalization.

This practice is based on the results of the PROVE IT-TIMI 22 (PRavastatin Or atorVastatin Evaluation and Infection Therapy-Thrombolysis In Myocardial Infarction) trial, and the Reversal of Atherosclerosis with Aggressive Lipid Lowering (REVERSAL) trial, both reported in 2005. In the PROVE IT Trial, 4,000 people experiencing heart attacks were treated with Lipitor (atorvastatin), 80 mg, or Pravachol (pravastatin), 40 mg. There was a reduction in events like recurrent heart attack from 13.1% in the Pravachol group to 9.6% in the Lipitor group. In the REVERSAL Trial, the Lipitor group also showed no plaque growth compared to the Pravachol group, which did progress, with disease tracked by intracoronary ultrasound.

I believe that many of my colleagues took the bait. In a half-hearted effort to reduce events and trend towards better coronary plaque control, writing a prescription for 80 mg rather than a lower dose has become increasingly popular.

Some problems: Despite the favorable tolerance to high dose Lipitor in these trials, I don't know anybody who can tolerate 80 mg per day for more than a few months in real life. In my experience, people inevitably end up with intolerable muscle aches.

Also, I believe it is folly to believe that we can regress coronary plaque on a broad scale by just using one drug that addresses only a single cause (i.e., LDL cholesterol). Yes, drug companies would argue that the statin drugs are so wonderful because of their so-called "pleiotropic", or non-lipid, effects like reducing inflammation. I have seen regression of plaque once using Lipitor alone. We struggle to reduce coronary plaque using a multi-faceted approach. It is highly unlikely that Lipitor alone at a 80 mg dose will be sufficient in most people to regress plaque. How about lipoprotein(a)? Or vitamin D deficiency? Lipitor has no effect on these patterns and people do not regress just by taking statin agents.

In early February, the FDA approved orlistat, formerly known as prescription Xenical, for over-the-counter sale. Orlistat is a blocker of fat absorption.

The new OTC version will be called "Alli" (pronounced like "ally") and will come at a dose of 60 mg to be taken three times a day with meals. Prescription Xenical came as a 120 mg tablet. However, the company claims that the reduced dose sacrifices only 5% in reduced fat absorption, dropping from 30% with Xenical to 25% with Alli. It will cost in the neighborhood of $1 to $2 per day, or $30-60 per month, far less expensive than the $110-150 for the prescription form.

Does it work? Is it worth the money? Clinical trials document around 5-10 lbs lost over a 3 to 6 month period, 50% greater than using diet and exercise alone.

Our experience is that it works, though inconsistently. Results depend heavily on how reliant you are on fat calories. If you were to follow a low-fat diet while on the drug, you likely will lose little or no weight, since there's little fat absorption to block. However, I have witnessed more substantial weight loss of 10-20 lbs. in people who follow a higher fat intake in their diet, e.g., a traditional American diet. However, these people gain the weight back immediately because they've made no effort to modify food choices.

It is messy. Even though the clinical trials claims modest inconvenient effects like gas and greasy stools, I have found that it is, without fail, a very annoying product that results in crampiness and frequent messy stools in nearly everybody.

The company has created a glitzy website that you can view at www.myalli.com and promises to provide a personalized program and support for registrants when it is up and running by summer 2007.

I think that's a good idea, since the drug itself is no more than a temporary fix unless it's combined with long-term diet changes. However, the website, I believe, oversells the value of the drug with a drug company's usual over-the-top hints and innuendoes without actually coming out with straight pitches of the truth.

Beware of the vitamin D-blocking effect of Orlistat. The period of time you take it may be a time to resort to some modest sun exposure (10-15 minutes; be careful not to burn), rather than than oil-based vitamin D capsules, in order to avoid the inevitable vitamin D plunge in blood level.

I am not a fan of orlistat, having seen it tried many times with minimal success. However, it is another option for those who are really struggling. Personally, I would try fasting or some of the other strategies we've detailed on the www.cureality.com website before I resorted to orlistat.

Art's first CT heart scan in March, 2006 yielded a concerning score of 1336. He felt fine--no chest discomfort, no breathlessness, etc.

Art agreed to take the statin cholesterol drug his primary care doctor prescribed. He also agreed to take the fish oil, niacin, and some of the nutritional supplements that we advised. But Art just couldn't bring himself to make the commitment to lose weight.

At the start of his program, Art--at 5 ft. 8 inches--was 40 lbs overweight (212 lb). This was important since his blood sugar wavered in the pre-diabetic range, going as high as 130 mg. (The American Diabetes Assn. defines diabetes as a blood glucose of 126 mg or greater.)

One year later, Art's lipid and lipoprotein values were corrected to perfection. But he still weighed in at a hefty 209 lbs--essentially no change. His blood sugar likewise hovered in the 120's.

I felt Art need to be prodded, so I asked him to undergo another heart scan. His score: 1935--a 600 point increase, or 45%!

Only now has Art begun to comprehend to power of diabetes and pre-diabetes to fan the flames of plaque growth. Recent published data, in fact, show that the majority of recently diagnosed diabetics already have well-established coronary artery disease.

Don't let this happen to you. Do not dismiss diabetic patterns as they will catch up to you. If Art can lose the 30-40 lbs in the abdominal weight that is creating the diabetic pattern, he will likely succeed in stopping plaque growth. Otherwise, it's just a matter of time before his heart attack, stent, or bypass.

Marta is a smart lady. She's worked in hospital laboratories for the last 23 years and knows many of the ins and outs of lab tests and their implications.

After years of being told that her cholesterol was acceptable, she needed to undergo urgent bypass surgery after experiencing severe breathlessness that proved to be a small warning heart attack at age 57. But this made Marta skeptical of relying on cholesterol to identify heart disease risk.

I met Marta two years after her bypass surgery when she was seeking better answers. And, indeed, she proved to have several concealed sources of heart disease: small LDL particles, Lipoprotein(a), intermediate-density lipoprotein (IDL--a very important abnormality that means she is unable to clear dietary fats from her blood), among others. But she was also mildly diabetic with a blood sugar of 131 mg (normal < or = 100 mg). This had not been previously recognized.

As I'm a cardiologist and our program focuses on reversal and control of coronary plaque, I asked Marta to return to her primary care doctor to continue the conversation about diabetes. She was a bit frightened but followed through.

"Well, you're not urinating excessively. And your long-term measure of blood sugar, hemoglobin A1C, is still normal. I wouldn't worry about it. We'll just watch it."

I guess I should know better. What the poor primary care doctor doesn't know is that pre-diabetes and mild diabetes are potent risks for heart disease. In fact, some of the most explosive rates of plaque growth occur when these patterns are present. It's well established that risk for heart attack in a diabetic is the same as that of someone who's already suffered a prior heart attack--very high risk, in other words.

Marta's primary care doctor's advice would be like inquiring about cancer and the doctor says "Let's just wait until it's metastatic--then we'll start to worry." Of course, this is insane.

Pre-diabetes and mild diabetes should not be ignored or just "watched". Even though the blood sugar itself may not be high enough to endanger you, the hidden patterns underlying your body's unresponsiveness to insulin creates a torrent of hidden coronary risk.

For better answers, Track Your Plaque members can read "Shutting Off Metabolic Syndrome" at http://www.cureality.com/library/fl_dp001metabolic.asp on the www.cureality.com website. ("Metabolic syndrome" is the name commonly given to the constellation of abnormalities associated with pre-diabetes and diabetes.)

It may sound silly, but after someone succeeds in stopping their heart scan score from increasing or reduces their score, I warn them to not get smug. Let me explain.

I'll tell you about Jack. I met Jack a few years ago after he had a heart scan at age 39. His score: 1441! A score this high at his age obviously puts him in the 99th percentile. Also recall that a score >1000 carries a 25% annual risk for heart attack.

This captured Jack's attention. At the start, his lipoproteins were disastrous with numerous abnormal patterns. Jack committed to the program. After one year, his lipoproteins were around 80-90% corrected towards perfection. He'd lost 27 lbs, was exercising six days a week, and felt great.

Jack's repeat score one year later: 1107--over a 300 point drop! A huge success. He was ecstatic.

Unfortunately, work and life in general distracted him. Jack allowed himself to drift back to old habits, indulging in fast food 2 or 3 times a week, slacking on exercise such that it became sporadic, half-hearted efforts, and regained 15 lbs. He even failed to show up for appointments and we lost contact for two years.

One day, Jack simply decided to see where he stood, so he got himself another heart scan. The score: 2473--over a doubling from his reduced score.

The message: Long-term consistency is key, even after you've achieved control over your score. Stick with your program--and don't get smug!

If you're on holiday from work today, make sure you're not on holiday from your health, too.

Too often, people come back to the office telling me that the holidays simply got out of hand--cookouts, picnics, family gatherings, etc.--and they simply couldn't avoid overeating, overdrinking, sitting around--and gaining 3-5 lbs in a weekend. (Our record is 10 lbs in a weekend!)

I don't want to harp on this issue and ruin your holiday, but I can't stress how important it is that you don't allow this to happen to you. Weight gained in a brief space of time has exceptionally destructive effects. Ever see the movie "Super Size Me"? It's an entertaining and well-done yet graphic portrayal of the damaging effects of rapid weight gain.

Enjoy your time off. Relax, enjoy your family and friends--but continue to pay attention to choosing the right foods, don't overeat, take time out to do something (or several things) physical. It'll pay off hugely in the long run.

Although not a perfect test, carotid ultrasound is an exceptionally easy and accessible test. Using high-frequency sound, clear images are available for most people.

I say it's not perfect because the way it's done in 2006 makes it a non-quantitative test. It is a qualitative test. In other words, you may find out that there's a 30% blockage ("stenosis"), at the far end of the common carotid artery on the right side. Unfortunately, this gives you an isolated measure of diameter of the plaque compared to the artery. What it does not tell you is what the volume of the entire plaque is. That's a far more accurate measure (and one that is incorporated into your heart scan score, by the way).

Nonetheless, carotid ultrasound is easy, very safe, and available in most hospitals and many clinics. One difficulty: most insurance companies will not allow you to go through a carotid ultrasound scan as a "screening" procedure, i.e., a test just to see if you have a carotid plaque. They will generally pay if you're having symptoms of a stroke or "mini-stroke" (transient ischemic attack, or "TIA"), have an abnormal sound in your carotid ultrasound detected by your doctor (a carotid "bruit"), or some other unusual indications. Sometimes, a resourceful physician will muster up a diagnosis based on something in your history (e.g., left arm numbness, a common and often benign complaint that can also signal stroke).

Another option are the mobile scanners or some hospital services that offer carotid screening, usually for a very modest price. Drawback: Sporadic availability, difficulty in obtaining serial scans, and imprecise reporting since it's viewed as a screening test. But it's better than nothing.

My hope is that, as screening services using safe imaging techniques like ultrasound propagate and increase in direct availability to the public, you'll be able to circumvent the obstacles imposed by your insurance company and even, sometimes, your doctor. But try your doctor first.

Rose, a 64-year old woman, just had a 70% carotid blockage identified by a screening ultrasound. When the result was given to her doctor, he prescribed Lipitor and told Rose that an ultrasound would be required every year. She would need carotid surgery, an "endarterectomy", if the blockage worsened.

"Can't I reduce the amount of blockage I have?" asked Rose.

"No. Once you've got it, it doesn't get any better."

Is this true? Once you've got carotid plaque, you can only expect it to get worse and it can't be reduced?

This is absolutely not true. In fact, compared to coronary plaque, carotid plaque is easier to reduce!

Of course, the Track Your Plaque program is designed to help you control or reduce coronary plaque. But, in our experience, people who have both coronary and carotid plaque will show far greater and faster reduction of carotid plaque. Dramatic reductions are sometimes seen. I've personally seen 50-70% blockages reduced to <30% on many occasions.

The requirements to achieve reduction of carotid plaque are very similar to the approach we use to reduce coronary plaque. One difference is that hypertension may play a more important role with carotid plaque and needs to be reduced confidently to the normal range before carotid plaque is controlled.

I find it shocking that the attitude like the one provided by this physician continue to prevail. Unlike coronary plaque, which has a relatively small body of scientific literature documenting how it can be reduced, carotid plaque actually enjoys a substantial clinical literature. Part of the reason is that the carotids are more easily imaged using ultrasound. (Heart structures can be seen with ultrasound, but not the coronary arteries.)

Numerous agents have been shown to contribute to reduction of carotid plaque: statin drugs, niacin, fish oil, the anti-diabetic "TZD" drugs (Actos, Avandia), several anti-hypertensive drugs, vitamin E, pomegranate juice, and several others.

It outrages me to hear stories like this. Rose is not the only one.

Don't accept the flip dismissals or the over-enthusiastic referral for carotid procedures. Insist on a conversation about plaque regression.

Note: Although I am a vigorous advocate of atherosclerotic plaque regression, this does not mean that if you have a severe (70% blockage or greater), or if there are symptoms from your carotid disease, that you should engage in a program of reversal. You must always take the advice of your doctor if your safety is in question.

Look up "coronary risk factors" in any text and you'll find high cholesterol, smoking, diabetes, and high blood pressure listed. You won't find deficiency of vitamin D listed.

Ask 99% of physicians if a deficiency of vitamin D is a coronary risk factor and you'll get rolling eyes and a sigh.

Yet, in the Track Your Plaque experience, vitamin D is emerging as a very important factor in coronary plaque development. We have observed that there are a substantial number of people whose lipids and lipoproteins are not abnormal enough to fully explain their heart scan score. In other words, there seems to be something else necessary to satisfactorily explain the magnitude of coronary plaque.

I believe that severe vitamin D deficiency is at least one of the most important factors. We've seen many people with blood levels of vitamin in the range of severe deficiency (<20 ng/ml of 25-OH-Vitamin D3) yet bland lipids and lipoproteins.

Correcting vitamin D blood levels to 50 ng/ml also seems to be among the required factors in stopping coronary plaque growth, or stopping your heart scan score from increasing.

Keep your eye on this extremely important and exciting issue. Sadly, it won't be propelled into the media like the conversation about cholesterol or high-tech procedures, since no company stands to profit from it. But you and I don't have to play that game.

I saw a patient in the office yesterday. He came to me for an opinion regarding his high heart scan score of 525, putting him in the 90th percentile (5% annual risk of heart attack).

His doctor had been puzzled because his LDL cholesterols had ranged from 110 to 131 mg--actually below average. (The average LDL for the U.S. is 132 mg.) Likewise, HDL was a favorable 63 mg.

Lipoprotein analysis told the story loud and clear. His LDL particle number, a far more precise measure of LDL, was 2448 nmol/l. This means that his true LDL was more like 240-250 mg! (You can get a sense for what the true LDL is from LDL particle number by dropping the last digit: 2448 becomes 244.) Conventional LDL was therefore inaccurate by over 100 mg.

He also had a severe small LDL particle pattern. The cause of his coronary plaque was a large excess of small LDL particles. LDL cholesterol (and total cholesterol, likewise) didn't even hint at this pattern. Nor did his favorable HDL.

Think of LDL particle number as an actual count of LDL particles per volume, e.g., number of particles per cc of blood. This makes it easier to conceptualize. LDL particle number is the measure you get when you have an NMR lipoprotein profile, our preferred method of lipoprotein testing. If this is unavailable to you, apoprotein B is a reasonable second choice, though not as accurate in my view. More info on NMR is available at their website, www.lipoprofile.com.

Want to make a $1,000,000 as a cardiologist in the next year? It's easy. All you have to do is:

1) Perform heart catheterizations or other procedures on anybody you can, even if it's not necessary. Perform them even if the patient has no symptoms and the stress test is normal.

2) Perform heart catheterizations if the patient is too timid or ill-informed to object.

3) Insert coronary stents in blockages, even when they're minor and it's not necessary.

4) Turn every heart procedure into a revenue-producing stream by looking for other profit opportunties, such as minor kidney artery blockages.

5) Heart disease is frightening. Scare the heck out of patients by exagerrating the dangers so they'll go through testing and procedures gratefully.

Sound absurd? Well, it would be if these weren't all true.

These are real examples, as awful as it sounds. I've witnessed all these behaviors. Not just occasionally, but with regularity.

Just today, I encountered a colleague who performs heart catheterizations routinely (up to several per day) when any symptom is present and the stress test is entirely normal. This is grossly inappropriate.

Your protection is being better-informed and avoid being sucked into the vast and frightening cardiovascular machine of revenue-yielding procedures. Part of your protection is to get a CT heart scan, then engage in a program of heart disease prevention.

I met Joyce today for a 2nd opinion. She told me about this conversation she'd had with her cardiologist:

"Doctor, do you think I could have lipoprotein (a)? I read about how it can cause heart attacks even when cholesterol is controlled."

"What does it matter? Even if you have it, there's nothing we can do about it. There's no treatment for it."

Joyce was understandably groping for some means to prevent her coronary disease from causing more danger. At 56, she'd already survived a heart attack that resulted in two stents to her left anterior descending. Around 9 months later, she received a 3rd stent to another artery.

Her doctor had put her on Pravachol and said that was enough. "We know that cholesterol causes heart disease and the Pravachol reduces it. Why do we need to know anything more?"

So Joyce came to me for another view. I explained to her that there are, in fact, several ways to deal with lipoprotein(a). It is, without a doubt, among the more difficult patterns to manage--but not impossible. In fact, we have a growing list of participants in the Track Your Plaque program who have stopped or reduced their heart scan scores.

I continue to be horrified at the level of ignorance that prevails among my colleagues, the cardiologists, and the primary care community. If your doctor gives you advice like this, get a new doctor.

If you are reading The Cureality blog chances are you care about your health. You care about what you eat. You want to remain healthy, free of disease, feel good and possibly even want to look and feel as vibrant as you were when you were 20. Many of us think of food all day long. Many of us love to eat. We plant gardens so we know our food is free of pesticides and other toxic chemicals. Food can be a cause of disease and it can minimize our chances of disease. We try and take care of our insides but did you ever wonder what in the world you apply to your skin on a daily basis? What do these products contain and are they safe? Why are there more endocrine disorders popping up. Could it be that some of things we apply to our skin every single day may be harmful to our insides?

A portion of the skin health section of Cureality will take a look at skincare products and cosmetics. Are the products we apply to our skin gluten-free, paraben-free and free of other harsh chemicals that can cause skin irritations and possible other unwanted diseases. I came across Mirabella cosmetics and I wanted to learn more about this particular product line so I tracked down John Maly, founder and CEO of Mirabella Cosmetics. Mr. Maly was gracious enough to take time out and answer my questions.This is what Mr. Maly has to say about Mirabella:

DD: Tell us about some key features about Mirabella, gluten-free cosmetics. What made you get started in a gluten-free line?

JM: We didn't start as gluten-free. Over time we have continued to make our line more beautiful AND more healthy for women. First we began with a mineral foundation. Then as we introduced new products, we made sure they were as clean and healthy, while still being fashion forward. We saw the benefits to our clients to take out those ingredients that didn't help them look and feel their best such as glutens, parabens and talcs.

DD: Some cosmetic companies carry partially gluten-free cosmetics. Are all of Mirabella products gluten-free, paraben-free and talc-free?

JM: Everything is paraben-free and talc free. And our brand is all gluten-free except our Skin Tint Creme foundation. That is a product that women love and we just cannot make the formula without a wheat protein to perform as well...yet! We will continue to work on it!

DD: Are there other ingredients in cosmetics that women should be cautious of using if they have skin sensitivities or allergies?

JM: Some women are sensitive to fragrance as well.This is another thing that we avoid with our brand. The biggest ingredients that women find that helps with their skin health is mineral products. They are natural and very breathable on a woman's skin.

DD: I think your velvet lip pencils are by far the most extraordinary lip pencil on the market. What are some of your other standout products your customers love?

JM: Pure Press Mineral Foundation is still our #1product. But the fastest growing product is Magic Marker Eyeliner. It is easy to use, doesn't smudge and lasts all day.

DD: Anything new on the horizon for Mirabella that you can share with us?

JM: In August we launch CC crème. This product has all the good for you ingredients to help with Anti-Aging like avocado oil, argan oil and Acai (Assai) berry. Plus it is a mineral formula, gluten-free, and paraben-free. And it has an SPF of 20. One of the biggest issues that women have with aging is lips. That is why we put Litchi Chinesis Fruit Extract in our Colour Vinyl lipstick. Then in your favorite Velvet Lip Pencil, we put Pomegranate Extract, Vitamin C and E in to assist with in Anti-Aging.

DD: Is Mirabella only sold in the US or do you have international distribution as well.

JM: We are sold in Canada, Australia, Finland and Russia.

DD: Where can we purchase your cosmetics?

JM: Our products are available at www.mirabellabeauty.com and at over 1,500 of the finest salons and spas. Go to our salon locator to find a retailer near you.

When it comes to mud runs, Tough Mudder is a big deal. This event covers ten to twelve miles of muddy running interspersed with challenging obstacles. Using the word “challenging” when describing the obstacles along the course is an understatement. Obstacles include getting an electrical shock, running through ice-cold water, jumping over fire, climbing over walls, and things you’ve seen when watching American Ninja Warrior. Plus these obstacles are all done on a rugged, muddy terrain. So, maybe the word dirty-insane-challenging would be a better fit to describe the Tough Mudder.

Don’t let this description lead you to think that this is an impossible feat. The Tough Mudder website states that 1.3 million people have completed this event since it’s inauguration. If Tough Mudder is on your bucket list, know that if they can do it so can you. Here are 5 tips to get you ready to tackle the Tough Mudder.

1) Train: This tip seems obvious, but it’s not. Many people are standing at the start line hoping for the best. This strategy puts you at high risk for injury and not completing the event. You need to train anywhere from 8 to 12 weeks for the Tough Mudder. Use this guideline if you have a regular workout routine established. If you’re new to exercise or have been on a workout hiatus you may need 4 to 6 months to get ready. Carve out time in your schedule to train 3 to 5 days a week to prepare for this event. If you need some guidance, join a training program to provide a road map to Tough Mudder success.

2) Run: Tough Mudder is like a half-marathon on steroids. Running is critical component when you find that you’re traveling up to a mile between obstacles. Incorporate running intervals, hills, and fartleks into your training program. Start your training off with a new pair of running or minimalist shoes so that by the time your Tough Mudder comes around your shoes are ready to get trashed.

3) Simulate Obstacles: To feel confident at the start line of Tough Mudder, you need to practice skills that can help you with the obstacles. This will reduce your risk of obtaining any injuries during the event. Utilizing stairs, fences, playgrounds, rock climbing walls, football fields, lakes, and beaches are great places to start when looking to simulate obstacles. Check out the Tough Mudder website to see a list obstacles. Use your imagination to find ways to incorporate obstacle training in your workouts.

4) Simulate Terrain: Running covered in mud with wet shoes is much different from running on the treadmill. Running in the grass, on the sand and through the water is much different from running on asphalt. Get ready to be a little uncomfortable. Your shoes will begin to slide around on your feet and your clothes will cling to your body. Get ready to work a little harder. Your stride will be affected by the changes in terrain. Practice running on the grass, in the water, and in the sand. Make sure you get wet and run with soaked shoes and clothes. You’ll realize what shoes and clothes to wear on race day to be the most comfortable and effective.

5) Team: Teamwork is what Tough Mudder is about. Teamwork is what keeps drawing people back to the Tough Mudder venue. From the start to the finish, it’s about getting everyone across the finish line. If you’re struggling to get over a wall, a hand is there to help pull you up. When fatigue is setting in, another person is there to bring up your spirits. You’re not alone out there. At other races you find you’re left in the dust. At Tough Mudder you are overcoming challenges with your muddy buddies. Get together with friends or a training group to form a team bond that will keep you accountable with your training and support you to the finish line.

Want personalized training??? Schedule a virtual appointment with Amber.

On Saturday my husband and I took our niece Anna out her annual birthday date. That date started with a trip to the Humboldt park playground. As with most kids, Anna ran straight to the spider-web jungle gym which I have to admit it looked pretty cool. Just before she began to climb up, she turned to look at me and said “Auntie Amber, climb up too!”

I was not wearing my playground apparel on Saturday. I had a cute pair of pink loafers on, skinny jeans, tank and a jean jacket. But it did look like fun so I decided to climb. No problems yet. I was good to go climbing around on the ropey, spider web apparatus. But of course, just climbing around was not enough. Anna suggested that we should race. Not just to the top, but to the top of the jungle gym over the side, across the rope bridge and down the slide. This is when my skill was put to the test.

As you could have guessed, Anna smoked me during our race. Not only that, but the jean jacket was off and I was working up a sweat. Was I getting a workout from my 9-year-old niece? I think so. But we both were having so much fun. We continued to climb up and down the fake rock wall, monkey bars and run around the playground. It was a blast.

But as I looked around the playground, I was the only adult climbing around the playground and playing. The other adults were sitting on park benches watching. One parent near by had to decline the request of a child they were with to join them on the playground equipment. I felt really good that I could be there with my niece running around, climbing and swinging.

Keeping up with our kids, grandkids, nieces and nephews is really important as we age. Otherwise we sit on the sidelines. How do you train for the playground? Get in the weight room. Lift heavy things, jump, pull yourself up, move side ways, and challenge your body to do movements beside sitting or standing. If it’s been awhile or you’re just not sure where to start then get a trainer and join some group workouts.

It’s time to get moving. Because it starts out at the playground now but soon it will be mud runs, Frisbee, triathlons and weekend football games. You need to keep up!

Vegetables are arguably the most important food group, the key to any healthy diet. They are one of the most nutrient dense food groups and serve the foundation to healthy meals and snacks. A frequent comment from people enjoying the Cureality way of eating is, “I am eating more vegetables than I ever have in my life!”

This is great because plentiful consumption is associated with decreased heart disease, reduced weight, lower blood pressure, glowing skin and decreased risk of some cancers. However, perhaps you’re reading this and feeling great that you eat your veggies but struggle to get your kids to do the same. If you are a parent, who is simply trying to provide nutritious options to your kids, give these tips a try.

1. Add cheese or butter to enhance flavor and increase the absorption of fat soluble vitamins A, D, E and K. Younger kids like to dip foods, so often pairing with a dip, such as hummus, can increase intake.

2. Try the “rule of 15” — putting a food on the table at least 15 times to see if a child will accept it. Don’t give up after a few attempts. This can indeed be frustrating, but have patience and continue to offer a small portion to expose children to veggies without forcing intake. Often parents feel like it’s their job to just make their children eat something. I suspect most children will always select apple pie over an apple. It is important to set the stage, at an early age, with what is offered. In addition, being a good food model is important. You can’t expect your child to try broccoli, if you make negative comments about its taste, texture or smell.

3. Once a food is accepted, parents should use “food bridges,” finding similarly colored or flavored foods to expand the variety of foods a child will eat. If a child likes pumpkin pie, for instance, try mashed sweet potatoes and then mashed carrots. If a child loves corn, try mixing in a few peas or carrots. Even if a child picks them out, the exposure to the new food is what counts.

4. Allow children to engage, as able. When grocery shopping or offering a snack, ask your child which option they would like to eat (e.g. ask which healthy foods they would prefer, blueberries or strawberries, cucumbers or carrots, etc.). When children are included in more food decisions it can decrease resistance. Include children in age appropriate preparation, as well, for example cutting produce, making a vegetable soup, or selecting produce at the grocery store.

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

There are various theories about the best time of day to workout. At the personal training studio I own, training sessions start as early as 5:45am and the latest sessions start at 8pm. We have people that get up early and get their workout done first thing in the morning. We also have other people that get it done after work to release the stress of the day.

So which group is getting the better workout?

If you’re an early bird or have too many evening commitments then a morning workout is ideal for you. Here are some benefits to training in the morning.

1. Very few things can get in the way when you workout in the morning. (Except for the snooze button.) Later in the day extra phone calls, meetings and tasks can get in the way of getting your workout done.

2. After a strength or interval training session, your metabolism is elevated for hours after your workout. Enjoy these post exercise benefits while you are awake and active instead of when you are at rest.

3. Exercise will boost your energy. Use the momentum from a morning workout to arrive at work energized, present and focused instead of feeling sluggish because you just got out of bed.

4. Exercise on an empty stomach before breakfast is a great way to burn more body fat. Upon waking, the body is in a fasted state. Without ready available glucose in the bloodstream, the body is forced to use fat as an available fuel source for the workout.

However, some of us need our sleep or need to burn off the steam of a hectic workday. Here are some of the benefits of working out in the evening.

1. Getting enough sleep is crucial for health and recovery. If you have to skimp on regular sleep to get up for an early workout, the benefits of the workout start to diminish.

2. Instead of taking that stress of work home, you hit the gym after work. Even after the worst workdays, exercise will boost your mood. Friends and family will be grateful that you get your workouts (aka therapy session) completed.

3. Often people feel stronger when they workout in the evenings. When performing strength tests people tend to lift heavier during evening workouts. This could be due to the fact that they are more awake or that they have food fuel to utilize during their exercise session.

4. Research shows that you can build more muscle with evening workouts because cortisol levels are lowest in the evening. The result of this will be a higher testosterone to cortisol ratio leading to a less catabolic workout.

So which time of day comes out on top for the best workout time? In my opinion, it’s the time that you can do consistently. It’s the time that works best with your natural energy rhythms, work schedule, and family commitments.

Experiment working out at different times to see what works best for you. When you find the right fit, schedule your workouts on your calendar to build the exercise habit.

“Looking over your medical record, Nancy, I’m a bit concerned about your risk for osteoporosis and hip fracture. It looks like your mom had a hip fracture at age 67. Is that right? ”

“Yes, she did,” Nancy responded. “And her life was never quite the same for the 15 years she lived after that.

“You’re 53 year old. Bone thinning develops over many years. Let’s get you scheduled for a bone scan.”

Two weeks later:

“Your z-score is 1.5, Nancy. This means you’ve got a mild form of osteoporosis called ‘osteopenia.’ Here: This is a prescription for alendronate, what used to be called Fosamax.”

“Aren’t there side-effects with that drug? A friend of mine said that her mom had a leg fracture from it.”

“Well, yes. All prescription drugs have potential side-effects. They’re rare, but they can happen and we can’t predict it. Besides leg fracture, there’s something called jaw osteonecrosis in which the jawbone dies and has to be surgically replaced. But would you rather run the risk of a hip fracture?”

“Before we jump to drugs, aren’t there natural things I could do first?”

(Big sigh.) “You can take calcium, but that only helps a bit. You’ve got to make a choice: Take the drug or risk a hip fracture.”

“I’m going to explore some natural remedies on my own first.”

Nancy’s dialogue with her doctor is fictional but based on similar encounters that occur thousands of times every day nationwide. Identify a problem, prescribe a drug. Natural remedies? “They don’t work.” “I don’t know anything about that.” “None of that is proven.” “I only practice evidence-based medicine.” You’ve probably heard a few of these explanations yourself if you ever question the wisdom of conventional medical care.

Each of Nancy’s fictitious interactions were no more 10 minutes long. If she is like most people, she will have one or two such interactions over the course of a year, unless she develops some acute illness. So she’s got something like 20-30 minutes per year to compress all of her “health” advice into the time allotted. 20-30 minutes per year to discuss bone health, nutrition, blood sugar issues, cholesterol issues, blood pressure, female issues, and all the other facets of health. Perhaps she has developed some chronic gastrointestinal complaints, too, and an odd rash on her elbows, maybe headaches a few times per week that she didn’t have before. Regardless, she’s going to have to make do with those few minutes, likely receiving one or more prescriptions or imaging procedures for each.

Such is the nature of modern healthcare: Provide the minimum interaction, address only a few, perhaps no more than one, problem, then prescribe a drug. This is, more often than not, wrong. Plain wrong. Tragically, awfully, unethically, unnecessarily wrong.

Let’s pick up again with Nancy. Upon learning of her osteopenia and long-term risk for hip fractures of the sort that changed her mom’s life and health irretrievably, Nancy started searching for solutions. Not only did she discover that, yes, there are indeed a number of safe and effective ways to deal with osteopenia. She also learned that such strategies have even been examined in clinical trials, some of the strategies pitted head-to-head with drugs and performed on a par, sometimes better, than prescription drugs. She also found that there are online communities that she could join and discuss her health situation with people all sharing the same health interests. During one such interaction at the start of her effort, when she was still a bit unsure and tentative, a woman she didn’t know but who shared a similar interest in restoring bone health, commented to Nancy, “Don’t sweat it, Nancy. I was in your shoes a little over a year ago. I followed a program for bone health: vitamin D, vitamin K2, magnesium, I made sure that I included leafy green vegetables at least once or twice per day, and I added strength training for a few minutes twice per week. I started with osteoporosis. My most recent bone density test showed that I reversed it completely—it’s entirely normal! So hang in there and be sure to share your questions and concerns with us here.”

THAT is what Cureality is all about. Cureality fills the gap of knowledge in health that is not being provided in a few minute-long medical interaction. Cureality reveals the astounding amount of credible, safe, scientific information that allows you to participate, sometimes take over completely, various aspects of health. You don’t have to fire your doctor; these efforts supplement the information and advice you obtain (or don’t obtain) in the doctor’s office. While critics may sometimes say that this can be dangerous or that misdiagnoses and dangerous treatments might be risked, our experience is the exact opposite: People do better by taking the reins of health themselves, choosing to use the health care system for acute or catastrophic illness—but not necessarily for health.

Our fictional woman, Nancy, returns to her doctor one year later after undergoing a repeat bone scan. The doctor opened her chart, clearly expecting to scold her for her foolhardy and careless attitude. Instead, he was speechless. After a pause, he said, “I don’t know how you did it, but your bone density is now normal, the density of a healthy 30-year old woman. Just continue doing what you’re doing.” He closed the chart and walked out.

Yes: “Just continue what you are doing”—not “Please tell me what you did so that I might learn something new,” or “Where did you learn about such strategies? I knew nothing about this!” Just “do what you’re doing.” Too often, that is the response you get that defines what modern health care has become.

You don’t want that kind of health care. Sure, it’s reassuring to know that the doctor and hospital are there in case you injure yourself or develop pneumonia. But obtain day-to-day health advice of the sort that keeps you slender, keeps blood pressure normal, maintains normal insulin and blood pressure responses, helps keep bowel health ideal, can even be used to reverse conditions such as autoimmune joint pain, diabetes, osteoporosis, or skin rashes, while costing next to nothing and yielding health care benefits for you and your family in multiple areas of health? That is the kind of health care you want.

That’s why we developed Cureality.

William Davis, MD
Author of #1 New York Times Bestseller Wheat Belly: Lose the wheat, lose the weight and find your path back to health, The Wheat Belly Cookbook, and Wheat Belly 30-Minute (or Less!) Cookbook published by Rodale, Inc.
Author, Track Your Plaque: The only heart disease prevention program that shows how the new CT heart scans can be used to detect, track, and control coronary plaque

For new comers to the Cureality nutrition approach, this question may invariably pop up. For many years, fats and oils, whether classified as good or bad, were demonized because they contain 9 calories per gram. Meaning, they contain more than twice the 4 calories per gram of carbohydrate or protein.

So this familiar logic stated, if you eat less fat, which by default meant more carbohydrate, you would eat fewer calories and lose weight. This misguided logic was based on the assumption that caloric density was the primary reason people either gained or lost weight. The result - obesity rates have climbed and low-fat diet recommendations have proven unsuccessful in thwarting the battle of the bulge.

Why? There are a multitude of reasons, as discussed in the Cureality Diet Track. The following two explanations are important to to avoid needlessly suffering on a low-fat diet.

1) Appetite satiation is drive by insulin response, not calorie density.

Meals that trigger a substantial insulin response trigger increased appetite and fat storage. Carbohydrates, such as whole grain bread, whole wheat waffles, and fruit juice trigger insulin release. Continuous insulin provocation equates to one heck of a time trying to lose weight, as insulin is a fat-storage hormone. In comparison, oils and fats are the least insulin provoking with protein a close second. Consuming adequate fat intake is essential to quench appetite and avoid the insulin surges and crashes that are the result of eating plenty of “healthy whole grains”.

2) Modern wheat increases appetite thereby increasing intake.

Portion control becomes a major challenge because the gliadin protein in modern wheat stimulates appetite to the tune of 400 calories more per day, 365 days per year. That’s a recipe for weight gain, not loss.

The Cureality nutrition approach encourages the generous use of healthy fats and oils to support healthy weight loss and cardiovascular health. These topics are discussed in much more detail in the Cureality Member Forum.

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

In my previous post I spoke about the close connection between gut health and thyroid health. Of course, as someone who lives with Hashimoto’s Thyroiditis I have a keen interest in anything related to the thyroid.

Just today, I came across an article revealing the 100 most-prescribed drugs in America and was stunned at what drug topped the list with more than 23 million prescriptions in 2013 – levothyroxine – the most commonly prescribed drug for treating hypothyroidism (but not necessarily the best in my opinion).

Some observers have warned about a pending epidemic of thyroid disorders. I believe the revelation of a thyroid drug as the most prescribed drug in America suggests that this epidemic is already a “fait accompli” (that’s French for the more colloquial expression “it’s a done deal!”).

I also believe it is due, in part, to the grim observations of experts like Dr. Davis who warn that we are literally “swimming in a sea” of endocrine disruptors, toxins that disrupt our hormonal glands such as the thyroid, adrenals, pancreas, ovaries, and testes. I would go farther to say we are drowning in that sea. Here are just a few examples of how ubiquitous and pervasive these toxins are.

Bisphenol A (BPA) in plastic containers has gotten a lot of bad press recently yet it still considered by the FDA to be safe in certain applications even though it has been shown to disrupt the sex glands and bind to thyroid receptors.

Triclosan is commonly used in hand-sanitizers and similar applications. Triclosan is known to decrease circulating levels of the thyroid hormone thyroxine (T4).

Polybrominated diphenyl ether (PBDE) is common used to make flame retardant clothing. PBDEs have been shown to disrupt both estrogen and thyroid hormones. The effects of PBDE exposure both in utero and shortly after birth can persist into adulthood.

Perfluorooctanoic acid (PFOA) in Teflon coated pots and pans and even microwave popcorn bags has been detected in the blood of more than 98% of the general US population. PFOA has implicated as both a carcinogen as well as an endocrine disruptor associated with thyroid disruption.

With all these “thyro-toxins” floating about it might not seem you like have a fighting chance to achieve thyroid health. But, the first step is to educate yourself - then take action. It is the essential sequence in what I call “Informed, Self-directed, Healthcare” (ISH).

Now that you have a better understanding of how to navigate the “thryo-toxin minefield” there are also positive steps you can take to stack the odds in favor of a healthy thyroid. If you participate in the Cureality program make certain to check out the Thyroid Health Track for a powerful list of proactive steps you can take.

Chris K. (aka HeartHawk)
Cureality Member Advocate

Source: IMS National Prescription Audit, IMS Health.

100% grain elimination is the theme that drives the Cureality nutrition approach. A common mistake made when eliminating grains is replacing wheat-based foods with gluten-free foods. Most gluten-free foods, as they are currently available in the supermarket, are made with rice starch, tapioca starch, cornstarch, and potato flour. These dried pulverized starches generate more insulin and blood sugar surges than wheat. Gluten-free foods made with these undesirable ingredients are free of the appetite stimulating gliadin protein and wheat germ agglutinin, a lectin protein unique to wheat that causes direct intestinal damage. However, at best they can be referred to as “less bad” or unwelcome additions to the diet. Increasing your intake of these junk carbohydrates is a recipe for weight gain, inflammation and sky high blood sugar.

When removing grains from the diet, the goal is to replace them with truly healthy alternatives that do not contribute to negative health consequences. There are several reasonable substitutions available that allow your favorite sauce and protein combos to shine in tasty pasta-like dishes. People following the Cureality nutrition approach frequently comment that they do not miss “real” pasta because of the available healthy replacements they have learned about and incorporated into their lifestyle.

Our nutritionist, Lisa G., is the champion at helping navigate this lifestyle. In this video, she demonstrates how to prepare spaghetti squash, which can be used to replace wheat-based pasta. In another video zucchini noodles are the star. Homemade meatballs, a zesty tomato sauce and zucchini “pasta” combine for a delicious meal. Who needs grains when you can enjoy meals that support increased energy and less joint pain?

Summer vacation is right around the corner. The temptation to deviate from your normal healthy eating habits may occur… but resist. So how in the world do you continue to eat The Cureality way when you're traveling internationally? Let me tell you how I do it. I would also like to add I am allergic to dairy and I avoid all wheat containing foods. This has been my way of life for years and actually is extremely simple for me to manage while away from my own kitchen.

I decided to pay Italy a visit. I knew I would be overwhelmed with wonderfully fresh smelling bakery, pasta, cheese, gelato, and pizza. All foods I either can't consume due to my dairy allergy or foods I choose to avoid because of their health effects.

I was correct in my food assessment: the grains, bakery, and gelato were in every nook and cranny I encountered. Food choices can be difficult while traveling but I ask numerous questions regarding ingredients and I am certainly not afraid to swap out french fries for grilled vegetables.

Here's what I did the first few days on vacation with my diet routine to minimize dietary booby traps:

Day 1:

Breakfast, Hmmmm….Italians like their bakery. WOW. Tough when most of the foods being served are grains and eggs with dairy mixed in. I had two hard boiled eggs, tomatoes, sausage and espresso.

Lunch: Arugula lettuce topped with a chicken breast, roasted peppers and tomatoes. A side of salmon and lots and lots of olive oil on top. Very tasty and filling with the olive oil.

Dinner: Hamburger (no bun) with tomato, mayo, lettuce topped with a mountain of sauteed spinach. Water and yes…Italian wine found it's place at the table.

Day 2:

Breakfast: I devoured two hard boiled eggs with lettuce, cucumbers, shredded carrots, tomato and pineapple slices. Two cafe Americanos and water.

Lunch: Lunch was spectacular: Beef tips, arugula, lettuce, shredded carrots, tomatoes, olive oil and raw salmon. Yes, I mixed it all together and it was fabulous. Plenty of water with the "frizzle."

Dinner: I'll be honest: I had a difficult time with this meal due to our location and choice of foods, but I managed. Another hamburger with no bun, salad with mixed vegetables, and a few potato wedges. Wine and water.

Day 3:

Breakfast: Hardboiled eggs were getting old. Nonetheless, I had two of them chopped with tomato. Deli meat--Italians love their deli meat as well. Cafe Americano and water.

Lunch: Seafood salad-shrimp, octopus and squid mixed with argulua, fresh tomatoes, cucumbers and olive oil. Water.

Dinner: One hefty salad with shrimp, pear slices, ginger, tomatoes, avocado and olive oil. Wine and water.

Day 4:
Breakfast: Scrabbled eggs/sauage and pineapple slices. Cafe Americano and plenty of water.

Lunch/Dinner: I had to combine these two meals today. I had a delicious meal of curried shrimp (I made sure there was no dairy in the curry sauce) and a very large plate of grilled vegetables. Wine and water.

My diet may not be the most lavish to some but I enjoy my choices. I'm confident I will have no troubles with the remainder of my vacation. I haven't eaten wheat for a number of years so I don't experience the craving for bakery, pasta, or pizza. Dairy, I simply have to avoid, because I truly experience ill-effects from consuming it. My experience with travel and food choices have always worked in my favor. Ask questions and resist putting on that 5-10 pounds of vacation weight.

Ciao-Ciao~

Control of blood pressure is crucial for coronary plaque control and stopping your heart scan score from increasing.

Dr. Mehmet Oz (of Oprah fame and a cardiac transplant surgeon at Columbia University) made graphic point of this on the ABC TV news show, 20/20, last evening on an episode called "Our Bodies: Myths, Lies, and Straight Talk". (See a summary on the ABC News 20/20 website at http://abcnews.go.com/2020/story?id=2109291&page=1)

Although I believe he somewhat overstated the case for hypertension (proclaiming "If you're going to remember one number, if you're going to focus and fixate on one number in your entire health profile, it better be your blood pressure"), he made the point that a blood pressure of 115/75 is what you should have for optimal health.

I couldn't agree more. Unfortunately, the old advice that desirable blood is 140/90 or less is absolutely wrong. At this level, we see flagrant increases in heart scan scores. We also progressive enlargement of the thoracic aorta, the large vessel that leaves the heart and branches to provide the major arteries of the body. Growth of the aorta to an aneurysm is also common at these formerly acceptable blood pressure. (The diameter of your aorta in the chest is an e Cureality | Real People Seeking Real Cures

Can natural treatments "cure" or "treat" any disease?

30. August 2006 William Davis (0)

According to current FDA policy, the answer is a flat "NO!"

No natural treatment, whether it be fish oil (as a nutritional supplement), l-arginine, vitamin D, magnesium, various flavonoids like theaflavin or resveratrol, can be declared to treat or cure any disease. That's why you see the evasive and vague wording on nutritional supplements, nutraceuticals, and various foods, like "Supports heart health" or "Supports healthy cholesterol". Claiming, for instance, that taking 6000 mg per day of a standard OTC fish will reduce triglycerides and stating so on the label of a supplement is unlawful and prosecutable.

Think what you will of Mr. Kevin Trudeau (author of Natural Cures They Don't Want You to Know About"): visionary, consumer advocate, David vs. the Goliath of the FDA and "Big Pharma", or huckster, scam artist, and one-time felon. But Trudeau got it right on one important issue: The FDA dictates what claims can be made to treat disease. On one of his ubiquitous informercials, Trudeau states:

"...the way the system works today, you have the Food and Drug Administration—the FDA, and you have the drug industry. They really work in tandem. Unfortunately, there’s an unholy alliance there. People don’t know that the majority of commissioners of the FDA, which allegedly regulates the drug industry, and the food industry—Food and Drug Administration, the commissioners of the FDA—the majority of them—go to work directly for the drug companies upon leaving the FDA and are paid millions and millions and millions of dollars. Now in any other format, that would be called bribery; that would be called a conflict of interest; that would be called payoffs. That’s exactly what’s happening right now. So what has occurred is the Food and Drug Administration is really working in tandem with the drug industry to protect their profits. Example: The Food and Drug Administration says that only a drug can diagnose, prevent, or cure any disease."

He goes on to say that

"...the Food and Drug Administration says only a drug--nothing else--can cure, prevent, or diagnose a disease. Therefore the Food and Drug Administration continues to call more and more and more things diseases. Therefore they eliminate all-natural remedies. No one can say what a natural remedy can do if it’s been classified as a disease. So Attention Deficit Disorder is now a disease. Therefore only a drug can cure, prevent, or diagnose it. Cancer is a disease. Acid reflux is now a disease. Obesity is now a disease."

(PLEASE do not construe this as an endorsement of Mr. Trudeau's overall opinions. But I do think he's right on this one point.)

The stated purpose of this restrictive policy is to protect the public. Indeed, in years past before protective legislation, ineffective and even poisonous products were commonly sold as therapeutic treatments. (Remember cocaine and morphine in cold remedies? Lead and other toxic agents were also common.) Unfortunately, a huge gap has emerged as clinical data accumulates that support the efficacy of nutritional treatments and other non-traditional methods to treat or alleviate diseases. Any disease, or anything construed as disease as Trudeau points out, can onlybe treated by a drug.

In the FDA's defense, they have made slow progress in allowing "claims" of benefits for several supplements and food substances, such as the beta-glucan of oat products, soy protein, and most recently barley (for cholesterol reduction). The scrutiny is quite thorough and the wording of the policy is quite specific. Regarding oat products, for instance, the policy states:

"FDA concluded that the beta-glucan soluble fiber of whole oats is the primary component responsible for the total and LDL blood cholesterol-lowering effects of diets that contain these whole oat-containing foods at appropriate levels. This conclusion is based on review of scientific evidence indicating a relationship between the soluble fiber in these whole oat-containing foods and a reduction in the
risk of coronary heart disease.

Food products eligible to bear the health claim include oat bran and rolled oats, such as oatmeal, and whole oat flour...To qualify for the health claim, the whole oat-containing food must provide at least 0.75 grams of soluble fiber per
serving. The amount of soluble fiber needed for an effect on cholesterol levels is about 3 grams per day."

(Source: FDA Talk Paper which can be viewed in its entirety at http://www.fda.gov/bbs/topics/ANSWERS/ANS00782.html.)

In light of the boom in nutritional and non-traditional research that validate or refute efficacy, is such a policy still necessary? Or does it inhibit the open dissemination of information and result in a extraordinary monopolization of health treatment for the drug companies?

This debate will likely rage for the next two or more decades, particularly as drug companies are increasingly viewed as profit-seeking enterprises and more validation is gained by non-drug treatments.

For the moment, don't dismiss a "treatment" because it doesn't come by prescription. But don't reject a drugjust because it is a prescription. We need to strike a healthy, rational balance somewhere in between.

Can procedures alone keep you alive?

29. August 2006 William Davis (0)

My days in the hospital remind me of what heart disease can be like when no preventive efforts are taken--what it used to be like even with my patients before taking a vigorous approach to prevention (though over 12 years ago).

Several cardiologists in my hospital, for instance, express skepticism that heart disease prevention works at all. Yes, they know about the statin cholesterol drug trials. But they claim that, given their experience with the power of coronary disease to overpower an individual's control, statin drugs are just "fluff". Coronary disease is a powerful process that can only begin to be harnessed with major procedures, i.e., a mechanical approach.

So these cardiologists routinely have their patients in the hospital, often once a year, sometimes more, for heart catheterization and "fixing" whatever requires fixing: balloon angioplasty, stents, various forms of atherectomy. Year in, year out, these patients return for their "maintenance" procedures. Their cardiologists maintain that this approach works. The patients go on eating what they like, taking little or no nutritional supplements, and medications prescribed by their primary care physicians for blood pressure, etc. But no real effort towards heart disease prevention beyond these minimal steps.

Can this work? Very little at-home, preventive efforts, but periodic "maintenance" procedures?

It can, perhaps, for a relatively short time of a few years, maybe up to 10 years. But it crumbles after this. The disease eventaully overwhelms the cardiologist's ability to stent or balloon this or that, since it has progressed and plaque has growth diffusely the entire period that maintenance procedures have been performed. In addition, acute illness still occurs with some frequency--in other words, plaque rupture is not affected just because there's a stent in the artery upstream or downstream.

Not to mention this can be misery on you and your life, with risk incurred during each procedure. It's also terribly expensive, with hospitalization easily costing $25,000-$50,000 or more each time. (Compare that to a $250 or so CT heart scan.)

As people become more aware of the potential tools for prevention of heart disease, fewer are willing to submit to the archaic and barbaric practice of "maintenance" heart procedures in lieu of prevention. But it still goes on. If you, or anybody you know, are on this pointless and doomed path, find a new doctor.

Bloodletting, another antiquated health practice

Support your local hospital: HAVE A HEART ATTACK!

25. August 2006 William Davis (0)

I'm kidding, of course. But, in your hospital's secret agenda, that's not too far from the truth. Catastrophes lead to hospital procedures, which then yields major revenues.

Prevention, on the other hand, yields nothing for your hospital. No $8,000 to $12,000 for heart catheterization, several thousand more for a stent, $60,000-plus for a bypass, $25,000 or more for a defibrillator. In other words, prevention of heart attack and all its consequences deprive your hospital of a goldmine of revenue.

The doctors are all too often conspirators. I heard of yet another graphic example today. A man I didn't know called me out of the blue with a question. "I had a heart scan and I had a 'score' that I was told meant a moderate quantity of plaque in my arteries, a score of 157. My doctor said to ignore it. But I got another scan a year later and my score was 178. So I told this to my doctor and he said, 'Let's get you into the hospital. We'll set up a catheterization and then you'll get bypassed.' Of course, I was completely thrown off balance by this. Here I was thinking that the heart scan was showing that my prevention program needed improvement. But my doctor was talking about bypass surgery. Can you help? Does this sound right?"

No, this is absolutely not right. It's another tragedy like the many I hear about every day. Heart scans are, in fact, wonderfully helpful tools for prevention. This man was right: he felt great and the heart scan simply uncovered hidden plaque that should have triggered a conversation on how to prevent it from getting worse. But the doctor took it as a license to hustle the patient into the hospital. Ka-ching!

This sort of blatant money-generating behavior is far from rare. Don't become another victim of the cardiovascular money-making machine. Be alert, be skeptical, and question why. Of course, there are plenty of times when major heart procedures are necessary. But always insist on knowing the rationale behind such decisions, whether it's you or a loved one.

Hospitals contain experts in ILLNESS

25. August 2006 William Davis (0)

Hospitals contain many experts in sickness. This seems obvious. But walk down the hallways of any hospital, and you'll quickly be convinced that hospitals contain almost no experts in health.

People (hospital staff, that is, not the patients) in hospitals are especially good at identifying and treating disease. They lack knowledge of health.

If your nurse is 100 lbs overweight and struggles to walk down the hall because of arthritis in both knees, would you entrust her with health advice?

If your doctor sits down in the cafeteria and eats his lunch of a ham sandwich with cheese on a bun, fried onion rings, and a milkshake and pastry, can you believe that he/she possesses any insight into health and nutrition?

If your physical therapist or cardiac rehabilitation counselor struggles nearly as much as you while climbing a single flight of stairs, can you accept their advice on how to regain your stamina and use exerise to full health advantage?

The answer to all these questions is, of course, no. Hospital staff are generally expert at dressing surgical wounds, stopping bleeding, identifying infections, and providing the support services for surgical and diagnostic procedures. In contrast, they are generally miserable at conveying genuine health advice. They certainly fall short in being examples of health themselves.

To hospitals and their staff, health is a temporary situation that persists only until you become ill. Illness is an inevitability in the hospital staff mindset. Health is a temporary state in between illnesses.

We need to shake off this perverse mentality. Health is the state of life that should dominate our practices and philosophies. Illness via the occasional catastrophe, e.g., broken leg from skiing, car accident, etc., is the province of hospitals. We should gravitate towards this philosphy and away from the over-reliance on hospitals that has come to dominate our present perceptions of health. Hospitals are not glamorous. They are, for the most part, profit-seeking businesses intent on portraying themselves as champions of health.

When I walk down the halls of hospitals, I am shocked and ashamed at the extraordinary examples of ill-health presented by hospital staff. Yet they falsely paint themselves as experts in both illness and health. Don't believe it for a second.

Are there still unexplored causes of heart disease?

23. August 2006 William Davis (0)

I met a woman today. She had her first heart attack at age 37. She just had her 2nd heart attack this morning, at age 40.

Several issues are surprising about her story. First, she's pre-menopausal. Heart attacks before menopause are unusual. We'll occasionally see women have a heart attack before or during menopausal years only if they're heavy smokers and/or they have had diabetes (either type I or type II) for many years. But this young woman had neither. She is slender and has never smoked.

Even more surprising are her basic lipid values: LDL cholesterol 35 mg/dl, HDL 150 mg/dl, triglycerides 317 mg/dl. This is a very unusual pattern.

Unfortunately, this is all developing acutely in the hospital. (I've just met her today--she's not a Track Your Plaquer!) Lipoprotein analysis would be extremely interesting. In particular, I'd like to see whether she has any other markers besides elevated triglycerides of a "post-prandial" abnormality, i.e., persistence of abnormal particles after eating. The high triglycerides make this quite likely.

If this proves true, the omega-3 fatty acids from fish oil will be a lifesaving treatment for her, since they dramatically reduce both triglycerides as well as persistent postprandial particles like intermediate-density lipoprotein (IDL). (Track Your Plaque Members: See the Special Report on Postprandial Abnormalities on the present home page at www.cureality.com for a more in-depth discussion of this fascinating collection of patterns that is just started to be explored.)

In the real world, especially acute care medicine, there's always a kicker: she speaks no English. Unfortunately, communicating the intricacies of a powerful program like ours that aims to identify all causes of heart disease, then corrects then and aims for coronary plaque regression, is difficult if not impossible.

I also do occasionally worry that, given this woman's extraordinary risk at a young age, and overall very unusual lipid patterns (HDL 150?!), if there are causes presently beyond our reach. We have to make use of the tools available to us for now.

Everything causes heart attack!

22. August 2006 William Davis (1)

The media are presently gushing about a recent study that associates caffeine intake with heart attack.

CBS News: That cup of coffee you're craving might not be such a good idea. Research in the September issue of Epidemiology suggests coffee can trigger a heart attack within an hour in some people.

Some reporters and their quoted sources are musing about whether it's the caffeine, cream vs. other whiteners, time of day, interaction with other risk factors, etc.

My advice: Get a grip! How many relatively benign, every day factors in life can be blamed for dire health risks?

The problem with many of these studies is that they are cross-sectional. They do not enroll participants, then "treat" with coffee (or other substance in question) vs. placebo. In other words, it is not a randomized trial, the sort of trial necessary to prove a hypothesis. That's all that can be generated by a study like this one: a hypothesis.

Perhaps there's a bit of warning for the person with uncorrected lipids and lipoproteins, has no idea that they have extensive coronary plaque because they've never had a heart scan, and have a slovenly lifestyle. Maybe that person might have exaggerated risk from a cup of coffee.

But for us, involved and intensively addressing all causes of coronary plaque to the point of stabilizing or reducing it, coffee is likely a non-issue.

For more conversation on coffee and this report, go to the www.cureality.com home page.

Excessive Heart Procedures Makes New York Times Headline

18. August 2006 William Davis (0)

One example of flagrant cardiac procedure excess has made New York Times headlines:

Heart Procedure Is Off the Charts in an Ohio City
The number of angioplasties performed in Elyria is so high that Medicare is starting to ask questions.

(The full article can be accessed through the New York Times website at http://www.nytimes.com/2006/08/18/business/18stent.html?pagewanted=2&ei=5094&en=b81be5f43f98a99b&hp&ex=1155960000&partner=homepage)

Cardiologists in little Elyria, Ohio, about a 30-minute drive west of Cleveland, do more coronary angioplasties and insert more stents than any other location in the U.S.--four times more than the national average, three times more than the Cleveland average. They perform even more than the recently-indicted cardiologist in Louisiana, who performed twice the national average of procedures.

The Times article, part of a series about financial incentives in medical care, provides a responsible and incredibly balanced report on the situation in Elyria. I have to give them credit, because from the eyes of a colleague (myself), this looks like blatant and extreme profiteering: "cathing for dollars".

I find it outrageous that this group of cardiologists claims that they have some special insight into heart care that justifies this extraordinary reliance on heart procedures. There's bound to be variation in practice patterns, but this is so outside the norm that I believe criminal behavior will be exposed. In fact, I believe that even the "norm", or average, rate of procedures is also excessive.

This is symptomatic of the perverse equation in heart disease care. If there's money to be made in major heart procedures, who wants to bother with prevention? Programs like the Track Your Plaque program present real potential to stop coronary heart disease in its tracks for many, if not most, participants--but don't expect to hear about it from your cardiologist. Don't expect to hear about it from the increasingly hospital-employed primary care physician.

Hopefully, media exposure like that in the New York Times is just the beginning of a public re-analysis of not only what's wrong with medicine today, but recognition of the tremendous power in preventive strategies when everyone stops being so enamored with hospital-based procedures. CT-based heart scanning that ignites your heart disease prevention program is your way to dodge the mainstream obsession with procedures.

More on "Bio-identical hormones" and Wyeth Pharmaceuticals

18. August 2006 William Davis (0)

In October 2005, Wyeth petitioned the FDA, requesting that it completely ban the bioidentical alternatives that women have been using in ever-increasing numbers to achieve optimal hormone balance. With bioidentical replacement therapy clearly reducing its market share, Wyeth asked the FDA to outlaw all compounded bioidentical hormone formulations that compete with its own discredited drugs. If Wyeth is successful, then menopausal women will have no choice other than to take potentially life-threatening hormone drugs or to forgo hormone replacement therapy altogether, thus enduring the physically and emotionally debilitating effects of menopause-induced hormone depletion.

Dave Tuttle
Life Extension Magazine
August, 2006

For more commentary on Wyeth Pharmaceutical's outrageous and brazen petition to the FDA to bar prescription "bio-identical" hormones, i.e., hormones that are identical to natural human forms, read Life Extension's article, Health Freedom Under Attack!
Drugmaker Seeks to Deny Access to Bioidentical Hormones

This well-researched article is in the August, 2006 issue of Life Extension Magazine. The article can also be accessed online at http://www.lef.org/magazine/mag2006/aug2006_cover_attack_01.htm

or go to www.lef.org and click on the August, 2006 issue.

The author, Dave Tuttle, details the baseless arguments raised by Wyeth, a pathetic and amazingly selfish act in the name of protecting profits for Premarin, their prescription agent. It's bad enough to be selling this worthless drug. It's even worse--criminal, in my mind--to try to stamp out our right to have a physician write a prescription for a pharmacy to mix up hormones identical to that humans produce, individualized to our needs.

If you are as angry about this as I am, please go to the Life Extension online reprint that provides access to the International Academy of Compounding Pharmacists website to send the FDA an e-mail describing your opinion, or go to www.iacprx.org.

How accurate is LDL cholesterol?

17. August 2006 William Davis (0)

Watch TV and you'd get the impression that the world revolves around LDL cholesterol: Commercials for Lipitor, Zetia, Vytorin, etc., all drugs to reduce cholesterol (total and LDL). Your doctor looks first and often only at LDL cholesterol.

If there's so much attention paid to LDL, how accurate is it? 100%? 90%? 80%?

Well, it varies widely. Occasionally, it's truly accurate, but most of the time it's miserably inaccurate . Every single day, I see people with LDL cholesterols that underestimates true (measured) LDL by 40%, 50%, and even over 100%. In other words, LDL cholesterol might be 120 mg/dl by the conventional method, but the genuine measured value might be 160 mg/dl, or even 240 mg/dl. It can be that far off--and it's not rare.

The converse can occasionally be true, though rarely in my experience: that conventional LDL overestimates true LDL. I saw someone in the office today like this, with a conventional LDL of 142 mg/dl but a true measured LDL of 115 mg/dl. I may see one or two more people like this the rest of this year.

Why is LDL so inaccurate? Several reasons:

--LDL in most labs is calculated, not measured. The "Friedewald calculation" derives LDL by substracting HDL and triglycerides (divided by 5) from total cholesterol. The higher triglycerides are, especially above 150 mg/dl, the more inaccurate the calculation becomes. As HDL drops below 50 mg/dl, this also introduces greater and greater inaccuracy.

--LDL particles vary in size. A more accurate representation and measure of LDL's dangers are therefore found in measures of LDL particle number , rather than a weight-based measure or calculation. LDL particle number can be measure as just that, LDL particle number (NMR), or as apoprotein B, the protein in LDL that occurs one apoB per LDL.

I liken conventionally calculated LDL cholesterol to a broken speedometer. You simply won't have an accurate measure of how fast you're going, though you may have a ballpark sense. But try telling that to the state patrol.

Or, as a cardiologist colleague said to me in a similar conversation about LDL: "Well, it's better than nothing!"

The lesson: If you're interested in plaque control, and control or reduction of heart scan score, you need a measured LDL, preferably LDL particle number by NMR or an apoprotein B. Another option is "direct" LDL.

Green tea: friend or faux?

15. August 2006 William Davis (0)

The www.HealthCastle.com website is a helpful website on healthy eating that sends out a free newsletter. The content is all produced by licensed dietitions and nutritionists. Although I don't agree with everything said on the site, there's still some good information.

I'm a fan of green tea. Although I believe the effects are relatively modest (weight reduction, cholesterol reduction, anti-oxidation, etc., with theaflavin and/or green tea as a beverage,) they alerted me to the fact that the Lipton Green Tea product is one you should steer clear of. Here are their comments:

"More like Soft drink than Green Tea!With 200 calories, 13 teaspoons of added sugar and a long list of artificial ingredients, Lipton Iced Green Tea is more like a bottle of soft drink than tea, in our opinion."

The Lipton website lists the ingredients:

Water, high fructose corn syrup, citric acid, green tea, sodium hexametaphosphate, ascorbic acid (to protect flavor), honey, natural flavors, phosphoric acid, sodium benzoate (preserves freshness), potassium sorbate (preserves freshness), calcium disodium edta (to protect flavor), caramel color, tallow 5, blue1.

An 8 oz serving yields 21 grams of sugar. If you drink the full 20 oz. bottle (not hard to do!), that yields 52.5 grams of sugar! You will also notice that the second ingredient listed after water is high fructose corn syrup. This ingredient, you may recall, causes triglycerides to skyrocket, causes an insatiable sweet tooth, and is a probable contributor to obesity and diabetes.

In their defense, the Lipton people do also offer a sugar-free alternative without the excessive sweeteners and empty calories.

Do the Lipton products offer the same kind of benefits from green tea catechins (flavonoids) offered by freshly brewed teas? This product has not been formally tested by an independent lab to my knowledge, though, in general, commercially prepared and bottled teas tend to have dramatically less catechin/flavonoid content compared to brewed. (The USDA website provides access to an extraordinary collection of flavonoid food content at their USDA Database for the Flavonoid Content of Selected Foods - 2003. You'll find it at http://www.ars.usda.gov/Services/docs.htm?docid=6231.)

I think the HealthCastle people got it right: Brew your own, making sure to steep for at least 3 minutes. Alternatively, a green tea or theaflavin supplement provides many of the benefits. (Theaflavin has been used in trials at doses of 375 to 900 mg per day.) An in-depth report on green tea will be coming in a future Special Report on the www.cureality.com Membership website.

Related posts

Comments (30) -

Christopher

Anonymous

Kristjan Mar

Anonymous

Might-o'chondri-AL

Anonymous

NatureDoctor

O Primitivo

David M Gordon

Hannu K.

reikime

reikime

Might-o'chondri-AL

Anonymous

Vlado

Paul

Dr. William Davis

Dr. William Davis

SVinay

Anonymous

Marie-Anne

Anonymous

Might-o'chondri-AL

Daniel A. Clinton, RN, BSN

imwendym

Anonymous

Anonymous

Anonymous

Dawn

Add comment