Mediterranean diet vs. American Heart Association Diet

In 1994, the Lyon Heart Study demonstrated a 50-70% reduction in coronary events in participants who followed a diet rich in vegetables, olive oil, fish, nuts, red wine, and enjoyed meals as a family activity. Various other studies have documented similar phenomena with less metabolic syndrome, better lipid patterns, less obesity with the Mediterranean lifestyle.

There are two fundamental differences between the Mediterranean diet and the diet advocated by the American Heart Association (AHA) for people with heart disease: the Mediterranean diet uses olive oil more liberally, such that fat calories can reach 40% of total; and, unlike the AHA diet, processed foods are not a part of the Mediterranean diet. Greeks, for instance, are far less likely to eat Count Chocula cereal for breakfast, or snack on Healthy Choice Premium Caramel Swirl Sandwich (ice cream sandwiches) or Malt-O-Meal Honey Nut Scooters. All three of these foods on listed on the AHA Heart-Check Mark heart-healthy program.

In other words, remove all the processed foods, and the AHA diet pretty closely resembles the Mediterranean diet. There are differences but they tend to be relatively small. If the only major difference is the presence of processed foods, wouldn't you therefore expect the AHA to embrace the Mediterranean diet?

Here's what their official stand on the Mediterranean diet states:

Does a Mediterranean-style diet follow American Heart Association dietary recommendations?

Mediterranean-style diets are often close to our dietary recommendations, but they don’t follow them exactly. In general, the diets of Mediterranean peoples contain a relatively high percentage of calories from fat. This is thought to contribute to the increasing obesity in these countries, which is becoming a concern.



The AHA is actually lukewarm towards the diet that was the first to show a dramatic decrease in heart attack and death. Why?

The answer is obvious, once cast in this light. To wholeheartedly endorse the Mediterranean diet might be seen as an indirect rejection of American processed foods. You know, the foods that have caused an extraordinary and unprecedented epidemic of obesity in the U.S., the foods that are manufactured by ConAgra, General Mills, Kelloggs--all also major financial contributors to the AHA, according to the AHA Annual Report.

I tell my patients: If you want heart disease, follow the American Heart Association diet. In my view, it is a diet founded on politics and money, not on health. How else could Cocoa Puffs be regarded as heart healthy?

Track Your Plaque in 50,000 BC

Imagine we could send you back in a time machine to 50,000 BC.

However, our agreement: no modern tools or equipment. Just your brain, hands, and legs. And your landing spot will be tropical or semi-tropical, the same climate that humans spent much of their evolutionary time in.

Not only might you rub elbows with contemporaries like homo erectus and neanderthalensis, you'd also have to fend for your life and survival.

To eat, you will have to chase and kill wild game, all with your bare hands or crude tools crafted from sticks and stones. You will have to learn what wild berries, roots, and plants are edible and distingusih them from those that make you retch, make your bowels run, or kill you. You won't be able to cultivate grain, at least for a good long time, since you don't have a community that makes such an undertaking easier.

Instead, you are constantly on the run, from the moment you awake until you finally settle back as the sun sets, hopefully with a full stomach, but often empty and growling, anticipating the hunt and forage of tomorrow.

You are outdoors all day, except for the period when you hide in your cave or self-made shelter. You wear what little clothing you can make yourself from your kills, a skin or two. Your skin becomes a dark brown, a 5 foot 10 inch male will weigh 140 lbs, a 5 foot 5 inch woman 95 lbs. There are obvious downsides: your teeth will rot, you will be prone to infections, and predators view you as fair game.

But the result will be that many chronic diseases of modern life will no longer be worries for you. Heart disease? Highly unlikely. Do you need vitamin D? No, because you are outdoors virtually all day with most of your body surface area exposed to sun. Omega-3 fatty acids? You get those from the wild game you eat, since they have higher omega-3 content feeding in the wild, not eating corn like modern livestock. Since your body fat is minimal, just enough for survival, you don't need niacin.

In other words, many of the strategies of the Track Your Plaque program are modern necessities, responses to the "deficiencies" of modern life. Of course, I don't really have a time machine. I also doubt that you wish to hunt wild game every day, forage for plants and roots, run nearly-naked in the sun. You probably also have become accustomed to brushing your teeth and not viewing every animal as a potential threat to your life.

Nonetheless, I find this an interesting exercise for understanding the role of all the tools we use in the Track Your Plaque program for plaque control.

When pessimism wins

When I first met Hank, I immediately sensed it: anger, hostility, fear. His heart scan score of 685 just made it worse.


He didn't want to be there talking to me. His wife was giving him a hard time. Work was a constant source of irritation. The receptionist at the front desk screwed up his paperwork. Our office charges were too much.


In short, Hank was a pessimist. A bad one.


All the nutrition information out there is bunk. Only he knew how he should eat right. It's stupid to take a lot of fish oil. "You want me to grow gills?"


Among the parameters we use in the Track Your Plaque program is blood pressure during exercise, which provides a surrogate measure of blood pressure during emotional stress, anxiety, etc. "No, I don't need that. I already exercise." No amount of justification could change his mind. "A guy at work had a stress test. They said everything was fine, then Bang! He drops dead. What good is that?"


Hank did go along with a few pieces of advice.


A repeat heart scan 12 months after the first: 870, a 27% per year rate of increase. That's about what would happen if Hank had done nothing, had taken no action to try and stop or reduce his heart scan score.


I don't know if Hank will ever succeed in dropping his score. In fact, I suspect that he will fail, meaning that plaque will grow and he will eventually, perhaps in a year, two or three, require several stents, heart bypass, or have a heart attack. In other words, Hank's pessimism is a self-fulfilling phenomenon: If he believes he will fail, he will. If he believes the world is a rotten place, it is.


Is it possible to "cure" someone like Hank of his deeply-rooted pessimistic attitudes? I don't know of any easy solutions for someone with attitudes as deeply-ingrained as Hank's. (See my prior post, "Cure for pessimism?" at http://heartscanblog.blogspot.com/2007_05_01_archive.html.)

I believe it does help to make someone aware of their attitudes and that it does indeed exert ill health-effects--if they will believe it. But this is a very tough nut to crack.

Bad news on CoQ10?

A review of the effects of Coenzyme Q10 (CoQ10) on the muscle aches and weakness (myopathy) of statin drug therapy was just published in the Journal of the American College of Cardiology.

(Marcoff L, Thompson PD. The role of coenzyme Q10 in statin-associated myopathy. J Amer Coll Cardiol 2007;49(23):2231-2237.)

This is not a study, but a review of the existing scientific and clinical data available on this topic. The study authors conclude with a lukewarm statement:

". . .there is insufficient evidence to prove the etiologic [causal] role of CoQ10 deficiency in statin-associated myopathy and that large, well-designed clinical trials are required to address this issue. The routine use of CoQ10 cannot be recommended in statin-treated patients. Nevertheless, there are no known risks to this supplement and there is some anecdotal and preliminary trial evidence of its effectiveness. Consequently, CoQ10 can be tested in patients requiring statin treatment, who develop statin myalgia, and who cannot besatisfactorily treated with other agents. Some patients may respond, if only via placebo effect."

Should the media get hold of this report, be prepared for the usual "Nutritional supplement no help for drug toxicity" headlines, or "Yet another nutritional supplement shows no benefit" with parallels drawn to vitamin C or E.

There are several issue that need to be factored into the discussion:

1) This is not a study, just a review. Thus, any biases of the authors are more likely to exert themselves.

2) The understanding of CoQ10 absorption among different preparations may be an issue. I just received a mailing from Life Extension that made extravagant claims about the superior absorption of ubiquinol, to be distinguished from ubiquinone, the more common form. They claim that eight-fold increased absorption and blood levels of CoQ10 are achievable with ubiquinol. Unfortunately, virtually all the supportive data are unpublished, proprietary observations, i.e., generated by companies who make or sell it. This is as reliable as drug manufacturers who publish glowing reports on their own drugs--perhaps it's true, but it requires unbiased corroboration.

3) Despite the lack of a large, well-funded clinical trial (all are small), the issue continues to live and breathe because of the powerful anecdotal experience.

In our experience, CoQ10 does work. It doesn't work all of the time, perhaps just 80-90% of the time. It does generally require higher doses (100 mg per day, occasionally more). It very clearly must be an oil-based gelcap (just like vitamin D) to work; capsules containing powder do not work.

It's difficult to doubt when someone starts a statin drug, develops the muscle aches and weakness, begins CoQ10 and obtains distinct relief, stops CoQ10 and aches and weakness return, then only to go away again with resumption of CoQ10 . I've seen this countless times.

We do need better information on CoQ10. There's no doubt about it. For people who obtain benefit from statin therapy, I think CoQ10 remains a useful solution. A better solution would be to get rid of the offending drug. But that's not always possible--e.g., LDL cholesterol 190 mg/dl despite the best diet and "adjunctive" food effort. Then CoQ10 can be very useful.

More on the American Heart Association Check Mark program

Take a look at the list of foods on the American Heart Association's (AHA) Check Mark endorsement program (below). After I saw the list, I was convinced either that the people who designed the program are either startlingly ignorant, or the AHA simply does this for money.

Many of these foods have nothing to do with health, heart or otherwise. In fact, many of these foods are prominent culprits that contribute to the American epidemic of obesity. There are cured meats with sodium nitrite (a potent cause of colon cancer). Some of these companies have been accused of unhealthy food manufacturing practices. Tyson Foods, for instance, has been in court many times defending their brutal factory farm practices and were the focus of a federal investigation for paying bribe money to USDA Secretary, Mike Espy. (Espy was acquitted but two Tyson executives were convicted, only to be later pardoned by then President Bill Clinton.)

This is a smarmy list to be included on. Though there are some rare healthy exceptions on the list, from the Track Your Plaque viewpoint, this is a list of shame, foods that have no place in a genuinely heart healthy nutrition program.



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Beefmaster Cattlemen, L.P.
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Bryan Foods, Inc.
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Bumble Bee Foods LLC
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California Giant
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California Strawberry Commission
California Fresh Strawberries
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Campbell Soup Company
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Campbell's Chunky Healthy Request Chicken Noodle
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Campbell's Chunky Healthy Request Old Fashioned Vegetable Beef
Campbell's Chunky Healthy Request Vegetable
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Cargill Meat Solutions
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Chiquita Brands Company, N.A.
Chiquita Bananas

Clearwater Seafoods Limited Partnership
Clearwater Frozen Arctic Surf Clams

Cliffstar Corporation
Deerfield Farms No Sugar Added 100% Grape Juice (Purple)
Safeway 100% Grape Juice (Purple)
Sam's Choice 100% Grape Juice (Purple)
Walgreens 100% Grape Juice (Purple)

Clougherty Packing Company
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Colleen Strawberries, Inc. / EKT Farms
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ConAgra Dairy Foods
Egg Beaters 99% Real Eggs-Frozen
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ConAgra Food Service
Lamb Weston Sweet Things Mashed Sweet Potatoes, Frozen

ConAgra Frozen Foods
Healthy Choice Café Selections Apple Glazed Pork Medallions
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Hunt's Family Favorites Seasoned Tomato Sauce for Lasagna
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Orville Redenbacher's Mini Bags Smart Pop Butter Microwave Popcorn
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ConAgra Refrigerated Foods
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ConAgra Retail Foods
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Cooper Farms
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Crider, Inc.
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Dare Foods Incorporated
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El Aguila Food Products, Inc.
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Eurofresh Inc.
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FPL Foods, LLC
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Farmland Foods
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Fieldale Farms Corporation
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Foster Poultry Farms
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Fresh Express Incorporated
Chiquita Apple Bites
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GFA Brands, Inc.
Smart Balance Smart 'N Healthy Deluxe Microwave Popcorn
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General Mills, Inc.
Apple Cinnamon Cheerios
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Berry Burst Cheerios-Strawberry Banana
Berry Burst Cheerios-Triple Berry
Berry Lucky Charms
Cheerios
Cheerios Crunch
Chocolate Lucky Charms
Cocoa Puffs
Cookie Crisp
Count Chocula
Dora The Explorer
Frosted Cheerios
Fruity Cheerios
Heart Smart Bisquick
Honey Nut Cheerios
Kix
Lucky Charms
Multi-Grain Cheerios
Oatmeal Crisp Crunchy Almond
Oatmeal Crisp Hearty Raisin
Oatmeal Crisp Maple Brown Sugar
Pillsbury Oven-Baked Whole Wheat Dinner Rolls
Progresso Healthy Favorites Chicken & Wild Rice Soup
Progresso Healthy Favorites Chicken Gumbo Soup
Progresso Healthy Favorites Chicken Noodle Soup
Progresso Healthy Favorites Garden Vegetable Soup
Progresso Healthy Favorites Italian-Style Wedding Soup
Progresso Healthy Favorites Minestrone Soup
Total Cranberry Crunch
Total Honey Clusters
Total Raisin Bran
Total with Strawberries
Trix
Whole Grain Total
Yogurt Burst Cheerios Strawberry
Yogurt Burst Cheerios Vanilla

Hain Celestial Group, Inc., The
DeBoles Organic Ancient Grain Penne
Health Valley Empower Cereal
Hodgson Mill, Inc.
Hodgson Mill Oat Bran All Natural Hot Cereal
Hodgson Mill Whole Wheat Angel Hair
Hodgson Mill Whole Wheat Fettuccine
Hodgson Mill Whole Wheat Lasagna
Hodgson Mill Whole Wheat Penne
Hodgson Mill Whole Wheat Spinach Spaghetti
Hodgson Mill Whole Wheat Whole Grain Elbows
Hodgson Mill Whole Wheat Whole Grain Spaghetti

Indiana Packers Corp.
Indiana Kitchen All Natural Boneless Pork Sirloin Roast
Indiana Kitchen All Natural Pork Tenderloin

Interstate Brands Corporation
Home Pride Whole Grains 100% Honey Whole Wheat Bread
Home Pride Whole Grains 100% Whole Wheat Bread
Merita Country Whole Grains 100% Whole Wheat Bread

KFP International, Ltd.
Kedem 100% Pure Concord Grape Juice-No Sugar Added

Kansas City Steak Company
Kansas City Seasoned Beef Chuck Tender Steak
Kansas City Seasoned Beef Medallions

Kashi Company
Kashi Heart to Heart Honey Oat Waffles
Kashi Heart to Heart Honey Toasted Cereal
Kashi Heart to Heart Instant Oatmeal - Apple Cinnamon
Kashi Heart to Heart Instant Oatmeal - Golden Brown Maple
Kashi Heart to Heart Instant Oatmeal - Raisin Spice
Kashi Heart to Heart Oat Flakes & Wild Blueberry Clusters

Kellogg USA, Inc.
Kellogg's All-Bran Bran Buds
Kellogg's All-Bran Extra Fiber
Kellogg's All-Bran Original
Kellogg's Frosted Mini-Wheats - Strawberry Delight
Kellogg's Frosted Mini-Wheats - Vanilla Creme
Kellogg's Frosted Mini-Wheats Big Bite
Kellogg's Frosted Mini-Wheats Bite Size
Kellogg's Frosted Mini-Wheats Maple & Brown Sugar
Kellogg's Smart Start Antioxidants - Original
Kellogg's Smart Start Healthy Heart - Maple & Brown Sugar
Kellogg's Smart Start Healthy Heart - Original
Kellogg's Smart Start Healthy Heart Cinnamon Raisin

King Soopers
Ground Beef 96/4 Extra Lean

Kroger Company, The
Kroger Moist & Tender Silver Platter Pork Tenderloin

Laura's Lean Beef Company
Laura's Lean Beef - Beef Pot Roast Au Jus
Laura's Lean Beef - Shredded Beef with Barbecue Sauce
Laura's Lean Beef 4% Fat Ground Round
Laura's Lean Beef 4% Ground Sirloin
Laura's Lean Beef Sirloin Steak

LiDestri Foods, Inc.
Francesco Rinaldi No Salt Added Traditional Pasta Sauce

Lido Veal & Lamb Inc.
Veal USA Boneless Veal Shoulder Roast from Lido Veal
Veal USA Low Fat Ground Veal from Lido Veal
Veal USA Veal Leg Cutlets from Lido Veal
Veal USA Veal Stew from Lido Veal

M & I Seafood Manufacturing Inc.
Chesapeake Bay Gourmet Crab Cakes

MW Polar Foods
Polar All Natural Chunk Light Tuna in Water
Polar All Natural Solid White Albacore in Water
Polar Chunk Light Tuna in Water
Polar Solid White Albacore Tuna in Water

Malt-O-Meal Company
Malt-O-Meal Balance
Malt-O-Meal Crispy Rice
Malt-O-Meal Frosted Mini Spooners
Malt-O-Meal Honey & Oat Blenders
Malt-O-Meal Honey Nut Scooters
Malt-O-Meal Hot Wheat Cereal - Chocolate
Malt-O-Meal Hot Wheat Cereal - Maple & Brown Sugar
Malt-O-Meal Hot Wheat Cereal - Original
Malt-O-Meal Maple & Brown Sugar Mini Spooners
Malt-O-Meal Mom's Best 100% Natural Quick Oats
Malt-O-Meal Mom's Best Instant Oatmeal - Apples & Cinnamon
Malt-O-Meal Mom's Best Instant Oatmeal - Maple & Brown Sugar
Malt-O-Meal Mom's Best Instant Oatmeal Variety Pack - Maple & Brown Sugar/Apples & Cinnamon/Cinnamon & Spice
Malt-O-Meal Raisin Bran
Malt-O-Meal Scooters

Maple Leaf Consumer Foods
Maple Leaf Sodium Reduced 98% Fat Free Cooked Ham with Natural Juices

Maverick Ranch Association
Maverick Ranch 96/4 Extra Lean Grass Fed Organic Ground Beef
Maverick Ranch 96/4 Extra Lean Natural Ground Buffalo
Maverick Ranch 96/4 Extra Lean Natural Ground Pork Sirloin
Maverick Ranch Free-Range Chicken-All Natural Air Chilled Boneless Skinless Chicken Breast
Maverick Ranch NaturaLite 96/4 Extra Lean Ground Beef Round
Maverick Ranch NaturaLite Beef - 96/4 Extra Lean Ground Beef Chuck
Maverick Ranch NaturaLite Beef - 96/4 Extra Lean Ground Beef Sirloin
Maverick Ranch Natural Beef Cubed Steak
Maverick Ranch Natural Beef Top Sirloin Steak
Maverick Ranch Natural Buffalo Top Sirloin Steak
Maverick Ranch Natural Center Cut Pork Loin Chops
Maverick Ranch Natural Lite 96/4 Extra Lean Natural Ground Beef
Maverick Ranch Natural Pork 4% Fat Extra Lean Pork Tenderloin
Maverick Ranch Natural Skinless Chicken Drumsticks
Maverick Ranch Natural Skinless Chicken Thighs
Maverick Ranch Organic Air-Chilled Boneless Skinless Chicken Breasts

Mayoli Inc.
Mayoli All Natural Reduced Fat Mayonnaise Dressing with Pure Olive Oil

McNeil Nutritionals, LLC
LACTAID® Calcium-Fortified Fat Free Milk
LACTAID® Fat Free Milk

Meijer Distribution, Inc.
Meijer Purple Grape Juice

Michael Foods, Inc.
All Whites Egg Whites - White Cheddar
Better 'n Eggs Ham & Cheese
Better 'n Eggs Plus
Better 'n Eggs Three Cheese
Kirkland Signature Egg Starts
Kroger Break-Free 100% Liquid Egg Whites
Kroger Break-Free Real Egg Product
Papetti Foods All Whites - 100% Liquid Egg Whites
Papetti Foods Better 'n Eggs

Mills Family Farms
Mills Family Farms Green Cascade Mix-Baby Romaine & Baby Green Leaf
Mills Family Farms Wholeaves Sandwich & Salad Lettuce - Green Leaf
Mills Family Farms Wholeaves Sandwich & Salad Lettuce - Red Leaf
Mills Family Farms Wholeaves Sandwich & Salad Lettuce - Romaine
Milton's Baking Company
Milton's Baking Classics Cinnamon Raisin Wheat Bread
Milton's Baking Classics Corn Bread
Milton's Baking Classics Oat Bran Bread
Milton's Baking Classics Wheat Bread
Milton's Healthy Multi-Grain Plus Bread
Milton's Healthy Whole Grain Plus Bread
Milton's Original Healthy Multi-Grain Bread
Milton's Whole Grains 100% Whole Wheat Bread

Motts LLP
Yoo-hoo Lite Chocolate Drink

Murray's Free Roaming Chicken, Inc.
Murray's Extra Lean 99% Fat Free Boneless & Skinless Chicken

New World Pasta Company
Ronzoni Healthy Harvest Multi-Grain Pasta-Fusilli
Ronzoni Healthy Harvest Multigrain Pasta - Spaghetti Style
Ronzoni Healthy Harvest Whole Wheat Blend Extra Wide Noodle - Style
Ronzoni Healthy Harvest Whole Wheat Blend Pasta - Linguine
Ronzoni Healthy Harvest Whole Wheat Blend Pasta - Penne Rigate
Ronzoni Healthy Harvest Whole Wheat Blend Pasta - Rotini
Ronzoni Healthy Harvest Whole Wheat Blend Pasta - Spaghetti Style
Ronzoni Healthy Harvest Whole Wheat Blend Pasta - Thin Spaghetti
Ronzoni Healthy Harvest Whole Wheat Blend Pasta-Lasagna
Ronzoni Healthy Harvest Whole Wheat Blend Wide Noodle - Style

Nonna's Kitchen, Inc.
Columbus Reduced Sodium Turkey Breast

North American Beverage Company
Chocolate Moose - All Natural Premium Milk Chocolate Drink
Chocolate Moose - Cookies & Cream Premium Milk Chocolate Drink
Mega Moose Energy Drink-Strawberry Blast

Nulaid Foods Inc.
Nulaid ReddiEgg Real Egg Product

Oberto Sausage Company
Kirkland Signature Premium Brisket Roast Beef

Old Orchard Brands LLC
Old Orchard 100% Grape Juice
Old Orchard 100% Grape Juice - Frozen Concentrate

POM Wonderful, LLC
POM Wonderful Fresh Pomegranate Arils
POM Wonderful Frozen Pomegranate Arils
POM Wonderful Pomegranates

Packerland Processing Co., Inc.
Meijer Extra Lean Ground Beef 96/4

Peco Foods, Inc.
Member's Mark All Natural Boneless Skinless Chicken Breasts with Rib Meat
Member's Mark All Natural Boneless Skinless Chicken Tenderloins

Pepperidge Farm, Inc.
Pepperidge Farm 100% Natural 100% Whole Wheat Bread
Pepperidge Farm 100% Natural 9 Grain Bread
Pepperidge Farm 100% Natural German Dark Wheat Bread
Pepperidge Farm 100% Natural Honey Flax Bread
Pepperidge Farm 100% Whole Wheat Bagels
Pepperidge Farm 100% Whole Wheat English Muffins
Pepperidge Farm 100% Whole Wheat Hearty Texture Whole Grain Bread
Pepperidge Farm 100% Whole Wheat Mini Bagels
Pepperidge Farm 15 Grain Hearty Texture Whole Grain Bread
Pepperidge Farm Farmhouse Soft 100% Whole Wheat Bread
Pepperidge Farm Golden Harvest Grains Hearty Texture Whole Grain Bread
Pepperidge Farm Light Style 7 Grain Bread
Pepperidge Farm Light Style Soft Wheat Bread
Pepperidge Farm Oatmeal Hearty Texture Whole Grain Bread
Pepperidge Farm Soft Honey Oat Smooth Texture Whole Grain Bread
Pepperidge Farm Soft Honey Whole Wheat Smooth Texture Whole Grain Bread
Pepperidge Farm Very Thin Soft 100% Whole Wheat Bread
Pepperidge Farm Whole Grain Multi-Grain Bagels
Pepperidge Farm Whole Grain Swirl Bread - Cinnamon
Pepperidge Farm Whole Grain Swirl Bread - Cinnamon with Raisins

Perdue Farms, Inc.
Perdue Individually Frozen All Natural 99% Fat Free Chicken Tenderloins
Perdue Tender & Tasty 99% Fat Free Individually Frozen Boneless Skinless Chicken Breasts
Perdue Tender & Tasty 99% Fat Free Individually Wrapped Boneless Skinless Chicken Breasts
Perdue/Kirkland Signature Individually Frozen All Natural 99% Fat Free Boneless Skinless Chicken Breasts

Pilgrim's Pride Corporation
Eat Well Stay Healthy Chicken Breast Salad
Eat Well Stay Healthy Fresh Boneless Skinless Chicken Breasts with Rib Meat (15% Chicken Broth)
Eat Well Stay Healthy Fresh Boneless Skinless Chicken Thin Sliced Breasts with Rib Meat (15% Chicken Broth)
Eat Well Stay Healthy Fresh Chicken Breast Tenderloins (15% Chicken Broth)
Eat Well Stay Healthy Fully Cooked Rotisserie Skinless Chicken Split Breasts - Garden Herb
Gold Kist Farms 100% Natural 99% Fat Free Boneless Skinless Chicken Breast
Gold Kist Farms All Natural 99% Fat Free Boneless Skinless Breasts
Gold Kist Farms/Kirkland Signature All Natural 99% Fat Free Boneless Skinless Breasts
HyVee/Country Pride 97% Fat Free Boneless Skinless Chicken Breast Fillets with Rib Meat (15% Chicken Broth)
HyVee/Country Pride 97% Fat Free Skinless Split Chicken Breasts with Ribs (12% Chicken Broth)
HyVee/Country Pride 99% Fat Free Boneless Skinless Chicken Breast Tenderloins (15% Chicken Broth)
Meijer Fresh Boneless Skinless Chicken Breast Tenderloins (15% Marination)
Meijer Fresh Boneless Skinless Chicken Breasts with Rib Meat (15% Marination)
Pilgrim's Pride Eat Well Stay Healthy Grilled Chicken Breast Fillets
Pilgrim's Pride Eat Well Stay Healthy Grilled Chicken Breast Strips
Pilgrim's Pride Eat Well Stay Healthy Italian Style Grilled Chicken Breast Fillets
Pilgrim's Pride Eat Well Stay Healthy Key Lime Flavor Chicken Breast Fillets
Pilgrim's Pride Eat Well Stay Healthy Kids Fully Cooked Breaded Chicken Nuggets
Pilgrim's Pride Eat Well Stay Healthy Kids Fully Cooked Breaded Popcorn Chicken
Pilgrim's Pride Eat Well Stay Healthy Lemon Herb Chicken Breast Fillets
Pilgrim's Pride Eat Well Stay Healthy Savory Chicken Breast Fillets
Pilgrim's Pride Eat Well Stay Healthy Szechwan Chicken Breast Tenderloins
Pilgrim's Pride Fresh Boneless Skinless Chicken Breasts with Rib Meat Individually Wrapped (15% Chicken Broth)
Pilgrim's Pride Fresh Chicken 100% Natural Boneless Skinless Breasts with Rib Meat
Pilgrim's Pride Fresh Chicken 100% Natural Boneless Skinless Breasts with Rib Meat (15% Chicken Broth)
Pilgrim's Pride Fresh Chicken 100% Natural Breast Tenderloins
Pilgrim's Pride Fresh Chicken 100% Natural Breast Tenderloins (15% Chicken Broth)
Pilgrim's Pride Fresh Chicken 100% Natural Skinless Split Breasts with Ribs
Pilgrim's Pride Fresh Chicken 100% Natural Skinless Split Breasts with Ribs (12% Chicken Broth)
Pilgrim's Pride Fresh Chicken Breast Tenderloins Individually Wrapped (15% Chicken Broth)
Pilgrim's Pride Individually Frozen Fully Trimmed 99% Fat Free All Natural Boneless Skinless Chicken Breasts (15% Chicken Broth)
Schnucks 99% Fat Free Chicken Breast Tenderloins
Schnucks 99% Fat Free Skinless Chicken Breast Fillets
Schnucks 99% Fat Free Thin Sliced Skinless Chicken Breast Fillets

Quaker Oats Company/Tropicana Products, Inc., The
Crystal Wedding Oats
Old-Fashioned Quaker Oats
Quaker Cinnamon Life
Quaker Essentials Oat Bran
Quaker Essentials Oatmeal Squares - Brown Sugar
Quaker Essentials Oatmeal Squares - Cinnamon
Quaker Essentials Toasted Oatmeal - Brown Sugar
Quaker Essentials Toasted Oatmeal - Honey Nut
Quaker Honey Graham Life
Quaker Instant Oatmeal - Apple Crisp
Quaker Instant Oatmeal - Apples & Cinnamon
Quaker Instant Oatmeal - Cinnamon & Spice
Quaker Instant Oatmeal - Cinnamon Roll
Quaker Instant Oatmeal - Flavor Variety
Quaker Instant Oatmeal - Maple & Brown Sugar
Quaker Instant Oatmeal - Raisins & Spice
Quaker Instant Oatmeal - Regular Flavor
Quaker Instant Oatmeal Bakery Favorites Variety Pack (Apple Crisp/Cinnamon Roll/Banana Bread)
Quaker Instant Oatmeal Crunch - Apples & Cinnamon
Quaker Instant Oatmeal Crunch - Magicolor Cinnamon
Quaker Instant Oatmeal Crunch - Maple & Brown Sugar
Quaker Instant Oatmeal Crunch - Mixed Berry
Quaker Instant Oatmeal Lower Sugar - Apples & Cinnamon
Quaker Life
Quaker Life Chocolate Oat Crunch
Quaker MultiGrain Hot Cereal
Quaker Oat Bran Hot Cereal
Quaker Take Heart Instant Oatmeal - Blueberry
Quaker Take Heart Instant Oatmeal - Golden Maple
Quick 1 Minute Quaker Oats
Tropicana Pure Premium Calcium + Vitamin D No Pulp Orange Juice
Tropicana Pure Premium Fiber Some Pulp Orange Juice
Tropicana Pure Premium Golden No Pulp Grapefruit Juice
Tropicana Pure Premium Grovestand Calcium + Vitamin D Lots of Pulp Orange Juice
Tropicana Pure Premium Grovestand Lots of Pulp Orange Juice
Tropicana Pure Premium Healthy Heart No Pulp Orange Juice with Omega 3
Tropicana Pure Premium Homestyle Some Pulp Orange Juice
Tropicana Pure Premium Light 'n Healthy Calcium No Pulp Orange Juice
Tropicana Pure Premium Light 'n Healthy Calcium No Pulp Orange Juice
Tropicana Pure Premium Low Acid No Pulp Orange Juice
Tropicana Pure Premium Original No Pulp Orange Juice
Tropicana Pure Premium Ruby Red Some Pulp Grapefruit Juice

R.A.B. Food Group LLC
Manischewitz Premium 100% Grape Juice

Rader Farms, Inc.
Rader Farms Nature's Three Berries

Red Gold, LLC
Sacramento Tomato Juice from Concentrate with Enhanced Tomato Flavor

Ruprecht Company
Sommers 100% Organic Extra Lean Beef Burgers

Sal & Judy's Products, LLC
Sal & Judy's Heart Smart Italian Sauce

Sealord North America, Inc.
Sealord Deep Sea Dory Fillets
Sealord Orange Roughy Fillets

Setton International Foods, Inc.
Setton Farms Heart Healthy Mix

Simmons Foods, Inc.
Member's Mark All Natural 99% Fat Free Boneless Skinless Chicken Breast

Smithfield Lean Generation Cuts
SLG: All Natural Pork Tenderloin
SLG: Marinated Hickory Sweet Center Cut Boneless Pork Loin
SLG: Marinated Hickory Sweet Pork Chops
SLG: Marinated Hickory Sweet Pork Loin Filet
SLG: Marinated Hickory Sweet Pork Tenderloin
SLG: Marinated Peppercorn & Garlic Pork Tenderloin
SLG: Marinated Pork Loin Fillet - Peppercorn & Garlic
SLG: Self-Basting Boneless Pork Loin Center Cut Chops
SLG: Self-Basting Boneless Whole Pork Loin
SLG: Self-Basting Pork Tenderloin

Smithfield Lean Generation Deli
SLG Deli: 98% Fat Free Canadian Brand Maple Ham
SLG Deli: 98% Fat Free Cooked Ham
SLG Deli: 98% Fat Free Honey Cured Ham
SLG Deli: 98% Fat Free Tavern Ham
SLG Deli: 98% Fat Free Virginia Brand Ham

Smithfield Premium Cuts
Smithfield: Self-Basting Pork Tenderloin

Solis Brands, Inc.
ZOIC Belgian Chocolate Nutrition Drink
ZOIC French Vanilla Nutrition Drink

Springerhill Ranch Meat Products
Springerhill Ranch Brand All Natural 98% Fat Free Beef Tenderloin Steaks
Springerhill Ranch Brand All Natural Ground Beef-98% Lean 2% Fat

StarKist Seafood Company
StarKist Chunk Light Tuna in Water
StarKist Chunk White Albacore Tuna in Water
StarKist Gourmet Choice Albacore Tuna Fillet in Water
StarKist Gourmet Choice Chunk Light Tuna in Water
StarKist Gourmet Choice Solid Light Tuna Fillet in Water
StarKist Low Sodium Chunk Light Tuna in Water
StarKist Solid White Albacore Tuna in Water
StarKist Very Low Sodium Chunk White Albacore Tuna in Water

Sunrise Growers, Inc.
Sunrise Growers California Strawberries

Swift Foods dba Swift & Company
Extra Lean Ground Pork
Swift Boneless Pork Sirloin Cutlets
Swift Natural Fresh Pork-Boneless Pork Center Cut Loin Chops
Swift Natural Fresh Pork-Boneless Pork Leg for London Broil
Swift Natural Fresh Pork-Boneless Pork Top Loin Roast
Swift Natural Fresh Pork-Pork Strips for Barbecue
Swift Pork Center Cut Loin
Swift Pork Sirloin Tip Roast
Swift Pork Tenderloin
Swift Premium Guaranteed Tender Pork-Boneless Bottom Round
Swift Premium Guaranteed Tender Pork-Boneless Center Cut Loin Chops
Swift Premium Guaranteed Tender Pork-Boneless Pork Loin Filet
Swift Premium Guaranteed Tender Pork-Boneless Pork Tenderloin
Swift Premium Guaranteed Tender Pork-Boneless Sirloin Cutlets
Swift Premium Guaranteed Tender Pork-Boneless Strips for Barbecue
Swift Premium Guaranteed Tender Pork-Pork Top Round
Swift/Kirkland Signature Pork Sirloin Tip Roast
Trader Joe's Butcher Shop - Pork Sirloin Tri Tip
Trader Joe's Butcher Shop Boneless Center Cut Pork Loin Cutlets
Trader Joe's Butcher Shop Natural Pork-Boneless Pork Loin Chops
Trader Joe's Butcher Shop Natural Pork-Pork Shoulder Boneless Strips
Trader Joe's Butcher Shop-Pork Tenderloin

T. J. Kraft, Ltd.
Hawaiian Pacific Ahi Tuna Steaks

Taylor Packing Co., Inc.
Century Farm 96/4 Extra Lean Ground Beef

The Baker
The Baker 7-Grain Sourdough Whole Wheat Bread

Thumann's Inc
Thumann's All Natural Black Forest Brand Ham
Thumann's All Natural Capless Roast Beef
Thumann's All Natural Oven Roasted Gourmet Chicken Breast
Thumann's All Natural Oven Roasted Gourmet Turkey Breast
Thumann's Buffalo Style Oven Roasted Chicken Breast
Thumann's Capless Roast Beef
Thumann's Golden Roasted Filet of Turkey - Rotisserie Flavor
Thumann's Golden Roasted Gourmet Turkey
Thumann's Our Short Cut Deluxe Cooked Ham - Lower Sodium
Thumann's Oven Roasted Premium Chicken Breast

Tony Downs Foods Company
Member's Mark 98% Fat Free Premium Chunk Chicken Breast in Water

Topco Associates, LLC
Food Club Individually Frozen Boneless Skinless Chicken Breasts-15% Seasoned Chicken Broth
Food Club Individually Frozen Chicken Tenderloins-15% Seasoned Chicken Broth

Tumaro's Inc.
Tumaro's Chipotle Chili & Peppers Healthy Flour Tortillas
Tumaro's Garden Spinach & Vegetables Healthy Flour Tortillas
Tumaro's Honey Wheat Healthy Flour Tortillas
Tumaro's Jalapeno & Cilantro Healthy Flour Tortillas
Tumaro's Pesto & Garlic Healthy Flour Tortillas
Tumaro's Premium White Healthy Flour Tortillas
Tumaro's Sun-Dried Tomato & Basil Healthy Flour Tortillas

Tyson Foods, Inc.
Tastybird Individually Frozen Chicken-Boneless, Skinless Breast Portions with Rib Meat
Tastybird Individually Quick Frozen Chicken-Boneless, Skinless Tenderloins
Tyson 100% All Natural Thin 'N Fancy Boneless Skinless Chicken Breasts with Rib Meat (<3% Water)
Tyson 100% All Natural Boneless Skinless Chicken Breasts with Rib Meat (<1%/,2% Water)
Tyson 100% All Natural Boneless Skinless Chicken Thighs (15% Natural Chicken Broth)
Tyson 100% All Natural Chicken Breast Tenderloins (15% Natural Chicken Broth)
Tyson 100% All Natural Chicken Breast Tenderloins (<1% Water)
Tyson 100% All Natural Premium Boneless Skinless Chicken Breasts with Rib Meat (15% Natural Chicken Broth)
Tyson 100% All Natural Skinless Split Chicken Breasts with Ribs (12% Natural Chicken Broth)
Tyson 100% All Natural Skinless Split Chicken Breasts with Ribs (>3% Water)
Tyson 100% All Natural Thin 'N Fancy Boneless Skinless Chicken Breasts with Rib Meat (15% Natural Chicken Broth)
Tyson Ice Glazed Chicken Individually Frozen 99% Fat Free Boneless, Skinless Breast Tenderloins (8% Seasoned Chicken Broth)
Tyson Individually Fresh Frozen All Natural 99% Fat Free Boneless Skinless Chicken Tenderloins (8% Water & Kosher Salt)
Tyson Individually Fresh Frozen Boneless Skinless Chicken Breasts with Rib Meat (15% Chicken Broth)
Tyson Individually Fresh Frozen Chicken Tenderloins (15% Chicken Broth)
Tyson Individually Frozen 100% All Natural Individually Wrapped Boneless Skinless Chicken Breasts (15% Natural Chicken Broth)
Tyson Individually Frozen All Natural 99% Fat Free Boneless Skinless Chicken Breast Tenderloins (8% Chicken Broth)
Tyson Individually Frozen All Natural Boneless Skinless Chicken Breasts with Rib Meat (8% Broth Glaze & 15% Seasoned Chicken Broth)
Tyson Individually Frozen All Natural Extra Lean Boneless Skinless Chicken Breast with Rib Meat (8% Chicken Broth)
Tyson Individually Frozen Boneless Skinless Chicken Breasts with Rib Meat (15% Chicken Broth)
Tyson/Kirkland Signature All Natural 99% Fat Free Boneless Skinless Chicken Breast (8% Water & Kosher Salt)
Tyson/Tastybird Individually Frozen Boneless Skinless Breasts with Rib Meat (10% Seasoned Chicken Broth)
Tyson/Tastybird Individually Frozen Chicken-Boneless Skinless Breasts with Rib Meat (10% Natural Chicken Broth)

Tyson Fresh Meats, Inc.
100% Pure Extra Lean Ground Beef 96/4
96/4 All Natural Extra Lean Ground Beef

United Food Group, LLC
Miller's 100% Pure Ground Beef - 4% Fat
Moran's All Natural 4% Fat 100% Ground Beef Hamburger Patties
Moran's All Natural 4% Fat Ground Beef
Trader Joe's Butcher Shop 4% Fat Ground Beef

Welch Foods, Inc.
Welch's 100% Grape Juice (Purple)
Welch's 100% Grape Juice (Purple) - Frozen Concentrate
Welch's 100% Grape Juice (Purple) - Pourable Concentrate
Welch's 100% Grape Juice Calcium (Purple)
Welch's 100% Grape Juice with Fiber
Welch's Organic 100% Concord Grape Juice
Welch's Organic 100% Concord Grape Juice - Frozen Concentrate

West Liberty Foods, LLC
Honey Roasted & Smoked Breast of Turkey - 98% Fat Free
Kirkland Signature All Natural Fully Cooked Sliced Turkey Breast
Oven Roasted Breast of Turkey Browned in Soybean Oil - 98% Fat Free

More on the American Heart Association

I'm very troubled by the American Heart Association's (AHA) willingness to lend its logo and stamp of approval to a multitude of garbage foods like Cocoa Puffs and Berry Kix cereals.

So I contacted the AHA and spoke to the manager of the Food Certification Program, Ms. Linda Rupp. Ms. Rupp proved very helpful in helping me to understand.

I originally called her to find out just how many products were turned down. In view of 768 products on the approved list, I wondered how many had been rejected to generate this "select" group.

Unfortunately, she said that the number of products rejected was not tracked, though she did intimate that it was not a lot. Sometimes, she added, a rejected product will undergo a few "improvements" to help it achieve the criteria necessary for AHA approval.

What exactly is considered in an application for the Food Certification Program?

A food must have 1)total fat 3.0 grams or less, 2) saturated fat 1.0 gram or less, 3) 20 grams or less cholesterol, 4) 480 mg or less sodium, all per serving.

She also pointed out that, given the fact that a food as useless and lacking in health qualitites as jelly beans could meet this criteria, the AHA employs a special "Jelly Bean Rule" that stipulates that 10% of the Daily Value of 6 nutrients (e.g., fiber, vitamins A and C, etc.) must also be contained in a serving.

So those are the startlingly lax requirements to gain the privilege of affixing the AHA Heart Check Mark on your product and informing the public that your box of Cocoa Puffs, Cookie Crisp cereal, or Berry Kix is "heart healthy."

There is an epidemic of obesity in the U.S. I don't believe that the AHA endorsement helps. In fact, I believe that it has been a contributor to obesity.

Pardon me while I eat this bag of M&M's for my heart.

Exercise and blood pressure

Stan did everything right.

He followed the Track Your Plaque "Rule of 60". He was slender, had run a marathon a few months earlier, in fact. He included fish oil at therapeutic doses. He replenished vitamin D to a blood level of 57 ng/ml 25-OH-vitamin D3. Though ambitious and hard-working, he was a generally happy, optimistic person.

Yet his CT heart scan score increased 28% in one year, from a starting score of 379 to 485.

What did he do wrong?

Well, Stan did nothing wrong. But I suggested to him that one "hole" in his program could be exercise-induced high blood pressure. I've witnessed this effect many times. Blood pressure normal or "borderline" high while seated and relaxed, sky-high with exercise.

So we put Stan on a treadmill. Starting blood pressure: 123/76. Blood pressure with exericse (13 mets): 220/78--sky high. That's why Stan's heart scan score went up. A good pressure with this level of exercise: 150/70, but certainly no higher than 170/80.

If blood pressure is high with exercise, it's probably high with emotional upset, anxiety, being in a hurry, etc., also, all the irritations and pressures of life.

We'll see in future how much of a role reducing Stan's blood pressure will play in gaining better control over his heart scan score. A practical difficulty will be in assessing the adequacy of blood pressure control in Stan, since its full potential only becomes evident with exerise. It means that future blood pressure assessments are more likely to be on a treadmill.

It would also explain why Stan's thoracic aorta was mildly enlarged and his aortic valve was mildly leaky when I met him, both potential consequences of intermittent high blood pressure.

Cheese and vitamin K2

If you've been following the Track Your Plaque conversation, you know that, contrary to prevailing opinion among many cardiologists, there is an emerging notion that coronary calcification is an active process, a true part of the disease.

Vitamin D3 is an important aspect of this question. So is vitamin K2. Not to be confused with K1 that plays a role in blood coagulation, K2 has an important role in calcium metabolism. Thus, vitmain K2 deficiency is related to osteoporosis and to coronary calcification.

Getting K2, like getting D, is difficult from food sources. The choices for K2 sources includes:

--Natto--generally, an impalatable choice. I've had it and it was intolerably gooey and weird-tasting. It is, nonetheless, the most concentrated food source of K2.

--Pate--Though liver products have the potential for containing many other unhealthy things, like pesticide residues, since the liver acts as a filter for the blood.

--Fermented cheeses--Since K2 is a product of fermentation of cheese, as it is in Natto.


For years, we've advised people to avoid or minimize cheese because of saturated fat or cholesterol content. I think that there's reason to re-think this advice based on the emerging data.

How can you tell the difference between fermented and non-fermented cheese? First, look for the holes in the cheese. The holes are the remnants of gas pockets created during fermentation. Second, look for the word "cultures" on the label, meaning organisms for fermentation were added. If "processed cheese" is anywhere on the label, this is a dairy product that has been chemically coagulated and is not fermented.

Fermented cheeses are generally "gourmet" cheeses, not eaten a pound at a time on a pizza, but meant to be eaten in small portions.

How much fermented cheese is necessary for its presumed inhibitory benefits on coronary calcification and osteoporsis? Are some fermented cheeses better than others? These issues remain unsettled. Stay tuned.

Vitamin D disappointment ahead

Anyone following the Track Your Plaque conversation know that we are rabid fans of normalizing blood vitamin D blood levels (25-OH-vitamin D3).

A wonderful report on vitamin D was aired this morning on the NBC Today show. The interviewed guests did a good job of describing the health effects of vitamin D, thought the focus was on some new data on the use of vitamin D for breast and prostate cancer.

I learned that shiitake mushrooms have some vitamin D--I didn't know that! (They contain 260 units per 4 mushrooms.)

Unfortunately, the closing comments from the guests, among whom was nutritionist and author, Joy Bauer,MS, was that you should get vitamin D from your multivitamin or your calcium with vit D.

That is absolutely wrong. When you check blood levels of vitamin D, as we do in everybody we see, you quickly learn what works and what doesn't.

Vitamin D in multivitamins is very poorly absorbed, if at all. Likewise, about 90% of the D in most calcium preparations is not absorbed. The vast majority of tablet or powder preparations, such as those in calcium tablets, are not absorbed to any significant extent. Take all you want and you remain vit D-deficient with osteoporosis, growing coronary plaque, low HDL, and exposed to risk for prostate and colon cancer.

If you take vitamin D in supplement form, it must--MUST--be in an oil-based capsule. The tablets are simply much too poorly and erratically absorbed to be reliable. There's nothing more frustrating to take, for instance, 4000 units of vitamin D in tablet form, only to have a blood level of 12 ng/ml--severe deficiency. Take the same 4000 unit dose in capsule form and blood level skyrockets to 58 ng/ml. And it's no more expensive.

One other thing: If you want to waste time and money, take the prescription vitamin D prescribed by many doctors. This is vitamin D2, also known as "ergocalciferol". Why use the synthetic vitamin D2 when D3 is the form your body needs? Because the D2 is patent-protectable and profitable to the drug manufacturer, similar to using Premarin (horse estrogens) when human preparations would suffice--or be superior. I saw a woman today taking 50,000 of prescription D2 once per week. Her blood level of 25-OH-vitamin D3? 17 ng/ml--severe deficiency. Don't waste your time with this garbage.

In search of truth

I am continually amazed at the amount of time and energy we all expend in the search for truth.

Rely on your hospital and you will be steered towards strategies that, at worst, aim to increase your use of hospital procedures. At best, they steer you towards physicians who are often under their employ.

How about your doctor? This is a source of immense frustration. Doctors remain interested in treating the catastrophic illness. They remain lukewarm towards prevention and self-empowerment. Thus, supplements are dangerous, everything requires a doctor's endorsement.

Drug companies? That's like relying on a used car salesman for truth. Exagerration, slick talk, and plain deception might be better descriptions of what you can count on from the drug manufacturers.

The internet? Perhaps, if you're selective. WebMD? An obvious voice-box for the drug industry. Just look at the proliferation of drugs ads that accompany each report. In fact, the majority (80%) of WebMD's revenues come from drug manufacturers.

The profit motive has created a mountain of good information. It has also created a sea of mis-information, all created to provide personal financial enrichment.

But I continue to be optimistic that the internet will also become a forum for truth, particularly through its capacity for networked interaction among participants. As our collective wisdom permits us to more effectively separate the wheat from the chaff in looking for the truth, I believe that we will zigzag towards a system of healthcare that is self-empowering, self-directed, and resorts to hospitals and procedures only in the most dire circumstances, saving billions of dollars every year.
Why is type 1 diabetes on the rise?

Why is type 1 diabetes on the rise?

Type 1 diabetes, also called "childhood" or "insulin-dependent" diabetes, is on the rise.

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

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

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


(From Vehik 2007)

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

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

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

I'd like to offer another explanation: wheat.

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

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

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

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

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

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

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

Comments (43) -

  • Marc

    2/16/2011 1:22:50 PM |

    Don't know about obsessed...but how can we not be "blown away" continuosly by everything we see all around us.

    I'm disgusted with the school system feeding my kids nothing but candy and cupcakes on an almost daily basis.

    Maybe youre right maybe wheat is the big villain, but mostly all I can really see is that what's being consumed as food...has nothing to do with actual food.

    I'm getting sadder by the way about it...but all i can do is live by example....and share some resources for people to look into...only if they ask.

    Thanks for all you do Doc.

    Marc

  • Steve Cooksey

    2/16/2011 1:50:42 PM |

    Dr. Davis,

    I think the rise in Type 1 Diabetes  *could* be a combination of several factors.

    1) Increase in inflammation due to wheat, sugar etc.

    2) Reduced D3 levels AND exposure to sunshine

    3) Reduced Cholesterol levels, which further impacts the D3 processing.

    Thoughts?

    Steve

  • Pater_Fortunatos

    2/16/2011 1:52:36 PM |

    In Romania there was even a campaign for small kids (6-10 years), named "Pretzel and Milk" (Cornul și laptele).
    Every kid got a daily pretzel and one dose of milk. The perfect recipe for addiction, ADHD, obesity and eventually a few autoimmune diseases.

    And of course, diabetes!
    ............................
    http://arthritis-research.com/content/12/6/147

    The autoimmune tautology refers to the fact that autoimmune diseases share several clinical signs and symptoms, physiopathologic mechanisms, and genetic factors and this fact indicates that they have a common origin (Table 1). In the previous issue of Arthritis Research & Therapy, Eyre and colleagues [1] report that variation within the TAGAP gene, at 6q25.3, is associated with three autoimmune diseases, namely rheumatoid arthritis, type 1 diabetes, and coeliac disease, in Caucasians.
    .......................

    This link provide a few important details:

    http://www.mucosalbarrier.com/

    ............................
    Mainstream medical knowledge, ignores gliadin capacity to increase Zonulin secretion, therefore increasing mucosal permeability.

    Same eeffect for lactose, but another mechanism

  • The Naked Carnivore

    2/16/2011 2:10:59 PM |

    It would also be useful to examine the carb load in the mother's diet. All that blood sugar is "feeding" the fetus.

  • Anonymous

    2/16/2011 2:14:13 PM |

    A good friend of mine who researches diabetes for a big pharma company in the Northern Illinois area told me there is evidence that if type 2 is not diagnosed it can eventually damage the pancreas and shut it down, causing type 1. It works by damaging a cellular function, which I, not being a scientist, cannot remember the term for. I would bet many children and young adults have the symptoms of type 2 and are oblivious to them, which in some may lead to type 1.

  • Anne

    2/16/2011 2:15:00 PM |

    There is more on T1DM and gluten in The Gluten File  Be sure to also check out "the more on Type 1 Diabetes" link

    One abstract is a case report:"We report on a 15-y-old adolescent boy affected by silent coeliac disease, abnormalities in glycoregulation and with autoantibodies specific to diabetes mellitus type 1 (ICA: islet cell antibodies) and GAD 65 (autoantibodies against glutamic acid decarboxylase), in whom normalization of glycoregulation and disappearance of the immunological markers of pre-diabetes were observed after 6 mo on a gluten-free diet. The patient was followed-up for 36 mo and showed a normal insulin response to an intravenous glucose tolerance test and no markers of autoimmunity. It is possible that undiagnosed coeliac disease over a long period could lead to a direct autoimmune mechanism against pancreatic beta cells. Conclusion: Our findings seem to confirm the theory that undiagnosed coeliac disease can induce an autoimmune process against the pancreatic beta cells and that, following a gluten-free diet, the immunological markers for diabetes mellitus type 1 will disappear." PMID: 12434905 2002

  • Brent

    2/16/2011 2:47:05 PM |

    If modern wheat is causing an increase in type 1 diabetes, it would have to be from an effect OTHER than the blood sugar spikes it causes.

    Two days ago I tried a pasta made from 100% einkorn, a grain unaltered for thousands of years.  The blood sugar results were terrible:

    Before meal:    108
    30 min after:   149
    45 min after:   132
    60 min after:   170
    120 min after:  180

    I do not dismiss that some component of modern wheat may be causing the increase in type 1 diabetes, but it is certainly not the blood sugar spikes as these seem to occur with old world wheat as well as modern.

  • Dr. William Davis

    2/16/2011 3:12:17 PM |

    Hi, Steve--

    Yes, indeed. The vitamin D issue is a real issue, as well, that has been shown to be involved in the type 1 occurrence.

    However, I am skeptical that this is responsible for the increase in incidence.

  • Dr. William Davis

    2/16/2011 3:34:14 PM |

    Thanks, Anne. A very persuasive case.


    Brent--The effect would likely have to be due to the gluten, since that is the most immunogenic of all wheat-related proteins.

    "Gluten" is really a large family of proteins that vary in structure and is highly immune-stimulating.

  • Anonymous

    2/16/2011 4:05:56 PM |

    Should I be tested for celiac disease?  I just learned about the possible connection between autoimmune diseases and grains two weeks ago.  I have allopecia areata and hashimoto's thyroditis and no doctor ever mentioned this possible connection.  Since I heard this two weeks ago I've been trying to learn more and have also started cutting out wheat (but I might still be getting some, I'm new at this) and to some extent other grains.  Then I read that in order to be tested I have to be eating gluten.  Some internet articles say it is important not to stop wheat before getting tested because then going back on gluten to do the test could cause "irreparable damage".  That scared me.  But won't I be doing damage continuing to eat wheat also? I have a dr appt. in 1 month.  Should I start eating wheat again in hopes that my doctor will be interested enough in this to test me at that time?  Wouldn't continuing to eat wheat for a month also cause damage?  I'm confused by the various recomendations and will have to wait a month to talk to a doctor face to face.  I also am nervous that my doctor might not be up on this research because he has never mentioned any possible grain/autoimmune connections so far.   Thanks for any insight you can provide.

  • Nigel Kinbrum

    2/16/2011 4:50:33 PM |

    I second Steve Cooksey.

    Both decreasing Vitamin D status & increasing wheat consumption adversely affect tight junctions in the gut. See Keep 'em tight.

  • Josh

    2/16/2011 4:56:03 PM |

    There has also been a big increase in gestational diabetes.

    Perhaps this is activating T1D genes in utero?

  • Might-o'chondri-AL

    2/16/2011 5:24:06 PM |

    T1DM "... occurs age 3" (or  4)suggests to me a pre-natal epigenetic program keyed to kick in post-natal, after certain developmental (infancy) physical consolidation, yet  before adolescent growth spurt (6?). Wheat can concievably share getting the blame of pushing child's metabolism over the edge with a host of other modern environmental insults, that are themselves capable of engendering epigenetic distortion pre- & post-natally.

  • Anonymous

    2/16/2011 7:16:51 PM |

    If, indeed, wheat is responsible for Type 1 diabetes it should be clearly visible in cross-country studies. The Japanese along with many other Asian countries (but not, e.g. northern China) consume little wheat. What's happening to them with regard to Type 1 diabetes?

  • water

    2/16/2011 11:05:32 PM |

    This study showed that avfoiding casein can help children at risk for T1. (this doesn't exonerate gluten, of course.)

    http://www.nejm.org/doi/full/10.1056/NEJMoa1004809

    "Early exposure to complex dietary proteins may increase the risk of beta-cell autoimmunity and type 1 diabetes in children with genetic susceptibility. We tested the hypothesis that supplementing breast milk with highly hydrolyzed milk formula would decrease the cumulative incidence of diabetes-associated autoantibodies in such children."

  • Dr. William Davis

    2/16/2011 11:40:36 PM |

    Anonymous about testing for celiac markers--

    This is a fairly complicated discussion that will be covered in a future post.

    In the meantime, it is a rock and a hard place issue. You do indeed need to consume wheat gluten for around 6 weeks to regenerate positive gluten markers like endomysial antibody.

  • revelo

    2/17/2011 1:10:12 AM |

    Several people (including Colin Campbell of "The China Study" fame, I know you don't think too highly of him) suggest that cow's milk is the problem. Cow's milk contains some proteins that are very similar to human proteins. When the human body attacks these milk proteins, it also attacks the pancreas as a side-effect. Colin Campbell supports this theory with the following evidence. Type I diabetes (and a number of other chronic diseases) were common in the 19th and early 20th century among Scandinavians living in the inland mountainous area, who ate a great deal of dairy products, but rare among those living near the coast, who ate little dairy but lots of fish.

    Fish consumption would also boost vitamin D, but I am skeptical that vit D deficiency is the cause of type I diabetes, for the following reason. Rickets due to Vitamin D deficiency was widespread among the poor in big cities of the northern United States in the late 19th century, especially among dark-skinned people. But I don't recall reading of a scourge of type I diabetes among the poor back then. The poor couldn't afford much milk then, but now they can, and the milk is now fortified with vitamin D. So we get,

    Then: no cow's milk for the poor, record of widespread rickets indicating widespread vitamin D deficiency, no record of widespread type I diabetes.

    Now: plenty of cow's milk consumption, cow's milk is now fortified with vitamin D, rickets eradicated, rising incidence of type I diabetes.

  • Anonymous

    2/17/2011 2:10:22 AM |

    research on gluten's role in T1:

    http://www.ohri.ca/profiles/scott.asp

  • Daniel A. Clinton, RN, BSN

    2/17/2011 2:27:58 AM |

    Clearly, the cause of Type I diabetes, and its rising incidence, is multifactorial. I think the data implicating Vitamin D deficiency is strong, and a reasonable mechanism is there. It seems likely to me more than one mechanism is capable of producing beta cell destruction, and certainly it requires an overlapping set of phenomena to trigger the immune system to attack the beta cells of the pancreas. I do believe those phenomena are less likely to occur in a child with adequate Vitamin D levels.

  • Patricia D.

    2/17/2011 3:17:38 AM |

    While I believe it clear that wheat plays a role in type II diabetes - I think it's less clear that it plays any role in the onset of type I diabetes. I can't say that wheat doesn't become a factor after onset though.  

    However, this presentation by the late, great Dr. Frank Garland explores the striking role of VD3 deficiency on the rate of diabetes type I in children in Finland.  
    http://www.ucsd.tv/search-details.aspx?showID=15771

    And there seems to be a clear role of VD32 deficiency in Type II diabetes as well - though not as dramatic.
    http://www.vitamindcouncil.org/researchDiabetes.shtml

    So while I personally believe that Wheat is clearly a factor in diabetes type II - it seems that VD3 deficiency magnifies and complicates the risk.

  • anonymous re celiac testing

    2/17/2011 3:23:10 AM |

    Thank you for your response Dr. Davis.  It is frustrating to be in between a rock and a hard place but ultimately I feel lucky that I have this information and can start exploring it further.  I feel hopeful now that there may be more I can do besides just cross my fingers and hope for the best.  Thank you for your blog, I look forward to your future posts!

  • Patricia D.

    2/17/2011 3:36:23 AM |

    Okay - this is England - not Colorado - but it makes a point.  BABIES going to the emergency room with brain seizures as a result of Vitamin D deficiency.  Kids just aren't getting outside anymore - and often when they do they're slathered in sunscreen which stops VD3 production in the skin.

    http://www.thisislondon.co.uk/standard/article-23876481-children-who-shun-the-sun-go-to-casualty-with-seizures.do
    *

  • Art Sands MD

    2/17/2011 4:48:37 AM |

    Dr. Davis - recent study in Finland   - they increased RDA of D3 to 2000 IU - decreased Type 1 DM in kids by 76%

    Art Sands MD

  • reikime

    2/17/2011 6:13:58 AM |

    Anonymous,

    There is a great book called "Celiac Disease, A Hidden Epidemic" by Peter H.R. Green MD. He is a nationally recognized expert.
    It is a very well written book for patients AND Docs who can admit if they don't have all the current info on celiac. The number who can't is staggering! (sorry docs out there) lol

    Read it first, then if your doctor doesn't agree with him,  consider getting another opinion. IMHO..as an RN deeply involved with celiac research.
    Good Luck!

  • Anonymous

    2/17/2011 7:09:34 AM |

    Type 1 diabetes can also be on the rise because - I don't know - MORE CHILDREN ARE BEING BORN?

    And grains/wheat are not the killer, as study after study shows that people who eat grains/wheat live longer than those that don't.

  • Lisa

    2/17/2011 3:13:02 PM |

    Revelo
    Another difference between "then" and "now" might be what the cows were eating. Probably grass then and grain now, which leads to them needing antibiotics, etc.

  • Anonymous

    2/17/2011 4:27:31 PM |

    Gluten and a particular beta-casein (BCM7 in A1 milk)
    have a similar negative effect biologically. Please see this:

    "His work related to both gluten,
    which is somatically quite similar to the BCM7 as well as to milk and casein, and the agribusiness industries over there were very, very negative"

    http://www.guernsey.net/~wgcf/PageMill_Resources/Acres_Woodford.pdf

  • reikime

    2/17/2011 6:55:56 PM |

    Anon,
    I can't get your link to work regarding the guernsey.net...

  • Might-o'chondri-AL

    2/18/2011 5:31:10 AM |

    About that A1 beta casein peptide implicated in health refered to earlier.

    A cultured milk, especially one of mixed bacteria and mycotic microrganisms like Kefir, might have enough proteolytic action(protein cleaving) to render a different peptide. Bacteria use their amino-peptidase enzymes to get amino acids they can use from protein molecules (peptide chains).

    The theory of A1 cow's casein causing "x" disease in lab animals should have a Kefir
    cultured A1 milk control. It would be a step toward proving no one's individual gut
    microbiome has a chance to neutralize A1 casein.

  • Anonymous

    2/18/2011 3:33:05 PM |

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  • Daniel

    2/18/2011 3:45:53 PM |

    Two othe rmajor things have changed in the last 50 years...  

    1.  Vit D levels have dropped due to sun-avoidance and the proliferation of indoor jobs.

    2.  Linoleic acid (omega 6) consumption has risen dramatically.  At the same time, omega 3 consumption has fallen.

    I'm not saying gluten is also a factor (and maybe a big one), but I suspect vit D and polyunsaturated fat are the more important culprits.

  • reikime

    2/18/2011 5:25:19 PM |

    Got it, thanks Nigel!

  • Against the Grain

    2/18/2011 6:12:31 PM |

    Dr. Davis, I was just wondering how your theory correlates with historical wheat intake.

    According to the USDA, per capita wheat consumption in the U.S. was 225 pounds in 1879.  In 1997, it was 147 pounds.  It has, however, been on a rise since bottoming out at 110 pounds in 1972.

    I'm not a data cruncher so I can't interpret these numbers.  But perhaps another HSB reader can.

    http://www.ers.usda.gov/briefing/wheat/background.htm

    Scroll down to "U.S. Wheat Use."

  • Against the Grain

    2/18/2011 8:58:42 PM |

    A chart with the above info graphed.

    http://www.ers.usda.gov/briefing/wheat/Gallery/Consumption/WheatConsumption.jpg

  • Might-o'chondri-AL

    2/18/2011 9:05:00 PM |

    Help me out here, please, on the vitamin D trail.

    Osteo-calcin, a hormone from bone osteo-blasts, raises pancreas Beta cell insulin production and makes fat cell raise adiponectin level for better insulin sensitivity. But, in insulin resistance (diabetes prelude) patients have low circulating osteo-calcin and low numbers of osteo-blasts.

    Osteo-blasts, bone builders,   have their own insulin receptors. They also respond to acidic pH conditions. Maybe a reader knows how acidic things have to get for them (osteo-blasts) to go and trigger osteo-clasts to resorb bone.

    The relevance of the preceeding is: this bone dynamic, of osteo-blasts influencing osteo-clasts goes on to then put osteo-calcin into circulation as an "active" hormone.

    Type 1 diabetic children are susceptible to weak bones; their osteo-clasts apparently provoke re-uptake of excessive bone - a pH driven reaction. And their poor insulin sensitivity seems to indicate osteo-calcin is not at work. I'm stuck on a paradox here somebody might understand.

    Now, diabetics show excessively elevated glycated haemoglobin (HbAC1 indicates high blood glucose persistant enough to stick to haemoglobin). High HbAC1is also seen in low "active" vitamin D individuals. It seems low active D is responsible for D's upstream default on maintaining enough osteo-calcin.
    Raise active D and HbAC1 drops, because osteo-calcin doing it's job improving insulin sensitivity to keep blood glucose controled.

    If someone can connect the way we normally get enough osteo-calcin active  without osteo-clasts tearing down bones please do tell. Is vitamin D able to keep bone pH in a just right
    "sweet spot" by controlling
    calcium ion homeo-stasis in the
    skeleton?

  • Dr. William Davis

    2/19/2011 12:53:00 AM |

    Re: dairy products

    I agree that the product of bovine mammary glands are a problem, as well. However, the magnitude of the problem, I believe, is several orders less than that of wheat.

    Beyond lactose intolerance and allergies to various dairy proteins, I worry about its 1) minor exorphin effect, and 2) the insulinotrophic (insulin-provoking) effect. But, all in all, I still think that wheat--modern wheat--is king in generating adverse effects.

  • Cherry Chapman

    2/20/2011 3:08:26 PM |

    quDear Dr. Davis,
           I do not live in the states anymore, but in addition to the every present processed wheat that we can blame, the diets of American children are just plain pitiful, sky high is all sorts of sugars and processed foods.
    I know that there is a small minority of food conscious American parents, but the vast majority  of children are hooked on juices, sugar sodas, kool aid, fake ice cream, sugary processed cereals, fast foods, chips, sugared salad dressings, and canned and boxed this and that, along with factory breads, and sweets.
    Fruits and vegetables are bred for shelf life rather than taste in the US. To me they taste like plastic in comparison to the fruits and vegetables here in France.
    American children are fed processed junk in  the schools supplied by the USDA.
    Here in Paris, all schools use organic meats and vegetables, The children have 1 and half to 2 hours for lunch. The menus  are given to the parents and are online.  They are 5 courses, including a cheese and fruit
    course and sound like a gourmet restaurant menu!!
    Healthy eating is very highly promoted to children here from a very early age.
    Paradoxically, you rarely see wheat bellies here, though the French usually start their day with a half baguette, thickly buttered in addition to bread at each meal. Big difference is most families buy artisanal bread from highly talented bakers, who generally do not use industrial grade flours.
    I could drone on, but American parents need to start cooking real foods , make family meals a time of sharing at a table, and not gobbled in front of the TV.
    What you grow up eating at home and at school will dictate your food tastes and preferences in the future, so you have to present healthy foods from infancy.
    Keep fighting to present the truth Dr. Davis!
    Cherry Chapman

  • Nigel Kinbrum

    2/21/2011 4:45:54 PM |

    revelo said...
    "Now: plenty of cow's milk consumption, cow's milk is now fortified with vitamin D, rickets eradicated, rising incidence of type I diabetes."
    1) UVB exposure (& supplementation) dictates Vitamin D levels in the body, not food/drink.
    2) Lack of rickets =/= Sufficient Vitamin D for proper gut permeability.

  • cwells

    2/21/2011 10:54:49 PM |

    pure bunk as many adults are becoming type 1 diabetics and it is no longer revered to as Childhood or Juvenile diabetics as many adults such as my self are becoming type 1's, (at age 24), for no discernible reason, It's simply refereed to as type 1 diabetes as it is the same disease, weather you get it as a child or adult it's the same thing.

  • Reijo Laatikainen

    2/22/2011 1:11:32 PM |

    @Art Sands MD .This vitamin D data bases on data from 1970s and is a cohort study (not RCT). Interesting though: and here is the link to the study: http://www.ncbi.nlm.nih.gov/pubmed/11705562

  • Yvonne

    5/17/2011 4:40:48 PM |

    I agree with wheat being a major reason for type 1 diabetes being on the rise. Another possible major player:  Untreated or undertreated hypothyroidism.  I believe that the increasing numbers of morbidly obese people walking on the streets in America may be hypothyroid, either undertreated or untreated, and iodine deficient due to drinking and bathing in fluoridated water.

    Many years ago, Dr. Broda Barnes noted several connections between diabetes and hypothyroidism. In his book, Hypothyroidism: The Unsuspected Illness, he wrote:  "I argue emphatically that since so many of the symptoms and complications of hypothyroidism are identical with those of diabetes, every patient with diabetes should have a basal temperature check and, if the temperature is subnormal, a trial of thyroid therapy." He further said that his diabetic patients who also received thyroid therapy were remarkably free of diabetic complications such as peripheral neuropathy, retinopathy and so on.

  • Dismayed American

    8/9/2011 4:36:04 AM |

    http://www.realmilk.com/raw.html

    http://realmilk.com/milkcure.html

    http://realmilk.com/why.html

    http://www.realmilk.com/testimonials.html

    http://www.realmilk.com/abc-news-raw-milk-story.html

    These are great reads for opening eyes. As an american I believe that what we need is a real milk campaign!

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