Vitamin D deficiency is rampant

12. May 2006 William Davis (0)
Today alone I've seen several people with severe deficiencies of vitamin D.

We're now checking everyone's blood vitamin D level at the start of the program. The measure that most accurately reflects your vitamin D status is 25-OH-vitamin D3. This is very confusing to many physicians, who traditionally have thought of 1,25-di-Hydroxy vitamin D3 as the standard test to measure. What they're failing to recognize is that this second measure is a kidney product, not a reflection of vitamin D status.

Using 25-OH-vitamin D3, several people today alone had levels of <10 ng/ml, clearly in the category of severe deficiency (generally regarded as <20ng/ml).

The majority of people we see in the office are Wisconsin residents. It's no wonder they're deficient. Although it's mid-May, we've seen the sun only a handful of days this year. And most of the days have been too chilly to wear short sleeves and shorts to permit sufficient surface area for UV exposure.

Living in a sunny climate, however, is no guarantee that you have sufficient blood vitamin D levels. Two recent studies have shown that 30-50% of the residents of sunny southern Florida and Hawaii are also deficient. (Why, I'm not sure.)

Although our experience thus far is anecdotal in several hundred people, my impression is that people who have normal blood levels of vitamin D (we regard normal as 45-50 ng/ml) have a far easier time of halting or regressing coronary plaque.

Vitamin D is among the most exciting nutritional tools we've come across in a long time. The conversation is making the media, which impresses me tremendously, given the fact that nobody stands to profit financially to any significant degree through vitamin D supplementation.

For a wonderful collection of discussions on vitamin D, go to Dr. John Cannell's website, www.vitaminDcouncil.com. You'll find a huge quantity of scientific background and conversation on the whole idea. I believe you will be thoroughly impressed with just how powerful the argument in favor of vitamin D has become.

What if wheat products were illegal?

11. May 2006 William Davis (3)
Imagine if anything made of wheat were illegal: bread, bagels, crackers, pasta, pretzels, donuts, Shredded Wheat cereal, Raisin Bran, pastry, cookies, cakes, cupcakes. . . Your grocery store would then be unable to carry any of these products.

How empty would the grocery store shelves be?

There would be very little. The stores would be filled instead with vegetables and fruits, meats, and dairy products. But aisle after aisle would be empty. There'd be no cereal aisle. There'd be no snack chip aisle. The ordinarily overcrowded bread shelves wouldn't be there.

Bakery? Nope, not there either. Pasta and noodles? Empty. How about cakes and pastries? Also gone.

Getting the picture? American groceries are dominated by wheat products. What would happen to your health and the health of your family if wheat were abruptly removed from your choices? Would you be less healthy?

No. In fact, your health would be hugely improved. You'd lose a significant quantity of weight. Extraordinary numbers of people would lose diabetic or pre-diabetic tendencies. Feelings of sluggishness, sleepiness, and moodiness would dissolve. Blood pressure would be reduced. The incidence of cancer, skin disease, and inflammatory diseases would plumet.

From a plaque control perspective, your HDL cholesterol would rise, triglycerides drop. Small LDL would improve dramatically.

The message: Slash wheat products from your diet. Yes, you'll miss the smell and taste of freshly baked bread. But you'll do it for many more healthy years. And you may do it without a 14 inch scar in your chest.

The sobering tale of small LDL

10. May 2006 William Davis (0)
Every day, I learn to respect small LDL more and more.

Small LDL particles, and its evil partner, low HDL, is among the most common reasons why someone fails to fully gain control of coronary plaque and heart disease risk.

Just yesterday, I saw a slender businessman (6 feet 1 inch in height, 186 lb.) whose small pattern persisted despite niacin, fish oil, oat bran, and raw almonds. We generally think of small LDL as an overweight person's pattern, but in some people the genetics are quite powerful and it can be expressed even in slender people.

The solution: More physical activity and exercise; cut back on processed carbohydrates, particularly wheat products like breads, pasta, crackers, breakfast cereals; think about magnesium (see our two recent reports on magnesium on the www.cureality.com membership website, the latest report to be posted this week); be sure sleep is adequate (gauge this by whether you're energetic during the day and don't fall asleep watching TV or movies). Lack of sufficient physical activity in people with sedentary jobs is probably among the most common reason the small LDL pattern persists.

Ignore small LDL and it can be like a hidden cancer in your body, growing and metastasizing (not literally, of course), fueling coronary plaque growth. Be sure your doctor assesses whether you have small LDL if you hope to gain control of your coronary risk.

Burn off the fat

9. May 2006 William Davis (0)

If you've ever wondered just how many calories you're burning with various activities like yard work, driving, climbing stairs, etc. go to this great website that will calculate it for you: http://www.caloriecontrol.org/exercalc.html.

Here are some examples:


Dancing for 30 minutes(fast, e.g., tango): 193 calories
Yoga for 30 minutes: 204 calories
Washing the car for 30 minutes: 173 calories
Vacuuming for 30 minutes: 88 calories

(All are for a 170 lb person.)

As you see, physical activity does not necessarily have to consist of exercise. It doesn't require fancy equipment or expensive outfits. But it does require you to keep moving. Sedentary work is among the most common reasons I see in my patients for failing to control weight and its associated lipoprotein patterns, like low HDL and small LDL.

If your work is sedentary, then a minimum of 60 minutes of physical activity per day is necessary to begin to correct weight-related patterns. If you gauge by calories burned, then a useful goal is 500 calories per day in physical activity--at a minimum.

Go the distance!

8. May 2006 William Davis (0)
How long should it take to stop or reverse coronary plaque growth? How long will it require to stop your heart scan score of, say, 350, from increasing at the expected rate of 30% per year, slow it down (we say "decelerate") to less than 30%, or stop it altogether? Or, actually reduce your score?

It can vary widely. Several simple patterns do seem to emerge, however. Our experience is that lower scores, particularly less than 100 at the start, are easier to gain control over. Scores of 50 or less, in fact, commonly can return to zero.

Higher scores, particularly those >1000, are more difficult to slow or reduce, though we've done it many times. You'll generally have to try harder and it may take longer. It's not uncommon to not stop plaque growth with a starting score this high until your 2nd or 3rd year of effort.

Sometimes it may take even longer. An occasional person requires four or five years to gain control. And there are, unfortunately, some people who never really gain complete control. They slow plaque growth compared to what it would have been with conventional efforts, but never completely halt growth. Why? Sometimes it's a matter of less than full commitment. Other times, we just don't know. Thankfully, these especially difficult cases are few and the majority enjoy substantial slowing or reversal.

Since, in some people, success may take time, you've got to stick it out. Have you ever gotten lost in a strange city only to find out later that the place you were looking for was right around the corner? It can be the same way with stopping coronary plaque growth. If you start with a score of 1000 and, after two years of effort, you've only slowed growth to 11% per year and then give up in frustration, you may have missed the opportunity to have stopped growth entirely in your third year.

All we can do is tip the scales heavily in your favor. We provide you with the best tools known. You've got to provide the commitment, the consistent effort of taking your supplements or medication, making the lifestyle changes, choosing the right foods and avoiding the wrong ones. But you've got to go the distance and not give up too easily.

What you need is an expert in health!

5. May 2006 William Davis (0)
Where can you find an expert in health?

In my experience, they're hard--very hard--to find.

Your hospital? Certainly not the hospitals I know. The hospitals I know are experts in disease, but not in health. Hospitals are helpful when you're sick. But if you're well and would like to stay that way, there's no reason to hang around a hospital. Prevent cancer, prevent heart disease, stay well? There's no place for this conversation in a hospital.

In fact, hospital staff are among the most unhealthy people I come across. Obesity is a nationwide problem affecting millions of Americans. But it's especially a problem among people who work in hospitals. I shudder in horror when I go to a hospital cafeteria and witness the sorts of food they serve in hospitals and see what the staff eat. Should they be regarded as experts in health?

How about doctors? If you associate with physicians like the ones I know, most have lots of knowledge about disease, but little understanding of health. A rare one has insight and interest in health.

I went to a recent meeting with my cardiology colleagues. Food served: pizza, Coca-Cola, spaghetti, fried onion rings, white bread with butter. They all dug in without hesitation. Over half were miserably overweight. Several were, in fact, diabetic; several more, pre-diabetic. I know that at least several are smokers. Experts in health?

Drug companies? Well, they're interested in health only as far as it provides profits. But health for its own sake? Ask anybody from a drug manufacturer about their views on the nutritional supplement movement and watch them sneer.

Food manufacturers? You mean like Coca-Cola, Pepsi-Cola, Nabisco, and General Mills? How about fast-food operations like McDonald's, Pizza Hut, and KFC?

The message: Know where to look for genuine information on health. You won't get it from hospitals. You won't get it from drug company marketing. For the most part, you can't even get it from your physician.

Instead, you're going to witness a broad movement towards self-empowerment in health, fueled by the internet and services like ours (Track Your Plaque). These are information resources that are not driven by profit, intent on providing truth, and not afraid to reject prevailing views.

It does not mean that hospitals are unnecessary, or that food manufacturers are evil, or that fast food should be legislated out of existence. We live in a capitalistic society, driven by supply and demand. Hopefully, demand is borne from educated choices from informed consumers. That's where information that's reliable, credible, and not profit driven come in.

Lipoprotein(a) and small LDL

4. May 2006 William Davis (1)
It's been my suspicion for some time that the combination of lipoprotein(a), or Lp(a), in combination with small LDL particles is a really bad risk for heart disease. People with this combination seem to have much higher heart scan scores for age than others. This seems to be a pattern that we'll see in the occasional woman less than 50 years old who already has a high heaert scan score. (It's unusual for women to have detectable coronary plaque before age 50.)

Very little data exists to support this idea and we are in the process of performing a small study to see whether it's true or not. My gut sense: it's among the most potent causes of coronary plaque around.

Case in point: Even though I spend a great deal of my time and energy advocating heart disease prevention, I still maintain my hospital privileges and skills. I had to cover one of the emergency rooms in town this past weekend (a requirement to maintain my hospital privileges).

One of the patients I saw was a 40-year old man--we'll call him Roland-- suffering a very large heart attack, a so-called "anterior myocardial infarction", or a heart attack involving the most important front portion of the heart. Thankfully, he came to the ER within 45 minutes after his chest pain started. The situation was immediately obvious and I was called to the ER. We quickly took him to the cardiac catheterization laboratory and put a stent in the left anterior descending artery and flow was restored. His chest pain dissipated over the next few minutes.

Nonetheless, Roland was left with a large area of reduced contraction of his heart muscle. Only time will tell how much recovery he'll have.

Roland was extremely lucky. The majority of people with closure of the artery that he'd experienced die within minutes. He did, in fact, "arrest" briefly, i.e., his heart became electrically unstable, though he recovered promptly.

Along with the multiple tubes of blood we required to run tests for his heart attack management, we had Roland's lipids and other measures sent off, as well. Wouldn't you know: Lp(a) and small LDL. This may have accounted for a heart attack at age 40.

Keep a lookout for this when you have lipoprotein testing. Conveniently, niacin can be used to treat both patterns, though higher doses are generally required for the Lp(a) part of the pattern. It's also my belief that the sort of Lp(a) measurement performed by the Liposcience laboratory (www.liposcience.com) is superior. They use a particle number based measure, not a weight-based measure. It is therefore independent of particle size, which can vary. Further work will, I believe, reveal some very important insights into the dreaded Lp(a).

"Please don't tell my doctor I had a heart scan!"

30. April 2006 William Davis (1)
I overheard this recent conversation between a CT technologist and a 53-year old woman (who I'll call Joan) who just had a scan at a heart scan center:


CT Tech: It appears to me that you have a moderate quantity of coronary plaque. But you should know that this is a lot of plaque for a woman in your age group. A cardiologist will review your scan after it's been put through a software program that allows us to score your images.

Joan: (Sighing) I guess now I know. I've always suspected that I would have some plaque because of my mother. I just don't want to go through what she had to.

CT Tech: Then it's really important that you discuss these results with your doctor. If you wrote your doctor's name on the information sheet, we'll send him the results.

Joan: Oh, no! Don't send my doctor the results! I already asked him if I should get a scan and he said there was no reason to. He said he already knew that my cholesterol was kind of high and that was everything he needed to know. He actually got kind of irritated when I asked. So I think it's best that he doesn't get involved.


This is a conversation that I've overheard many times. (I'm not intentionally an eavesdropper; the physician reading station at the scan center where I interpret scans--Milwaukee Heart Scan--is situated so that I easily overhear conversations between the technologists and patients as they review images immediately after undergoing a scan.)

If Joan feels uncomfortable discussing her heart scan results with her doctor, where can she turn? Get another opinion? Rely on family and friends? Keep it a secret? Read up about heart disease on the internet? Ignore her heart scan?

I've seen people do all of these things. Ideally, people like Joan would simply tell their doctor about their scan and review the results. He/she would then 1) Discuss the implications of the scan, 2) Identify all concealed causes of plaque, and then 3) Help construct an effective program to gain control of plaque to halt or reverse its growth. Well, in my experience, fat chance. 98% of the time it won't happen.

I think it will happen in 10-20 years as public dissatisfaction with the limited answers provided through conventional routes grows and compels physicians to sit up and take notice that people are dying around them every day because of ignorance, misinformation, and greed.

But in 2006, if you're in a situation like Joan--your doctor is giving you lame answers to your questions or dismissing your concerns as neurotic--then PLEASE, PLEASE, PLEASE take advantage of the universe of tools in the Track Your Plaque program.

People tell me sometimes that our program is not that easy--it requires reading, thinking, follow-through, and often asking (persuading?) your doctor that some extra steps (like blood work) need to be performed. The alternative? Take Lipitor and keep your mouth shut? Just accept your fate, grin and bear it, hoping luck will hold out? To me, there's no rational choice here.

Doctor, why do I have heart disease?

30. April 2006 William Davis (0)
I see a great many people in my practice who come for a 2nd opinion regarding their coronary disease.

When I ask patients whether they ever asked their primary doctor or cardiologist why they have heart disease in the first place, I get one of several responses:

1) My doctor said it from high cholesterol.

2) My doctor said it was "genetic" or "part of your family history" and so unidentifiable and uncorrectable. Tough luck.

3) I didn't ask and they didn't tell me.


Let's talk about each of these.

Can heart disease be only from high cholesterol and, if so, can taking a statin cholesterol drug be a "cure"? In the vast majority of cases, in my experience, cholesterol by itself is rarely the only identifiable cause of coronary disease.

Most people have a multitude of causes (e.g., small LDL, low HDL, vitamin D deficiency, concealed pre-diabetic patterns, etc.). This explains why many people with high LDL don't have heart disease and why others with low HDL do have heart disease. High LDL cholesterol is only part of the cause.

Does "genetic" or being part of your family's history also mean unidentifiable and uncorrectable? Absolutely not.

What your doctor is really saying is "I don't know enough to diagnose the causes because I haven't kept up with the scientific literature", or "I don't want to be bothered with this because it takes a lot of time and pays me very little money; I'd rather wait until you need a stent ", or "The drug representatives haven't told me about any new drugs". This is ignorance and laziness at best, greed and profiteering at worst. Don't fall for it. I hope that by now you recognize that the great majority of causes of heart disease are identifiable and correctable.

If you didn't think to ask, now you know that you should. If you and your doctor don't think about why you have coronary plaque in the first place, how can you develop a program to control it?

You need to ask. And you need to get confident answers. "I don't know" or "It's genetic" and the like are unacceptable.

Pill pushers

28. April 2006 William Davis (1)
Have you read the latest cover story from Forbes magazine? It's entitled "Pill Pushers: How the drug industry abandoned science for salesmanship".

It's great reading. (A condensed version is available at the www.forbes.com website: http://www.forbes.com/business/forbes/2006/0508/094a.html. They require you to provide your e-mail address though it's free.)

Drug industry advertising has raised consciousness of all the prescription therapies available for us--that's good. However, they've gone so far overboard trying to squeeze more and more revenues out of drugs that they've cost this country a huge amount in increased health care costs and even lost lives. (Forbes does a great job of summarizing some of these instances.)

Drugs like Lipitor, Crestor, Zocor; diabetes agents; anti-hypertensive agents, etc., that is, medications taken chronically, a huge financial bonanzas for drug companies. Not only do they get $100-200 per month, but they get it month after month after month. That's per drug.

Now not all medications are bad or unnecessary. There are times when they can be truly necessary and beneficial. But don't rely on drug company advertising to tell us when.
American Heart Association diet makes a monkey out of you

American Heart Association diet makes a monkey out of you

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

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

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

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

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

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

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

Would you like a banana?
Tags :

Comments (38) -

  • Anonymous

    2/21/2011 3:48:54 AM |

    Back in 2004 I was seeing a Cardiologist because of AFib (since "cured" by an ablation).  The good Doctor wanted to put me on a Statin for reasons having to do with unexplained multiple "risk factors". Not being a big fan of legal drugs, I asked if I could try diet first. He said, "Sure, you can try the American Heart Association diet but...it never works".  Undaunted I tried it anyway and sure enough 3 months later I had gained 15 lbs and my LDL was even higher (I couldn't stop eating).  BTW, I quit the Statin 2 years ago and have been Paleo since. - Jay

  • Sara

    2/21/2011 5:29:27 AM |

    No thank you,
    bananas spike my glucose above 140, he he!!!

  • Anonymous

    2/21/2011 8:56:27 AM |

    I think you are taking the article completely out of context. The monkeys were on the American Heart Association diet and then they added in high frutcose corn syrup. The monkeys got fatter because of the carbs from the corn syrup, not from the AHA diet. Personally I am paleo, but you are pulling a Glenn Beck here.

  • Aerobic1

    2/21/2011 3:28:48 PM |

    The point is not whether HFCS or wheat was the cause, but rather that all simple and refined carbohydrates will create the pot belly that Shiva and most of Americans have.  The animal cruelty police should spend their efforts in Washington protesting the plethora of garbage advice that is forced on us by organizations like the AHA and cut their funding.  By doing so, it will have a significant positive impact and help reverse the upward trends of obesity, diabetes and heart disease that your tax dollars go to perpetuate.  The AHA is one of the most corrupt and lobbied groups by special interests agriculture, the same folks who bring you the refined carbs.  Once the agriculture industry checks clear in the AHA bank account, the AHA "heart Healthy" seal of approval is on the box.  If you bother to look most of the AHA "Heart Healthy" cereals have refined cereals grains and high fructose corn syrup.

  • Anonymous

    2/21/2011 4:35:17 PM |

    Researchers in England and Singapore have developed a device which can assess the risk of heart disease.

    http://insideireland.ie/2011/02/21/watch-like-device-to-assess-heart-disease-risk-9317/

  • Anonymous

    2/21/2011 6:08:36 PM |

    I have followed this blog for sometime. I do appreciate Dr Davis's efforts and the comments made in the blog.
    But I think he needs to address the criticisms made in the previous blog entry. Completely ignoring the comments and questions and moving onto a new topic seems to point toward an unseemly arrogance and a lack of respect for the readers.

  • jean

    2/21/2011 6:41:17 PM |

    Um, click on the link, but prepare for a very sad sight, the poor guy, (or girl) looks miserable.

  • Anonymous

    2/21/2011 7:28:25 PM |

    What's Dr. Davis' alternative to AHA? Is it in a book or something?

  • Anonymous

    2/21/2011 8:23:41 PM |

    As an alternative to the AHA and the ADA dietary guidelines,see Jenny Ruhl's two sites for a start.

    Blood sugar 101
    http://www.phlaunt.com/diabetes/

    Low carb dieting
    http://www.phlaunt.com/lowcarb/index.php

  • Anonymous

    2/22/2011 12:13:08 AM |

    To all the entitled anonymous douchebags, if you don't like what Dr. Davis says in his blog leave! Dr. Davis doesn't work for you.

  • Anonymous

    2/22/2011 12:35:43 AM |

    Two weeks after no dairy, no wheat and some really delicious juicy steaks I am five pounds lighter and feel great.
    I don't give a rip what my lipids are because I am not going to do anything any differently anyways!

    Blood sugars never break 100.

  • Drs. Cynthia and David

    2/22/2011 1:07:42 AM |

    @second Anonymous- try reading the article before criticizing Dr. Davis for mischaracterizing it.  You'll see he was correct.

  • Lori Miller

    2/22/2011 1:20:03 AM |

    @Anonymous #2, the group on the HFCS drinks (among other things) and the group on the AHA diet were two different groups of monkeys:

    "Dr. Grove [of Oregon Health and Science University] and researchers at some other centers say the high-fructose corn syrup appears to accelerate the development of obesity and diabetes....

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

    "Still, about 40 percent do not put on a lot of weight.

    "Barbara C. Hansen of the University of South Florida said calories, but not high fat, were important. 'To suggest that humans and monkeys get fat because of a high-fat diet is not a good suggestion', she said.

    "Dr. Hansen, who has been doing research on obese monkeys for four decades, prefers animals that become naturally obese with age, just as many humans do. Fat Albert, one of her monkeys who she said was at one time the world’s heaviest rhesus, at 70 pounds, ate 'nothing but an American Heart Association-recommended diet', she said."

    The article goes on to refer to the first diet as "high fat," even though it's only 33% fat, and the way the article is written, it's hard to tell the groups apart.

  • Might-o'chondri-AL

    2/22/2011 1:49:54 AM |

    Take the banana; a banana a day for one year offers hormetic (small bit of bad does good) low dose radiation of +/- 3.6 milli-rems for the entire year. Low dose radiation boosts the cytokine activity of NK (Natural Killer), the tumor stopper. A chest x-ray doses out 10 milli-rems by comparison.

    Potassium Kiss, found in bannanas, is 0.0118% K40 isotope potassium. It emits mostly gamma radiation (when proton snags an extra electron) and some beta particles (when neutron mass spins off an electron and neutron becomes a proton); which are "slow" in collision with things, like a cell.

  • Anonymous

    2/22/2011 2:00:22 PM |

    To a recent "Anonymous":

    Dr Davis does have have an obligation to his readers. By convention, he is expected to explain himself and respond to polite and appropriate questions regarding his blog. That is why the interaction is provided, and he seems usually to encourage the dialogue. Dr Davis could have just as easily established this blog without the interactive feature. Currently, among usual glowing reader comments and often enlightening questions has come some criticism. His response to this criticism is what is currently lacking ... of course, this is only my opinion.

    By the way, I am not exactly sure what "entitled anonymous douchebags" have to do with anything.

  • John Townsend

    2/22/2011 3:11:15 PM |

    RE: “blah blah ... completely ignoring the comments and questions and moving onto a new topic seems to point toward an unseemly arrogance and a lack of respect for the readers.” by anonymous.

    Fortunately, commentary on this excellent blog is for the most part constructive and informative. However a comment like this is frankly annoying because it’s mean-spirited, disingenuous, cowardly, and clearly not helpful. The poster is not obliged to read this blog, let alone dump on it like this anonymously!

  • Misty

    2/22/2011 4:13:12 PM |

    Interesting!  I have been advising a woman who works in a chimpanzee sanctuary in the North West.  There is one chimp who had blood sugars of 1000.  

    Sadly, they have put this chimp on Crystal Light and Tofu as a remedy.  

    Chimps share 99% DNA with humans.  We know that aspartame and soy are both dangerous to the human body.  

    The most interesting thing is, she rebelled when her goodies were taken away.  

    They too are addicts just like us.

  • Flavia

    2/22/2011 7:20:22 PM |

    You're the only doctor I trust. The more i see the changes in my BP and overall health following your advice, plus the more I learn about what should first be done to treat hypertension, the more pissed off I get.
    What jerk puts a young woman on atenolol without even asking for some tests or if she eats too much salt or if she's wound high at the dr's office!!?? What the hell!?

    BTW, my blood pressure has dropped even more- an average of around 121/81- from 151/102. This is with 12mg of atenolol which I should hopefully kick to the curb soon Smile

  • Might-o'chondri-AL

    2/22/2011 7:40:32 PM |

    Hi Misty,
    Although chimps and humans share 96% identical proteins the implication of our intervention is complicated. Here's why.

    We actually have 40 million genome variables, including 500
    DNA repair/apoptosis pathway proteins. 5% of proteins show different splice variations; we have different arrangements of coding regions on the chromosomes we share.

    Chimps have 2.5 splice variations in places where humans only 1.5 gene splicing possibilities. 80 proteins we share similar gene intron segments for the chimp's intron is longer. Humans have more genetic activity post-translation to further modify events.

    Humans don't have Neu5Gc (N-glycolyl-neuraminic acid) which is a sialic acid binding immuno-
    globulin-like lectin (Siglec). This mediates molecules of sialic acid to perform differently. It directs what gets bound; the result is spleen macrophage response for chimps immune system works differently.

    The chimp ligand (thing that binds to something) processing mechanism extends to how they metabolize estrogen and phyto-estrogen iso-flavenoids (like soybeans contain). They pass both ligands, like wheat lectins, and estrogens more fully in their urine than humans do.

    For chimps a high fat diet causes less urinary excretion of estrogen, as well as less of the fragments of peptides from lectin ligands. To be precise high protein and high carbohydrate diets also diminish those metabolites % in chimp urine; just less so than high fat.

  • worldinside

    2/22/2011 8:46:30 PM |

    Dr Davis,

    I have just found your blog because I have only recently begun searching for dietary info in order to guide me in rebuilding my skeletal muscle (and brain) after a so-far-11-month bout of severe adverse effects to a statin.  (When prescribed my readings were: Total Chol 297, HDL 117, LDL 165, triglycerides 73 – after 2 months of little exercise as the result of pneumonia and eye surgery.)

    The widespread acceptance of the "Paleo" diet interested me greatly, because I independently came to some of the same conclusions several years ago.  There is, however, a big Something that I don't understand and that I haven't seen addressed.  I hope you can – briefly, I know – educate me.  Why such severe restrictions on carbs when they were so important in our survival?

    The characterization of Paleo as high protein, high fat, low low carbs doesn't square with my college science courses and subsequent reading.  Early, early man would have grubbed around for whatever he could find, and, yes grubs would have been eaten were he lucky enough to find them, as well as other insects, wounded  small game, carrion, and fruit/berries/nuts.  Early man would also have discovered ROOTS and TUBERS very early on, and wild pea pods and the like, long, LONG before he was capable of running down game alone or in concert, or could even be sure of modest, reliable supplies of protein and fat.

    And once he was a hunter, then what?  Not much fat on wild monkeys and stressed hooved animals (lots of other predators were after them, too), and one had to live between those perhaps widely spaced hunts that were successful and had to be shared.  More ROOTS and TUBERS – because fruit alone tends to leave you hungry for more (the fructose), whereas a nice raw potato, a few carrots, could calm the gnawing in the stomach.

    Yes, I see that we now need considerable protein and a lot of fat (compared to current guidelines) because as we progressed  our expanded diet of increased amounts of protein and fat permitted our brains, especially, and our bodies to evolve to take advantage of such nutrients.  But I can't agree with the demonization of a large segment of our natural food supply.  Cut out grains.  I can see that.  But the sweet potato?  In the skin?  With generous amounts of butter gilding its fiber-rich goodness?

    Why?

  • Anonymous

    2/22/2011 10:09:55 PM |

    This may clarify, in their recent 2010 paper, M Konner and SB Eaton, estimate the ancestral diet (as % of daily energy) composed of
       35-40 acrbohydate,
       25-30 protein, and
       20-35 fat.
    They comment that the carbohydrate source for “hunter-gatherers” (HG) was from fruit, vegetables, and nuts, not from grains. They go on to say that the reduction of carbohydrates to extremely low levels is not consistent with the HG model, but neither is a high-carbohydrate, “meat as a condiment” type of diet.

    Konner and Eaton, both physicians, published their seminal paper on Paleolithic nutrition in 1985. The statistic above comes from their most recent paper of 2010. For those interested in how the popular interpretation of scientific research tends to “spin” the original detail, references to both their papers are below. Unfortunately, the 1985 article in the New England Journal of Medicine is restricted to paid subscribers only, while the recent invited article in Nutrition in Clinical Practice is available free online.

    Eaton SB, Konner M. Paleolithic Nutrition: A consideration of its nature and current implications. N Engl J Med. 1985 312:282-289.

    Eaton SB, Konner M. Paleolithic Nutrition: Twenty-five years later. Nutr Clin Pract 2010 25:594-606. http://ncp.sagepub.com/content/25/6/594

  • Brent

    2/22/2011 10:22:14 PM |

    There seem to be a few anonymous people making posts giving their opinion about how this blog should be run. Some of their assertions remind me of the entitlement mentality ruining this country.

    First, Dr. Davis is under no obligation to answer anyone's comments or questions.  How much do you pay to come here and read? I thought so.

    Second, when he chooses to respond, understand it is taking time out of his day that could go to his medical practice, (Real clients who pay for his services) his family, or without knowing the man personally, his hobbies or other interests.  How much time do you think it would take to write an answer to each person who poses a question in the response section on this blog?  Keep in mind how much slower writing is than speaking! It would take hours.

    Maybe it hasn't occurred to some of you that an answer to one person in the comments section won't be seen by very many people.  A much better use of his time is to write a short blog post at some time in the future that will be seen by many, and will be search-able, rather than answering the same question over and over again in the comments section.

    It's not all about you, people. Get a life.

  • Lori Miller

    2/23/2011 1:20:07 AM |

    Worldinside, first, there's no one paleo diet. At certain times and places, like Cro-magnon Europe, the diet was nearly all meat. Paleolithic humans ate animals (snout to tail, not just muscle meat), fruit (in season), and, yes, tubers when they were available.

    Second, probably unlike Paleolithic humans, many readers of this blog don't have normal blood glucose reactions to carbohydrates. As you probably know, carbohydrate consumption spikes blood sugar even in normal, healthy people. In people with diabetes or metabolic syndrome, eating a tuber can cause BG levels that can lead to organ and tissue damage. Overconsumption of carbs over a month in such people can lead to high triglycerides as well--not to mention weight gain.

    While it's useful to look at how Paleolithic humans ate, we also need to look at medical science and keep our own individual quirks in mind. Humans need to eat protein. We also need to eat fat; we can't make essential fatty acids ourselves, and dietary fats have a unique ability to allow us to absorb vitamins A, D, E, and K. But there's no such thing as an essential carbohydrate (people who have hypoglycemia aside). Our liver can make blood glucose from protein. And just because something is natural and somebody else can eat loads of it, doesn't mean everybody can eat it.

  • revelo

    2/23/2011 1:47:45 AM |

    Assuming your goal is longevity and health in old age, it doesn't matter what our hunter-gatherer ancestors ate, because they didn't live much beyond age 70, which is quite young by modern standards. Living to 100 and being healthy in your 90's is very unnatural, so it follows that those of us who want to live that long should eat unnaturally. All the evidence I've see suggests that being lean and conditioned is the way to go, regardless of diet, but that a mostly vegetables diet is most conducive to longevity. Eating mostly grains is also okay. Eating high-fat or high-meat is NOT conducive to longevity.

    If you are not lean and conditioned, then first priority is to become lean and conditioned, and any diet which helps towards this primary goal is a good diet. Only after you become lean and conditioned do you really need to start worrying about diet.

  • Anonymous

    2/23/2011 4:03:16 AM |

    … as always such enlightening comments …

    In my neighborhood, it is generally accepted that the life expectancy at birth for preindustrial populations was 30-35 years. This was due not to the absence of older people but due to the extremely high infant and child mortality. Deaths overwhelmingly were due to infectious diseases that are now under control, more or less. With the longer average life spans came the advent of the diseases of civilization: atherosclerotic cardiovascular diseases, type 2 diabetes mellitus, chronic obstructive pulmonary disease, lung and colon cancers, essential hypertension, obesity, diverticulitis, and even dental carries. As of 2011, US life expectancy at birth is 78 years.

    For sure, aerobic fitness is essential to health and longevity in the modern world however, medical science has demonstrated that many of the diseases of civilization would be minimized with appropriate dietary modification. Yes, the same medical science that we are throwing rocks at in the current “cutesy” survey of the AHA offered in this blog session.

    One method of analysis in medical research is the examination of the Paleolithic diet supporting the discordance hypothesis that tries to explain that the mismatch in our modern diet from that what our genome has evolved is the cause of some chronic diseases. As an example, consider the modification of sodium intake. Studies of our ancestors diet estimates their sodium intake at about 800 mg/day, compared to a current adult average of 10,000 mg/day estimated by the WHO. Well-validated computer simulations predict that a reduction of 3000 mg/day (30%) in sodium intake would result in 40,000 to 90,000 fewer deaths from coronary heart and stroke each year in the US. On the other hand, moderate ethanol intake has been shown to reduce cardiovascular risk. Ethanol consumption was probably nonexistence before the invention of agriculture and not part of the paleo lifestyle.

    No one has all the answers but blindly following any particular lifestyle or lifestyle advocate will probably not get you to a healthy 9th decade or simply a healthy older life. However, with a little luck and the judicious adoption of demonstrated healthy habits in fitness, nutrition, and lifestyle we all may get there.

  • Anonymous

    2/23/2011 4:31:32 AM |

    I think the problem people have with The Heart Scan Blog is that they forget the doctor is referring to people who have metabolic problems. I've met many people who are fat and who eat potatoes and fruits yet keep their cals low and lose a ridiculous amount of weight. But at the same time I know people who, if they ate the same way, they would gain weight.

    In general, the info on this blog is really good. Sure there are times where it seems that the doctor has recanted his hate of weight so much that he begins going after the most random stuff (i.e.. butter), but realize that this is a blog and that - as mentioned previously - everyone is different.

    Closing anecdote: My grandfather is 94. He's incredibly healthy (runs a whole mango farm in Asia). His diet would be deemed bad by most of the people on this blog. He eats oatmeal topped with mangoes for breakfast, Hawaiian Bread with SPAM sandwich (because he's out on the farm), and he eats white rice for dinner. His cholesterol is perfectly fine. His heart is perfectly fine. In fact, the doctors are always amazed at how healthy it is.

    So it goes to show, it depends on YOU. Do your research, see what info is out there, don't rely entirely on any one source of info. So a doctor recommended you a diet you don't agree with? Guess what? Go see another doctor! Just be sure you aren't going from one doctor to another until you hear the answer you WANT to hear as opposed to the one you NEED to hear.

  • worldinside

    2/23/2011 10:40:57 AM |

    Thank you to all the  Anonymousi, Lori and Revelo who replied to my question, especially the first responder.  I've downloaded the paper and am looking forward to reading it.  I was pleased to note that, as I believed, those early diets were pretty well balanced.

    And thanks, Lori and another, for pointing out that this site is intended largely for people with CVD and/or metabolic disorders.  (That explains the every 15 min BG readings!)

    I was not questioning because I was confused about which diet to follow, but rather, was confused by the way the term "Paleo" [diet] was being thrown around on this site by several commenters, as in "I've been Paleo for two months now and feel great.  No more carbs for me."  And I wondered if that was the site terminology for the diet plan envisioned by Dr Davis.

    Revelo, I don't think I agree with your statement, " Only after you become lean and conditioned do you really need to start worrying about diet."  First of all, unless you've a metabolic disorder I think you should be mindful rather than worrying about your diet.  Second, I'm inclined to believe that once you're conditioned that's when you can stop worrying, if you were so inclined.  You've cranked up the mitochondria and they're working away at increased effectiveness even while you're not working out.

    By the way, I used to love oatmeal in the morning.   Several years ago I started what turned out to be about two years of oatmeal for breakfast every single morning – with half and half or cream and brown sugar.  Then I stopped as suddenly as I had started.  I think my body needed something the oats supplied, and then it no longer did.  And I stayed slim all that time.  Now I don't touch fructose except in fresh fruit (Thank you, Dr Lustig), so no sugar either white or brown should I ever again get the oatmeal urge.

  • Eric

    2/23/2011 1:15:16 PM |

    To all the "anonymous" posters-

    After reading Dr. Davis' blog for some time now, I can assure you he will respond if the comment is worth his time.

    General bad mouthing is rampant on a blog and if he spent most of his time refuting narrow minded opinions he wouldn't have time to be a cardiologist or write. So chill out or go elsewhere.

    Also- his views aren't directed to just people with metabolic syndrome. It's for people who seem to be the American picture of "health" but are a ticking time bomb for diabetes, stroke, heart attack. His knowledge delves deeper than just a typical lipid panel (LDL, HDL, triglycerides).

    People should know what they speak of, before the pop of at the mouth about topics they aren't well suited to debate.

    Good post Dr. Davis.

  • terrence

    2/23/2011 5:33:37 PM |

    Anonymous February 23, 2011, said "…. after looking it over following a very strong recommendation, I can say that I will not be back."

    Thank you anonymous - based on your silly comment from which I took the quote, you have absolutely NOTHING to say. I am delighted you are going.

    r Davis, thank you for yet another informative, intelligent post.

  • Might-o'chondri-AL

    2/23/2011 7:38:26 PM |

    Some are not abreast of the science and how it is clinically relevant. A 33 year 14,000 patient study of Danes, published 18 Feb 2011 in Annals of Neurology, indicates Doc's insistance is well founded.

    (In case you wonder why neurologists' data are relevant it is because 87% of fatal strokes are ischemic strokes. Now on to the science reported.)

    Danes followed those with strokes over 33 years and found that NON-fasting triglyceride levels were more of an indicator than cholesterol level.
    Specificly: women and men with over 89 mg/dl NON-fasting triglycerides had 1.2 times more stroke risk.

    Doc's rants about blood sugar after eating, including butter induced spike, are in line with NON-fasting triglycerides being
    a risk factor. He does detail
    triglyrerides in other posts and goes into the VLDL mechanism too. My layman's focus on LDL & genetics overlooked what this blog clued me in to.

    Laboratory lipid blood work shows the fasting trigylceride number. Doc pushes home test of
    post-meal blood sugar since it is a surrogate of VLDL and NON-fasting triglycerides getting elevated (or not).

  • Might-o'chondri-AL

    2/24/2011 12:08:16 AM |

    Non-diabetics, like me, think blood sugar science is for the other guy. Doc seems to be trying to hammer it home that it is relevant to some more of us.

    Let's focus on coronary problems, like multi-vessel coronary disease, although it is all tied in to cardio-vascular "events". A meta-analysis of 20 studies covering 90,000 non-diabetics is worth summarizing.

    Over 12 years those 90,000 non-diabetics' heart risk (multi-vessel coronary artery disease) correlated exponentially with both fasting and post-meal blood glucose levels. This was irregardless of the person not meeting the diagnostic criteria for being diabetic; and irregardless of "normal" fasting blood sugar, or even signs of glucose intolerance. In other words, the +/- 2 hour span of blood sugar dynamic is connected to cardio-vascular events.

    (Multi-vessel coronary disease is when the left ventricle functions, but there is +/- 70% stenosis narrowing of blood vessel from plaque.)

    European Diabetes Epidemiology Group's 2003 "DECODE" research shows that the interplay  of blood sugar and cardio-vascular risk can start even in the "normal" blood sugar range. The risk progresses in a linear
    fashion, yet there is no specific point where can say individual has passed the point of no return into danger.

    Again, the DECODE data's
    significance is that post-prandial (after meal) glycemia, and to a lesser extent fasting blood sugar level, is relevant to cardio-vascular events even in some non-diabetics.

    Non-diabetics can still share some of the 30 risky genes with type II diabetics and yet not become diabetic. We don't know which of us has what of those allelo-morphs (a.k.a. allele; a DNA sequence on a chromosome).

    So, non-diabetics (specificly those with the alleles similar to diabetics) may have normal fasting &/or normal post-prandial blood sugar yet be at risk of a cardio-vascular event. Furthermore, non-diabetics with suspiciously elevated fasting blood sugar are thought to be manifesting one of those genetic SNPs (single nucleotide polymorphism, a.k.a. mutation).

    Clinically 35% of diabetics have cardio-vascular events and 5 years later 35% of those go on to have a fatal incident. In comparison 24% of non-diabetics have cardio-vascular events, yet 5 years later 33% of those who share the risky allele(s)go on to have a fatal incident. In other words, everybody who took a first "hit" has virtually the same chance of dying; speculation is the non-diabetics who go on to die share the dying
    diabetics risky allele(s).

    Discussing what (say) grand-dads
    eating habits is annecdotal; as is we non-diabetics assumption time won't alter things for us.
    Many of us do not share genes with any diabetic risk, so Doc's "gluco-phobia" is irrelevant. He obviously
    sees plenty, diabetic and non-diabetic, who come to him so they won't die unnecessarily.

    For you who may live long enough to see routine testing, or doing research, here is a list of the 10 alleles most associated with European ancestry adult onset diabetes relevant to what was discussed above.

    It bears mentioning that each may have up to 3 allele sub-variations for each risk
    gene. In no particular order, they are:
    FTO rs8050136, IGFBP2 rs4402960,
    CDKAL1 rs7754840, HHEX rs1111875,
    SVC30A8 rs13266634, PPARG
    rs1801282, KCNJ11 rs5219, TCF7L2
    rs7903146, CDKN2A/B rs10811661and rs93000039.

  • Dr. William Davis

    2/24/2011 12:20:46 AM |

    Wow. I see I enter a fascinating conversation.

    In response to a question posed by Worldinside: The difficulty with carbohydrates differs substantially from person to person, based on 1) genetics, e.g., apo E2, 2) intensity of physical activity, 3) preceding lifelong carbohydrate exposure, 4) current weight and insulin sensitivity, 5) vitamin D status, 6) lectin content of consumed foods. There are other factors.

    Point: There cannot be a one-size-fits-all approach to diet. This is one of the main reasons I advocate postprandial glucose checks, a means to assess a specific individual's carbohydrate tolerance.

    And thank you, Eric and Terrence, for understanding that this is a blog and that I do my best to respond, given my time constraints. I've just finished a 10 hour day in the office, spent 2 hours starting in the early a.m. editing a new book (to be released by Rodale in fall). I now turn to website responsibilities until late tonite.

    There's only so much you and I can fit into a day.

  • Kent

    2/24/2011 4:13:42 PM |

    Can't wait for the new book, the first one was truly a God send.

    Does it have a title yet?

  • Anonymous

    2/24/2011 5:00:16 PM |

    I find this blog to be very helpful in sorting out what to eat and how it may effect me.  
    I have increased the amount of Vit D and fish oil that I take daily.
    He is providing a good public service with the blog for which I thank him.

  • ArtsyNina

    2/25/2011 1:26:37 AM |

    Dr. Davis- I've been following your blog for a while now and always enjoy your posts! Informative for sure - both the posts and all of the comments.  Your sign off question gave me a good giggle.  Keep up the good work!


    artsynina.blogspot.com

  • Gene K

    2/28/2011 6:22:23 PM |

    @Kent

    You can read the already written chapers of the book if you log in to the TYP site: trackyourplaque.com.

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  • John Gardner

    7/11/2011 5:23:22 AM |

    The American Heart Association had always given good advice on caring for one's heart. It is up to us if we heed them or not.

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