Santa Claus is alive . . . and works for the drug industry

12. December 2008 William Davis (7)


Maybe your teenagers no longer believe in Santa Claus, but I assure you: Not only is he alive, I believe that we have evidence that he works for the drug industry!

Psshaww! you say. Yet another rant from that kook, Davis. Who can he pick on next? What other imagined "conspiracies" can he uncover?

Let me recount the evidence and I'll let you decide how damning it all is:

--Christmas is a culture of excess, overeating, celebration: Cookies, candy canes, pie, chocolate, egg nog, more cookies . . . A virtual wheat and sugar frenzy!

--Wheat and sugars make us diabetic!

--What does a diabetic look like? How about big protuberant abdomen, florid cheeks, baggy eyes (from sleep apnea)? The red outfit and beard is optional, of course. Could you think of a better representation of what happens to a person when they eat goodies all the time?


I therefore submit that Santa Claus is at the root of a campaign to cultivate diabetes! Diabetes: a growth industry that is raking in billions of dollars for the drug companies!

I'd bet that Mr. Claus would agree with the dietary advice dispensed by the folks at the American Diabetes Association website:

A place to start is at about 45-60 grams of carbohydrate at a meal. You may need more or less carbohydrate at meals depending on how you manage your diabetes.


Eat more carbohydrates, get fatter in the abdomen, require more medication to keep sugar low. Then start over: eat more carbohydrates, get fatter, more medicines. Kaching!

"You may need more?" Personally, I'd be rendered comatose and helpless if I indulged in such carbohydrate gluttony.

If Mr. Claus were, instead, interested in our health and keeping us non-diabetic, Christmas would be a time for pistachios, almonds, dark chocolates, and tea.

You want health advice? Don't ask Santa Claus!

Another case of aortic valve disease reduced with vitamin D

12. December 2008 William Davis (8)
I watched Seth's aortic valve deteriorate over a two year period.

I was first consulted in 2004 to offer an opinion on Seth's heart scan score of 779 and flagrantly abnormal cholesterol patterns, including triglycerides in the 400 mg/dl range. But I heard a murmur, as well, a murmur of a leaky aortic valve, "aortic valve insufficiency."

Over the next two years, I watched Seth's aortic valve worsen, going from mild leakiness to severe.

In 2006-2007, I tiptoed into vitamin D replacement and asked Seth to add some vitamin D. Time passed and Seth's aortic valve got progressively worse.

Over the past year, However, he's maintained a truly healthy level of vitamin D, with blood levels consistently in the 60-70 ng/ml range.

While Seth's last echocardiogram showed a severely leaky aortic valve, the most recent echo showed mild leakiness ("mild aortic insufficiency")--a dramatic reduction.

I continue to see this in many, though not all, patients with aortic valve disease. Though I've more frequently witnessed either stalled progression or reversal of aortic valve stenosis (stiffness), I've now seen a handful of people with aortic valve leakiness (insufficiency) also reverse.

I've posted about this peculiar phenomenon previously:

Aortic valve disease and vitamin D
More on aortic valve disease and vitamin D

Prior to vitamin D, I had NEVER witnessed any aortic valve disease stop or reverse.

A formal trial at some point would be invaluable.

Track Your Plaque Program Data Tracking Tools

7. December 2008 William Davis (3)
At last: After talking about the new Track Your Plaque community tools for the last year, our data tracking software is now available!



Track Your Plaque is, admittedly, somewhat data-intensive. The basic concept relies on the fact that we track heart scan scores, cholesterol values, lipoprotein values like percent small LDL and Lp(a), vitamin D blood levels, intake of omega-3 fatty acids, etc. Our new data tracking tools will help Members track their data over time.

Even more interesting, you can allow other Members (not required) to view your data for comments and feedback. You can also view the program data of other Members (if they choose to make their data "public") to learn how they are going about stopping and reversing their coronary plaque.

In other words, our graphic data tracking tools are yet another way we are using to acquire a collective wisdom on how to put a stop to coronary heart disease, heart attack, and perverse "let's make money with heart procedures" hospital solutions.

One of the aspects that helps make this work is the sharing of data. So far, the people who have begun to enter their data have all made their information "public." It's not truly "public," but viewable only by other Track Your Plaque Members. Also, Members can, in effect, anonymize their data simply by using a nickname, e.g., heartprotection or hearthawk.

The data tracking tools are in beta-test version, so there are bound to be a few glitches. But we're eager to hear from our Members' experiences on how to improve these tools. Report any problems or make your suggestions on the Track Your Plaque Member Forum--Technical Support.

Yet another reason to avoid fructose

6. December 2008 William Davis (5)
Have you seen the Corn Refiners Association commercial campaigns to educate the American public on the safety of fructose? If you haven't, you can view these interesting specimens on You Tube:

"Get the facts--You're in for a sweet surprise: Fructose is safe in moderation!"

Two Moms

Two lovers


Beyond the fact that fructose stimulates liver production of glycerol, which thereby increases liver VLDL production and raises blood levels of triglycerides; likely stimulates appetite; increases cholesterol levels; fructose has also been clearly implicated in increasing blood levels of uric acid.

Uric acid is the substance that, in some people, precipitates in joints and causes gout, the painful inflammatory arthritis that has been increasing in prevalence over the last four decades since the introduction of fructose in 1967. While blood levels of uric acid in the early part of the 20th century averaged 3.5 mg/dl, more recent population assessments have averaged 6.0 mg/dl or higher. (Non-human mammals who don't eat processed foods, drink fruit drinks or beer, and don't eat candy have uric acid levels of <2.0 mg/dl.)

Uric acid is looking like it may prove to be an important risk factor for coronary disease and atherosclerotic plaque. It is no news that people with higher blood levels of uric acid are more likely to experience adverse cardiovascular events like heart attack. People with features of the metabolic syndrome also have higher uric acid blood levels; the more characteristics they have, the higher the uric acid level. However, the prevailing view has been that uric acid is simply an accompaniment of these processes, but not causal.

However, more recent observations suggest that increased levels of uric acid may instead be a cause of metabolic syndrome and high blood pressure.

Increased blood levels of uric acid have been shown to:

--Increase blood pressure
--Induce kidney damage (even in the absence of uric acid kidney stones)
--Antagonize insulin responses

A diagnosis of gout is not required to experience all of the adverse phenomena associated with uric acid. (For not entirely clear reasons, some people, perhaps based on pH or other factors, are more prone to trigger crystallization of uric acid in joints, similar to the phenomena of sugar crystallization when making rock candy.)

Which brings us back to fructose, a sweetener that clearly substantially increases uric acid levels. I suppose that the mothers and lovers in the Corn Refiners' commercials are right to a degree: Our kids will survive, as will you and I, despite increases in triglycerides, enhanced diabetic tendencies, amplified appetites, and increased uric acid due to fructose in our diet. We will also likely survive despite being 100 lbs overweight, partly due to the effects of fructose.

But if long-term health is your desire for you and your family, fructose has no role whatsoever to play.

Interestingly, the obviously expensive and slick ad campaigns from the Corn Refiners' videos have triggered some helpful video counterarguments:

High-fructose corn syrup
Conspiracy for Fat America
High-fructose corn syrup truth


A full discussion of uric acid, the scientific data behind uric acid as a coronary risk factor, and the nutritional means to reduce uric acid will be the topic of a thorough discussion in an upcoming Special Report on the Track Your Plaque website.

Free the Animal

4. December 2008 William Davis (10)
Richard Nikoley from the Free the Animal Blog contributes this informative comment:



'Bout 18 months ago, I was at 230 (5'10) and looked awful. I was on Omeprezole for years for gastric reflux, a variety of prescription meds since early 20s for seasonal sinus allergies, culminating finally in the daily, year round squirts of Flonase-esque sprays (the best for control without noticeable side-effects), and finally, Levothroid for about the last 7 years or so, as I had elevated TSH (around 9ish).

My BP was regularly 145-160 / 95-110.

I decided to get busy. I modified diet somewhat, cutting lots of junk carbs, and began working out -- brief, intense, heavy twice per week. BP began coming down immediately, such that within only a couple of weeks I was borderline rather than full blown high. Then after about six months, a year ago, I went to full blown low-carb, high fat, cutting out all grains, sugar, veg oils, etc, and replacing with animal fats, coconut, olive oil. You know the drill. Then, first of the year I felt great and simply stopped all meds, including the thyroid. I also began intermittent fasting, twice per week, and for a twist, I always do my weight lifting in some degree of fast, even as much as 30 hours.

That's when the weight really started pouring off. Take a look:

http://www.freetheanimal.com/root/2008/09/periodic-photo-progress-update.html

http://www.freetheanimal.com/root/2008/08/faceoff.html

In July I figured it's about time for a physical. Here's the lipid panel, demonstrating am HDL of 106 and Try of 47, great ratios all around:

http://www.freetheanimal.com/root/2008/07/lipid-pannel.html

However, my TSH was even higher -- 16ish. It seems odd that I was able to lose 40-50 pounds of fat (10-15 pounds of lean gain for a 30 pound net loss at that time -- now an additional 10 pounds net loss).

One disclosure is that I was drinking too much, almost daily, and quite a bit (gotta save some vices...). Anyway, I'm at the point now where I want to drill down. I know I need to see an endocrinologist and have T3 and T4 looked at, but in advance, I wanted to see if the recent changes I've made could make a difference:

1. Stopped all alcohol.
2. Stopped most dairy, except ghee and heavy cream, and cheese is now used as a "spice," i.e., tiny quantities -- no more milk.
3. 6,000 IU Vit D per day.
4. 3 grams salmon oil, 2 grams cod liver oil.
5. Vit K2 Menatetrenone (MK-4) -- side story: getting off grains reversed gum disease for which I have had two surgeries, then supplementing the K2 DISSOLVED calculus on my teeth within days -- hygienist and dentist are dumbfounded. Stephan (Whole Health Source), who comments here, has an amazing series on K2.


If you view his photos, you'll appreciate just how far he has come.

Overall, Richard's program is wonderful and his pictures clearly display his success. However, Richard, thyroid function is indeed a problem, a problem that needs to be fixed ASAP. Remember, low thyroid function used to be diagnosed at autopsy at which time the coronary arteries and other arteries of the body were found to be packed solid with atherosclerotic plaque, even in young people.

I'd recommend:

1) Consider 200 mcg Iodine per day from kelp if you do not use iodized salt.

2) Seeing your doctor right away for thyroid replacement, hopefully with consideration of your T3 status.

3) A heart scan--Not to lead to procedures, but something for you to track over time as your program improves and thyroid function is restored.

Beyond this, keep up the great work. Great blog, too!

Low Thyroid and Plaque

3. December 2008 William Davis (12)
Having now tested the thyroid status of several hundred patients over the last few months, I have come to appreciate:

1) That thyroid dysfunction is rampant, affecting at least 25% of everyone I see.
2) It is an enormously effective means to reduce cardiovascular risk.


I'm not talking about flagrant low thyroid dysfunction, the sort that triggers weight gain of 30 lbs, gallons of water retention, baggy eyes, sleeping 14 hours a day. I'm talking about the opposite extreme: the earliest, subtle, and often asymptomatic degrees of thyroid dysfunction that raises LDL cholesterol, lipoprotein(a) (Lp(a), a huge effect!), and adds to coronary plaque growth.

Correcting the subtle levels of low thyroid:

1) Makes LDL reduction much easier

2) Facilitates weight loss

3) Reduces Lp(a)--best with inclusion of the T3 fraction of thyroid hormone.

Recall that, 100 years ago, the heart implications of low thyroid weren't appreciated until autopsy, when the unfortunate victim would be found to have coronary arteries packed solid with atherosclerotic plaque. It takes years of low thyroid function to do this. I advise you to not wait until you get to this point or anywhere near it.

I find it fascinating that many of the most potent strategies we are now employing in the Track Your Plaque process are hormonal: thyroid hormones, T3 and T4; vitamin D (the hormone cholecalciferol); testosterone; progesterone; DHEA, pregnenolone. Omega-3 fatty acids, while not hormones themselves, exert many of their beneficial effects via the eicosanoid hormone pathway. Elimination of wheat and cornstarch exert their benefits via a reduction in the hormone insulin's wide fluctuations.

We haven't yet had sufficient time to gauge an effect on coronary plaque and heart scan scores. In other words, will perfect thyroid function increase our success rate in stopping or reversing coronary plaque? I don't know for sure, but I predict that it will. In fact, I believe that we are filling a large "hole" in the program by adding this new aspect.

Fat and fiber composition of nuts

30. November 2008 William Davis (16)


From Mukuddem-Petersen J, Oosthuizen1 W, Jerling JC. J Nutr 2005.



If you haven't yet done so, adding raw nuts to your health program yields a broad panel of health benefits.

Contrary to conventional advice, nuts can be eaten in unlimited quantities. Provided they are raw--unroasted, unsalted (since salting only accompanies roasted nuts), not roasted in unhealthy oils like hydrogenated cottonseed or soybean (very common)--they do not make you fat, regardless of the quantity consumed. Beer nuts, honey-roasted nuts, mixed nuts roasted in unhealthy oils with salt added are either fattening or exert other unhealthy effects (e.g., hypertension, rise in Lp(a), and cancer from the hydrogenated fats).

Some notable observations from the chart:

--Hazelnuts and macadamians are the richest in monounsaturates
--Walnuts are the richest in the omega-6 linoleic acid, while also richest in the "omega-3" linolenic acid.
--From a fat composition standpoint, raw cashews and dry roasted peanuts aren't so bad.
--Pistachios figure pretty favorably in this analysis, rich in monounsaturates.
--Coconuts are unusually rich in saturated fat, though about half is lauric acid--an issue for future conversation.



Here's a listing of the fiber composition of nuts per 1 oz serving (about a handful):

Almonds (24 nuts) 3.5 g
Brazilnuts, dried (6-8 nuts) 2.1 g
Cashew nuts, dry roasted, with salt added (18 nuts) 0.9 g
Hazelnuts or filberts 2.7 g
Macadamia nuts, dry roasted, with salt added (10-12 nuts) 2.3 g
Mixed nuts, dry roasted, with peanuts, with salt added 2.6 g
Peanuts, all types, dry-roasted, without salt 2.3 g
Pecans (20 halves) 2.7 g
Pine nuts, dried 1.0 g
Pistachio nuts, dry roasted, with salt added (47 nuts) 2.9 g
Walnuts, English (14 halves) 1.9 g

Data courtesy USDA Nutrient Database


Note that almonds are the winners with 3.5 grams fiber per ounce, pistachios a close second. Pine nuts and cashews place last on the fiber content chart.

Not addressed by the charts is protein content of nuts, as well as the low sugar content, all additional beneficial aspects of nuts. Nuts are also a moderate source of magnesium (though seeds like pumpkin and sunflower shine in the magnesium content area).

Rather than micromanage the specific fat and fiber content of your diet, why not get a little of the good of everything on the list and just mix and match the nuts? (Mixed and matched on your own, of course, not a hydrogenated cottonseed oil nut mixture).

Flush-free niacin kills

29. November 2008 William Davis (12)
Here, I re-post a conversation I've posted before, that of the scam product, "no-flush" niacin, also known as "flush-free" niacin.

I find this issue particularly bothersome, since I have a patient or two each and every week who forgets the explicit advice I gave them to avoid these scam products altogether. Despite costing more than conventional niacin, they exert no effect, beneficial or otherwise. Niacin--the real thing--exerts real and substantial beneficial effects. No-flush or flush-free does nothing except drain your wallet. I continue to marvel at the fact that supplement manufacturers persist in selling this product. Ironically, it commands a significant premium over other niacin forms.

They are outright scams that should be avoided altogether.


My former post, No-flush niacin kills:

Gwen was miserable and defeated.

No wonder. After a bypass operation failed just 12 months earlier with closure of 3 out of 4 bypass grafts, she has since undergone 9 heart catheterization procedures and received umpteen stents. She presented to me for an opinion on why she had such aggressive coronary disease (despite Lipitor).

No surprise, several new causes of heart disease were identified, including a very severe small LDL pattern: 100% of LDL particles were small.

Given her stormy procedural history, I urged Gwen to immediately drop all processed carbohydrates from her diet, including any food made from wheat or corn starch. (She and her husband were shocked by this, by the way, since she'd been urged repeatedly to increase her whole grains by the hospital dietitians.) I also urged her to begin to lose the 30 lbs of weight that she'd gained following the hospital dietitians' advice. She also added fish oil at a higher-than-usual dose.

I asked her to add niacin, among our most effective agents for reduction of small LDL particles, not to mention reduction of the likelihood of future cardiovascular events.

Although I instructed Gwen on where and how to obtain niacin, she went to a health food store and bought "no-flush niacin," or inositol hexaniacinate. She was curious why she experienced none of the hot flush I told her about.

When she came back to the office some weeks later to review her treatment program, she told me that chest pains had returned. On questioning her about what she had changed specifically, the problem became clear: She'd been taking no-flush niacin, rather than the Slo-Niacin I had recommended.

What is no-flush niacin? It is inositol hexaniacinate, a molecule that indeed carries six niacin molecules attached to an inositol backbone. Unfortunately, it exerts virtually no effect in humans. It is a scam. Though I love nutritional supplements in general, it pains me to know that supplement distributors and health food stores persist in selling this outright scam product that not only fails to exert any of the benefits of real niacin, it also puts people like Gwen in real danger because of its failure to provide the effects she needed.

So, if niacin saves lives, no-flush niacin in effect could kill you. Avoid this scam like the plague.

No-flush niacin does not work. Period.


Disclosure: I have no financial or other relationship with Upsher Smith, the manufacturer of Slo-Niacin.


Copyright 2008 William Davis, MD

CT coronary angiography is NOT a screening procedure

28. November 2008 William Davis (3)
I've recently had several hospital employees tell me that their hospitals offered CT coronary angiograms without charge to their employees.

Among these hospital employees were several women in their 30s and 40s.

Why would young, asymptomatic, pre-menopausal women be subjected to the equivalent of 100 chest x-rays or 25 mammograms? Is there an imminent, life-threatening, symptomatic problem here?

All of these women were without symptoms, some were serious exercisers.

There is NO rational justification for performing CT coronary angiography, free or not.

What they really want is some low-risk, yet confident means of identifying risk for heart disease. Cholesterol, of course, is a miserable failure in this arena. Framingham risk scoring? Don't make me laugh.

Step in CT coronary angiography. But does CT coronary angiography provide the answers they are looking for?

Well, it provides some of the answers. It does serve to tell each woman whether she "needs" a heart procedure like heart catheterization, stent, or bypass surgery, since the intent of CT angiography is to identify "severe" blockages, sufficient to justify heart procedures.

Pitfalls: Because of the radiation exposure, CT angiography is not a procedure that can be repeated periodically to reassess the status of any abnormal findings. A CT angiogram every year? After just four years, the equivalent of 400 chest x-rays will have been performed, or 100 mammograms. Cancer becomes a very real risk at this point.

CT angiography is also not quantitative. Sure, it can provide a crude estimation of the percent blockage--the value your cardiologist seeks to "justify" a stent. But it does NOT provide a longitudinal (lengthwise) quantification of plaque volume, a measure of total plaque volume that can be tracked over time.

What's a woman to do? Simple: Get the test that, at least in 2008, provides the only means of gauging total lengthwise coronary plaque volume: a simple CT heart scan, a test performed with an equivalent of 4 - 10 chest x-rays, or 1 - 2.5 mammograms.

Perhaps, in future, software and engineering improvements will be made with CT coronary angiography that reduce radiation to tolerable levels and allows the lengthwise volume measurement of plaque. But that's not how it's done today.

The Wheat Deficiency Syndrome

26. November 2008 William Davis (21)
Beware the dreaded Wheat Deficiency Syndrome.

Like any other syndrome, you can recognize this condition by its many tell-tale signs:

--Flat abdomen
--Rapid weight loss
--High energy
--Less mood swings
--Better sleep
--Diminished appetite
--Reduced blood sugar
--Reduced blood pressure
--Reduced small LDL and total LDL
--Increased HDL
--Reduced triglycerides
--Reduced C-reactive protein and other inflammatory measures


Of course, you could choose to cure yourself of this syndrome simply by taking the antidote: foods made with wheat flour, like bread, breakfast cereals, pastas, pretzels, crackers, and muffins.

All the signs of the syndrome will then disappear and you can have back your protuberant abdomen, irrational mood swings, exagerrated appetite, higher blood sugar, etc.
Blood glucose 160

Blood glucose 160

26. February 2011 William Davis (28)
What happens when blood glucose hits 160 mg/dl?

A blood glucose at this level is typical after, say, a bowl of slow-cooked oatmeal with no added sugar, a small serving of Cheerios, or even an apple in the ultra carb-sensitive. Normal blood sugar with an empty stomach, i.e., fasting; high blood sugars after eating.

Conventional wisdom is that a blood sugar of 160 mg/dl is okay, since your friendly primary care doctor says that any postprandial glucose of 200 mg/dl or less is fine because you don't "need" medication.

But what sort of phenomena occur when blood sugars are in this range? Here's a list:

--Glycation (i.e., glucose modification of proteins) of various tissues, including the lens of your eyes (cataracts), kidney tissue leading to kidney disease, skin leading to wrinkles, cartilage leading to stiffness, degeneration, and arthritis.
--Glycation of LDL particles. Glycated LDL particles are more prone to oxidation.
--VLDL and triglyceride production by the liver, i.e., de novo lipogenesis.
--Small LDL particle formation--The increased VLDL/triglyceride production leads to the CETP-mediated reaction that creates small LDL particles which are, in turn, more glycation- and oxidation-prone.
--Glucotoxicity--i.e., a direct toxic effect of high blood glucose. This is especially an issue for the vulnerable beta cells of the pancreas that produce insulin. Repeated glucotoxic poundings by high glucose levels lead to fewer functional beta cells.

A blood glucose of 160 mg/dl is definitely not okay. While it is not an immediate threat to your health, repeated exposures will lead you down the same path that diabetics tread with all of its health problems.
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Comments (28) -

  • Pater_Fortunatos

    2/25/2011 8:20:12 PM |

    There are lot of unusual and interesting formulations you are using, but I really can't understand the meaning of this one:

    "Glycation and of LDL particles."

    Maybe my english is not the best (I am no native english speaker).Maybe you could enlighten me?

    About the article. Now I realize that during 35 years of life, I had lots of such glycemic  values and not having any idea about effects.
    Do you have any ideea about glycemic index if I eat quite a lot of fruits? (can't control it lately).

    Thank you!

  • Might-o'chondri-AL

    2/25/2011 8:50:30 PM |

    Hi Pater_F.,
    I just read this post too, so see your quote shows a word to edit out. Remove the word "and", then it reads correctly "Glycation of LDL ...."

  • Flavia

    2/25/2011 9:05:59 PM |

    Hi Dr. Davis,

    What do you think is a safe amount of carbs to eat in one sitting? No more than 50 maybe? What really gets me is the aging!! I do not want wrinkles!

    For a 5'4, 125lb woman, what would you recommend is the top limit of carbs to have per meal to avoid this?

  • susan

    2/25/2011 10:54:14 PM |

    Thanks for the info about how the body handles high glucose levels. Funny you should mention a glucose of 160…

    I generally stay with the low carb lifestyle. I’ve been checking my glucose on a fairly regular basis and it generally runs in the high 80s to high 90s. Exercise can bring it down to mid 70s. Fasting levels are creeping up into the low 100s.

    Late yesterday afternoon, however -- after a good low carb day -- I succumbed to my baser urges and consumed several handfuls of mini Reese’s PB cups. Pretty dumb, I know.  

    2 hours later, BG = 161  -- whoa, I guess that was even dumber than I thought
    After a good low carb dinner, BG = 99  -- respectable, considering  
    This morning’s AM Fasting BG = 150 – what the heck??  (it’s been running a little high, but not that high
    Large coffee w/ cream on the way to work, BG = 118  -- getting there, slowly  
    Low carb breakfast and lunch, BG = 113  -- wow! Never dreamed it would take this long  

    Well, I knew it was a stupid thing to do. Now I know how stupid it really was. I’m sure my BG will continue to come back down to a reasonable level. I’ve been toying with the idea of rejoining the gym and starting the Slow Burn program. Guess it’s time.

  • Dr. William Davis

    2/26/2011 12:41:00 AM |

    Thanks for catching the typo, Pater and Might.

    HI, Flavia--

    It is truly an individual thing. For some, it's 20, 30, or 50 grams. For others, it's zero.

    Body size, age, genetics, recent exercise, et. all enter into the equation. This is why I am a fan of checking postprandial blood glucoses.


    Hi, Susan--

    It can really be a sobering experience. When this happens to me, I feel awful for several hours, sometimes all day. I've learned that it's not worth the momentary indulgence.

  • belly fat exercises

    2/26/2011 7:22:01 AM |

    Yes insulin lowers blood sugar levels by converting glucose to glycogen which is stored in the liver and by increasing cell permeability to glucose.

  • Might-o'chondri-AL

    2/26/2011 8:41:02 AM |

    Individual liver condition may influence how dangerous the blood sugar reaction actually is.

    "Fasting, overnight, trigs (triglycerides) are mostly bound to VLDL. But once eat there are trigs complexed to chylomicrons (from the intestine), IDL (intermediate density  lipo-protein, a VLDL spin off), in standard VLDL and even HDL.

    HDL, "good" lipo-protein, is the returner of cholesterol from the peripheral regions of the body back to the liver; it too carries trigs. In the liver hepatic trig lipase enzymes hydrolize (cleave) off the HDL's trig load; and those trigs can then get complexed to both IDL and chylomicrons.

    The re-circulated trigs add to the new trigs certain foods generate. When we look specificly at LDL bound trigs those trigs were passed on over from VLDL trigs, whether if were freshly tagged onto VLDL or from overnight fasting VLDL trigs.

    In the case of chylomicron trigs and IDL trigs the lipase enzymes in the adipose (fat) tissue and
    intestine, as well as triglyceride lipase enzymes in the liver, cleave those trigs into component free fatty acids and glycerol. In practical terms that's when we get fat in a form we can "get fat" from.

    Fat in the liver tissue also causes extra fatty acids to go out into the blood stream and, among other tissue, into skeletal muscles. The muscles of course do have the potential to use fat as fuel.

    Only problem is when insulin resistance starts to develop progressively in the liver, when fat in there messes with our trig balancing act. The back log concentration of intra-hepatic trigs is one of the conditions
    when post meal hyper-insulinism is dangerous.

    Then there is a further complication. When insulin resistance starts to go on outside the liver those peripheral tissues keep performing lypolysis. They are
    trying to burn fat while waiting on blood glucose stuck outside their cells. So even more freed up fatty acids go back in the blood to burden the liver.

    At this stage the liver
    can't re-esterfy (break back down) the burden of free fatty acids into trigs. So more gets built into fat inside the liver and eventually can lead to blockages (steatosis). It is a vicious cycle looping trigs and free fatty acids in a double "whammy" on the liver.

    To recap the immediately preceeding. A new/young/healthy liver takes in a meal, produces some extra trigs and sends it out tagged to VLDL. Once liver damaged/old/fat there are high levels of free fatty acids in circulation, the liver response to insulin drops (liver insulin resistance), the liver passes along meals glucose but the skeletal muscles are full of trig derivatives (di-acyl-glycerides, to be precise), so the muscles don't pick up the glucose either.

    Once an individual's liver fat is interfering with things to an even worse degree there are further complications. Namely the trigs complexed to VLDL get out of the liver less and it is mostly chylomicron trig and IDL trig complexes circulating in the blood.

    In fact, a measurement where total trigs keeps dropping can
    indicate chronic liver disease. And in hepatitis the physical synthesis of VLDL is
    progressively reduced; the virus inhibits protein movement in the liver microsome needed for VLDL production.

    Remember there is a liver triglyceride lipase enzyme. It has several functions and can act as a binder for many other lipoproteins, including LDL.

    Individuals who geneticly, or due to pathology (like in hepatitis), produce too little of this enzyme have another problem. This enzyme insufficiency makes the blood
    level of HDL complexed trigs keep rising (trig can't be cleaved off HDL who brought it back to liver)so HDL can't do it's "good" cholesterol job.

    The same enzyme insufficiency also lets trigs complexed to LDL, IDL and chylomircrons become elevated in the blood stream.

  • Might-o'chondri-AL

    2/26/2011 9:04:46 AM |

    Cut off my post's theory, too long.

    If individual has no fat in the liver (or minimal liver fat that is not enough to mess up trig metabolism), then blood sugar spike generated trigs not a problem. This can be genetic propensity, liver circadian rhythm co-incidence &/or life style.

    Those laying down liver fat, geneticly impinged &/or life style disadvantaged seem to be getting good advice from Doc.

  • Anne

    2/26/2011 1:14:56 PM |

    Watch out if you are in intensive care. The American College of Physicians now recommends that blood sugar be maintained between 140-200mg/dL. Their main concern is blood sugar going too low. In Hospital Blood Sugar Levels Should be Higher

    They will also feed you an ADA approved high carbohydrate diet to guarantee those highs.

  • Nigel Kinbrum

    2/26/2011 3:05:29 PM |

    @Dr. Davis: Are those your own BG readings after eating oatmeal? If low-carb/keto adapted, eating a pile of carbs is a bad idea as glycolytic pathways are down-regulated.

    @Anne: How about wearing a bracelet with important medical information on it in the event of becoming unconscious?

  • Anonymous

    2/26/2011 3:09:43 PM |

    These recent blog entries regarding blood sugar are extremely simple even to the point of being vague.

    I have found a site that goes into great detail regarding blood sugar, its control, and the problems associated with both high and low blood sugar levels. The blogs entries are so successful that they were edited and published as a book.

    The author continues to blog weekly and includes practical detail, as well as references to current medical science. Don't let the label "diabetes" throw you. There is a tremendous amount of information regarding how to avoid T2DM with improved blood sugar control. How and when to check your blood sugar, using your meter to determine the impact of what you eat on blood sugar, the deleterious effects of higher than normal blood sugars, even what is normal sugar are all addressed and in useful detail...there are even discussions regarding low carb and paleolithic diets. If you want 5-10 quickly and poorly written sentences on a topic, read the HeartScan blog. If you are interested in reading entire well written intelligent essays visit these sites below. I think that the "MD" label misleads many readers. Don't let the fact that the writer of the Blood Sugar 101 sites is not an "MD" throw you. She is a diabetic and has lived with it for several years. Her approach to medical treatment is that it should be "evidence-based" which seems often missing from other sites.

    Take a few minutes to review,

    Blood sugar 101 (general information site)
    http://www.phlaunt.com/diabetes/

    Associated blog site
    http://diabetesupdate.blogspot.com/

  • Anonymous

    2/26/2011 4:59:13 PM |

    What happened to the post about the Blood Sugar site? It seems to have been deleted. I am sute that I saw it here earlier. Does anyone know the url for the site. it looked interesting.

  • Anonymous

    2/26/2011 6:45:18 PM |

    yeah i saw it too. seems poster was a bit critical of Dr. Davis last several postings. sorry don't have the web sites mentioned. didn't know that you could delete a post that you don't like.

  • Anonymous

    2/27/2011 2:30:17 AM |

    @ Anne,

    In the ICU, there is risk with both too high and too low a blood sugar.  Perhaps 140-200 is an unhappy medium where risks are balanced.

    'Recent research, including a study in the Feb. 15 issue of the Annals of Internal Medicine, has found that the use of intensive insulin therapy comes with an increased risk of low blood sugar (hypoglycemia) which can be deadly. The study also concluded that using intensive insulin therapy to significantly lower blood sugar levels isn't associated with greater improvements in health outcomes.'

    Many ICU patients aren't eating anything anyway.  It isn't until after they are on the general medical floor that the ADA diet is given, and their sugars chased down to a lower range with insulin and/or drugs!

    Teresa

  • Might-o'chondri-AL

    2/27/2011 2:32:27 AM |

    11,000 Koreans studied by Stamford's Sun Kim, M.D. published in Journal Clinical Endocrinology (2011):

    27% had fatty liver (ultrasound diagnosis); 47% of those with fatty liver had high fasting insulin vs. only 17% of those without fatty liver having high fasting insulin. All subjects with fatty liver also had high blood sugar, high trigs and low HDL.

    Participants followed for 5 years; and data correlated on those with, and those without fatty liver who became clinically diabetic. Study conclusion is that fatty liver in participants preceeds Type 2 Diabetes by +/- 5 years in a statistically significant number (ie: no fatty liver = less risk of developing adult onset diabetes).

    Doc undoubtably has new patients and blog readers who have mildly fatty livers that don't think he's right. He should make them hire Revelo to put them through their paces instead.(Joke attempt there Revelo, not a personal digg.)

  • Anonymous

    2/27/2011 5:07:52 PM |

    I am familiar with the web sites that were mentioned in the deleted post. I did not think the post was very critical at all. It only said that these sites provided more detailed information regarding the recent blood-sugar related topics being discussed here. By the way, these sites contain a good deal information that you will only see around here at the Doctor’s pay-to-join blog.

  • revelo

    2/27/2011 7:59:44 PM |

    The martinet in me would be happy to whip anyone into shape who needs it. Seriously though, even the most extreme exercise program is child's play compared to what happens when you get sick. Imagine someone saying to you: "First I'm going to saw through your ribcage, and then I'm going to slice through your arteries..." It's like something out of a horror movie. And yet that is what happens during open heart surgery. And then there are those ailments for which there is no medical relief, surgical or otherwise. Be afraid of getting sick, be very afraid. Be willing to endure any sort of diet and exercise regime to avoid getting sick.

  • Dr. William Davis

    2/27/2011 8:08:44 PM |

    Ni, Nigel--

    No, not my personal blood sugars, but typical responses I've seen in many patients.


    Re: deleted comments
    I have no problem with criticisms. I do have problems with people saying things like "you're an asshole" or similar comments that add nothing to the conversation.

    I now have a zero-tolerance policy for rudeness, but NOT criticism.

  • Anne

    2/27/2011 9:16:04 PM |

    @ Nigel - I like MediAlert bracelets.

    @ Teresa - IMHO, the ADA meal plan is much too high in carbohydrates. It does not make sense to me to cause an elevated blood sugar and then use a medication to bring it down. How about lower the carbohydrate load and use minimal medication? You can find this program in Dr. Richard K Bernstein's book "Diabetes Solution".

    I am T2 and am able to keep my blood sugars in a good range by diet alone by greatly limiting my carbohydrates.  

    I understand those in the ICU present with many challenges to obtaining optimal blood sugar control.

  • Anonymous

    2/28/2011 1:50:55 AM |

    @ Anne,

    I was concerned that anyone without medical training who didn't look at the article linked to in your post wouldn't realize that there are risks to both too low and too high blood sugars in the intensive care unit.

    The comment about the ADA diet and using insulin and drugs to control blood sugars, was meant to poke fun at the ADA.  I apologize.  

    Teresa

  • Helen

    2/28/2011 11:54:36 PM |

    I don't doubt that high blood sugars are harmful, but I do wonder if when they are very transient if the effect is so terrible.  I have always had poor glycemic control.  In terms of going to 200 on a glucose tolerance test, I have diabetes.  But my blood sugars have been lower on a low-fat diet than they were on a low-carb one.  It also now takes me three times as many carbs to get to 175 or so than when I was on a low-carb diet and they are disposed of very quickly - I get down to 75-90 within an hour and a half.  I do think I have a MODY-like form of diabetes - that I'm not particularly insulin resistant.  I'm still not sure what all is going on, but I've been checking my blood sugar rather compulsively for 10 months, and this is what I've found.  

    I'm nearly 45 years old, have great blood pressure, triglycerides of 44 (this may be part of my particular MODY diabetes profile - a few types have genetically low triglycerides), high HDL and low LDL.  I look young for my age.  I don't have any microvascular complications.  I'm still very concerned about my glucose levels, but whatever diet I'm on my BG goes up above 160 with nearly every meal (I can catch it if I test at just the right time), but transiently.  A high-carb diet makes my fasting glucose and between-meal readings much lower, so the overall average is lower.

    Perhaps M-Al is right, if you are  storing fat in your liver, or if you are insulin resistant, it's a different story.  Perhaps anti-oxidant status, overall diet quality, and other lifestyle factors have an impact that large-scale studies don't pick up, since the numbers and outcomes of those with a Dunkin Donuts diet are averaged in with those with a whole foods diet, one along the lines of what Stephan Guyenet suggests.  

    I do think I'm not normal, and a "normal" person with the blood sugars Dr. Davis cites is courting trouble.  But I'm worried about getting too obsessive about my normal, since there's only so much I can do to control it.  It might be that I can be healthy even given the givens.  

    I also think it's worth considering that someone on a low-carb diet often is going to have more trouble disposing of a sudden influx of carbs.  It takes about three days of consistently higher carbs before the body adjusts.  Some people clearly develop higher triglyerides and other trouble on a high-carb diet.  My point is just that the context of one's particular phenotype is important - and sometimes tough to figure out.

  • Might-o'chondri-AL

    3/1/2011 5:56:01 AM |

    Hi Helen,
    I don't want to over step blog protocol, so this is just feedback. The blood test for glycated hemoglobin shows how the blood glucose dynamic is playing out the last couple of months.

    HbA1c is that test and, I believe, Doc set a result over 5.5% is undesireable. Maybe it would give you some insight to how your ranges of blood sugar are playing out.

    Someone here (thank you sir) recommended summitcountymedicalsociety.prepaidlab.com ; I recently used them. Credit card payment gets you an email prescription (to print out) for blood tests, they've cooperating independent
    blood drawing clinics nationwide and lab results are emailed to you. (I needed their 800 phone # help some and they resolved every issue promptly.)

    Charge = US$13 for HbA1c test plus +/- $16 for processing fee(one fee for unlimited tests, it seemed). Their prices were so much cheaper than other online options.

  • Helen

    3/1/2011 11:51:40 AM |

    Thanks, M-Al -

    At initial Dx, my A1C was 6.4.  After seven months on a strict low-carb diet (like 60 g carbs/day) and a 20 lb weight loss (I'd only been 10 lbs overweight at Dx, for the first time in my life, but I lost 20 during that time.  I've now lost nearly 30, not all for good reasons.) it was down to 6.0.  I'm monitored quarterly and am due for another A1c.  We'll see if my lower readings are borne out by the test.  I don't expect miracles, but I'm doing the best I can.  Some people's blood sugars only come down so much.  Metformin was ineffective for me and insulin would probably be dangerous, since my BG dips so far on its own post-prandially after peaking.

  • Anonymous

    4/16/2011 9:58:46 AM |

    DISCLAIMER, MY ENGLISH IS NOT VERY GOOD and this is loong SO BARE WITH ME ON THIS,I HAVE READ @ printed all this BLOG AND DROVE MY FAMILY(DOCTORS) and FRIENDS @  CARZY 1 ! THANKS!

    So i finally got my  glucometer:  OneTouch Ultra (ahh) + brand new strips (ouch) not cheap here where i live...  my old man  (doctor, lives on a diet of coffee, diet soda, bread pasta, cookies, candy etc, etc, etc + a few drugs... and is tall and "lean") thinks im completely crazy. ( im 33, 78kgr, also lean and muscular)

    so my pattern: OMP-day  fasting
    ( 23h, 24h, 27h, 30 hrs regular fasts) + 3 day wrkts
    (home, chin ups, push ups, squats) rest of the tm im mostly sedentary

    my readings so far...

    D1: 13-4

    10:00 >  71mg/dL >  FS@BS (prior that  day ate a bit of candies... pascuas)

    11:00 >  ERROR (didnt put the right code, got pissed @ didn't test)

    D2: 14-4  (no carb)

    3:07 > 70mg/dL >  FS@BS

    EAT: meat (+)yolks(+) cheese (+) butter (-) water

    4:05  > 81 mg/dL > AE@BS

    5:05  > 77 mg/dL > AE@BS

    D3 15-4 "workout" day (chin ups)  + carb
    ERROR, 2 little blood, !"·$%didn't test  (assumed 70mg/dL  FS@BS)



    11:00 >EAT: (pWRKOUT)

    meat(-) yolks (+) cheese(-) butter (-) tomato juice (+) 350CC Whole MILK+ 100G " 60% CHOCOLATE"  ( 37g carbs. aprox 20@30g sucrose + milk sugars )
    this baby

    http://www.chocolatesaguila.com.ar/uploads/info_nutricional/tabletas_rellenas_3344.pdf

    ( copy paste if u care)

    11:00 >EAT

    12:05 >  75 mg/dL > AE@BS

    12:20 > 72 mg/dL  > AE@BS

    1:06 >  82 mg/dL > AE@BS  
    ( waited 2 long there?)

    2:09  > 70 mg/dL > AE@BS

    6:12 > 67 mg/dL > AE@BS

    D3 16-4  
    ("rest day" upped the carbs anyway)

    "FS@BS"  (didn't bother to test. low as usual, i guess)

    1:00 > ??? mg/dL
    EAT: salted peanuts... roasted in vegetable oil... 100gr (could not find my chocolate...)

    2:00 > ??? mg/dL
    EAT:
    one lean, small cut of meat+ ham+ 6 yolks omelet fried in butter,  the usual 100g cheeses- Roquefort, sardo, pategras,cuartirolo,feta, 6tbs tomato juice, salt, peeper, (napolitanta)

    Dessert: -2-  ice cold glasses of 300CC WHOLE MILK + 2 TBS of Cheap sugary cocoa powder  (approx 20@30g sucrose total + milk sugars)

    3:05 > 107 mg/dL (!)

    - moved my arse a bit and did 2  slow sets of dumbbell squats, (40 reps with16k w total, super slow and easy)

    3:36 > 83 mg/dL

    4:37 > 66 mg/dL

    ok, any comments ? are my number ok?  what makes more sense , eating chocolate ( fiber, slower absrs possible less sucrose, or drinking  milk?  (talking desert here) i do not  eat vegetables, ( just, pepers, tomato juice and mushrooms) do not  eat fruit, and of course do not even touch gluten nor refined crap, and always try to limit my PUFA, and fructose load.

    also im thinking i should test my BS levels differently?  maybe  eating one (large) H fat, H 2 moderate protein, meal per day changes things a bit?  so maybe waiting 1 hrs is not enough ( thats why i used milk x 2 today, and did not wrkout to speed things a bit)

  • Anonymous

    4/16/2011 10:19:41 AM |

    edit, im 68 kgr ( not 78) ... always do the same mistake, maybe i need to gain weight!

  • Anonymous

    4/16/2011 11:01:28 AM |

    OneTouch Ultra Meter
    Eating pattern: OMP-day  
    ( 23h, 24h, 27h, 30 hrs  fasts)


    D1 REST DAY

    3:07 > 70mg/dL >  FS@BS

    EAT: meat (+)  yolks (+) cheese (+) butter ( -)  water

    4:05  > 81 mg/dL > AE@BS

    5:05  > 77 mg/dL > AE@BS


    D2 WRK DAY

    11:00 >  71mg/dL  FS@BS

    EAT: meat (-) yolks (+) cheese(-) butter (-) tomato juice (+)  +  350CC Wf MILK + 100G " 60% dark chocolate"

    12:05 >  75 mg/dL > AE@BS

    12:20 > 72 mg/dL  > AE@BS

    1:06 >  82 mg/dL > AE@BS

    2:09  > 70 mg/dL > AE@BS

    6:12 > 67 mg/dL > AE@BS


    D3  REST DAY (upped the carbs, + added liquid sugar, wrst  case)


    1:00 > ??? mg/dL
    EAT: salted peanuts... roasted in vegetable oil... 100gr

    2:00 > ??? mg/dL
    EAT:one lean, small cut of meat+ ham+ 6 yolks omelet fried in butter, 140g cheese, 6tbs tomato juice,  (napolitanta) 2  ice cold glasses of 300CC W MILK WITH 2 TBS of Cheap sugary cocoa powder  (aprox 20@30g sucrose + milk sugars)

    3:05 > 107 mg/dL (!)

    -did 2   slow sets of dumbbell squats, (40 reps with16k w total, no effort)

    3:36 > 83 mg/dL

    4:37 >  66 mg/dL

    Hypoglycemia?
    any opinions about my numbers, (imm33) should i ditch the milk @dark chocolate and eat "healthy vegetables" and "fruit" (no)


    should i wait longer 2 test my BS? (slower digestion time, one meal and all)

  • Anonymous

    4/17/2011 8:50:49 AM |

    today


    17-4 > WRKT

    9:00 > 69 mg/dL

    10:58 > EAT (6 YOLKS, CHEESE, BUTTER, 1TBS TOMATO JUICE - OMELET + 400GR MINCED MEAT, 6 STRIPS BACON, 5TBS TOMATO JUICE, BUTTER)

    2:07 > END

    DISHWASHING

    2:16 > 350cc WHOLE MILK

    2:21 > 100G 60% chocolate

    2:34 > END

    2:40 > 300cc WHOLE MILK + 1 TBS SUGAR (nesquik)

    3:01 > 71mg/dL

    3:36 > 74mg/dL

    4:39 > 83mg/dL

    5:42 > 74mg/dL

    650cc milk + lots of  sucrose... where is the zomg 160 blood glucose doctor? (btw i had been eating sucrose @ and grains like crazy 90% of my life, now im eating waay less sugar and 0 grains)

  • Anonymous

    4/17/2011 11:57:29 AM |

    edit,

    1:58 > EAT  (not 10:58...)

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