Wow, these numbers are wild.  It'd be great to see where they are in six months, assuming a change in diet.

Did you see the WSJ article today?

"Giving Up Gluten to Lose Weight? Not So Fast"

The last sentence is priceless:

“Also, for dieters, going back to gluten after avoiding it can lead to stomach cramps, bloating, diarrhea and other symptoms, at least temporarily.”

If an egg had that effect on you, they'd do a recall.

http://online.wsj.com/article/SB10001424052748703846604575447413874799110.html

great post! would be cool if you could pipe the links to your posts into your twitter account as well (there are online services), so that it can easier be forwarded by followers of you.

The WSJ should give up the diet reporting and stick to what they (supposedly) know - financial news.  

There's giving up gluten and then there's giving up gluten but maintaining a high starch alternative grain  GF diet.   Of course replacing one starch with another won't result in weight loss if one is overweight.  It's even possible to gain weight on such a GF diet.    

Are people really silly enough to take diet advice from "creaky bones" Gwenyth Paltrow?

I watched the WSJ video.  It wasn't bad.  It was mainly ridiculing "gluten-free" imitation products.  The lady recommended eating natural foods that are gluten free.

I am completely baffled by some of the lipid panel numbers I see. She had 7 stents put in but there are many out there seemingly with no problems, with high numbers like that. Meanwhile I have eaten right and exercised seriously for the last 30 years, have never been overweight, always been in shape, had good lipid panel results but suffered a heart attack last year anyway. I just had bloodwork shortly before the attack and once again (as had been the case for years) I was told I was in perfect health. My triglycerides were good as was my CRP and my complete lipid panel. Actually any test I took ever, always produced good results. Even after my heart attack they couldn't get my heart rate up high enough in my stress test unless I ran longer and at the steepest incline. I'm still in great shape.....but I had a heart attack.  I never had a belly or bulge and still don't. 5'10" 169 lbs.  Go  figure.

My results after eight months: http://paleohacks.com/questions/9124/first-post-paleo-blood-work-results

After 8 months and -50lbs  I can safely say that the std American flour/sugar diet is complete bullshit.

I bet that poor woman has forgotten what it's like to feel good. She'll surely feel better with an improved diet. I wish her the best.

Re: WSJ article, I got a stomach ache that lasted two days the last time I ate a chocolate chip cookie made of wheat flour. That's some kind of "temporarily"!

Lipids after two years of high-fat, moderate-protein, very low-carb eating:
Total Cholesterol: 220, Triglycerides: 69,
HDL: 98,
LDL: 108.
I think I'll carry on that way.

After 7 stents and she still refuses to change her eating habits? I think that got my attention more than anything else in your report of this patient. I guess I am baffled on why people do not take charge of their health especially when expert advice is offered on a "silver platter".

Tommy,

Sorry to hear that.  I guess it goes to show nothing is a guarantee.  No matter what we do, the chance is always there.

Tommy, your case only goes to prove that cholesterol doesn't cause heart attacks.  
There is something else causing CVD.
Inflammation from Poly fat and grains seem the most plausible to me.

"Tommy, your case only goes to prove that cholesterol doesn't cause heart attacks.
There is something else causing CVD.
Inflammation from Poly fat and grains seem the most plausible to me."

I had my CRP checked and it was below 4 just before my HA. After taking care of myself for the last 30 years and always doing well in every aspect I really felt backed against the wall afterward. My numbers are very low now (pretty close to 60's across the board) but all of this is more complexed than just numbers.

Hi, Tuck--

That's great!

It reminds me of the USDA's request for public commentary on the food pyramid revision, prefaced by "We don't understand why, after we tell people to increase consumption of whole grains, they keep on gaining weight and becoming diabetic."

42--

Well said!

"eating right" and "taking care of myself" only tells me you were healthy by your standards or by the governments standards.  Most of the people I hear say "I eat healthy" means they eat lower fat but mostly trans fat when they do.

There has to be something causing your problem.  I would suspect what ever makes you extra hungry would be a possible cause.  Maybe it's too low cholesterol.  Agreed; very complicated.  Maybe it's just genetics.  Maybe there's something in the past 30 years that was not right but what?  A lot of maybes there.  Have you had a calcium score?

Tommy-

Do you have Lipoprotein(a)? You sound to me like a textbook Lp(a) case. Better get it checked and address it.

Trans fat? nooooooooo...lol.
No refined crap, no processed anything. Damn...I don't even eat ketchup(sugar)!! I consider AMA snobish about food intake. I had a conversation with a "heart healthy" dietitian from the hospital after my heart attack and she wanted me to have less than 50 g of fat per day (impossible). I told her I go by percentages of total calories consumed and explained it to her. She had no clue and didn't understand it in simplest terms. "Ok what if I wanted to consume more fat and just added non fat calories to my total intake....that would lower my percentage right? Uhhh....what? lol

@ David
I am thinking I may be LP(a) and I have been taking extra Vitamin D as well as a high dose of fish oil. Next cardiologist visit I will discuss Niacin as well as pattern B possibilities.

Tommy, what about stress and sleep?  Stress is a killer...

David, that is my suspicion. It's complicated because a lot of things happened at once at that time. Through July and August I was under stress from problems at work combined with personal family issues. In September i went on a cruise an ate up a storm as well as drank more than normal gaining 14 lbs. (my prior good blood labs gave me confidence ..ha ha ha.) Then I came home, worked out hard and lost all the weight in a week. Then my grand daughter got sick and I was very stressed out about it while my work issues were still mounting. In October I had an argument in the morning before leaving work (I had been switched to an overnight shift)and was stewing when I went to sleep. I woke up a few hours later having a heart attack. The rest is history.

Hi Dr. Davis.

These numbers are awful, but I think a point must be stressed regarding natural vs. industrial carbohydrate-rich foods. These numbers are not typical for normoglycemic folks who eat natural carbohydrate-rich foods.

Avoiding natural carbohydrate-rich foods in the absence of compromised glucose metabolism is unnecessary. Those foods do not “tire” the pancreas significantly more than protein-rich foods do.

Protein elicits an insulin response that is comparable to that of natural carbohydrate-rich foods, on a gram-adjusted basis (but significantly lower than that of refined carbohydrate-rich foods, like doughnuts and bagels).

http://healthcorrelator.blogspot.com/2010/04/insulin-responses-to-foods-rich-in.html

And nobody can live without protein. It is an essential nutrient. Usually protein does not lead to a measurable glucose response because glucagon is secreted together with insulin in response to ingestion of protein, preventing hypoglycemia.

I definitely get the whole low-carb thing, but I think you always use the extreme cases to make your point.  Even dietitians would not recommend that much starch.  In fact, many of the "top" dietitians limit starch quite drastically in their meal plans.  They are not as ignorant as you think.  However, because they have clinical experience (which I know you have too), they know that draconian, restrictive diets do not work.  Therefore, they work starches in the diet a bit, so people don't feel "deprived."  Still they choose "better" starch options like beans (OMG LECTINS!!!).

I do not believe for one second that the majority of people claiming to be eating according to the USDA guidelines are doing so within the correct caloric guidelines.  They are eating far too much and making terrible choices for starches to boot.  Portion control is tough obviously.  I think people who cannot master it may find low-carb useful because they eliminate starches/sugars outright and don't have to worry about serving sizes.  Plus, ketosis gives them a metabolic advantage allowing them to consume more calories and still lose weight.  It definitely is not an end all solution though.

Also, they don't bad mouth carbs in the press because people being people would start avoiding things like vegetables.

There is nothing inherently wrong with carbs.  We just have to eat them within reason.  Just like calcium for example.  Too much calcium is linked to heart attacks and prostate cancer.  But in moderate amounts, it is helpful.

Okay, I went my two weeks without wheat carbs. My results are purely non-scientific, but here goes. I lost 4 pounds, down to 156. I wasn't hungry at all. I didn't have any bread cravings like I thought I would. But I did have a hard time sleeping, for whatever reason.

After my two weeks I had angel hair pasta and a hamburger on a wheat roll. My stomach was slightly upset for a couple of days once I started eating wheat carbs again - probably just a coincidence though.

So I proved I could do it and I proved to myself that I wouldn't starve or go crazy without my bread. So, I think I'll be more careful about the wheat I put into my system. On the other hand, it looks like May needs to correct things and do it sooner than later.

Just goes to show ya. I'd *love* to weigh what Mary weighs - but it seems there is more involved that that. I just had an NMR test recently myself. Total LDL particle count was 2018. My doctor is freaked and says it's a horrible number. Every website I consult says it's a horrible number -though my small LDL is 212, only 10.6% of the total. But all the websites I consult say the total number is far more a risk factor than paticle size.

But what were the HDL and triglycerides of the people with high particle counts. High like Mary's? My own HDL (measured just last week) is 66 and my triglycerides 49.

But how do you get the particle number down? I've already been low-carb for four years, gluten-free for 18 months, avoid all sugars, take D3, magenesium, K2, 1500 mg niacin.

Might it go down if I can get my thyroid normalized? That's one issue I'm still trying to work through with my doctor. Sheesh, the older I get the harder it gets. So many things to consider I sometimes wonder how anyone manages to stay alive for a few weeks - let alone many years for most of us.

So for people with existing coronary artery issues and Small particle LDL is it true that increasing fat (especially saturated fat) only makes this worse? If you go low carb you need to also be low fat?
I read that "low fat" is bad for Pattern A but beneficial to pattern B.

Dr. Davis?

Google Hinze Hogendoorn http://tinyurl.com/3t48zhf
17-year-old Dutch undergraduate student Hinze Hogendoorn  has created scientific history with his simple experiments.

is there ever any good news from the food science arena?

Metabolite screening should be done to compare with old standard and apparently is being done to some extent; there will always be someone who reacts adversely to what is innocuous to most people.  Since field agriculture is not free of  problems there will always be need for adaptations.

Japanese daikon root pickle made today has a different degree of physiological benefit  than when made with a traditional old cultivar of smaller sized daikon.  Hinze's rats might have found old fashioned fare more appetizing but they don't have to struggle to produce it like hungry people worldwide must try to do.

*  2006 article "Transgenes has less impact on the transcriptome of wheat grain than conventional breeding"
Plant Biotechnology Journal 4, 369 - 380

* 2006 article "Effect of transgenes on global gene expression in soybean is within the natural range of variation of conventional cultivars"
Journal Agricultural Food Chemistry 56, 3057 - 3067

* 2008 article " Microarray analyses reveal that plant mutagenesis may induce more transcriptomic changes than transgene insertion"
Proceedings National Academy Science USA 105, 3640 - 3645

It's astounding that tests are not done -- are not mandated by law and international treaty -- on hybridized plants prior to the plants being sold for human consumption! One doesn't need to be a bio-chemist to see the danger there.  Of course, I have to wonder what kind of tests should be required.  Some dangers may not be readily apparent.  It could take a human generation or two for the problems to be recognized.  We are lab rats!

Our number one forage crop is in danger of infecting the nation's livestock with an organism that is causing infertility in a large percentage of food animals.

Don Huber Interview - Roundup Ready GMOs - PATHOGEN NEW TO SCIENCE.flv
swirly78777@mypacks.net

The URL to the Don Huber video is:  http://bit.ly/k25NpH

Thanks, MK.

Anyone with even a passing interest in food and food safety absolutely need to view the video link posted by MK Davis (no relationship).

Dr. Huber brings an incredible depth of insight into the glyphosate GMO crop question.

I'm surprised to see stuff about hybrid and GMO plants here.  

I was an avid gardener before I became disabled and very gung-ho about using open-pollinated seeds, mostly heirlooms.   Even though I didn't save seed, I only bought open-pollinated seeds and plants in order to encourage their preservation by seed companies.  No F1 seeds for me, and DEFINITELY no GMO.  

When you look into the history even a little bit, you realize even the so-called heirlooms are all pretty new plants.  

It's been a very short period of time that sweet corn has even existed - corn was always a grain, not a vegetable.  

Similarly, tomatoes used to be much more acidic than modern varieties are.  It used to be safe to can tomatoes in a hot-water bath.  But new tomatoes need to be canned in a pressure canner... or you have to add acid to the recipe to safely do the water-bath thing and avoid botulism.

Also, most people have no idea how much yummier heirlooms are.  Vegetables for factory farming have been bred for things like uniform harvest by machinery, ability to keep in storage, not bruising when shipped across country, etc.  Not for TASTE.  

A Brandywine tomato (my favorite heirloom) tastes NOTHING like what you can buy in a grocery store - because when individuals were doing the breeding, taste was a factor as opposed to  ease of machine harvest and transport and long-term storage.

You can get good seeds from companies that have taken the No-GMO pledge... such as Baker's Creek Heirloom Seeds, Bountiful Gardens, Southern Exposure Seed Exchange, Pinetree Garden Seeds and Seed Savers Exchange.

The largest problem is with corn.  Monsanto corn has a gene that makes the plant resistant to Round-up, their primary pesticide.  Even farmers who intend to raise heirlooms have found their fields pollinated by neighbor's Monsanto corn - and been sued since the gene is patented.  

Farmers that raise heirloom seeds have to raise corn in very isolated spots, and good seed companies test each batch of seed to make sure it's not been infected by the GMO gene.

Almost ALL corn available today is not only not open-pollinated, but not even normal hybrid corn; rather most of it is GMO.  There's a very few sources of things like non-GMO cornmeal and almost no sweet corn.  

Same with soybeans - it's all pretty much GMO.  

IMO, very good reasons to avoid these products in the diet.  I keep a small batch of non-GMO  cornstarch and non-GMO tamari for cooking purposes, but we eat very little corn or soy - and absolutely none of their oils.  Even the non-GMO stuff, corn is very carby, soy causes thyroid issues, and their oils are full of PUFAs. But the small amounts we use in our diet are absolutely non-GMO.

I forget if it's been released yet or not, but there's a GMO alfalfa coming down the pike.  If the gene is as invasive as the corn gene is, soon it'll be hard to find pasture-raised meat and dairy that hasn't been raised on GMO feed.  

The largest problem worldwide is in poor countries, where farmers traditionally saved seed to plant again the next year.  These folks literally cannot afford to buy seeds every year.  When all that is available is patented seed or hybrid seed, they are screwed in terms of being able to raise their own food.  People literally starve due to the geopolitics of GMO seed.

Read up on Monsanto.  They're pretty damned evil.  Probably responsible for more infant deaths than even Nestle.  I personally won't buy products from any company that sells Monsanto products; it's really THAT bad.

Well, I shall stop my rant now.  I've been ranting about this since back when I was in grad school doing recombinant DNA work myself... I'm getting bored with myself.  ;)

I actually stopped by to drop off this link for you, Dr. D: http://www.diabetesincontrol.com/articles/diabetes-news/10953-common-test-predicts-early-death-in-diabetes-

Thanks for the detailed commentary, jpatti. Exceptionally well said.

A return to the simplest forms of farming and plant selection are, I agree, are about the only ways to dodge all the genetic shenanigans provided by agribusiness. Scary stuff.

Now we know who the snesible one is here. Great post!

Thank you! for stating a musing I have expressed for years! Plant breeding starting with Mendel has probably done a whole lot more than soem obscure snippet of gene insertion....not being a proponet here but I agree that a much larger point is missed......but this theme seems to run in a lot of directions in the health world like worrying about "SmartMeters" and their radiation when that cell phone, cordless phone and wireless signals are right there in their face......or how African-American kids in urban environments are asthmatic and all the potential causes make the news  EXCEPT that the notion that that high carb diet they most likely are eating is the main trigger......ditto for all the suffering this population group has later in life.....

thanks for reviving this Mark Twain quote... to book end it  perhaps reviving Parkinson's Law would be appropriate.

Maybe "size matters" and maybe not so much. I am only 5'3" and 117 lbs yet I require 8000 iu/day to hold steady at around 50 ng/ml.  So small body needs large dose. I have seen the opposite as well.

I totally agree that the current recommendations are absurd but appropriate dosage for Vitamin D cannot be determined by body size nor any other observable I know of except for blood testing.

Grassrootshealth have recently published new data on responses to vitamin D supplementation.
A 25(OH)D test shows how your body responds to oral supplementation / sun exposure.
Everyone responds individually, most people require more than expected.
Remember in the same way our natural production of the anti-inflammatory anti-oxidant cholecalciferol has been disrupted by current lifestyle changes so to most people fail to get sufficient sleep, so production of the other anti-inflammatory antioxidant, melatonin, is disrupted by light at night and insufficient exposure to bright light during the day.
We make a  very good job of totally wrecking our natural secretion/production of anti-inflammatory anti-oxidant protection.  It's such a shame inflammation and oxidation create dysfunctional mitochondria resulting in metabolic syndrome, diabetes, heart disease cancer and Alzheimer's etc.
Pity we haven't sufficient common sense to go to bed early and spend time outdoors in the midday sunshine.

Vitamin D supplementation does not work in linear manner.  From International Journal of Cancer Research 2011 (pdf link on request by commentators):

Starting at the following vitamin D ng/ml participant levels and adding on increments of 1,000 25(OH)D supplement daily:

10 ng/ml + 1,000 D = 11 ng/ml
30 ng/ml + 1,000 D = 38 ng/ml
50 ng/ml + 1,000 D = 55 ng/ml
90 & above each 1,000 D adds 1.6ng/ml

* and 10,000 IU D daily put no one over 200 ng/ml "toxic" threshold
* and 50,000 IU D daily would be required to surpass 200 ng/ml and be toxic

Geoffrey: I completely agree.  I take 10,000 IU/day and at that I STILL only had 41 ng/ml in February.  My GP, who is, well, of substantially lower mass than I am -- probably to the tune of 100 lbs less, at least -- is in pretty much the same boat regarding dosage and results both.

While I don't disagree... we live in a culture were I'm sure their lawyers are telling them not to change their opinion.

Can we expect these expert associations to change their opinion when they are probably faced with law suits up their ... if they do?

Loved his post.
I have added graphs to IU which should be added for age, skin color, latitude, season, etc.
http://www.vitamindwiki.com/tiki-index.php?page_id=1460

The real deal with IOM's recommendation is that it is simple minded. It's more than conservative; it was doomed from creation. An RDA is a failed way to attempt to convey helpful nutrition information to the American public. Sometimes it takes more than one number to convey something of value, and sometimes oversimplifying a concept does more harm than the good generated by its discovery.

Size in weight, of different adults, is probably less of a factor in the D levels they each get from the same IU D taken as a supplement . The measurement is of our D in fluid concentration (ng/ml), not kg. of our body.

A 13 month baby dose of 600 IU/d
is safe for their blood volume. Adults have more blood volume than infants; the weight difference is a distraction (I think).

Between "average" adults we've
similar amount of blood volume.
Two "average" height adults taking the same dose of vitamin D (like rfrancis describes) are likely starting from a different baseline on ng/ml.

Data I reported was for 5 years tracking +/- 3,400 non-hispanic white adults : age 52 +/- 13 years; weight 74 kg. +/- 17 kg.; height 1.71 mt. +/- 0.10 mt.; latitude N. +/- 40.2*; women = 2090; men = 1312.

For some people who are taking a high dose of D3 and are not getting adequate levels as indicated by 25-hydroxy vitamin D test, 1,25 dihydroxy-vitamin D must be checked as well. They might be hyperconverters.

HI, Henry--

Wow! Nice work.

Anyone wanting to see a graphic representation of some thinking about vitamin D, take a look at the graphics commenter Henry Lahore created:http://www.vitamindwiki.com/tiki-index.php?page_id=1460


Hi, Daniel--

Well said!

One thing I would like to see noted on Vit D levels is the name of the lab that does the test. I believe there are only 2 labs in the US that do the test: Lab Corp and Qwest Labs. The reference ranges are different (Lab Corp 32-100 and Qwest 18-77)

I had my D tested in July of 2008 and was found to be low (15.8 Lab Corp). My doctor gave me the standard script for 50,000 units 1x a week. I knew that D3 was suppose to be superior to the D2 that was prescribed. I decided to go with the D2 for the first 8 weeks, then switch to D3 for the next 8 weeks to compare the results and rate of rise in Vit D levels.

On the D2 my levels went DOWN to 14.9! I was shocked. The nurse pretty much called me a liar and said I hadn't taken the D2. Not only did I take it, I was fanatic about it. I enjoyed the chance to do a small interesting experiment on myself. I then switched to D3 (Carlson Labs brand) for the next 12 weeks at 50,000 units a week. That brought my level up to the low 30s. I quit following the docs advice of 50,000 units per week and increased to 100,000. That got the level up in the 50s. I then read an article by the Iowa bone center in Waterloo, IA that recommended 150,000 units per week. After 4-5 months of that my level was 77. I now take 100,000 per week and am waiting to retest.

I take 10,000 u soft gels by Carlson Labs, and they are small enough to be easy to swallow. I get them at Vita Cost online, current price is $10.93 for 120.

(I am not affiliated in any way with Carlson Labs, their products just work well for me.)

"The Institute of Medicine kept thinking about vitamin D somewhere in the Stone Age"
If they did we would all be better off. You can gauge the optimal evolutionary level of vitamin D by looking at present day hunter gatherers. I don't have time now to find the link but it is in the 40-50 ng/ml range.

"You can gauge the optimal evolutionary level of vitamin D by looking at present day hunter gatherers. I don't have time now to find the link but it is in the 40-50 ng/ml range."

Reference please !

I think you will find that the highest vitamin D levels are found in northern Europe.

Vitamin D production from UV radiation: The effects of total cholesterol and skin pigmentation

RIP Frank Garland

My 71 yo husband's recent test came out surprisingly high at 111! The doctor advised him to stop taking extra vitD. He's been taking 2000IU for at least 2 years and his number was always around 50. Nothing else has changed. He only goes out into the sun maybe once a week for an hour or less.

Are mistakes common in these test results?  

I guess he'll have to retest soon to see.

Para-thyroid hormone rises and  the kidney tubules re-absorb calcium; then inactive 25 D is converted into active 1,25 D. If someone can show me cholesterol controls our para-thyroids I'd like to hear.

Low magnesium in circulation stops para-thyroid up-regulation.
Adequate magnesium is desireable for down the line active 1,25 D production.

I'm 6'2'' and 200 and so far I haven't been able to get my level above 31. I went from 3,000 to 5,000 units and picked up maybe two points. I switched to carlson oil based capsules and bumped it up to 8,000 a day. Wondering if I should push it to 12,000 (caps are 4,000 apiece). I plan on re-testing in August.

Kenneth

"I believe there are only 2 labs in the US that do the test: Lab Corp and Qwest Labs."

Single test:
http://www.zrtlab.com/vitamindcouncil/home-mainmenu-1.html?page=shop.product_details&flypage=flypage.tpl&product_id=4&category_id=1

If you trust the accuracy of blood spot tests for Vit D (and the Vit D Council seems to!)--
4 test kit:
http://www.zrtlab.com/vitamindcouncil/home-mainmenu-1.html?page=shop.product_details&flypage=flypage.tpl&product_id=5&category_id=1

For some, when the level of (inactive) 25 D hits 30 - 40 ng/ml the para-thyroid feedback loop kicks in. The hormone secretion diminishing then causes  a 25 D production down shift.

When the (active) 1,25D is being generated in the kidney tubules it draws down on the pre-cursor 25 D. For some individuals they might see measured blood level of 25 D drop then; if liver synthesis or fat storage slow to respond.

One commentator M.D. here made the point that we want to measure 25 D and not 1,25 D. It seems what's available on demand is more significant than what got activated already.

In November 2010, my vitamin D level was tested with the 25(OH)D, twice. The first result was 12 ng/ml and the second results (a week later) was 7 ng/ml. My doctor prescribed 50,000IU/week. I took that for about 8 weeks and through some more in-depth research which led me to this blog, I discovered the difference between D2 and D3 and, of course, my prescription is Ergocalciferol. At that point, I bought the Kirkland-brand 2,000IU D3 gelcaps and have been taking them (4 per day = 8,000IU or 56,000IU/week) since early- to mid-January. My levels were re-tested again on February 18, 2011 and it is 46 ng/ml.

Is that a quicker-than-normal increase in the 25(OH)D? It seems very quick for the level to rise 34-39 ng/ml. Should I reduce the dosage at this point or maintain it at 8,000IU/day for the next 3 months to see what the level does?

Thanks in advance for any advice or guidance those in the know can provide!

Jeff