What role cholesterol medication?

10. April 2006 William Davis (0)
A frequent conversation point among my patients, as well as participants in the www.cureality.com program, is "Are cholesterol medications really necessary?"

No, they are not. What IS necessary is to correct all manifest and hidden causes of coronary plaque. Among these causes, in my view, is LDL cholesterol of 60 mg/dl or greater. There are many other causes of coronary plaque--e.g., small LDL particles, unrecognized hypertension, Lp(a), hidden diabetic patterns, etc.--but reducing LDL to 60 mg is still an important part of a plaque-reversing effort.

Insofar as we wish to get LDL to this goal, the statin cholesterol drugs like Lipitor, Zocor, Crestor, etc. may play a role. However, they should only be considered after a full effort dietary program is pursued. Don't follow the American Heart Association's diet unless you want to fail. It's nonsense.

For a more detailed discussion of how to use nutrition and nutritional supplements to reduce LDL cholesterol, go to www.lef.org, the website for the Life Extension Foundation. I wrote an article for their magazine called "Cholesterol and Statin Drugs: Separating Hype from Reality". You'll find the article at http://search.lef.org/cgi-src-bin/MsmGo.exe?grab_id=0&page_id=1295&query=davis%20cholesterol%20natural&hiword=CHOLESTEROLA%20CHOLESTEROLS%20DAVI%20DAVID%20DAVIE%20DAVIES%20DAVIN%20DAVIO%20DAVISON%20DAVISS%20DAVIT%20NATURALBASED%20NATURALES%20NATURALIZED%20NATURALLY%20NATURALS%20NATURE%20NATURES%20cholesterol%20davis%20natural%20.)

Can your plaque-reversal efforts succeed without statin drugs? It depends on your causes. For instance, someone with small LDL and Lp(a) only may do great on our basic program and then add niacin. Unfortunately, another person with a starting LDL cholesterol of 240 mg/dl--sky high--will have more success with these drugs.

Believe me, I am no blind supporter of drug companies and their flagrantly profit-seeking practices which, in my view, are cut-throat, shoving anyone and anything out of their way to increase profits and market share. I share many of Dr. Dave Warnarowski's views on how vicious their tactics can be; see his recent Blog post at http://www.drdavesbest.com/blog/ called "I smell a rat".

Nonetheless, the deep and well-funded research of the pharmaceutical industry does yield some useful tools. You don't have to love the insect exterminator, but if your house is being eaten by termites, his services can be useful. Same thing with these drugs. Useful--not the complete answer, not even close, but nonetheless useful in the right situations. Sometimes antibiotics are necessary, even life saving. That's how cholesterol drugs are, too.

Take it all in the proper perspective. Your goal is not cholesterol reduction, per se, but plaque control, preferably reversal.

Supplement Mania!

9. April 2006 William Davis (3)
Ever hear of "polypharmacy"? That's when someone takes too many medicines. People will have lists of 15-20 prescription medicines, for instance, with crazy interactions and oodles of side-effects.

Well, how about "poly-supplments"? That's when someone takes a large number of nutritional supplements.

Let me tell you about a 45 year old man I met.

In an effort to rid himself of risk for heart disease that he felt was likely shared with his family (brother and father diagnosed with heart attacks in their late 40s), Steve followed a program of nutritional supplementation. You name it, he took it: hawthorne, anti-oxidant mixtures, vitamins C, E, B-complex, saw palmetto, 7-keto DHEA, velvet deer antler, gingko biloba, policosanol, chronium picolinate, green tea, pine bark extract, St. John's Wort, CoEnzyme Q10, papain and other digestive enzymes...He became a distributor for a nutritional supplement company to allow him to afford his own extraordinary program.

To satisfy himself that he had indeed "cured" himself of heart disease, he got himself a CT heart scan. His score: 470, in th 99th percentile. Steve's heart attack risk based on this score was around 10% per year. High risk, no question.

For weeks after his scan, Steve admitted walking around in a daze, not knowing what to do. Years of telling himself that he had effectively dealt with his heart disease risk, now all down the drain.

When we met, I persuaded him that to think that this collection of supplements would reverse heart disease was magical thinking. We trimmed his list down to the essentials and got him on the right track.

Heart disease is controllable and reversible, but not this way. Don't fool yourself into thinking that some collection of supplements will be enough to stamp out your heart disease risk. Just like taking an antibiotic when you don't have an infection achieves nothing, so does taking the wrong supplements.

What does heart scanning mean to you?

8. April 2006 William Davis (0)
CT heart scans can mean different things to different people.


What does a heart scan mean to you? There are several possibilities:

1) A way of reducing uncertainty in your future.

2) A tool to crystallize your commitment to health.

3) A device to help you track how successful your heart disease prevention program is.

4) A trick to get you in the hospital.

5) A moneymaking tool for unscrupulous physicians hoping to profit from "downstream" testing, particularly heart catheterizations.


Like anything, heart scans can be used for both good and evil. How can you be sure that your heart scan is put to proper use--for your benefit and not someone else's profit?

Simple: Get educated. Understand the issues, be armed with informed questions.

If, for instance, you're a 55-year old female with a heart scan score of 90, active without symptoms, and you're told to have a heart catheterization right off the bat---run the other way. This is bad advice. A heart procedure like catheterization at this score in an asymptomatic woman is very rarely necessary. That decision can only be made after a step-by-step series of decisions are made by a truly interested, unbiased party. (A stress test is almost always required in this situation before the decision can be made to proceed with a catheterization.)

Unfortunately, in 2006, getting unbiased advice from your doctor is still a struggle. That's why we started Track Your Plaque---unbiased information, uncolored by drug or device company support, with an interest in the truth.

Coronary disease is drying up!

7. April 2006 William Davis (1)
I had an interesting conversation with a device representative this morning. He was a sales representative for a major medical manufacturer of stents, defibrillators, and other such devices for heart disease.

Since I'm still involved with hospital heart care and cardiac catheterization laboratories, this representative asked me if I was interested in getting involved with some of the new cardiac devices making it to market over the next year or two. "The coronary market is drying up, what with coated stents and such. We've got to find new profit sources."

Well, doesn't that sum it up? If you haven't already had this epiphany, here it is:

HEART DISEASE IS A PROFITABLE BUSINESS!

Why else can hospitals afford billboards, $10 million dollar annual ad campaigns, etc.? They do it for PROFIT. Likewise, device and drug manufacturers see the tremendous profit in heart disease.

The representative's comments about the market "drying up" simply means that the use of coated stents has cut back on the need for repeat procedures. It does NOT mean that coronary disease is on the way out. On the contrary, for the people and institutions who stand to profit from heart care, there's lots of opportunity.

Track Your Plaque is trying to battle this trend. Heart disease should NOT be profitable. For the vast majority of us, it is a preventable process, much like house fires and dental cavities.

Mammogram for your heart

6. April 2006 William Davis (0)
With the booming popularity of "64-slice CT scans", there's a lot of mis-information about what these tests provide.

These tests are essentially heart scans with added x-ray dye injected to see the insides of the arteries. However, to accomplish this, a large quantity of radiation is required. In addition, the test is not quantitative, that is, it is not a precise measure that can be repeated year after year.

It is okay to have a 64-slice CT coronary angiogram. It is NOT okay to have one every year. That's too much radiation. However, a heart scan can be repeated every year, if necessary, to track progression or regression. Once stabilization (zero change) or reduction is achieved, then you're done (unless your life takes a major change, like a 20 lb weight gain).

The tried-and-true CT heart scan is the gold standard--easy, inexpensive, precise, and repeatable. Not true for 64-slice angiograms.

Is your doctor using "leeches"?

4. April 2006 William Davis (0)
What if you went to your doctor for a problem and he/she promptly placed leeches on your body?

Yeccchhhh! Would you go back? I'd bet that you'd run the other way as fast as your bleeding legs could take you. Outdated health practices like "bleeding" are outdated for good reason.

Then why would you allow your doctor to approach your heart disease prevention program by checking cholesterol and then waiting for symptoms to appear? That miserable approach leads to tragedy and death all too often--ask Bill Clinton! He might as well have had leeches!

Don't allow your doctor's ignorance or disinterest impede your prevention program. Get your coronary plaque measured, then attack it from all sides by knowing all causes, hidden and obvious. That's why Track Your Plaque is such an effective program.

I often wonder why more doctors aren't using this unbelievably powerful approach to deal with heart disease. But when I see colleagues implanting stents, defibrillators, and the like for many thousands of dollars per patient, the answers are obvious. Given a choice of a rational, effective program of prevention that pays the doctor a few hundred dollars for his time, versus $2000 to $10,000 for a procedure, you can see that the temptation is irresistible for many physicians.

All in the family--What to do if there's heart disease in your family

3. April 2006 William Davis (0)
What should you do if a close relative of yours is diagnosed with coronary disease?
This question came up recently with a patient of mine. The patient--a strapping, 47 year old businessman who looked the absolute picture of health--was undergoing bypass surgery. Although I'd met him for the purposes of plaque reversal, he was already having symptoms and his stress test was flagrantly abnormal, all discovered after a heart scan score of 765. On the day after the patient's bypass, the patient's brother came to me. Understandably concerned about his own health, he asked what he should do. The answer: get a heart scan.
Measure the disease with the easiest test available. If his heart scan score is zero, great--he's at exceptionally low (near zero) risk for heart attack. A modest program of long-term prevention is all that's necessary. What if his score is like his brother, should he get in line for his bypass? No, absolutely not! But he will need two things: 1) a stress test to ascertain whether or not he's safe (60% likelihood a stress test would be normal), and 2) an effort to determine how the heck he got so much plaque. (We favor lipoprotein testing, of course, for greatest diagnostic certainty.)
Message: Learn from the lessons your own family provides. Don't let this valuable information go to waste.
Bet you can't fast

Bet you can't fast

26. May 2011 William Davis (28)
People who continue to consume the world's most destructive grain, i.e., wheat, can rarely endure fasting--not eating for an extended period--except by mustering up monumental willpower. That's because wheat is a powerful appetite stimulant through its 2-hour cycle of exaggerated glycemia followed by a glucose low, along with its addictive exorphin effect. Wheat elimination is therefore an important first step towards allowing you to consider fasting.

Why fast? I regard fasting as among the most underappreciated and underutilized strategies for health.

In its purest form, fasting means eating nothing while maintaining hydration with water alone. (Inadequate hydration is the most common reason for failing, often experienced as nausea or lightheadedness.) You can fast for as briefly as 15 hours or as long as several weeks (though I tell people that any more than 5 days and supervision is required, as electrolyte distortions like dangerously low magnesium levels can develop).

Among its many physiological benefits, fasting can:

  • Reduce blood pressure. The blood pressure reducing effect can be so substantial that I usually have people hold some blood pressure medications, especially ACE inhibitors and ARB agents, during the fast since blood pressure will drop to normal even without the drugs. (A fascinating phenomenon all by itself.)

  • Reduce visceral fat, i.e., the fat that releases inflammatory mediators and generates resistance to insulin.

  • Reduce inflammatory measures

  • Reduce liver output of VLDL that cascades into reduced small LDL, improved HDL "architecture," and improved insulin responsiveness. (The opposite of fasting is "grazing," the ridiculous strategy advocated by many dietitians to control weight. Grazing, or eating small meals every two hours, is incredibly destructive for the opposite reason: flagrant provocation of VLDL production.)

  • Accelerate weight loss. One pound per day is typical.


Beyond this, fasting also achieves unique subjective benefits, including reduced appetite upon resumption of eating. You will find that as single boiled egg or a few slices of cucumber, for example, rapidly generate a feeling of fullness and satisfaction. Most people also experience greater appreciation of food--the sensory experience of eating is heightened and your sense of texture, flavors, sweetness, sourness, etc. are magnified.

After decades of the sense-deadening effects of processed foods--over-sugared, over-salted, reheated, dehydrated then just-add-water foods--fasting reawakens your appreciation for simple, real food. On breaking one of my fasts, I had a slice of green pepper. Despite its simplicity, it was a veritable feast of flavors and textures. Just a few more bites and I was full and satisfied.

Once you've fasted, I believe that you will see why it is often practiced as part of religious ritual. It has an almost spiritual effect.

More on fasting to come . . .
Tags :

Comments (28) -

  • Soul

    5/26/2011 12:43:19 PM |

    Thought this interesting, talking about wheat, saw yesterday on the news that NBC is hosting "health week" this week.  It is sponsored by General Mills, if I remember correctly, with emphasis on the importance of eating whole wheat for good health.

  • Gene K

    5/26/2011 3:56:41 PM |

    1. Should I continue to take all my supplements and medications during fasting, e.g. Niacin, or does it depend?
    2. If upon fasting, satiety comes after eating a small amount of food, how do I make sure my nutrition is sufficient to maintain the muscle mass? How do you combine fasting and exercise?

  • Joe

    5/26/2011 4:52:26 PM |

    Gene, my guess is that you can't. Or shouldn't. But then you're probably not going to fast for more than a few days at most, so going without exercise for a few days is probably not going to cost you any muscle mass.

    I would also think it's probably okay to take your usual supplements, too.  Medicines may be a problem, depending on what they are.  People with serious health issues probably should avoid fasting altogether, unless under the close supervision of his or her doctor.

    I'm interested in hearing what Dr. Davis has to say regarding fasting.  Hurry up doc!

    Joe

  • Kent

    5/26/2011 5:22:21 PM |

    Is it true that fasting can also improve LP(a)?

  • Steve Cooksey

    5/26/2011 8:27:45 PM |

    Agreed Dr. Davis.

    I am a big fan of intermittent fasting.... looking forward to more posts.

  • Rob O.

    5/26/2011 8:54:14 PM |

    I've had a similar experience to your post-fast feeling upon eating by doing a 2 or 3 day liquid-only diet that's heavy on water and includes a large protein shake each day.  It's as though you have to periodically remind the part of your brain that listens to the stomach what "full" means.

    Like the others, I'm very interested in what the doc has to say in the next article in this series!

  • Paul

    5/26/2011 9:28:09 PM |

    To what extent does a person with impaired adrenal and/or thyroid function need to be careful when fasting or low-carbing?

  • Mark. Gooley

    5/26/2011 10:24:13 PM |

    Type 1 diabetic for 40 years, and nowadays I eat about a thousand-calorie high-fat breakfast and a similar dinner.  I rarely eat lunch, and skipping breakfast (simply omit the pre-meal shot of insulin) as well is usually not a big deal any more: I do it occasionally.  Control of blood sugar is much easier now, and Hb A1c around 6 rather than over 10: still room for improvement.  When I was eating skimmed milk with Grape-Nuts or Uncle Sam (whole wheat flakes with whole flaxseed) for breakfast I would have blood sugars as high as 300 by mid-morning and a powerful hunger by lunchtime.  Whatever benefits fasting may have, I find it a lot easier now than it once was, and plan to try it more often, as I'm still overweight.

  • Gene K

    5/27/2011 3:07:21 AM |

    Is snacking on raw green vegetables between meals also considered grazing?

  • JLL

    5/27/2011 11:22:09 AM |

    I experimented with intermittent fasting (IF) for a little over a year. I first got interested in IF through calorie restriction (CR) -- there were a couple papers suggesting that you could extend lifespan through IF without the CR, which seemed like the perfect combination.

    These papers are still quoted on many blogs, but I doubt many have actually read them, since none of them actually show you can increase lifespan without restricting calories. See this post for a more detailed analysis:

    http://inhumanexperiment.blogspot.com/2010/05/does-intermittent-fasting-increase.html

    Anyhow, I still think there might be benefits for doing intermittent fasting -- though I've also seen some studies showing it might have negative effects as well -- and certainly it seems pretty good for weight loss. When I was on a high-fat, low-carb diet and fasting for 24 hours, then eating for 24 hours, I was the leanest I'd ever been. And that was without trying or counting calories:

    http://inhumanexperiment.blogspot.com/2009/08/year-of-intermittent-fasting-adf.html

    And one more shameless plug, some tips for those who have trouble going without food for 24 hours (or more):

    http://inhumanexperiment.blogspot.com/2010/01/how-to-deal-with-5-most-common.html

    Personally, I never went for several days without food. I'm not sure it's needed for weight loss anyway, although it might have other health benefits.

    - JLL

  • Dr. William Davis

    5/27/2011 11:40:28 AM |

    Hi, Gene--

    Green vegetables have no discernible postprandial chylomicron/VLDL consequence and is the exception. I'd consider that safe "grazing."

    We usually hold niacin during a fast due to the fluid struggles, which can magnify the hot "flush." We usually continue the other supplements, however.

  • Dr. William Davis

    5/27/2011 11:41:49 AM |

    Hi, Paul--

    If not yet corrected, I don't think it would be a good time to fast, since you could feel pretty crumby during your fast.

    Fasting should be a positive experience, not something to endure. I'd wait until these issues are corrected.

  • Dr. William Davis

    5/27/2011 11:45:56 AM |

    Hi, JLL--

    Agreed. In fact, I believe that the greatest benefits of intermittent fasting are the subjective benefits of reawakened taste and appreciation of food, rather than the physiologic benefits. Nonetheless, it makes sense that, since atherosclerosis and arterial dysfunction are to a large degree postprandial phenomena, prolonged "no-prandial" periods might facilitate arterial health.

  • Carl N

    5/27/2011 1:26:16 PM |

    Is it possible that current wheat strains have been selected or genetically engineered to be addictive?

  • Steve O

    5/27/2011 4:36:54 PM |

    Today's Urban Dictionary Word of the Day: Carb Coma -- The sleepy feeling after eating a large meal comprised chiefly of carbohydrates, whether in the form of rice, noodles, bread or dough.  "Dude, I was totally dozing at the office after that giant serving of chow mein for lunch. Total carb coma."

  • Curtis

    5/27/2011 6:12:12 PM |

    I have been following Fast-5 for three years, and quickly got down to a healthy weight. I'm 58 years old and lost 25 lbs to get down to 160lb (5'-11''), and a reasonable BMI. I fast daily for 19 to 21 hours with absolutely no effort required - it is just the way I live now. During this whole time I have made no effort to restrict wheat in any way. I don't eat a lot of wheat and I don't eat it every day, but on the day after pigging out on pizza I have no trouble with my fasting. There's your black swan.

  • Might-o'chondri-AL

    5/28/2011 12:28:56 AM |

    Ketone metabolites from Beta oxidation of fatty acid, B-hydroxy-butyrate , increase when fasting;  these metabolites act on visceral fat receptor HM74A. The result is upregulation of the anti-inflammatory  molecule adiponectin;  it (adiponectin)  also keeps less glycerols  (think of tri-glyceride group).

    The increased adiponectin upshot is the white visceral adipose (not subcutaneous fat) does less lypo-lysis (fat cleaving) and there is a reduced level of free fatty acids going into circulation.  This relief, from excessive "freed" fatty acids ,  permits the response to insulin to improve (ie: sensitivity to insulin better) when go back to eating;  and the longer the fast went on for  the longer the boost of circulating adipinectins stays  around   than before.

    Low serum adiponectin levels are common in the obese, hyper-glycaemic,  diabetic;  individuals with  hyper-triglycerides, coronary artery disease (and often even the children of  hyper-tensives.  Metabolic syndrome tends to low adiponectin and concurrent high levesls of circulating triglycerides.

    The  actual anti-inflammatory action of adiponectin is a major  part of why the fast makes the body feel so much better;  the digestive  organ rest is given too much focus.   Many individuals report  " pain gone"  from diets  that favor more ketone derived energy
    production (like low carb,  calorie restriction &/or  ferments for gut bacteria) ;  because,  there too, the metabolite Beta hydroxy-butyrate is instigating more circulating adiponectin that  then stymies pro-inflammatory cytokines.

  • Dr. William Davis

    5/28/2011 3:08:20 PM |

    Hi, Might--

    You make a crucial point that, I believe, explains much of the benefits to fasting: via improvements in cytokine levels and tissue responsiveness, especially adiponectin.

    Fabulous!

  • Dr. William Davis

    5/28/2011 3:09:26 PM |

    Hi, Curtis--

    Exactly. There are going to be exceptions. However, I speak for the 80% or more people who do indeed have addictive and appetite-increasing relationships with wheat.

  • Shreela

    5/29/2011 6:08:03 AM |

    I wasn't able to fast when Dr. Davis started discussing it about 1-2 years ago. Most of my life, if I didn't "graze", I'd get hypoglycemic symptoms like my mother, and my paternal grandmother. My mother even got a note from my doctor that I had to have a sandwich before Jr high band practice, else I'd get headaches or light-headed - that's how long I've dealt with frequent hypoglycemia episodes.

    So I came up with my own personal mini-fast-challenge. I would only eat when an actual hypoglycemic symptom happened, ignoring the regular hunger pangs. Then when I ate, I avoided sugars, starch and wheat - I did have a bit of rice though. I'm guessing it was about 3-4 days before I could go 5-6 hours with no hypoglycemic symptoms, and about 10'ish days before I could go 12 waking hours with no calories (I draink tea with stevia).

    Looking back, both my parents' families ate lots of wheat: bread, biscuits, pasta, so that's probably what gave my paternal grandmother, mother, and then me our hypoglycemia. If I have a hypoglycemic symptom, I start my mini-fast-challenge again. I finally figured out my family's curse is wheat, so I avoid it except the occasional pasta dish.

  • Paul Lee

    5/30/2011 11:27:42 AM |

    I followed the "East Stop Eat" approach a while back, with good results. I agree with one poster that said best to skip the breakfast insulin surge. In fact I think the whole "three square meals" with grazing in between, needs to be challenged (perhaps one meal a day). My guess is that humans are designed to go days without food and have plenty of energy. Its an ability that needs to be regained. Also I gather fasting is good for HGH response, especially if combined with resistance training.

  • Matt Titus

    5/30/2011 4:34:48 PM |

    Dr. Davis, I have done intermittent fasting for a long time...so long, I have lost count but I think that it has been 4 years. I do my version on a daily basis so it I am not as strict as someone who does this occasionally. Now that being said, my final meal of the day is the meal that I begin my fast so I keep it as nutritious and ketogenic as possible. So, I eat my final meal at around 7:00 P.M. I don't eat again until 3:00 P.M. the following day. Eating is such a treat and I eat very tasty low carb food when I break my fast. I will have my morning coffee with heavy whipping cream and MCT oil. Or I will have a glass of water with MCT oil. I take my vitamin D at this time of day because it wards off any allergy bugs lurking in the air. This summer I would like to lose 10 lbs so I will just kick up my fasting method in intensify my diet by keeping it balanced between protein and fats.

    I am not athletic in the least but I find that being active is not hindered during fasting. I strongly believe that we should not need to eat before exercise. Nor should we need to eat immediately after exercise.

  • Mary Titus

    5/30/2011 4:38:17 PM |

    Sorry, I just noticed that post came up under my husband's name. That post on fasting should come up under my name Mary...I am the one playing flute.

  • Mary Titus

    5/31/2011 4:27:54 AM |

    Yes, I do agree with you . I read about HGH becoming activated through a combination of fasting and resistance training.

  • bbtri

    6/6/2011 1:17:06 AM |

    18 hour fasts are easy, 24 hour fasts are hard, but once I break the 24 hour barrier, another 12-16 hours isn't bad.  My diet isn't wheat heavy, but I certainly don't avoid it.  What works for me is moderate physical activity, which gets me over the hump.  The hump may be the switchover from carb burning to fat burning, which moderate activity of a couple hours duration trains the body to do.

  • Whoosh

    6/9/2011 6:36:41 PM |

    I was quite sold on IF but keep finding conflicting findings, any comments on this http://chriskresser.com/blog/intermittent-fasting-cortisol-and-blood-sugar/ ?

  • M R

    6/29/2011 9:22:19 PM |

    Dr. Davis,
    Please refer me to your source of  "wheat is destructive".  I have eaten Shredded Wheat breakfast cereal every day for 25 years.  It is the only breakfast cereal I am not allergic/sensitive to.  After eating it for breakfast, it fills me up and I do not eat again for 6 hours.  I understand about wheat products raising a person's glycemic index, but I have read that the fiber in Shredded Wheat takes so long to digest that it actually controls a person's blood sugar all day.
    I am a healthy, near ideal-weight 50 year-old female.  My experience finds this statement to be false: "wheat is a powerful appetite stimulant through its 2-hour cycle of exaggerated glycemia followed by a glucose low, along with its addictive exorphin effect".
    Thank you for your time.

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