Wheat-free 2007


Long ago, most of us made the change of reducing saturated fat in our diet. Few people now rely on butter (despite the idiotic butter vs. margarine controversy), full-fat dairy products, fried foods, and greasy meats. That's a healthy change, since saturated fat has conclusively been tied to various cancers, high blood pressure, rise in LDL, and is calorie-dense.

But if there were just one change you were to make beyond a reduction in saturated fat, a change that would translate into dramatic health benefits, it would be a drastic reduction, even elimination, of wheat products.

People do indeed eat enormous quantities of wheat flour-containing products. U.S. per capita consumption of wheat flour was 110 pounds in the early 1970s, and rose to 141 pounds in 1991. It's even higher now. 20% or more of most people's caloric intake every day is provided by wheat flour products.

Wheat containing foods are tasty and convenient. Witness the popularity of bagel shops, the goodie counter at Starbuck's, the proliferation of crackers, breads, and breakfast cereals at the grocery store. Patients are horrified when I suggest that they find a substitute for the sandwiches they eat every day. Even Mom said they were okay!

You're unlikely to hear much about this from the popular press. The wheat industry is enormous and exerts extraordinary clout, just like the drug industry. Texas alone farms 6 million acres of wheat, yielding over $2 billion for the state's economy. The "wheat chain" is complex and far-reaching: growers, processors, food manufacturers, the transportation industry, retailers, chemical producers, and on and on. Wheat futures are traded on the Chicago Board of Trade. Wheat is a major export industry for the U.S.

Of course, these are not evil people, intent on corrupting your health. In fact, most of them are probably working under the perception that they are raising a healthy product. The point is that the notion that wheat is healthy is deeply entrenched in the minds and economy of the U.S. Don't expect to hear unbiased commentary on the health effects of wheat products from most media sources.

What can you expect if you sharply reduce or eliminate wheat? The majority of people:

--Feel like a cloud has been lifted from their thinking.
--Don't experience the afternoon blah or tired feeling after lunch.
--Lose weight, sometimes substantial quantities.
--Raise HDL.
--Reduce small LDL.
--Reduce triglycerides, particularly if they start >100 mg/dl.
--Reduce blood sugar.

The reduction in small LDL can be especially impressive.

For most people, reducing or eliminating wheat is a sacrifice, a major change in food choices and even a loss of convenience. But the health benefits for most people can be dramatic.

Is vitamin D a "vitamin"?

Vitamins are crucial participants in the body's reactions and are obtainable from food. Vitamin C, for example, comes from citrus fruits and vegetables. Vitamin K comes from green vegetables. The B vitamins are found in meats, soy, dairy products, and grains. Vitamin A comes from carrots, squash, and other orange and green colored vegetables.

How about vitamin D? What foods contain vitamin D? The list includes:


Food International Units(IU) vitamin D per serving

Cod liver oil, 1 Tablespoon 1,360
Salmon, cooked, 3½ ounces 360
Mackerel, cooked, 3½ ounces 345
Tuna fish, canned in oil, 3 ounces 200
Sardines, canned in oil, drained, 1¾ ounces 250

Milk, nonfat, reduced fat, and whole, vitamin D fortified, 1 cup 98
Margarine, fortified, 1 Tablespoon 60
Pudding, prepared from mix and made with vitamin D fortified milk, ½ cup 50
Cheese, Swiss, 1 ounce 12

Ready-to-eat cereals fortified with 10% of the DV for vitamin D, ¾ cup to 1 cup servings (servings vary according to the brand) 40

Egg, 1 whole (vitamin D is found in egg yolk) 20
Liver, beef, cooked, 3½ ounces 15

(Modified from the Office of Dietary Supplements, National Institutes of Health)


You'll note that the only naturally-occurring food sources of vitamin D are the modest quantities in fish, egg yolks, and liver. All the other vitamin D-containing foods like cereal, milk, and other dairy products have vitamin D only because humans add it.

It takes me (personally) 6000 units of vitamin D per day to bring my blood level to an acceptable 50 ng/ml. To obtain this from eating salmon, I would have to eat 58 ounces, or 3 1/2 pounds of salmon--every day. Or, I could eat 30 cans of tuna fish.

If I didn't want to eat loads of fish every day, I could drink 60 glasses of milk every day. After I recovered from the diarrhea, my vitamin D might be adequate, provided the milk indeed contained the amount stated on the label (which it often does not when scrutinized by the USDA).

If vitamin D is a vitamin, how are humans supposed to get sufficient quantities? I don't know anybody who can eat 3 1/2 lbs of salmon per day, nor drink 60 glasses of milk per day. But aren't vitamins supposed to come from food?




The problem is that vitamin D is not really a vitamin, it's a hormone. If your thyroid hormone level was low, you'd gain 20, 30, or more pounds in weight, your blood pressure would skyrocket, you'd lose your hair, become constipated, develop blood clots, be terribly fatigued. In other words, you'd suffer profound changes. Likewise, if thyroid hormone levels are corrected by giving you thyroid hormone, you'd experience profound correction of these phenomena.

That's what I'm seeing with vitamin D: restoration of this hormone to normal blood levels (25-OH-vitamin D3 50 ng/ml) yields profound changes in the body.

If there's one thing that I've come across lately that packs extraordinary potential to help us in reducing heart scan scores, it's the vitamin--sorry, the hormone--cholecalciferol, or D3.

Heart scan curiosities 3


Note the shape of the chest in this 64-year old man. The front of his chest (upper portion of scan) is concave. In other words, if you were looking at this man (shirtless, of course) face to face, his chest would bow inward, rather than the usual outward configuration. The official name for this is "pectus excavatum".





Compare this to the normal chest in the second image, in which the chest is convex. Face to face, the chest would bow slightly outward.















What does it matter? The pectus excavatum in and of itself has no importance, just a curiousity. (I personally find this surprising, given the fact that the heart actually appears squashed by the sternum, or chest wall.) However, it is commonly associated with a "floppy" mitral valve (also called mitral valve prolapse), a common congenital disorder of the mitral valve often accompanied by a slender build, loose joints, and even a nervous disposition. Occasionally, in its more severe forms, the aorta is also enlarged. (This man's aorta is not enlarged.)

So, while we can't actually visualize the mitral valve by a CT heart scan, we can surmise that he likely has a floppy mitral valve, is slender, is probably a nervous sort, and has long limbs with loose joints. He probably required braces as a child, since many people have a phenemenon of "crowded teeth". The roof of his mouth, or hard palate, probably unusually high up in the mouth. He probably has a "weak chin", meaning a less prominent protuberance of his chin. His fingers and toes are likely unusually long and slender.

It could mean that some attention and exploration of how floppy his mitral valve might be could be useful, e.g., an ultrasound or echocardiogram. He might even require oral antibiotics at the time of any oral or some gastrointestinal procedures, since floppy valve are more susceptible to blood infections when potentially "dirty" orifices are instrumented.

All that from a heart scan!

Gratitude

The holidays and the end of the year may be a good time to reflect on how grateful we should be for having the freedom to discuss the ideas we share on this Blog, the Track Your Plaque website, online and offline.

Although I rant and rave against the status quo in heart disease, the shameful profiteering of my colleagues and hospitals, the cut-throat marketing practices of drug and device manufacturers, I am truly grateful that, in the U.S., I have the extraordinary freedom to say these things. You have the freedom to agree or disagree and none of us pays a price for truth.

I've been reflecting myself a great deal on this idea of happiness and gratitude being a critical component of coronary plaque regression and dropping your heart scan score. (See The Heart Scan Blog from earlier this week.) The more I think about this, the more I think that it is indeed true: Harboring anger and resentment, regrets, irritability, all those petty emotions that most of us know are not good for us, erode our chances for success in dropping your heart scan score.

We could rationalize it this way: Anger and other negative emotions are adrenaline-driven states, also characterized by activation of the "sympathetic" nervous system. (Despite its name, the sympathetic system is not sympathetic, as in compassionate; its the "fight-or-flight" activator that accelerates heart rate and blood pressure.)

Happiness, contentment, and gratitude are "parasympathetic" states characterized by slower heart rates, deeper respiration, greater variation in beat-to-beat heart rates (a powerful predictor for health and the basis for the HeartMath program of Lew Childre), lower blood pressure, and even a subtle change in brain waves. In other words, happiness is not just a mental and emotional state, it is a constellation of physical phenomena.

Even though I pick on Dr. Dean Ornish for his stubborn adherence to the outdated low-fat mantra, I do agree with him on the value of happiness. His book, Love and Survival, articulates this concept. Ornish has even said on several occasions that it wasn't the diet that was most important but the connection and warmth that was created by the comraderie created by participation in the Ornish Program group sessions.

I am personally grateful that the concepts I promote are gaining a following and that I can say so without fear of prosecution. I am grateful that Track Your Plaque followers are not just sharing our concepts, but obtaining genuine and powerful health advice that will help keep them home and healthy, away from hospitals, procedures, and the dangers of heart disease.

I hope you share in my gratitude and are thankful for all the truly wonderful things that surround us. I wish you all a wonderful holiday and long, healthy life filled with gratitude.

A Track Your Plaque failure

We recently had a man suffer a heart attack after beginning the program. Let me tell you the details.

Jerry's heart scan score 781, age 53. Multiple lipoprotein abnormalities: HDL 32 mg/dl, triglycerides 279 mg/dl, nearly all of his LDL was in small particles with an "effective" LDL (LDL particle number), and very high IDL. So Jerry added fish oil 6000 mg per day, niacin, and vitamin D to the statin drug prescribed by his primary physician. Jerry added oat bran, ground flaxseed, and tried to eat fish at least once per week.

However, Jerry continued to smoke. He'd smoked for 40 years (!), up to 2 packs per day, and just reasoned that it was too late to quit. He also continued to indulge in the packaged, processed foods that were part of his convenience story business.

Jerry's stress test was normal--no chest pain, normal EKG, normal images of blood flow, though he was somewhat breathless, likely from his lung disease from smoking.

Two months into his program, he abruptly experienced severe crushing pain in his chest. Because he was traveling, he ended up in a small local hospital. A failed angioplasty led to urgent coronary bypass surgery.

Jerry's alive. Now he's a non-smoker. He's got the pursed lips and peculiar breathing pattern that smokers get, but he's breathing.

Lesson: In the face of the most powerful program for heart disease known, it can still be overpowered by Twinkies, Hoho's, pretzels, chips--and cigarettes.

The new year is approaching. Be grateful for another year of healthy life and commit to a new year of even greater health. If you're a smoker, there's no choice: you've got to quit.

Are you more like a dog or a rabbit?

Dr. William Roberts, editor of the American Journal of Cardiology and cardiovascular pathologist, is a perennial source of clever ideas on heart disease.
In a recent editorial, Dr. Roberts comments:








"Because humans get atherosclerosis, and atherosclerosis is a disease only of herbivorers, humans also must be herbivores. Most humans, of course, eat flesh, but that act does not make us carnivores. Carnivores and herbivores have different characteristics. (1) The teeth of carnivores are sharp; those of herbivores, flat (humans have some sharp teeth but most are flat for grinding the fruits, vegetables, and grains we are built to eat). (2) The intestinal tract of carnivores is short (about 3 times body length); that of herbivores, long (about 12 times body length). (Since I am 6 feet tall my intestinal tract should be about 60 feet long. As a consequence, if I eat bovine muscle [steak], it could take 5 days to course through those 20 yards.) (3) Body cooling for carnivores is done by panting because they have no ability to seat; although herbivores also can pant, they cool their bodies mainly by sweating. (4) Drinking fluids is by lapping them for the carnivore; it is by sipping them for the herbivore. (5) Vitamin C is made by the carnivore's own body; herbivores obtain their ascorbic acid only from their diet. Thus, although most human beings think we are carnivores or at least conduct their lives as if we were, basically humans are herbivores. If we could decrease our flesh intake to as few as 5 to 7 meals a week our health would improve substantially."



You can always count on Dr. Bill Roberts to come up with some clever observations.

I think he's right. Some of the most unhealthy people I've known have been serious meat eaters. Most of the vegetarians have been among the healthiest. (I say most because if a vegetarian still indulges in plenty of junk foods like chips, crackers, breakfast cereals, breads, etc., then they can be every bit as unhealthy as a meat eater.)

Should you become a vegetarian to gain control over coronary plaque and other aspects of health? I don't believe you have to. However, modern livestock raising practices have substantially modified the composition of meats. A steak in 2006, for instance, is not the same thing as a steak in 1896. The saturated and monounsaturated fat content are different, the pattern of fat "marbling" is different, the lean protein content is different. Meat is less healthy today than 100 years ago.

Take a lesson from Dr. Roberts' tongue-in-cheek but nonetheless provocative thoughts. Pardon me while I chew on some carrots.

Are happy people more likely to reduce heart scan scores?

I was talking to Darryl, a patient today: 71 years old with a heart scan score of 378, as well as an enlarged aorta (4.5 cm).

We had identified numerous lipoprotein abnormalities 12 months ago and advised him on a program for correction. His patterns included small LDL, high triglycerides, sky-high IDL (VERY important when you have an enlarged aorta), and lipoprotein(a). Blood pressure was also high, another crucial fact to correct when the aorta is enlarged.

Anyway, Darryl corrected lipoproteins to perfection: basic lipids were substantially better than 60-60-60; lipoprotein(a) was reduced well into the desirable range; IDL was eliminated; blood pressure was 108/64. Repeat heart scan score: 354.

There's nothing spectacular about Darryl's story, except that, despite these issues, Darryl was a happy man. He smiled throughout our conversation. He has told me on several occasions how grateful he is for the life he has.

Darryl is not wealthy. He retired around 4 years ago and fills his day with helping his wife, walking outdoors, helping out at his church, and contributing to the care of his grandchildren. Through all this Darryl is incurably, unfailingly, and irrepressibly happy.

It made me think back through all the other people who've also had great succes in their Track Your Plaque program. It struck me that, for the most part, they too were a happy bunch: generally optimistic, happy, not overly stressed nor prone to extremely stressful responses to stressful situations. All seem to also be grateful for the good in their lives, though most had no more money than the average person and had their share of difficulties in life. In fact, I can only recall one person who reversed coronary plaque who was an angry, pessimistic personality. Just one.

Could it be that happy, optimistic people are more likely to reverse coronary plaque? It would, after all, be consistent with all the other observations that type A personalities have more heart attack, etc.

Anyway, this is just an informal observation but one that seems very consistent. Track your plaque--and be happy!

Don't overdo the vitamin D

As time passes and I advise more and more people to supplement vitamin D, I gain increasing respect for this powerful "vitamin". I am convinced that vitamin D replacement is the reason for a recent surge in our success rates in dropping CT heart scan scores. I believe it is also explains the larger drops we've been witnessing lately--20-30%.

But vitamin D can be overdone, too. Too much of a good thing . . .

Despite being labeled a "vitamin", cholecalciferol is actually a hormone. Vitamins are obtained from food and you can thereby develop deficiencies because of poor intake. Deficiency of vitamin C, for instance, arises from a lack of vegetables and fruits.

Vitamin D, on the other hand, is nearly absent from food. The only naturally-occuring source is oily fish like salmon and sardines. Milk usually has a little (100 units per 8 oz) because milk producers have been required by law to put it there to reduce the incidence of childhood rickets.

A woman came to me with a heart scan score of nearly 3800, the highest score I've every seen in a woman. (Record for a male >8,000!) She was taking vitamin D by prescription from her family doctor but at a dose of 150,000 units per week, or approximately 21,000 units per day. This had gone on for about 3-4 years. This may explain her excessive coronary calcium score. Interestingly, she had virtually no lipoprotein abnormalities identified, which by itself is curious, since most people have some degree of abnormality like small LDL. Obviously, I asked her to stop the vitamin D.

Should you be afraid of vitamin D? Of course not. If your neighbor is an alcoholic and has advanced cirrhosis, does that mean you shouldn't have a glass or two of Merlot for health and enjoyment? It's a matter of quantity. Too little vitamin D and you encourage coronary plaque growth. Too much vitamin D and you trigger "pathologic calcification", or the deposition of calcium in inappropriate places and sometimes to extreme degrees, as in this unfortunate woman.

Ideally, you should have your doctor check your 25-OH-vitamin D3 blood levels twice a year in summar and in winter. We aim for a level of 50 ng/ml, the level at which the phenemena of deficiency dissipate.

"It must have been the statin"

After four years of trying, Randy finally reduced her heart scan score. It not only dropped, it plummeted. After four previous scans that showed 25% or more increases, she'd finally dropped her score 23%. (I Blogged about Randy's case a few weeks ago.)

Randy also works for a cardiologist. When she told him that she had reversed her coronary plaque and reduced her heart scan score by 23%, he said, "It must have been the statin agent."

Randy was indeed on a statin drug at a low dose. But she also had taken great efforts in exercise, food choices, fish oil, and vitamin D. In fact, her score had progressed dramatically while she was taking the drug. Put simply, it was not the statin.

But that is the mindset of the conventionally thinking cardiologist. Stent, bypass, or statin drug--what else is there? Even with crystal clear evidence for coronary plaque regression, they refuse to acknowledge that tools that are not in their everyday consciousness could have achieved so spectacular a result.

Given a choice, 9 out of 10 cardiologists would rather put a stent in and walk away $2000 richer for an hour of work. Don't allow them to have this choice. Take control now.

Statin Drugs May Help the Healthy:
Cholesterol-Lowering Statin Drugs May Benefit People Without Heart Disease


That's the headline on WebMD, reporting the findings of a recent study published in the Archives of Internal Medicine. In reality, it wasn't really a study at all, but a re-analysis of previously published data, a so-called meta-analysis.

Nonetheless, the University of Toronto group re-analyzed the results of several studies, pooling data on 28,000 people, none of whom had known coronary disease. The results were similar to the results of the studies that were reported individually: a 29% reduction in heart attack and other "events" in people taking statin drugs.

What's surprising to me is this notion that statins, or any other treatment for that matter, prevent heart attack in people without heart disease. This is idiotic. Of course they had coronary heart disease. You can't have a heart attack in the absence of coronary disease. (There are very rare exceptions, like cocaine users, who experience coronary spasm from the drug).

What the study shows is that people with unrecognized heart disease experienced a reduction in heart attack. What it also means is that many, many people truly without heart disease were unnecessarily treated. As you'd predict, the drug manufacturers love this sort of broad, untargeted use of their drugs. It's an approach that brings in billions of dollars of revenues. The article on WebMD, in fact, was accompanied by three ads for various cholesterol drugs on this single page story.

What if only people with heart disease, as identified by CT heart scan scores, were treated? You would indeed witness an even larger reduction in heart attack risk, because the group receiving treatment both has the disease and is thereby at greater risk. Treatment should yield even greater risk reduction than treating broad groups who superficially appear to not have heart disease.

Ignore this nonsense about statin drugs reducing heart attack risk in people without heart disease. If you don't look for it, you won't know you have it. Once again, you can be lots smarter than the media. Get a heart scan and find out if your risk is worth reducing.

How far wrong can cholesterol be?

How far wrong can cholesterol be?

Conventional thinking is that high LDL cholesterol causes heart disease. In this line of thinking, reducing cholesterol by cutting fat and taking statin drugs thereby reduces or eliminates risk for heart disease.

Here's an (extreme) example of just how far wrong this simpleminded way of thinking can take you. At age 63, Michael had been told for the last 20 years that he was in great health, including "perfect" cholesterol values of LDL 73 mg/dl, HDL 61 mg/dl, triglycerides 102 mg/dl, total cholesterol 144 mg/dl. "Your [total] cholesterol is way below 200. You're in great shape!" his doctor told him.

Being skeptical because of the heart disease in his family, had a CT heart scan. His coronary calcium score: 4390. Needless to say, this is high . . . extremely high.

Extremely high coronary calcium scores like this carry high likelihood of death and heart attack, as high as 15-20% per year. So Michael was on borrowed time. It was damn lucky he hadn't yet experienced any cardiovascular events.

That's when Michael found our Track Your Plaque program that showed him how to 1) identify the causes of the extensive coronary atherosclerosis signified by his high calcium score, then 2) correct the causes.

The solutions, Michael learned, are relatively simple:

--Omega-3 fatty acid supplementation at a dose sufficient to yield substantial reductions in heart attack.
--"Normalization" of vitamin D blood levels (We aim for a 25-hydroxy vitamin D level of 60-70 ng/ml)
--Iodine supplementation and thyroid normalization
--A diet in which all wheat products are eliminated--whole wheat, white, it makes no difference--followed by carbohydrate restriction.
--Identification and correction of all hidden causes of coronary plaque such as small LDL particles and lipoprotein(a)

Yes, indeed: The information and online tools for health can handily exceed the limited "wisdom" dispensed by John Q. Primary Care doctor.

Comments (32) -

  • Jan

    8/17/2011 6:36:25 PM |

    Time to stop bashing primary care docs, doc. Online sites are full of B.S.
    Show me the evidence that testing with CAC improves outcomes (Sure it predicts risks, not the same as actually preventing disease, especially in those at lower risk of CAD.)

  • Might-o'chondri-AL

    8/17/2011 8:11:19 PM |

    Hi Jan,
    Since you accept plaque showing up as being a cardio-vascular risk factor then if Doc reports he has treated some patients whose measurement of plaque has diminished using his protocol would you also accept the proposition that those patients have reduced one of their cardio-vascular risk factors?
    If Doc has patient records showing diminished plaque and therefore one less risk might that not be considered preventative due to his patient following his protocol ?
    As for those individuals with hypothetically lower risk of CAD (ex: the 63 year old low cholesterol example Doc gave) are they not going to undergo changes as they age ?  
    A primary care physician is valuable and yet older westerners are increasingly engaging specialists for good reasons.  Doc has a self-professed specialty tracking plaque  that he wants to impart; sure, his blogging tone may not always be mellow.

  • Jan

    8/18/2011 2:52:13 AM |

    Dear Might,
    Your comment is akin to those who report the association of statin use with lowered risk of MI. A correlation does not prove causation until valid  scientific research confirms.
    How do we know treating CAC lowers risk of MI until a study proves this? Docs have been wild to accept the association of statin use lowering cholesterol components as the mechanism of effectiveness for prevention of MI, ignoring studies in which dietary measures that did the same were ineffective. Just pointing out the need for caution in going so far as to treat a test without evidence that the intervention is working on the test findings (rather than something else).
    Perhaps there are studies that are underway or perhaps the evidence, er association, is just considered too strong, (Bradford-Hill criteria) to ethically justify a trial. My concern is for individuals who score in the lower range of abnormal. At what cost do we label and treat those?

  • joel oosterlinck M.D.

    8/18/2011 9:21:42 AM |

    just remembret the lyon heart study, by  Renaud & de Lorgeril demonstrating the efficacy  of mediterranean diet in lowering the risk of recurrent MI in French patients. although cholesterol levels were higher with diet than with statins. Dietary measures seem there to demonstrate  efficacy

  • Dr. William Davis

    8/18/2011 12:15:43 PM |

    Not only is it NOT time to stop bashing primary care docs, but it's time to begin accepting that their role is outdated. In fact, an average nurse practitioner or physician's assistant can do an equal, if not better, job than most primary care physicians. How health care is dispensed is going to undergo dramatic transformation, just as the business of travel agents and real estate have been transformed by rapid information exchange.

    In our program, we see virtually NO heart attacks. Not a randomized clinical trial, but watching heart attacks drop from a weekly event to almost never is good enough for me to not accept the status quo and continue to work along a path that, from every indication, works exceptionally well.

  • JC

    8/18/2011 12:49:19 PM |

    If high crab diets are considered unhealthy then why do some cultures like the rural Chinese live long healthy lives on nearly 100% crabs,mostly rice and vegetables?

  • majkinetor

    8/18/2011 2:16:50 PM |

    Isn't the best thing for calcium on wrong places vitamin K2 ?
    In my country doctors even prescribe it for calcification issues.
    Dose is around 100mcg/day for 6-12 mo.

  • Marlene

    8/18/2011 4:06:07 PM |

    Read Gary Taubes' "Good Calories, Bad Calories" to find several instances of other cultures eating the typicial high carb food yet seemingly stay within the healthy range.

  • Jan

    8/18/2011 4:22:12 PM |

    Trust my care (or a family members care) to a NP or PA who does not have the capability of complex medical decision making - no thanks. NP's actually are complimentary to physicians with different skill sets. So glad to know your level of knowledge about them. PA's are nothing but junior medical students with enormous salaries. Working 9 to 5 - oh, yeah!

    I'm certain your referral network of primary care docs would be interested in your belief system.

  • Joe

    8/18/2011 4:49:51 PM |

    Dr. Davis:
    I don't know if you've seen this new video yet, but I think you'll want to.
    http://www.youtube.com/watch?v=3vr-c8GeT34&feature=player_embedded
    If you do watch it, I have a question. This doctor thinks sugar (by itself) plays a huge role in causing plaque to rupture and cause heart attacks, etc. If after watching the video you agree with him, would you please tell me how (biologically) it does this?
    Thanks!

    Joe

  • Might-o'chondri-AL

    8/18/2011 8:51:08 PM |

    Hi Jan,
    True correlation does not necessarily equate to causation. As for statins, it seems that statins act to lessen inflammatory processes; and it is this dynamic, rather than numerically lowering cholesterol, that is a crucial way that statins correlate with reduced risk. Which, to me,  seems to further support Doc's contention here in this posting that  low cholesterol levels doesn't  tell one if they have abnormal plaque (ex: patient above with "exceedingly high" score) .

    I will accept Doc's data, as given ,that very high plaque is a 15-20% risk factor since many other published sources cite even carotid plaque as a risk factor . As far as who to test for what, and when, I am not qualified to make recommendations. I do know that time can remodel some cellular dynamics and the aging cardio-vascular system is vulnerable to alterations.  Doc's got my attention because no one at all in my paternal male ancestral line lived past their late 50's due to heart problems and I am 60; while my 61 year old brother already was hospitalized from transient ischemic attack  .

  • Might-o'chondri-AL

    8/18/2011 9:33:17 PM |

    Mediterranean diet's efficacy for heart health is probably due to the % of poly-amines per calorie consumed and of course isn't in keeping with Doc Davis' detestation of modern wheat (among other protocols). As we age our poly-amine levels decrease and Mediterranean diet supplies lots of poly-amines.

    Poly-amines ( molecules inelegantly named spermine, spermadine and putrescine) are all anti-inflammatory, especially spermine; in our body we synthesize poly-amines from arginine. Mediterranean diet's high poly-amine levels spares the amount of arginine our body uses in synthesizing poly-amines; and thus we can more readily produce the vaso-dilator signalling molecule NO (nitric oxide) from body's arginine. NO is valuable to keep oxygenated blood reaching the heart muscle cells; NO keeps vessels from constricting dangerously.

    Poly-amines lower inflammation and in the context of age associated problems the less low grade inflammation the better.  Inflammation leads to defectively functioning cells and molecular processes; with time the  over stimulation of immunological responses (both innate and adaptive immunity) leaves the body burdened with unknown clones of T cells (both memory and effector types). Eventually the build up of  T cell clones limits new variants and what occurs is more macrophages circulating; once an over abundant macrophage stage reins the body is essentially always in low grade inflammation , and prone to various age associated pathology (including cardio-vascular).

  • Dr. Johns

    8/19/2011 12:25:40 AM |

    @jan....
    A vast majority of primary care doctors are extremely limited in their abilities to treat/advise patients for CVD risks. They don't understand nutrition, effects of supplements upon serum biomarkers, nor effective diagnostic testing for heart disease.
    CAC is a much better biomarker for who is at greater risk of CVD than serum markers:
    http://www.eurekalert.org/pub_releases/2011-08/jhmi-sfc081611.php

    I seriously doubt even 1:100 primary care docs see studies like the aforementioned one.
    And I seriously doubt the one doc would understand it....
    Dr. John

  • Gene K

    8/19/2011 1:48:19 AM |

    An interpretation of the same study for a broader audience just appeared at http://www.webmd.com/heart-disease/news/20110818/is-calcium-test-the-best-way-to-check-for-heart-risk.

  • Thomas White

    8/19/2011 2:09:49 AM |

    I'd accept a bashing of physicians in general.   But to single out primary care physicians - overwhelmed with paperwork and patients with multiple problems, and vastly underpaid and underappreciated, and continually put down by "Partialists" - Really ? Cardiologists are superior? Really ?

    Forget my support and admiration henceforth.

  • Might-o'chondri-AL

    8/19/2011 5:43:43 AM |

    CRP (C-reactive protein), an inflammation marker surrogate, does not directly correlate with whether there is coronary artery calcium (CAC), or the degree of CAC severity. CRP is also subject to variables of race and age, so it loses some potential as a predictive marker. Yet looking at CAC along with CRP is considered useful for complex insight into a patients pathology.

    Analysis of the Multi-Ethnic Study  of Atherosclerosis (MESA) involving 6,800 men & women seems to indicate that inflammatory markers (ex: CRP) relate to the physiology of pathological processes other than CAC laid down; possibly because plaque undergoes morphological changes over time. The CRP level is proposed, by some, to relate more to the stability of plaque from rupturing and the incidence of blood clotting in a thrombosis.

    The inflammatory marker of Interleukin-6 (IL-6) anti-bodies seems to be better than CRP and fibrinogen for correlating an individual's trend toward CAC. Thus the cytokine IL-6 is a better indicator of sub-clinical atherosclerosis; Doc likes to cut to the chase, eyeball the plaque and track it with current technology ( that is not available worldwide).

  • David

    8/19/2011 6:16:33 AM |

    Is it typical for someone with such low ldl and high hdl to have such a high CAC score? Had he previously had a higher LDL and then been placed on a statin?

  • TT

    8/19/2011 12:36:37 PM |

    The energy expenditure of the rural Chinese is very high.  They don't drive, they walk, or ride bicycles.  They don't sit in office from 9am to 5pm, they work hard in the rice field from 5am to 9pm.  They can eat anything without gaining weight.
    For the urban Chinese, it is a different story.  They have the same life sytle as ours, and they are getting heavier every year.  More and more people become diabetic, even young kids.

  • Dr. William Davis

    8/19/2011 1:51:32 PM |

    K2 is indeed a fascinating nutrient. There are extensive discussions about it on the Track Your Plaque website.

  • Dr. William Davis

    8/19/2011 1:53:33 PM |

    Thanks, Joe. I watched the entire thing and was impressed with Dr. Diamond's grasp of the issues.

    I'm going to post this on the main page because I think his overview was extremely effective.

  • Dr. William Davis

    8/19/2011 1:55:24 PM |

    Sorry you see it that way. This was a comment directed at the system of primary care in general.

    I reread the post and I didn't see the name "Dr. Thomas White" mentioned anywhere. If you choose to feel slighted in some way, that's your choice.

  • Kent

    8/19/2011 3:20:32 PM |

    Jan, I would certainly trust my care (or a family members care) to a NP or PA who looks outside just the pharma driven medical journals which primarily support a diagnose & drug philosophy.  And I'll take an NP or PA who actually uses some common sence rather than being a puppet given to the pushy drug rep.

    I live in a family of MD's, and they have made it clear as to their terribly limited training and knowledge they gain from med school on the level of building and supporting the body from within.  Example, I have an Aunt that is currently suffering from stage 4 cancer. Due to the chemo treatment that she's instructed to not spend time in the Sun. Her Dr. has not even checked her for vitamin D levels. This is not the exception, but the norm when it comes to common sence treatment, pathetic.

  • Joe

    8/19/2011 6:56:14 PM |

    Okay, Dr. Davis.  I'll be looking for it. When you do, please take a moment and explain how you think that sugar might be responsible for plaque rupture.
    Thanks again!

    Joe

  • steve

    8/19/2011 7:06:59 PM |

    Sugar is just one part of the equation.  As Dr. Davis has covered on this website, small LDL is also a villian and needs to be minimized as much as possible.

  • Might-o'chondri-AL

    8/19/2011 8:05:24 PM |

    Hi Joe,
    Thanx for the video ... maybe the following answers you.

    Regarding sugar: see 59:33 into presentation, where diagram shows "sugar" blurb  - lecturer is using compact word sugar to represent how glucose's glycation end products alter the artery and make the artery vulnerable. It is not a molecule of sugar acting all by itself; lecturer explains slide when talks of how glycation is a problem (another of  Doc Davis'  peeves).

    Follow up at 1:01 into presentation: see diagram's top left  where the various adverse influences on artery  are specified as "modified lipoprotein", "hemodynamic insult" (includes, but is not limited to blood sugar's  glycation end products affect on artery), "reactive oxygen species" (ROS) and "infectious agents".

  • Thomas White

    8/20/2011 12:22:15 PM |

    Thank you for all your hard work and dedication to your web site and education.

    I apologize for cluttering up the discussion with a personal statement.

    TRW

  • Joe

    8/20/2011 4:13:56 PM |

    Thank you, Might. I guess I'm going to have to do some research on glycation before I can fully understand what you're saying above.

    I didn't even notice the PowerPoint Presentation that was included with Dr. Diamond's video presentation.  Sigh.

    Thanks again!

    Joe

  • Jim

    8/20/2011 7:55:03 PM |

    AMEN! Right on target.

  • Louis

    8/23/2011 2:05:01 PM |

    I don't know if you're aware of the differences between calculated test that most doctors use and NMR that Dr. Davis uses. When your diet consists of mostly carbohydrates leading to chronic high blood sugar level, it tends to raise your SMALL DENSE LDL level but calculated cannot measure it accurately. It often greatly underestimate it.  Dr. Davis has covered it many times. Dig through his website for it.

  • Louis

    8/23/2011 2:16:27 PM |

    Optimal vitamin D level helps lower IL-6. It can be a big problem with black people as they tend to have the lowest vitamin D level of any races. Dr. Cannell mentioned that in his new book called Athlete's Edge Faster Quicker Stronger with vitamin D with the hope that the word about vitamin D would spread out faster if more and more professional athletes started using it to gain some advantage over opponents much like what East Germany and formerly USSR used to do in 1960 and 1970s at the Olympic games and other world events.

  • live-healthcare

    8/27/2011 4:31:48 AM |

    Yes Joe i have seen the video you linked. That's right i also think the same.

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