The Big Squeeze

Some colleagues of mine brought this scary phenomenon to my attention last evening.

As insurance and Medicare reimbursement to doctors and hospitals fall (Medicare is enacting a series of substantial cuts, which will be followed by the private health insurers), you would expect the use of hospital procedures to drop. Makes sense, right? Less money paid per procedure, less incentive to do them.

Unfortunately, that's not how it's playing out in the real world. Your neighborhood interventional cardiologist or cardiothoracic surgeon is accustomed to a level of income and lifestyle. That lifestyle is now threatened by shrinking reimbursement. True to the Law of Unintended Consequences, rather than reducing use of procedures, diminishing procedural fees are prompting a good number of practitioners to do more.

In other words, if each heart catheterization pays less, why not do more of them, along with more stents, pacemakers, defibrillators, and the like? If four heart catheterizations per day pays less, why not do five to make up the difference?

Voila! Income protected. Of course, it comes at the cost of more work. But I will give one thing to my colleageus: They are a generally hard-working bunch who rarely balk at 12-16 hours days in the hospital.

How do you do more procedures? Easy. Just lower the bar on who to do a procedure on. Use more aggressive criteria for pacemaker implantation. Interpret the always-fuzzy nuclear stress tests weighed more towards abnormal. Use scare tactics: "You never know--that chest pain could be the last warning you're going to have!" Because the criteria for performing procedures is "soft" in the real world, it is easy to bend the criteria any way you want.

It's too early to measure the full impact of this unintended consequence of reduced reimbursement. But don't allow yourself to become a casualty in the reimbursement war. Remain vigilant. Recognize that, despite the fuzziness at the edges, there are still rational reasons for performing heart procedures. Always be armed with information and the right questions. Never submit unquestioningly or without satisfactory answers to your questions.

Tim Russert's heart scan score 210. . .in 1998

Despite the media blathering over how Mr. Russert's tragic death from heart attack could not have been predicted, it turns out that he had undergone a heart scan several years ago.

A New York Times article, A Search for Answers in Russert’s Death, reported:

Given the great strides that have been made in preventing and treating heart disease, what explains Tim Russert’s sudden death last week at 58 from a heart attack?

The answer, at least in part, is that although doctors knew that Mr. Russert, the longtime moderator of “Meet the Press” on NBC, had coronary artery disease and were treating him for it, they did not realize how severe the disease was because he did not have chest pain or other telltale symptoms that would have justified the kind of invasive tests needed to make a definitive diagnosis. In that sense, his case was sadly typical: more than 50 percent of all men who die of coronary heart disease have no previous symptoms, the American Heart Association says.

It is not clear whether Mr. Russert’s death could have been prevented. He was doing nearly all he could to lower his risk. He took blood pressure pills and a statin drug to control his cholesterol, he worked out every day on an exercise bike, and he was trying to lose weight, his doctors said on Monday. And still it was not enough.

“What is surprising,” Dr. Newman said, “is that the severity of the anatomical findings would not be predicted from his clinical situation, the absence of symptoms and his performing at a very high level of exercise.”


Buried deeper in this article, the fact that Mr. Russert had a heart scan score of 210 in 1998 is revealed.

That bit of information is damning. Readers of The Heart Scan Blog know that heart scan scores are expected to grow at a rate of 30% per year. This would put Mr. Russert's heart scan score at 2895 in 2008. But the two doctors providing care for Mr. Russert were advising the conventional treatments: prescribing cholesterol drugs, blood pressure medication, managing blood sugar, and doing periodic stress tests.

Conventional efforts usually slow the progression of heart scan scores to 14-24% per year. Let's assume the rate of increase was only 14% per year. That would put Mr. Russert's 2008 score at 779.

A simple calculation from known information in 1998 clearly, obviously, and inarguably predicted his death. Recall that heart scan scores of 1000 or greater are associated with annual--ANNUAL--risk for heart attack and death of 20-25% if no preventive action is taken. The meager prevention efforts taken by Mr. Russert's doctors did indeed reduce risk modestly, but it did not eliminate risk.

We know that growing plaque is active plaque. Active plaque means rupture-prone plaque. Rupture prone plaque means continuing risk for heart attack and death. Heart attack and death means the approach used in Mr. Russert was a miserable failure.

While the press blathers on about how heart disease is a tragedy, as Mr. Russert's doctors squirm under the fear of criticism, the answers have been right here all alone. It sometimes takes a reminder like Mr. Russert's tragic passing to remind us that tracking plaque is a enormously useful, potentially lifesaving approach to coronary heart disease.

Who needs to go next? Matt Lauer, Oprah, Jay Leno, some other media personality? Someone close to you? Can this all happen right beneath the nose of your doctor, even your cardiologist?

I don't need to remind readers of The Heart Scan Blog that heart disease is 1) measurable, 2) trackable, 3) predictable. Mr. Russert's future was clear as long ago as 1998. Every year that passed, his future became clearer and clearer, yet his doctors fumbled miserably.



Copyright 2008 William Davis, MD

Another failure of conventional cardiac care


Though Tim Russert was widely known and respected for his political commentary, he will likely be better remembered as an example of the gross shortcomings of the conventional approach to heart disease.

Let's face it:

Standard heart disease prevention efforts are a miserable failure.

A Track Your Plaque member brought this interview of Mr. Russert's doctor to my attention.

It appears that his doctor did all the correct conventional things. You know what became of it. In the eyes of the public and of any attorney, or even of my colleagues, no wrong was committed. The blame does not lie with Mr. Russert's hapless doctor. The blame lies on the system that endorses procedures, prescription medications, the blind adherence to dogma dictated by the pharmaceutical industry and FDA, along with a prevailing philosophy of preferring the management of catastrophes to preventing them. Dr. Newman's idea of a solution: Making an automatic defibrillator (AED) more widely available (!!!).

How long does this sort of idiocy have to go on? How many people have to die before the system uses the tools that are already available, tools that could have prevented this tragedy and many more like it?

If you and your doctor subscribe to the program that the unfortunate Mr. Russert was prescribed and the brainwashing, unthinking nonsense that his doctor follows, you are a fool. Shame on you. You therefore likely subscribe to the same variety of marketing BS that issues from food manufacturers about Cheerios, whole grains, and low-fat diets.

Get with the program. Sadly, Mr. Russert is not the first, he's not the last. The tragedies of conventional advice that line the pockets of drug and food manufacturers number in the millions. We're not talking about some obscure, rare disease. We're talking about the number one cause of death in both males and females nationwide.

I deeply wish this message could have reached Mr. Russert before his untimely death. We could all look forward to another Sunday morning with his usual incisive, unforgiving probing of the day's political figures.

Tribute to Tim Russert

The sudden passing of news giant, Tim Russert, yesterday of sudden cardiac death struck a blow to American consciousness.

Perhaps his hard-hitting interviewing style, while making guests squirm, made him seem invincible. But, of course, none of us is invincible. We are all vulnerable to this disease.

We should not allow Mr. Russert's tragic death to occur without taking some lessons. The media have already resorted to interviewing prominent doctors for their opinion.


Douglas Zipes, M.D., former President of the American College of Cardiology,was quoted in the media:

"An automated external defibrillator (AED) could have been a life-saver. AEDs should be as common as fire extinguishers."

This is typical sleight-of-hand, medicine-is-too-complex-for-the-public-to-understand sort of rhetoric that is surely to issue from the conventionally-thinking medical people and the press. Instead, let's cut the BS and learn the real lessons from Mr. Russert's needless death.

It is virtually certain that:

--Mr. Russert ruptured an existing coronary atherosclerotic plaque, prompting rhythm instability, or ventricular fibrillation.

--Making automatic external defibrillators (AED) available might have Band-Aided the ventricular fibrillation, but it would not have stopped the heart attack that triggered it.

--Though full details of Mr. Russert's health program have not been made available, it is quite likely that he was prescribed the usual half-witted and barely effective panoply of "prevention": aspirin, statin drug, anti-hypertensive medication. Readers of The Heart Scan Blog and members of Track Your Plaque know that this conventional approach is as effective as aspirin for a fractured hip.

--It is highly unlikely that all causes of Mr. Russert's heart disease had been identified--did he have small LDL (it's certain he did, given his body habitus of generous tummy), Lp(a), low HDL, pre-diabetic patterns, inflammatory abnormalities, vitamin D deficiency, etc.? You can be sure little or none of this had been addressed. Was he even taking simple fish oil that reduces the likelihood of sudden cardiac death by 45%?

--Far more could have been done to have prevented Mr. Russert's needless death. And I don't mean the idiocy of making AED's available in office buildings. I'm talking about preventing the rupture of atherosclerotic plaque in the first place.

Far more can be done to prevent future similar deaths among all of us.

Our jobs are to use the tragic death of Mr. Russert to help those around us learn that heart disease is identifiable and preventable. Though Mr. Russert did not stand for BS in his political commentary, he sadly probably received it in his health advice. Don't let this happen to you or those around you.

Why do skinny people get heart disease?

There's no doubt about it: The majority of people with heart disease are overweight. They may not be grotesquely overweight, just a few pounds over. But weight plays a crucial role in activating numerous factors that heighten risk for heart disease.

Excess weight reduces HDL cholesterol, raises triglycerides, increases small LDL (enormously), fans the fires of inflammatory responses (CRP, IL-6, TNF-alpha, etc.) raises blood pressure, increases resistance to insulin and raises blood sugar. Overweight people tend to be less physically active, may develop diseases of obesity like sleep apnea, and on and on. You've heard this all before.

But why do slender people develop heart disease? If we can't blame weight, what is to blame? By slender, I mean body mass index (BMI) of <25. (Yes, I know there are other ways, better ways, to gauge healthy weight. But, for simplicity, I'll use BMI.) Let's put aside the two obvious causes of heart disease, cigarette smoking and Type I diabetes. (I'd be shocked if any cigarette smokers read this blog.)

Slender people develop heart disease because:

1) They have lipoprotein(a)--The big, big neglected risk factor. In fact, the Lp(a) genotype is, in my casual observation, associated with a slender phenotype (genotypic expression). The prototypical example that makes headlines is the marathon runner--slender and superbly fit, but develops heart disease anyway. People wax on about the uncertainties of exercise and fitness when they hear about Jim Fixx and Alberto Salazar. But one factor would explain it all: Lp(a).

2) The murky category of the normal weight obesity. These people are generally recognizable by their flaccid tummies despite falling into a favorable BMI <25. Small LDL is the standout red flag in these people.

3) They were previously overweight but lost it.

4) They were former smokers.

5) Vitamin D deficiency--Deficiency of vitamin D is important for everyone's health. But there appears to be some people for whom it is the dominant risk. I believe that one of our great Track Your Plaque success stories, Neal, falls into this group. Some people who are vitamin D deficient develop colon cancer, others develop diabetes, others develop osteoporosis or multiple sclerosis, while others develop coronary heart disease and plaque. The likely reason for the varied expression is variation in vitamin D receptor genotypes (VDR genotypes).

6) The murkiest of all: Hypertension genotypic variants. This is a poorly sorted-out category, and one principally based on my observations along with scattered observations in such things as variations in the angiotensin converting enzyme genotypes. But I am convinced that there is a small percentage of slender people who show variation in some genetic type that predisposes to hypertension and heart disease. They also show a propensity towards enlargement of the thoracic aorta. This group is also among the most difficult to control in the Track Your Plaque approach, i.e., they have difficulty slowing or stopping the growth of heart scan scores. While blood pressure control in this group is important, it does not seem to remove the excess source of risk.

So, yes, being slender does put you into a lower risk for heart disease category. But it does not mean you are immune.

You can also be an overweight person who still harbors some of the features of the slender--you're an overweight slender person. The above list can still therefore apply.

Cardiology Confidential


Okay, so it's a shameless knockoff of chef Anthony Bourdain's titillating Kitchen Confidential.

But the confidences that I've heard whispered in the corridors of health involve something more provocative than how your food was prepared. Any service for humans performed by other humans is subject to the idiosyncrasies and weaknesses of human behavior. That's just life.

In healthcare for your heart, the consequences can be more profound than eating three day old fish on Monday's dinner menu.

Over my 15 years practicing cardiology in a variety of settings in three different cities, I've witnessed just about everything from shocking to sublime. Some of it speaks to the extraordinary commitment of people in healthcare, the unexpected courage people show in the midst of illness, the devotion of family in difficult times. It can also speak of mewling, sobbing carryings-on over the most minor conditions, the meanness that emerges when people are frightened, the vultures circling just waiting for Grandpa to kick the bucket and leave his will declaring the spoils.

For the most part, my cardiology colleagues are a hard-working bunch committed to . . . Uh oh. I was going to say "Saving lives, preserving health." But that's not true. Once upon a time, it was true for many of my colleagues, often revealed over $2-a-pitcher beer-softened, "we're going to save people" conversations in medical school. Ahhh, medical school. I remember walking along the street alongside my medical school in St. Louis, bursting with pride and a sense of purpose.

But, for many of us, something sours our purpose through the years. Maybe it's the smell of money, maybe it's the series of distasteful experiences that show that healthcare providers are, in the midst of health crises, the innocent recipients of anger, frustration, disappointment.

Whatever the genesis, the stage is set for an imperfect scenario that pits healthcare provider against patient in a less-than-perfect system.

This would read as a mindless rant if it wasn't based on such pervasive and pravalent truths, tales of the flawed deliverers of healthcare driven by motives less lofty than "saving people."

Take Dr. S, a doctor who performs a large number of procedures on patients. I'm told he is very capable. He manages an extraordinary amount of heart work--in between jail time for wife beating and Medicare fraud.

Or Dr. C, well-known in the region for his procedural talents, also. Usually acerbic and freely-swearing, he opens up engagingly when drinking--which is most of the time. Paradoxically, as is true for some serious drinkers, he works more effectively while intoxicated.

Or Dr. ST, who proudly admitted to me one evening over dinner that he has accepted 6-figure payments from medical device companies on a number of occasions to use their products.

Or the manic ups and downs of Dr. J, who refers just about every patient he sees for emergency bypass surgery when in his down phase, mangles coronary arteries in daring angioplasties during his up phase.

How about 310-lb Dr. P, who hounds her patients about indulgent lifestyles? That would be excusable as innocent lack of self-insight if it weren't for her propensity to use heart procedures on patients as punishment. "I have no choice but to take you to the hospital."

Dr. M. manages to maintain the appearance of straight-and-narrow during the day, all the way to attending church twice a week with his children. His daytime persona effectively covers up his frequent visits to prostitutes.


We are ALL flawed. My colleagues are no different. But some circumstances cultivate the flaws, fertilize corruptibility, reward it. Such has become the state of affairs in healthcare for heart disease. Why? Is it the excessive potential for money-making that existed until recently? Is there something about the save-the-day mentality of heart disease that attracts imperfect personalities looking for the adrenaline-charged thrill but morphs over time into near-psychopathic lives?

It's not the end of the world. The fact that my colleagues' behavior has reached such extravagant lows signals a bottom: things are about to change.

In the meantime, let me tell you a few more secrets . . .



Copyright 2008 William Davis, MD

Fanatic Cook on the American Heart Association

The Fanatic Cook has posted a stinging criticism of the American Heart Association (AHA):

American Heart Association My Fat Translator

Beyond the nonsensical nutritional recommendations (e.g., substitute small French fries for large French fries), she lists the major financial contributors to the AHA, a Who's Who in the pharmaceutical and processed food industry.


"For an organization that brought in close to a billion dollars last year, you'd think they could come up with something a little more pronounced. If I was more cynical I'd say the AHA had an interest in keeping Americans fat . . . or at least dependent on a highly-processed, fast food diet, requiring drugs to tweak lab values."

To be sure, the AHA does a great deal of good in funding research and educating the public about the prevalence of heart and vascular disease. But their fund raising interests have clearly subverted the honesty of their nutritional advice. Sadly, it is the AHA dietary advice that hospital dietitians use in counseling people with heart disease after their heart attack, stent, or bypass surgery. After my patients are discharged from the hospital for any reason, I tell them to please forget everything the nice hospital dietitian told them. It is not okay to eat the factory farm-raised hamburger on the sugar-equivalent enriched flour bun. Low-fat ice cream is not a healthy substitute for full-fat ice cream.

The AHA is no different than the USDA and the American Diabetes Association, "official" organizations that have, in effect, sold out to industry.

Sleep for heart health

Sleep is a fascinating phenomenon.

Virtually all animals, certainly all mammals, sleep. While the form and shape of sleep can vary, sleeping is a universal phenomenon. Even fish sleep, though their eyes remain open.

Sleep disorders like sleep apnea ("apnea" = without breathing) are growing in prevalence nationwide as the country gets fatter and fatter. Our throats assume a smaller diameter, even our tongues get obese. This results in intermittent obstruction to the airway during sleep, causing snoring. It also results in sleep interruption, particularly during attempts to "descend" down to the deepest phases of sleep. Dire health and cardiac consequences can sometimes emerge, such as high blood pressure, higher blood sugar, abnormal heart rhythms, impaired heart muscle function, even sudden death.

We are all familiar with the perceptible effects of sleep deprivation: edginess, crabbiness, diminished attention span, slowed reaction time. I'm not talking about sleep apnea or sleep disorders, but just simple duration of sleep. Data are emerging that both sleep deprivation and sleep excess may trigger undesirable changes in lipids (cholesterol values):



Associations of usual sleep duration with serum lipid and lipoprotein levels.

Kaneita Y, Uchiyama M et al.

STUDY OBJECTIVES: We examined the individual association between sleep duration and a high serum triglyceride, low HDL cholesterol, or high LDL cholesterol level. DESIGN AND SETTING: The present study analyzed data from the National Health and Nutrition Survey that was conducted in November 2003 by the Japanese Ministry of Health, Labour and Welfare. This survey was conducted on residents in the districts selected randomly from all over Japan. PARTICIPANTS: The subjects included in the statistical analysis were 1,666 men and 2,329 women aged 20 years or older. INTERVENTION: N/A. MEASUREMENTS AND RESULTS: Among women, both short and long sleep durations are associated with a high serum triglyceride level or a low HDL cholesterol level. Compared with women sleeping 6 to 7 h, the relative risk of a high triglyceride level among women sleeping <5 h was 1.51 (95% CI, 0.96-2.35), and among women sleeping > or =8 h was 1.45 (95% CI, 1.00-2.11); the relative risk of a low HDL cholesterol level among women sleeping <5 h was 5.85 (95% CI, 2.29-14.94), and among women sleeping > or =8 h was 4.27 (95% CI, 1.88-9.72). On the other hand, it was observed that the risk of a high LDL cholesterol level was lower among men sleeping > or =8 h. These analyses were adjusted for the following items: age, blood pressure, body mass index, plasma glucose level, smoking habit, alcohol consumption, dietary habits, psychological stress, and taking cholesterol-lowering medications. CONCLUSIONS: Usual sleep duration is closely associated with serum lipid and lipoprotein levels.

Triglycerides go up with too little or too much sleep. Note especially the extraordinary association of low HDL cholesterol with sleeping <5 hours (nearly 6-fold increased risk) or sleeping >8 hours (more than 4-fold increased risk).

Why do these effects develop? Does sleep deprivation, for instance, trigger higher adrenaline levels, encourage carbohydrate cravings or binges, make us less likely to engage in physical activity? Cortisol is elevated; could this be a factor? I know that I am a different person when sleep-deprived: irritable, less clear-thinking, quicker to anger, more critical, and I develop carbohydrate cravings. It's curious that triglycerides increase when sleep excess is present; what might that represent?

Anyway, the data are growing: Sleep is an important facet of health, both for maintaining a bright outlook and to discourage development of low HDL and high triglycerides. Though not specifically examined in this study, we know that low HDL/high triglycerides are, as a rule, associated with the undesirable small LDL particle pattern.

As a practical matter, you may also find sleep and waking from sleep more satisfying and restful if you sleep in increments of 90 minutes, e.g., 7 1/2 hours (rather than 7 or 8 hours). This is because the full cycle of sleep, from phase 1 to REM (rapid-eye movement sleep), requires 90 minutes for completion. That doped feeling that sometimes develops when awaking will disappear if you sleep according to your sleep cycle, which is usually 90 minutes long.

Is normal TSH too high?

There's no doubt that low thyroid function results in fatigue, weight gain, hair loss, along with rises in LDL cholesterol and other fractions of lipids. It can also result in increasing Lp(a), diabetes, and accelerated heart disease, even heart failure.

But how do we distinguish "normal" thryoid function from "low" thyroid function? This has proven a surprisingly knotty question that has generated a great deal of controversy.

Thyroid stimulating hormone, or TSH, is now the most commonly used index of the adequacy of thyroid gland function, having replaced a number of older measures. TSH is a pituitary gland hormone that goes up when the pituitary senses insufficient thyroid hormone, and a compensatory increase of thyroid hormone is triggered; if the pituitary senses adequate or excessive thyroid hormone, it is triggered to decrease release of TSH. Thus, TSH participates in a so-called "negative feedback loop:" If the thyroid is active, pituitary TSH is suppressed; if thyroid activity is low, pituitary TSH increases.

An active source of debate over the past 10 years has been what a normal TSH level is. In clinical practice, a TSH in the range of 0.4-5.0 mIU/L is considered normal. (Lower TSH is hyperthyroidism, or overactive thyroid; high TSH is hypothyroidism, or underactive thyroid.)

The data from a very fascinating and substantial observation called the HUNT Study, however, is likely to change these commonly-held thyroid "rules."

The association between TSH within the reference range and serum lipid concentrations in a population-based study. The HUNT Study

In this study, over 30,000 Norwegians without known thyroid disease were enrolled. TSH levels and lipid (cholesterol) levels were measured.

In this large and extraordinary observation, increasing TSH levels were associated with increasing levels of LDL cholesterol and triglycerides, and decreasing HDL. At what level of TSH did this relationship start? At TSH levels as low as 1.0!

In other words, there were perturbations in standard lipid measures even with TSH levels ordinarily regarded as "normal," even "perfect."

A subsequent observation from the HUNT Study was even more recently published:

Thyrotropin Levels and Risk of Fatal Coronary Heart Disease: The HUNT Study

Abstract:

Background Recent studies suggest that relatively low thyroid function within the clinical reference range is positively associated with risk factors for coronary heart disease (CHD), but the association with CHD mortality is not resolved.

Methods In a Norwegian population-based cohort study, we prospectively studied the association between thyrotropin levels and fatal CHD in 17 311 women and 8002 men without known thyroid or cardiovascular disease or diabetes mellitus at baseline.

Results During median follow-up of 8.3 years, 228 women and 182 men died of CHD. Of these, 192 women and 164 men had thyrotropin levels within the clinical reference range of 0.50 to 3.5 mIU/L. Overall, thyrotropin levels within the reference range were positively associated with CHD mortality (P for trend = .01); the trend was statistically significant in women (P for trend = .005) but not in men. Compared with women in the lower part of the reference range (thyrotropin level, 0.50-1.4 mIU/L), the hazard ratios for coronary death were 1.41 (95% confidence interval [CI], 1.02-1.96) and 1.69 (95% CI, 1.14-2.52) for women in the intermediate (thyrotropin level, 1.5-2.4 mIU/L) and higher (thyrotropin level, 2.5-3.5 mIU/L) categories, respectively.

Conclusions Thyrotropin levels within the reference range were positively and linearly associated with CHD mortality in women. The results indicate that relatively low but clinically normal thyroid function may increase the risk of fatal CHD.


In other words, the findings of this substantial observation suggest that the ranges of TSH usually regarded as normal contribute to coronary events, cardiac death, as well as lipid patterns. While several other studies have likewise shown a relationship of higher TSH/lower thyroid function with lipid abnormalities and overt heart disease, no previous study has plumbed the depth of TSH to this low level and to such a large scale.

I believe that these findings are enough cause to begin thinking seriously about monitoring thyroid function more seriously to uncover "borderline" TSH increases in the "normal" range. While higher TSH levels predict cardiovascular events, does thyroid replacement at these levels reduce it? Critics will say it's a big leap, but I think that it is worth at least considering.

Stay tuned for a lengthy Special Report followed by a full booklet on these issues on the www.cureality.com website.


Copyright 2008 Wiliam Davis, MD

Talking heads

Tne Philadelphia NBC affiliate's website carried this commentary from a colleague of mine:


Mark from the Lehigh Valley is curious about scans that can detect heart disease.

He asked, "I am in my early 50s. My father had a heart attack in his 40s. I am healthy with no symptoms of heart disease, should I consider a heart scan?"

"Well, Mark, occasionally family history needs to be considered more closely. If your father had coronary disease at a relatively young age at the absence of any known risk factor for heart disease for example diabetes, smoking, obesity, high blood pressure, than your level of risk should be considered more closely," Dr. Kevin Shinal, a cardiologist, said.

"There are a number of studies available to access [sic] your level of risk. One such study is a calcium score. A calcium score is a form of a CAT scan that access [sic] the calcium burden or presence of calcium in your coronary arteries. It assigns you a score and score is translated into a level of cardiovascular risk," Shinal said.

But the doctor warned because Mark doesn't have active symptoms, the scan probably wouldn't be covered by insurance.



Was there an understandable answer in there? I certainly couldn't find it.

Why pick on some yokel responding inarticulately to the local media's quest for content? Because this is, all too often, what the public hears: Ill-informed blather from someone who has little or no understanding of the issues. Maybe this doctor wanted his practice group to get some free publicity. "Doctor, could you just answer a few questions from viewers?"

Unfortunately, it's not just local media who are guilty of consulting with know-nothings with only passing knowledge of an issue. National media are guilty of it, too. The need to fill airtime with content is better filled with talking heads who present a compelling story, whether or not it is accurate or insightful, rather than an expert with deep insight into a topic who might not present as pretty a story. I've seen this countless times. A good portion of my day, in fact, is occupied responding to patient questions based on the misinformation presented in some media report.

My message of this brief rant: Be very careful of the messages delivered by the media, even if provided by some supposed "expert." In fact, I regard "experts" in health about as believable as politicians. Sure, sometimes they provide accurate information. But they often do not, or provide information with limited understanding. Or, worse, information intended to serve some hidden agenda.

Were the media to ask me to respond to the question, however, I would say:

"Yes, you should absolutely have a heart scan--yesterday! With your family history, there is no other way to accurately, easily, and inexpensively quantify the amount of coronary atherosclerosis in your heart's arteries. A stress test only uncovers advanced disease. A heart catheterization is overkill and absolutely not indicated in an asymptomatic man. Judging the presence of heart disease from cholesterol values is folly.

"What's left? A CT heart scan. So, yes, you need a CT heart scan ASAP with no doubt whatsoever."

But they didn't ask.
Don't lament no OTC mevacor

Don't lament no OTC mevacor

After Merck's third go at FDA approval for over-the-counter (OTC) status for its statin cholesterol drug, Mevacor (lovastatin), the FDA advisory board suggested that its request be denied. They expressed concern that too many people would not understand how the drugs would be used and that misuse would be common.

Similar sentiments were echoed by Dr. Sidney Wolfe, director of the Health Research Group at Public Citizen; the American Medical Association (though the AMA always fights anything that threatens to erode physician control over health); and the de facto spokesman for cardiologists, Dr. Steven Nissen of the Cleveland Clinic.

Although I am a supporter for tools and legislation that yield greater self-empowerment in health care to the public, there is no need to lament the failed OTC status for Mevacor. For one, Merck had no plans to reduce the price on its OTC preparation. For many people, this would have meant an increase in cost, since health insurers would surely not cover a non-prescription agent.

Second, OTC status sends the implicit message that cholesterol is the most common cause of heart disease; it is not. (Small LDL particles are the number one cause, a pattern only partially addressed by any statin drug and a pattern largely responsible for the failure of statin drugs to "cure" heart disease despite pharmaceutical manufacturer's attempts to increase doses to take up any slack in effect.)

Thirdly, you can achieve the same effect--no, a superior effect--by incorporating several simple strategies into your life. These strategies are superior to Mevacor because they do more than just reduce LDL cholesterol. You can achieve similar LDL-reducing effect to Mevacor, 20 mg, just by adding:

--2 tablespoons oat bran or ground flaxseed per day (choose flaxseed if you have sugar problems or small LDL; flaxseed contains no digestible sugars, only protein and fiber)
--Raw almonds or walnuts--at least a handful, though more is fine and will not make you fat. (It's nuts like party mixes, mixed nuts roasted in unhealthy oils, and honey-roasted nuts that make us fat, not raw.)
--Soy protein sources--probably the weakest effect of all foods listed, but a contributor that can be obtained in a variety of forms, such as tofu, soy protein powders, and soy milk.
--Other foods that reduce LDL include pectin sources (e.g., citrus rind), flavonoids (e.g., green tea); stanol esters found in butter substitute Benecol (recall that sterol-containing products like Take Control and the flood of new products on the market like HeartWise orange juice might have potential for allowing sterol esters to enter the blood, so I do NOT recommend them); and, of course, niacin.

Many of these strategies also reduce small LDL, raise HDL, reduce triglycerides, and reduce blood sugar, effects that go beyond that achieved with Mevacor. Of course, a combination strategy is not as easy as popping one pill a day, it's better for you.

I will certainly not shed any tears for Merck and its relentless efforts to gain a stronger foothold in the "transform conditions into diseases" marketing strategy, the same strategy that classifies shyness, toe fungus, and sadness into medical conditions necessitating medication. While I do generally support efforts to increase public access to strategies that increase their health care power, this one was not necessarily all good.

Members of Track Your Plaque can read the complete report, Unique nutritional strategies to Reduce cholesterol naturally on the Track Your Plaque website.



Copyright 2007 William Davis, MD

Comments (4) -

  • Anonymous

    12/18/2007 10:30:00 PM |

    Dr. do psyllium husks also reduce small ldl ?

  • Dr. Davis

    12/19/2007 3:46:00 AM |

    Not specifically. They reduce total LDL of all sizes.

  • Anonymous

    12/19/2007 10:21:00 PM |

    Ok I'm sorry but I'm confused. Does ground flax seed help get rid of small ldl or is it just like psyllium husks and reduces all ldl?

  • Dr. Davis

    12/20/2007 4:55:00 AM |

    Mostly total.

    There may be a slight preference for small LDL, but documentation is rather skimpy.

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Is direct-to-consumer drug marketing a failure?

Is direct-to-consumer drug marketing a failure?

According to the poll just completed by 80 participants on The Heart Scan Blog, 50% of respondents said they were less likely to take a drug after viewing an advertisement for it. A whopping 3 (4%) said that they would be more likely to take the drug after viewing an advertisement.

I find that interesting. If half the people responding are less likely to become customers of a drug company, then how does the drug industry justify running around-the-clock, every-few-minute ads? Spending by the drug industry for direct-to-consumer (DTC) advertising has ballooned over the past few years, and is now well over $30 billion dollars per year.

Unfortunately, despite the views of the highly-educated, curious, think-for-yourself, health information-seeking sorts of people who read this blog, drug companies still come out on top by DTC advertising. Estimates vary, with a 2006 U.S. Government Accountability Office study reporting that, for every $1 DTC advertising, sales are increased by $2.20. A 2000 Harvard study showed a higher return of $4.40 for every advertising dollar spent.

I'm sure the drug companies themselves have a very tight accounting handle on their own set of figures. We may not be terribly fond of these people and their often suspect tactics, but they're not stupid. They are certainly not stupid when it comes to making money.

Interestingly, 80% of the funds spent on DTC advertising focus on the 20 or so most popular drugs, all of which are used for treatment of chronic conditions like high cholesterol and high blood pressure, markets that are large and long-term. It pays very little to advertise drugs that may serve small markets for a short period. The implicit message is that this is not at all about informing the public. It is about advertising to grow revenues and profits--pure and simple.

It makes me wonder what the results of our poll would have been had we conducted it in 2000 before many people hadn't yet been brought to the brink of vomiting from the endless onslaught of commercial after commercial, complete with smarmy spokespeople (a la Lipitor's Dr. Robert Jarvik). What will it show in two years? Will the broader public join the more informed people who read this blog and become increasingly inured to the hard sell tactics?

For further discussion of this topic, click here for a reprint of an August, 2007 New England Journal of Medicine study, A Decade of Direct-to-Consumer Advertising of Prescription Drugs provides background, along with commentary on the impact of DTC drug marketing since the FDA allowed it 10 years ago. (Because it is a study and not an editorial, the editors fall short of making any recommendations for improvement or calling for a moratorium.)


Copyright 2008 William Davis, MD

Comments (4) -

  • shreela

    4/23/2008 9:22:00 PM |

    I usually try to avoid taking a drug that hasn't been on the market for 5 years. One exception was when my knee doctor HIGHLY recommended Celebrex. It worked great at first, but the effectiveness wore off after a while, so I stopped taking it, and just took iced my knee when it swelled, and took ibuprofen if the ice wasn't enough. I also discovered later that biking brought down the swelling.

    Looking back on that, although I'm glad he gave me Celebrex instead of Vioxx (shudders), I'm glad I only took the Celebrex for a little while. Even though their commercial brag that they're the only prescription anti-inflammatory that hasn't been taken off the market, I recall reading about some severe side-effects I'd rather not have.

    If there's a natural way to decrease any ailment, I'd much rather try that, instead of taking a new drug, as long as there's studies that back up the natural treatment/diet. That's why I'm so grateful for your blog, and others like it from licensed health professionals; you and the others provide balance between the old school AMA way, and the 'alternative' methods that sometimes are a bit out there.

  • Anonymous

    4/24/2008 10:31:00 AM |

    It's all about supply and demand really. Make people believe they need it and they will want it. Marketing trumps truth a lot fortunately.

    But then there's those of us who realise that if a company's trying too hard to push something, they're trying to sell us off yogurt with a fragrance in it.

  • ethyl d

    4/24/2008 4:48:00 PM |

    Most Americans are not "highly-educated, curious, think-for-yourself, health information-seeking sorts of people," and many of them prefer taking a pill to control a health condition rather than changing what they eat and how they live, so the drug ads probably are influential. I also suspect that the bombardment of all those ads makes people more likely to worry about having or someday getting the diseases the drugs supposedly help with, and instilling the belief that prescription drugs are the best or even the only way to alleviate or cure the condition. "Don't worry, American public, if you get sick, we've got a pill to make you all better."

  • Anne

    4/26/2008 1:17:00 PM |

    I probably would have answered "more likely" 6 years ago before I got on the internet and met some very smart people. It was with their help I discovered that lifestyle changes, not more prescription medication, would do more to optimize my health. This is an ongoing journey. I am still learning.

    Sadly, I have found most people I meet are more interested in the newest drug for their symptoms than in changing lifestyle.

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Vitamin D increased my cholesterol

Vitamin D increased my cholesterol

A friend told me this story.

Her friend, Linda, had added vitamin D to her daily supplements. Because she'd had a vitamin D blood level of 22 ng/ml, she was taking 6000 units per day.

However, Linda also had a high cholesterol value with a total cholesterol of 231 mg/dl. After several months on the vitamin D, she had another cholesterol panel. Total cholesterol: 256 mg/dl.

"It must have been the vitamin D! So I stopped it right away."

Is this true? Does vitamin D raise the level of blood cholesterol? Yes, it does. But it's a good thing. Let me explain.

Followers of The Heart Scan Blog know that total cholesterol is really a mix of 3 other factors:

Total cholesterol = LDL cholesterol + HDL cholesterol + triglycerides/5

This is the Friedewald equation, still used today in over 95% of cholesterol panels. So, by the Friedewald equation, anything that increases LDL, HDL, or triglycerides will increase total cholesterol.

One of the spectacular changes that develops over a year of taking vitamin D is that HDL cholesterol skyrockets. While sensitivity to this effect varies (probably on a genetic basis), HDL increases of 10, 20, even 30 mg/dl are common. A starting HDL, for instance, of 45 mg/dl can jump up to 65 or 70 mg/dl, though the effect requires up to a year, sometimes longer.

Vitamin D can also reduce triglycerides, though the effect is relatively small, usually no more than 20 mg/dl or so. Likewise, the effect on LDL is minor, with a modest reduction in the small type of LDL.

So the dominant effect of vitamin D from a cholesterol standpoint is a substantial increase in HDL. Looking at the equation, you can see that an increase in HDL is accompanied by a commensurate increase in total cholesterol. If HDL goes up 25 mg/dl, total cholesterol goes up 25 mg/dl.

So Linda is absolutely correct: Vitamin D increases cholesterol--but it's a good thing that reduces risk for heart disease and is an important part of a coronary plaque-reversal program.

This is yet another reason why I advocate elimination of total cholesterol on lipid panels. There is no useful information in the total cholersterol value, only the potential for misinformation.

Comments (38) -

  • Anonymous

    10/2/2009 12:48:55 AM |

    I know enough to not stress about lipid levels that send some docs for their prescription pads.  However, I was a bit shocked to see my recent numbers as follows:
    TC 465
    HDL 102.18
    Trig 48.95
    LDL 353.73
    Even doing a more accurate calculation, the LDl is high, although all the ratios seem to be in order.  I'm mid 50's, slim and with no family history of heart disease.  I also do not have any of the indicators for Lp (a).  Anything else that would cause this?

  • David

    10/2/2009 12:55:49 AM |

    Dr. Davis,

    I was wondering why my HDL went up with my latest Lipid Panel test results I received yesterday from my Endocrinologist (Type 2 diabetes). It was a pleasant present on my 60th birthday – HDL of 65!

    My Lipid Panel results: - Total Cholesterol -127,     HDL – 65,  Triglycerides – 51,  LDL - 52

    I have been taking 4,000 IU of D3 for the past six months after reading your blog. Actually, my HDL was in the mid fifties to sixty since for a few years I have been taking 500 mg of Slo-Niacin along with two Omega 3 fish oil capsules per day. Added to this is four days per week at the gym for the last three years. This helps too.

    My HDL has never been so high at 65 and I didn’t realize the positive affect of the Vitamin D3 until the current test results.

    I believe my LDL is so low because I am taking a 20 mg dosage of Simvastatin, although I am now taking it every other day. Along with the Simvastatin, I am taking Metformin and Diovan all prescribed by my Endocrinologist. After researching on the Internet I added the Omega 3, Niacin, and from your blog Vitamin D3. My doctor doesn’t have much to say about this, although I have mentioned it to him.

    Vitamin D3 really seems to work on the HDL!

    Now I really have to try to cut down on my wheat consumption to drop my A1c below 6.4.

    I appreciate your blog along with your book.

    Thanks for all your helpful information.

    David

  • Dr. William Davis

    10/2/2009 1:26:15 AM |

    Anon--

    You must--MUST--consider getting an NMR lipoprotein test to obtain the LDL particle number.

    Given the very high HDL , it is possible that the true LDL is far, far lower than the calculated LDL. It likely will be high, but not that high.

  • Dr. William Davis

    10/2/2009 1:26:24 AM |

    Great work, David!

  • steve

    10/2/2009 2:38:01 AM |

    Dr. Davis:  How do you know the increased HDL is due to the D3 and not from the wheat elimination you recommend?

  • Lyn

    10/2/2009 2:40:24 AM |

    Raises TC?!!!  Wow, thanks!  Gonna print out and show to Primary, Endo, and Cardio who are talking statins (Primary said statins or niacin). Comments?

    Aug 08: D=15.2, TC=212, TRI=181, HDL=47, LDL=129, TSH=2.795(normal free T3 & T4), A1C=11...50K IU/wk of D2 for 8 wks, then 1K D3 daily. Very low carb diet, metformin ER, Januvia (terrible CNS side effects), Maxzide, Cozaar. BP=140s/65 <1800 mg sodium told to add a bit more.

    Dec 08: D=33, TC=205, TRI=119, HDL=57, LDL=124, TSH=4.289 (normal free T3 & T4), A1C=6.9, TSH=2.667(normal free T3 & T4)...2K D3 daily.  Very low carb diet, metformin ER, Maxzide, Cozaar (half dose). BP=130s/75

    Jun 09: D=36, TC=231, TRI=119, HDL=57, LDL=150, TSH=4.548(normal free T3 & T4), A1C=6.4...4K D3 daily.  Very low carb diet, metformin ER, Maxzide, Cozaar (1/4 dose) on days following apnea events that wake me up (on CPAP), aver BP=128/72

    Sep 09: D=41, TC=235, TRI=145, HDL=60, LDL=147, TSH=5.51 normal free T3 & T4), A1C=6.5 (tried new foods-meals & spiked)...4K D3 daily (thinking of upping to 5-6K).  Very low carb diet, metformin ER, Maxzide, Cozaar (1/4 dose) on days following apnea events that wake me up, aver BP=130/70, started generic Levothyroxine 25 mcg/day, just started Iodoral 12.5 mg a wk ago--body temp finally staying the 98s. Subbing a high-protein (lots of BCAAs) shake for breakfast and 1/2 shake for snack -- lost 4 pounds in 6 days (monitoring BGs frequently). ApoB=111 (<109 normal)...oops.

    So, are my rising cholesterol numbers the results of the following or ?
    - Very low carb (<40 gms) diet (guessing larger LDL particles)
    - Rising TSH levels(hypothyroidism increases cholesterol right?)
    - Increased amts of D3

    60 yo female. Lost 50+ pounds but still obese (takes time). 35-60 mins/day low intensity recumbent exercise bike. Laidoff--lots of angst & stress.  All other bloodwork results good (high RBC down to normal, guessing less apnea desats). Using topical progesterone, 3 wks on, 1 wk off a la Dr John Lee. No CVD in family, just Type 2 and hypothyroidism.  If niacin is good, which form?  Not sure I can handle flushing, have touchy skin, used to have rosacea.

  • Lynn M.

    10/2/2009 5:38:54 AM |

    Anonymous,

    Hypothyroidism will jack up cholesterol and LDL.  People can be hypothyroid even if they're slim.  Have you had your FT3 checked?

  • moblogs

    10/2/2009 9:27:36 AM |

    I actually found different. I've been on 10,000IU of D3 and found a general dip in my cholesterol levels (although a slight increase in HDL).

    Here's a scan of my results in '07 (when I was just 15nmol/L) and recently where I'm above 76nmol/L (I just say above as my most recent D reading is yet to arrive).
    http://bit.ly/3h9X4C

    Of course it may be co-incidence too, but both my brother and father have had no change at all in their cholesterol levels in the last few years. My brother's on D but only just enough as recommended by a doctor.

    My levels this year are now well below UK average (which is 5.7mmol/L and I'm now 4.95 from 5.62) and correspondingly I wasn't told to modify my diet or go on a statin, even though my cholesterol level was deemed as only marginally high before.

  • denparser

    10/2/2009 11:41:02 AM |

    wow.. how could it be? in fact, if that's gonna be true, not all vitamins are good for the body in the sense that it has a side effect inside the body.

  • Jim Purdy

    10/2/2009 12:00:27 PM |

    I read this and then immediately ordered some vitamin D.

  • Anonymous

    10/2/2009 4:02:13 PM |

    Anonymous,

    Has your LDLs always been this high or have you never had your cholesterol tested before? If so, then perhaps you have Familial Hypercholesterolemia like I do. If your LDLs have been tested before and were never that high, then it must be something else.

    Since your Trig. are so low and your TC is over 250, the standard Friedewald equation isn't the most accurate for you. Here is a better calculator for people like you:

    http://homepages.slingshot.co.nz/~geoff36/LDL_mg.htm

    Regardless, that still is a high LDL. Have you recently started taking new supplements?

    The reason I ask is because I was once was advised to take a several difference supplements in the hopes of raising my Testosterone and they all had some zinc in them and my LDLs skyrocketed (even for me)! I later learned that too much zinc can do this. I was taking around 100 or 110mg of zinc daily if my memory serves me correctly. I believe taking too much zinc can adversely affect copper levels which in turn can raise cholesterol. Now I try to stay around 100% to 200% of the RDA (15mg - 30mg) and I don't have that problem.

    Are you taking sterols? Maybe you're absorbing the sterols...just a thought.

    Maybe it was a just lab fluke. I would recommend a retest (preferably using a NMR or a VAP test).

    Good luck!

    John M.

  • trinkwasser

    10/2/2009 4:25:01 PM |

    Put your numbers through this

    http://homepages.slingshot.co.nz/~geoff36/LDL_mg.htm

    it brings your LDL down to 286, still a bit high, I'd suggest there's something else occurring, could be thyroid?

    One "authoritative" site for calculating cardiovascular risk won't even permit HDL levels over 100 to be entered, so you've aced that, and the trigs

  • Anonymous

    10/2/2009 5:48:46 PM |

    http://www.elements4health.com/cholesterol-buildup-in-diabetes-patients-deficient-in-vitamin-d.html

    interesting...have you read or posted on this yet?

  • Helena

    10/2/2009 7:50:31 PM |

    Total Cholesterol is by far a wrong way to measure the risk of heart disease. In this case, if the doctor she was going to was one among many she would have been prescribed statin drugs without further investigation. Higher Cholesterol must be bad right - let's make a buck and sell her some lipitor or Simvastatin! People in general are too uneducated and trust doctors more than anything else. This makes me scared! A low carb high fat (LCHF) diet will gett people more healthy all over! Better cholesterol quota, less over weight, less risk of developing type 2 diabetes, less risk of inflammation, and better energy! You can't go wrong! Thanks for this very important post!

  • Anonymous

    10/3/2009 2:34:28 AM |

    Dr. Davis,
    Thanks so much for your response.  Would it make a difference to know that I have eaten low carb for several years, and seldom eat grains?  Also, apparently my lipids were 'normal' when last checked 10 years ago.
    My GP claims ignorance of the difference between calculated and direct measure of LDL, or of different particle size.  He just knows the numbers the lab sends.  I believe I would need to see a specialist to get tested further.  Worth the trouble?

  • Dr. William Davis

    10/3/2009 12:33:08 PM |

    Hi, Steve--

    You are absolutely correct: Given sufficient time, wheat elimination increases HDL also. However, vitamin D can also increase it independently. I've seen many people add vit D to an already established no-wheat diet and still send HDL through the roof.

    Lyn--

    As you can see, it's probably a combination of all the good things you've done.

  • Lieta

    10/4/2009 2:40:15 AM |

    I've been supplementing with 6,000 mg of D3 each day for a month and following a low carb but not wheat-free diet for 2 months. I was surprised to see my HDL come back so low and my LDL so high on a recent test:

    HDL: 34
    LDL: 203
    VLDL: 9
    Trig: 47

    I will add Niacin to my supplement regimen to help bring down the LDL, and eliminate wheat. I am about 40 lbs overweight, with no other health issues (that I know of!). My A1C and fasting insulin numbers are good (A1C 4.7, Ins 4.3). I wonder if I need to pursue a more agressive approach to bring down my LDL, or just give the Vitamin D/Niacin supplementation time to work (and give up wheat)?

  • World Vitamins Online

    10/4/2009 9:25:55 PM |

    Very good information. Many people do not understand how to decipher the information when they get the results of a cholesterol test. This should help out some.

  • Anonymous

    10/4/2009 11:30:46 PM |

    I started taking 500mg niacin daily
    (for 40 days now) and increased my HDL to 49 from 35
    but my TC went from 189 to 251!
    (my trig is 62)
    Can niacin increase TC also?

  • Dr. William Davis

    10/6/2009 2:08:45 AM |

    Lieta--

    When it comes to vitamin D and wheat elimination, it generally requires about 6 months for full effect to be reflected in your blood work.

    So patience pays!

  • Dr. William Davis

    10/6/2009 2:09:27 AM |

    Anon--

    Niacin or any other agent that increases HDL will likewise increase total cholesterol. It's all good!

  • Anonymous

    10/6/2009 2:28:53 PM |

    Do you have a recommended brand of Vit D3?  Does it have to be taken with Vit A (as I've read in some other places)?

    Thanks

  • Alex

    10/8/2009 2:22:51 PM |

    Does the lack of useful information in total cholesterol value extend all the way down to 150 and below, which is the level Joel Fuhrman and others say people should strive for?

  • Brian

    10/31/2009 2:07:32 PM |

    This reminds me of a story that the renowned physicist Richard Feynman told about the poor quality of textbooks he had reviewed, which gave students totally useless problems with no practical purpose.

    His example was a problem that listed the temperature of 3 random stars, and asked the student to calculate the total temperature, a totally meaningless and pointless number that tells you absolutely nothing about anything.

  • Calculating cholesterol

    12/14/2009 2:07:28 AM |

    I have looked at many sites on this subject and not come across a site such as yours which tells everyone everything that they need to know. I have bookmarked your site. Can anyone else suggest any other related topics that I can look for to find out further information?

  • Kerri Knox

    4/20/2010 2:09:57 PM |

    Dr. Davis,

    Do you have any studies to support that vitamin d increases HDL? I've searched it and could find nothing but neutral studies on it or studies in combination with omega's and niacin.

    This study that was ONLY with vitamin d saw no effect.

    http://www.ncbi.nlm.nih.gov/pubmed/19352377?dopt=Abstract

    and this study showed that atorvastatin needed adequate vitamin d levels in order to work.

    http://www.hindawi.com/journals/ije/2010/320721.html

    but I couldn't find anything saying that vitamin d raised HDL. Any references that you can refer me to or is this just your observations?

  • Anonymous

    9/27/2010 1:21:55 PM |

    Vitamin D doesn't raise cholesterol - cholesterol uses sunlight to synthesize or create Vitamin D.  If you are taking a cholesterol lowering medication, your body can't process the cholesterol to make Vitamin D.

  • Anonymous

    10/5/2010 11:22:57 PM |

    In May 2008 I had a D3 level of 25. Now it's near 80, after 1+ years on 5000 IU of D3 per day. My LDL cholesterol has gone up (it's in the 170s) and my HDL is still low (40-50). HDL has actually changed very little while LDL has increased over time since the first time it was tested in 2002.

    Despite the info presented here, I'm not convinced that there's such a clear relationship between LDL and Vitamin D.

  • buy jeans

    11/3/2010 6:41:09 PM |

    So the dominant effect of vitamin D from a cholesterol standpoint is a substantial increase in HDL. Looking at the equation, you can see that an increase in HDL is accompanied by a commensurate increase in total cholesterol. If HDL goes up 25 mg/dl, total cholesterol goes up 25 mg/dl.

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    Vitamin D is one of the only vitamins produced naturally by the body. Vitamin D is unique because it is derived both from sunlight and foods. Vitamin D Maintains Your Calcium Balance.

  • paul

    4/28/2011 8:25:17 AM |

    Thanks a lot for the tips. Reduce your cholesterol by taking the necessary vitamins and supplements. Avoid eating fatty food and focus more on eating healthy fats.

    -Supplements Canada

  • Brian

    12/4/2013 8:36:08 PM |

    Vitamin D3 supplements will absolutely increase both your LDL and HDL cholesterol.  The impact on each can be quite large.  I know people want to believe that supplements can do nothing negative, but it is what it is.  All you have to do is buy a Cardiocheck PA meter or the like and test your cholesterol at home.  Take 5000 IU per day of vitamin D3 for 2 weeks and recheck -- your LDL will go up dramatically, and your HDL will rise as well (and so your total will increase a fair amount).  The exact same thing will happen if you get massive amounts of sun without sunscreen over a number of weeks.  Who know whether this effect is a good or bad thing -- your guess is as good as mine.  But I'm always amazed at all the $30 million dollar studies that have to be done to find out what any person can see with a single affordable at-home monitor...

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Just who is "Real Facts 2000"?

Just who is "Real Facts 2000"?

This is an example of what seems to be developing over at Amazon.com, posted as a "book review":

The author has no credentials, no credibility, just a small cult of terribly misinformed followers. Don't be fooled by the high volume screech against wheat and grains. Allegations of "secret ingredients in wheat" to make you eat more, or comparisons to cigerettes. Seriously?! For over 8000 years wheat has sustained and grown human kind, oh and it tastes good when mixed with a little water and yeast. Every nutritionist and serious medical professional will tell you that bread is the most economical and safe source of essential nutrients. In fact, bread is handed out in natural disasters because it sustains life without food safety issues or requiring refrigeration. And now, suddenly it will kill you. Comical! This book is such a bone headed, misinformed way to just scare people into not eating.

As for secret ingredients, humm, apparently the author is ignorant of the food laws that regulate everything that goes into food and on food labels. Unlike some enforcement agencies, the FDA has some serious teeth behind its enforcement. As for frankenwheat, again seriously?! Wheat, due to its ubiquitous presence in the world is treated as sacrosant from any GMO research or development.

If you need real, science based information on healthy eating, check out [...] and leave this book and its cult in the compound.


If you recognize the wording and tone, you will readily recognize the footprints of the Wheat Lobby here. "Terribly misinformed followers"? . . . Hmmm. "Food laws"? I didn't realize that eating more "healthy whole grains" was a . . . law?

Make no mistake: There are people and organizations who have a heavy stake in your continued consumption of the equivalent of 300 loaves of bread per year. There are people and organizations (read: pharmaceutical industry) who have a big stake on the "payoff" of your continued consumption of "healthy whole grains."

This is not a book review; this is part of a concerted, organized campaign to discredit a message that needs to be heard.

Anybody from the media listening?

Comments (38) -

  • Linda J

    9/29/2011 3:24:51 AM |

    Time to report that review - and click that it wasn't helpful.   There is a remedy and we need to get on it.

  • Donald Kjellberg

    9/29/2011 5:04:36 AM |

    On one of his/her other reviews, there is a reference that states, "For real information on healthy and balanced lifestyles including moderate physical activity go to www.mypyramid.gov."

    Moderate physical activity? Is that like moderate eating activity?

  • Sean

    9/29/2011 8:33:04 AM |

    Another person comparing a Paleo-style diet to a cult. You really just have to laugh at these idiots. Sure I like to shave my head and chant over a hunk of beef in the basement, whilst burning candles and wearing a robe, but that's not because of Dr Davis.

  • Howard Lee Harkness

    9/29/2011 10:57:00 AM |

    Hope this isn't a dupe; I tried posting and got an "internal server error," so I'm trying again.

    Dr. Davis: Have you heard of the "Streisand Effect?" This 'reviewer' is basically drowned in positive reviews, and is best ignored. The review that you mention is feeble enough that anyone capable of sentient though would dismiss it, and I think you would have been better off not calling anybody's attention to it.

  • Dr. William Davis

    9/29/2011 11:18:51 AM |

    Hi, Howard--

    Point taken.

    What I was intending to do was not so much pick on a negative review, which I can live with quite easily, but point out that this may be the start of a bigger effort, a larger campaign of disinformation. In other words, if this was just some guy who thought Wheat Belly sucked, that's okay. But I suspect this was not the work of a lone individual; I'll bet this was posted by an ad agency being paid by the wheat lobby.

  • Dr. William Davis

    9/29/2011 11:19:35 AM |

    If you step back for some perspective, Sean, you are absolutely right: This is, at many levels, pretty entertaining stuff!

  • Dr. William Davis

    9/29/2011 11:23:25 AM |

    Funny, Donald.

    I feel pretty "balanced" myself!

  • Dr. William Davis

    9/29/2011 11:25:27 AM |

    Raise awareness is my answer, Linda.

    Raise awareness that this is not likely the work of someone who disagrees with the premise of Wheat Belly. It is likely the work of someone in an advertising agency being paid for by the wheat lobby, the start of a broader disinformation campaign---just like they said they would in their press releases.

    It reminds me of the magazine ads from years ago paid for by Big Tobacco countering the arguments that smoking was bad. Did anybody take them seriously?

  • nina

    9/29/2011 11:51:48 AM |

    Well of course they are right.  Just look at some of the people online who have wrecked their health by eliminating healthy wheat:

    http://www.dailymotion.com/video/x23grt_my-atkins-diet-success-story_webcam

    http://www.youtube.com/watch?v=8WIH9TnQ1uY

    Yep brothers and sisters, keep the faith, eat the wheat (and drink the Kool Aid) NOT.

    Nina

  • nina

    9/29/2011 11:57:11 AM |

    Oh..... I forgot the other zombie cripple who is a victim of an unhealthy wheat free diet.

    Yep Dr Richard Bernstein.  He was just an engineer, but trained as a doctor so he could spread the world.


    Very very dangerous man.

    http://www.youtube.com/watch?v=vyOI9bk3VZc&feature=related

    Keep the faith and eat a muffin (NOT).

    Nina

  • chuck

    9/29/2011 12:05:39 PM |

    To many people, there are many NEW revelations in the book Wheat Belly.  I have seen so much criticism of this book in various forums and it is by people who have never even held the book in their hand let alone read it.  Over time, this book will have a pretty big impact as more people actually do read it.

  • marilynb

    9/29/2011 12:25:08 PM |

    With just the first 5 words of that review, "The author has no credentials", I knew the reviewer was just blowing smoke out his butt.  Hello, a cardiologist is not credentialed???  The whole thing is unprofessionally written.  If the wheat lobby wants to discredit your book. they'll need better people than this joker.

  • Soul

    9/29/2011 1:33:53 PM |

    You know it is kind of funny, I'm often asking the opposite question of where isn't media!

  • James Buch PhD

    9/29/2011 2:23:42 PM |

    "Rsyinh Greens Alters Your Genes"

    A new Chinese study showing that genes from plants survive the digestive tract and can be expressed in animal tissues. There is some limited discussion near the end of other studies regarding GMO genes and the claim that in at least one study, the GM O genes were found in animal tissues.

    So, the dangers of drastic gene modification and cross-breeding of plants (such as our friend wheat) may be getting a more scientific basis.... but this is only one animal study. So, time will tell, hopefully.

    http://www.newscientist.com/article/mg21128323.100-eating-your-greens-alters-your-genes.html?

  • Jana Miller

    9/29/2011 3:02:45 PM |

    So creepy....I guess with all the opposition, you must be on the right track. Thanks for all your research. I appreciate you.
    Jana

  • Tyler

    9/29/2011 3:40:34 PM |

    You are absolutely right. The cultish comparisons are very laughable, but I think there are some similarities when someone discovers such a drastic improvement in the quality of their life in such a small change... sure, eliminating wheat and eating more bacon are a science backed and delicious notion, but I, for one, am willing to admit that I have happily proselytized a handful of curious friends.

    Now they eat a more paleo/primal diet and no longer suffer from the fatigue, lethargy, and autoimmune issues they weren't even aware of. So I guess I have converted them (like a cult aims to do?), but it wasn't malicious or ill-founded. It's changed their lives in tangible ways and none of them have looked back on the glorious life of cupcakes and doughnuts as a safe harbor before their new increased energy levels, more comfortable and fit body, and depression and mood swing-less days.

    So maybe we should be weary of sharing "the good news" of paleo lifestyle/wheat elimination... or maybe we shouldn't feel bad about sharing this information with people who want what we've uncovered.

    Either way, Sean, are we still on for bleeding out that lamb in my garage tonight? I'd like to boil the bones, too.

  • Fat Guy Weight Loss

    9/29/2011 4:13:46 PM |

    You could be optimistic this is just a classic troll, but I agree given the tone and wording that this is obviously written by someone paid by someone from the wheat lobby.  Heading over to hit the button that that review is not helpful.

  • Dr Ostric

    9/29/2011 4:45:20 PM |

    I left an e-mail with John Stossel, who has written about toxic partnerships involving government and ADM in his books. I like his work, and I like his ideas. I don't know if it will help, but I am on your side Dr. Davis. I am committed to ideas and not ideology, and dialogue and not dogmatism. Keep up the excellent work. I am recommending Wheat Belly for all of my obese patients who have wound problems, diabetes, and even for my carpal tunnel patients who have type II and are obese. With 47 trillion dollars expected to be spent for care of chronic illness in 2030, we need to do something. What I was so surprised about this book is how my wife took to it, and now is spreading the word to. By the way, your recipes ROCK!

  • STG

    9/29/2011 6:01:00 PM |

    I am going to amazon right now to make so waves with this ignorant post by the wheat trade organization rep.--what bogus propaganda!

  • Lindas

    9/29/2011 10:51:38 PM |

    Dear Doctor Davis and fellow anti- wheat bellies:::::I'll be posting this on Amazon

    Attention real facts 2000 and other uninformed critics who fear the truth, that can save your own life
    .....Walk down the street and see the flagrant, extreme, mutli-generational obesity. Go into a doctors waiting room and see the huge numbers of diabetic, metabolically ill patients.
    Look at some old photos taken in America in the 1900's- 1970's such as those of crowds on Jones' Beach, or crowds in the streets after World War II AND OBSERVE ONE VERY SIGNIFICANT thing...there is no  OBESITY !   WHAT'S WRONG...WHAT HAPPENED???? APPARENTLY THE "SO-CALLED-RECOMMENDED FDA DIETARY EATING PROTOCAL "   HAS FAILED....IT'S NOT WORKING !!!!!!     America 's got a lot of weight to loose.....At least try getting the wheat out.    TTthere is too much MSG (wheat based) a known neurotoxin hanging around in our food sources also.
    Be sure your fighting for your health....not against it !

  • John Lorscheider

    9/30/2011 12:04:28 AM |

    If Washington, along with the various special interst groups, would have real interest in promoting health and economic reform they would get rid of corporate welfare like wheat, corn, soybeans, rice, and cotton subsidies instead of lining their pockets with taxpayer dollars.  The following excerpt is from http://www.downsizinggovernment.org/agriculture/subsidies

    Six Reasons to Repeal Farm Subsidies

    1. Farm Subsidies Redistribute Wealth. Farm subsidies transfer the earnings of taxpayers to a small group of fairly well-off farm businesses and landowners. USDA figures show that the average income of farm households has been consistently higher than the average of all U.S. households. In 2007, the average income of farm households was $86,223, or 28 percent higher than the $67,609 average of all U.S. households.19 When large-scale federal farm subsidies began in the 1930s, farm incomes were only half the national average.

    Although policymakers love to discuss the plight of the small farmer, the bulk of federal farm subsidies goes to the largest farms.20  For example, the largest 10 percent of recipients have received 72 percent of all subsidy payments in recent years.21 Numerous large corporations and even some wealthy celebrities receive farm subsidies because they are the owners of farmland. It is landowners, not tenant farmers or farm workers, who benefit from subsidies. And one does not even have to be the owner of farmland to receive subsidies: Since 2000 the USDA has paid $1.3 billion in farm subsidies to people who own land that is no longer used for farming.22  

    2. Farm Subsidies Damage the Economy. The extent of federal micromanagement of the agriculture sector is probably unique in American industry. In most industries, market prices balance supply and demand, profit levels signal investment opportunities, market downturns lead to cost cutting, and entrepreneurs innovate to provide better products at lower prices. All of those market mechanisms are blunted or nonexistent in government-controlled agriculture markets. As a result, federal agricultural policies produce substantial “deadweight losses” and reduced U.S. incomes.

    Farm programs result in overproduction, overuse of marginal farmland, and land price inflation, which results from subsidies being capitalized into land values. Subsidy programs create less efficient planting, induce excess borrowing by farmers, cause insufficient attention to cost control, and result in less market innovation. And policies often work against the claimed goals of Congress. As an example, while members of Congress say that they support small farms, owners of large farms receive the largest subsidies, which has given them the financing they need to purchase smaller farms.23

    In 2006 the Congressional Budget Office reviewed major studies that examined the repeal of U.S. and foreign agricultural subsidies and trade barriers.24 The CBO found that all the studies they reviewed showed that both the U.S. and global economies would gain from the repeal of subsidies and trade barriers.  

    3. Farm Programs Are Prone to Scandal. Like most federal subsidy programs, farm programs are subject to bureaucratic inefficiencies, recipient fraud, and congressional pork-barrel politics. The Government Accountability Office found that as much as half a billion dollars in farm subsidies are paid improperly or fraudulently each year.25 Farmers create complex legal structures to get around legal subsidy limits.26 And many farmers decide not to pay back their USDA loans: in 2001 the GAO found that more than $2 billion in farm loans were delinquent.27

    Congress and the USDA distribute payments for farm emergencies carelessly. Disaster payments often go to farmers who have no need for them, and in many cases have not even asked for them.28 To receive benefits, some farmers claim to have experienced damage even when they haven’t.

    A powdered milk scandal in 2003 illustrates the USDA’s bureaucratic ineptitude. That year, the government decided to give some of its massive stockpile of powdered milk to cattle ranchers for feed after a drought. But much of the milk ended up being illegally diverted to other uses, which allowed speculators to earn large profits at taxpayers’ expense.29

    Perhaps the biggest scandal with regard to farm subsidies is that congressional agriculture committees are loaded with members who are active farmers and farmland owners. Those members have a direct financial stake whenever Congress votes to increase subsidies, which is an obvious conflict of interest.

    4. Farm Subsidies Damage U.S. Trade Relations. Global stability and U.S. security are enhanced when less developed countries achieve stronger economic growth. America can further that end by encouraging the reduction of trade barriers. However, U.S. and European farm subsidies and agricultural import barriers are a serious hurdle to making progress in global trade agreements. U.S. sugar protections, for example, benefit only a very small group of U.S. growers but are blocking broader free trade within the Americas.

    The World Trade Organization estimates that even a one-third drop in all tariffs around the world would boost global output by $686 billion, including $164 billion for the United States.30  Trade liberalization would boost the exports of U.S. goods that are competitive on world markets, including many agricultural products, but U.S. farm subsidies and protections stand in the way of that goal.

    5. Farm Programs Damage the Environment. Federal farm policies are thought to damage the natural environmental in numerous ways. Subsidy programs can cause overproduction, which draws marginal farmland into active production. Similarly, trade barriers induce agriculture production on land that is less naturally productive. As a result, marginal lands that might otherwise be used for parks or forests are locked into farm use because farm subsidy payments get capitalized into higher prices for land.

    Subsidies are also thought to induce excessive use of fertilizers and pesticides. Producers in regions that have better soils and climates tend to use less fertilizers and pesticides than do producers in less favorable climates, who can only afford to farm in the poor locations because of subsidies. An excessive use of chemicals can contaminate lakes, rivers, and other water systems.

    Florida sugar provides a good example. Large areas of wetlands have been converted to cane sugar production because of artificially high domestic sugar prices. Unfortunately, the phosphorous in fertilizers used by sugar farmers has caused substantial damage to the Everglades. Farming, like any industry, can cause negative environmental effects, but it is misguided for federal policies to exacerbate those problems.

    Federal subsidies for irrigation have also been a cause of environmental concerns. The Bureau of Reclamation runs a vast water empire in the western United States, which sells water to farmers at a fraction of the market cost. The resulting overuse could lead to a water crisis as the West’s population continues to rise.31 The solution is to move water into the free market and allow prices to rise to efficient and environmentally sound levels.

    6. Agriculture Would Thrive without Subsidies. It is normal for people to fear economic change, but many industries have been radically reformed in recent decades with positive results, including the airline, trucking, telecommunications, and energy industries. If farm subsidies were ended, and agriculture markets deregulated and open to entrepreneurs, farming would change—different crops would be planted, land usage would change, and some farms would go bankrupt. But a stronger and more innovative industry would likely emerge having greater resilience to shocks and downturns.

    Interestingly, producers of most U.S. agricultural commodities do not receive regular subsidies from the federal government. In fact, commodities that are eligible for federal subsidies account for 36 percent of U.S. farm production, while commodities that generally survive without subsidies, including meats, poultry, fruits, and vegetables, account for 64 percent of production.32 And, of course, most other U.S. industries prosper without the sort of government coddling that farmers receive.

    Another point to consider is that farm households are much more diversified today and better able to deal with market fluctuations. Many farm households these days earn the bulk of their income from nonfarm sources, which creates financial stability. USDA figures show that only 38 percent of farm households consider farming their primary occupation.33

    Some USDA programs provide useful commercial services such as insurance. The USDA says that its insurance services are “market-based,” but if that were true, there would be no need for subsidies and the services ought to be privatized. After all, most U.S. industries pay for their own commercial services. Also, financial markets offer a wide range of tools, such as hedging and forward contracting, which can help farmers survive cycles in markets without government subsidies.

    An interesting example of farmers prospering without subsidies is in New Zealand.34 That nation ended its farm subsidies in 1984, which was a bold stroke because the country is four times more dependent on farming than is the United States. The changes were initially met with fierce resistance, but New Zealand farm productivity, profitability, and output have soared since the reforms.35  New Zealand’s farmers have cut costs, diversified their land use, sought nonfarm income, and developed niche markets such as kiwifruit.

    Today, data from the Organization for Economic Cooperation and Development show that farm subsidies in New Zealand represent just 1 percent of the value of farm production, which compares to 11 percent in the United States.36 New Zealand’s main farm organization argues that the nation’s experience “thoroughly debunked the myth that the farming sector cannot prosper without government subsidies.”37 That myth needs to be debunked in the United States as well.

  • John Lorscheider

    9/30/2011 1:47:10 PM |

    Realfacts2000 is no doubt a special interest and/or the mouth piece of the wheat lobby.  I you follow the money trail it will always lead one to the truth and what is behind the scenes.  This taken from North American Millers Association website http://www.namamillers.org/NewsArchives10/Mar10News.html .  Billions of your tax dollars go to subsidize wheat growers every year.

    NAMA urges government funding of cereal crops research
    NAMA and the National Oat Improvement Committee submitted a joint letter to Representative Tammy Baldwin expressing support for the National Barley Improvement Committee's appropriations request for the USDA-ARS Cereal Crops Research Unit (CCRU) at Madison, WI. CCRU was established in April 2007 with the goal of studying and identifying antioxidant chemicals in oats and barley that may play a role in protecting humans from degenerative diseases such as cancers and heart disease. "However, current funding is insufficient to meet a substantial increase in operating costs for the new building and maintain programs for seven CCRU scientists (currently only five positions are filled and two are vacant due to inadequate funding.)" Government funding is essential as oat research receives no private investment.

    Industry supports Obama's pledge to double U.S. exports
    A coalition of food/feed and agricultural industry organizations are in support of President Obama's pledge to double U.S. exports within five years as a way to create millions of new export-related jobs in this country. The coalition, of which NAMA is a member, sent a letter to Speaker of the House Nancy Pelosi, Republican Leader John Boehner, Majority Leader Harry Reid, and Republican Leader Mitch McConnell urging them to take the necessary actions to support this goal—including passing the pending free trade agreements with Colombia, Panama, and South Korea. These agreements would allow U.S. exports to be on par with other countries and compete effectively in the export market.

    The letter also noted concern over recent legislation (H.R. 3012 and S. 2821) that would "require the Administration to demand the re-negotiation of all current pending trade agreements to modify provisions to permit inclusion of certain requirements." This legislation has the potential to drastically damage export relations and U.S. agriculture. To view the letter, please visit NAMA’s web site at http://www.namamillers.org/NewsArchives10/Ltr_FTA_Mar2010.html.

  • dmg

    9/30/2011 3:10:27 PM |

    All pioneers wear Arrow shirts.

  • Dave90291

    9/30/2011 9:10:13 PM |

    I just finished the book and posted a review on my blog for anyone who is interested in a more in depth analysis than IT ROCKED! The strong sales and largely positive reviews are a good sign, which is probably why the wheat industry hacks are posting negative reviews.

    http://aminoaciddiet.com/2011/09/30/book-review-wheat-belly/

  • Debbie B in MD

    10/1/2011 1:31:27 PM |

    Yep, I must admit I am working to bring people to this "cult." I am probably a bit annoying or I like to call it persisitent in my FB posts. Oh well, the proof is in the pudding. The change in my body and outlook has been so dramatic, it is hard not to share. I'll take my chances.

  • Debbie B in MD

    10/1/2011 1:38:23 PM |

    I have watched a friend lose 94 pounds on medifast. She works out like a crazy woman. Now, she is getting burned out and starting to gain weight. She has seen me lose 37 pounds over the last year or so. Admittedly I still have about 37 to go. I got into the gf replacements for a while. Now that I am off of them the weight is going away again. At any rate, I wish she would listen to what has helped me. She claims it is only because I have celiac. It doesn't apply to those who don't. I can't get her to read the book, but maybe, just maybe she will read the blog. I hope she doesn't listen to the critics.

  • Dr. William Davis

    10/1/2011 1:44:18 PM |

    Don't fret, Debbie. Your friend will come around when she witnesses your profound and effortless weight loss--no extreme exercise, no colon cleanse . . . just no wheat.

  • Dr. William Davis

    10/1/2011 1:55:30 PM |

    Yup, you got it, Dave.

    Very nicely written review, by the way. "A giant among dwarves"? That's great!

  • Dr. William Davis

    10/1/2011 2:01:39 PM |

    Hi, John--

    No doubt. Note that, at the left on the Millers Association website and listed as a "partner," is the USDA Food Plate. How revealing! Imagine a chemical manufacturer calling the EPA a "partner."

    This wheat-free message is, indeed, potentially economically disruptive. None of us, of course, are demanding legislative reform to ban wheat; we are simply trying to raise awareness to allow better-informed individual choice. This issue has come up repeatedly in my interviews on Canadian media, since they are such large wheat exporters.

  • Dr. William Davis

    10/1/2011 2:08:42 PM |

    Thanks, John. Fascinating reading!

    We are confronting head-on with vertically-integrated agribusiness and Big Food, all of whom stand to lose big-time by elimination of government subsidies. I, too, find it incredible that this still goes on.

  • Dr. William Davis

    10/1/2011 2:10:13 PM |

    Thank you, Lindas!

    Your clear-minded wheat-free logic shines through!

    The USDA and HHS need to get off their high horse, blaming our sloth and gluttony. They are to blame.

  • Dr. William Davis

    10/1/2011 2:11:37 PM |

    Thanks, STG!

    I'm shocked that there are PR people out there who do this just for a paycheck.

  • Dr. William Davis

    10/1/2011 2:13:36 PM |

    Wow, thanks, Dr. Ostric!

    The John Stossel idea is terrific. He is a champion among whistleblowers; adding his voice would be priceless!

    And thanks for the feedback on the recipes.

  • Dr. William Davis

    10/1/2011 2:16:07 PM |

    I noticed that, too, Chuck: The criticisms seem to be coming from 1) wheat trade group PR stooges, and 2) people who think they know what the book says but haven't read it.

    It actually makes me laugh! Real criticisms would be one thing. But this stuff is just fluff.

  • Jackie G

    10/13/2011 3:14:03 PM |

    Yeah, I have to treat this information like religion... People are THAT fanatical about their food. But, I have managed to get a few people to go lc. And thanks to the good DR. here, I got my mom started. I just said, "fine, but do me a favor. Go wheat free for a month. While you're doing that, buy full fat dairy. Then tell me what you think." I'd never thought to put it so simply.

    You would think the fact that my husband has lost 80+ lbs and I've lost 45lbs in under 5 months would sound some bells. Our cholesterol has dropped 30+ points each (while raising HDL a bit.) and my Trigs are down more than 150 points. Yeah - you read that right. So of course people ask us... then get ANGRY about the answer. We stay the heck away from frankenfood. We eat full fat cheese, and leave the fat and skin on our chicken.

    Put that on your "government regulated food plate" and eat it!

    *Sorry for post hijacking, got carried away.

  • Dr. William Davis

    10/14/2011 1:00:23 AM |

    Yes, but it was a good hijacking, Jackie!

    Very excellent results for you and your husband.

  • [...] are acting like it with some dubious claims and flat out attempts at character assassination with comments like this on the Amazon page for Dr. William Davis’ book Wheat Belly:  The author has no credentials, no credibility, just a small cult of terribly misinformed [...]

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