Well, since you touch on it, i'd be very interested in what you think about GF alternative flours.

I know you have said in various places to avoid wheat & "corn starch."  Also indications that oats are not very good for us either.  But there are so many other grains.  Amaranth & quinoa are both supposed to be high in protein. Buckwheat?  Corn meals?  Millet?  I could go on & on.

Are nut & coconut flours the only option to living low carb?  

I try to keep your recommendations in mind, but frankly, i struggle with giving up all grains.

Thanks.

Dr Davis, I certainly appreciate you looking for alternatives to the destruction wheat poses, but seems like this product may have issues as well?

Wouldn't the problems with soy greatly out weigh anything positive one could gain from using tofu?

This was taken from an article on Dr. Mercola's site concerning tofu. http://articles.mercola.com/sites/articles/archive/2008/09/18/what-s-so-bad-about-tofu.aspx

"Many health-conscious Americans, in an effort to improve their eating habits, have switched to eating tofu in place of meat or eggs. The soy industry would have you believe that this is a smart move for your heart health, but in reality processed soy, which includes tofu, is not a health food.

You are much better off eating organic eggs, grass-fed meat and raw dairy products than you are eating processed soy.

"Unlike in Asia where people eat small amounts of whole soybean products, western food processors separate the soybean into two golden commodities--protein and oil. There's nothing safe or natural about this,” Dr. Daniel says.

To Kent:  shirataki noodles are available WITHOUT soy, but you have to order those online, mostly the grocery store variety has soy.  The ones from MiracleNoodle.com are soy free.  I buy mine online at amazon.com, try this link: http://www.amazon.com/JFC-White-Shirataki-Noodles-16-0/dp/B002GDH5Y8/ref=sr_1_6?ie=UTF8&s=grocery&qid=1287069415&sr=1-6

I don't miss noodles enough to bother with these, but I have tried them.  They work best with Asian-style noodle dishes better than Italian-style dishes, IMO.  I used the noodles made without tofu, however, as I make antibodies to soy, so I avoid it.

One thing to note for those who try these noodles for the first time - when the package is first opened the aroma is slightly fishy.  They are NOT spoiled.  The smell will go away when they are drained and rinsed.  I tossed two packages before I discovered that was normal.  

Dana Carpender, a popular low carb cookbook author and blogger, had a post up on her Hold The Toast blog not long ago about these noodles.

Kathryn,

Quinoa, and maybe amaranth (I haven't looked at the protein content of that one)  IS higher in protein (and the protein is more complete) than the common grains, but I wouldn't say it is HIGH in protein.  It still has a considerable amount of starch.  That's probably fine if for those who have a robust glucose tolerance.   But I need to limit starches, so I still limit these foods.  I might toss in a handful of quinoa to a pot of stew to thicken it up, but per serving, that's not much at all.  

The longer I cook for my family with little or no without grains, the less I miss them.   I'd like my son to grow up without a huge craving for grain foods.

Anna, you beat me to the punch.

I call these noodles "FISH STRINGS"
They smell bad

I guess it's better then pasta, but all in all, it's still a pretty processed product.

Marc

Try Kelp Noodles sometime. I get them at Whole Foods, in the Deli case (refrigerated).  They're virtually tasteless and when cooked have a great noodle texture.

I much prefer them to Shirtaki noodles.

Sorry doc, But now you avoid the gluten from grains and you introduce the lectins from the legume soy. This leads to a leaky gut and autoimmune diseases http://bit.ly/a9Gvjk

soy noodles??!?! tofu....for real?

"Unlike in Asia where people eat small amounts of whole soybean products, western food processors separate the soybean into two golden commodities--protein and oil. There's nothing safe or natural about this,” Dr. Daniel says."

While I agree with the soy issue and stay away from processed soy (I do eat a little fermented soy tempeh) I am not sure about these reports I've read about the Japanese eating soy in small amounts. A Japanese friend of mine who recently came back to the U.S. after living in Japan for a few years says that there are actually Tofu stands on the street much like hot dog vendors in the U.S. He says they have tofu of all kinds (even flavored) and it is a popular snack. According to him Tofu is everywhere in Japan. He was puzzled when I mentioned the reports of low soy/tofu consumption in Asia.

I tried shirataki noodles for the first time and loved them. I agree Asian dishes would be absolutely delightful with these noodles.

@Kent. I have heard a fair amount about this Dr. Mercola you speak of. Sounds like he's not the most sciencific guy out there. Is he just out there trying to sell his products and really not caring about the science part of it?

See below:
http://www.sciencebasedmedicine.org/?p=2116

Dr Mercola is one of the only sane voices out there and he is right about soy.  And yes he IS science based, the difference is he tells the truth and doesn't hide the truth and just dole out pills like most doctors.

http://www.quackwatch.com/11Ind/mercola.html

of course the government tries to silence Dr Mercola, if they knew about the Heart Scan blog they'd try to silence its author as well since it doesnt recommend the food pyramid and tons of grains to support the US dept of Agriculture, LOL.  Its so obvious.

Tommy, if you are interested in good, alternative medicine & natural ways of healing, Quackwatch is NOT the place to get your info.  He is paid much money to present his very biased (in favor of conventional medicine) articles.  

If he doesn't yet have an article on what Dr. Davis does here, he probably soon will.

Let me add a qualifying comment.

This, and perhaps some other ideas and suggestions in future, are simply meant to help people who seek replacements for familiar wheat-based foods.

However, I believe that we should still focus primarily on real foods, not substitutes. Real eggs, real meats, real vegetables, real nuts, etc.

Foods like shirataki noodles are meant to be occasional fun dishes.

For the majority of people, I do not share Joe Mercola's fear of soy, provided you take an iodine source such as kelp tablets.

Hi, Kathryn--

Gluten-free foods are candy, unfortunately.

Here's my previous post on this issue: http://heartscanblog.blogspot.com/2010/07/what-increases-blood-sugar-more-than.html

Quackwatch busted:  http://www.gaia-health.com/articles251/000277-quackbusters-are-busted.shtml

I have never read or followed Quackwatch and have no interest. While Googling Mercola that popped up. Ionly  posted it only as a statement that for every claim of life saving/altering advice one can point out there are just as many who disagree with it and show data to support their disagreements with all these doctors and gurus, diets etc.

I continue to be amazed at the support "both" sides of all this diet stuff show; all with supporting data and studies.  It sort of reminds me of the Helmet law wars the bikers used to have with the Government. For every proof (with studies) of the safety of helmets there was  also a counter (with studies) of the danger.  It seems the same with diet.  I feel like I'm watching a tennis match...lol. My head goes back and forth, back and forth...

@Tommy
I totally agree! I've been on both sides and they both have their 'scientific' proof. Also, everyone seems to want to or have to lose weight. That too is quite frustrating for me since I've been slender all my life and have no high BP or triglycerides - just have to watch my blood sugar. And here too both sides have their proof that it works. UGHHH!!!

I've tried these and really have tried to give them a place but they taste like rubber. The worst.

Spaghetti squash. Problem solved.

Right on Carl, spaghetti squash rocks.

SHiritaki noodles with soy are typically about 20% soy so that's not going to be a ton of soy unless you eat them often.  The other 80% is fiber from a tuber.  You actually don't need to boil these noodles, just rinse well and then add to your dish at the last minute to heat them.  Over cooking makes them more rubbery.  YOu really only need to heat them.  They also will NOT soak up liquid so make sure your sauce is plenty thick before adding the noodles.  If anything the noodles tend to release a bit of water back into the dish.  I don't normally eat soy but am OK with the small amount in an occasional dish of shiritaki noodles.

I'm very sensitive to starches, and grains, pseudo-grains, and starchy tubers all spike and crash my blood sugar. Beans, however, do not. When I want to indulge in pasta, I buy mung bean fettuccine at the healthfood store. They're made from whole mung beans, not refined mung bean starch, like the translucent, mung bean based, Asian noodles.

I use zucchini and yellow squash as a great low-carb replacement for noodles. Not only do they lack carbs, but they are a decent source of some vitamins and minerals.

Check out miraclenoodle.com, they have the soy free and have tons of varieties, try the orzo!!!

Pardon me,     Server error makes me post here ....
Colon cancer runs in my family & 1st cousin succumbed in his early 40s; USA colon cancer affects +/- 2% of men and +/-1.5% women aged 50 - 70, with higher rates among African-americans. Cancer pathology does not follow lineal constructs, so I will be generalizing (again); colon cancer can be hereditary non-polyposis, familial adenomatous polyposis (polyps), flat adenoma or sporadic colorectal cancer.

Dietary fiber provides the environment for intestinal bacteria to make butyrate for us; and butyrate is beneficial when it produces hydrogen sulfide (H2S). In the large intestine (colon) epithelial cells this butyrate H2S induces a proton "leak" in that cell's mitochondrial electron transfer chain (that cell uses & needs  less oxygen); this uncoupling slows that cell's cycle so that there is less cell division, and simultaneously depresses cytochrome c oxidase 1 & 2 enzymes which prevents that mitochondria from signalling for apoptosis (death). The boost in colonocyte (cellular) H2S also raises that cell's level of the anti-oxidant glutathione; and fosters other beneficial mitochondrial  processes by opening the mitochondrial membrane's K-ATP channel.

Dietary derived H2S comes from sulfurous protein (ie: amino acids methionine, taurine, cysteine & cystine) metabolized by intestinal bacteria;  and more significantly this type of  dietary induced load of H2S depresses the beta-oxidation of butyrate in colonocytes. When it comes to the sexes it is women who more readily produce H2S from sulfurous protein, yet men will produce a higher total amount of H2S; which may indicate why both sexes have similar colon cancer rates.

Sulphur rich cruciferous vegetables (broccoli, cauliflower, brussel sprouts, cabbage & kale) are not high in sulfurous proteins;  metabolism of their sulphur favors a bit more sulphur uptake into local colon tissue than bacterial H2S pathways. Think of the slow steady butyrate H2S output in colonocytes as a pre-treatment; this pre-conditioning is hormetic (hormesis is how a little bit of something potentially dangerous, like H2S, can be good for you that some might phrase as "what doesn't kill you makes you stronger").


Cancer of the colon unfortunately can side-step the preventative action of butyrate H2S when one of the enzymes (cystathine Beta-synthase) butyrate uses to generate H2S gets knocked out. How or why this happens in an individual is not dealt with here; the point is that a certain level of reliable H2S from butyrate will hold down the viabilty of colon cancer cells. Once the colon cancer cell has shifted  it's pheno-type from epithelial pheno-type to mesencymal pheno-type the same cellular protective effects of H2S (see 2nd paragraph above) will then unfortunately help that cancer cell avoid dying (apoptosis).

In a petri dish H2S will kill some colon cancer cell lines; this works because those cancers are not interfacing with the colon's bacterial dynamic. The "nooks and crannys" of the intestinal crypts have 2 distinct mucus (mucin) made up from long chain carbohydrates (oligo-saccharides); the sialo-mucin is more to the surface and usually deals with microbes, while the sulfo-mucins are in the lower depths of the crypts. We individuals have different antigens that affect the rate at which we degrade the sialo-mucin; furthermore, there is a drop in the number of sialo-mucins when the transformation of colo-rectal cancer occurs. It should be noted that the density of sialo-mucin and sulfo-mucin has differences all along the length of the colon and rectum, with nuances related to gender and can shift their ratios at a site.

There are specific colon bacteria which utilize the sulfate they get from sulfo-mucin; sulfate reducing bacteria use it for their own "respiration" and put out H2S. Yet "normally" sulfate reducing bacteria  are apparently not mostly using the sulfate we add to the colon from our food (this may be because certain  sulfur bacteria varieties, like "normal" desulfovibrio, have a cellular program to interact readily with an oligo-saccharide property of sulfo-mucin in order to take up that sulfate). When there is a shift to depleted sialo-mucin and extra ordinary sulfo-mucin the colon sulfur bacteria population varieties also alters; and certain sulfate reducing bacterial varieties become enriched at the expense of other bacteria.

At which time the colon levels of  bacterial produced H2S can rise and, just like high dietary spin off H2S; this then will depress butyrate's output of H2S  in colonocytes (where any incipient colon cancer's epithelial pheno-type needs to be held in limbo). The natural anti-cancer slow release of H2S from butyrate is then an altered state of high level of H2S in the colon;  with not enough sialo-mucin in the upper portions of colon crypts epithelial cells deeper in the crypt are more vulnerable .

Furthermore, with the shift toward excessive sulfate reducing bacteria (ex: desulfobacter, desulfobolbus and desulfotomaculum as opposed to  "normal" desulfovibrio) , there is the possibility that some cancer cell lines will use that bacterial supplied H2S to more readily morph into their mesenchymal pheno-type. This would be due to H2S impairing certain coloncyte cell line's DNA repair so that there is then damage to the original genome. For details see Mol Cancer Res 2006;4(1):9-14 "Evidence that H2S is a Genotoxic Agent"  complete text at http://
mcr.aacrjournals.org/content/4/1/9.full

To Greensleeves  (Server blocking where belongs),
You might enjoy this all sourdough rye study "Structural diff. btwn. Rye & wheat ...lower post-prandial insulin ..." in 2003 Am J Clin Nutri; 78(5):957-964 full text http://www.ajcn.org/content/78/5/957.full

And 2009 "Endosperm & whole grain rye breads ... beneficial blood glucose profile" in Nutrition Journal 2009, 8:42 full text http://www.biomedcentral.com/content/pdf/1475-2891-8-42.pdf

Hello Dr Davis,

Interesting post about hard and soft plaque.  I recently had a discussion with my GP regarding my serious increase in scan score (Jan 2006 = 235, Nov 2007 = 419).  

After the first scan we started aggressively going after my LDL, HDL and Trig.. 196,59,221

And have them down to 103, 65, 92 - we still have a way to go to 60/60/60 -

So the increase is a suprise, but my doctor said that the increase could in part be cause some of the soft plaque had been converted to hard plaque and the scan would show that conversion.

Does hard plaque register more than soft?

Thanks for what you  are doing.

Hi, Dave--

I'm glad your doctor is working with you on gaining better control over your plaque growth.

However, there is no such thing as soft plaque converting to hard plaque to increase calcium scores.

Think of it this way: Calcium is a surrogate measure of TOTAL plaque, both soft and hard. In the majority of settings, there is little advantage to characterizing soft vs. hard.

To seize better control, don't neglect: 1) hidden lipoprotein patterns, 2) vitamin D. Also see  our report "10 steps to take if your heart scan score increases more than 10% per year" at http://trackyourplaque.com/library/fl_02-006tensteps-2.asp.

Good luck!

Dr Davis,

Thanks for the response.

  I wonder if you are seeing any trends that indicate a "flywheel" or momentum in the creation of plaque.  I notice you have some patients that take two years or more to stop the growth.  

Starting point Jan 06 - score=236
Quit smoking - Jan 06
Vitamin D - taking 1200
Lost 20 #'s (5'11)=195
Exercise 40min 4x
Fish Oil = 1600 DHA+EHA
Crestor = 10mg
baby aspirin
Basic good diet - no processed foods
Oatmeal and blueberries/raisins everyday.

This month = score=419

After last scan
just added Zetia
Just quit all wheat products
Considering quiting redwine - I tend to have 3-4 glasses versus the recommended 2
Doctor is still saying no to L-arginine (not enough studies)
Considering Niaspan

Any comments?

Thanks again - Dave K

P.S. One more question... maybe this should be a separate post.  Do we know the exact connection between smoking and plaque?  Does it lower LDL size, lower HDL - iritate the lining of the vessels? Is it just elevated blood pressure?  What did my thirty years of smoking do to my heart (versus lungs)?

Hi, Dave--

I'm afraid there's too much to cover in this Blog. You will need lipoprotein testing and almost certainly require more than a baby-dose of vitamin D to gain better control over plaque growth. This rate of growth, however, is very concerning.  

I would invite you to look at the hundreds of pages of discussion on the www.trackyourplaque.com website devote to just this question.

Thanks Again Dr Davis,

I have poured over your website and I'm still reading.  I plan to make your list of turn around "stars".

BTW - here is the comment from my GP - sounds exactly like the cardiologist you mentioned in the original post.

"Remember that although your coronary calcium score has gone up, this does not mean that you are at greater risk than you were a year ago.  Remember that the most dangerous plaque is the not-yet calcified soft plaque, which will not show up on an EBT.  It is only the safe, calcified plaque that can be measured with the EBT.   For your score to go up like it did, while your lipids came down so much, what had to happen was that lots of dangerous unstable plaque was converted to stable, calcified plaque.    There are no accepted guidelines for interpreting changes in calcium scores over time, because the scores tend to go up as treatment converts dangerous plaque to safer plaque.    We do know that aggressively lowering LDL reduces both unstable and stable plaque, and we know that risk can be further lowered by adjuvant therapy such as I listed above. "

Sigh . . .

It's amazing what a simple reading of the literature by your doctor would reveal to him/her.

In near future, I will be posting some blogs that summarize crucial studies in the heart scan literature in an effort to provide better weapons in your fight.

Dr Davis,

Thanks again for all you are doing and I look forward to whatever you can post.  I plan to challenge some of my GPs positions.  Your data certainly is of enormous value.

Dave K

P.S. I going to 2000 vit "D" tomorrow.

Also - have you thought about a "track-your-plaque" certification.  Something to indicate that our Drs are at least up to speed on the latest in *preventative* proceedures...?  I would switch.....

Hi, Dave--

Yes, excellent thought.

It is something we'd like to aim for, but over the long term, since right now there are too few to make a difference. One by one, they are declaring themselves and separating from the "pack."

Stay tuned for more on this issue. In the meantime, I continue to try and inform my colleagues about what is right, what is wrong, what is preferable for patient safety and yields truly empowering information, and try to impress on them that the practice of cardiology is not just about enriching their retirement accounts.