I'm glad I found this blog after finding out that I may have a 1.7 spleen aneurysm (need ultrasound to confirm). Will study this and the other blog you have for ideas. Also it is first year my cholesterol was over 200 (218) in years and I think diet can be related. I asked this on other comment but am wondering about spelt flour and breads made with it claiming to be wheat-free.

they also drink alcohol daily

I wouldn't entirely dismiss genetic factors to.

I believe the Japanese apo e profile may be better than caucasian (on average) --

A racial difference in apolipoprotein E allele frequencies between the Japanese and Caucasian populations

http://onlinelibrary.wiley.com/doi/10.1111/j.1399-0004.1986.tb01901.x/abstract

A bad Western diet may trump this genetic profile, hence why those who leave Japan/eat poorly still get heart disease.

But there could be some genetics in play too.

Bear in mind that the soy they consume is typically fermented, including natto, which is extremely high in vitamin K2 - MK7.

I just returned to the US after having spent the last 10 years there.  Some observations:

(1) While it is true that consumption of breakfast cereal or donuts for breakfast is exceedingly rare, virtually nobody under the age of 70 eats miso soup with tofu, fish, green onions, etc. for breakfast.  The typically breakfast for younger people nowadays is a fried egg, white toast, and coffee.  And lunch and dinner often includes white rice and/or wheat noodles.

(2) Contrary to what the first anonymous said, the typical Japanese does NOT drink alcohol everyday.

(3) Contrary to what the third anonymous said, most soy is consumed in the form of tofu, and only a relatively small percentage of Japanese eat natto on a regular basis.

(4) The amount of refined wheat products consumed by the average Japanese is large and growing.  For example, you will see a huge number of bread, cake, pastry, etc. shops in virtually every neighborhood in Japan nowadays.  Take a stroll down a supermarket aisle in Japan and you will see large amounts of goods made from refined wheat products (bread, cookies, etc).

(5) US fast food chains are ubiquitous and always packed with young people.

Based on the eating habits among young people I've observed there, my guess is that we'll be seeing an increase in heart disease to rival that of the US.

If Japanese consume K2 a lot, this might be big part of the solution to this enigma (since natto is the best source of K2 in the world). Calcification of soft tissues is one of the major CV problems and eliminating it from equation changes the scene.

I wonder what is the reference for "less sugary foods" claim.

It was the main issue in Alan Aragon's bashing of "Sugar: The bitter truth" video by Lustig. While I think that Alans review is junk, it has some interesting points, among others, the suspicious claim that Japanese people don't consume suggary food.

Japan Public Health Center 1990 dietary highlights for 40,000 men and women +/- 48 - 50 years old. All were without cardio vascular disease and had BMI of +/- 23.5.

The women:
calories/d = 1,227-1,491
rice gr/d  = 164-182
fish gr/d  = 31-54
% miso 3x/d= 18-33% did

The men:
calories/d = 1,910-2,344
rice gr/d  = 294-336
fish gr/d  = 38-66
% miso 3x/d= 23-46% did

Nationwide for Japan in 1990 3% of adults had a BMI of 30 or more (obese); and at that time, 20% of women plus 24% of men had a BMI of 25-29 (overweight).

Compared to 1960 statistics by 1994 there were 4 times the number of overweight adults; and the increase in overweight adults was higher among the rural population.
A Japan National Survey (exact year not in my notes) stated the average adult protein intake was +/- 60 grams of protein per day; with 1/2 of that protein coming from rice.

1. Re salt. I read an article recently showing that in people with diabetes, the higher the salt intake, the lower the overall mortality. This is only one study and might be a fluke, but it's interesting.

2. Re sugar. This is annecdotal. Many moons ago, in early 1960s when I was in college, I lived in a Coop dorm where we did all the cooking. One night a friend and I were trying to make a casserole that ended up bland, so we kept adding things to improve the taste. It got worse and worse, and there was no time to start over again.

Finally, when the rest of the dorm was nagging us to get the food on the table, we threw in a can of pineapple.

A student then said to us, "I hope dinner is extra good tonight, because I have a friend from Japan visiting, and I want to impress her." We were very embarrassed.

Afterward the Japanese woman came up and asked if we'd cooked the meal. We had to say yes. She said, "Oh thank you so much! This is the first food I've had in America that was sweet enough."

Now, maybe she was unusual. Maybe her family was adopting American tastes. But it's made me question comments about Japanese not eating sugar.

I suspect the key may be the amount of food consumed in meals. Those beautifully displayed boxes of food don't actually contain a lot. Maybe they like sweet things but don't eat a lot of them.

Natto is said to be more popular in the east of Japan, like Tokyo; and less popular in Osaka & Kobe regions. Here's the average natto consumption for select decades I have:

1960 =  0.45 kg/yr/person
1970 =  1.1 kg/yr/person
1980 =  1.3 kg/yr/person

Natto generally is sold in +/- 40 gram unit packets; so 365 days in a year x 40 gr. natto = 1.46 kg/yr/person , which would be the contemporary natto eaters intake. One gram of Natto +/- =  0.17 gr. protein + 0.14 gr. carbohydrate + 0.108 gr. total fat (0.016 gr. saturated fat) + 10 mcg. Mk-7 + 0.84 mcg. Mk-8 + 0.0072 gr. nattokinase +  0.55 gr. water.

By mid 2000s there were Japanese newspaper reports that the natto consumption was trending downward.
Apparently, the natto industry response was to make hybrid natto food products to attract the younger Japanese market.

I agree with Anonymous. Japanese people have begun eating lots of puffy white bread/pastries. It will take some time for this to be reflected in the heart disease stats.

I've lived in Japan for the past three years in southern Osaka. The claim that Japanese people (below, say the age of 60 or so) don't eat many sweet things is patently false.

There, I think, has been a huge shift in diet trends over the past generation or two, with the older generation still eating mostly as the article suggests, and the younger generations eating progressively more and more like westerners.

Most people I talk to consider fluffy white sweet bread (lots of sweetener in the dough itself) topped with extra sweet jam or jelly with some orange juice or heavily sweetened coffee breakfast.

Even some slightly more traditional dishes like sukiyaki are cloyingly sweet as prepared by most people, or if made from packaged mixes (fewer people can / are interested in cooking, especially from scratch, nowadays).

Another example that comes to mind is Kimchi. That Korean stuff is a tangy, spicy, fermented delight, white most of it found in Japanese supermarkets is filled with sugar -- sometimes even as the second or third ingredient after hakusai!

It's true, however, that the "heart healthy whole grains" message is largely absent here, and that there is really no fear of fatty meat (yakiniku!).

Regardless, the article flies in the face of what contemporary Japan actually eats; the article sounds more like a stereotype of what people ate just before or just after WW2.

Besides, the Okinawans have (or rather had) the longest life expectancy of all, and they practically revered pork fat! Pork, fish, sea vegetables, tubers, and veggies, is what their traditional diet is purported to be.

(end ramble)

Several commenters make the crucial point that the Japanese diet is changing. I agree: Western influence, from Dunkin Donuts to McDonalds, has infiltrated their culture. I expect that we will see the cardiovascular advantage of the Japanese erode over the coming decades. But the point remains: At least at one time, they followed a diet that likely provided at least part of the reason for their reduced risk for heart disease.

I am Japanese and, when we were kids, we lived on tofu, taukuan, rice, omeboshi, natto, and all the other foods from Japan that we could get from shops in New York. We did eat rice cakes containing sweet beans, but sweet was simply, at least in that period, not a prominent part of the diet. Salt was, however.

I would be interested to know what this dietary pattern consisted of since it was also associated with an increase in CVD:  "The 'animal food' dietary pattern was associated with an increased risk of CVD"

Stephanie A.

I have heard that they have a much higher incidence of stroke.  I'm not sure if this is true or not but I have seen data suggesting it is 5X as likely in Japan as it is in the U.S.  I have also heard that dying from heart disease is considered less honorable than dying from stroke.  There is some speculation that the Japanese diagnose death due to stroke at higher rates.  The two can be difficult to diagnose correctly.  Stroke and heart disease are the same problem.  I think their diet in general is less stroke/heart prone than the US but their arteries may not be as unclogged as the heart disease numbers suggest.

I'm another long-time Japanese resident. While taking care of my wife in the hospital here, I noticed what seemed like an epidemic of diabetes. So even without massive obesity, and without the same level of heart disease, the modern Japanese diet (toast for breakfast, lots of white rice) is having its effects.

Once again, I really believe it comes down to eating as many whole foods as possible while reducing the amount of processed products.  This article on the Japanese lifestyle coincides with my conviction.

We do not necessarily have to adopt the exact regimens they follow, but understand that the closer we align ourselves with whole, natural foods, the closer we will be to improving health.

"It's the small things in life"; seems worth noting, since we in the west overlook what we don't have a frame of reference for. A Japanese meal is traditionally accompanied by things we don't think much of.

Old style pickles ("Nukazuke") were food items embeded (buried) in a rice bran medium; the "bed" innoculated the pickles with micro-organisms. It could be interpreted to be a pro-biotic dietary practise. (I have an easy rice bran pickle recipe if anyone wants.)

Miso's many substrates, and some pickles (ex: eggplant; recipe on request) are made by embedding the substrate in Koji. Koji is usually rice innoculated with a fungus strain of Aspergillus oryzae.

Soybean miso is the most commonly known miso,in one form or another, in the west; people attribute it's benefit to what they know (the soy). Actually the koji is what lowers the per-oxidation of linoleic acid; and it is the koji fraction that provides the beneficial scavenger activity against our cell oxidants.

Koji in miso is infused with the fungal (A. oryzae's) tri-acyl-glycerol lipase gene and gluco-amylase pro-chymosin gene. It can make some of the miso substrate's medium chain fatty acids into a form we can absorb (ie: esterified); with  attendant anti-oxidant properties.

Oh, and those lectins in grains and beans people seem to disparage these day? Well fungi, like A. oryzae, have enzymes to break lectins down; so koji fermented foods enhance mineral bio-availability.

For east coast USA Koji and Natto contact "Katagiri" Japanes Grocery in N.Y.C. (on an east 70+ street, near Bloomingdales). For west coast USA bulk (35 lbs. box or six 1 lb. tubs box) white rice Koji contact producer  "Miyako" Oriental Foods in Baldwin Park (near L.A.). For Japanese cultures to make your own contact "G.E.M." Cultures, now in Wash. state. I have no financial interest in any venture; gotta go check on today's natto batch....

Why is more Iodine helpfull?

edit needed for my last comment above, see the 6th paragraph (next to last)....
Replace the word "lectin" with "phytates" ; and then the enzyme which fungi have are going to be a "phytase", the type of enzyme with ability to break down "phytates".

Rice consumption cited in one comment above clearly indicate that rice consumption has inverse association to increasing cvd. It again sugggest that increased consumption of other foods such as more animal foods, more fat, junk, McDOnalds, sugar etc, which probably replaced rice therefore increasing incidence of CVD.

@ Might-o...where can I get instructions. Do they come with the order? Or are you offering some here? I'd love to make some. Great post...again.

I have been here 10 plus years and even in that time I have seen a  visible increase  in the number of overweight and the recent  "Metabo"  metabolic syndrome craze.

Go to any supermarket: it's aisle of processed grains, snacks, cookies and cakes for miles.
Go to any convenience store and see one whole aisles of "Snack pun" - snack bread. This stuff is hideous. 400-600 calories of bleached white bread,  margarine and sugar rich fillings. Its essentially mostly sugar and this  kind of thing is replacing the fish and  miso breakfast. A staggering  large percentage of teens and young adults consider this a decent  breakfast or lunch.
As a teacher I frequently see  students buying two snack puns at the cafeteria  and that's their lunch.  1000  calories of basically sugar.
Instant Noodles are hugely popular and not helping either.
This current generation is going to  seriously dent  the  precedent of statistics their grandparents and great grandparents.

As for the good stuff, yes still more fish consumed on the whole than  elsewhere but huge amounts of grain fed overproceesed meats.
Seaweed- yes still about and definitely  beneficial and the ubiquitous onigiri is still popular, though  at the convenience store  the snack breads seem to rule in terms of selection these days.
An for grains have you seen the standard food pyramid in Japan? or the spinning top as it's called.
Very grain heavy.

http://www.mhlw.go.jp/bunya/kenkou/pdf/eiyou-syokuji5.pdf

More walking - much much more walking in Japan compared to the  USA has more to do with it I suspect!

The Japanese used to eat a lot less than us. I bet eating 2700 calories a day average of any diet ups your cvd risk.

What about chlorine in the Japanese water supply - do they use as much chlorine as we do in the US?

chlorine? A heavily industrialized nation like Japan? you better believe it! but it  does vary to place to  place.
Some cities  it's like the water is coming straight out of a swimming pool.
The tap water is ok to drink after some basic filtration.

Hi rhc,
I am not selling anything; the sources for specialty items are all places I have bought from. If you can't track them down online then I'll get you contact details; assuming Doctor Davis doesn't object.

To make your own Natto it is really easy. Koji making involves more steps, but there are a lot of different things you can do with it.

Rice bran pickles are the simplest of all to crank out daily, once your rice bran "bed" builds up it's microbial flora. The rice bran "bed" needs to be stirred (ideally)daily to keep funky microbes from taking over; but if you put some (say)veggies in the rice bran bed you can hand stir it then and enjoy those "pickles" later the same day. Sacks of rice bran are sold in many Japanese groceries (like Katagiri) and I've used "Bob's Red Mill" brand rice bran (health food store/mail order).

G.E.M. Cultures is now run by Gorden E. McBride's daughter up in Washington state. They mail order the pure Japanese Natto spores I've used for years and send instructions a novice can follow. (I have some incubating now at +/- 105* Farenheit in a covered dish set up over a scrapped food dehydrator's heat coil base.)

G.E.M. also provides the culture for making Koji; they actually have several Koji strains, depending on what end product you want to make - instructions always are included. To make white rice  Koji from scratch you want to be able to get "sticky" white rice (ex: "Hakubai" or "Wel-Pac" Sweet Rice, from JFC International) and steam cook it.

G.E.M. also sells the already innoculated Koji and a little bit doesn't really go very far except for experimenting. Miyako Oriental Foods is a modern Koji "factory"; they sell rice Koji (and Miso) to places like Katagiri in individual tubs under the label "Cold Mountain". Koji has a very long shelf life (dry stored, no direct heat), so refrigeration is not absolutely essential.

For those who have lived in Japan, do the Japanese do any formal exercise? walk a lot?

It would be interesting to hear your thoughts on French diet as they too have a much lower incidence of heart diseas( not as low as Japanese), but their diet is western oriented.  My guess would be lack of sugar, junk food, and minimum Omega 6 intake.  They do eat wheat, but not in quantities similar to those in U.S.

@ might-o... Thanks so much for the additional info. I've printed it all out and will start investigating the sources and processes.

@ Steve:

http://wholehealthsource.blogspot.com/2010/11/observations-from-france.html

http://wholehealthsource.blogspot.com/2010/05/does-red-wine-protect-cardiovascular.html

http://www.vinopic.com/index.php/roger-corder/roger-corder-intrinsic-quotient#red-wine-quality

Cheers!

The body's internal ratio of Magnesium (Mg) to Calcium  (Ca) in East Asia and the USA
typically differ; with African Americans having even lower Mg % than their caucasian countrymen. Specificly the East Asians statisticly have/had more Mg relative to Ca; and conversely Americans had less Mg relative to Ca in their bodies.

The Japanese living outside of Japan (or those eating more like the west inside) Japan could be having less Mg %; this could explain several things. Low Mg is implicated in inflammation, insulin resistance, metabolic syndrome & Type II diabetes; 2000 data for U.S.A. showed 79% were below MDR Mg.

In other words the American diet supplying much more Ca in relation to more sparse Mg creates a ratio, that in the body is involved in the dynamic of pathological development. Ca is not "bad" in itself, but in the context of too little Mg the inflammatory underpinning of many diseases wrecks havoc (ex: coronary heart disease, insulin resistance, Type II diabetes, etc.).

Ca has systemic roles in signalling for various cell cycles. Mg plays a role in (among other things) DNA repair and lowering insulin levels. Special gut ion uptake channels  with the gene TRPM 7 (transient receptor potential melastatin) regulate Mg.++ balance; shear volume of Ca++ can interfere with that ion channel taking up the Mg (Ca & Mg ion charges tend to compete).

One researcher thinks the really low Mg to strong Ca ratio explains the African American susceptibility to more coronary events. Maybe this Mg:Ca ratio explains some (not all) of the  data showing Japan has/had less heart disease; and also a big factor why Japanese in the west are/were relatively more prone to heart disease.

Might--

Fascinating detail on the organisms used to ferment!

I'm also quite impressed that you can actually eat natto. Even though I was exposed to it by my Mom as a kid, I still can't stomach the stuff.

The Birth Control Pill only recently became legal in Japan. To me it points to the sudden increase in heart disease among Japanese women.
~ Sue Ek, BOMA-USA

Physical activity is more fundamental than diet.

East Asia = 1 Magnesium  per 1.6 Calcium
U.S.A.    = 1 Mg. per 2.8 Ca
Of course, those are statistical generalizations of vast regions of people. One researcher speculates the "American Heart Healthy" diet benefit, of eating more whole grains, might be due to their extra Mg.

Meta-analysis of adult women taking Ca supplements may provide another clue. For every 1,000 women taking Ca supplements over 5 years time there were 6 extra heart problems (strokes and infarctions); while for the same scenario (1,000 over 5 years) the Ca supplementing only prevented 3 fractures.

That analysis went on to speculate it is not the exact dose of Ca that mattered; since the risk factor went up whether taking less than 500 mg. Ca or 1,000 mg. Ca. daily. The theory proposed was that it was the 5 years of abrupt blood Ca loading that created the risk.

Data was that (with Ca pill) the risk of myocardial infarction
rose 25 - 30 % and the stroke risk rose 15 - 20 %; with obese women having less fatal events than their non-obese counterparts (more tissue mass to stash the Ca load ?). If wondering, the addition of vitamin D to the Ca supplement seemed not to be a factor in mitigating or increasing the risk.

If the Ca supplement implications
(women only studied) are suggestive and we add to the body equation a poor base line Mg ratio to Ca maybe this explains some of the historical pattern of heart disease. America went in big for non-whole grain food and favored dairy (ie: Ca)in the post-wars 1900s; Japan during that same epoch wasn't big on milk and had (in theory?) better Mg. intake ratio.

Interesting how many readers have lived in Japan. My wife is Japanese, so I have some first hand experience, besides living there for a ferw years.

Not mentioned so far is the close and cohesive social network that most Japanese enjoy. While in Okinawa I saw lots of old people gathering daily, doing things together, playing games, ball, eating together and generally share the news and gossip. This kind of social web is heart-protecting. We know from studies that loneliness and hostility is detrimental to cardiac health. Possible physiological mechanism: Stress hormone Cortisol would go down, Oxytocin would go up.
Another factor: "Hara hachibu", this means literally "Stomach 80%".
It refers to the habit of filling your stomach only 80% and not 100%. Thus eating less and therefore practicing a mild form of caloric restriction, which we know, is clearly life extending.  
In all, I think it is a mix of everything mentioned here and each part is contributing.
Renfrew

Might-

I couldn't agree with you more about the calcium/magnesium link to heart problems.  I've thought that for years after doing a minor study of magnesium related issues.  In fact the clear implications of magnesium deficiency is astonishing. When you consider the large number of processes that it is responsible for and the lack of it in the American diet it becomes increasing obvious that it has a very important part to play in all of this.

Marc

My sister lives in Japan, and she sent my kids some Japanese Chocolates for Christmas. The Japanese Chocolate was not nearly as sweet as American Chocolate. I think Americans have a problem with moderation. We want to much of a 'good' thing. The sugar in Japanese chocolate is just a small example, but could be an indicator that there are small differences in everything they do that add up to make a difference.

Dr. Davis,

I note that in your post you OMIT the fact that the staple food of the Japanese is rice, and that carbs traditionally comprise 80% of the Japanese diet.

Stop lying to and misleading people about carbs and weight gain.

You and I are on the same side about sugar and refined junk carbs.

OK?

Diana, I note that in your post you OMIT any links or proof that the Japanese eat an 80% carb diet. If you are going to make statements and claim them as "fact", you need to prove them. Otherwise, it's just your opinion.

If I eat much rice my blood sugar goes way up.  Did that happen to Japanese on the traditional diet?

The Japanese eat seaweed.

It can't even be said with 100% certainty that the high amont of salt they may consume is bad.

Very interesting point! Yes, he did not mention rice, but the other components are all very good for you. Great posting, Dr.

Gosh, I wish I would have had that infrmoation earlier!

And I was just wnodeirng about that too!

IJWTS wow! Why can't I think of thgins like that?

To think, I was confused a mtinue ago.

In visiting France (Cannes and Paris), I noticed that there is a focus on fresh (whole) foods everywhere, and I mean EVERYWHERE.  Only in highly populated urban areas did I see availability of processed snacks and junk food.  Fresh vegetables and free-range meats were what i found.  Most importantly, the portion sizes were small (similar to Japanese).  Though they did eat numerous times through the day, portions were small.  Sweets are big in France, but no one ever over-indulges.  They take the time to savor and enjoy their sweets from a patisserie or cafe.  It''s their food culture from the ground up that has led to their long lives and, quite frankly, very attractive frames.

I am a bit confused by the mention of soy sauce......Kikkoman ingredients read, "Water, WHEAT .........."  thought the idea was to stay away from wheat

Dr. Davis:

Wondering if you could clarify your thoughts a bit. You promote elimination of wheat and corn starch (which I fully believe in) but then also comment on the elimination of carbohydrate (in the aggregate) as being a key factor for health. I'm not convinced that all carb is problematic for a person with a normal metabolism. Of course, it doesn't hurt anything; just wondering at your experience with those who don't go low carb but do drop the wheat.

Thanks.

Scott

So why have so many doctors bought into this whole statin thing?  If you question the need for a statin, you are first bullied to take them and second shown the door if you continue to resist!

Dear Dr. Davis, the improvement you describe for Mr. Lew is mainly because of wheat elimination, fish oil supplements or 25-hydroxy vitamin D increased levels? Or is just because of the significant weight loss and hypocaloric diet? In other words, from your experience, would you expect similar results in other people, for example, with the same approach but with no weight loss at all?

Dr. Davis,

Are you still recommending Niacin?  I haven't seen it mentioned for low HDL in a while.

It would be interesting to know how long Lew's dietary/supplemental changes were in effect before his hsCRP impressively dropped from 4.1 mg/dl to .4 mg/dl?

Two months into a LC diet and two weeks without grains my hsCRP was 2.43 mg/dl, HDL-75, TGs-82, calculated LDL-105, VLDL-16. Yes, my doctor advised me to go on a statin and a low-fat, high fiber diet to lower my LDL number to <75 (not going to happen). In my case, I do not need to lose weight, just manage blood sugar.

Still, it would be interesting to know when to expect a lowering of CRP and what other factors beside coronary plaque determine the measured hsCRP when one is mimicking Lew's strategy?

I have had a dramatic improvement in my hs-CRP, but it occurred slowly. Nine years ago my hs-CRP was over 13 and I was having one stent after another and ultimately bypass. As I made lifestyle changes, my hs-CRP started to fall a little. In 2003 I stopped eating gluten(wheat, barley and rye) and by 2005 my hs-CRP dropped to 4.98.

Now I have given up all grains because of blood sugar issues and my hs-CRP is 2.19 - not perfect but heading in the right direction. My vitamin D is now 54ng/ml instead of 24. I do take fish oil.

I doubt a statin could lower hs-CRP from 13 to 2.19

i have been looking to join the track your plaque website,but the site that asks for a credit card does not appear to be secure/encrypted; it is not an https site for example.  Therefore any data you put in for a credit card is out there in cyber space.  any suggestions?

Great results, Anne!

In general, CRP reductions occur over several months. The phenomenon that both exerts profound effects but can slow the process down is WEIGHT LOSS.

Scott--It depends on whether there are metabolic measures that reflect intolerance to wheat and other carbohydrates, such as small LDL or increased CRP.

Dr. Davis,

when you say eliminate wheat and other food that cause small LDL : which other foods are you referring to? Is it all simple carbs such as sugars, processed foods etc. or something else?

Thanks.

Vin--

Eliminating wheat means just that: anything made with wheat. Otherwise, the effect does not kick in.

The ml/dl units for CRP levels are likely a typo, one that is widely found in the medical literature and confusing for the novice attempting to determine normal serum CRP levels.  Levels above 2 or 3 mg/L are often cited as indicative of increased cardiac risk and levels at or above 2 mg/L (0.2 mg/dl) were required for eligibility in the Jupiter study.

Dr Davis,

I've been on a Low carb diet for the last six months.  My triglycerides is 60, HDL 61 but my direct LDL is 174, APOPROTEIN B is 119. My CRP was .6.  Should I be worried about the APOPROTEIN B score of 119?  My doctor recommended that I take a Statin drug....with the high LDL score and APO_B score.  I don't eat any grains and currently taking fish oil, niacin and vitamin D gel based pills.  I would like to stay away from statins....but I'm getting frustrated in not being able to lower my LDLs through diet.

To those of you who have eliminated grains; reduced your fear of naturally saturated fat (be wary of trans fats and most vegetable oils, though); have seen your HDL go up; etc., but are still worried about what seems like an elevated LDL (remember, it's probably just a calculated number, not a direct measurement), then consider that few primary care docs even see people who eat like that, so  they don't know what to do with the unusual profile that comes up.  They rec a statin as a knee-jerk reaction to any "elevated" LDL number, despite all the other "risk factors" that look fine - it's to cover their you know whats (one doc even said that to me).

I ran into this with my endo who noted in my file the high calculated LDL and total cholesterol numbers (but the ratios and triglyc are great and far better than they were 5 ya before I got my BG under control by restricting carbs, then eliminating wheat).  

In response to the suggestion I consider a statin, despite no other reason besides the high "calculated" (estimated) LDL number, I said, "then let's take a closer look at that LDL.  Please order a detailed cholesterol lipoprotein panel [same as TYP recommends] to directly count and measure the LDL particles, because I think it's highly likely the LDL will be few in number plus will be the large fluffy kind not associated with CVD."  At that point I did know that my atypical high fat, low carb diet that I followed to manage my BG tended to promote the right LDL and minimize the small dense LDL particle formation.  So I wasn't worried at all about the LDL number, but probably most people are conditioned to worry about LDL these days.

That was before I knew about heart scans.  Now that I've had a heart scan with an unsurprising 0 score.  So if I get another statin recommendation (prob less likely now),  I'll say that "there is no measurable plaque in my coronary arteries,  so no thanks" (not to mention the questionable benefit of statins for women, anyway).  

These days, before I consider taking *any* treatment that wasn't needed on an emergency basis, I look into it thoroughly
from ALL angles and make sure no stone is unturned - to be sure I truly will benefit from it and not be harmed (and that means a direct look at the so-called risk factors and side effects or undesireable outcomes, not just an estimate or calculation.  We've been programmed to fear any high LDL number, but we need LDL; that's why we make it -  it serves a physiological function.  We just have to get past the oversimplification of "good and bad" cholesterol and make sure we make the the healthier forms.

Good going Anna!

The cluefulness factor varies a lot between doctors. One of mine noted "weird" lipids without relating them to what was obvious "diabetic dyslipidemia". Many in the UK will only look at TChol.

My current one is more competent than many, she agrees that my slightly high LDL is not dangerous since my trigs and HDL have become so good. But she is adamant that I cannot have CRP or homocysteine tested and lipoprotein panel is totally unavailable. Not entirely her fault, it's those accountants.

I'm trying to educate her into the benefits of carb lowering. She's coming round to understanding my point of view but is restricted by protocols from recommending it to others. I'm getting through better with the nurses who seem more able to suggest useful techniques without fear of being disciplined or losing their jobs.

Hello Dr. Davis,

I'm on a ketogenic diet and in the process of weight loss. Went to the doc and got my blood test to find out that my cholesterol numbers were good, however, I had high CRP (5.5). The doctor immediately suggested statins. No additional tests to rule out an infection or other strategies to determine the cause of the inflammation.

I'm aware that during weight loss the blood test results can be skewed. (You talk about this here: http://www.trackyourplaque.com/blog/2011/09/what-is-this-wacky-thing-called-weight-loss.html) However, given that my cholesterol results are good, I'm wondering why the CRP would be high.

You can get a more detailed background about my case here (which includes blood test results): http://www.reddit.com/r/keto/comments/o4lk8/bloodwork_after_3_months_of_keto/

Sincerely,

A.E.

Though the sixservings blog invites readers to "Join the Discussion" and add a comment, they have yet to publish any comments, including mine made two days ago,

Continuing my role as tepid devil's advocate...

"Wheat gliadin has been associated with ..."  -- "associated with" or "linked with" is the prototypical claim made when hard scientific evidence is lacking.  "Correlation is not causation" applies to all, not just to the other side of a debate.

"...died at their product’s hands."  "Product's hands" is an unfortunate metaphor.  Here I'm acting as English composition scold, not nutritional critic.

In my view the threat of legal liability serves no constructive purpose.  To hold the work of Norman Borlag (*), who won the Nobel Peace Prize for his work on the development of high-yield wheat -- which arguably has saved millions from starvation -- as culpable is not credible, even if the health claims in Wheat Belly are true.

(*) http://en.wikipedia.org/wiki/Norman_borlag

Dr. Davis,
I need your clarification on a few things. I have been following your advice for a couple of years to better understand and control my cholesterol without medication: no wheat or grains,taking vit D, fish oil, correct blood tests, checking post-prandial glucose, etc. Things are going well.  

Recently watched "Forks over Knives" and reading Dr. Esselstyn's book on heart disease management with surprise and confusion. He recommends the bowl of oatmeal for breakfast, whole grain wheat bread and pasta, absolutely no oil, meat, eggs, dairy and then back to Dr. Ornish and the low fat mantras of the past.

What is your take on it? I'm trying to make sense of it all!

Thanks.  Jan

Nor have they published mine It's still in "moderation" LOL

Keep it up, Dr. Davis

I took your permission to publish your Open Letter to the Grain Foods Foundation on my guestdietblog. I thought it was well-written, although I agree with Mr. Brecher's assessment that the claim of legal liability (I agree that they really *are* culpable, but still...) is less than helpful.

On a related topic, I do not believe that eliminating wheat is the Holy Grail of weight loss. While necessary, it is *not* sufficient. I eliminated wheat (and all other grains) from my diet in 1999. I fairly quickly lost 100 lbs and greatly improved my health. Unfortunately, I needed to lose 150 lbs, and that last 50 lbs has stubbornly clung to my frame despite several "tweaks" to my low-carb diet over the last dozen years.

Modern wheat's  " juju" (a CathyN-ism) is it's  "antigenic profile".

Great open letter! As the Grain Foods Foundation targeted Dr. Davis' well documented book, and published demonstrable falsehoods regarding the references and sources, I feel this open letter is accurate and, if anything, subdued in its tone.

To be clear, Dr. Davis did not threaten legal action; he pointed out that the promotion of wheat as "healthy", combined with ignoring the scientific evidence against modern wheat positions the Foundation solidly in the same position as the tobacco companies. They do have legal liability, especially as they are engaging in the same type of public denials with incomplete information (read that: lies).  We may see, in our lifetimes, the same government assisting the wheat growers turn and sue them, just as the tobacco industry has experienced..

A medical doctor can combine his scientific training to evaluate claims and evidence with practical, real world experience with thousands of patients that no researcher can match. "Wheat Belly" shows both Dr. Davis' clinical experience and the depth of his research on the topic.

To Howard:
Does Dr. Davis say that eliminating wheat is the Holy Grail of weight loss, or are those your words? For what it's worth, no I don't think it is, but it's a very important facet of weight loss. If you're otherwise not controlling your carb intake, eating enough healthy fats, not exercising, not getting enough sleep, etc., those "last 50 pounds" may never come off.

Joe

Dr Davis:
"Wheat gliadin has been associated with cerebellar ataxia, peripheral neuropathy, gluten encephalopathy (dementia), behavioral outbursts in children with ADHD and autism, and paranoid delusions and auditory hallucinations in people with schizophrenia, severe and incapacitating effects for people suffering from these conditions.
.....
I propose that you and your organization, as well as the wheat industry and its supporters, are at risk for legal liability on a scale not seen since the tobacco industry was brought to task to pay for the countless millions who died at their product's hands."


I have multiple autoimmune diseases, a result of gluten intolerance. My mother became schizophrenic when she was 35, and I was 10. It wrecked our family for the rest of my parents' lives.

And we are only starting on cancer.

You can't even imagine how I feel about wheat.

Jan Jones?

Dr. Esselstyn's book relies heavily on his own non-controlled study. Esselstyn applied his brand of vegan diet to a number of his heart disease patient. Esselstyn claims that his diet arrested their deterioration, and attributes the results to veganism.

The problem? Dr. Esselstyn also told participants to stop eating baked goods, flour and vegetable oils. Also, Dr Esselstyn treated these participants with pharmaceutical drugs.

There's a significant difference between the protein in oats and the protein in wheat. I wouldn't eat either grain. If you must eat one, eat oats.

Eliminated grains--> lost 100 pounds

Seems pretty successful to me. There's a huge health risk difference  between carrying 50 extra and carrying 100 extra. I lost 118 and resolved my Metabolic Syndrome. Yes, I could lose another 40 to be NOT overweight anymore, but 118 made a huge difference.

Many formerly obese people have affected BMR (lower than non-obese would be at same height/weight/etc). We've damaged our bodies. Perhaps to get to normal weights, we have to be even more vigilant, exercise harder/smarter, tweak macronutrients. Of course, it's more important to keep OFF the lost ones than fight even the last pile of fat hanging on. If ditching grains made that much of a difference, I see it as vindicating their elimination.
But the fat fight goes on, regardless, as for some of us, it's just never gonna be easy....

Good morning doctor, I keep a daily page from Spain, gustría me know if your books are translated into Spanish. If not please do so, some people are interested in reading.

Hi, Marta--

Not yet. However, I will announce here and elsewhere when international editions are released.

Thanks for asking!

118 pounds?! Wow. That's fabulous, Princess!

If you could post your full details here, I will post your story as a wheat-free Success Story . . . a BIG success story.

Yes, Bob, I agree 100%. This thing being sold to us called "wheat" is so bad in so many ways. And we're told to eat more of it.

This will go down as the biggest dietary blunder ever made in the history of humans on earth. But therein lies the silver lining: Elimination of wheat is also the single most powerful health strategy I have ever witnessed.

Imagine what life would be like if we didn't come to recognize this! Makes me shudder.

Thanks, Frank.

Yes, indeed. I have not hired any attorneys. But I do believe we have an incredible wrong committed on an international scale with liability for deaths and illness in tens of millions.

Obviously, the whistle blowing will NOT come from within the system. Nobody in the USDA, FDA, or Surgeon General's office is sounding this alarm. They all agree, in fact: Eat more healthy whole grains. Reminds me of the old cigarette commercial: "More doctors recommend Chesterfields than any other cigarette!"

Excellent, Might!

Thanks, Howard.

I wouldn't pooh-pooh 100 pounds of weight loss eliminating wheat. That's an incredible result! People pay a lot of money and suffer deprivation and hunger to achieve a lot less.

Your experience highlights that the diet for weight loss should be 1) wheat-free, then 2) limited carbohydrate. But there are other issues that many people have to address. Thyroid dysfunction, for instance is rampant and can put a damper on weight loss. And don't accept the conventional "rules" for diagnosis of thyroid dysfunction; they are flat wrong and will impair both weight loss and increase risk for heart disease. (There are several thyroid discussions on this Heart Scan Blog, by the way.)

Thanks, Anthony. Between the blog comments, my open letter that I emailed to their representative, Ashley Reynolds, and all the comments I and others have posted on their Facebook page, I think we got their attention. We'll have to see what happens.

While I admire Dr. Esselstyn's motivations, having devoted his later career to the cause of preventing and reversing heart disease (changing course from his training as an ear-nose-and-throat surgeon), I believe he is wrong.

I did the diet he advocated 20 years ago: eliminated all meat and oils, extremely-low fat, plenty of fruits and vegetables, and lots of "healthy whole grains." I promptly gained 30 lbs, my HDL dropped to 27 mg/dl, my triglycerides shot up to 350 mg/dl, and I became a diabetic. This was while I was jogging 5 miles a day. (Ironically, I was living in Cleveland and Esselstyn was a neighbor.)

The vegetarian, low-fat approach Esselstyn advocates does indeed yield improvement, however, compared to a standard American diet, especially if the person is an apo E4 genetic type, which creates some fat sensitivity.

Points take, Steve. But I disagree.

When you read the scientific literature on gliadin, there is no question that it is causative. But let me clarify: It does not cause schizophrenia or ADHD; it just makes it much worse in a vulnerable mind.

And, just because the evil health effects of the high-yield semi-dwarf variant that led to Borlaug's Nobel Peace Prize were not recognized in 1970, that does not release anyone from culpability. It was wrong--pure and simple. DDT was hailed as a great breakthrough in pesticides, sprayed widely and indiscriminately in neighborhoods, forests, and directly on humans. It was then banned (due, in part, to Rachel Carson's Silent Spring) when its terrible health effects became widely recognized.

That makes about 9 of us at last count, Kurt. Their silence and censorship, however, speaks volumes!

Prior to the beginning of August, I was unemployed (for about 6 months), and the only healthcare I had access to was the VA Medical Center. Since my blood pressure goes up every time I have to sit through Dr. Ghory's lecture on how I should eat less fat and red meat, she insists that I should be taking blood pressure meds (last time I was there, it was 150/95, I have been keeping a log of bp for the last month, and it averages 130/75 without meds). She insists my thyroid is normal, and that I should just "eat a healthy low-fat diet." Nevermind that my fasting glucose is 95, and my tryglicerides are very low, she also wants me on statins for my "high" cholesterol (don't remember exactly what it was, but I think it was around 150, with 90 of that being HDL).

I now have health insurance (and a good income). It appears that in order to get any real medical help, I'm going to have to go outside of the VA "medical" system (unfortunately, thanks to obamacare, all healthcare will resemble the VA system before long). How would I go about locating a local private practicing doctor who has a clue about nutrition?

I put this on the six servings blog today:
"Fat, sick, obese America deserves the truth....is the current whole wheat product....the same grain people have been eating for centuries OR...was it re-engineered in the 1980's. Please let us know....America deserves the truth."

This is a copy of a post I placed on Fathead and Jimmy Moore's blogs today. I am curious about the apo E4 mentioned above and wonder if this at place in this dilemma?

After my long diatribe about my family and how we have all been
rescued from fates worse than death by low-carb diets, I have to admit
that there is one family member for whom low-carb does not seem to have
worked. I have mentioned before that my sister is not able to control
her blood sugar or lose weight in spite of careful low-carb dieting for
nearly 12 years. She is so desperate that she went to see Dr. Mary
Vernon, in spite of reading negative reviews about Dr. Vernon’s practice
and both Tom Naughton and Jimmy Moore enthusiastically endorsed that
plan. It has been about 6 weeks since she went to Lawrence, KS (not an
inconsiderable investment of time and money). She commented on my
Facebook posting of Gary Taubes latest blog with “Why doesn’t all of this
work for me?” I replied “What does Dr. Vernon say?” I am pasting in
Jane’s reply because I think it is important that everyone in the
low-carb community know about this. I also am desperately seeking an
answer to why my beautiful sister can’t find the relief of her health
problems that everyone else in my family has found through the low-carb
lifestyle. She is the only one of my generation to be officially
diagnosed as “Type II” and she spent years on low-fat, low-calorie,
high-carb diets (including the 3 months on Weight Watchers + walking 5
miles a day when she gained 10 pounds and received her official
diagnosis). Well, here is a direct quote:

Jane wrote: “Well basically nothing. She (Mary Vernon) is very hard to get ahold of
(never answers the phone or e-mails) and I’m not sure that she believes
me that I am following the diet and it just isn’t working for me. I had
all those expensive tests and I have heard nothing from her about the
results. I have only heard once from her nurse and she said that maybe
they would put me on Januvia which I already take and listed on the form
they had me fill out when I went there. I am not happy with the
situation at all.”
I am interested in your take on this and any input/ideas I can receive from the blogosphere. We are really desperate.

Dr. Davis,

Is the grain used in French bread, i.e., of the sort gotten, e.g., in Paris, somehow "different" from the genetically re-engineered variants here in the US? I notice that when we go to France, especially in Paris, I'm struck with it that the only FAT people I seem to notice are foreigners, i.e., US, Germans, Scandinavians, and the now and again, Asian.  Parisiennes, however, virtually invariably look great, and not only the 20, 30, 40 somethings. So is there something about the grain they consume that exempts them from "Wheat Belly?"

Genome of wheat  was estimated in 2002 to be +/- 16.5 gigabase and thus +/- 5 times the human genome.

These free full text papers may help doubters improve their understanding.
Evidence for gliadin antibodies as causative agents in schizophrenia.
http://precedings.nature.com/documents/5351/version/1/files/npre20105351-1.pdf

Presence of celiac disease epitopes in modern and old hexaploid wheat varieties: wheat breeding may have contributed to increased prevalence of celiac disease
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2963738/?tool=pubmed

Yes I looked into this a while ago.
There are a lot more "HOBBY" farmers in France so there are more smaller holdings where people tend to farm more traditionally and stick with the traditional heirloom varieties that they know grow well on their land.
http://notulaebotanicae.ro/nbha/article/viewFile/4731/4560
Diversity of Seven Glutenin and Secalin Loci within Triticale Cultivars Grown in France
I think they are more interested in breadmaking qualities than in pesticide resistance.

Hi Anthony,
Any idea why 10 years ago these European children aged 7 - 9  weight profiles are so different ?
France (data 2000):
boys overweight = 14% & obese = 3.9%
girls overweight = 14.7% & obese = 3.6%
Portugal data (2001- 2002):
boys overweight = 19.1 % & obese = 10.3%
girls overweight = 21.1% & obese = 12.3 %

Hey, Doc,
In your book, you recommend avoiding vegetable oils like canola completely.  Yet you recommend eating certain foods that have mayonnaise.  Do you know of any mayonnaise brands without those nasty oils in them?

I have to admit, Ari, that I purchase mayonnaise so infrequently that I don't have the names on the tip of my tongue. However, unless you are a mayonnaise aficionado, the small exposures to linoleic acid-rich oils or canola likely have little impact on health. Soybean oil is another frequent oil; not perfect, but not bad. Even if GMO, there are not going to be proteins that make it to the end-product.

Hi, Ted--

You're discovering exactly what I did: There is already an incredibly diverse literature documenting the adverse effects of wheat consumption. The rest of the world has been falsely lulled by the "whole grains are better than white processed flour" logic.

Wow, Might!

I can always count on you to tell me something I didn't know!

Hi, Anthony--

See Ted's helpful comments below.

I can only speculate that, in addition to some of the heirloom forms of wheat being consumed (e.g., einkorn from Provence and Languedoc), the higher fat intake of the French may blunt the wheat effect. There may be more to this "French paradox," such as more socially-friendly eating, as opposed to the eat-and-run style of American eating.

You know, I switched from regular mayonnaise, made with soybean oil, to one made with expeller  pressed canola oil after reading Michael Eades' recommendation in ' "Protein Power Life Plan".  I guess it's the lesser of two evils but I wonder if it's worth it?

Hi, Peggy--

I really depends on what you mean by "not responding." On the surface, it sounds like she is not apo E4, but apo E2, which causes postprandial (after-eating) abnormalities and creates incredible carb intolerance, such that half an apple triggers excessive responses. Alternatively, she might have suffered pancreatic damage in some form, wheat or otherwise, that now limits her own capacity to generate the expected changes in diet.

A lipoprotein panel that includes an apoprotein E and HbA1c would provide insight.

Hi, Linda--

I feel them blushing and stammering already!

Hi, Howard--

Sadly, I believe there are so few nutritionally-savvy physicians that it can be a real tough search. Word of mouth still, even in 2011, remains the best tool, though with obvious limitations.

Thanks, Dr. Davis. My sister was diagnosed as Type II in the fall of 1999 and has been following some form of a low-carb diet since 2000. Before that, she followed various versions of low-calorie, low-fat diets and I am sure that she did suffer metabolic damage, as so many of us have. I am simply passing on what she reports, but she says it is not so much post-prandial blood sugar readings that are high and of concern, but fasting blood sugars. She also has experienced readings over 200 whenever she has a cold or infection of any type, Her first morning readings can be quite high and are chronically around 150. She finds the readings drop through out the day and says it doesn't matter what she eats - nothing raises or lowers the numbers. Her HbA1C is usually around 6-7 because of her high morning readings. Since she still retains a good deal of abdominal fat (she is the proverbial apple type), I would assume she is still producing insulin. As I mentioned, the family history of insulin-resistance is pretty dramatic and she seems to have inherited an extreme degree of IR which was probably intensified by her years of low-fat eating.
I have a sense of what she has been eating for the past 12 years, and it is a reasonably restricted diet in terms of carbohydrates. She saw Dr. Vernon with the hopes of tweaking her diet to see if she could get the fasting readings lower, and she was basically given an Atkins induction diet. She has followed it for 6 weeks with no weight loss and no change in fasting blood sugar.  I have asked that she send me copies of her food diary (she has sent them to Dr. Vernon) and perhaps that would shed some light on this dilemma. However, there seems to be more this than just diet. Hormones? Stress?
I hope you will continue to correspond with us on this and see if there is an answer.

I make my own mayo with extra light olive oil (Eades recipe).

When I stpped eating wheat my small LDL went down 15% but my total particle number went up by more than that.  I can't tell if this is a good trade-off or a bad one.

Dr. Davis, I am a Plastic surgeon in Chicago, and I have read your book. As a doctor, I understand your line of reasoning and the science, and teh short of it is, Ithink you have written and excellent, informative, and important book. This one could be a game-changer, as I see it.

But the more important point, I wanted to make is that I have 2 kids with juvenile diabetes, and we have no family history. I want to know why. and  Ihave always wanted to know why. And what's worse, is that I feel, working as a doctor, that there are many vicious cycles and toxic partnerships in medicine that sell you food on one hand that causes ill health and sells us cures on the other.
I have come to the conclusion that the road to hell really is paved with good intentions, and frankly, I would prefer someone who I know is trying to take advantage of me than one who is trying to help me. Fighting world hunger is noble, but its also a rhetorical point as well. Who wants people to starve? Likewise, it is a moral sentiment, which in this case did not rationally consider its possible unintended consequences by asking the question: Is this high-yield wheat good for people?
Unfortunately, you see this pattern play out a lot: A moral sentiment gets popular and eventually gets ruled and polluted by profit motive.
And what irks me is when a person uses the argument that correlation doesn't prove causation for rhetorical purposes. Correlation is good observation, which is crucial to good science. You have to make good observations so you can create good hypothesis that can ultimately be tested. You can't also run a double-blind study on everything. And if you do, it doesn't mean that its results are accurate or that it was well designed. Cause is an important thing to determine--this is true--but to say you have not made good observations and reasonable arguments and hypotheses that warrant further investigation because you don't have a bunch of double blind studies, or the like is the definitition of--no pun intended--a straw man argument.

OT
Dr Davis...........................
As a glaucoma patient, I am always searching for possible solutions. Am now taking 5000 UI a day of Vit D and I am starting to notice minor changes. Do you agree with this post on FB?

http://www.facebook.com/note.php?note_id=136737770479

Thank you so much

I posted this today (9-6-11) @ six servings blog:
Attention six serving blog:
A lot of people that are being helped by the "Wheat Belly" book's position wonder why you don't leave our posts on or reply to them . I posted this yesterday and it's gone, Also I never received a response?

Posted 9/5/11 :
“Fat, sick, obese America deserves the truth….is the current whole wheat product….the same grain people have been eating for centuries OR…was it re-engineered in the 1980′s. Please let us know….America deserves the truth.”
Where are all the comments posted?

If you haven't already, add the bloodsuger101 blog to your reading.
http://diabetesupdate.blogspot.com/
Best wishes for your family

Thanks, Linda!

I don't envy them, getting barraged with all these comments!

Hi, Linda--

Sorry, but you're way out of my areas of confidence. I sure HOPE it's true, however.

I will say that, between vitamin D and elimination of wheat, these combined strategies tackle more abnormal conditions than I ever imagined.

Thank you, Dr. Ostric. I like changing the game!

Dr. Ostric--

I would compare the release of high-yield, semi-dwarf wheat into the human food supply to releasing an untested drug into the pharmaceutical armamentarium for widespread prescription. It might work, but chances are it will not. It might, in fact, have plenty of unintended ill-effects.

I believe this is what has happened. Among its potential effects: an increase in the incidence in type I diabetes in children.

Hi, Peter--

Disappointing results. Have you assessed apo E status? This can modify an individual's response to diet,

Excellent!

Oh, boy, Peggy. A bit too complicated to handle in a blog response.

It could indeed be that her pancreatic function has been exhausted and there is no return from diabetes at this point. Another alternative: hypothyroidism, as this is prevalent and powerful. I assume that she has already corrected vitamin D, which is crucial; we aim for a 25-hydroxy vitamin D level of 60-70 ng/ml.

I have been reading here for a year, and my health has improved as I've tried to implement your suggestions. The topic of glycation is new to me. Have you read the research that shows that Benfotiamine, a form of thiamine,  may help prevent glycation? The fat-soluble thiamine is more effective. I ran across references to this supplement while looking up neuropathy online. It might have a role especially for diabetics.
http://www.peoplespharmacy.com/2011/07/18/vitamin-reverses-nerve-pain/  (see especially comments from Dr. Charles.) I would be very interested to hear what Dr. Davis, Mito and others of you think about this.
for example:
"The effect of magnesium on peripheral neuropathy pain could be related to the effect of benfotiamine (fat soluble derivative of thiamine). Both magnesium and thiamine (in the form of thiamine pyrophosphate) are cofactors of a very important enzyme, Transketolase.
The Transketolase enzyme helps to regulate some key functions of small blood vessels. When the small blood vessels are dysfunctional there is less blood flow to nerves and tissues. This can be one basis for pain (decreased perfusion of blood) in peripheral neuropathies. It can also contribute to severe muscle cramps and to restless legs syndrome in my opinion.
What happens in small blood vessels (capillaries and venules) can be literally and figuratively out of sight to most all physicians. Benfotiamine treatment of peripheral neuropathy has been in the medical literature since 1994+. There is very little recognition by the medical community, even in Germany where benfotiamine was synthesized of its efficacy in treating diabetic peripheral neuropathy and other conditions."

Hi Dr. Davis,

I'm convinced that lectin proteins like wheat gluten are responsible for virtually all autoimmune diseases ......either via direct reaction, or via cytokine inflammation. I'm also convinced that these proteins are primary causes of cancer.

I've been reading how one of cancer's main metabolic pathways has cells importing free glutamine from the extracellular matrix. In an insulin resistant environment glutamine subverts the citric acid cycle, making it create mutated tissue instead of energy. Normally glutamine is held in the extracellular matrix by tissue transglutaminase (tTg). Glutamine becomes free when the immune system removes  tTg. This happens in people with wheat-caused autoimmunity.

Wheat is a prime cause of insulin resistance and of free glutamine. I'm convinced. Wheat causes cancer. There are important chemicals missing from this explanation, like mTOR, tyrosine, PKM2 and mRNA.

Just to be clear, back in 1999, I did eliminate wheat from my diet. But I also eliminated every other grain, along with anything containing added sugar. It wasn't until sometime around 2005 that I figured out that I needed to eliminate anything containing soy, along with vegetable oils. The wheat elimination resulted in the most immediate and remarkable results, as I wrote in a post entitled "A Story About Gluten" on my blog (guestdietblog.com), but the journey to my optimum health is not complete.

I am putting out "feelers" for a family practice physician with a clue, but so far, have come up empty. Your observation on the lack of whisteblowers in the industry, along with old cigarette commercials reminds me of an experience in my own childhood. Around the ripe old age of 6, I became dimly aware of the connection between my multiple allergies and my father's cigarette smoking. Our family doctor completely dismissed that connection, and told me I was allergic to "house dust," then took another drag on his cigarette (yes, in his office, in the presence of a young child). I endured another 10 years of completely useless allergy shots before getting up the gumption to tell the doctor where he could stick it next.

HI Might-o'chondri-AL. I'm very interested in getting my hands on the paper where you got that information. Do you think you could provide me the reference?
Thank you
Pedro

Dear Dr. Davis,

I and very interested in reading your book, but I'm still waiting for it to arrive from Amazon. Since I haven't read it yeat, I don't know if you have included in your book data from the DART Trial published in Lancet a long time ago.

We have recently pointed out that data in a review paper (and before our paper, Dr. Staffan Lindeberg had included it in his Food and Western Disease book and I believe Stephan Guyenet had also included it in his blog a few years ago), but unfortunately this data is forgotten by many nutrition researchers, who use epidemiology (which can't show cause and effect) and trials with soft end points to support whole grains.

The DART study was one of the very few human controlled dietary intervention trials with hard end-points, and it found a tendency towards increased cardiovascular mortality in the group advised to eat more fiber, the majority of which was derived from cereal grains [1]. Of relevance, this non-significant effect became statistically significant, after adjustment for possible confounding factors (such as medication and health state) [2].
There's also the Women's health Initiative trial.

Whenever someone throws epidemiology or trials with soft end points regarding whole grains and CVD, I would simply show the data from the DART study and the Women's health Initiative trial, because RCTs with hard end points are the best we have to draw significant conclusions and these seem to go against the grain, although I would like to see more RCTs where wheat or gluten grains in general is the only variable manipulated.

Pedro Bastos

I forgot the references regarding the DART study:

1.  Fish and the heart. Lancet. 1989 Dec 16;2(8677):1450-2

2.  Ness AR, Hughes J, Elwood PC, Whitley E, Smith GD, Burr ML. The long-term effect of dietary advice in men with coronary disease: follow-up of the Diet and Reinfarction trial (DART). Eur J Clin Nutr. 2002 Jun;56(6):512-8

On a final note, I too believe that wheat (and perhaps also other gluten grains) are the main problem with grains and the reason why the DART study found that increasing fiber from whole grains had a negative cardiovascular outcome. In western countries, increasing whole grains normally means increasing whole gluten grains. IN many countries in Asia, the main grain is rice and not wheat and that could be another explanation for the better health profile of Asians compared to westerns.

We are trying to conduct a pilot study with a gluten, alcohol, dairy, trans and isolated sugar free diet, high in fish, vegetables and low fructose fruits in RA patients here in Portugal and we will allow them to eat rice and tubers (to be able to do this properly we have to compromise).

Purely hearsay anecdotal story from my dad. Last year, at the age of 65, He cut all grains and sugars from his formerly bread/pasta dominated diet and dropped 25 lbs in just 3-4 months. His sinus problems cleared up, many of which were apparently due to grain sensitivity. I had mentioned anti-grain literature (Rob Wolff et al.) to him, so can't help but take a bit of credit. Of course my Pops must have struggled mightily to ditch some things that had dominated his diet.  I will follow up with him on his blood work and see if he even needs to keep taking the statins he was on.

Hi Bob. Interesting connections.
Do you think you could provide me with some references, as they would be very useful for my work.
Thank you!

Hi, Court--

Anecdotal, yes, but very consistent with what I've witnessed over and over and over again.

Hi, Pedro--

Wow! That particular interpretation of the bothersome DART outcome had never occurred to me!

Please keep me informed on how/when/where of your study. I'd be very interested in your investigators and outcomes.

Hi, Howard--

Incredible. And to think that was only around 40-50 years ago. I still remember ashtrays in the hallways of the hospital for the doctors to put their ashes!

I'm with you, Bob. I've had that same suspicion that wheat is an extravagant cause of cancer.

Unfortunately, if you just compare white flour to whole wheat, whole wheat comes out shining. But NO wheat, I think we'd both predict, would come out as an important and miserably underappreciated risk for cancers of all sorts from mouth to anus.

Hi, DC--

We will be planning to cover this issue extensively in future. Thanks for asking!

Most cases of LADA diabetes get mis-diagnosed as type 2 diabetes. Some of these diagnoses get corrected. Most don't.

LADA diabetes is the adult equivalent of type 1 juvenile diabetes. Typically it progresses over two to ten years. This slow progression helps mask the disease from diagnosis. Type 2 diabetes is characterized by insulin resistance, constant insulin release and elevated blood sugar. LADA diabetes is an autoimmune attack against the pancreas.

Low carb dieting, especially curbing wheat and fructose consumption, can curb the progression of both diabetes types. In this limbo LADA sufferers can show symptoms of type 2. This is where I'm at.

Dear Dr. Davis,
I almost died of undiagnosed coeliac disease, after a lifetime's following medically-prescribed, high-carbohydrate, wholegrain, low-calorie diets. By the time I was diagnosed I was 100lb overweight (despite my long periods of disciplined near-starvation), unable to breathe, unable to walk unassisted, unable to keep my balance owing to ataxia, barely able to see through my double-vision, unable to feel any of my limbs owing to nerve damage, doubly-incontinent,  agoraphobic, claustrophobic, depressed, anxious, and paranoid. (I used to be a live broadcaster, sought after for my humour and quick-wittedness.)  I was fatigued to a degree I never thought possible. I once stared at my computer for an entire day, unable to remember how to open a document, having previously taught computing to university standards. I  couldn't even hold my baby. I missed his entire babyhood and toddlerhood, having desperately wanted him. I didn't even have the strength to lift a newborn. I began to  suffer regular episodes of shock, all requiring the attendance of doctors, none of whom recognised the shaking, cold-sweating and collapsing as being related to the wholewheat sandwich I was usually eating when it happened. My organs began to be affected, one by one. I underwent surgeries in an attempt to control abdominal pain. I developed gallstones; the agony's only being relieved when one grew so large it lodged in Hartmann's (sp?)  pouch. According to my surgeon, one ovary and one kidney had effectively rotted. Investigations had to stop when I was found to have suffered massive internal injuries from an unexplained, peritonitis-like acute illness.  I was sewn up, and told that nothing could be done. The internet saved my life. I Googled my symptoms, and soon suspected autoimmune problems. A biopsy confirmed my suspicions. In the wake of my diagnosis, my two sons were able to be diagnosed with wheat and gluten intolerances, too. (My elder son was twenty three and autistic. He was depressed, vomiting after his breakfasts (cereal), had a giant beer gut (despite never having tasted alcohol), and the swollen ankles of a seventy year old drunk. My younger son, then nine, was so unfocused that I was being called in to school to explain his daydreaming and falling asleep in class. His fatigue was nearly misinterpreted as child neglect on my part - this for a child who asked to go to bed so early that he sometimes could not keep awake for his evening meal at 5pm. He had so little strength that his arms could not support his own tiny bodyweight, so he was never able to do gym or games, which was stigmatising.) Both my boys have vastly improved health now. The day after removing grains and gluten from my own diet I was able to see properly, and could get out of bed by myself. It has been a slow recovery, and I now know it will not be complete. I have been left disabled. But compared to the nightmare I lived before, my low-carb life is fabulous. I am proof that you are right. Wheat and other cereals are deadly to many, and, I believe, damaging to all. Biology is biology, and science is science. Why do other doctors, the food industry, and governments pay no attention to it?  My own experience was dramatic. Others are probably dying slowly, and by degrees. Doctors don't do gluten testing when they sign death certificates. Perhaps if they were allowed to, we would see what role grains are really playing in the lives, and deaths, of long- suffering people. I view them as poison, not nutrition. My own reactions to wholegrain ranged from kidney damage to fertility problems, via a skin coated in open, running sores - not forgetting the arthritis. What is it doing to others? Please let me know if I can ever stand beside you as proof of your arguments. In denying that toast and tortilla wraps almost killed me, that is also to deny the evidence in my medical notes, my ultrasound scans, and my xrays. And, for anyone still unconvinced, perhaps I could demonstrate my persisting inability to walk a straight line when I am tired,  my failure to get through a whole day without soiling myself, and - for a finale - give a tour of the horrific, cruel scars carved into my body in the name of grains? Sending warm wishes.

Sorry, I meant coeliac testing, not gluten testing.

PS I've lost 30lb already this year, without dieting, or perhaps I should say without counting a single calorie.

Yes, indeed: Not dieting, but removing this perverse product of genetics research called modern "wheat"!

Thank you, Ali, for having the strength to relive and retell your long struggles.

You are a reminder of the gravity of these issues. This is not about some diarrhea and cramps; this can be about incapacitating, life-ruining diseases that doctors often fail to recognize.

I would like to post your story in my Success Stories area. I will indeed need articulate people with powerful stories to bring to the broader media. Please let me know if you are interested.

I think you're barking up the wrong tree with this letter.  Or wheatstalk, rather   Mullen is a huge advertising agency. [http://en.wikipedia.org/wiki/Mullen_Advertising http://mullen]  As you can see from their client list, The Grain Foundation is like pretty small potatoes.  

Ms. Reynolds is the Mullen account executive and a registered dietician.  I assume  you've seen this? http://www.bakingbusiness.com/News/News%20Home/Business/2011/9/Foundation%20sets%20strategy%20to%20deal%20with%20Wheat%20Belly.aspx

Better to target The Grain Foundation's higher-ups.  http://www.gowiththegrain.org/about/  This is like so many industry PR-based groups purporting to bring "information based on sound science".  But private exchanges are of limited value, this will be public and it won't have anything to do with sound science or rational debate.  Just look at the member companies.  They still remember the distinct pain the industry suffered during the short-lived low-carb "fad".

They are going to bring out the big guns, it's just a matter of time.  Their goal will be to turn you into, well, toast   The upside is that they are worried enough that your book is on their radar.The downside is that they are worried enough that your book in on their radar.  But as they say, bad publicity is still publicity.  

Your strongest argument to the book-buying public isn't even justifying the science or counting studies cited, you can simply say "Be your own one-rat science experiment and try it for yourself for a month, then make up your own mind."  Savings will pay for the book and then some.

Good luck!

P.S. On Mullen's client list: the ADA (American Diabetes Association).

Hello Dr. Davis,
I will email you my full name and address for your own records, and so that we can arrange this offline.  You probably guessed that I posted without my full name only so that I could retain a modicum of privacy - after all, I am talking about my bodily functions on the internet! Because of the length of the post, I omitted other symptoms and illnesses that you may feel important to include in any story.  For example, according to my gastroenterologist, the severe latex allergy I developed, twelve years before being diagnosed with wheat and gluten intolerances, was attributable to coeliac disease's beginning its final rampage. It was a clue my GP, and even my consultant immunologist, missed at the time. Even putting aside all the functional bowel problems I still have, and the fibromyalgia that dictates I live my life in the one, precious hour a day I have energy, the anaphylaxis is "the biggie". I had to change my career to avoid running into rubber in the environment. I've been hospitalised for anaphylactic shock. I've survived some terrifying near-misses (always in hospitals or doctors' surgeries), and live a very restricted life because of it. I carry an adrenaline shot, and must be accompanied  everywhere new that I go: All from coeliac disease... all from bread...  all from grains.

Glad I might be of some help.

Ali

HI, Michia--

This reminds me of the movie, Michael Clayton: Layers of intrigue, bad people in high places plotting evil doings.

I'm putting my ear to all packages to listen for any ticking!

Thank you Dr. Davis. I read here every day, and I'm learning as much as I can.

With Dr. Davis's indulgence.....
Recently Dr. Davis blogged, saying that low dose naltrexone (LDN) causes wheat eaters to lose
weight. This weight loss happens because LDN blocks nerve endorphin receptors.

http://www.trackyourplaque.com/blog/2010/11/why-do-morphine-blocking-drugs-make-you-lose-weight.html

Wheat protein is a cornucopia of exogenous opioids which mimic endorphins. These exorphins
plug into cells and organ transduction nerves all over the body ......including pancreas islet cells.
Using LDN to block interaction between wheat and nerves restores control of metabolism.

A curious side effect of LDN is that it severely curtails the growth and spread of cancer.
http://fourfoldhealing.com/2010/06/10/a-holistic-approach-to-cancer/

Massive population study shows increased correlation between wheat and cancer
http://rawfoodsos.com/2010/07/07/the-china-study-fact-or-fallac/

Large scale study shows up to 5-fold increased cancer incidence among type 2 diabetics:
http://www.sciencedaily.com/releases/2010/05/100521102629.htm

Beta endorphin in the human pancreas:
http://jcem.endojournals.org/content/49/4/649.abstract

Wheat causes insulin release:
http://www.ncbi.nlm.nih.gov/pubmed/7637543

Wheat causes insulin resistance:
http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=4510292&ordinalpos=7&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

Cachexia is the underlying disease of cancer:
http://www.ncbi.nlm.nih.gov/pubmed/6145877

Cells become cancerous by fermenting sugar:
http://www.thecancerblog.org/blogs/permalinks/11-2009/warburg-effect-against-cancer.html

mTOR scouts for free glutamine:
http://www.cell.com/abstract/S0092-8674(08)01519-5

Afinitor chemotherapy works by inhibiting mTOR.
http://alberghi-portofino.info/page/49/

Glutaminolysis in tumor transformation:
http://en.wikipedia.org/wiki/Glutaminolysis

tTg protects against cancer
http://www.molecular-cancer.com/content/4/1/33

Wheat induces autoimmune attack against tTg.  It goes back so far that it's hard to nail down.
Anti-tTg antibodies, both IgA and IgG, are part of every celiac test panel.

Dr Davis,
Recently you blogged, saying that low dose naltrexone (LDN) causes wheat eaters to lose weight. This weight loss happens because LDN blocks nerve endorphin receptors.

http://www.trackyourplaque.com/blog/2010/11/why-do-morphine-blocking-drugs-make-you-lose-weight.html

Wheat protein is a cornucopia of exogenous opioids which mimic endorphins. These exorphins plug into cells and organ transduction nerves all over the body ......including pancreas islet cells. Using LDN to block interaction between wheat opioids and nerves restores control of metabolism.

A curious side effect of LDN is that it severely curtails the growth and spread of cancer.
http://fourfoldhealing.com/2010/06/10/a-holistic-approach-to-cancer/

A massive population study shows increased correlation between wheat and cancer
http://rawfoodsos.com/2010/07/07/the-china-study-fact-or-fallac/

A arge scale study shows up to 5-fold increased cancer incidence among type 2 diabetics:
http://www.sciencedaily.com/releases/2010/05/100521102629.htm

Beta endorphin in the human pancreas:
http://jcem.endojournals.org/content/49/4/649.abstract

Wheat causes insulin release:
http://www.ncbi.nlm.nih.gov/pubmed/7637543

Wheat causes insulin resistance:
http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=4510292&ordinalpos=7&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

Cachexia is the underlying disease of cancer:
http://www.ncbi.nlm.nih.gov/pubmed/6145877

Cells become cancerous by fermenting sugar:
http://www.thecancerblog.org/blogs/permalinks/11-2009/warburg-effect-against-cancer.html

mTOR scouts for free glutamine:
http://www.cell.com/abstract/S0092-8674(08)01519-5

Afinitor chemotherapy works by inhibiting mTOR.
http://alberghi-portofino.info/page/49/

Glutaminolysis in tumor transformation:
http://en.wikipedia.org/wiki/Glutaminolysis

tTg protects against cancer
http://www.molecular-cancer.com/content/4/1/33

Wheat inducement of autoimmune attack against tTg goes back so far that it's hard to nail down. Anti-tTg antibodies, both IgA and IgG, are part of every celiac test panel.

I am 78 year old who has been on the Ornish reversal diet for 21 years, thinking that if it could reverse heart disease that it must be good for the long-term.  Boy from what I have learned in the last 3 months since my son put me on to limiting carbs shows just how wrong I was.  In the meantime, in the last 10 years I have developed a partially blocked artery, the rhymbus intermedius (which I may have misspelled).  (I have had two catheterizations, in 2000 and 2009, after suspicious stress tests. In neither case did the catheterization confirm the doctor's suspicion.  No blockage at all in 2000.)  I may not have been following the latest version of the diet, since I understand that Ornish said stay away from at least some wheat.  I was eating rolls and bread in great quantity.  Now two points:  Despite my diet, I was not overweight.  I am 72.5 inches tall and weighed about 158.  Nor do I have yet developed Type II diabetes, though my fasting glucose is around 100.  (In the 1960's I was diagnosed as a borderline diabetic and underwent numerous glucose tolerance testing, but after starting distance running my fasting glucose has always been OK.  I have no idea yet how high the glucose spike goes now or went before I starting limiting carbs.  My more normal weight may be because I have always been a heavy exerciser, once running up to 40 miles a week.  Now I get aerobic exercise virtually every day and lift weights three days a week.  I walk over 4 miles 4 days a week over hilly streets and use an aerobic machine at the gym for 20 to 30 minutes at a pretty high level, despite being on atenolol to control supra ventricular tachycardia (spelling?) and blood pressure.  My HR gets into the mid 120's.  Before the SVT, I routinely achieved a HR of 150.  Now since I started controlling carbs and eating meat for the first time since 1990 I have lost almost 10 pounds in about 6 weeks and I haven't felt hungry.  Of course, I stopped eating a big bowl of popcorn or a bowl of shredded wheat and grape nuts covered with raisins as an evening "snack".  Before, I really needed four high-carb meals a day to keep my weight up to 158 or so.   I have pretty much eliminated wheat, but fresh sweet corn on the cob is still in season, though I have cut back on that also.  No more oatmeal covered with shredded wheat grape nuts and raisins for breakfast either.  Obviously I must have cut my calories significantly.  Now I guess I am going to have to start counting calories and maybe add a much more calorie rich snack in the evening.  Any comments?

Hi, Sam--

It sounds like someone needs to help you conduct a metabolic analysis on your current status. It's really quite easy.

It should include measures like HbA1c, glucose, and lipoproteins. Also, strongly consider apo E. You will then know what the ideal balance of carbs/protein/fat is.

Hi, Bob-

Sherlock Holmes would have a field day with wheat, wouldn't he? Fingerprint, footprints, motive, opportunity . . . wheat sure looks guilty to me!

I thought you sounded awfully smart!

Thanks, DC.

I see my PCP October 3.  I don't think I reported that in February my cardiologist put me on simvastatin. After noticing pains in both calves and an inability to lift as much in the gym as before, I stopped simvastatin about July 15.  I told my cardiologist on August and he wasn't happy.  He obviously believes in statins and referred me to the Heart Protection Study (Lancet, 2002?), which I found unconvincing.  Because of the statin I have had two recent blood tests, but they did not include HbA1c (see below) or apo E.  The statin brought my total cholesterol from 187 to 133 and my Trig. from 130 to 83.  My fasting glucose was 94 mg/dl.  It was 102 on 08/11/2010 and 115 on 01/19/2010 which seems borderline high. Other values from the test about 3 weeks before I stopped the statin:  HDL 40 mg/dl (about as high as I have ever measured since the Ornish diet); LDL 131 to 76.2 mg/dl:ALT 23 U/L: AST 28 U/L; CK 62 U/L; Hemoglobin A1C 5.6% IIs this the same as HbAic?)    The previous numbers are from 02/09/2011 except for glucose.  From what I've read, total Cholesterol below 160 is associated with increased canser risk and also that the elderly love longer with higher cholesterol.  In any case I won't risk a statin also damaging my heart, which being a muslce also must be vunerable.  I also want to know what my small dense LDL is and I would like also to be able to monitor my glucose to see what I can eat without huge spikes in blood glucose.  I suspect I may have been spiking well above 150 and that over the years could have lead to my partial blockage.  I sent my PCP a letter with documention to tell him that I stopped simvastatin and that I have changed my diet to low carbohydrate, though I'm not quite there yet.  I referenced Ravnskov's book, but since have erad Su's and have ordered Wheat Belly which I shall have read before I see him.  I'll have them all with me in case he is interested.  I suspect he is pretty conventional not into low carb.  I am counting on him to at least cooperate with my experiment and prescribe the necessary blood tests.  I consulted with a Highmark dietician and it became clear that I know more about modern diet science than she did.  We are dominated here in Pittsburgh by big medical UPMC and Highmark.  I have read Dr. Ufe Ravnskov's and Dr. Su's books and now think that medical-diet science is just as corrupt as climate-change science, which I have been studying for 5 years.  After being a high-carb Ornish-diet guy for 21 years, I have now changed to at least restricted carb.  I just need to get my wife to read the books and other references to make things easier.  As I said above, I have to eat more meat to keep my weight around 150.  Today I enjoyed my first Big Mac (without the bun) for lunch in a long time! Thanks for your response.

Yup, Sam: You will find that YOU know more about nutrition than your doctors and dietitians . . . combined!

You are well on the right track. Your HbA1c of 5.6% tells all: You have been overexposed to carbohydrates that have led to high triglycerides, reduced HDL, and small LDL lurking beneath the surface.

Don't forget your vitamin D!

At least he has that right.  My PCP when I first transferred to him from my previous PCP (who was drinking erratic, and may now be out of practice, but otherwise a very knowledbable guy) he tested for D and I and my wife now take 2,000 units a day of D3.  What should HbA1c be?  5.6% is right in the middle of the "acceptable" range on the test report.

Thanks

I don't see how those people on the 6 servings website sleep at night in the face of such overwhelming evidence. And all they have is "appeal to authority" arguments.

I guess they sleep as well as the tobacco industry.

They want to ignore all the issues associated with wheat consumption by saying that there are nutrients in it? Wow. That's an intelligent rebuttal. lol.

Good for you for standing your ground here against the Grain Food Foundation.

Well played Doc.

-JK

Thanks, JK.

Yes, I found their arguments fairly silly. I've had better debates with 5-year olds.

Yes, indeed, Dave. They are scrambling to carry out damage control from attacks coming from several directions. Then, all of a sudden, this cinderblock hits them on the side of the head called "Wheat Belly."

I almost--almost--feel sorry for them.

How much of the wheat now eaten is GMO?  The hybrid "dwarf" high yielder - hybrid or GMO, both???

Hi, Anita--

Surprisingly, none. But let me qualify.

Genetic modification refers to the insertion or deletion of a gene or genes. Wheat has not been genetically-modified. But here's where the geneticsts start to play games. Wheat has been the recipient of "traditional breeding methods" that includes extensive hybridization (with other wheat strains and non-wheat grasses), back crossing to bring out specific genetic traits, chemical mutagenesis (using toxic chemicals to induce mutations), gamma irradiation, and high-dose x-ray. Ironically, these "traditional breeding methods" are WORSE than genetic-modification, but have been going on for 50 years and are still being used--but not questioned or scrutinized.

Dr. Davis,

Do you recommend eating other types of grains besides wheat? Like oats, quinoa, brown rice, etc? I am a vegan so I get a lot of my protein from things like quinoa in addition to beans and soy. I am also a medical student so I was very interested when I ran across your book. I have noticed that gluten-free foods have recently become very popular and I was wondering why all of these people suddenly realized that they had celiac disease. One other question, is it the gluten protein that is causing all of this trouble or other components of wheat? Thank you.

Taylor

Hi, Taylor--

A common point of confusion: It is NOT about celiac disease or gluten intolerance. It is about a variety of reactions to this corrupt and genetically-manipulated thing called wheat.

I would refer you to my Wheat Belly Blog, as well as the book, Wheat Belly, for further discussion.

Sometimes I think having celiac disease is one of the best things in my life; I have no more joint pain and enough energy to do sprint triathlons (started at age 42) and now CrossFit (at age 46).  Sadly, I wonder how much of this grain focussed diet contributed to my mother's dementia.

Thanks for posting this.  My husband has allowed himself to be carried along with my strict low-carbing for a few months now, and has lost 25 pounds +  or so so far. He had labs a couple of months ago, and his Triglycerides were up and his HDL somewhat low.  So of course his physician wants him to repeat the labs in Oct., and will want to put him on meds , I'm sure, if he still exhibits that profile.  But I will advise him to wait, to continue with what he's doing until his weight loss stabilizes, and this post will give me the concise authoritative ammo I'll need to encourage him both to continue with carb restriction and to resist medication, which he almost certainly is not a proper candidate for.  Perfect timing for us, and thanks so much! jennytoo.

on another subject, but I'm curious about your thoughts on krill oil.

Here's a post by Michael Eades on the subject:
http://www.fourhourworkweek.com/blog/2008/07/23/krill-oil-48x-better-than-fish-oil/

Hi Dr Davis,

While fat is stored as triglycerides, it is released from adipose stores as non esterified fatty acids, and these will be predominantly palmitic acid in humans. Non esterified palmitic acid appears to be an excellent inducer of insulin resistance, and insulin resistance has been hypothesised by several authors to be a completely normal physiological adaption to fasting or seasonal carbohydrate absence. While weight loss is on going, the circulation is flooded with NEFA and "physiological" insulin resistance should predominate. If the person continues to consume "good" carbohydrate at above acute metabolic needs, the excess will get shipped out of the liver as VLDLs. Under insulin resistance lipoprotein lipase, routinely under the control of insulin, won't be doing much lipolysis and so VLDLs can hang around in the circulation... Muscle can happily accept NEFA as a prime source of energy without lipoprotein lipase having to split the lipids from VLDLs, so leave the VLDLs there to show up as fasting trigs....

Once weight is stable the NEFA release from adipose tissue will be much better matched to metabolic needs. With the improved insulin sensitivity due to loss of visceral fat, control of both adipose hormone sensitive lipase and endothelial lipoprotein lipase activity should normalise and allow VLDLs and HDL to settle in to  more cardiologically acceptable numbers.

Just an idea. The prediction it makes is for a reduced HbA1c due to the reduction in bulk carbohydrate (this must happen to allow lipolysis for weight loss), coupled with no drop or an increase in fasting blood glucose due to the NEFA induced insulin resistance. Very curious as to whether this happened...

Idea is open for kicking.

Peter

Thanks for the article.  In the midst or losing a good deal of weight I had a finger prick test here at work.  My HDL had indeed dropped into the low 20's but my Triglycerides had also dropped (maybe a good does of fish oil and cod-liver oil help those?).  Anyway my weight has pretty much stabilized at a good level and I'm looking to do a good blood test in a few weeks.  Hopefully the HDL numbers are coming up.

The post about Brad is from August of 2008.  So how is he doing now?  Did the triglycerides drop and HDL rise?

I wonder what happened to Brad now? How did it go? By the way, I wanna share this video I came across with: http://www.youtube.com/watch?v=lj-ZnG3NoZY You'll surely learn a lot of information here.

Hi Dr Davis,

Really excellent to see this discussion of the much vilified saturated fat. If this results in a softening of the approach to saturated fat in your program I will welcome it. It seems like there have been other tweaks in this direction recently in your posts. Making a good thing better is always the way to go. Redefining that awful term "healthy fats" would be a great move.

Peter

I have the greatest respect for you, Dr. Davis. In your efforts to find the best strategies for the treatment and prevention of cardiovascular disease, you are willing to question everything and follow the evidence wherever it leads -- the mark of a true scientist. You would certainly find Gary Taubes' new book, "Good Calories, Bad Calories" to be of interest. Even if you don't necessarily accept all of his conclusions, Taubes does us all a great service by revealing the shaky underpinnings of what "everyone knows" about nutrition and health.

Jen

THANKS again for the opportunity to share with your readers, Dr. Davis!  The saturated fat issue is indeed an exciting one to watch out of the research community in the coming years.  A lot of minds will be changed if people will embrace what the evidence shows them--I am sure of it!

By the way, I also have a popular podcast show called "The Livin' La Vida Low-Carb Show with Jimmy Moore" with nearly 100 encouraging, educating, and inspiring episodes under our belt.  THANK YOU again for interviewing me for your blog!  Keep up the great work you are doing, Dr. Davis!

You should check out Gary Taubes newly released book, "Good Calories, Bad Calories".  It is a historical look at the studies that were done that vilified fat, animal protein and glorified carbohydrates.  It is a study is how really poor science led to the current recommendations.

I've been low-carbing for many years due to diabetes, but after my MI, angioplasty and bypass in May/June, I've become much, much more interested in the fat question and have been reading like crazy.  The following are my preliminary conclusions.

Fish oil is a flatout necessity to get the EPA and DHA we need.  Because of the importance of the bioactive form of vitamin D (which this blog first clued me into), I  prefer cod liver oil to regular fish oil.  

While we don't convert vegetable-based omega3 to EPA and DHA very well, there does seem to be some good reason to get a lot of ALA on it's own.  Flax and nuts are a good source of ALA. Personally, I find whole nuts and seeds or nut butters very easy to overeat, so I prefer nut meals.  A combination of almond meal and flax meal makes a great replacement for flour in making breads, muffins and cereals.  The meals can even "raise" with a bit of baking soda.  For me, it is a great dietary choice to replace starches with these good fats.

Everyone agrees monounsaturated fats are good or at worst neutral, so it's a no-brainer to use virgin olive oil on salad and avocado oil for strifry.  A friend tells me rice bran oil works well for stirfry also.  Preferring these  oils over polyunsaturated vegetable oils reduces the omega6 in your diet, thereby improving the overall omega3:omega6 ratio.

Unfortunately, canola oil as sold in supermarkets is not a virgin oil, but hydrogenated. The process produces just few enough trans fats to allow them to round down to 0 grams trans fat on the label.  If you have a source for virgin canola oil, it moves up into the olive oil and avocado oil category; otherwise, it's a trans fat and should be ditched.

We all agree, monounsaturated fats are good and trans fats are bad, the next question is whether polyunsaturated fats or saturated fats are bad.  There are bright people of goodwill with research to back them up on either side of the question.  As I've looked into this, I've come to the conclusion that it's not a simple issue.  

The primary issue with polyunsaturated fats is that they contain too much omega6 for most of our diets.  Thus the vegetable oils that were pushed as heart-healthy for so long because they were not saturated turn out to have problems in themselves.  

There's three primary issues with research showing that saturated fats are bad.  First is how often older research included trans fats in the same category as "normal" saturated fat.  We know for sure that any amount of trans fats are bad and should be avoided.

Second is that it turns out that saturated fats containing primarily mid-sized fatty acids chains are in a different category than those made of the long chains, a distinction that has only been made relatively recently.  For me, this means eggs are best fried in coconut oil, and I make my own chocolate now with coconut oil, cocoa, flavoring and sweetener.  While very caloric, it is almost all fat and therefore has almost no effect on bg, which makes it a convenient food to eat between meals.

Finally, the saturated fats from meat and dairy products produced from pasture-raised animals contain a lot of CLA (an omega6 fatty acid that turns out to be VERY good for us) and much more bioactive vitamins A and D than those raised on grain in enclosed feedlots where they don't get much sun.  For me, this means that I need to spend the money for the more expensive pasture-raised products even if that means eating less of them overall.  

I never waste the bones from pasture-raised meat or poultry, but instead make stock.  Recipes generally instruct you to skim the fat off, but I figure when I'm using pasture-raised meat, the fat is good stuff.  Besides using stock for soups and gravies, if you concentrate down until it pretty much forms a layer of gelatin under a layer of fat, it makes great stuff to saute/fry vegetables in.

I am also preferring raw milk fermented cheese for a number of additional health benefits in addition to their fat content.

I use butter from pasture-raised animals on some vegetables, e.g. artichokes.  I consider anything that makes vegetables more palatable in the diet to be a good thing as I've come to believe vegetables should be the bottom of the food pyramid.  IME, low-carbers tend to eat much more fiber than otherwise due to their high vegetable intake, so I don't see fiber as a reason to eat grains.

When pasture-raised meat and dairy is unavailable or prohibitively expensive, I would prefer low-fat dairy and the leanest meats instead.  There is definitely research that shows that monounsaturated oils are healthier than the regular saturated fats from the grocery store.  But with the pasture-raised products, I believe the saturated fat is very healthy and heart-protective.

You can located pasture-raised meats and dairy products in your area here: http://www.eatwild.com

You can locate raw dairy products in your area here: http://www.rawmilk.com

While I must low-carb for bg control, I have come to believe the macronutrient content of a healthy diet is much less important than making the *best* choices for each macronutrient.  One can do either a low-carb or low-fat diet in a healthy or unhealthy manner.  For me, the criteria in choosing foods from each macronutrient category is doing so in a manner that maximizes the micronutrients.  

Fresh vegetables, especially the nonstarchy ones, should be at the bottom of everyone's food pyramid.

Even a diabetic can handle a serving or two of the low-sugar fruits every day, though usually not for breakfast.  

Those who can tolerate a higher carb level than myself can also eat *real* whole grains, such as wheat berries, field corn, whole oats, brown rice, barley, etc.  These real cereals are much healthier than anything produced by General Mills or Post.

In practice, I buy too much fresh produce every week and then rush to try to eat it all before it goes bad.  I think this is a great shopping strategy for health.  

A great source for locating farmer's markets and community-supported agriculture (CSAs) for all your fruit and veggie needs is: http://www.localharvest.com

Those in the northeast might look to see if there is a Wegmans nearby.  One just opened up near me and I can now buy all of these products in a regular grocery trip instead of having to shop a variety of sources.

Short of quitting if you smoke, I believe controlling bg is the most important thing anyone can do to improve their heart health.  I have seen research that shows that the A1c is much more highly correlated with heart disease than lipid panels, even in nondiabetics ranges.  This is likely a large part of the explanation for low-carb being so heart-protective for most folks.

While I have been low-carbing for many years, I had lost control of my bg due to a bout with acute pancreasitis about a year prior to my MI.  I recently received my hospital records and I noticed something interesting: during my hospitalization, I was tried on several insulin regimens before they got my bg controlled.  Two days after my bg was controlled, my triglycerides and LDL (calculated) were cut in HALF.  So it seems to me that bg control is primary, which does imply a controlled-carb diet.

I think whatever the macronutrient makeup of a diet, it's a matter of choosing the best carbs, the healthiest fats and getting sufficient protein from as wide a variety of good foods as possible.

If saturated fat is not yet understood and you are trying to reduce your calcium score, do you want to risk eating it?

Jpatti--

Thank you for your exhaustive discussion!

But I'm bothered by one question: Why do you have heart disease?

With your deep appreciation of health and nutrition, how did this happen?

Hi, Rich--

At this point, I truly don't know. I thought I knew. I have to admit that the entire conversation has to, at least, raise some doubts.

It is disturbing, to say the least, that "fact" we accepted for decades seems to crumble in light of new information. There's no need, however, to dive into a diet rich in saturated fats just yet.

Hi Dr. Davis,

I'm confused about the meaning of Low-Carb labeling and an example from a recent post within the TYP member forum triggered this question.  I ask the question here because, hopefully, the great Jimmy Moore might have a thought about it too.

At the http://www.foodforlife.com/ website, I took a look at "Ezekiel 4:9® Organic Sprouted 100% Whole Grain Flourless Bread".

On the label, the Total Carbohydrates are shown to be 15 per slice.  3 grams of dietary fiber carbs and 0 sugar carbs.

So my first stupid question is "where and what are the missing 12 carbs?"

Second question is (perhaps for Jimmy):  I understand that the 3 dietary fiber carbs don't count toward the Atkins carb count right?  But would the 12 carbs of unknown type be counted toward an Atkins Diet carb count?

Thanks Dr. Davis and thanks to Jimmy Moore!!

It sounds like there's 12 g of non-sugar carbohydrates, meaning complex carbohydrates (polymers of glucose). Unless it's cellulose (which is indigestible to humans), it would indeed count towards a carbohydrate load.

Dr. Davis,
Do you recommend a particular % of calories from carbohydrate?  Or a grams-per-day?

Dr. Davis, I didn't HAVE this understanding before May.  I've been doing nothing but reading since though.

What I had was 2 decades of being a T2 diabetic, the first decade of that uncontrolled until I got a bg meter and began low-carb.

When I had pancreasitis, my bg went up to the 300s and stayed there for a year.  I was irrationally scared of going on insulin; I knew I needed insulin and kept postponing it out of fear.  I suspect that is the primary cause of my MI.  I'm on insulin now anyway AND had to have a bypass on top of it, so that was a pretty dumb move on my part.

I haven't kept up with the literature since I was first diagnosed T2 and lots more has been discovered in nutrition since then.      I was a PhD candidate in biochemistry when I was diagnosed as a diabetic, but haven't worked in the field in most of that time and discovered I knew NOTHING when I started studying.  Nutrition discussions are all about compounds that weren't even on the radar screen a couple decades ago.  This is another reason I've become convinced of the importance of whole foods as I have no idea what they'll have discovered another couple decades down the road.

Learning how the various insulins best work in my body was my first step, and it was mostly empirical as dosing information is skewed towards the ADA diet (which is pretty much as stupid as your rants against the AHA) and T1s.  

Now I'm studying heart disease itself, inflammation and endocrinology generally.  

I've also done a lot of reading about fat and nutrition along the way.  You can't study this stuff without doing so.  I'm still in recovery and not able to work, so there's little for me to do besides study this stuff day and night.  Frankly, I'm obsessed.

The fat question is a BIG question and there are intelligent arguments on both sides of the aisle.  My conclusions on this are important to me since I'm apparently betting my life on being right.  I very much want to see any evidence if I'm not right!

Or maybe not betting my life, but betting another bypass.  I've read a bypass "lasts" 15 years.  I want mine to last forever.  I know there are people who have them multiple times, but I can't understand that.  I found it to be the most horrible experience of my life and prefer to not do it again.

BTW, I'm all of 45 years old.  I am postmenopausal, but I'm still pretty young for this; I was the only one under 80 in the CCU.

The angio report said all my arteries other than the left descending (which is where the blockage was) looked good.  The bypass report said my mammary arteries looked good.  So I have a very good shot at being heart-healthy in spite of my history and diabetes if I am wise about my choices.

This is one of the reasons I'm a fan of yours.  While I'm someone unlikely to get useful information from a heart scan, I'm extremely motivated to do the bits that you've seen work in your patients.

P.S. To wccaguy: It's starch. Your body reacts to it pretty much identically to sugar because it breaks it down to sugar.  The only "complex carbs" that are not sugar in the body are fibers, we hardly break down much soluble fiber to glucose at all and don't break down any insoluble.  But starch is the same thing in your body as sugar and it's not reported separately on the label.

Hi, Bix--

For the people who need to restrict carbohydrates (e.g., low HDL, small LDL, high triglycerides, blood sugar > 100 mg/dl), we're generally recommending that carbohydrates be reduced to <30% of calories until patterns are corrected.  

However, in all practicality, I rarely actually tell patients to follow this guideline. Instead, I suggest a virtual elimination of wheat and other processed carbohydrates and this has worked well. Fibers therefore come from vegetables, low glycemic index fruits, oat bran, ground flaxseed, and raw nuts and seeds.      

If serious weight loss is needed, then <50 gram carbohydrates per day yields substantial results.

Hi DR Davis,
          Some clinical studies (Westman et al., American Journal of Medicine 2002; O’Brien et al., AHA Scientific Session 2002; Hickey et al., Metabolic Syndrome and Related Disorders, 2004; Greene et al., Obesity Research, 2003) indicate that LDL levels decrease in people following a low-carbohydrate diets. Yet despite the evidence provided by science, the majority of health professionals remain skeptical of this effect. The source of this skepticism is most likely the mistaken belief that all saturated fats cause an equivalent increase in LDL levels. Such a sweeping judgment, however, ignores a significant difference between distinct subtypes of saturated fatty acids (SFA). They include the following:

1. Lauric acid (C12:0) – this is the most atherogenic SFA, i.e. it increases LDL more than any other SFA
2. Myristic acid (C14:0) – this SFA is the second most atherogenic
3. Palmitic acid (C16:0) – this SFA is the third most atherogenic
4. Stearic acid  (C18:0) – this SFA has no effect on blood LDL, i.e. it is considered “neutral”

          Foods like red meat, butter, cheese, poultry, eggs, pork and fish are primarily composed of palmitic and stearic SFAs (typically in a 3-4:1 ratio) and contain minor amounts of lauric or myristic acids. Such a composition of SFAs would typically cause either a minor net increase or net lack of effect on total LDL levels. Yet one may ask, if a minor net increase in LDL levels is possible, then how does consuming such foods, cooked in heart healthy vegetable oils as part of a low-carbohydrate diet, lead to a reduction in LDL levels for some people?

          Firstly, it is important to note that the primary oils utilized in the ANA include olive, safflower, flaxseed, and canola oils which are rich in unsaturated fats and exert a potent reduction in LDL levels. Secondly, and more importantly, individuals who switch to a low-carb diet from a typical Western diet minimize consumption of hydrogenated oils, i.e. trans fats, found in high-carb processed food items. Since trans fats are the most atherogenic dietary fats, by increasing LDL and simultaneously decreasing HDL, it is easy to see how a low-carbohydrate diet may decrease LDL levels by this fact alone. In effect, people switching from a high-carbohydrate to a low-carbohydrate diet must, by default, consume the majority of calories from whole foods, thereby avoiding consumption of trans fats typically found in carbohydrate-rich, processed foods.

          Lastly, a reduction in LDL levels from a low-carbohydrate diet may also occur as a result of the reduction in triglyceride levels observed in the overwhelming majority of studies on low-carb diets. As triglyceride levels serve as a proxy measurement for VLDL levels, when triglycerides decrease, the VLDL size and/or particle number may decrease as well. As VLDL can be converted to LDL (following triglyceride delivery to body tissues by VLDL), it is easy to see that a reduction in triglyceride levels, and thereby VLDL, can lead to reduction in net synthesis of LDL in the blood which leads to a net reduction in total LDL levels. One further fact needs mention here. High carbohydrate consumption is known to cause an increase in triglyceride levels. Given the biochemical conversion mechanism mentioned above, this may explain why LDL levels increase on such a diet. In short, high-carb diets may be dangerous to ones cardiovascular health.

          In closing, given the enormous complexities of human metabolism, it is difficult to determine a priori who will experience a reduction in LDL levels as this effect is dependent on numerous factors that are not easily measured (previous dietary habits, genetic factors, overall lifestyle, etc). Nonetheless, known and demonstrated scientific facts reveal that it is not counterintuitive nor misleading to expect that in some individuals LDL levels may decrease in a low-carbohydrate dietary regimen.

Great converstaion, thank you for this opportunity.
Colette Heimowitz

Hey wccaguy,

THANKS for your very kind comments!  When it comes to marketing labels on so-called "low-carb" products, my advice would be to be smart about what's right for YOU!

The Ezekiel bread question is a good one and I've heard it regarding the Atkins Nutritionals bars and Dreamfields pasta most often.  It really will depend on the individual and how it impacts YOU!

Personally, Atkins bars don't bother my weight and Dreamfields does not raise my blood sugars.  But there are "missing" carbs in both of those products just like there are in the Ezekiel bread.

One good thing I like about the Ezekiel breads is the fact that they are all-natural, sprouted sources.  But I agree with Dr. Davis that the carb counts in these breads are MUCH too high.

I prefer the low-carb breads from the Francis Simun Bakery in Dallas, TX.  They are the best low-carb breads I've ever tasted and only have a couple of net carbs per slice after you subtract the dietary fiber.

Excellent question!  Feel free to contact me anytime at livinlowcarbman@charter.net.

Hi, Colette--

Wow! Well said! Very helpful discussion of the differing saturated fatty acid effects on LDL.

Yes, I agree. I've seen many people reduce LDL particle number and small LDL, as well as triglycerides and VLDL, by reducing carbohydrates.

Fascinating discussion!

I have a message for jpatti:

If you change your proportions of macronutrients closer towards the following (in g per kg of ideal body weight per day):

Protein 1 g/kg,

Fat 1.5-3.5 g/kg, (mostly animal fat including whatever beef or pork fat comes handy including corn or wheat-fed cattle as well; please be not afraid of saturated fat, if such fat hurt I would be dead long ago!)

Carbohydrates 0.5-0.8g/kg,

- your glucose control will further improve and you may be able to minimize your insulin injections, or even discontinue it if your pancreas is still producing even a little bit.

Stan B.

Colette,

Can you provide a cite for your ranking of the SFAs by atherogenicity?  I have been looking for this very thing.

Thanks

Hi there, I'm a regular reader and occaisional commenter at Jimmy Moore's blog, and since someone asked about saturated fats affects on your calcium score, just thought I'd add my experience with that very subject.

In a word, for me at least, none. Not at all. Zero.

I've been low carbing for five years, eating saturated fats in a very liberal fashion. Lots of beef, butter, cheese, etc. etc.

Went to get a cholesterol test, my doc is alarmed at my LDL and total score (201 and close to 300,) I tried to explain to her that on a low carb diet, triglycerides are low, LDL will be large safe fluffy kind (btw, go see Dr. Eades blog at www.proteinpower.com for lots of excellent info on this-hey why not interview him as well?), but it went in one ear and out the other. She tried, really tried to get me to go on statins, but I refused. She then asked if I would consider a CT scan.

Sure, why not.

Long story short, scan results come back, ZERO calcium. Doc never mentioned statins again.

mrfreddy,

Good for you, but keep in mind that you're a sample of one and that a negative CAC scan doesn't prove that you're not doing serious damage to your arteries.  Especially if you're young, five years could be way too short a timeframe to see calcified coronary plaque emerge, although you may be full of soft plaque.  (Do you know your LDL is big and fluffy because you've had your lipid subfractions checked, or are you just assuming because of what you've read on the Internet?  You should also consider a carotid IMT.)  The foods you eat have been proven to cause transient endothelial dysfunction, the very sort of abnormal changes in vasodilatory capacity seen in diseased coronary arteries.  These changes are measurable and reproducible.  (See Esselstyn's Prevent and Reverse Heart Disease.)

Atherosclerosis aside, you're also skyrocketing your risk of certain cancers (esp. prostate), cardiomyopathies and arrhythmias, liver and kidney diseases, etc.  Again, no doubt your creatinine and other kidney function tests would look fine right now, but you don't see abnormal changes in these tests until the vast majority of your kidney tissue is destroyed, and at that point it doesn't come back.  I'd urge you to recognize that you're making yourself a guinea pig  and not to get too confident on the basis of a single test result.  Documentation on the dangers of high animal product consumption goes back for many decades, but we have perhaps 5-10 years' experience with Atkins and related diets, and already the results aren't good.  Atkins himself was overweight and suffered from hypertension, CAD, cardiomyopathy and CHF at the time he supposedly slipped and hit his head.

I really wish Dr. Davis wouldn't dress down you low-carbers on his blog.  Atkins did us a favor by pointing out the dangers of refined carbs, but the fact that HFCS and white flour are toxic junk foods does not imply that butter, bacon, and cheese aren't also toxic junk foods.

bad,

I'm not so young, I'm 51 in fact.

It's actually amazing to me I didn't have any calcium, since I had an atrocious diet before I found low carb.

As to the LDL, it is widely known that if your triglycerides are low, your LDL will always (well, almost always, there might be weird cases...) be the large fluffy kind. That said, yes, I did have an LDL subtype test done, and yes, it's mostly the large fluffy kind, type A pattern I think they call it. Btw, my HDL is pretty high too.

As to the supposed dangers of a animal based diet, I'll point you towards Gary Taube's book, Good Calories Bad Calories, where he examines the sloppy science that leads to these sorts of nonsense conclusions. There's an article about it in today's NY Times Science section, you should check it out.

As for the 5 -10 years of low carb diets, I'm not worried. We humans evolved over the past 2 million years on a diet that surely was high fat and had to have been low carb. I am hardly a guinea pig, in fact, those of you following a low fat/low sat. fat diet are the ones taking on a new, experimental, and unproven diet, when you look at it from the long view- two millon plus years versus the past 30 or 40 or so. Early results indicate your fat phobic diet - skyrocketing obesity, diabetes, heart disease, cancer-aren't too good.

As to Atkins, didn't you mention something about a case of one? Anyway, I'll just say you are badly misinformed about his condition at the time of his death, and about the cause of his death.

I'm off to enjoy some nice non-toxic grass fed beef, and some low starch vegetables smothered in non-toxic grass-fed butter.  but first I have some non-toxic grass-fed cheese as a snack...

enjoy your tofu dude....

mrfreddy,

Cool calcium score. I visit here because I feel Dr Davis is a pragmatist and will do whatever is needed to drops scores. It is just possible that this could be the watershed after which saturated fat is finally recognised as the perfectly healthy human food that it is. Scores like your's will push TYP in that direction. In 20 years time, what will we think about the saturated fat phobia so prevalent today?

Peter

mrfreddy,

Thanks for the book recommendation.  I hadn't heard of it (looks like it's very new), but I'll check it out.  I have read sat fat apologia in the form of Enig's Know Your Fats.

Appeals to "man's natural diet" are pseudoscience at its worst, and I refuse to address them or base my own diet on them.  No question humans evolved as omnivores; our dentition, digestive enzymes, etc. prove it.  (Those few claiming otherwise tend to be animal rights whackos.)  Furthermore, we can be certain that grains (but also dairy, don't forget) appeared only in the last 10,000 years, refined flours, oils, and sugars in the last couple thousand, and HFCS and hydrogenated oils in the last <100.  But it's still a quantum leap to Atkins.  Nobody knows the ratio of meat to plants eaten by paleolithic man, and it's a moot point anyway because we don't know the impact on his health or longevity (although it's a safe bet he usually didn't live long enough to suffer heart attacks or prostate cancer).  So all nutritional camps are stuck working with basically post-WWII research.

I'd recommend to you Eat To Live by Joel Fuhrman.  Among many other misconceptions, it addresses the low-carb mantra, "We tried low-fat and got obese from it."  But we didn't!  The stats show a slight reduction in fat as a % of calories over the last 30 years, along with a shift to more vegetable oils and a simultaneous large increase in total calories.  We are still eating almost as much of the animal fat and adding the trans-fat and white flour on top.

Finally, wherein did I err about Atkins?  This was all over the press after the coroner's report was leaked to PCRM.  But if I'm wrong, please correct me.

You can research Atkins health and cause of death on your own, just don't rely on PCRM. That is just a propaganda wing of PETA, one of the most unethical and dishonest organization as I've ever heard of. Even their name is a lie. It leads you to believe their members are all doctors, but only a small fraction actually are.

I'm familiar with Eat to Live... the only good thing I can say about it is that it is as low carb as a diet that avoids animal protein and fat can be. Which is a good thing, if you insist on being a vegetarian. But why avoid animal protein? To get the protein you need in a meal, you can eat a 12 ounce steak, or 35 cups of brocoli, hahaa. I know what I prefer. Anyway, none of the so called science the ETL crowd likes to quote stands up to any serious scrutiny.


Low carb diets, including Atkins, are about as close as we can get, or need to get IMHO, to a true paleo diet. The important thing is to keep sugar and starch out of the diet. as this wasn't present during most of our evolution. It makes sense-our bodies evolved to deal with fats and proteins, we thrive on it. But we don't react very well to sugar. Of course, it's a good idea to supplement with Omega 3, and to eat grass fed as much as you can.

It all boils down to the question of whether or not saturated fats are bad for you. When you look at the origins of that idea, and take an objective look at the science behind that idea, it falls apart. That, and given the likelihood that our ancestors probably ate as much of the rich fatty animal parts they could get their hands on, should tell you something.

Here's a couple of other facts for you to ponder. If you don't eat enough saturated fats, and you aat a lot of carbs, guess what your body turns those carbs into? Yup, good old saturated fats. If it's so harmful, why does the body make it?

Also, I've read that mothers milk can contain a lot of saturated fats.

I realize I'll never convince you, but give the Taubes book a go, and try to be objective about it. You may find yourself tucking into a juicy ribeye someday soon without a shred of guilt.

Hi badCRC,

You wrote: "But if I'm wrong, please correct me.". Where do you want me to start? Much of what you said is as "bad" as the Cyclic Redundancy Check (CRC) on your computer, I am afraid.

I read what you wrote in response to mr.Freddy. For starters, Mary Enig, PhD is one of the premier lipid specialists. I hardly would call her writings and experience "sat fat apologia". She is the one that can be credited for our current (after decades of fighting for it) understanding of the many dangers of the man-made, engineered fats called trans-fats. Not exactly the work of a delusional person or apologist.

Second, your assessment of the statistics regarding total fat consumption is seriously flawed. First, you base it on epidemiological "evidence" which is nothing but number crunching games that can, basically, be used to prove that the moon is made out of green cheese. The fact is that there is not a single piece of scientific evidence proving beyond reasonable doubt that (saturated) fat consumption in itself is detrimental to health. What IS there, is again epidemiological number games. But association doesn't prove causation. There are simply no tightly controlled, randomized clinical studies proving this.

Third, you point to the solution in your answer. White flour, sugar, starch, and overconsumption of Omega-6 vegetable oils are the culprit. Not saturated fat which has shown to be, at worst, health-neutral. Not to mention the vast amount of clinical, tightly controlled studies that show an abundance of evidence for the many health benefits of, for example, tropical virgin coconut oils - a "super-saturated" fat.

Fourth, you are definitely wrong to dismiss the brilliant work of the many (especially early) anthropologists, researchers and scientists that studied (and still study) real populations under real-life circumstances. Without exception they all reported that these "primitive" peoples were in excellent, vibrant health and showed none of the many ailments and illnesses we "modern" idiots suffer from. Only when "civilized" CRAP (Cereals Refined And Processed) was introduced, including, of course, sugars in it's many (also hidden) forms, health would decline and suffer.

Finally, you are completely off the mark on Dr. Atkins death. That despicable group called PCRM you are referring to is nothing else than a bunch of wild-eyed ultra-low-fat anti-meat (vegetarian) fanatics that will do anything, say anything, and distort any truth or half-truth to get their dietary delusions exposed by the media - that same media that is always willing and ready to do anything to sell more newspapers. This PCRM and associated violent terror groups(!) like PETA have been earmarked by the FBI as a terrorist organization and many of it members (including the director) have been prosecuted and convicted. The fact is that AFTER his untimely death dr. Atkins showed a higher weight - which is completely normal as a result of fluid retention as organs shut down, one by one. Do some research (and find out the real facts!) before you believe PCRM propaganda and other nonsense. Trust me, you could not be more wrong on this one.

Peter said he visits here because Dr Davis is a pragmatist and will do whatever is needed to drops scores.  Me too.  A heart scan is unlikely to give me useful info because of the bypass, but it is AWESOME to know what has actually been shown to work in live patients wrt actual measurements of coronary disease.  I've not seen anything like it anywhere.

I mentioned previously I've been low-carbing for a very long time before my pancreas was damaged.  I know about low-carb.  Unfortunately, I know about piles of mozzarella and pepperoni melted on a low-carb tortilla as a "pizza" and lots of other low-carb junk food.  Low-carb is a good start, but it's not the whole thing.

You can do any diet unhealthily.  Living on low-carb "bars" and sugar-free candy isn't much healthier than doing low-fat by eating Snackwells; reminds me of vegetarians that live on chips and french fries.  

Macronutrients are only part of the picture.  IME, we have ignored the importance of micronutrients.  This is why I like the fat from pasture-raised meat and dairy.  And this is why I *now* eat up to 10 servings of veggies per day, and a couple servings of fruit as well, which I did not do prior to the heart attack.

I reread the diet chapter in TYP last night.  I agree with more than 90% of it.  In fact, I suspect the disagreement on the topic of saturated fat is much less important to overall health than the huge emphasis on vegetables.  We need this stuff - and we don't yet know half of why we need it.  The emphasis on unprocessed food is also very, very important.  

There's minor points I disagree with Dr. Davis on wrt to diet - most having to do with fats.  And I don't see why anyone should eat nasty soy protein powder when there's lovely milk and whey protein powders!  But I agree MUCH further than I disagree.  Nearly everyone, whether eating low-carb, low-fat, or just the typical American diet, would be doing better to follow Dr. D's diet.  

I am of the opinion that if more than half the food on your plate at each meal is vegetables, it's much less important whether it's lowfat cheese or pasture-raised fullfat cheese melted over it.

It's a *good* choice to use 2 eggs in an omelet instead of 3, to cut the cream cheese in the middle in half, and to make up the difference with an artichoke or quarter head of butterhead.  But it's not because it cuts fat, rather because it adds veggies.  

There's a certain amount of focus on macronutrients which implies that's the primary difference in our diets.  But my diet has more in common with a low-fat veggie eater than it does with many low-carb folks.  The type of dressing that tops a salad is much less significant than eating salads daily.

I'm a long-time reader of this blog but seldom contribute.  This thread must be a record for Dr Davis.  The last few commenters reminded me that extremists exist in both sides of the lowfat discussion. And I tend to disbelieve extremists for no other reason than they're extremists.  

Another lowcarb site recently published a study of what wild monkeys eat.  This is worthwhile because early man would have evolved eating the same way.  It showed wild monkeys eat a lot of fruit during the summer months, turning excess sugar into fat.  During the winter months they burned that fat.  Overall monkeys eat a varied diet of fruits, nuts and bugs.  No saturated fat, I assume.  Meaning no butter, no steak...  It suggests that although we can live on saturated fats, that just means we can adapt to digest just about anything, not that it's the best longterm diet.  

I eat a lot of lean meats, vegetables, nuts and fruits.  Very little wheat, as Dr Davis recommends.  I'm 51, my resting pulse is 50, my BP is 105/55.  It may be healthy but a "juicy steak" is something I find repugnant.

Annonymous,

you should understand something about human evolution. We came from pre-human creatures that yes, ate a mostly vegetarian, monkey like diet. Over a very long stretch of time, we ate more and more meat, making it possible for us to develop bigger brains and smaller stomachs. We needed an energy dense food to do that. Meat is that energy dense food. Fats in particular.

I'm no expert, but my understanding is that because monkeys still have the big stomachs and small brains, they need to eat all day long to get enough nutrition out of what they eat. Mostly vegetation, but they do eat some meat (even other monkeys!) and bugs.

I'll remain civil here and just point out that a sneering tone and ad hominems won't save your life or mine.

I don't trust PCRM either, so here's the coroner's report on Atkins, indicating a history of MI, CHF, etc.:

http://www.thesmokinggun.com/archive/atkinsmed4.html

(Surely you're not arguing that the coroner had an animal rights agenda?)  I realize Atkins swelled with fluid; I'm referring to his weight at admission to the hospital: just shy of 200 lbs.  At his height, 6'0", that's a BMI of 27 -- significantly overweight.  If you had read Fuhrman, you would know that (although there are better measures than BMI) the true ideal weight for longevity is much lower than the CDC/WHO arbitrary cutoff of 25.

It's interesting that you Weston Price people dismiss all epidemiological studies out of hand, yet gush over the "brilliant work" of the early anthropologists -- Price himself, presumably -- which was just an informal version of the same thing, without statistical controls.  Stopping on a tropical island for a few days to snap pictures of the natives' teeth is good science, but peer-reviewed multiple regression analysis on thousands of subjects in different countries is junk science, moon made of cheese, etc.  Could it be special pleading because those studies aren't finding the results you like?  Anyway, there's a small sample at the bottom of this blurb from Fuhrman:

http://drfuhrman.com/library/article2.aspx

... and for the rest, I'll just refer you to the many hundreds of citations in his book (which also addresses your misconception about protein requirements).

Still not good enough, you say.  You want "objective science" proving the danger of sat fat.  Did you miss the reference to Esselstyn in my original post?  You can measure the damage inflicted on your arteries by animal fat using brachial artery flow-mediated dilation (FMD).

If you're not familiar with this test, they take an ultrasonic measurement of the diameter of the subject's brachial artery at a spot on the forearm, then wrap a BP cuff around the upper arm and inflate it to crazy pressures, like 300 mmHg, for five minutes (ouch).  Then they release the cuff and repeat the measurement over time.  At first the artery is much narrower.  In subjects with normal endothelial function, the artery soon gets much bigger in diameter than when it started.  This is called "compensatory dilation" and is caused by the inner layer of arterial tissue, the endothelium, secreting nitric oxide, your natural vasodilator.  It's the same mechanism your body uses e.g. to swell the coronaries in response to increased oxygen demand by the heart.  In subjects with dysfunctional endothelium (e.g., because of atherosclerosis), the artery doesn't dilate like it should.

Interestingly, you can induce that same dysfunction by feeding the subject a high-fat meal.  They fed a test group a 900-cal breakfast rich in animal fat (Sausage McMuffin meal, IIRC) and a control group a 900-cal low/no-fat breakfast (mostly shredded wheat, again IIRC) and found normal dilation in the controls but severely inhibited dilation in the high-fat group for several hours after eating.

I won't repeat this again; read the book.

Finally, as big an issue as sat fat is, you're wrong to think that it boils down to that.  The larger issue is nutrient density -- the fact that animal products (along with refined grains and oils) are rich in energy (calories) and deficient in carotenoids, flavonoids, organosulfides, etc., and hundreds of other protective micronutrients still undiscovered in fruits and vegetables.

howdy again MR. Bad,

sorry if I was sneering, just get carried away sometimes!

about that coroner's report-do you know how coroner's reports get filled out? Some guy in a coroner's office, who isn't familiar at all with a patient's history, scribbles something on a piece of paper. Yes Dr. Atkins did have heart issues, but his claim was that it wasn't related to his diet. I personally don't know, and you don't either.

And yes, he was slightly overweight, as are a lot of folks who follow his advice to not worry about calories, just cut the carbs. That only gets you so far. That's why I stopped "doing Atkins" a long time ago. I still low carb-he got that part right.

Do you know how that coroner's report got  into the public's eye? Your nasty and unethical PCRM folks obtained it illegally and distributed it, that's how. Because, in their view,it's a usefull piece of propaganda.

I believe you said something earlier about a study of 1 doesn't mean much. I agree. So enough about Dr. Atkins.

About Dr. Furhman, he's gotta do more than list a load of references. You need to make an objective, scientific analysis of those studies, and of ALL the relevant studies. You can't start with a conclusion already in mind-animal fats are bad-and find all the studies that support that notion, or seem to. That is sloppy science. That's what Taube's book is about.And I guarantee you that is what Furhman has done. He is ignoring all the evidence - and it is growing bigger all the time - that animal protein and fats are not the problem, but it's excessive carbs/starch/sugar.

Speaking of sloppy science, the study you mentioned is a fine example. A McDonald's sausage McMuffin? Oh puh-leaze. Do you know how many carbs are in that thing? Not to mention trans-fats?

And yes, I always eat lots of vegetables and fruit. Right next to my steak and with butter (on the vegetables, not the fruit! Although, buttered blueberries? hmm, might be better than it sounds...)

bad_cr

You've missed out in your reading somewhat, check this link

http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=12064344&ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSuml

before you bet your life on those mysterious undiscovered

"hundreds of other protective micronutrients still undiscovered in fruits and vegetables"

which you believe in.

Here is the last line of the abstract from the above citation:

The overall effect of the 10-week period without dietary fruits and vegetables was a decrease in oxidative damage to DNA, blood proteins, and plasma lipids, concomitantly with marked changes in antioxidative defence.

Please note the word decreased.

I do have the full text, which is interesting but irrelevant to anyone fully committed to herbivory.

Personally I'm more impressed by a EBCT score of zero than the advice to read Fuhrman's book.

Peter

PS here are the comments from one of the main funders of this vegetable wash out study:

"The study has been carried out with financial support in part from a Danish Food Technology grant (FØTEK2, ‘Antioxidants from plants’) and in part from the Commission of the European Communities, Agriculture and Fisheries (FAIR) specific RTD programme, CT 95-0158 ‘Natural Antioxidants from Foods’. It does not necessarily reflect its views and in no way anticipates the Commission’s future policy in this area"

I doubt it will affect your future policy either.  However, I genuinely wish you luck. You may need it.

Sorry the link got chopped, the paper is

Green tea extract only affects markers of oxidative status postprandially: lasting antioxidant effect of flavonoid-free diet.

Young et al Br J Nutr. 2002 Apr;87(4):343-55

Enjoy

Peter

bad,

If you and Dr. F. and the PCRM are right about saturated fats, how do you explain EACH of the following:

1) Native populations who ate animal protein/fat almost exclusively (Inuit, Masai, etc.)did not have heart disease. No cancer either. No diabetes. If saturated fat alone was the boogey man you think it is, this simply could not be possible. Clearly other factors are involved.

2) Your own body makes saturated fat when you don't eat enough of it.

3) Mothers milk contains saturated fat. A lot of it.

4) Human evolution. How could we have gotten to the point we're at now, if animal protein/fat was really so dangerous?

5) Our bodies have numerous mechanisms/hormones, etc. to RAISE blood sugar. Only one, insulin, to lower it.

6) Test after test of a true low carb diet have shown that the diet improves cholesterol, particularly in regards to reducing the only really meaningful part of cholesterol numbers, low density, small LDL particles. These are dangerous because they are small enough to penetrate cell walls and form plaque. Low carb diets have been proven, again and again, to reduce their presence. High carb diets do the opposite.

Given all that, I think I'll continue to eat the diet that my body seems to be designed (exquistly so I might add) to eat.

Baddie my pal,

About that sausage mcmuffin study, take a look at what Dr. Eades has to say about that one:

http://www.proteinpower.com/drmike/?p=144

Here's my condensed version:

The "researchers" only reported on a SUBGROUP,ie a MINORITY, of the subjects of the study-they IGNORED the majority of subjects who didn't give them the response they were looking for.

In reality, most of the subjects involved in the test actually had improved "arterial compliance" on the ridiculous high fat high carb" meal.

This is a classic example of truly sloppy science.

Here's a little quote from Dr. Eades.

So, actually, a majority of the subjects had improvement in arterial compliance with the high-fat diet as compared to the high-carbohydrate diet. But our researchers remained undeterred by these facts as they went on throughout the rest of the paper describing all the negative findings in the minority of subjects who responded negatively to what could only be described as a horrendous meal by anyone’s standards (except executives of McDonald’s, I suppose).

Thanks for the amicable responses.

mrfreddy,
I don't remember for sure if it was a McD's breakfast.  It wasn't the carbs, because the control group meal was loaded with what you and I would agree are junk carbs (shredded wheat).  Could have been the trans fats, but there were several experiments, and the same results were demonstrated with other high-fat meals -- including the beloved extra-virgin olive oil.  Again, this was Esselstyn, not Fuhrman.

I should make that distinction clear:

Esselstyn:
- afraid of all fats, plant or animal; strictly vegan, <10% fat by calories; allows unlimited whole grains
- cured advanced CAD in a small group of subjects using this diet
- member of PCRM

Fuhrman:
- not affiliated with PCRM (AFAIK)
- allows animal products for up to 10% of calories; nutrient density, not avoidance of specific foods, is the point; most "vegan" diets are horrible
- much harder on refined carbs than animal foods; whole grains allowed in moderation, but totally unnecessary and harmful for certain individuals
- fats from whole plants are beneficial; optimal diet varies somewhat by individual, and may be anywhere from 10% to 40%+ fat

Now to your points:
1. Inuit, at least, still have worse longevity than even fat Americans.  (See http://www.itk.ca/media/backgrounder-health.php)  Almost any traditional diet seems to be better than McMuffins, soda, and Twinkies (surprise).  But what's optimal?  The populations with the highest proportion of centenarians (Okinawans, Abkhazians, Vilcabambans, etc.) all eat diets almost entirely of whole plants.  None are strictly vegan.

2. Irrelevant.  How much glucose do you eat?

3. I thought human milk fat was mostly medium-chain triglycerides, not the atherogenic long-chain SFAs; I'll have to read Mary Enig again.  Human milk is also 42% sugar (lactose) and only 7% protein by calories!  (http://www.disknet.com/indiana_biolab/b120a.htm)  Nobody disputes that babies' dietary needs are different from adults'.  What's your point?

4. Evolution only needs you to live to about 30, so I don't see how this is relevant.  Natural selection wouldn't have selected out smokers, either.

5. I don't get what you're saying here.  Clearly, for most of our evolutionary history our overriding concern was getting enough calories from any source.  All these appeals to "evolution" are conjectural BS.  What do comparative and epidemiological studies show to be optimal for health and longevity?  That's the question.

6. Fuhrman addresses this.  Yes, starting from the toxic American diet, low-carbing causes (rarely maintained) weight loss and, consequently, improved lipid profile, insulin response, etc.

The absence of clinically apparent disease (right now) isn't the same thing as good health.

Peter,
Your PubMed link got truncated.  Please try again or post the title and abstract.  I am very interested in reading this very counterintuitive-sounding study.  (Even the most diehard low-carber usually doesn't argue that veggies are bad for you?)

Interesting comments.  (I got a lot of ideas for my reading list!)

Dr. D, thank you for your response.

Curious - If we remove the argument of whether saturated fat is good or bad ... is there an opinion of whether meat protein is good or bad?  I'm wondering about the hormones, the iron, the amines, the bacteria, etc.

Bad bad,

responding to your responses..

Now to your points:
1. Inuit, at least, still have worse longevity than even fat Americans. (See http://www.itk.ca/media/backgrounder-health.php) Almost any traditional diet seems to be better than McMuffins, soda, and Twinkies (surprise). But what's optimal? The populations with the highest proportion of centenarians (Okinawans, Abkhazians, Vilcabambans, etc.) all eat diets almost entirely of whole plants. None are strictly vegan.

Noone knows what caueses these populations to live longer. This is data chery picking at it's best.

2. Irrelevant. How much glucose do you eat?

haha, got a chuckle here. you actually have a good point... the body makes sugar from protein, to provide the glucosse the body needs. However, sugar, or glucose, is only used in very very small amounts, for just a few places in your body. My understanding is that sat. fats are a critical building block for all cells throughout the body.

3. I thought human milk fat was mostly medium-chain triglycerides, not the atherogenic long-chain SFAs; I'll have to read Mary Enig again. Human milk is also 42% sugar (lactose) and only 7% protein by calories! (http://www.disknet.com/indiana_biolab/b120a.htm) Nobody disputes that babies' dietary needs are different from adults'. What's your point?

Point is, if nature provides it, how can it be dangerous? It supports the notion that saturated fats are beneficial, even needed, by our bodies.  as for human breast milk, I think it's content varies a lot, even on the same day. I've seen all sorts of descriptions of what's in it, none of which agree with the other. But it does include lots of protein, and saturated fats.

4. Evolution only needs you to live to about 30, so I don't see how this is relevant. Natural selection wouldn't have selected out smokers, either.

If you want to disregard the fact that your body evolved over millions of years to thrive on a diet of meat and fat, because early humans tended to die early (no doctors, medicine, plumbing, not to mention nearby tribes and beasties that want to kill you....), well, I don't know what to tell you.

5. I don't get what you're saying here. Clearly, for most of our evolutionary history our overriding concern was getting enough calories from any source. All these appeals to "evolution" are conjectural BS. What do comparative and epidemiological studies show to be optimal for health and longevity? That's the question.

comparative epidemicologial studies are the height of BS. Read Taubes.

6. Fuhrman addresses this. Yes, starting from the toxic American diet, low-carbing causes (rarely maintained) weight loss and, consequently, improved lipid profile, insulin response, etc.

I would say that a low carb diet is helluva lot easier to stick to and maintain that Dr. Furhman's diet. I've been on it five years plus. I stick to it because it satisfies, really satisfies, to the core. In a way that Dr. F's rabbit food could never satisfy.

There are thousands on the low carb forums that have maintained quite easily.

I would also say that any given low carber's lipid profile is better than it would be on Furhman's diet. It' the triglycerides number that really counts. While his diet is a low sugar as it can be for a mostly vegetarian diet, it still delivers a lot of sugar to the body.

what's your triglyceride count, btw? I think mine was 60 or so, but I'd have to look it up to be sure. If your's is under 100, I'd be suprised.

The absence of clinically apparent disease (right now) isn't the same thing as good health.

Only if we accept your definition of "good health". I'll take very low small LDL, zero calcium, and the fact that I rarely get sick (I've only had two or three colds in the past five years, in spite of the fact that I work in close proximity with folks who are coughing and hacking away, not to mention my carb loving gf who gets two or three colds a year...)

I'm waiting patiently for your response to Dr. Eades on your silly Sausage McMuffin study. Particulary the point that the researchers only found the adverse reaction in a small minority of subjects, that most of them reacted better to the horrendous high fat/high carb meal. This is pure junk science.

The reference for the intervention trial is here. NB this was NOT a low carb study.

Youmg et al  Br J Nutr. 2002 Apr;87(4):343-55 Green tea extract only affects markers of oxidative status postprandially: lasting antioxidant effect of flavonoid-free diet.

Some idea of how plant consumption produces sustained antioxidant effects is given here, thank goodness for uric acid:

Lotito SB and Frei B (2006) Consumption of flavonoid-rich foods and increased plasma antioxidant capacity in humans: cause, consequence, or epiphenomenon? Free Radic Biol Med. 2006 Dec 15;41(12):1727-46

A very much weaker observational study "associating" antioxidants with DNA damage (but it's as valid/invalid as those associating red meat with cancer) is this one:

Watters JL et al (2007)  Associations of antioxidant nutrients and oxidative DNA damage in healthy African-American and White adults. Cancer Epidemiol Biomarkers Prev. 2007 Jul;16(7):1428-36

I have only the abstract for that study but here's the punchline:

"African-Americans had statistically significantly lower plasma concentrations of vitamin E, alpha-carotene, beta-carotene, and lutein + zeaxanthin than Whites, as well as lower self-reported intake of most antioxidants. Levels of oxidative DNA damage, measured using the alkaline comet assay, were lower in African-Americans than Whites."

I make no specific suggestion that eating plants is bad for you, other than the vast array of poisons they have evolved to combat herbivores, more that there are publications you should consider. In the words of Eeyore "Think of all the options... before you settle down to enjoy yourselves"  A.A. Milne (1928) The House at Pooh Corner. Methuen & Co. Great Britain p96.

Peter

mrfreddy,
Forgot to respond to the Eades rebuttal...  Actually, the paper Eades attacks isn't one of the ones Esselstyn cites, which are:

Robert A. Vogel, Clinical Cardiology, June 1999: "Brachial Artery Ultrasound: A Noninvasive Tool in the Assessment of Triglyceride-Rich Lipoproteins."
http://grande.nal.usda.gov/ibids/index.php?mode2=detail&origin=ibids_references&therow=407824

Note: In the book he doesn't mention McDonald's; I think it was in the video talk on his website: http://www.heartattackproof.com/media.htm

... and the olive oil one:
R. Vogel, M. Corretti, and G. Plotnick, Journal of the American College of Cardiology, 2000: "The Postprandial Effect of Components of the Mediterranean Diet on Endothelial Dysfunction."
http://content.onlinejacc.org/cgi/content/abstract/36/5/1455

Anyway, I read the abstract and I say Eades is attacking a straw man.  They didn't just slice off the bottom tail of the curve and conclude circularly that some people react badly to McMuffins.  They showed that, in that subgroup of "fat reactors" (and only in that group), the endothelial dysfunction correlated with markers of insulin resistance, including baseline TG, glucose, and insulin, and peak postprandial TG.  I think the article was badly titled; their real conclusion seems to be this sentence: Normal weight young subjects with an insulin resistance phenotype show significantly decreased vascular compliance, increased postprandial TG peaks, and markedly reduced plasma nitric oxide metabolites after a high-fat meal.

Given what we know about the importance of NO-mediated vasodilation, these studies are hardly junk science.  Still, Esselstyn definitely implies that everybody will exhibit that same set of responses.  In reading the two Vogel abstracts, nothing jumps out at me that contradicts that, but the Blendea article certainly suggests that it's not that simple.  Geez, this is complicated enough even assuming everybody is intellectually honest.  Thanks for that link.

Peter,
I'll have to look over these.  I am aware that a lot of the nifty antioxidant effects seen in vitro turned out not to work in vivo.  I will say that Fuhrman doesn't overemphasize "antioxidants" in touting the many benefits of veggies.  Anyway, I picked up Taubes' book today and am plowing through it.

Dr Davis said:

"At this point, I truly don't know. I thought I knew. I have to admit that the entire conversation has to, at least, raise some doubts."

It's statements like this that set Dr. Davis and this blog apart.  He is willing to look at the data and follow it wherever it leads, even if it might mean letting go of a long standing belief.

Thank you, Dr. Davis, providing such valuable information.

I asked my doc for advanced lipid profiling and she says the jury is still out on this, I asked for a repeat calcium score test, I have to pay for it myself $400 as she says they don't know how accurate it is.or whats the info useful for??

I take Lipitor 10mg a day and would love to get off it as reviews for women and lipitor are not good, I eat low carb, am off insulin, down 80 lbs and have good labs results. My last calcium score was 183 in 2004 and would like to see if it is down is it worth me pushing her to order these tests??

Actually thats a dumb question to ask here, I read your book Dr D, great, but I don't eat grains as need a shot of insulin to do so, and I do use some sat fats, not allot but some cream in a coffee once a day and some butter on vegs,  try to keep under 20 gr a day.

I think you already know what I think: I have no hesitation whatsoever in suggesting that repeat CT heart scans, especially after a 3 year interval provide INVALUABLE feedback on your program. Also, have you addressed vitamin D?

Hi, yes I am going next week to ask again for the calcium score as just switched Dr. I use Vit D 1000 u a day.

For the last 5 years I've focused on raising my HDL, both with diet and immediate-release niacin. By eating a moderate fat (38%) diet rich in polyunsaturates and low in saturated fats and taking 4g niacin daily I was able to raise my HDL from 32 to 44.  After reading Gary Taube's book, I decided to transition to a high fat (60%), low carb (7%), approach and also increased by saturated fat intake (31% of calories) that contained significant amounts of coconut oil.  My LDL increased by 4 points while my HDL skyrocketed up to 71!  Polyunsaturated fats now account for only 6% of calories.  BTW, my triglycerides also dropped significantly.

Meta-analysis of prospective cohort studies evaluating the association
of saturated fat with cardiovascular disease
Full text of this paper is online thanks to http://metabolismsociety.org

For those who aren't aware Frank Hu and Ronald M. Krauss, M.D are significant figures in lipid research and the American Journal of Clinical Nutrition is probably the world's most prestigious nutrition journal.

Very funny this appears the same week the UK's Food Standards Agency starts it Ban the Butter campaign.

QUOTE:
" I'm going to give the einkorn bread (I've got to make some more) to people who experience acute reactions to conventional wheat and see if the einkorn does the same."

Who knows?  You may have a promising and prosperous future as an einkorn baker.

Jim Purdy
The 50 Best Health Blogs

Mortar and pestle are not the best implements to grind flour. It's no wonder you couldn't get it done. Take a look at this. I have played with this kind of grinder in my childhood and its eminently doable and good exercise.

Please post on the blood glucose effect findings.

Have you considered incorporating wild yeasts and long fermentation time (as in days days, not minutes or hours) instead of using a single commercial strain of yeast?  In addition to the wheat having changed in recent generations, so has the yeast.  While this bread may have an ancient strain of wheat, it still seems pretty modern in other ways.

Long fermentation times with wild yeast sourdough starter allows for fuller breakdown of the gluten protein.  Many, if not most sourdough breads on the market aren't truly sourdough fermented, but merely enhanced with sourdough starter or sour flavoring.  Commercial yeast is still used to speed dough rising and production times.  

I haven't yet tried the "bread man's" bread below (as I also have to consider the CHO/BG issue in addition to the gluten) but if I was going to eat wheat bread again, this is the kind of bread I would try to make (he does conduct workshops, btw).  This year I drive  through LA regularly so if the timing works out on one of my trips, I may stop and try the bread sometime.  

www.cheeseslave.com/2009/03/31/top-10-reasons-to-eat-real-sourdough-bread-even-if-youre-gluten-intolerant/

www.yelp.com/biz/bezians-bakery-los-angeles

$24 + labor to yield one loaf of bread.  One would have to be a diehard bread lover to spend that time and money.  When I consider the flavor and nutrient opportunity cost of that loaf in the form of pastured meats, fresh cream, ripe berries and cherries all deliciously in season right now, that golden brown loaf doesn't look so appealing.

I am interested in knowing how your subjects react to einkorn wheat.

Fascinating experiment. I'm looking forward to seeing more on this.

Too bad you didn't try making sourdough bread with it instead of conventional yeast bread.

Hi Dr. Davis,

I'm new to reading your blog.  Does your program actually reduce plaque in arteries?

Yes. Please refer to the main website, www.trackyourplaque.com, for full details, including many of our success stories.

Dr. Davis, I'm 100% in agreement.  I think that we as a medical community view our patients as lazy, not willing to make the changes to their lifestyles and diets needed.  And for most, sadly, we're right, our patients are stuck in their ways of eating and sitting on their rear ends.  But for those few very motivated patients, who essentially go vegetarian and take up an active lifestyle, they can do quite well.

I'm skeptical of your theories on fasting, though.  I've never heard of an article in a peer-reviewed journal that supports periodic fasting in coronary disease.

Yes.

Though my approach articulated in the Track Your Plaque program for reversal of heart disease is based on genuine science, my thoughts on fasting are admittedly based only on experience with patients, but not on scientific examination.

But can't the experiences of real life serve as the basis for future scientific scrutiny?

Dr. Caldwell B. Esselstyn has published numerous scientific papers on the elimination and prevention of heart disease. For more information go to http://www.heartattackproof.com

Why are Esselstyn's and Ornish's dietary plans not “palatable” to the public? Despite all the evidence pointing to their efficacy?

For two and and a half year now, I have, like you, tried to present the virtues of their plans on the web. Obviously, that page gets, by far, the the highest bounce rate. When I look at the time spent on the page, it points to the time at which most readers will encounter the word vegetarian. They then flee and run away.

This has to be somewhat of a cultural nature. As North Americans we have been brought up in a culture that sees the ingestion of meat as being “Manly” and the ingestion of legumes and vegetables as being sissy or belonging to the female gender. Some TV ads for a notorious Nutritional System even talk about “man food”.

I am not surprised that real food is hard to push. The consumer is bombarded by constant advertising from the meat-packing industry and the fast food industry. The physician is also heavily courted by the pharmaceutical industry ...telling him / her that their pill is better than any diet. Physicians also know that, the moment they mention the word “vegetarian”, they will see the patient immediately lose interest in the important things they try to convey.

For a page with a high “vegetarian” bounce rate, view: http://www.heartmonitron.com/hm_meddigest_journals_on_nutrition-_heart_and_diabetes-_cholesterol_and_healthy_weight_003.htm

This phenomenon has to be cultural. We view the ingestion of meat as being the best thing we can do. I, sincerely, wish you the very best luck in your endeavor. As for me, I will keep advocating those principles that have proven to be capable of reversing CHD and shrinking plaque.

heartMonitron,
NGBeditor

After all, isn't this the theme followed in cancer treatment? If you had a tumor, isn't cure the goal? Would we accept an oncologist's advice to simply reduce the likelihood of death from cancer but ignore the idea of ridding yourself completely of the disease? I don't think so.