Track Your Plaque goes global

21. September 2007 William Davis (3)
I don't use this space to toot my horn (at least I don't too often), but we were looking at the listings of our viewers and members. I was surprised to learn that we now have Track Your Plaque followers in 15 different countries around the world!

We have members from Europe including England, Ireland, Switzerland, Belgium, and the Czech Republic. We have members from as far away as South Africa, Australia, India, Singapore, Thailand, and China.

I see the entire Track Your Plaque process as a grand experiment. Never before in history has a system of health been delivered via a communication medium like the web. The internet provides more interactivity than television, it's more fluid than a book, it's more dynamic and evolves more rapidly than a face-to-face interaction. While we cannot be hands-on over the internet, we can still deliver all the crucial information and, hopefully, the knowledge on how to get it done.



Track Your Plaque is part of an even grander experiment: The movement to shift control over health away from the medical system, doctors, and hospitals and back to individuals. When you think about it, the idea that "health" (more acurately sickness) should be managed by people and institutions (e.g., hospitals and insurance companies) outside of the individual is a 20th century concept. I predict that this notion will also become a relic of the 20th century.

Someday, we will look back and laugh at the folly of the 20th century style of paternalistic health care. Perhaps it was a necessary step in the sequence to transform health to a better system that returns control to the individual. But it's clearly time for a change.

Track Your Plaque is an example of the extraordinary power that can be taken by a lone individual with only minimal assistance of a health care provider. I see Track Your Plaque members who understand heart disease (at least the coronary disease aspect) far better than 95% of my cardiology colleagues, 100% of my internal medicine and family practice colleagues. Physicians maintain a role, but their role has shrunk and receded. They should be facilitators of success in health, educators, a resource to turn to when we need help. It's not that way today. It will be in 50 years.

But, right now, we can get started on this wonderfully self-empowering--liberating-- movement by participating in this global experiment known as Track Your Plaque, the program with the goofy name that has the potential to usurp and unravel this enormous institutionalized system of health care the world has created.
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Comments (3) -

  • J Phillip

    9/21/2007 1:01:00 PM |

    Bravo, Dr. Davis!  As always, you have hit the proverbial nail on the head. It is refreshing to see a medical professional who truly believes that cardiac (and overall medical) care should be the responsibility of the individual with guidance as necessary from their doctor.  Every time I see my doctor (part of a large hospital-based practice), he only wants to schedule a $5000 stress test, even though I have repeatedly 'stressed' to him that I feel great, have no symptoms and would much rather have a heart scan (alas his hosptal does not offer this test, so it is clearly not an option... I'll have to arrange for it on my own... taking care of my own health, I imagine!).  The doctor only rolls his eyes, I can only guess he doesn't understand the importance of the scan or views it as unimportant since his facility doesn't get to bill for it.  Who knows for sure, but it clearly is time for a new forward-thinking medical professional!
    I would like to tell you that I believe your blog is of immense value to those with current cardiac disease, as well likely as anyone over the age of 30 with a heart, and I look forward to every post... thanks!

  • J Phillip

    9/21/2007 1:02:00 PM |

    Bravo, Dr. Davis!  As always, you have hit the proverbial nail on the head. It is refreshing to see a medical professional who truly believes that cardiac (and overall medical) care should be the responsibility of the individual with guidance as necessary from their doctor.  Every time I see my doctor (part of a large hospital-based practice), he only wants to schedule a $5000 stress test, even though I have repeatedly 'stressed' to him that I feel great, have no symptoms and would much rather have a heart scan (alas his hosptal does not offer this test, so it is clearly not an option... I'll have to arrange for it on my own... taking care of my own health, I imagine!).  The doctor only rolls his eyes, I can only guess he doesn't understand the importance of the scan or views it as unimportant since his facility doesn't get to bill for it.  Who knows for sure, but it clearly is time for a new forward-thinking medical professional!
    I would like to tell you that I believe your blog is of immense value to those with current cardiac disease, as well likely as anyone over the age of 30 with a heart, and I look forward to every post... thanks!

  • wccaguy

    9/23/2007 2:56:00 AM |

    Kudos to you Dr. Davis for the work you've done to understand the various dimensions of dealing with coronary artery disease in preventative and crisis management situations.

    Thanks also for not sitting on that knowledge but instead establishing a vision and engaging in activity to assist those of us who suffer from the disease to make more informed and better choices to deal with it.

    I just found your work in the last 6 weeks or so and still have a lot to digest and implement.  Nevertheless, to be honest, I already consider you to be the best source for cardiology information and advice.

    My HMO has been great and I'm sure will be great as needed in my crisis situations but is virtually worthless for purposes of understanding prevention except to process my lipid medication prescriptions.

    I'm moving through your TrackYourPlaque book now.  It's great.

    Thanks.

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Breakfast of champions?

Breakfast of champions?

12. April 2006 William Davis (1)
I spend time every day educating or reminding patients that breakfast cereals are not health foods.

I see jaws drop in shock when I tell them that, in my opinion and despite the marketing claims, Cheerios, Raisin Bran, Shredded Wheat, and the like do not yield health benefits. In fact, they do the the opposite: dramatically raise blood sugar and trigger an adverse cascade of events that eventually leads to diabetes and heart disease.

Why the health claims in advertising? Because these products contain insoluble fiber, the sort that makes your bowels regular. Yes, your bowels are important to health, too. But the benefits end there.

Breakfast cereals are a highly refined, processed food that are not good for your plaque control program. What they are is a highly profitable, multi-billion dollar business, deeply entrenched in American culture ("They'rrrre grrrrrreat!"--Tony the Tiger; "There's a whole scoop of raisins in every box of Post Raisin Bran!" Bet you remember them all.)

I find it particularly upsetting when I see the stamp of approval from the American Heart Association on some products. Gee, if the Heart Association says it's good for you, it must be true! Don't you believe it. The American Heart Association relies on corporate donations, just like any other charity.

If you must eat breakfast cereals, refer to www.glycemicindex.com for a full database of glycemic indexes. You can look up a specific product and it will list its glycemic index, or sugar-releasing properties. You should try to keep glycemic index of the foods you choose below 50.

For a revealing discussion of the influence of food marketers on our perceptions of food, see Track Your Plaque nutrition expert, Gay Riley's discussion The Marketing of Food and Diets in America at her website, www.netnutritionist.com.
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  • Anonymous

    4/12/2006 8:07:00 PM |

    Dr. Davis,
    Your daily posts are very interesting with extremely valuable information.
    Thank you.

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Getting your dose of fish oil right

Getting your dose of fish oil right

23. December 2008 William Davis (11)
Confusion often stems from the simplest of calculations: dose of fish oil.

Actually, you and I don't take fish oil for fish oil. We take fish oil for its content of omega-3 fatty acids, the dominant ones being EPA and DHA. The contents of fish oil outside of its EPA + DHA content likely exert little or no benefit (beyond that of other dietary oils).

To determine what you are currently taking, simply examine the back of your fish oil bottle and look for the EPA + DHA composition. This should be clearly and prominently labeled. If not, don't buy that brand again. Add up the EPA + DHA content per capsule, then multiply by the number of capsules you take per day. That yields your daily EPA + DHA intake.

The only other substantial source of omega-3 fatty acids is fish. Other food sources, such as non-fish meats, eggs, etc., contribute little or none. Processed foods that bear health claims of "contains heart healthy omega-3" often contain linolenic acid or flaxseed oil, which contributes very little to total EPA + DHA, or contain relatively trivial quantities of DHA. What are you doing eating processed foods, anyway?

What should the total daily dose of EPA + DHA dose be? That depends on what your goals are.

If your goal is to modestly reduce the risk of dying from heart attack, then just eating fish a couple of times per month will begin to exert an effect, or just taking a dose of 300 mg EPA + DHA per day from a low-potency capsule will do it. However, that's an awfully unambitious goal.

Our starting omega-3 dose in the Track Your Plaque program has, over the years, increased and now stands at 1800 mg EPA + DHA per day. However, the dose for 1) full reduction of triglycerides and/or triglyceride-containing abnormal lipoproteins, 2) reduction of Lp(a), and 3) the ideal dose for coronary and carotid plaque control are substantially higher.

But once you know your desired daily target of total EPA + DHA, you can easily determine the quantity of capsules to take by doing the above arithemetic, totaling the EPA + DHA per capsule. For example, if you have been instructed to take 6000 mg per day EPA + DHA, and your capsule contains 750 mg EPA + DHA, then you will need to take 8 capsules per day (6000/750).
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Comments (11) -

  • JoeEO

    12/24/2008 4:27:00 PM |

    Merry Christmas, Dr. Davis!

    Peace

    Joe E O

  • Anonymous

    12/24/2008 5:15:00 PM |

    Now this I can understand! Thanks for blogging so clearly.

    Smile

    Stevie

  • rabagley

    12/24/2008 9:15:00 PM |

    I have no idea why people mess around with capsules when the bottled lemon-flavored fish oil is so much more palatable and easier to take.

    1.5 tablespoons of Carlson's finest fish oil (which is about what the large spoons in my kitchen drawer hold) contains:

    3600mg EPA
    2250mg DHA
    1350mg other O-3 fatty acids

    And all of that goes down in one smooth, lemon-flavored swallow.

    I take enough supplements as pills already without having to choke down six or nine more of those fish oil capsules.

  • Anonymous

    12/24/2008 9:43:00 PM |

    Dr Davis, I know you no longer post here, but I wanted you to know that you gave me a great Christmas present. Diagnosed with high LP(a) of 87 I couldn't get it below 35-45 even with 1500mg of Niacin daily. Reading your blogs I increased my Fish capsules to 1800 3 months ago along with the 1500 Niacin. Just got my blood workup back and after 6 yrs of trying my LP(a)is now "normal" at 11.
    I think the D helped too that I learned about on your blog.
    You deserve a Santa hat and my gratitude. Thank You and Happy holidays......... Over&Oout

  • Craig

    12/24/2008 11:22:00 PM |

    My fish oil has total 300mg. of epa/dha.  The label then indicates 300mg of omega 3's.  Do those count for any heart benefits?  The bottle label claims these are 1,000mg fish oil softgels but I can't find anything that adds up to
    1,000mgs.  So, my question is am I getting 300, 600, or 1,000mgs in one capsule?  Your posted explanation is very clear, but I need a bit more clarification.

    Thanks.

  • Rich

    12/25/2008 3:21:00 PM |

    I second the vote for the liquid fish oil - the only way to go if you are trying to take a therapeutic dose of fish oil.  I’ve been using various liquid brands for many years – also avoids the “burps” you get with some softgels.

    The only downside to the liquid is if you travel, as it needs to be kept refrigerated, which can be inconvenient.  I keep a small supply of softgels around for when I am travelling.

    In response  to Craig:  on your bottle, all you care about is the amount of EPA+DHA listed in the ingredients – in your case, apparently a total of 300 mg EPA+DHA per softgel.   So, for example, if you want a dose of 1800 mg EPA+DHA per day, you will need 6 softgels.

  • Jack Cameron

    12/27/2008 12:32:00 AM |

    In my opinion high vitamin cod liver oil is the best way to get a base amount of fish oil. One tablespoon provides about 1 mg of EPA + DHA and all the vitamin A and D you need. I use fish oil tablets to supplement the cod liver oil.

  • Anonymous

    1/2/2009 1:38:00 AM |

    I have posted a couple of times here and I guess I will join the TYP since I have found good guidance in general. When I started out at the end of 2002 with angina problems, I was encouraged by a U.Guelph study discussing the benefits of a combination of fish oil and Garlic (Adler et al) Here, on Track your Plaque, the mega-dose of fish oil is also recommended.
      
    BUT..... Chris Masterjohn, who appears to provide well researched and ref. articles, states clearly that it is only DHA that is desired and that excess EPA can inhibit the conversion of ALA....
    SO...... Good or bad, high fish oil intake with EPA ?

    are there any sources of just DHA?

  • Anonymous

    5/15/2009 12:21:00 AM |

    Cod liver oil has too much vitamin A.  Fish oils make a big contribution to overfishing, much more than eating fish.  You can get algae-derived DHA supplements, and two companies make a DHA/EPA product from algae :www.water4.net, maker of V-Pure; and www.source-omega.com, maker of Pure One.

  • buy jeans

    11/3/2010 10:33:05 PM |

    If your goal is to modestly reduce the risk of dying from heart attack, then just eating fish a couple of times per month will begin to exert an effect, or just taking a dose of 300 mg EPA + DHA per day from a low-potency capsule will do it. However, that's an awfully unambitious goal.

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What's the best lipoprotein test?

What's the best lipoprotein test?

29. May 2007 William Davis (5)
This is a frequent question from Track Your Plaque Members and others interested in improving their heart disease prevention program beyond that of simple-minded cholesterol testing.

I obtain lipoprotein testing every day on patients. I can tell you with the confidence of having done thousands of these tests that plain, old-fashioned cholesterol testing is like relying on riding a scooter to work compared to an 8-cylinder modern automobile. The scooter might get you there, but any rain, snow, or long distance to travel and you can just forget it.

All too often, lipoprotein testing uncovers abnormalities that standard cholesterol testing simply fails to uncover.

So, among the various lipoprotein tests available, which is best?


There are three commercial tests available today:

1) Gel electropheresis (GGE)--often known by its "brand" name as the Berkeley lipoprotein profile, after Berkeley HeartLabs. GGE uses a gel with an electric field applied to cause lipoproteins to migrate, based on particle size and charge.

2) Vertical auto-profile (VAP)--a form of centrifugation, or high-speed spinning of blood plasma to separate lipoprotein particles.

3) Nuclear magnetic resonance (NMR)--the idea of putting plasma in an NMR (also known as MRI) device to characterize blood proteins.

All three tests do an excellent job. All are competitively priced. All have validating data--lots of it--to justify their broad use (though health insurers, in their vast wisdom, would still have you believe that the tests are "experimental").

But is one better?

Having done many of all three (though least of VAP), I am partial to Liposcience's NMR. (By the way, I receive no fees from Liposcience to use their test, nor to promote it in any way.)

I believe NMR is superior in a few ways:

1) I believe that the LDL particle number is the best way to truly quantify LDL, better than apoprotein B and "direct" LDL.

2) It provides what I believe to be more accurate small LDL measures.

3) It provides intermediate-density lipoprotein (IDL), a post-prandial, or after-eating, measure not available on the other two.

Perhaps I'm biased because I use the NMR most frequently. But I've used it because I felt it yielded superior, more clinically believable, data.

In truth, all three laboratories do an excellent job and you'd be served fine by obtaining any of the three. But my heart goes to NMR.
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Comments (5) -

  • Anonymous

    5/30/2007 3:41:00 AM |

    Thank you for clarifying which test to use.  

    I personally find this information very helpful.

    My previous testing was done at Berkeley.

    How often do you suggest retesting be done?  Yearly or ??

    Thank you.

    Marilyn

  • Dr. Davis

    5/30/2007 11:30:00 AM |

    Marilyn--
    In the Track Your Plaque program, we advocate lipoprotein testing at the beginning to diagnose the full extent of causes of coronary plaque, and then again when correction is believed to have been achieved. Standard lipids are used in between to assess response. Of course, this is just one way we've used that we've become comfortable with.

  • Anonymous

    1/24/2009 12:51:00 AM |

    The VAP does provide IDL on their profile.

    What sort of external validation does NMR have on their methods?

  • Charlotte jess

    9/27/2010 12:35:23 PM |

    Randox provide a kit which tests for the full lipid profile - a group of tests comprising triglycerides, total cholesterol, HDL and LDL cholesterol. The lipid profile is used, together with other risk factors, to assess a person's risk of cardiovascular disease (CVD).

    It is very important to get the balance between the protective HDL and the destructive LDL right in order to reduce the risk of CVD. This can be achieved either through dietary and lifestyle changes or treatment with cholesterol reducing drugs called statins.

    All Randox cholesterol tests, including small LDL, are direct enzymatic clearance tests, and as such are highly accurate even in lipaemic samples.

    For more information click here http://www.randox.com/lipid%20profile.php

  • buy jeans

    11/3/2010 2:56:03 PM |

    Having done many of all three (though least of VAP), I am partial to Liposcience's NMR. (By the way, I receive no fees from Liposcience to use their test, nor to promote it in any way.)

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