200 point drop in heart scan score

Some of the math-savvy will have noticed that we often report drops in CT heart scan scores on a percentage basis. Unfortunately, it this were a competition (which, of course, it is not), this would be unfair.

A score of 50, for instance, that drops "only" 25 points would represent a 50% drop in score.

But someone with a score of 1050 who drops his or her score the same quantity, or 25, will have dropped their score less than 5%.

In other words, the magnitude of your starting score determines how large a percentage drop you achieve, even when the absolute, or real, quantity of plaque reversal is the same as someone who begins with a lower score.

I qualify this discussion in this vein because of Grady's story. Grady, a soon-to-retire attorney, started with a heart scan score of 1151. On the Track Your Plaque program, he saw his score drop nearly 200 points--200 points!

But, if we gauged Grady's success just on a percentage basis, he dropped his score only a measly 17% or so. (Imagine the headlines if this program were sponsored by a drug manufacturer. The Track Your Plaque program proudly has nothing to do with the drug industry.)

Of course, the Track Your Plaque program is not a competition. It is an effort to help everyone possible, the more the better. Even if Grady failed to set a new Track Your Plaque record gauged on a percentage basis, he will have achieved an extraordinary advantage in health: the virtual elimination of the dangers of heart disease.

With this drop in score, Grady's risk for heart attack plummets from a spine-chilling 25% per year to nearly zero. (I know of NO other program that can claim such a track record.)

Grady's full story will be reported in the August, 2007 Track Your Plaque newsletter. To subscribe or to just view when it is posted, go to www.cureality.com website, click on the upper right hand corner What Does My Heart Scan Show? graphic, which then takes you to the page to view the newsletter. Or, Track Your Plaque Members can just go to the Library and click on newsletter archives.
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Omega-3 Index: 10% or greater?

Omega-3 Index: 10% or greater?

We've previously considered the question:

What is an ideal level of omega-3 fatty acids in the blood?

Recall that omega-3 levels in red blood cells (RBCs), a measure called the "omega-3 index," have been associated with risk for sudden cardiac death:





In a recent analysis, 265 people experiencing sudden death during a heart attack (ventricular fibrillation, successfully resuscitated) showed an omega-3 index of 4.88%, while 185 people not experiencing sudden death during a heart attack showed an omega-3 index of 6.08%.

We have more ambitious goals than just avoiding sudden death, of course! How about the omega-3 index associated with reduced risk for heart attack? A recent analysis of females from the Harvard School of Public Health suggested that RBC omega-3 levels as high as 8.99% were still associated with non-fatal heart attack (myocardial infarction), compared to 9.36% in those without heart attacks, suggesting that even higher levels are necessary to prevent non-fatal events.

Most recently, another study comparing 50 people after heart attack with 50 controls showed that people with heart attack had an omega-3 index of 9.57% vs 11.81% in controls--even higher. (This study was in a Korean population with higher fish consumption. There was also a powerful contribution to risk from trans fat RBC levels.) The investigators concluded: "The area under the receiver operating characteristic curve of fatty acid profiles was larger than that for traditional risk factors, suggesting that fatty acid profiles make a higher contribution to the discrimination of MI cases from controls compared with modified Framingham risk factors."

The data suggest that, while an omega-3 index of 7.3% is associated with reduced risk for sudden cardiac death, a higher level of 10% or greater is associated with less risk for heart attack. Surprisingly, fish consumption and fish oil intake account for only 47% of the variation in omega-3 index.

I believe the emerging data are becoming increasingly clear: If you desire maximal control over heart health, know your omega-3 index and keep it 10% or higher.

Comments (19) -

  • Medical Answering Services

    2/9/2010 1:29:37 PM |

    There are foods, which can easily lower the LDL. You should consume fishes. They are considered to be the greatest source of omega3 fatty acids. They can easily lower LDL levels and increase good cholesterol levels. In order to discard heart diseases, it is always advisable to eat high soluble fibers. You should consume lots of green colored vegetable, fruits and cereals to reduce LDL.

  • Matt Stone

    2/9/2010 1:38:00 PM |

    Thanks Dr. Davis. This is definitely very interesting. Would it be plausible that higher omega 3 levels are protectorant solely because omega 6 intake and cellular AA is so astronimically high?  

    I ask if you've considered this because there is a sect of researchers that believe, when both omega 6 and 3 levels are low, an even more beneficial and anti-inflammatory PUFA is produced in its place called Mead Acid.  

    Just wondering if you've encountered these ideas, and if so, why you've written them off in favor of achieving a high omega 3 level.

  • Ed

    2/9/2010 1:53:29 PM |

    My guess is the other biggest cause of variation in omega-3 index, after omega-3 consumption, is omega-6 consumption. Inversely of course. Dr Bill Lands writes extensively about this on his essential fatty acids education (efaeducation) web site hosted by the NIH.

    Does the omega-3 index likewise have the same striking correlation with stroke incidence?

  • Mike

    2/9/2010 4:28:58 PM |

    Dr Davis,

      Is there any issues with international orders for the O3 Index kit?  For myself, Canada specifically.

    Also, I'd be interested to hear your thoughts on *over* consumption of omega-3s and the potential health hazards, if any, in a future post.

  • MontyApollo

    2/9/2010 6:36:37 PM |

    I'm kinda fuzzy on the interaction between omega-6 and omega-3. Would lowering omega-6 consumption increase the Omega-3 Index as well?

  • Will @ Fitness Achievement

    2/9/2010 6:55:06 PM |

    I've lost over 40 pounds so far with diet and exercise.  I blog at Fitness Achievement

  • Dr Matti Tolonen

    2/10/2010 9:52:14 AM |

    Harris and v. Schacky proposed omega-3 index in 2004 as a novel physiologically relevant, easily modified, independent, and graded risk factor for death from CHD that could have significant clinical utility
    http://tinyurl.com/ybxmor4

    In my view it is impossible to reach a 8-10% omega-3 index just by increasing intake of fish and other seafood. One needs fish oil as dietary supplements.

    The role of LDL cholesterol in atherosclerosis is a major misunderstanding. The mechanism of the disease is mainly chronic low-grade inflammation, and omega-3:s are excellent anti-inflammatory agents. JELIS demonstrated it nicely. The effect goes beyond cholesterol.
    http://tinyurl.com/ye55mfr

    E-EPA (1.800 mg/day), as dietary supplement, prevented angina pectoris, clinical myocardial infarctions and new cases of coronary heart disease in Japanese population, although they eat 5-6 times more fish and Americans.

  • brainpower

    2/10/2010 11:45:33 AM |

    And even more important: keep the Omega-6 low. One you do that, you won't have to worry so much about additional intake of omega-3.

  • Peter

    2/10/2010 5:16:11 PM |

    If fish oil does turn out to be the fountain of youth it will be bad news for the fish.

  • Alfredo E.

    2/10/2010 11:01:53 PM |

    Omega 3 and omega 6 should in a 1/1 ratio. In order to maintain that you need a low carbs diet and supplement with about 3.000 mg of fish oil per day.

    Commercial fish is loaded with omega 6, so is most of the meat you buy at the supermarket.

    So, in the real world you have to cut all grains, grain oils and take some omega 3 supplements.

    If any of the readers is interested in reading about omega 3 in spanish, please go to http://www.omega-3-fish-oil-wonders.com/omega3.html

    Best wishes,
    Alfredo E.

  • Healthy Oil Planet

    2/12/2010 3:44:26 PM |

    While fish oils are a viable source for omega 3 fatty acids, reports indicate krill oil may be a more suitable supplement for cholesterol lowering strategies.  

    A recent study on neptune krill oil and cholesterol found patients taking 500 mg. per day of Neptune Krill Oil experienced total cholesterol decrease of 19%, LDL cholesterol decreased by 44% and HDL cholesterol increased by 33%.  Study subjects who took 3 grams a day of fish oil supplements experienced Total cholesterol decrease of 6%, LDL cholesterol decrease of 4% and HDL cholesterol increase of 4%.  

    Fish oils do offer cardiovascular benefits, but it may appear Neptune Krill Oil could be a more suitable supplement for patients seeking more aggressive cholesterol lowering treatment.

  • Anonymous

    2/13/2010 2:20:51 PM |

    What a great resource!

  • tareq

    2/14/2010 5:10:28 PM |

    I ate fishes but fried them in sunflower oil but there was no benifit

  • Dr Matti Tolonen

    3/4/2010 5:19:52 PM |

    Here is the latest article written by Prof Clemens von Schacky about Omega-3 Index
    http://20.fi/3779

    Dr Pentti Raaste and yours truly have just published a small leaflet for prevention and self treatment of cardiovascular diseases http://20.fi/3780

  • TedHutchinson

    7/26/2010 12:25:28 PM |

    30-Days of High Omega-6 Diet--Stiffens Arteries and Increases Belly Fat

    I was shocked to see what happens when someone with a good omega 3 status changes to an omega 6 rich diet for a month.

    Now consider what happens when people have been consuming too much omega 6 in relation to omega 3 from  conception and throughout their entire lives.

  • buy jeans

    11/3/2010 8:44:26 PM |

    The data suggest that, while an omega-3 index of 7.3% is associated with reduced risk for sudden cardiac death, a higher level of 10% or greater is associated with less risk for heart attack. Surprisingly, fish consumption and fish oil intake account for only 47% of the variation in omega-3 index.

  • best omega 3

    2/2/2011 10:00:23 AM |

    That graph really shows how healthy omega 3 is. It is just a very amazing thing. I think taking omega 3 regularly will keep our body healthy.

  • Susan

    5/27/2011 4:39:02 PM |

    I discovered the powers of omega-3 when I was diagnosed with rheumatoid arthritis. of course, that didn't cure me but I'm really better now on omega-3 supplemts. It's not eliminating fats what we need to be healthy (as many would say), it the RIGHT fats. I'm glad the healthy fats topic is getting more and more popular.

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The Detection Gap

The Detection Gap

You've heard of the Generation Gap, the Income Gap, the Technology Gap, the Gender Gap, and the Achievement Gap.

How about the Detection Gap?

Haven't heard of it? That's the gap between coronary heart disease detected by conventional methods widely practiced in the community and the real prevalence of the disease.

The standard approach to coronary heart disease detection is a relatively simple formula. One of three things are sought:

1) Symptoms of heart disease like chest pain or breathlessness.
2) An abnormal EKG or abnormal stress test.
3) A catastrophe like heart attack or sudden cardiac death.

By this equation, the American Heart Association (AHA) estimates that 36% of American men and women have coronary disease.

However, we say the number is more like 48%. That's the number we arrive at when we ask: How many men and women have CT heart scan scores above zero?

The difference is the Detection Gap. Though only around 12%, it amounts to millions of people. The problem is that, by the conventional approach to detection of heart disease, you often don't know you have it until you're lying on a hospital gurney being wheeled off to a major procedure. Or your friends, family or neighbors find your body.

If heart disease is detected by a CT heart scan, it tends to be early, before catastrophe strikes. You can use tools like niacin, vitamin D, flaxseed, etc., all the components of the Track Your Plaque approach.

If heart disease is detected by waiting for the appearance of symptoms, then a stress test (usually nuclear) is followed by a heart catheterization, stents, bypass, etc. So there's more than a Detection Gap. There's also a difference in the sorts of therapies chosen. There's certainly a difference in cost.

In my view, there is no rational reason not to close the Detection Gap. While CT heart scan scores aren't perfect, they're damn close. The Detection Gap could be closed to around 2%. We'd also save billions of dollars.

Comments (3) -

  • Mike

    7/5/2007 6:06:00 PM |

    Those billions of dollars that would be saved are billions of dollars that would not go to medical professionals. Where is their incentive to prevent heart problems?

  • Susie

    7/5/2007 7:57:00 PM |

    If I'm a woman age 52 in apparent good health,  how could I get a doctor to order a CT scan?
    SWR, Ph.D.

  • Dr. Davis

    7/5/2007 9:07:00 PM |

    Of course, there is no way to compel someone to do something like order a test. However, many states do not require a doctor's order to perform a CT heart scan. It's best to check with a center performing the scan and they can tell you if an order is necessary.

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Let me float an idea

Let me float an idea

I'd like to float an idea.

The Track Your Plaque program is a fee-for-membership website. We chose this method of covering our costs--website development, graphics, software coding, etc.--since we do not accept advertising. I do believe that not having any advertising on our website has kept us impartial and unbiased--we mean what we say and not because we are selling something.

But there's a downside to assessing a membership fee: It limits the number of people who are willing or able to access the information. It also limits the dissemination of these concepts, due to such phenomena as limited content exposure to internet search engines.

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Why average cholesterol values can be so bad

Why average cholesterol values can be so bad

Jack had been told again and again that there was absolutely nothing wrong with his cholesterol panel. His numbers:

Total cholesterol 198 mg/dl

LDL cholesterol 119 mg/dl--actually below the national average (131 mg/dl).

HDL 48 mg/dl--actually above the average HDL for a male (42 mg/dl).

Triglycerides 153 ng/dl--right at the average.


So his primary care physician was totally stumped when Jack's heart scan revealed a score of 410.


Lipoprotein analysis (NMR) told an entirely different story:

LDL particle number 1880 nmol/l (take off the last digit to generate an approximate real LDL, i.e., 188 mg/dl).

Small LDL 95% of all LDL particles, a very severe pattern.

A severe excess of intermediate-density lipoprotein (218 nmol/l), suggesting that dietary fats are not cleared for 24 hours or so after a meal.

And those were just the major points. In other words, where conventional cholesterol values, or lipids, failed miserably, lipoprotein analysis can shine. The causes for Jack's high heart scan score become immediately apparent, even obvious. Jack's abnormalities are relatively easy to correct--but you have to know if they're present before they can be corrected. A shotgun statin drug approach could only hope to correct a portion of this pattern, but would unquestionably fail to fully correct the pattern.

As I've said before, standard cholesterol testing is a fool's game. You can squeeze a little bit of information out of them, but there's so much more information that can be easily obtained through lipoprotein testing like Jack had.

Comments (23) -

  • DietKing2

    8/29/2007 9:56:00 PM |

    Doctor,
    Have you ever heard of this?
    I hear you talking about Lp(a) quite alot and I'm not counting on my daily dose of Lipitor to straighten out whatever else might be going on backstage in my bloodstream, you know?
    Let me know what you think.
    Adam
    http://www.thecureforheartdisease.com/pauling/lpatent.html

  • Dr. Davis

    8/30/2007 12:36:00 AM |

    Hi, Adam--

    Yes, we've tried the Rath/Pauling formula informally but have never seen any substantial effect.

    Lipoprotein(a) is a very real phenomenon that clusters in high-risk families with heart disease. The treatment is specific, e.g., niacin, testosterone, and others. However, it must be measured specifically. Be sure to see the extensive conversations on our website, www.trackyourplaque.com.

  • Anonymous

    8/30/2007 2:53:00 AM |

    hello- I am new to your blog and just wondering your opinion on "The South Beach Diet" or what diet/book you recommend.
    I am a 50 year old male on a statin with a calcium score of 2. My lipid numbers are OK now but I really want to get off the statin and am totally confused by all the contradicting diet info out forthe public.Help!

  • Anonymous

    8/30/2007 3:21:00 AM |

    Hi Dr. Davis,

    I joined TrackYourPlaque today and appreciate your insight there.

    The story you relate in this post is incredible really and one I can relate to...

    10 years ago I had a mild heart attack at 43 which led to 3 stents.  5 years ago, just symptoms which got me to the hospital which led to a triple bypass.

    I've met with a lot of doctors, including cardiologists who appear often to know less about what they're doing than I have come to know through research and reading on the internet.

    I guess it's understandable that every adult patient wouldn't get sophisticated lipoprotein subfraction analysis as a matter of course.

    But you'd think that someone in my situation would get sophisticated input.

    My HMO was and is great for emergency conditions and has highly qualified surgeons and facilities.

    But after reading this post, I was struck again by how little informed and significant knowledge about best practice treatment methods one can really get in some HMO contexts.

    I know that I've spent a lot of time doing my own research to learn everything I could ('cause I don't want to die young) and I have to wonder sometimes what happens to folks with issues similar to mine who don't have a research and read orientation or the time to learn enough to protect themselves with preventative measures.

    Mid Life Male in CA
    aka "wccaguy"

  • Dr. Davis

    8/30/2007 11:45:00 AM |

    South Beach Diet is a wonderful program, at least phases 1 and II. Phase III, in my opinion, is too lax by including too much wheat. However, it is an overall solid and healthy diet. Also beware of its over-reliance on processed foods. The best foods for all of us are in the produce aisle, the ones with no labels.

    Our principal website, www.trackyourplaque.com, will also soon be releasing the NEW Track Your Plaque Diet that incorporates many of the concepts discussed here to help achieve control over heart scan scores.

  • Dr. Davis

    8/30/2007 11:50:00 AM |

    Mid Life Male--

    Yes. Lipoprotein testing, in my view, can make or break success in gaining control over your disease.

    Unfortunately, the lack of knowledge in this area is not confined to the HMO's. HMO's are, in fact, poorly represented in Wisconsin, yet ignorance among my colleagues regarding lipoprotein testing and other advanced measures of risk persists outside of the HMO setting. In short, it's everywhere. It's up to us to talk about it and spread the word.

  • Anonymous

    8/30/2007 3:02:00 PM |

    Hello- Greg here- I posted the South beach Diet question- thanks so much for the response. A couple questions:
    - Is your new book coming out actually a book to purchase or part of your membership web-site?
    - Can you tell me when it will be available?
    - I know you don't recommend wheat flour products but can you comment on sprouted grain bread line Eziekiel or similar brands, are these any better in moderation? Or should I just forget about bread entirely?
    - My calcium score was 2. That was about 3 years ago, now at 50 when should I have it done again?
    Thanks!
    Greg

  • Anonymous

    8/30/2007 3:19:00 PM |

    Greg - again- sorry, I might be confused here. My calcium score was 2 is that the same as a heart scan score?
    I am not sure I know the difference.
    Thanks!

  • Anonymous

    8/30/2007 4:11:00 PM |

    Hello- sorry for all  my comments but I just found your site and I am very impressed.
    I did a search for Splenda and didn't come up with much- can you comment on this product and the use of it in your program.I have dessert issues... I did enjoy the ricotta dessert on South Beach but what do you think of jello and the use of Splenda in desserts without wheat!There is so much on the web about the evils of Splenda- who to believe?
    Thanks!
    I really should just become a member I suppose.
    Greg

  • Anonymous

    8/30/2007 6:48:00 PM |

    Another question- do you have any thoughts on Dr. Gott's "No Sugar, No Flour Diet"? He is coming out with a cookbook this December to compliment this book.
    Thanks!
    Greg

  • Dr. Davis

    8/30/2007 8:20:00 PM |

    Sorry, no. I've heard of it but haven't yet read it. I like the title, however!

  • Dr. Davis

    8/30/2007 8:22:00 PM |

    In my experience, I've not witnessed any ill effects from Splenda or Stevia. I have seen plenty of mental cloudiness, however, with aspartame. I still think it's a good idea to keep your sweeteners, natural or synthetic, to a minimum.

  • Dr. Davis

    8/30/2007 8:23:00 PM |

    Yes, a heart scan score and a calcium score are the same thing.

  • Dr. Davis

    8/30/2007 8:26:00 PM |

    The New Track Your Plaque Diet will be a Special Report posted on the www.trackyourplaque.com website sometime in the next few months.

    With a starting score of 2, I would not recommend another scan for 3 to 5 years.

    I actually have a 18-month old loaf of Ezekiel bread in my freezer that I have not yet had a chance to play around with. So, no, sorry, no experience nor much knowledge of this specific product yet.

  • Anonymous

    8/30/2007 8:28:00 PM |

    Thanks for the responses.
    Can you tell me, in general, how often a person should have a heart scan done. As I said my last one was at 48 ( a score of 2)  I am now 50.
    Thanks!
    Sorry if I already asked this.
    Greg

  • Anonymous

    8/30/2007 8:56:00 PM |

    OK- I have been reading many of your posts today and thanks for your patience with my posting enthusiasm... I think I asked the same question twice!
    I have beed struggling for sometime with diet and my physician is no help.
    I did lose on South Beach but gained much of it back.
    I see that you recommend South Beach but as I read your postings it seems you lean toward a vegetarian diet too or am I reading into this.
    By joining the web-site would I get access to recipes and meal plans?
    Thanks for help and patience with the new guy.
    Greg

  • Dr. Davis

    8/30/2007 9:17:00 PM |

    Greg--

    South Beach is a wonderful program. Following a vegetarian diet is a choice, but not a necessary part of doing well on our program.

    Unfortunately, meal programs will not be found on the Track Your Plaque website, just discussion of principles and occasional recipes. We are working towards that, however.

  • Anonymous

    8/30/2007 9:45:00 PM |

    Thanks!
    I think I have been reading too much over the years as I have dealing with higher blood lipids and weight gain.
    The whole vegan/vegetarian crowd can make me nervous - The China Study, Ornish, McDougall, Fuhrman, Esselstyn, Pritikin, etc.... they all say theirs is THE way. I had the nutritionist write me back from the Pritkin Center and say South Beach (in the one study done) showed no decrease in LDL and that it is a horrible diet.
    Also there was an article between Ornish and Agatston in Ornish's column he writes for Newsweek where Dr. Agatston said Ornishes approach was aggressive but perhaps he should offer it to those that want to try it in the future ( I am not quoting correctly but you can google Ornish and Agatston and find the article) It kind of made me feel like he wasn't too proud of his program or maybe he was just trying to appease Ornish.... urrhhh... not sure.
    I know as the public we are really lead down different paths and the more I read the more confused I get.
    Best- Greg

  • Dr. Davis

    8/31/2007 11:33:00 AM |

    I always remind people not to  confuse diets meant to achieve WEIGHT LOSS and diets that correct causes of HEART DISEASE. There is a good deal of overlap but there can be crucial differences.

    The inclusion of abundant grains, for instance, from whole wheat or whole grain bread and breakfast cereals, magnifies undesirable small LDL particles and raises triglycerides, both powerfully related to increased coronary plaque growth.

    We use the heart scan score as our endpoint and guided along the way by lipoprotein patterns. I think this makes us worlds smarter about diet, what works and what doesn't.

  • Anonymous

    8/31/2007 1:32:00 PM |

    Thanks so much for all your help.
    I am wondering if your counsel patients at your clinic- either you or your staff.
    I am near LaCrosse, WI so not that far away. Or is it better just to join your site?
    I did have the LDL test and my particle size were a bit on the small side and as you know I have a calcium score of 2.
    Just wondering about next steps for myself- I know you cannot counsel via this blog, just looking for a general recommendation.
    Thanks!
    Greg

  • Dr. Davis

    8/31/2007 2:14:00 PM |

    Hi, Greg--
    I would suggest using our website.

    In all honesty, I do not do the website work to increase my practice. My practice is already bursting to overflowing. I am confident that the Track Your Plaque website can serve your purposes quite well.

  • Ask A Doctor

    8/13/2009 3:10:50 PM |

    I think that the lipoprotien tests should be included in the standard list for testing Cholesterol.

  • buy jeans

    11/3/2010 8:43:25 PM |

    As I've said before, standard cholesterol testing is a fool's game. You can squeeze a little bit of information out of them, but there's so much more information that can be easily obtained through lipoprotein testing like Jack had.

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