I often wondered about the one from Wal-Mart. i'm not sure if it's same as the one from Wal-green. The name brand rung a bell. My wife ended up with a little cold while on it. Needless to say, we went back to the old one. I also got a little cold but was over it quickly. I'll have to go there and see which brand. It was very cheap too. hmm...

Wow, goodbye Nature Made!  Has anyone tried and had luck with the Trader Joe's brand?

Just called NatureMade Co and they told me their D3-2000 softgels are also sold under the Kirkland brand by Costco.  I have been taking those for 6 mos. and will now get my level checked. I'll be switching if it's not where it's been for the past year.

Thanks.

Jan

Dr. Davis:
This is excellent and important  information; thank you for reporting it.

Question:  has Nature Made been made aware of this?  I'm not defending them by any strtch, but is it possible that something they're not aware of has occurred?  They've always seemed to be a reputable company.
Also, I've never seen them offer a 10,000 unit single dose.

Just want to make sure you mean Nature Made and not Nature's Bounty, both of which are sold by Walgreens.

I have been taking 6,000 IU NOW Foods (brand) vitamin D3 gelcaps/day for the last three years.

My 25-hydroxy vitamin D blood level has been ~60 ng/ml after two tests in those three years.  So far, so good.

Does anyone have experience with the Country Life brand gelcaps?

By the way, Dr Davis, when you say "You might consider a 25-hydroxy vitamin D blood level", do you mean that we might consider having our 25-hydroxy vitamin D blood level measured?

can you comment the same on niacin

Thanks Dr. Davis, I have personally learned so much from reading your blog..... I wanted to know how much I appreciate you taking time from your schedule to give us such valuable advice. My father is a open heart surgery patient and the food in hospital up to his surgery was appalling and his cardiologists standard low fat recommendations is stupendous. However my parents are of the age where doctor is = GOD. I am the nutcase for advocating D3, and salmon oil, & coconut oil.... THANKS AGAIN!!!! Sharan from Ontario, Canada

Wow, that is worrying news but I am not surprised either.. there is a lot of scams out there.. but you would have thought they would be more unfamiliar brands than something we can pick up everywhere, or maybe that is just why. No one is questioning them because the brand is so known! I wonder if this goes for their other supplements too? I will for sure send this information along.

Last september 25-0H-lab 20. I started with 10000/d dried pills. March lab 140!Really surprised that the resorption of ordinary pills can be that high. Luckily no toxic "side effects". Sure I´ll pause now till next winter.

I have developed hypervitaminosis of vitamin D only taking 3000 IU daily of D3 during 5 months. I have removed all vitamin D3 of my supplements until I have levels under 50-60 ng/ml or even below.

My experience has told me that some doctors/scientists are prescribing megadoses of vitamin D to population. Probably no more than 1000 IU daily of D3 to general population is a good dose.

The comments from several people highlight the absolute need to monitor 25-hydroxy vitamin D blood levels. We have our patients' levels checked every 6 months. Only then can you truly know what your status is.

My email to Nature Made:

"I am a practicing cardiologist who monitors vitamin D blood levels in all my patients every 6 months.

The Nature Made vitamin D is yielding no increase in 25-hydroxy vitamin D blood levels, despite prior full restoration with other brands.

This suggests that there is either little or no vitamin D in the capsule.

I'd appreciate your response."

We'll see what happens. Don't expect them to say much. The chain of communication in these companies is often not open to our scrutiny, nor will they say anthing that makes them legally liable in any way.

Adolfo David,

your statement doesn't even make sense. Did you spend a lot of time outside during warm season?

1,000 IU a day is very low for most people during the winter. That being said, I'd stick with 2,000 IU a day at the most during the summer and 5,000 IU during the winter. We easily make 20,000 IU of vitamin D in the skin just being outside at midday in the summer with the body mostly exposed after 20-30 minutes so I don't see how doctors are giving megadose when they say to take only 400 IU a day. We do not routinely get tested for it unless we request for it.

If you can't get to a reputable vitamin/supplement store, head over on the Internet to Vitacost.com.
I've been buying from them for years now.
They sell hundreds of name brands at discounted prices.
I've been using Carlson's VitD3 during the winter months here in Fla.
I then get a blood test going back into the winter months.

Anyone have any experience with Sam's Club's Member's Mark brand?

http://www.samsclub.com/shopping/na

vigate.do?dest=5&item=412704&pCatg=

11017

Huhu, it would be interesting to see if they answer and what answer. It is so important to choose brands of high quality when you buy supplements like Life Extension, NOW, Nordic Naturals, New Chapter..to name only a few I think are in the top quality.

Eloise, its strange that you have not felt any side effect with 140 ng/ml of vitamin D, it is almost a toxic level!

Adolfo,

I see that you're from Spain. I wonder if the testing lab is doing it right or the dosing is way off the mark.

1,000 IU isn't very much when it comes to keeping vitamin D level in the optimal range during the winter. During the summer, we (except for elderly people) can produce as much as 20,000 IU in the skin at midday with most of the body exposed to the sun after 20-30 minutes (for light skin). Much longer for dark skin. That's why your statement doesn't make sense.

My husband and I have been using the Costco Kirkland D3 (2000 IU per gel cap) and have had wonderful results. Recently I measured in at 81 ng/mL and my husband's measured level was 53 ng/mL -- note, I am more religious about taking my vitamins everyday than he is.

Dr D.

I had been taking the NOW brand of Niacin.  I also tried the "pharma" Niaspan.  The impact on my trigs was the same (35% reduction).  recently there was a package change here in Canada. Unfortunately the contents lable indicated niacinamide.  NOW said it was a lable error and the contents were niacin.  We have not seen a new packet yet.

I have tired rexall and wallmart brands, niether produce a flush that gives me the comforting feeling there is niacin at the strength I need for trigs reduction.

If you have a resource recommendation to find quality suppliments for D3,K2 and Niacin, it would be much appreciated

One other "D" issue is that quite a high number of people do not absorb the dry form (even of D3) well if at all.  Many, like Eloise, obviously do but many can take fairly high doses of it for some time w/ no change in blood level, switch to the oil base and bring it right up.

Dr Davis:

The subject of Vitamin D supplementation is a confusing one for me. I have been following the various postings on this blog and other news articles pointing out all the benefits of Vitamin D3. However, there seems to be vast disagreement on what constitutes a deficiency across ethnic/racial groups.To quote from wikipedia's page:

"Recommendations stemming for a single standard for optimal serum 25(OH)D concentrations ignores the differing genetically mediated determinates of serum 25(OH)D and may result in ethnic minorities in Western countries having the results of studies done with subjects not representative of ethnic diversity applied to them. Vitamin D levels vary for genetically mediated reasons as well as environmental ones.[30][31][32][33]  Among descent groups with heavy sun exposure during their evolution, taking supplemental vitamin D to attain the 25(OH)D level associated with optimal health in studies done with mainly European populations may have deleterious outcomes.[11]

I'm of South Asian(Indian) descent and my 25(OH)D levels on a recent test were 31.3 ng/ml.

What level would you say is safe for someone like me ? I take a 1000 IU supplement a day now but am more than a little concerned as what is safe.

Thank you Dr. Davis for following up with Nature Made.  While they may not want to make any comments that might be self-incriminating, the evidence is in the gel caps themselves; they either contain the amount of D3 claimed, or they don't.  I think  the salient issue is the amount of D3 in the gelcap.  An argument can be made that the company is not responsible for guaranteeing patient D3 levels because of individual biology.
  If the users of the NM product have any of the original capsules remaining, they might want to hold onto them, and even purchase an unopened bottle for possible future action.

Thank You Dr Davis for your excellent blog and your easy, straight-to-the-point posts!

After discovering you back in the Fall, I joined the Grassroots program and tested for Vit D at a low level of 12.

I took 5000-10000iu of Vit D3 daily since Nov 20th and recently retested (with ZRT again).

Although the searing, scorching pain in my joints has nearly all faded (thyroid/fibro?), and I was hoping for an optimal level, my lab results were only 19 last week


Curious after reading this though - I was taking Natures Bounty from Walgreens (5000iu max strength soft gel with soybean oil).

Does anyone know if Natures Bounty is the same as Nature Made?

As always, I appreciate the time you take to relate your stories and experience with us.

Somebody asked about Country Life.  I use their 2500 IU non-fish oil gelcap and my levels are 45ng/ml, which seems about right.  Thus, I think that company is indeed selling D3.

Your advertising Glucosan? A supplement that's banned in countries like Australia? Thats stuff put me in the emergency room last year. It absorbs moisture and swells in your gut. I am very surprised to see you advertising this.

OK might have spoke too soon. I've written the company and asked them if their product contains any glucosan and if not, why they would name their product after it.

Thanks

I would expect you'll hear from them.  It's probably the most damaging publicity their brand will receive this year.

Dr. Davis

Thanks for the information.  8000iu of Walgreen's "Finest Natural" D3 gelcaps had raised my HDL's from 23 to 60.  I will test my HDL's ASAP.

William Faloon at Lef.org likes Metformin to keep appetite under control,  potential disease prevention, anti-aging benefits,  correcting "metabolic syndrome" and anti-cancer effects.
I am having problems getting under 18% body fat and am wondering if you have had good results?

This is interesting. I've been taking high dose Bio-Tech capsules which get to me 56.4ng/ml at 10,000IU, so maybe gel caps of a different brand require a smaller amount (or more)? I guess if 10,000IU of Bio-Tech works for me I'll just stick with that - just hope they don't stop selling vitamin D.
That said I think Bio-Tech's value is probably fine (and I consume it with yogurt) as my first attempt at supplementation a few years ago was 400IU D2 in gelcap which didn't do much for raising levels at all, albeit also being D2.

Here are some brands that have yielded predictable and consistent increases in vitamin D blood levels:

Vitamin Shoppe brand
NOW
Sam's Club Members Mark
Nature's Life

There are surely more, but insufficient numbers of people in my population have been repeatedly tested. Also, all of the above have been GELCAPS. Tablets are not worth it, since they are so inconsistently absorbed. Oddly, the capsules filled with powder are better absorbed, perhaps equivalent to gelcaps.

I forgot to mention Carlson.

While, in general, I've had good experiences with Carlson preparations, we've seen some inconsistent blood results with their vitamin D. This has applied to about 3 people, so it may be premature to raise a stink. However, if you are taking Carlson, it may be wise to check a blood level.

I believe the brands at Walmart also seem to work fine, though the high-dose 5000 unit capsule has not been around long enough to allow repeated testing.

Lou, I take care a lot of my skin, I use everyday all year a UVA-UVB sun protector in all my skin exposed to sun, at least SPF 15-20 in the winter and SPF 30-40 in the spring-summer. I tend to avoid sun rays directly over my skin.

Taking 3000-4000 IU everyday during 5 months has produced to me 110 ng/ml of vitamin D. It has perfect sense in people like me who are probably vitamin D3 senstive. Also I am young, so I absorb so well vitamin D3.

If you dont get a blood test I never recommend more than 2000 IU of vitamin D3 daily.

Lou, I have read a lot about Vitamin D, I am health journalist very concerned about Vitamin D deficiency and I have read many articles and papers of John Cannell and Michael Holick.

About sun and vitamin D: you produce 10.000 UI of vitamin D with sun exposure if your body needs this amount. If not, sun does not produce more vitamin D. For this reason, you cannot reach a hypervitaminosis level with sun exposure.

My diet is mainly organic, much of this also paleo, with eggs, fish and some wild fish, some organic cheese... All these have vitamin D3.

I had great results with the Bio-Tech D3 powdered capsules, 50,000 IU once per week. My D3 last month was at 79.  

For the previous year and a half I'd been taking D3 emulsion drops with my numbers in the 40s-50s at 4000 IU/day. I think the drop size was too inconsistent.

Thank you for posting this information.  I recently had my levels tested after taking 5000 IU of the Healthy Origins brand D3 gelcaps for 6 months.  Levels had only gone from 37 to 39.  I'll be switching to Vitamin Shoppe or Now brands!

Or, you can increase your pre-sunburn exposure to sunlight, which yields about 10,000 IU. With no risk of overdosing, due to down-regulatory mechanisms with the "battery is full".

Dr. Davis, I recall seeing a post in this blog about people over 40 not producing vitamin D from sunlight exposure. Do you still believe that to be the case?

I ask because empirical research with elderly patients (65 and older) suggests that people in this category (i.e., the elderly) produce only a little less (80 percent or so) than 20 and 30-year olds:

http://healthcorrelator.blogspot.com/2010/02/vitamin-d-levels-sunlight-age-and.html

Dr Davis --

Are there any simple tests for crudely estimating one's level of arterial plaque which can be performed at home?

Thank you,

-- Tom Robinson

Adolfo,
I am also a little confused about what you are saying, but this might help you since we often measure Vitamin D as micro gram (mcg) in Europe.
5000IU of Vitamin D is (from what I understand) 125 mcg. (1 mcg = 40IU)

At the moment I am taking 2 different kinds of Vitamin D, Nature's Bounty gelcaps and one in a liquid form with arginine. I am unsure of the result from each. But last time I checked I was at 76ng/ml.

I wish there was an easy way to test this at home like the sugar levels in your blood! I hate going to the doc to do this cause they always gives me the lecture that I am eating too much vitamins, and even questions why I do it - they say I should get enough from a normal diet. And when that happens I just want ask 'what the heck is a normal diet' I am pretty sure his and mine idea of a normal diet is different.

Dr Davis - you should have a test right here on your blog for different Vitamin D products!! I would do it! Tell us what brand we should eat and for how long... test our levels, and then let us switch to another - do another test, and so forth... Each person could probably test 3 different brands in a year, or?? Just a thought.

For those asking about experience with different brands, here are my results:

Niacin - Neutraceutical Brand (Vitacost online) - 1,000 mg. capsules, 1 daily:  noticable flush, even after 1 year.  Trigs went from 178 to 87.

Vit. D3 - NOW Brand, 5000 IU gelcap, 1 daily.  Measured D3 in February was 74.

I'm now going to try the Neutraceutical 10,000 iu capsule, every other day and see what happens with test results.

I am glad to hear that the capsules filled with powder are absorbed effectively.  I mistakenly ordered Vitamin Shoppe Source Naturals D-3 Bioactive Form 2000 IU capsules thinking I was ordering gelcaps.  It turned out to be capsules filled with power.

My partner and I have had our Grassrootshealth results back today, We take Country Life 5000iu softgels in MCT oil and use UVB from sunbed in winter and sun, when available, in summer.
Mine was 64ng/ml and she is 74ng/ml.
She is weighs less than me.

Eades (who led me to your blog through a tweet of this and past tweets) recommended Biotech to me. I tested at 64 taking 5,000 iu and living like a bat (if I leave the house during daylight hours I wear the finest French sunblock, Anthelios #50/60, pour la visage - for the face). Many thanks for your post. Very important, knowing this. Retweeted.

Eades (who led me to your blog through a tweet of this and past tweets) recommended Biotech to me. I tested at 64 taking 5,000 iu and living like a bat (if I leave the house during daylight hours I wear the finest French sunblock, Anthelios #50/60, pour la visage - for the face). Many thanks for your post. Very important, knowing this. Retweeted.

Several people commented on sun and vitamin D.

Despite the media's repeated claim that 10 minutes of sun will provide 10,000 units of vitamin D, this does NOT apply to the majority of us.

This tends to apply only to young people, generally younger than 30 years old. Over 40, and most (but not all) have lost much of the ability to activate vitamin D in the skin with sun exposure.

Ignore the "talking heads" who tell you that 10 minutes of sun provides sufficient vitamin D. They probably read about it in a website last evening, then speak as "authorities."

I am like Adolfo I think. When I took 4,000 IU D3 per day for just four months over the winter a couple of years ago my 25(OH)D level reached 154 ng/ml. I am not young, I am in my mid 50s but I am slim. I cut down to 2,000 IUs per day and my levels have stabilized between 60 and 80 ng/ml. I get tested every four months or so. I do not go in the sun, but I did when I was in France last year and my 25(OH)D level actually fell ! I too eat a Paleo diet with lots of oily fish which contains D and I think this helps keep my 25(OH)D level up despite only taking 2,000 IU D3. I take Carlsons.

Dr. Davis, I was not referring to anything said by "talking heads", but to research done or reviewed by Reinhold Vieth.

For the Anonymous person that asked about Niacin...I take the brand name Slo-Niacin I get at Walmart or Sam's Club...2000mg
per day to raise my HDL.  If I spread the 4 tablets out over a couple of hours I get no flushing.

HDL went from 42 to 85mg/dL in a matter of 3 months.

Other "no flush" products for me
severe flushing.

TYP uses Slo-Nicain brand.

Anyone have any experience with Sam's Club's Member's Mark brand?

That's what I take. One 5,000 units capsule every other day (plus there supposed to be 600 IU in the multi I take daily).

Definitely a good stuff. It is so ridiculously cheap, it's hard to believe it's good. How do I know? First, a test a year ago. Second, I get two weird side effects of taking vitamin D: 1) a low grade acne that I used to get once in a while disappears completely, 2) two small wart-like tumors on my wrist shrink and become very flat, barely visible.
How do I know it's vitamin D that does it? - Just for kicks, I once stopped taking it for 3 months and both effects reverted.

Here's the response from Nature Made. It's the usual corporate-speak nonsense that says nothing.

Unfortunately, because the experiences I have are from patients, not my own vitamin D, I do not have the bottles nor lot numbers to supply them. In past, when I have gone to the trouble of getting them, it never came to anything. You provide it, the information goes into the company, you never hear anything more.

So, given the difficulties, I would suggest that we all avoid Nature Made vitamin D. By the way, their fish oil is not a very good product, either. Nature Made is one of the brands we consistently see stomach upset with.



Date:     April  9,  2010
From:     Marissa Reyes, Consumer Affairs Department
Subject:  Reference #346236

Dear William Davis, MD:

We recently received your e-mail regarding Nature Made products.  We regret to hear that the quality standards of our company. [?]

Our company is called Pharmavite, and we manufacture Nature Made nutritional supplements.  We have been in business since 1971.  We are committed to quality control, and have very high quality standards.  Our Quality Control personnel sample and test all raw materials as they enter our plant, and again assay the finished product, before final packaging.  

Dietary Supplements are regulated under the FDA through DSHEA (Dietary Supplement Health & Education Act of 1994). The United States Pharmacopoeia (USP) establishes standards for the composition of drugs and nutritional supplements.  This voluntary non governmental organization was set up in 1820 and has officially been recognized by federal law since 1906.  Standards established by USP for products are legally enforceable by the FDA.  At Pharmavite we participate in the USP Dietary Supplement Verification Program (DSVP).  Many of our products have earned the DSVP seal and additional products are currently being evaluated.  Our DSVP certified products will have the DSVP seal on the product label.

Our Nature Made Vitamin D 400 IU tablets have been reviewed by the USP and bears the DSVP symbol on the label. Although the USP has not reviewed all of the Nature Made Vitamin D supplements, all of our products go through the same rigorous quality testing at Pharmavite. The products which have earned the seal help us to demonstrate the high quality of our products.

We would like to look into the product(s) your patients have been using. If you could provide the UPC and lot numbers of the product(s), we will be happy to review our records. In addition, if you would like us to test the product(s) that you currently have, we will be pleased to send a prepaid postage mailer so you may return the product(s) to us so that our Quality Control Department can
examine it. Please let us know if you would like us to send you the prepaid postage mailer.

We thank you for contacting us and hope that you will continue to use and enjoy Nature Made products with complete confidence.

Sincerely,
Marissa Reyes
Consumer Affairs Coordinator
Pharmavite, LLC
MR:346236-10

I use 5,000 iu/day from WalMart and Sam's Club and my last test result was 79 ng/ml.  I use their fish oil also.

I have taken the Biotech D3-50, 50,000 IU powder caps for about 3-4 years now.  Have not found a good source of oil caps that strong. I have not been sick in 8 years, first 4 from colloidal silver, and last 4 from D3. My 25-OH-vitaminD has been around 62-64 ng/ml.. take two 50,000 IU per week.  Now, after reading Dr Davis on powder D3 "may have erratic absorbtion", I started chewing up a gelcap with a teaspoon of coconut oil.  6 weeks later, my D3 level went from 62 to 80! on the same dose. Six weeks is probably not enough time to stabilize. I bet I may go to 90-100 when I retest next month.

Dr Cannell (www.vitamindcouncil.org) reccommends 25 IU per pound of body weight per day long term for starts and then test.  My dose works out to be 14,286 IU/day and my weight is around 300lbs.. pretty close.  No wonder skinny people build up too much D3 in their blood, no fat to store/buffer it.  Also had a couple of warts/moles, and they went away after high dose D3. I think they are caused by viruses and D3 builds up the immune system enough to fight off most viruses
--ghg

I had been taking the NOW brand of Niacin. I also tried the "pharma" Niaspan. The impact on my trigs was the same (35% reduction). recently there was a package change here in Canada. Unfortunately the contents lable indicated niacinamide. NOW said it was a lable error and the contents were niacin. We have not seen a new packet yet.

I began supplementing a total of 4,000 iu of vit d at the beginning of January. (2,000 from my multivitamin and 2,000 from Sam's Club gelcaps).  My vit d level on Feb 1 was 32.

Upon receiving these results in the middle of February, I began taking 2 drops (4000 iu) of vitacost's brand of vit d (in addition to the 2000 in my multi).  So a total of 6,000 iu per day.  

I received the results yesterday of my vit d level taken 2 weeks ago-- 94.8!

My hdl went from 38 in February to 31 two weeks ago.  
I have also been following a higher fat, lower carb (30-75g/day) diet for the past 2 months.
My triglycerides, overall cholesterol, and LDL levels have all dropped by 30-40 points.
I've cut back to 4,000 iu of vit d.

I can't seem to lose weight, however, even with the low carbs.  I am a T2 diabetic.  (AIC of 6.7 in February).

hello,i live in islamabad,pakistan.last year i ws diagnosed having osteopenia then my dr also asked me for d3 n calcium tests both came very low.since last nov i hav been taking 500IU d3 alongwith osteocare syrup.but after 7,8mnths my result was  still  the same vit d3 being 16 (here in our labs normal range is considered above 30)and calcium came 8.4,(normal range starts from 8.8)please do suggest me something really useful and effective.i want to concieve too but i think might be being so defiecient i am suffering from hormonal imbalance too.my age is 32,i have  a son 4yrs old,am quite slim 5.3height with 110pounds.thnx

Vitamin D3 2000 Iu:

NOW Vitamin D softgels supply this key vitamin in a highly-absorbable liquid softgel form. Vitamin D is normally obtained from the diet or produced by the skin from the ultraviolet energy of the sun. However, it is not abundant in food. As more people avoid sun exposure, Vitamin D supplementation becomes even more necessary to ensure that your body receives an adequate supply. Vitamin D3 2000 Iu on discount at NutroVita.com.

For more details please visit:
http://www.nutrovita.com/32760/now-foods/vitamin-d-3-2-000-iu.htm

You have done a marvelous job by exploring this subject with such an honesty and depth. Thanks for sharing it with us!
termpapers99@gmail.com

Dr. Davis, I agree that consumers should be cautious of their medicine intake. I've heard of various over the counter vitamins and food supplements being sold even in stores like Wal-Mart and elsewhere. Although, they have the same content like vitamin D, there can be some problems with the percentage in each capsule. That's why they need to be guarded of the brands that they would patronize.

Aside from vitamin D, a lot of people today wanted to buy resveratrol too. They consult online resources and friends on where to buy resveratrol. Like in most drugs, experts advise to check the label, before purchasing any product to be sure of its content and effectiveness.

Thanks for sharing.

Gee, makes me want to check my medicine cabinet and the brands I have in there.
Not because it's well known means it works well.
Mavic
vitamin supplement industry

I've been taking Source Naturals 2000 IU vitamin D3.

My vitamin d is 85 ng/mL.

Is that too high? when to stop supplementing? I highly recommend this brand for increasing your vitamin D level, and it's pretty easy to get.

The costco brand was also fine - increased the level as well.

25(0H)D levels decline from Sept though to March above latitude 30N. So continuing to take 2000iu/daily will (for you as you appear to be a high responder) maintain your status above the 60~70ng/ml that provides a good reserve of D3.
Adverse events may be expected above 200ng/ml and you nowhere near that level.
Most readers require 6000iu/d to attain and maintain 60~70ng/ml through the winter.
Depending on the amount of time you spend outdoors next year it may be worth considering supplementing  alternate days or with perhaps 3 x 2000iu a week during midsummer if being above 80ng/ml bothers you. Personally I'd only reduce intake if I was repeatedly above 100ng/ml. Some test methods are slightly more variable than others and so your current level may be simply a

i'm taking 2 gms of prescription niaspan but flush very bad.  any tips on limiting this effect?

I have been taking 2000 IU daily dosage of vitamin D3 for several months with marginal improvement in level - went from 10 to 15.  Visiting this blog-post revelaed thwe reason - I have been using the NatureMade brand.

Kaiser's doctors recommended 50,000 iu weekly which initially had side effects - but I learnt it was perhaps because I was not taking it with heavy meals.

I have now been recommemded 5000 iu daily, and I thingk I will go with Carlson or Now brand. But a quick question; Isn't the 50,000 IU prescription dosage prepared by the Kaiser Lab more reliable than any leading brands? I mean - can't we trust the in-the-lab prepared prescription more than the over-the-counter branded pills?

Would appreciate if someone throes some light on this.

Did the monkeys get to vote? ;)

I would LOVE to read a response from the AHA!

Come on Doc, these statistics are obviously bias. That's like asking the readers of an vegan/animal-rights blog, "Do you think meat is murder?" and trying to transpose the results as being all encompassing.

I have to agree with Anonymous here. Nothing surprising in the fact that the majority of readers of a blog that regularly criticizes the AHA have a critical stance towards the AHA.

Move along, these are not the droids you're looking for.

I think you are being a bit generous to them. I certainly agree about the ADA. They seem to be in it for the money and they are getting plenty of it from drug companies. I am a physician and a diabetic and if I followed their advice my blood sugars would be out of control. As it is I am on a very low carb life style and in excellent control!
Thanks for your posts.

certainly it's not a random sample, but nonetheless, I would have to agree that all of these organizations and government agencies are losing credibility with the public and fast.  As a health professional myself, I can only hope my colleagues may begin to soften their stance before our credibility is completely shot with the public.

Tuck, the monkeys must make up the extra 18%.

Doctor, I truly appreciate your blog, read it religiously and follow much of your advice, but before forwarding to the AHA, you might want to check the numbers.

I think the AHA has done a lot of good in the treatment of heart attacks and keeping people alive.  However, I was thinking mainly of the "prevention" side when I voted "Tries to maintain the procedural and medication..."

Likewise, the ADA and other diabetes orgs are no doubt doing some good research into causes and prevention of type 1 diabetes, but their nutritional approach is a disaster.  Again, just maintaining the status quo for so long that they would be afraid to admit they were wrong if they finally did see the light.

Their heart is in the right place. In another 40 years scientists will be deriding the intriguing bloggosphere theories.

I just dislike these organizations jumping on a bandwagon d'jour, and trying to apply it to everyone blanketly.

People are not a " one size fits all " species!  When will the AHA, ADA, etc, stop aligning with big agriculture and pharma and think of individual people and their specific needs?  Is that just a pipe dream?

Real Food RD, I'm with you!

I was going to throw the other ADA in that stack too.  I've let them know several times how I feel about their corporate sponsors and partners.  Disgusted.

To be honest... after promoting such a lifestyle for so many years... wouldn't a sudden change in opinion open them to law suits?

How can they respond to that?

Great point Brian. I hadn't even thought of it.

Wouldn't it be the same with any condition that current medical research might up- end the treatment protocols?
ie..remember when patients with gastric ulcers were advised to drink milk and cream and avoid spicy foods etc?  
Then enter H. Pylori...albeit some 10 years after published studies and much derision from U.S. gastros. Treatment standards changed dramatically. Never heard of lawsuits over that.

Could people leave more than one response?  The percentages add up to more than a hundred.
Bob

OK, I did the math.  Apparently about 375 unique respondents, with 70 or so choosing more than one answer.

My impression is that 'disease associations' exist primarily to ensure their continued existance.

I have heard good reports on the Muscular Distrophy Assoc.

Dr D, I don't think the AHA is sending you a Christmas card this year

Interesting results.  I follow a low-carbohydrate (<60 g/day) eating plan and I recently had blood drawn and sent to a lab for glucose and cholesterol testing.  It was supposed to be fasting, but the sample was drawn 4.5 hours after I had gotten up for the day.  By then, I'd already eaten breakfast several hours earlier and my coffee with coconut creamer and  half-and-half which represents around 60 grams of fat and 9 grams of carbs.  Both my  glucose and triglycerides were 91.  My total cholsterol was unchanged.  My fasting triglycerides are usually around 45.  I did exercise prior to having the sample taken which could influence my triglycerides.

On an earlier occassion, I also had a non-fasting cholesterol test performed by a lab and the sample was taken mid-afternoon.  I'd consumed around 150g of fat total that day, starting nine hours earlier and my triglycerides were 79.

Having done similar myself though only testing blood sugar, I can say for certain that if you ate a truly low fat diet (<10% calories from fat) for 2 weeks prior to the test and then ate a truly low fat meal, your blood glucose curve would have been similar to that for the low carb meal.  The spike comes from insulin resistance, largely caused by dietary fat.  It takes about 2 weeks on a low fat diet for that component of IR to be reversed.  I have repeated this same experiment several times with identical results.

There are two ways to keep a fairly flat sugar curve.  One is a very low carb diet, the other a very low fat diet.  For the low fat diet to work however it must be constant without cheating.  In my experiments I found that only one meal of "normal" fat content, increased IR and caused sugar spikes for many days after.  Over about 10-14 days, my post postprandial sugar curve returned to normal.

Any chance of persuading someone (Oxford Group, say) to do a randomised crossover intervention trial with a suitable washout period and using different Carb/Fat percentages e.g.
15P, 55C, 30F (Standard American/English Diet) alternating with:-
15P, 5C, 80F
15P, 15C, 70F
15P, 25C, 60F
15P, 35C, 50F
15P, 45C, 40F
15P, 65C, 20F
15P, 75C, 10F but without adding extra sugar? The trial previously mentioned has received criticism on a board I post on for adding extra sugar to exaggerate results.

DrStrange, perhaps it was not clear from the quoted material, but I am diabetic. My BG would go up on a low-fat diet. That's what I was on for about 6 months after diagnosis, and I certainly did not have normal blood glucose levels. My A1c was much higher than it was on low-carb, high-fat.

However, it would be very interesting if nondiabetic people repeated my experiment. I think exaggerated TG responses may be caused by whatever it is that causes the diabetes.

I think DrStrange illustrates that there must be momentum to physiological responses to what is a typical diet for any one person. A low carber's insulin levels may not be ready to handle an untypical (for them)carbohydrate load while a person with a low fat diet maintains higher insulin at all times.

My experiment was flawed in several ways. I was not planning on publicizing the results, so I didn't weigh food or make sure the protein amounts were the same.

And I didn't do the usual 3-day high-carb eating to make sure I was producing carb-producing enzymes. Not eating carbs can produce diabetes blood glucose (BG) levels in a nondiabetic: called "starvation diabetes" because starvation is the ultimate LC diet.

However, I already knew I was diabetic. And people with diabetes have different lipid responses, so someone without diabetes would probably not see such a dramatic difference.

A good experiment for a nondiabetic who has been on a LC diet would be the following:

1. Measure BG and TGs for a day on your usual LC diet. Weigh the food so you can get exact nutrient levels. This would tell you what happens when you're adapted to the LC diet. Probably measuring every 2 hours would be enough.

2. Eat a low-fat diet without preparation and follow BG and TGs for a day.

3. Continue to eat the low-fat diet for a minimum of 3 days, maybe a week or 2 as suggested by DrStrange. Then repeat the experiment in No. 2, eating exactly the same thing.

4. If you wish, repeat the experiment in No. 1, to see if your lipids went high when you weren't adapted to the LC diet.

I do know someone else who was concerned that she might be diabetic, and while on a LC diet, her BG levels in a home "glucose tolerance test" approached diabetic levels. She then went on some kind of vegan diet, and on this diet, her BG levels stayed low on the GTT.

So yes, not eating carbs and eating more fat (two different inputs) can produce a result that looks like diabetes. Which of these two factors is more important is not clear because when you reduce one nutrient you have to increase another to keep the calorie content constant.

Gretchen, were you consistently at about 10% total calories from fat on your "low fat diet"?  Fat intake for most needs to always be not more than about 10% of total calories  for insulin resistance to be dramatically reduced. If someone is insulin dependent, the insulin they take will be maximally effective in that case but the fat intake must be at that low level for every meal ongoing.  One meal with excess fat and IR can shoot up and take many days to come back down.  This is what I found in my body.  Also, this is presupposing that all carbs are coming from very few fruits, vegetables, whole/intact grains (not flour, not sugar, etc)

I really do not know which is healthier in the long run for someone who is insulin dependent, low fat/high carb or high fat/low carb.  There are studies showing increases, long term, of a number of health problems w/ high fat intake.  On the other hand, w/ the low fat diet you would need to use more insulin which is inflammatory.

Anonymous, I do not have high insulin levels, in fact the opposite!  My A1c was creeping up a couple years ago (peaked at 6.4) so i tried low carb for 9 months and felt worse and worse the entire time.  More research and switched to low fat/high carb.  I have been on a very low fat, vegan (McDougall) diet for about 20 months now.  My A1c last tested 5.1 fasting insulin is <2.00 uIU/ml.  Recent glucose tolerance test with insulin values showed this after fasting ingestion of 75 gm glucose (I am only 5'3" 110 pounds:

BG (mg/ml) fasting=82, 1/2 hour=114 1 hour=103, 2 hour=86, 3 hour=100

insulin (uIU/ml) fasting<2, 1/2 hour 8.5, 1 hour=11.0, 1 1/2 hour=13.4, 2 hour=18.1

DRStrange

Maybe we should discuss this privately, as the best way to treat diabetes is really not the topic of this blog. There are so many variables. You can get my e-mail on my blogsite, which is at the end of the stuff that Dr. Davis cited. Use Wildly Fluctuating.

Gretchen makes a crucial point: Some of the effects of diet changes evolve over time, much as triglyceride levels changed substantially for her on the day following her experiment. Wouldn't it be interesting to see how postprandial patterns develop over time if levels were observed sequentially, day after day?

De novo lipogenesis is almost non-existant in humans. Trigs being high the day following a high carb meal probably reflect the regular trigs levels for a particular person. This would be true for any macronutrient composition that is not low in carbs.

Naturally after a low carb meal there is an increased turnover of lipids because the brain does not have any glucose or glycogen sources for fuel. Thus, triglyceride levels fall ad fasting triglyceride levels are low.

More importantly, fasting triglycerides DO NOT independently predict risk of heart disease once you adjust for post-prandial triglycerides. (Bansal et al_JAMA 2007_Fasting Compared With Nonfasting Triglycerides and Risk of Cardiovascular Events in Women)

The effects of a low carb diet on postprandial triglycerides has been measured over 4 weeks in a study by Natalie et al_Diabetes Care 2009. They also found a worsening of triglycerides post prandially.

It is unfortunate that Dr Jack Kruse had to miss the cruise due to a twitter incident, but he published his intended keynote in his blog (http://jackkruse.com/ct-12-getting-back-on-board-with-my-message/). It would be extremely interesting to see Dr Kruse's program adopted by the broad low-carb community and especially in the TYP program.
Dr Davis, would you recommend Dr Kruse's Leptin Rx and cold adaptation program to your patients? Was it in any way discussed on the cruise in the absence of Dr Kruse?

Did you give Jimmy Moore any tips on his inability to stop gaining weight no matter how low carb he goes? It is just frightening to think that this can happen to even the most staunch and informed low carber.

Hi Doc,

Just heard the tail end of a story on the BBC this morning where a researcher from Oxford Univ. was recommending that everyone in the U.K. over the age of 50 be put on a statin as a prophylactic measure - arguing that based on all relevant research, the rewards dramatically outweighed the risks.  Any thoughts?

"Good" HDL cholesterol may not protect heart after all, study suggests:
http://www.cbsnews.com/8301-504763_162-57436495-10391704/good-hdl-cholesterol-may-not-protect-heart-after-all-study-suggests/


Doubt Cast on the ‘Good’ in ‘Good Cholesterol’:
http://www.nytimes.com/2012/05/17/health/research/hdl-good-cholesterol-found-not-to-cut-heart-risk.html

This recipe is a filling and nutricious breakfast and you would never know you are eating low carb.

Pam's Veggie Skillet Breakfast for Two

1 Bunch of Asperagarus cut into 1-2 inch pieces
1 Large red, green or yellow pepper or 3-4 small peppers diced into 1 inch pieces
1 bunch green onions thinly sliced
2 cloves garlic
3 small partially cooked and diced red potatoes (or leave out if you have a very restricted carb intake or add more if you can tolerate more carbs)
1 TBL apple cider vinegar
3-6 eggs
1 TBL Grape Seed Oil
1TBL Olive Oil
Sea Salt and Pepper

Saute all the vegetales in a 12 inch skillet for three to five minutes with the Grape Seed Oil.  Add sea salt and pepper.  Do not over cook the veggies as they will continue to steam witth the eggs.  Add 3 to 6 eggs to the top of the vegetable bed being carefull not to break the yolk.  The trick is to gently lay the egg on top of the vegetables.  Cover the pan and let the veggies and eggs steam together until the eggs are done to your liking.  This is usually about three to five minutes for a softer egg that mixes well into the vegetable bed.  

Serve on plates and add more salt and pepper.  Sprinkle with the apple cider vinegar and olive oil.

Hi,

I have a quick question about your blog, do you think you could email me?

Jillian

Sounds yummy, though I'd replace the grapeseed oil with coconut oil.  

A cup of grapeseed oil has 218 mg Omega-3 fatty acids and 151708 mg Omega-6, so is a pretty bad oil to use if you value your heart health.  Most of your veggie oils are this way, WAY too much omega 6 for heart health.

I'd insist on pastured eggs (for nutrition) and freshly ground black pepper (for taste).  

Also, this sort of thing, you don't need a recipe, this much of that veggie, this much of the other.  Basically, just whatever you have leftover in your fridge is good.  I'd need an allium of some sort (onion, shallot, scallion), but otherwise... chop and throw into a skillet whatever you've got hanging about or leftover.

The big trick with fresh produce is using it up before it goes bad, and this is a great recipe to use stuff up with.

I don't know enough modern biochemistry to follow the logic of the letpin reset and haven't researched the cold stuff enough to have formed an opinion yet.

But about HIM - Google for his TED talk, where he claims to have gained 20 lbs on purpose, gone for plastic surgery to remove it, and injected himself with MRSA prior to the surgery, but it was all OK cause he soaked in a tub of ice water for hours afterwards.  

There may be something to his ideas, but... his behavior at that talk did not elicit respect for his ideas.

Thanks for posting, Pam!

On the other hand:

Low levels of HDL cholesterol lead to an increased death rate
This study was published in the Journal of Lipid Research 2012 Feb;53(2):266-72

Study title and author:
Fifty-three year follow-up of coronary heart disease versus HDL2 and other lipoproteins in Gofman's Livermore Cohort.
Williams PT.
Lawrence Berkeley Laboratory, Berkeley, CA 94720, USA. ptwilliams@lbl.gov

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/22128321

This study assessed the relationship of high density lipoprotein (HDL) cholesterol levels with total death rates and heart disease death rates. The study lasted for 53 years and included 1,905 men.

HDL cholesterol is made of HDL 2 and HDL 3. HDL 2 is larger than HDL 3.

After analysing 53 years of data the study found:
(a) Those with the lowest HDL 2 cholesterol had a 22% increase in total death rates.
(b) Those with the lowest HDL 2 cholesterol had a 63% increase in total heart disease death rates.
(c) Those with the lowest HDL 2 cholesterol had a 117% increase in premature heart disease death rates.
(d) Those with the lowest HDL 3 cholesterol had a 28% increase in total heart disease death rates.
(e) Those with the lowest HDL 3 cholesterol had a 71% increase in premature heart disease death rates.

The results of the study show that low levels of HDL cholesterol, especially HDL 2 cholesterol, are associated with higher total death rates and higher death rates from heart disease.

The best dietary way to raise HDL cholesterol levels is to eat a diet high in saturated fat. See here.

since i don't see ferritin, iron stores, or transferrin in your index, i'm going to assume you don't buy into the hypothesis that high iron stores in men can lead to CVD.  please correct me if i'm wrong.

My focus is strictly on his ideas and how they change lives of other people when they follow his example and advice. While some people may see his behavior negatively, I respect him for taking time to reply to every single comment to his blog posts, of which he receives many hundred per post.
I don't have a background to reason about Dr Kruse's conclusions and recommendations, but given that they are mostly consistent with the recommendations of other unorthodox doctors such as Dr Davis and Dr Eades who I trust, and go further extending those recommendations, and given that I have been following these recommendations with good consistent results, I don't need to worry about Dr Kruses's behavior when he has to deal with detractors.

I don't care about his detractors particularly either; I'm not a member of the Paleo community and haven't been a member of the low-carb community for some time, so have no horse in this race.

However, his behavior in that video is pretty irrational; I don't need a detractor to tell me this; my own judgment is that messing with MRSA is just flatout STUPID.

Dr. Davis and both of the Dr. Eades differ from Dr. Kruse in that they haven't behaved like stark raving lunatics.  I don't agree with everything they say, but respect them and have learned a lot from them, and from other sources as well.

I've read Dr. Kruse's ideas, and as I said, I've not researched them.  They may well be valid as I haven't spent the time on PubMed to figure it out.  Similarly, I haven't researched the ideas of the folks who hang out at the Philly Amtrak station talking to invisible people.

I can't spend my life researching, as I have to eat, sleep, exercise, talk to my husband, pet my cats, work in my garden, go to the Farmer's Market, etc.  So there must be some method of determining what to look into in depth and what to ignore; watching Dr. Kruse deliver his TED talk limited my interest in further researching his ideas.

If his ideas ARE valid, his behavior is not earning them a hearing from me.

Another contributor: Conventional LDL is a calculated value, not measured. The calculation for LDL is thrown off by any reduction in HDL or rise in triglycerides. In Katie's case, the rise in HDL from 48 to 54 means that calculated LDL is becoming more accurate and rising towards the true measured value. At the start, Katie's true measured LDL was 122 mg/dl, 35 mg higher than the calculated value. Calculated LDL is therefore approximating measured LDL more accurately as HDL rises.

Dr. Davis,
As cholesterol in the skin is a precurser to Vitamin D, it makes sense that there'd be a seasonal fluctuation in circulating cholesterol.  In summer months, with skin exposure, the cholesterol in the skin is being converted and "used" and more has to come from the rest of the body to take it's place. Couldn't that naturally draw down the serum choesterol levels?

Zuleika's Vitamin D Experiment shows data from http://www.anaboliclabs.com/company_main/PDFS/Vit%20D%20telecon%20-%20Jan%202007.pdf

January 2007

Deficiency <50 nmol/L
Insufficiency 50-80 nmol/L
Optimal 80-250 nmol/L
Excess/Tox: >250 nmol/L

Great thought. It would make sense.

I'm uncertain if the quantity of cholesterol taken for conversion of inactive to active vitamin D in the skin is sufficient impact on blood levels. It will be interesting to see how this argument unfolds as the vitamin D experience grows worldwide.

Perhaps vitamin D raises HDL by improving glucose metabolism. There are vitamin D receptors in pancreatic beta cells, and vitamin D deficiency has been shown to impair insulin synthesis and secretion in humans and in animal models [1]. Vitamin D supplementation in women with type 2 diabetes increased first phase insulin secretion, and also reduced insulin resistance, though not significantly [2].

1. Mathieu C, Gysemans C, Giulietti A, Bouillon R. Vitamin D and diabetes. Diabetologia. 2005 Jul;48(7):1247-57. Epub 2005 Jun 22.

2. Borissova AM, Tankova T, Kirilov G, Dakovska L, Kovacheva R. The effect of vitamin D3 on insulin secretion and peripheral insulin sensitivity in type 2 diabetic patients. Int J Clin Pract. 2003 May;57(4):258-61.

I'm going to a new doc soon and want to have my vit d levels checked. I've been taking supplements and want to find out my level.

What test do I ask for? Is it just a blood level? or is there more to it?

I also am going to ask for CRP, hemocystine and ferritin in addition to all the normal labs for a 53 yr old woman.

I'm also concerned about the cholesterol testing. My levels are high, and I reacted badly to statins. What's the best thing to ask for with the cholesterol tests. I'm in the Duke system, so I'm sure almost everything is available, but can't afford anything that insurance won't cover.

Cindy--
Ask for a 25-OH-vitamin D3 level. Be certain it is NOT a 1,25-diOH-vitamin D3. They sound and look the same but are very different. The second is a measure of kidney function. Only the 25-OH form serves as a measure of vitamin D.

We suggest an NMR lipoprotein profile with lipoprotein(a), C-reactive protein, glucose, insulin, homocysteine (though you'll get some resistance on this one).

Dr. Davis

What about the seasonal differences of diet and physical activity on total cholesterol? Our winter and fall diets are heavier with foods that raise cholesterol whereas in the warmer spring and summer we tend to eat lighter and maybe more salads and fruits.  And the warmer weather of spring and summer also makes us more active, going outdoors for walks, working on our yards, going to the beach, etc.

I’ve seen it happen over and over. It doens't occur in everybody but occurs with such frequency that it’s hard to ignore or attribute to something else. What I’m not clear about is whether this effect only occurs in the presence of the other strategies we use to raise HDL, a “facilitating” effect, or whether this is an independent benefit of HDL that would occur regardless of whatever else you do. Time will help clarify.

Gary Taubes, in "Good Calories, Bad Calories", would argue that what is causing the small LDL is in fact the same thing causing the obesity.  Over consumption of starchy carbohydrates and sugars basically.  

I think you'd find that book amazing. It is a comprehensive history in the mis-information cascade about diet and heart disease (and cancer).

Previous month oats (oatmeal/oatbran) were advised for correcting LDL numbers.
No grains is the advise this month.
Oats are also grains, are they not?
So is it okay to eat oats or not?

Hi, Nancy--

Yes, I agree. I am presently reading Taubes' book and am impressed with his grasp of the issues, a refreshing re-examination of issues most of us accepted as "fact."

I'm using the word "grains" too loosely. I really mean processed wheat. I've had positive experiences with oats and flaxseed. I think some of the coarse grains like quinoa and barley are good to neutral.

Dr Dave - why do you think the American Heart Association, and other similar influential organizations, are failing to advise the public about wheat products, if they are contributing to the raise in small LDL particles, as you state?

I can't speak for them, but I suspect that, as always, it has to become common knowledge among physicians before the policy makers in the AHA decide to make a change. They usually wait until data become overwhelming before allowing it to become their position. Also, there is a lot of money in the low-fat concept. See my posts about the AHA Heart CheckMark program, a very profitable program.

Yes the unfortunately it's the 'Big Business' monopoly again. Quite sickening actually!

I am very interested but also concerned about this, and as a dietitian I do recommend wheat based products - can you suggest any journals/books on this matter?

Yes, several sources:

1) See my Blog post Oat vs. Wheat at  http://heartscanblog.blogspot.com/search/label/Oat%20vs.%20wheat in which I discuss Dr. Brenda Davy's study.

2) Dr. Ronald Krauss has published rather extensively on this. Enter "Krauss" and "small LDL" into your PubMed search.

3) Look at Dr. Loren Cordain's website, www.paleodiet.com, that contains reprints of his many reviews of the effects of grains on health.

The most recent addition to the lay literature on this topic is Gary Taubes excellent book, "Good Calorie, Baad Calorie".

Dr Davis - many thanks for that, I will look into it.

Excellent clip: leftover pizza = healthy breakfast. I love it. I can hear my friends now, "I order pizza because the leftovers make such a good breakfast."

Next we'll hear that chocolate muffins made with vegetable oil are good for b'fast because "they're better than nothing, have no cholesterol and chocolate enhances serotonin function."

Healthy breakfast choice = bad food + one slightly positive attribute grossly exaggerated.

Well said!

I would love to hear your thoughts (review) on Taubes' book, "Good Calories, Bad Calories", after you have finished reading it.

Thank you. I will.

We are also going to add a Book Review section on the www.trackyourplaque.com website near future.

I'm only a few hundred pages into Taubes book, but one of the things I'm liking a great deal thus far is his explanation of many of the factors measured in the TYP program.

I was already familiar with the carb/insulin stuff (which is greatly simplified, leaving out the effects of glucagon, amylin, cortisol, the thyroid and sex hormones - all of which also effect blood glucose).  

I'm much newer learning about heart disease.  A lot of what was empirical in the TYP book is explained much more thoroughly by Taubes.

I like the Fanaticcook blog entry also - it's refreshing to see someone discuss whole grains who actually knows what a whole grain *is*.

I watched the online video debate between Taubes, Ornish, and Dr. Barbara Howard of the AHA.  Taubes appeared to be unaware of the TYP program and the kind of incredible results being frequently reported at the TYP forum by forum members.

Here's the YouTube link:

http://www.youtube.com/watch?v=JPyme62niYM
For what it's worth, IMO, you and Mr. Taubes need to have a chat so he's better armed with evidence of what a low-carb diet can do with heart disease.  (As if you needed more to do, huh?)

Jimmy Moore must have his contact information given that he did an interview with Mr. Taubes.

You da' man doc!

I watched the online video debate between Taubes, Ornish, and Dr. Barbara Howard of the AHA.

wccaguy,

FYI: I am pretty sure that this show is from 2001, after Taubes published his "What if it's all been a big fat lie" article on saturated fats and the lipid hypothesis.

You comment "whole grains create small LDL!". Would beer (which is grain-based) be a culprit in your opinion, even in moderation? tia

John

Hi, John--

Great question. However, I am uncertain. There is very little data on this specific issue, nor have I seen enough lipoprotein patterns pre- and post- beer inclusion.

My gut sense: one or two beers a day is okay, provided weight is not impacted

Not meaning to belabor the subject, you single out wheat versus "grains" in general as particularly detrimental, while oats for example are not, and can be even beneficial. Where does corn sit in this whole "grains" scheme? In a typical TYP program, are corn-based tortillas for example preferred to wheat-based ones, or are both to be avoided?

Hi, John--

From a glycemic index/small LDL/weight standpoint, corn products are every bit as detrimental as wheat.

I single out wheat, however, since Americans are over-dependent on wheat products by such a huge margin. It isn't at all unusual, for instance, for someone to eat wheat products 5 times a day. That would be very unusual with corn products, however.

Interesting article, never thought that grains may do such things. I was also wondering the same that John about beer.

It sure sounds healthy, but it's same worn advice that has resulted in a nation drowning in obesity. The food choices advocated by this dietitian keep us fat. It also perpetuates this epidemic of small LDL particles.

In response to Johns comment about beer:

I'm no expert on the subject but from my experience with home brewing, it is my understanding that all, or at least most, of the carbohydrates are converted to simple sugars which are then fermented by yeast into alcohol and CO2.

And so, rather than the sugar ending up in the persons blood stream, it is transformed into alcohol which enters the blood stream.

So the real question is:

"How does alcohol affect the ammount of small-LDL in the blood stream?"

What I do know is that alcohol tends to lower the blood glucose levels, which I would think would be beneficial since it's blood glucose that the body uses to produce small-LDL.

After further research i've descovered this:

http://jcem.endojournals.org/cgi/content/full/92/7/2559

Results: Alcohol intake was associated with total low-density lipoprotein (LDL) particles in a U-shaped manner. Consumers of one or more drinks per week had the highest number of large LDL particles, whereas consumers of 7–13 drinks per week had the lowest number of small LDL particles. Alcohol intake was strongly positively associated with large- and medium-sized high-density lipoprotein (HDL) particles but had an inverse relationship with concentrations of small HDL particles and small- and medium-sized very-low-density lipoprotein particles. Average particle sizes of all three lipoproteins were positively associated with alcohol intake. Associations were generally stronger among women than men but in similar directions. Beverage type did not consistently modify these findings.


Long story short:

DRINK MORE BEER!

Transform all those nasty carb ridden grains into beer!

Grain industy's happy, people are happy and we'll all be alot healthier.

CRISES AVERTED!