Carotid plaque can be shrunk

28. May 2006 William Davis (1)
Rose, a 64-year old woman, just had a 70% carotid blockage identified by a screening ultrasound. When the result was given to her doctor, he prescribed Lipitor and told Rose that an ultrasound would be required every year. She would need carotid surgery, an "endarterectomy", if the blockage worsened.

"Can't I reduce the amount of blockage I have?" asked Rose.

"No. Once you've got it, it doesn't get any better."


Is this true? Once you've got carotid plaque, you can only expect it to get worse and it can't be reduced?

This is absolutely not true. In fact, compared to coronary plaque, carotid plaque is easier to reduce!

Of course, the Track Your Plaque program is designed to help you control or reduce coronary plaque. But, in our experience, people who have both coronary and carotid plaque will show far greater and faster reduction of carotid plaque. Dramatic reductions are sometimes seen. I've personally seen 50-70% blockages reduced to <30% on many occasions.

The requirements to achieve reduction of carotid plaque are very similar to the approach we use to reduce coronary plaque. One difference is that hypertension may play a more important role with carotid plaque and needs to be reduced confidently to the normal range before carotid plaque is controlled.

I find it shocking that the attitude like the one provided by this physician continue to prevail. Unlike coronary plaque, which has a relatively small body of scientific literature documenting how it can be reduced, carotid plaque actually enjoys a substantial clinical literature. Part of the reason is that the carotids are more easily imaged using ultrasound. (Heart structures can be seen with ultrasound, but not the coronary arteries.)

Numerous agents have been shown to contribute to reduction of carotid plaque: statin drugs, niacin, fish oil, the anti-diabetic "TZD" drugs (Actos, Avandia), several anti-hypertensive drugs, vitamin E, pomegranate juice, and several others.

It outrages me to hear stories like this. Rose is not the only one.

Don't accept the flip dismissals or the over-enthusiastic referral for carotid procedures. Insist on a conversation about plaque regression.


Note: Although I am a vigorous advocate of atherosclerotic plaque regression, this does not mean that if you have a severe (70% blockage or greater), or if there are symptoms from your carotid disease, that you should engage in a program of reversal. You must always take the advice of your doctor if your safety is in question.
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Comments (1) -

  • buy jeans

    11/3/2010 7:35:40 PM |

    The requirements to achieve reduction of carotid plaque are very similar to the approach we use to reduce coronary plaque. One difference is that hypertension may play a more important role with carotid plaque and needs to be reduced confidently to the normal range before carotid plaque is controlled.

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What's important, what's not in your plaque-control program

What's important, what's not in your plaque-control program

6. July 2006 William Davis (0)
Sometimes it's hard to know what is really important in your plaque-control or plaque-reducing efforts.

There are, indeed, crucial make-it-or-break-it factors that are necessary to gain control over plaque. If you hope to stack the odds of reducing your heart scan score as much as possible in your favor, then fish oil, vitamin D, 60-60-60 in the way of standard lipids, elimination of small LDL, etc. -- all the elements of the Track Your Plaque program--are necessary.

But there's lots of things that sidetrack people. I spend much of my day fielding questions from patients about all the things that either provide very little benefit for plaque control, or provide none at all.

Among the things that we have found to be too weak or useless for plaque control, or are "non-issues", include:

--Caffeine--Go ahead and enjoy a couple cups a day (though not a pot). The effect is too trivial to make much difference.

--Hawthorne--Yes, it may dilate coronary arteries modestly, but not enough to make any difference.

--Garlic--with the possible exception of a specific preparation called Aged Garlic Extract (an acqueous, non-oil-based, extract from Kyolic), garlic's effects are too tiny to help, e.g., drop in blood pressure 1-2 points. Use it, but don't expect much. Aged Garlic Extract may be an exception, in that a single study from UCLA suggested specific effects on slowing coronary plaque growth. We await more info on this.

--Anti-oxidants--There is no shortage of extravagant claims about the benefits of anti-oxidants. Unfortunately, there's very little human exerience with pine bark extract, pycnogenol, grapeseed extract, and so on. Is the purported benefit from anti-oxidation or through some other means, e.g., enhancement of nitric oxide synthase? No data.

--Policosanol--If you've followed the Track Your Plaque Special Reports, you already know what a disappointment this agent has been, despite the too-good-to-be-true clinical data. It doesn't work.

--"No-flush niacin"--Unfortunately, no flush, no effect. This high-priced supplement is still sold widely in the U.S. despite its complete lack of efficacy. It does not work in humans. (It works great in rats!)

Track Your Plaque continues to try to be the arbiter of truth in what works, what doesn't in truly stopping or reversing your coronary plaque. The proof positive? Stopping or dropping your heart scan score.
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A dirty little secret

A dirty little secret

21. April 2007 William Davis (0)
Here's a dirty little secret many people don't know about.

If I implant a stent, I might get paid somewhere around $2000 for the heart catheterization, stent implantation, femoral artery closure device, hospitalization charges. That's not too bad.

But what if I'd like more? What if I'd like to squeeze this unsuspecting patient for more, or actually his/her insurance company?

Easy: Add on complex procedures to the basic procedure that yield more professional charges. For instance, I could perform laser angioplasty, a procedure that adds another couple thousand dollars. I might pull out the old rotational atherectomy device, a high-speed diamond tipped drill that also adds substantial professional charges. I might also use the intracoronary ultrasound device, an otherwise helpful device, but I might pull it out to use on everybody.

With the exception of ultrasound, all the "add-on" procedures were more popular in the early and mid-1990s--before they were shown in clinical studies to provide no advantage, perhaps even add to procedural risks.

Thus, a patient might undergo a heart catheterization, balloon angioplasty with stent implantation into the proximal left anterior descending coronary artery (LAD), followed by laser angioplasty of the mid-LAD, followed by intracoronary ultrasound of the vessel. Next, rotational atherectomy of the circumflex, followed by stent and ultrasound. Total charges for this 2-3 hour procedure? Somewhere around $8000 to the cardiologist. Of course, hospital charges are far more.

Ironically, patients are invariably impressed. Hearing that they went through all sort of high-tech procedures makes them grateful for receiving the benefits of the skills of their cardiologist. Of course, they would like have done as well with a far simpler procedure. Perhaps they didn't need the procedure at all.

If the excessive use of procedures and devices fails to benefit patients, why don't hospitals discourage it? Two reasons: 1) It's difficult to legislate or regulate decisions made on judgement, which can be a tough issue with many fuzzy edges, and 2) hospitals made oodles more money from the practice.

If you have a salesman in your new car lot and he outsells all his colleagues by 30-50% and makes you a couple hundred thousand a month more in sales. You've watched him at work and he's clearly good at it. But you suspect that he pushes the envelope of propriety frequently--badgering customers, add rustproofing to a little grandmother's car that will be driven 3000 miles a year, selling cars for prices far above what they would have sold for had the customer bargained more vigorously.
do you put a stop to it at the risk of pushing your star salesman away? Few would.

Only a minority of my colleagues are guilty of this despicable practice. I only know of a few who openly do it. Hopefully, you're not among their patients.
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Metabolic syndrome--cured

Metabolic syndrome--cured

27. February 2007 William Davis (0)
Peter started out at age 59 at 248 lbs, standing 6 ft tall (BMI = 33.6!).

Along with his weight, Peter had the entire panel of phenemena of the so-called "metabolic syndrome", or pre-diabetes:

--Triglycerides 238 mg/dl and associated with extremes of excess VLDL and IDL
--High blood pressure
--Blood sugar 115 mg/dl
--High c-reactive protein
--Small LDL particles 99% of total LDL

Interestingly, Peter's HDL was a surprisingly favorable 58 mg/dl (HDL is usually low in this syndrome). However, when broken down by size, he had nearly zero large, healthy HDL (sometimes called HDL2b). Though total HDL was favorable, most of it was simply ineffective.

Peter eliminated snacks and processed foods, particularly bread; increased his reliance on healthy oils and lean proteins; incorporated soy protein; increased vegetables. He added 30 minutes of a rapid walk on a treadmill every day. He added vitamin D to achieve a blood level of 50 ng/dml. He added a magnesium supplement.

Peter has lost 31 lbs. in the last year. Weight 207 lbs., BMI 28.1 (desirable <25). Blood sugar: 96 mg/dl; triglycerides: 56 mg/dl; HDL 71 mg/dl with 35% in the large fraction; small LDL 45% of total. Not perfect, but a damn site better.

Control of metabolic syndrome is an achievable goal for over 90% of people, just with these simple efforts. We haven't yet had a chance to assess the effect on the progression or regression of Peter's heart scan score, but he has, at the very least, spared himself a future of diabetes and all its complications.
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More catheterizations would make me happy!

More catheterizations would make me happy!

11. October 2006 William Davis (0)
I received this fax today from a cardiologist seeking a position:

"I would prefer to perform as many interventions [stents, angioplasties, etc.] as possible..."

That about sums it up, doesn't it? The goal of this young man, trained in major universities including Columbia University, Harvard, and Emory, is not to pursue an avenue of investigation or healthcare that yields real answers. His goal is to perform as many procedures as possible.

This attitude is deeply ingrained in cardiologists. It's also shared by all procedural medical specialties: the drive to do more and more procedures. It's not because it does more good for the public, but it fulfills a primitive impulse to spread your influence, enlarge your territory, and--of course--make more money.

Personally, I find this impulse repulsive. The fact that this young cardiologist looking for a position is willing to make this statement out in the open demonstrates how widely accepted this attitude is. Imagine your cancer surgeon, looking for a new job, said, "I'm looking to remove as many tumors as I can."

My colleagues have lost sight of the fact that we're trying to reduce or eliminate disease, not enrich our pockets or service some primitive impulse to beat others at our game.
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Do the math: 41.7 pounds per year

Do the math: 41.7 pounds per year

14. October 2011 William Davis (21)
Consumers of wheat take in, on average, 400 calories more per day. Conversely, people who eliminate wheat consume, on average, 400 calories less per day.

400 calories per day multiplied by 365 days per day equals 146,000 additional calories over the course of one year. 146,000 calories over a year equals 41.7 pounds gained per year. Over a decade, that's 417 pounds. Of course, few people actually gain this much weight over 10 years.

But this is the battle most people who follow conventional advice to "cut your fat and eat more healthy whole grains" are fighting, the constant struggle to subdue the appetite-increasing effects of the gliadin protein of wheat, pushing your appetite buttons to consume more . . . and more, and more, fighting to minimize the impact.

So, if you eat "healthy whole grains" and gain "only" 10 pounds this year, that's an incredible success, since it means that you have avoided gaining the additional 31.7 pounds that could have accumulated. It might mean having to skip meals despite your cravings, or exercising longer and harder, or sticking your finger down your throat.

400 additional calories per day times 365 days per year times 300,000,000 people in the U.S. alone . . . that's a lot of dough. Is this entire scenario an accident?

Or, of course, you could avoid the entire situation and kiss wheat goodbye . . . and lose 20, 30, or 130 pounds this year.
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Comments (21) -

  • Keenan

    10/14/2011 3:56:07 AM |

    On Sept. 10 I stopped my consumption of wheat containing foods and multi-grain rice crackers. Two weeks later I began having aching elbows which have not bothered me for years. I'm a 65 yr old male, thin with a bit of a 'wheat belly'  which is shrinking but my muscle mass is also shrinking. Have you heard of anyone experiencing changes in joints after stopping wheat and grains?

  • David Klatte

    10/14/2011 10:58:16 AM |

    That math isn't right and it is pretty misleading because a person who ate 400 more calories per day would gain weight up until they reached an equilibrium. It would be better to use something like the Harris Benedict equation to get a sense of how bad that is.

    I did that for a six foot 180 pound male who is 30 years old who is lightly active. Such an individual would maintain their weight at about 2246 calories per day. If they instead consumed 2646 calories per day, you would expect their weight to top off at about 244.7 pounds after some period of time. About a 65 pound gain, so nothing to sneeze at.

  • Dr. William Davis

    10/14/2011 12:48:30 PM |

    Hi, Keenan--

    I've only seen relief from arthritis, not a triggering of arthritis. That's strange.

    Of course, we are all subject to conditions that fall outside of wheat. It will be interesting to see whether this persists.

  • Dr. William Davis

    10/14/2011 12:49:04 PM |

    Thanks, David.

    Yes, this was hardly a scientific analysis, just an argument to graphically illustrate what we are battling.

  • Philippa

    10/14/2011 12:51:54 PM |

    This would be actionable advice across the Atlantic in the UK, where the Health Minister landed himself in a controversy this week by annoucing the Brits need to cut 5 billion calories off their annual diet.
    http://www.dailymail.co.uk/health/article-2048738/Jamie-Oliver-blasts-Andrew-Lansleys-plan-tackle-obesity.html

  • Teresa

    10/14/2011 8:23:30 PM |

    I couldn't post this below about the drug companies.  

    While I agree that a person should not be made to take medications against their will, what am I to do for a patient with a blood pressure of 220/110, on several occasions?  I have had a few.  They refused meds, and also refused to make any diet or lifestyle changes that may have helped.  While I haven't discharged any patients because of this, I do make sure they know the potential consequences of severe hypertension, including death.  Or worse, complete paralysis on one side, requiring total care.  Sometimes it's a matter of lesser evils.

    More of my patients want the  pills, because they are unwilling to do anything else to help their condition, even though I encourage them, and offer referrals for further education.  I hear it's too complicated, or their insurance won't cover it and it's too expensive.  I doubt I could make a living in my community without a prescription pad.  I wish I could!  I'll keep trying.

  • Princess Dieter

    10/14/2011 9:29:06 PM |

    Just a heads up (although you may have already seen it) is that Gillian Riley, the UK expert on food addiction/breaking out of overeating, recommended WHEAT BELLY in her October newsletter. http://www.eatingless.com/archive-newsletters.html#

    I've often recommended Ms. Riley's books--EATING LESS ; BEATING OVEREATING; and WILLPOWER!--to fellow hyperconditioned overeaters.

    Not eating wheat/sugar  sure helps in the "not overeating" dept. Laughing And Gillian is on board with that.

  • Corey

    10/14/2011 9:42:55 PM |

    Love your site doctor, but this is a terribly naive and simplistic approach. Calorie numbers are irrelevant, it's the kind of calories. Yes, I understand that the 400 you mention would most likely be 400 calories of additional carbs, but calories in/calories out don't determine weight now, do they?

    Really shouldn't post anything reinforcing the outdated but still omnipresent "calorie equilibrium" theory (fairy tale is more like it) of weight gain.

    Otherwise, keep up the good work.

  • Rieland Rigg

    10/15/2011 1:30:51 AM |

    I guess that explains pretty clearly why I've been able to lose about 40 lbs so far in 9 months... Smile

  • Ted Hutchinson

    10/15/2011 9:14:49 AM |

    If you live in the Northerm hemisphere Vitamin D levels drop from September through to March unless effective strength supplementation is implemented.
    Also 65yrs old the natural production of the antinociceptive, anti-inflammatory, antibiotic, antioxidants melatonin and vitamin d will have declined (by age 75 only 25% of vit d capacity is possible if sufficient 7-dehydrocholesterol remains in skin) so everyone becomes far more sensitive to pain/inflammation (and infection).  You can replace the missing Vitamin D3, melatonin with at least 5000iu/D3/oil based gelcap and 3mg Time Release melatonin (Also pay strict attention to improving natural melatonin secretion by using Flux getting outdoors midday and total darkness while asleep. ) Search this site for good Vitamin D3 & Melatonin information.

  • Kris

    10/15/2011 12:11:25 PM |

    A few months ago I did an experiment and cut all wheat and sugar out of my diet.

    That is, if it would contain even a trace amount I would not touch it. I managed to follow this approach for two months, I didn't measure my food intake but my body fat dropped quite a lot and I could see much more muscle definition, especially in my abdominal area.

    Personally I think sugar and wheat are the two main contributors to obesity, and I think the "minimum effective dose" for optimal health would be to remove those two ingredients completely. And of course that doesn't allow any room for "cheat meals" like some people think.

  • Dr. William Davis

    10/15/2011 1:25:26 PM |

    Well said, Chris.

    I agree. In particular, I find that no wheat is far better than less wheat. I believe this is mostly due to the appetite-triggering effect of wheat gliadin.

  • Linda

    10/15/2011 1:27:22 PM |

    @Ted
    I am also living in the Northern Hemisphere [Iowa] and do not get nearly as much sunshine as I should.I tend to be a hermit and spend most of my day inside.  Also over 65. I am taking 5000 IU a day of Vit D, gelcaps.
    Without a lot of testing, is there a way to determine if I should take more and, if so, how much. My biggest concern is tightness in the hip area every morning.

  • Dr. William Davis

    10/15/2011 1:28:17 PM |

    Well, Corey, allow me to elaborate on my "terribly naive and simplistic approach."

    This is clearly not a scientific analysis, but a simple effort to illustrate what happens with simple math what could theoretically happen with an additional 400 calories per day intake but ignoring all other factors, such as proportion fat vs. carbohydrates.

    So of course this is simplistic. It just makes the point that the increased calorie consumption triggered by wheat gliadin has potentially huge effects.

  • Dr. William Davis

    10/15/2011 1:44:40 PM |

    Good to have friends in this battle, Princess!

    We are up against the incredible financial and lobbying might of vertically-integrated Agribusiness and Big Food, who have billions of dollars to allocate on lobbying, marketing, and pushing their agenda. We have social media, the internet, and our wits.

  • Dr. William Davis

    10/15/2011 1:46:00 PM |

    Hi, Dr. Teresa--

    That's all you can do: Keep on trying.

    I'm impressed that you DO try, since most of our colleagues pay no mind whatsoever to even considering genuinely effective dietary changes.

  • Dr. William Davis

    10/15/2011 2:16:54 PM |

    Hi, Philippa--

    Let's see: England, population 51 million times 400 calories per day, times 365 days per day, equals 7.446 x 10,000,000,000,000 calories, or several thousand times more than the Health Minister proposes.

    5 billion calories would be child's play.

  • Ted Hutchinson

    10/16/2011 8:41:41 AM |

    I don't think there is any way anyone can accurately predict their 25(OH)D level either from uvb exposure or daily supplement usage. It depends on individual response. The banner graph at GRASSROOTSHEALTH.ORG shows for any regular daily intake the 25(OH)D achieved varies up to 100ng/ml. Taking 5000iu daily D3 only increases your chances of staying around 50ng/ml  but you could be anywhere between 20ng/ml and 120ng/ml without testing you can't know. After you've had a few tests you get to the point where you can predict the result but it's still worth retesting annualy to make sure nothing's changed. You should be able to find a 25(OH)D test for $60.

  • Fat Guy Weight Loss

    10/16/2011 3:11:20 PM |

    I eliminated sugar and wheat from my diet just from the observation that the food did not keep me full as long compared to other foods of same number of calories.  Not only led to weight loss but also eliminated my ocassional GERD as well as frequent stomach discomfort.  Now I have even more reasons to stay off the stuff and now being 95% wheat free (indulge in ocassional small portion of dessert) I no longer crave these foods and feel great.

  • Dr. William Davis

    10/18/2011 12:52:08 AM |

    How about "Skinny Guy Weight Loss"? (I didn't feel right calling you "Fat Guy . . .")

    It's such a simple formula for returning to health. I, personally, experienced relief from the same gastrointestinal effects. With any small indulgence, I am provided a graphic reminder of how it used to be.

    Stay strong. Your body will be grateful!

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Death to chelation?

Death to chelation?

19. May 2008 William Davis (5)

Does chelation work?

It's a question I get asked fairly frequently. Although I have never performed chelation, IV or oral, and therefore have no direct experience, my concerns for this purported therapy have included:

1) The concept of extracting calcium from atherosclerotic plaque by removing it first from the blood is absurd. Early chelationists believed that this was the means by which EDTA might reverse coronary atherosclerosis. However, removing calcium from blood would more likely lead to osteoporosis or calcium extraction from bone, since bone is a more ready repository for calcium. Blood calcium levels are also tightly and narrowly controlled; any significant reduction in calcium ("hypocalcemia") can be life-threatening. And, indeed, there have been deaths from hypocalcemia in people receiving chelation.

More recently, chelationists have argued that removal of heavy metals like lead and mercury are responsible for the purported benefits of chelation. And, indeed, blood levels of these heavy metals can be reduced by chelation. That alone may be a benefit. But to then make the leap to say that it also regresses atherosclerotic plaque by the same mechanism has no basis in science.

2) Practitioners associated with chelation tend to be shady. I have seen homeopathic therapies (among THE most ridiculous of concepts), "energy balance" therapies, desiccated organ extracts ("applied kinesiology"), and a variety of other fringe treatments offered by practitioners offering chelation. This doesn't necessarily mean, of course, that chelation is also fringe or suspect, but it tends to be offered by practitioners who engage in generally unscientific, unfounded practices.


The few people I've seen go through multiple courses of chelation (usually 30 or so infusions) have shown no impact on heart scan scores or any other measure of heart disease.

In response to the many questions I receive on chelation, I had been answering that, if we would simply wait for the publication of the NIH-sponsored trial of IV chelation therapy, perhaps we'd know once and for all.

However, in a lengthy criticism, four expert authors argue that the TACT trial to assess chelation study is doomed to failure for an entire list of reasons and should therefore be abandoned. The discussion is available on Medscape Cardiology. (Free sign-in required.)



Why the NIH Trial to Assess Chelation Therapy (TACT) Should Be Abandoned
We investigated the social and the scientific histories of chelation therapy beginning in the 1950s. We examined TACT protocols and consent forms, which, in response to Freedom of Information Act (FOIA) requests, the NIH provided to us with curious redactions. We examined the existing RCTs and the numerous case series cited by the TACT protocols. We examined evidence for risks, including information that is not in the standard medical literature. We examined various hypotheses that advocates have offered to explain how chelation "works."

We present our findings in 4 parts. First, we provide a brief history of the use of disodium EDTA as a treatment for CAD. Next, we describe the origin and nature of the TACT. Next, we discuss the evidence for chelation as a treatment for CAD and for atherosclerosis in general, and place it in the context of other proposed treatments that have been ineffective after an initial period of enthusiasm. Finally, we discuss the risks. For each topic, we contrast our findings with relevant statements in the TACT literature, to the extent that such statements exist.


Among the highlights:

--Since the mid-1970s, court documents and newspapers have reported at least 30 deaths associated with IV disodium EDTA, most of it administered by ACAM members.

--Early chelation investigators had chosen the disodium salt of EDTA, reasoning that if it could remove calcium from atherosclerotic plaques, it might shrink them. That notion was soon demonstrated to be invalid. It has largely been replaced by a "toxic heavy metals" antioxidant hypothesis, which is based on the potential for metal ions to produce free radical damage. Chelationists now cite "removing heavy metals" as the basis for their claim that chelation is effective for approximately 70 conditions, ranging from schizophrenia and autism to cancer. This provides them with numerous reasons to ignore any trial that finds chelation ineffective for CAD.

--Biochemical literature, either not cited or misrepresented in the TACT protocols, has demonstrated that the heavy metals hypothesis is implausible. Antithetically, it also demonstrates that the chelation mixture used in the TACT has pro-oxidant effects in vitro.

--In our opinion, TACT literature -- including 2 versions of the protocol, the consent form, information posted on the NCCAM Web site, and 2 editorials co-authored by the PI -- has misrepresented chelation, its risks, and the facts of the study. It has exaggerated the value of supportive case series, not only by ignoring evidence of bias and incompetence, but by misrepresenting citations and reporting erroneous data. It has minimized the dangers, both by understatements and by omissions of specific, published complications. It has not acknowledged the deaths mentioned above. It has repeatedly conflated disodium EDTA and a different drug, calcium-sodium EDTA.

--The TACT includes nearly 100 "chelation site" co-investigators who, in our opinion, are unsuitable to care for human subjects or to report trial data. Most espouse implausible health claims while denigrating proven methods; several have been disciplined, for substandard practices, by state medical boards; several have been involved in insurance fraud; at least 3 are convicted felons. Several were members of the ACAM or GLACM IRBs mentioned above. Few appear to have real expertise, required by TACT literature, in treating patients with CAD or in conducting clinical trials. Most continue to promote chelation while the TACT is in progress, contrary to good science, to human studies ethics, and to US Federal Code.


While the criticism itself does not prove the point one way or another, as a clinical trial should, anyone contemplating chelation therapy would be well-advised to read the document first. Another reference: EDTA chelation therapy for cardiovascular disease: a systematic review.


The authors of the exhaustive discussion are:
Kimball C. Atwood IV, MD, Anesthesiologist, Newton-Wellesley Hospital, Newton, Massachusetts; Assistant Clinical Professor, Tufts University School of Medicine, Boston, Massachusetts; Associate Editor, Scientific Review of Alternative Medicine
Author's email: katwood@partners.org

Elizabeth Woeckner, AB, MA, President, CIRCARE (Citizens for Responsible Care and Research), Columbia, Maryland

Robert S. Baratz, MD, DDS, PhD, Medical Director, South Shore Health Center, Inc., Braintree, Massachusetts; Assistant Clinical Professor of Medicine, Boston University School of Medicine, Boston, Massachusetts; President, National Council Against Health Fraud, Inc.

Wallace I. Sampson, MD, Clinical Professor of Medicine (Emeritus), Stanford University, Stanford, California; Senior Attending Physician and formerly Chief of Medical Oncology, Santa Clara Valley Medical Center, San Jose, California; Editor-in-Chief, Scientific Review of Alternative Medicine



The authors provided the following disclosures:


Disclosure: Kimball C. Atwood IV, MD, has disclosed no relevant financial relationships in addition to his employment.

Disclosure: Elizabeth Woeckner, AB, MA, has disclosed that she has received compensation for consulting in civil litigation and professional disciplinary actions.

Disclosure: Robert S. Baratz, MD, DDS, PhD, has disclosed that he has been retained by state licensing boards, the Office of the US Attorney, and plaintiff counsel as an expert in disciplinary proceedings and litigation with regard to chelation therapy and associated matters. He is compensated only for his time and has no commercial interest in the outcome of the proceedings or litigation.

Disclosure: Wallace I. Sampson, MD, has disclosed no relevant financial relationships in addition to his employment.
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Comments (5) -

  • Rita.

    5/19/2008 10:17:00 AM |

    Vitamins A and K2 help the body put calcium where it belongs--in bones and teeth. Vit D helps in absorbtion but the other fat solubles assist in proper incorporation away from arteries and soft tissues.

  • Jeffrey Dach MD

    5/19/2008 10:38:00 AM |

    For a more balanced view of EDTA chelation for heart disease, see the Toledo Cardiologist, James C. Roberts MD FACC

    Roberts is a practicing invasive cardiologist.  He lectures extensively on his clinical success with Phosphatidylcholine(IV or in Liposomal Oral Format with EDTA):  Reverse Cholesterol Transport and Metal Detoxification.  A DVD of his lectures is available which describes considerable clinical success with oral EDTA.

    Regarding the reference: "EDTA chelation therapy for cardiovascular disease: a systematic review".  The authors of this hatchet job make their living by denouncing chelation therapy indicating political economic motivations.  The alternate information presenting studies showing benefit was not presented.  We find the same type of denouncement in the medical literature for all types of natural therapies including the recent meta-analysis showing that vitamins increase mortality:

    Mortality in Randomized Trials of Antioxidant Supplements,Goran Bjelakovic, MD, JAMA 2007;297:842-857.

    For more on this see:

    My Vitamins Are Killing Me!

    Jeffrey Dach MD

  • Anonymous

    5/21/2008 9:56:00 PM |

    Rita, how much K2 would you recommend someone take and as I believe there are a number of different subsets of K2 which one or brand would you recommend?

  • jpatti

    6/4/2008 4:32:00 PM |

    I think chelation is silly, but on the other hand, I'd rather be a subject in this study than in the one where they wanna do prophylactic bypasses on diabetics.

    As for the K2 question, I recommend Twinlab D3/K2 dots.  I don't believe anyone knows how much K2 is ideal yet, so I just dose them to my D3 serum levels and take the K2 that comes along with them.

  • kenneth

    2/25/2011 5:14:57 PM |

    chelationists=devils workers

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Quieting the insulin storm

Quieting the insulin storm

1. November 2008 William Davis (15)
The cycle of eating, satiety, and hunger is largely driven by insulin and blood sugar responses.

For instance, if I eat a bowl of Cheerios, my blood sugar will surge to 140 mg/dl or higher (how high depending on insulin sensitivity). The flood of sugar from this Frankenfood triggers the release of insulin; blood sugar then settles back down.

The decline in blood sugar back down to normal or below normal powerfully triggers hunger. Variable degrees of shakiness, mental fogginess, and irritability also commonly occur. Most people experience this to some extent; some experience an exagerrated version called "reactive hypoglycemmia" and can suffer peculiar personality changes, irrational and even violent behavior.

Foods made with wheat or cornstarch raise blood sugar higher and faster than table sugar. Accordingly, blood sugar and insulin swing more widely with these food: highs are higher, lows are lower. People who therefore follow the standard mantra of "eat plenty of healthy whole grains" therefore experience a 2-3 hour long cycle of eating, brief satiety, and recurrent hunger. Cravings for snacks, impulsive eating, and overeating all occur during the period when blood sugar has dropped and hunger is powerfully triggered.

Eliminating this up and down fluctuation is therefore key to regaining control over appetite, losing weight, reducing small LDL and triglycerides, reducing blood sugar, and putting out the fires of inflammatory responses.

You can accomplish this by:

1) Eliminating foods that trigger the exagerrated rises in blood sugar--Wheat, cornstarch, polished rices, white and red potatoes, and candy.

2) Adding a healthy oil to every meal--a strategy that prolongs satiety and helps suppress sugar-insulin fluctuations.


The ful nuts and bolts details of this diet will be released with the New Track Your Plaque Diet. Part I has already been released; part II is coming any day on the Track Your Plaque website.
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Comments (15) -

  • Anne

    11/2/2008 11:08:00 AM |

    I bought your book 'Track Your Plaque' just over eight months ago and I am rather upset that you are bringing out changes to it which are only available to members of the TYP website. I cannot afford to join TYP and I guess the book is now out of date in parts :-(

    Anne

  • Peter Silverman

    11/2/2008 12:29:00 PM |

    I have to wonder why the countries that eat huge amounts of rice, Japan for instance, usually have such low rates of diabetes and heart disease.

  • Anonymous

    11/2/2008 7:00:00 PM |

    It's all quite confusing: Doctors such as Gundry advise eating even whole fruit, while other such as McDougall and Ornish say eat all you want. This simply shows that insulin control is poorly understood. What's a body to do?

  • madcook

    11/3/2008 1:19:00 AM |

    I am so looking forward to the debut of your new TYP diet plan.  Part I was interesting, but I am really looking forward having all the details in a concise format.

    I am also looking forward to the updated edition of Track Your Plaque, which I believe is due out next Spring.  We have learned so much about prevention and reversal in the past 5 or so years, an update is the logical progression!

    Thanks for all of your efforts on this blog, and on the TYP website.

    Terri
    madcook

  • Scott Miller

    11/3/2008 3:59:00 AM |

    Dr. Davis, I have spent 4-5 hours this weekend reading your blog, from the oldest post to the newest. I am a self-taught wellness expert (relative to most people--always learning, of course) of 12 years, having read over 200 books, and countless articles, blogs, newsletters, and I participate in numerous health forums. I specifically focus on longevity techniques, including strength training, nutrition, HRT and supplements (90-ish daily). At 47 yrs I'm in superb health, 11% bodyfat, and look 35-ish to most people. I test over 125 bio-markers 3 times every 2 years, via Kronos Labs.

    Anyway, I think your blog is superb and I have already begun recommending it to many others--as an influential person in the longevity community, I hope it drums up more readers for your enlightened straight talk.

    As enlightened as you are (relative to the vast majority of your colleagues), there are still numerous areas you haven't touched upon that are greatly beneficial to the goal of preventing & reversing heart disease. For example, the reduction and/or reversing of advanced glycation end-products, which is a key component to my supplement program, and many others in a similar position as me. Also, free testosterone is another critical factor that correlates with heart disease (practically all men over 35 have reduced free testosterone, leading to reduced vascular protection).

    Practically *everything* you have written agrees with the basic truths we've come to understand in the longevity community, such as grains being unhealthy, along with oxidized small LDL, low-fat diets (my diet is approx. 50% fat in terms of cals), and so on. Plus, you've accepted and seen the importance of D3, K2, you gave one post to cocoa (cocoa deserves a LOT more attention!), and you've mentioned resveratrol. But you're missing several others that can significant help, such as pomegranate extract (punicalagins), blueberry extract (pterostilebene--a resveratrol-like molecule), and GliSODin (brand name for a supp that elevates the plaque reversing natural antioxidant, sodium dismutase).

    Keep up the great crusade! But for all of us, there's still more to learn...

  • Anonymous

    11/3/2008 7:24:00 AM |

    I don't know what a "body" is to do, but apparently what PETA members are doing is trolling the net in a desperate attempt to spread disinformation about low-carb, since the science is so persuasively in its favor.

    "Poorly understood" my ass!

  • Anne

    11/3/2008 12:11:00 PM |

    I have had great success in reducing my blood sugar spikes by using a glucometer to identify foods that cause it to rise. I have found I can have fruit if I keep the serving very small. I do best with berries. My blood sugar use to zoom up to 200 after eating, now I can keep my blood sugar from going over 120 with food choices alone. I hope this is low enough.

    I followed the directions in Blood Sugar 101 on how/when to use the glucometer. Blood Sugar 101 is a blog and a book.

    Gluten Free Anne

  • Anonymous

    11/3/2008 6:19:00 PM |

    " I have to wonder why the countries that eat huge amounts of rice, Japan for instance, usually have such low rates of diabetes and heart disease."

    But don't individual Japanese tend to eat small portions frequently as opposed to the mounds that we Westerners consume at a sitting.

  • Dr. William Davis

    11/3/2008 8:23:00 PM |

    Hi, Scott--

    Thanks for your kind comments.

    Some of these topics are covered in the Track Your Plaque website. Others, like the Superoxide Dismutase, I am awaiting more persuasive real human experience with.

    I am also mindful of not deconstructing diet too much. In other words, I'd like to avoid replacing healthy foods with isolated components that recreate the effect of these foods.

    Nonetheless, your observation is similar to mine: many of us are heading in parallel in the same direction.

  • Dr. William Davis

    11/3/2008 8:27:00 PM |

    Peter--

    I am half Japanese and my Mom would cook us traditional Japanese fare when we were kids.

    Yes, we did eat rice, but the portions were modest. Rice also seems to lack the addiction potential of wheat and doesn't quite trigger blood sugar quite as profoundly. That said, I still think we should minimize our exposure to rice and rice products.

  • Scott Miller

    11/4/2008 3:07:00 AM |

    Something else I will add just as food for thought. Just as there are natural solutions to reversing heart disease and calcification (although, few doctors practise these solutions due the the extreme bias of using FDA-approved solutions), there are ALSO non-FDA-approved, yet highly effective ways of beating cancer, even many if not most terminal cancers.

    You will not find these solutions with the conventional wisdom of the American medical system.  But again, just as they exist for heart disease, there's a whole set of solutions that also work against cancer.  In fact, some of these solutions are the same, such as resveratrol, marine-based omega-3's and vit. D3.  Resveratrol, especially, deserves special mention as it combats cancer in the five currently known ways that cancer can be defeated, and without any negative effects.  No FDA-approved drug attacks cancer in more than one of these five ways, and none are side effect free.

    Many people have been cured of terminal cancer, by taking matters into their own hands, including a 70-yr-old genetic biologist who started mega-dosing on resveratrol after learning he only had a few months to live with leukemia -- that was four years ago, and he shows no signs of this cancer.

    Oncologist are just as bad as most cardiologist (of which Dr. Davis is a rare exception) when it comes to using money-making treatments like radiation and toxic chemo, while not recommending their patients, for example, stop eating simple carbs and grains, which merely feed cancer's growth like pouring gas on a fire.

    I wish we had a blog written by a practising oncologist as enlightened as Dr. Davis. The results would be just as fantastic, because the solutions to cancer are just as real and effect as the solutions to reversing heart disease.

  • Anna

    11/4/2008 7:23:00 PM |

    Peter,

    Have you ever been to Japan?   The differences between Japan and the US are far more complex than diet book writers and epidemiologists like to suggest.   Yet they can't resist distilling one or two obvious features of Japanese diets as reasons for better health and longevity.  But it wouldn't be wise (it's already been done with soy and that's been a huge, sad joke).  

    Aside from the huge differences between American and Japanese diets, cooking methods, and food production systems, we must consider vastly different social norms, which can't be overlooked.  

    America is a nation of people focussed on their individuality; Japan is a nation of people focussed on the group.  Those powerfully opposing ways of interacting.  I'm  not suggesting one is better than the other, just that they provide a different context to life in each place.  

    Even if we adopted a handful of Japanese foods that were scientifically proven to be of benefit to longevity and health, without the overall context of food and living in Japanese culture, I seriously doubt we'd start to see even a glimpse of Japan's health and longevity statistics here.

  • Dr. B G

    11/5/2008 6:14:00 AM |

    Scott,

    You make interesting parallel observations.

    Oncologists are often reimbursed by the RADS (dose of radiation) ordered.  There currently is no incentive for radiation-sparing treatment in other words. Much like cardiovascular prevention, my understanding is that no ICD (billing code) exists for obtaining reimbursement for consultation, nutritional counseling or office visits for coronary prevention at this time (in Medicare or elsewhere).

    Sad state of affairs, right?

    It's all upon the shoulders of self-empowered, fully-aware, intelligent people like you who do not feel entitled to a 'MAGIC PILL' that will solve everything...  ha haaa!

    -G

  • Dr. B G

    11/5/2008 6:14:00 AM |

    Scott,

    You make interesting parallel observations.

    Oncologists are often reimbursed by the RADS (dose of radiation) ordered.  There currently is no incentive for radiation-sparing treatment in other words. Much like cardiovascular prevention, my understanding is that no ICD (billing code) exists for obtaining reimbursement for consultation, nutritional counseling or office visits for coronary prevention at this time (in Medicare or elsewhere).

    Sad state of affairs, right?

    It's all upon the shoulders of self-empowered, fully-aware, intelligent people like you who do not feel entitled to a 'MAGIC PILL' that will solve everything...  ha haaa!

    -G

  • buy jeans

    11/2/2010 8:25:30 PM |

    Eliminating this up and down fluctuation is therefore key to regaining control over appetite, losing weight, reducing small LDL and triglycerides, reducing blood sugar, and putting out the fires of inflammatory responses

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When meat is not just meat

When meat is not just meat

18. December 2007 William Davis (7)

The edgy nutrition advocate, Mike Adams, over at NewsTarget.com came up with this scary photo tour of a processed meat product from Oscar Mayer: Mystery Meat Macrophotography: A NewsTarget PhotoTour by Mike Adams







Along with increasingly close-up photographs of this meat-product, Adams lists the ingredients in Oscar Mayer's Cotto Salami:


Beef hearts
Pork
Water
Corn syrup
Beef

Contains less than 2% of:
Salt
Sodium lactate
Flavor
Sodium phosphates
Sodium diacetate
Sodium erythorbate
Dextrose
Sodium nitrite
Soy lecithin
Potassium phosphate
Potassium chloride
Sugar


As I reconsider the role of saturated fat in diet, given the startlingly insightful discussion by Gary Taubes of Good Calories, Bad Calories, I am reminded that not all meat is meat, not all saturated fat sources are equal.

I am concerned in particular about sodium nitrite content, a color-fixer added to cured meats that caused a stir in the 1970s when data suggesting a carcinogenic effect surfaced. The public's effort to remove sodium nitrite from the food supply was vigorously opposed by the meat council and it remains in cured meats like sausage, hot dogs, and processed meats like Cotto Salami. A 2006 meta-analysis (combined analysis of studies) of 63 studies did indeed suggest that sodium nitrite was related to increased risk of gastric cancer. This argument is plausible from animal models of cancer risk, as 40 animal models have likewise suggested the same carcinogenic association.

Also, fructose? This is most likely added for sweetness. Recall that fructose heightens appetite and raises triglycerides substantially.

I personally have a natural aversion to meat. I don't like the taste, the look, smell, and the thought of what the animal went through to make it to the supermarket. But, considered from the cold, carnivorous viewpoint of the question, "Is meat okay to eat?", among the issues to consider is whether the meat has been cured or processed, and does that process include addition of sodium nitrite.

Cotto Salami and similar products are not, of course, what carnivorous humans in the wild ate. This is a processed, modified product created from factory farm animals raised in cramped conditions and fed corn and other cheap, available foods. It is not created from free-ranging animals wandering their pastures or pens, eating diets nature intended. This results in modified fat composition, not to mention hormones and antibiotics added. These are not listed on the ingredients. Wild meat does not contain fructose or color-fixers, either.

So don't mistake "meat" in your grocery store for meat. It might look and smell the same--until you look a little closer.



Copyright 2007 William Davis, MD
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Comments (7) -

  • Nancy M.

    12/18/2007 3:04:00 PM |

    Wasn't Good Calories, Bad Calories good?  Man, just what the medical world needs, a good wake-up call into how schlocky their science is (sometimes).  

    Did you finish the book yet?  Parts of it infuriated me at the stupidity and arrogance of people.  And I have to say it is getting harder and harder to have respect for medical "authorities" when you know the horrible science their training was based on, that they don't question the basis for these assumptions yet assume their patients are all idiots.

    I'd love to hear more of your comments on his book if you get a chance to blog about them.

  • MAC

    12/18/2007 3:05:00 PM |

    Would be interested in any comments you have as you "reconsider the role of saturated fat in diet" as a low carb diet appears to be beneficial in raising HDL.

    This research  from Jeff Volek was of interest: Jeff Volek, et al: Low carb diet reduces inflammation and blood saturated fat in Metabolic Syndrome. http://www.sciencedaily.com/releases/2007/12/071203091236.htm

    Also, Cordain makes the case in his FAQ for the Paleo Diet that saturated fat averaged 11% in wild animal carcasses.

  • Ross

    12/18/2007 5:50:00 PM |

    If you're going to buy something like salami, ham, bacon, sausage, or other meat product, the best source is often a deli that makes it on site.  Not only will the salami, ham, or sausage be made with fewer ingredients, but it's much tastier, fresher, and often a similar cost to mass-marketed processed meats.  

    This will not be practical for people everywhere.  Living in LA as I do, there are specialty delis all over the place and it isn't too hard to find locally made sausage, etc.  One alternative would be a deli that takes great pride in presenting the craft-made meat products of a smaller supplier.

    I've actually ignored what might be the best option of all, which is to make it yourself.  Simple ham, proscuitto, bacon, salami, many different kinds of sausage, etc. can all be made in the home with inexpensive tools and (for proscuitto and salami) a decent dry place where they won't be disturbed.  It's also fun!

    But at all costs, avoid anything made by oscar mayer or any other mass produced meat product.  It's all crap.

  • chickadeenorth

    12/20/2007 5:26:00 AM |

    Even Dr Atkins said no meats allowed that are processed or have nitrates, only meats like our ancestors ate, he said it was like "the kiss of death".I don't even considered those types of meat to have sat fats, but poision, they are all part of Franken foods to me, like Snackwell cookies.. If I have sausage I get a local German butcher to make organic elk meat into garlic sausage for us.To me low carb means nutrient dense whole foods.

  • Dr. Davis

    12/20/2007 5:36:00 AM |

    What's frightening is that, whenever I've discussed the Atkins' approach with people doing it on their own, they've virtually always included plentiful cured and processed meats.

    Somehow that part of the message didn't get stressed enough.

  • Dr. Davis

    12/20/2007 5:38:00 AM |

    In response to Nancy's first post:

    I'm embarassed to admit that Taubes was so tremendously unique and entertaining (in a nerdy sort of way) that I've savored each discussion slowly and carefully. So it's literally taken me two months to read his book. But I have enjoyed every word.

  • chickadeenorth

    12/21/2007 7:21:00 AM |

    Yes I think those of us who used the board and forum understood it better and we could call his office and talk to his nurse or leave him a question, lots misconstrued they should eat a lb  bacon a day, He said no nitrates and sat fats under 20 gr a day.I learned his big boo boo was eventually incorporating rungs adding breads, potatoes etc, they are the kiss of death IMHO.

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