Hmmm the Kitavans break your first rule and they don't have any signs of heart disease.

Danny,

Multifactorial, much?  And of the 20% or so of TEI from fat, the Kitavans consumed most of that as SFA.  Quite a bit different from the Ornish recommended screw you fat down as low as you can go approach.

Hmmm... maybe they're good on the other 9 steps perhaps???

I'm just curious about the inclusion of a multivitamin. How does a multi increase your chances of a heart attack? Maybe the ones with iron? Thanks

Elliot

I would love to know the reasons behind these - would you be interested in posting brief explanations?

I'm assuming the multi-vitamin is included for those types who can eat shite but as long as they are swallowing 20 vitamins & minerals everyday, they'll be fine and dandy... no need to change your diet when you can get everything you need from a pill you know.

Very good advice for thrill seakers. Perhaps, to make it even more exciting, you can advice them to consume lots of omega 6 containing vegetable oils. VBR Hans

This post is something one has to ead carefully as far as heart health is concerned. A source of information like this will help you understand so much about your health and how to deal with unexpected illness like heart attack.

To me, if one learns something about health, it shows how care for yourself and how good you take care of your precious body.

I say well done ! doc.

The Eades have a chapter about iron overload. Basically, our bodies have no mechanism for ridding excess iron, this historically happened naturally through blood loss: trauma and parasites. Then there's the famous study showing that beta carotene and vit A supplementation (18,000 people!) http://content.nejm.org/cgi/content/abstract/334/18/1150 Better to get things in their natural state, like from a vegetable, rather than popping a Centrum. I use a few supplements, mostly to try and make up for what I perceive as lacking from modern lifestyle, vit D for inadequate sunlight, coQ10 for lack of organ meat consumption, etc. I chucked the Centrum.

Danny, the Kitavans also smoke a lot, so hey, that must be really good for your heart, also!

oops ... showed that vit A and beta carotene actually increased death rates by 28% for people at risk for lung cancer. The CARET study.

@Danny

It depends if you consider coconut and fatty acids from fish as low-fat foods...i know i don't.

Kurt Harris will tell you about the Kitavans, Danny

http://www.paleonu.com/panu-weblog/2009/11/2/im-so-bored-with-the-kitavans.html

I have to say: On my old "American" diet, my LDL was 155, on a 20% fat diet, it was 113, and on a 10% fat diet, it was 95.

Oh, my.  Well, I don't do any of these things any longer, so that's good.  However, I recently switched to natural sea salt after reading Sally Fallon's Nourishing Traditions, which is not fortified with added iodine.  Should I go back to the processed, bleached stuff?  I really don't want to, so how should I make sure I get enough iodine?

I would've kept my high-fat diet going for heart health, but I got tired of having chest pains.

@Jan: No way, never go back to regular table salt. Stick with the good stuff. We have used Redmond's for years now and I was happily surprised when I first visited our new family doc and saw an empty Redmond's bag on his desk. I asked him why he had it there and he said it's the only salt he recommends to all his patients. My nurse (part of the same practice) actually told me to mix a tsp. of Redmond's in a glass of water each day for my thyroid. I also take supplemental iodine... and Vit.D because we live so far north we don't get much natural D absorption here, something about the angle of the rays.

Pretty much I follow your advice but it seems like there are lots of indigenous cultures that eat unrefined carbs and seem to be much healthier than us.

So what about Okinawa, Sardinia, Costa Rica and other places where little meat is consumed?  How do they live to be 100?

In Okinawa they eat a lot of pork and cook everything in lard.

I eat breakfast cereal because it's the simplest thing to prepare. All I need to do is mix milk and cereal and I'm done. In my half awake state, I funnel it into my tummy and I'm done.

What is a good substitute for cereal that follows this beautiful simplicity? Help me check #3 off the list.

-- Boris

Dr. Davis,

With respect to iodine, do you have any feelings regarding the use of granulated kelp?  For a while I had toyed with the idea of mixing it in a shaker with the seal salt I use, however the issue of arsenic levels made me hesitant to go that route.

-Robert Daly

@praguestepchild.  Well I can see by your picture that you are male.  For  50% of the population, menstruation might be a possible regular blood loss event. Just sayin'

My mother has #11: have your grown children live with you.

I didn't tell her that #12, in susceptible individuals, is to live with your parents.

Re: iodine, I eat dulse, a wild Atlantic sea vegetable (read: seaweed). Properly prepared, it tastes good to me. To rehydrate it, I put it in a sealed container with salad overnight.

The package says a 1/3 cup serving has 780% of the RDA of iodine and only 3g of carb, 2g of which are fiber.

Please submit a clarification or list of what one SHOULD DO (instead ) DO rather than the list of things here - I'm completely confused now! - I'd like some sort of explanation  - I want to ensure that I have an excellent lipid profile, low cholesterol and low risk or neglible heart disease and atherosclerosis, what SHOULD one do ???

While I don't use Dr Esselstyn's diet I'm impressed that 100s of his heart disease patients have totally avoided repeat heart attacks by avoiding animal fat.  This record goes back decades.  I've taken Dr Davis' advice and generally avoid wheat (except for a little wheat germ) but I see nothing wrong with unprocessed grains for most people.
http://www.youtube.com/watch?v=AYTf0z_zVs0&feature=channel

Anon,

If you read this blog on a regular basis, you'd know what to DO.
DO your homework!

Jeanne

Love to get your take on this Dr. Davis: http://www.msnbc.msn.com/id/38007231/ns/health-diabetes/

Dr Davis,

Speaking of heart attacks, a friend of mine's wife is in the hospital as we speak with heart attack symptoms. (Chest pains, numbness in arm, sweating, etc).  She is only 42 years old. They have been running a series of tests including the tropinin test from the sounds of what he describes, which has been flutuating up and down to high of 13. They have done a Catheter Angiography amd say everything "looks fine", with no blockages, and say they are puzzled at this point. They don't want to release her due the the chest pains and tropinin test and are considering tranferring her to another hospital.  Any ideas? also, does the cardio angiography rule out plaque blockages?

Thanks!
Kent

What's wrong with yogurt?

Hey folks,
I see that the moderator side of things for this blog appears to have gone away in that posts appear straight away.  No doubt some culling will occur.

For those who are new, check out this blog for key items such as Vitamin D, Vitamin K2, LDL particle size (making the distribution mode larger),  HDL (increasing it), effect of Niacin on LDL and tryglycerides (dropping), impact of low fat/high carbs diets on type II diabetes, Iodine impact on thyroid function and finally Omega 3/fish oil intake.

All this info is on this blog or you can download an interview of Dr Davis with Jimmy Moore of http://livinlavidalowcarb.com

As someone mentioned, you should do your own homework, and make your decision on what is best

other sources, Baylor College's www.lipidsonline.org  and the Med journal Circulation, eg http://www.circ.ahajournals.org/cgi/content/full/99/4/591 tells you about antioxidants.

This blog, IMHO, is a good motivator and launch point for literature research.  If you need more hand holding then spring for the TYP subscription, what is your health worth to you?.  Personally, I am fine with the web and that has given me the confidence I need to chose diet and ask questions of my FP.

I take a 20mg statin with 2.5g Niacin (most effective combination to lower trigs and reduce CAD event...See lipidsonline.org ), I eat mostly vegetarian but some fish. I have steered away from high amounts of wheat, based on information presented in this blog, and lowered my exposure to PUFAs based on Chris Masterjohn's blog (http://www.cholesterol-and-health.com/Vegetarianism.html .  Vitamin D3 normalization (8000IU),  3g DHA/EPA and 120mu vitamin K2 round out the preventative measures for me personally,  Some other folks will swear by their approach. One size does not fit all.  Make an informed decision based on a dialog with your doctor.  

be healthy, not paranoid
Trevor

Lori--

I love your numbers 11 and 12!


Jamie--

My comment about multivitamins was not meant to bash multivitamins per se. People often say to me, "I don't need to take vitamin D, fish oil, magnesium, iodine, etc. because I already take a multivitamin."

It is folly to believe that you can obtain all you need from a multivitamin. It would have to be the size of a golf ball.

Trevor again..... one other good source for nubbies

http://dhaomega3.org

Dr Bruce Holub University of Guelph

shows biggest risk factors for all-cause morbidity (1st smoking, 2nd high blood pressure). 70% higher risk of CAD event from the combination of High Trigs and low HDL.... DHA/EPA Omega3 is key to lowering risk factors

@ Trevor

Wonderful summation Trevor. Most of the answers are here in Dr. Davis' blog.  With your dose of Statin, why aren't you taking CoQ10?

@ anonymous Trevor
Cholesterol Lowering, Cardiovascular Diseases, and the Rosuvastatin-JUPITER Controversy
A Critical Reappraisal The results of the trial do not support the use of statin treatment for primary prevention of cardiovascular diseases and raise troubling questions concerning the role of commercial sponsors.

I recently saw a cardiologist to get an order for a second EBCT and I explained to him how I increased my HDL from 32 to 71.  I could see that he didn't have a frame of reference for processing that information.  He also commented on how all he knew about nutrition was what he learned in medical school.  I simply remarked "I understand".  I don't think he meets many well-informed patients.

He also didn't think it was possible to reduce the calcium score.  Assuming he follows the ten rules listed by Dr. Davis, I think it's safe to say he never will.

@ Ted,
I hear you. That was a pretty dumb move by AstraZeneca.  Healthy people with no risk profile should not take any drugs "just in case".  

Combination therapy of niacin and statin lowers the risk on CAD events by almost 90%

@ Anon,
I have used CoQ10 at the suggestion of my family physician.  But not so convinced of the need/expenditure.
Trevor

[citations needed]

6 months ago after following a vegan diet my HDL had dropped to 21 and triglycerides were at 256. Now, with low-carb, niacin, vitamin d and fish oil HDL is at 61 with triglycerides at 98.

What about people with the APOe 3/4 genetics? I was told by Berkley Labs that fish oils actually do the reverse for people like me. I  have had a 3 way bipass, am 52 yrs. old and can't get my HDL up past 32, even with 1500 mg niaspan. On an extremly low fat diet LDL went down to 76 but HDL didnt go up. What should a person do if they have hyperlipidemia and are APOe 3/4?

Dr. Davis
I sure wish I could find the truth for Apoe 3/4 people. I get conflicting reports about fats. I have spent the last 3 mo. researching and can see that your info is good for most people. What about us? I know that efa's are important to help ward off alzheimers, but I have been told that I can't process them and should count them in my daily fat allowance. Also Berkleys research showed that omega 3 helped all heart patients except APOe 3/4. What am I going to do? Yvonne

Hi, Yvonne--

We will be having some conversations about the influence of Apo E genetics on dietary considerations in a future Track Your Plaque discussion.

Your tips are really great. Thanks for sharing such a great post.

For the question about cereal for breakfast, use cooked brown rice or other whole grain cereal, gluten free if necessary.  Put it in the crock pot overnight with grass fed pastured milk, butter, honey and nutmeg or cinnamon.  Or crock pot it with delicious bone broth and some animal fat.  Add some lovely pastured cream and butter in the morning and a few bananas or berries, depending on the flavors you have going.  In the morning, just spoon it up and enjoy.  

Next day if you have time, after it congeals in the frig, slice and saute it in bacon fat or butter until the edges are crispy.  Serve with a couple of over easy pastured soy free eggs.   MMMM!

Dear Dr. Davis,

I'm new to your blog, which I find very interesting and full of what appears to be insightful comments and recommendations. I also find your "unorthodox" stance in many issues very refreshing. I would like to know:
1.have you published research backing the advice you give on your blog?
2. have your work been peer reviewed?
3. could you, please, let me know where I can find them?

Thanks in advance for your help.

Dr. Davis,

I really appreciate it if you could provide an answer to my previous comment regarding research backing your advice.

Thanks!

Dear Dr. Davis,

I'm extremely disappointed you haven't answered my question regarding your research, either in this forum or via e-mail. I want to give you the benefit of the doubt, otherwise I would have to conclude that your advice is baseless and does not carry any scientific weight.

most of the stuff makes sense, but what is the issue with multi vitamins?

I often soak raw almonds (and other nuts) about 24 hours in filtered water with sea salt, then dry them a day or two at about 150°F in the oven.  I doubt the studies take this kind of "processing" into account, but any idea how that might change the absorption scenario?

I'm glad you posted this.  A few women I know have been wary of eating many nuts for fear that fatty nuts would cause them to gain weight.  

Really like the little bit on healthy gut flora caused by almonds too.  A healthy gut is important to me.

I would certainly agree that it is possible to eat enormous quantities of nuts without absorbing all of their calories. I noticed I could remain weight stable while sedentary and eating 3,500 calories back when I used to eat large quantities of nuts. Even when well chewed a proportion of them end up you-know-where! Just flush...

Peter

Dr. Davis, this is a great example. Thanks for posting it. I have a question on the 88 calories. I tried to work through the calculations to demonstrate this to one of my clients. I couldn't come up with 88 calories per ounce.

I kept coming up with 80 and here's how. 50% calories from fat is 63. I used 50% for protein and digestible carbs - based on the info provided. For protein, that leaves 3 gms or 12 calories. For carbs, half of 2.5 gms is 1.25 gms, which equals 5 cals. These add up to 80 (63 + 12 + 5).

I’m probably making a silly mistake but I’d like to come up with the same numbers when demonstrating this to clients – makes me feel kind of silly.

Thanks again for the blog, I greatly appreciate the information you post.

Brian

Does pasteurization affect the positive effect almonds have on gut bacteria? Last year it became manditory that all California almonds must be pastuerized by one of these methods: fumigation with propylene oxide, blanching and oil roasting. This is to prevent salmonella. http://www.almondboard.com/Programs/content.cfm?ItemNumber=890&snItemNumber=450

I eat a handful of almonds just about every day. I have wondered if there benefits have been compromised.

The study was sponsored by The Californian Almond Association

In the era of the 64-oz. soda, the 1,200-calorie burger, food companies now produce enough each day for every American to consume 3,800 calories per day as compared to the 2,350 needed for survival. Not only adults but kids are also consuming far more calories than they can possibly use. http://www.phentermine-effects.com

For a long time I've suspected that some foods are very inefficiently absorbed. I've particularly suspected that raw nuts are relatively poorly absorbed and thus yield only a fraction of the calories ingested.

Dr. Davis, your readers may be interested to listen to a recent BBC Radio 4 program which takes a close look at some impressive-sounding figures obtained from statin drug trials and shows how they are in fact not in the least bit impressive (e.g. a reduction in mortality from 3 in 600 people to 2 in 600 being hyped by statin manufacturers as being an over 33% reduction! Brings to mind Disraeli's adage about damned lies and statistics.

The take home message is that statins appear to be hugely over-subscribed - the UK is gaining on the US in this regard - and statins are of no benefit for 99% of people taking them for primary prevention of heart disease.

You can listen to the program online using the BBC Real Player at this link. Click Listen Live at the top right of the screen.

My apologies, it appears that the BBC radio 4 program (The Investigation) about statins is no longer available. I think the show's transcript will be made available in due course.

If anyone would like me to send them the mp3 file of the show (shhh, don't tell the BBC!), please leave a comment here. It's a worthwhile listen.

I would like to know how long one can expect to lengthen their life by taking a statin How many actual years does it add to your life and what about the risk of cancer from taking statins over a 20-30 year period?