The disastrous results of a low-fat diet

4. November 2009 William Davis (16)
Rob was never that committed to following the program in the first place.

I met Rob because of a modest heart scan score and consultation for a cholesterol abnormality. Rob had been cycled through all the statin agents by his primary care physician, all of which resulted in terrible muscle aches that he found intolerable.

I started out, as usual, characterizing his cholesterol abnormality with lipoprotein testing (NMR):

LDL particle number 1489 nmol/L
LDL cholesterol (Friedewald calculation) 143 mg/dl
Small LDL 52% of total LDL
HDL 50 mg/dl
Triglycerides 82 mg/dl

(LDL particle number is the emerging gold standard for LDL quantification, superior to calculated or Friedewald LDL cholesterol for prediction of cardiovascular events.)

Rob is a busy guy. After only a couple of brief visits, life and work got in the way and Rob let his attentions drift away from heart health. Since the information I provided made little impact on his thinking, he reverted to the low-fat diet his primary care doctor had originally prescribed and that he read about in magazines and food packages. He also ran out of the basic supplements I had advised, including fish oil and vitamin D, and just never restarted them.

A couple of years passed and Rob decided that just poking around on his own might not cut it. So he came back to the office. We repeated his NMR lipoprotein analysis:

LDL particle number 2699 nmol/L
LDL cholesterol (Friedewald calculation) 229 mg/dl
Small LDL 81% of total LDL
HDL 53 mg/dl
Triglycerides 78 mg/dl


Two years of a low-fat diet had caused Rob's LDL particle number to skyrocket by 81%, nearly all due to an explosion of small LDL. Recall that small LDL is more susceptible to oxidation, more inflammation-provoking, more adhesive--the form of LDL particles most likely to cause heart disease.

Also, note that, despite the enormous increase in small LDL, HDL and triglycerides remained favorable. This counters the popular rule-of-thumb offered by some that small LDL is not present when HDL is "normal."

Low-fat diets as commonly practiced are enormously destructive. In Rob's case, a low-fat diet caused both calculated Friedewald LDL as well as LDL particle number to increase dramatically. In many other people, low-fat diets increase calculated Friedewald LDL modestly or not at all, but cause the more accurate LDL particle number to increase significantly, all due to small LDL.

I'm happy to say that, once Rob witnessed how far wrong he could go on the wrong program, he's back on Track. (Sorry, pun intended.) He has resumed his supplements and eliminated the food triggers of small LDL--wheat, cornstarch, and sugars.
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Comments (16) -

  • Jim Purdy

    11/4/2009 3:06:47 PM |

    Wheat, cornstarch, and sugars ... all have been out of my diet for a while now.

    I really appreciate the information and advice in your blog.

  • Nancy LC

    11/4/2009 6:02:11 PM |

    Dr. Davis,

    There's a belief in the low carb community that if triglycerides are low that LDL tends to be the large, buoyant sort that isn't problematic.  But this fellow's triglycerides are fairly low and clearly he has an issue.  What do you think?  Can one depend on having the harmless sort of LDL if you've cut out the grains and sugars?

  • 8bitpixel

    11/4/2009 9:09:41 PM |

    When can we expect an update on his numbers?

  • LPaForLife

    11/4/2009 9:54:12 PM |

    A low fat high carb diet reduced my HDL big time and didn't effect my total LDL much. This seems quite different from these results. I thought low fat usually reduces HDL. Am I wrong?

  • Jeff

    11/4/2009 10:05:49 PM |

    What are the sources of cornstarch? I can't think of anything that has cornstarch in it except, well, cornstarch.

  • Dr. William Davis

    11/4/2009 11:48:36 PM |

    Hi, Nancy--

    No, you cannot.

    Humans are a hodgepodge of varying genetic tendencies. While elimination of these small LDL triggering foods reduces small LDL, it doesn't always eliminate them, especially in the genetically predisposed.

  • Joe D

    11/5/2009 1:41:55 AM |

    I don't want to waste your time, but in case you don't know: I (and maybe others) received this email today. It was marked as "SPAM" but I opened it anyway since it had your name on it. If you didn't authorize it maybe you should mention it in your blog. Thanks. Joe.

    From: Dr. Davis - PharmaNutrients (email addressed followed) hilary at pharmanutrients.com
    Subject: Dr. Davis recommends Cardio for optimal heart health
    Date: November 4, 2009 8:02:02 AM MST

    http://www.pharmanutrients.com/cardio-landing-a

  • AMK

    11/5/2009 6:55:57 AM |

    Supplements can be of great help in getting rid of free radicals  to our body.  A good source of vitamins and antioxidants to suffice what we lack from food intake.

  • Dave Brown

    11/5/2009 11:08:15 AM |

    Hello Dr.,

    So if after eliminating wheat, cornstarch and sugars the lipoprotein test still show a high percentage of small LDL particles (probably due to genetics) - What could be done next?

  • Dr. William Davis

    11/5/2009 4:08:37 PM |

    In my view, once wheat has been eliminated, it should stay that way. I've seen too many people explode in weight and lipid abnormalities with resumption of wheat. I liken it to stopping alcohol in an alcoholic--once "dry," I would not recommend a drink or two.

  • Dr. William Davis

    11/5/2009 4:09:34 PM |

    Hi, Dave--

    The reduction of small LDL after dietary changes are made is among the most difficult patterns of all the address. This is discussed in great detail in several reports and forums on www.trackyourplaque.com.

  • Bonnie

    11/5/2009 6:14:25 PM |

    I've been reading your blog for about a year.  I am fitness professional at a healthy weight, but have had issues with genetic moderately high cholesterol (including Lp(a)). High HDL, low Triglycerides, high end of normal LDL (mixed A/B size) AND several high liver enzymes for some unexplained reason (possibly NAFLD?).

    I finally eliminated wheat from my diet (95% of the time) about 8 months ago.  My recent blood work came back and the most profound change was that ALL of my LDL particles are now in the Large range, AND nearly all of my liver enzymes are within normal range for the first time!  An unexpected surprise!

    Could it be that my liver doesn't like wheat??  Go figure!  

    I am now a believer Smile

    Thanks for your educational blog!

    Bonnie

  • Dr. William Davis

    11/6/2009 1:18:00 PM |

    Hi, Bonnie--

    That's great!


    Nigel--

    Yes, it applies to females, as well.

  • Anonymous

    11/11/2009 8:22:00 PM |

    How do we know that these results aren't more about the "dangerous" foods than the times they were eaten? If this experiment had been done with a few slices of turkey and a big salad and a glass of milk, would the results have been the same?

  • ultrasonic liposuction guide

    1/27/2011 5:40:26 AM |

    Well, I don't believe that high carbohydrate diets are causing ADD, but I do feel that some ADDers may be especially sensitive to high insulin levels generated by the modern low fat diet.

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Tribute to Tim Russert

Tribute to Tim Russert

14. June 2008 William Davis (11)
The sudden passing of news giant, Tim Russert, yesterday of sudden cardiac death struck a blow to American consciousness.

Perhaps his hard-hitting interviewing style, while making guests squirm, made him seem invincible. But, of course, none of us is invincible. We are all vulnerable to this disease.

We should not allow Mr. Russert's tragic death to occur without taking some lessons. The media have already resorted to interviewing prominent doctors for their opinion.


Douglas Zipes, M.D., former President of the American College of Cardiology,was quoted in the media:

"An automated external defibrillator (AED) could have been a life-saver. AEDs should be as common as fire extinguishers."

This is typical sleight-of-hand, medicine-is-too-complex-for-the-public-to-understand sort of rhetoric that is surely to issue from the conventionally-thinking medical people and the press. Instead, let's cut the BS and learn the real lessons from Mr. Russert's needless death.

It is virtually certain that:

--Mr. Russert ruptured an existing coronary atherosclerotic plaque, prompting rhythm instability, or ventricular fibrillation.

--Making automatic external defibrillators (AED) available might have Band-Aided the ventricular fibrillation, but it would not have stopped the heart attack that triggered it.

--Though full details of Mr. Russert's health program have not been made available, it is quite likely that he was prescribed the usual half-witted and barely effective panoply of "prevention": aspirin, statin drug, anti-hypertensive medication. Readers of The Heart Scan Blog and members of Track Your Plaque know that this conventional approach is as effective as aspirin for a fractured hip.

--It is highly unlikely that all causes of Mr. Russert's heart disease had been identified--did he have small LDL (it's certain he did, given his body habitus of generous tummy), Lp(a), low HDL, pre-diabetic patterns, inflammatory abnormalities, vitamin D deficiency, etc.? You can be sure little or none of this had been addressed. Was he even taking simple fish oil that reduces the likelihood of sudden cardiac death by 45%?

--Far more could have been done to have prevented Mr. Russert's needless death. And I don't mean the idiocy of making AED's available in office buildings. I'm talking about preventing the rupture of atherosclerotic plaque in the first place.

Far more can be done to prevent future similar deaths among all of us.

Our jobs are to use the tragic death of Mr. Russert to help those around us learn that heart disease is identifiable and preventable. Though Mr. Russert did not stand for BS in his political commentary, he sadly probably received it in his health advice. Don't let this happen to you or those around you.
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Comments (11) -

  • Anonymous

    6/14/2008 2:09:00 PM |

    Amen to everything you said Dr. and one other point I heard a nimber of times yesterday, everybody was in shock because Mr. Russert had just had a stress test done in April and passed with no problems ! As all your readers know what a stupid thing to say.

  • lenjoe

    6/14/2008 8:59:00 PM |

    Dr Davis,
    I appreciate your posting on Tim Russerts passing.  I was a big fan of his. I believe if he had worked half as hard on his heart health as he did on his career we would be enjoying him on TV for many years to come.  Of all the commentators discussions since his passing, the most important things aren't being discussed.  His diet (low fat I'd guess), his meds (statins I'm sure)...He did have a good stress test April 29.  Lot of good that did.

  • Anonymous

    6/15/2008 12:00:00 AM |

    Russert had both CAD & diabetes.

    Newsweek health article about Russert and sudden cardiac arrest:

    http://www.newsweek.com/id/141450?from=rss

    Usual blather about not being able to prevent/predict sudden cardiac death, risk factors, and usefulness of defibrillators, etc.

  • The Daley Planet

    6/15/2008 12:33:00 AM |

    Thank you for this commentary.
    His passing is very sad.
    My uncle had the same thing happen at a relatively young age as well.

    By the way, can you suggest a fish oil for those of us whom are allergic to shellfish?
    I've heard we can use any type of fish oil; just not krill oil.
    Does Sam's Club Maker's Mark fall under that category?

    Thank you!

  • Mike Donovan

    6/15/2008 3:33:00 AM |

    Regarding the death Of Tim Russert:

    In the new issue of Newsweek, Dr. Steven Nissen, chair of cardiovascular medicine at the Cleveland Clinic told the magazine when asked about the role of STRESS and heart attacks:

    "Most of us do not think it is terribly relevant," and explained this with a shocking lack of logical thinking: Newsweek writes, "After all, he notes, "many people in this world have stressful jobs," and they don't all die of of heart attacks.

    Time Magazine named Dr. Nissen one of the 100 Most Influential People In The World in their "Scientists and Thinkers" section.

    Think about that.

    Now, consider the completely illogical statement from Dr. Nissen bolded above. One thing should be made perfectly clear in light of this statement: He believes cholesterol as very relevant to heart attack risk. Yet, to turn his Newsweek comments around, "many people in this world have **high cholesterol**" and they don't all die of heart attacks.

    In fact, study after study shows countries with the highest rates of fat intake and the highest average cholesterol rates have the lowest incidence of heart disease. Imagine that!

    Dr. Nissen's irresponsible and illogical comments in Newsweek shows - again - the complete bamboozlement the cholesterol hypothesis has on western medicine just because, "everyone knows," high cholesterol causes Coronary Heart Disease. How do they know this? "Because everyone knows." Ad nauseum. With a little research, the facts show this is simply not true.

    What Dr. Nissen said about stress can be said about high cholesterol. Plenty of people live with both without having heart attacks.

    Maybe Mr. Russert's death can help in bringing us back to real science as opposed to what Big Pharma dictates as what is science - and what is not. Follow the money.

    How ironic that it was Dr. Nissen who made such a horrible misstep in logic with his comments to millions of readers in Newsweek.

  • Henry Fielding

    6/15/2008 11:00:00 AM |

    I have a couple of questions that were put to me about Heart Scans that I can't answer. Perhaps you will indulge me.

    First, from a Doctor friend of mine:  Most of the widely used diagnostic tests have been studied with respect to their Specificity, Sensitivity, positive and negative predictive value, etc. We know how to use them, and we know how to interpret the information they provide. Last I read, there is not enough correlation between the amount of calcium present in the walls of the coronary arteries, and the degree of coronary sclerosis. Maybe in time there will be enough convincing data - but for now, it is wrong to blame the slowness of the acceptance of the test by the medical community solely on financial interest.

    Second, from another friend:

    I had the EBT test and showed a calcium score of 950. An angiogram showed no blockage. Go figure. The Doc thinks the calcium is in between the artery walls with the lumen free.

  • Dr. B G

    6/15/2008 5:02:00 PM |

    Russert traditionally appeared on Charlie Rose right before Father's Day.  They were good friends -- Rose sold his house in Washington DC to him and aired a moving tribute the night after his sudden MI.

    Russert loved his father and wrote a famous book about him 'Big Russ'. It is ironic his own death was right before Father's Day today. And so much much more awful for his surviving son whom he loved so much and was very vocal about.

    I hope a new movement for cardiovascular and diabetes prevention may be sparked over this needless, rescue-able, tragic event.

    He touched so many lives... fathers, Buffalo fans, media, political enthusiasts...

    (I'm glad my Dad is aware of Track Your Plaque -- Thank you Dr. Davis... and Happy Father's Day!)

    -G

  • Dr. William Davis

    6/15/2008 9:36:00 PM |

    Mike--

    Thank you for your thoughtful and insightful comments. I coudn't agree more.

  • Dr. William Davis

    6/15/2008 9:38:00 PM |

    Henry--

    I'm sorry, but if friend told you that, you need new friends.

    The literature exists and there's quite a bit of it. Just because your friend is completely ignorant of a body of scientific literature several thousand studies long does not mean that it doesn't exist.

    All of your questions can be answered on the www.trackyourplaque.com website.

  • Henry Fielding

    6/15/2008 9:40:00 PM |

    I buy my Fish Oil from Costco. It happens to be Nature Made 1200mg softgels. Don't let anybody worry you about mercury content on this kind of product. None of these brands have any in them.

    If it causes any problems, take it with food.

  • buy jeans

    11/3/2010 2:23:19 PM |

    --Far more could have been done to have prevented Mr. Russert's needless death. And I don't mean the idiocy of making AED's available in office buildings. I'm talking about preventing the rupture of atherosclerotic plaque in the first place.

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