Yes, quality and contamination of fish oil IS important.
I have heard that KRILL oil is superior to fish oil on all fronts. It supposedly has much less contamination than fish oil, better bioavailability (bound to phospholipids) and additional ingredients, i.e. Zeaxanthin (important for retinal health).
Can you comment on this?

Thanks.

"My prediction: High-quality fish oil supplements will match or exceed prescription fish oil."

Not to mention the incredible difference in price... in the patients' favor... and not the pharmaceutical company's bottom line!

madcook

After my sample bottle of Lovaza from my physician was done, I switched over to Trader Joe's brand. It's really cheap at $10 per bottle and the EPA/DHA concentration is 50%. I take about 5 to 6 capsules a day and my last triglyceride in December was 109 (down from 255). I also tried Omapure too but it's pretty expensive. Omapure's advantage over the TJ stuff is that it is independently tested by IFOS. Who knows where TJ's stuff comes from? I tried the Spring Valley (or is it Nature Made) brand from Walmart. Pure nastiness! Stay away from those yellow bottles.

I bet some MBA guy dreamed up Lovaza at a brainstorming session intended to come up with ideas to boost sales in a sagging economy.

Dr. Davis, your EPA/DHA content listings in the post seem to contradict the label on the bottle. The bottle claims 2 capsules contain 1100 mg of EPA and 500 mg of DHA. That would translate to 550 mg of EPA and 250 mg of DHA. What am I missing?

-- Boris

I always suggest opening fish oil capsules once in a while to see if the oil is stinky.  That is the advantage of liquid oils is that you can smell and taste them.  One of my nurses opened a Lovaza capsule and told me it made her gag it was so fishy.  The antioxidant used in Lovaza is hydrogenated soybean oil!!.  One of my patients who is sensitive to soy reacted to Lovaza with a rash.

Dr. Davis,

The following question was somewhat inspired by this post, although it relates more specifically to seafood consumption.

A few months back, I started ordering seafood from Vital Choice. According to the Vital Choice website, their Albacore tuna has 0.05 ppm of methyl mercury and that number falls to 0.03 ppm for their sockeye salmon (which Is what I typically order).

http://www.vitalchoice.com/uploads/Merc%20Comp%204_06.pdf

I often hear a general guideline that 2 servings of non-predatory fish (preferably wild caught and definitely not farm-raised) is generally accepted as safe, or at least minimally risky, and that this is likely a good guideline for everyone, but especially pregnant women and children.

However, when I would place a sizable order, I would find myself serving it at least 2, and often up to 4 times per week. So that would be up to 4 servings of roughly 4-6 ounces of fish during some weeks that I would serve to my wife and for myself.

In your opinion, should we cut back to 2 or fewer servings or are the levels listed by Vital Choice low enough to skirt potential issues?

NOTE: the only seafood I eat is what I purchase from Vital Choice, so that I know the source. While the methylmercury is a focus, I am also curious if this level of consumption is also risky in terms of PCB’s and dioxins. It’s frustrating to realize that there will always be some measure of inherent risk.

My wife and I aren’t eating this in place of supplementing with a purified fish oil supplement, we simply add this to it, so on days when we eat fish we lower our dose a bit and on days we don’t, we bump up that dosage. Our primary reason for consuming it is the delicious taste, along with the “bonuses” of protein, astaxanthin, vitamin D, and omega 3’s that come along for the ride.

On one final note, I am also curious if the selenium content of the seafood is at all protective against methylmercury, particularly at these lower levels found in the Vital Choice fish. I’ve heard selenium has the potential to chelate methylmercury, but I am uncertain if this lessens the risk to any noteworthy degree, that is if I am not misinformed to begin with on this front.

-Rick Bachmann

I'd need a second job to buy either one. Kirkland from Costco is my favorite.

One concern with all over the counter supplements, is that they are not continually tested. The test is applied to one batch of the supplement, perhaps years earlier.

As a result, when random samples are sent to labs contamination is often found in supplements that claim to be free of contaminants.

I don't know if there is better supervision in the case of products sold as pharamceuticals, but I think we have to be very careful in accepting purity claims from any company operating in the Wild West unregulated supplement market. The track record when these products are spot checked is terrible.

Another question that (I think) is yet to be answered is if DHA enriched fish oil is more effective than normal DHA/EPA fish oil at improving a person's omega-3 index.

Another option is to eat sardines whole - approx. 1.6 g of omega-3 per 100 g - about 2 sardines, according to my estimation:

http://healthcorrelator.blogspot.com/search/label/recipe

These are wild-caught sardines, not the canned ones.

Your promotion of PharmaNutrients' Cardio is quite shocking. The price for 15 capsules is $29.95. That's $2/capsule - not far from $4/capsule of Lovaza. Surely you must remember your own post "Lovaza rip-off"?
http://heartscanblog.blogspot.com/2008/12/lovaza-rip-off.html

Ren-

While I think that krill oil is a fascinating product that we have used, I feel that the manufacturer's over-the-top marketing has clouded its real value. It is absurd to propose that krill oil be used as a replacement for fish oil until we have 1) confident data on omega-3 RBC levels, and 2) outcome data.

In other words, fish oil has been shown to dramatically reduce cardiovascular risk. Krill doesn't yet enjoy this advantage. While it might be true, it is premature to make claims to that effect.

HI, Rick--

Sorry, but I've not heard about this argument that selenium counteracts the mercury in fish. That seems a bit of a stretch.

Any idea where this came from?

Hi, Jenny-

Sorry, but I've got to disagree with you on this one.

Take a look, for instance, at the two analyses by Consumer Lab (www.consumerlab.com). 77 fish oil products tested; 2 flunked due to oxidative byproducts. None flunked due to mercury, dioxin, PCBs, or related compounds. This has held true in Consumer Report and several other analyses.

Frankly, I wouldn't be caught dead taking Lovaza, because I care too much about healthcare costs. Why stick it to other people when I can buy fish oil for a lot less?

@ Dr. William Davis
Any idea where this came from?
Most recent
Dietary selenium protects against selected signs of aging and methylmercury exposure.

Fish, Mercury, Selenium and Cardiovascular Risk: Current Evidence and Unanswered Questions Dariush Mozaffarian Free full text online summary of the evidence.

Jenny, I've seen you bashing supplements before.  Do you have any references for your claims?

Biotivia is going to launch a 100% vegetarian Omega 3 about which says has teh greatest EPA DHA levels around, also with resveratrol, green tea or sesame lignans. I would prefer Omega 3 in one supplement and resveratrol in others, not together because children pregnants..shouldnt possible take resveratrol. But I am so intriguing with a vegetarian Omega 3 with high levels of EPA DHA, arent you?

I strongly agree that Lovaza is a rip-off.

But unfortunately, the brand it's being compared to (PharmaNutrients) is a rip-off too. Once upon a time you were mentioning the benefits of Costco brand fish oil, or cheaper alternatives. $30/bottle isn't really cheap, when anyone can go to iHerb and get much better deals.

Jarrow Formulas, EPA-DHA Balance, 630mg/Gel -- $13 for 120 softgels. Or 240 softgels for $23.

PharmaNutrients vitamin D is another ripoff. $20 for 120 gels, 2000IU. I can get 120 gels of 5000IU for around $8 at iHerb (Now brand).

I question why you decided to choose PharmaNutrients as a partner, when they are clearly so overpriced.

Do any of you have any experience with Vectomega, a phospholipid coated salmon oil?

Hi, Dr. Trumbower--

Only limited experience. Because it has omega-6 added to the preparation, I have been avoiding it.  I can't imagine why they do it. Also, the astaxanthin added makes the capsule appear orange, making it difficult to judge its oxidative status.

The good doctor here gives lots of free advice that runs counter to the big bucks pockets of the drug and insurance industry. So far his advice hasn't failed me yet. My lipid profiles have greatly improved since I started reading this blog. If Dr. Davis wants to partner up with a premium brand of omega-3 then that is OK by me. Nothing comes free and this is one way we can all say thank you and support this blog.

http://online.wsj.com/article/SB10001424052748704107204575039590838522222.html

Is there anything fish oil can't do?

How about as an engine oil additive. Could prevent those gummy deposits.

http://online.wsj.com/article/SB10001424052748704107204575039590838522222.html

Wish we could get Dr Oz and Dr Davis together somehow...... see the following from the RealAge website where Dr Oz is suggesting animal fat are bad and grains are good...again

source http://www.realage.com/tips/live-longer-with-this-protein

"The red-meat and processed-meat eaters also had a higher risk of dying from cancer or heart disease. Why? Researchers aren't exactly sure. Could be the preservatives in processed meats. Could be the artery-clogging fats found in beef and bacon. Or it could be that both red- and processed-meat eaters consume less body-friendly foods like whole grains, fruit, and veggies. In fact, other research shows that vegetarians fare best when it comes to heart disease mortality."

The last line is interesting.
Trevor

I often hear a general guideline that 2 servings of non-predatory fish (preferably wild caught and definitely not farm-raised) is generally accepted as safe, or at least minimally risky, and that this is likely a good guideline for everyone, but especially pregnant women and children.

I also take OMAPURE.  It's almost as pure as LOVAZA (70% vs. 84%) but is tested by third party IFOS and has no PCBs and mercury.  I wish OMAPURE was cheaper but it is still less than Sears Fish Oil and much much less than the rip off Lovaza!  Lovaza is such a joke - should be exposed on 60 minutes.

This Pharmatrend Cardio Formula is ALMOST as concentrated as Lovaza.  Lovaza is about $150 for 120 capsules (a 1 month supply for a the FDA approved 4g/day dose for triglyceride reduction).  The Pharmatrend is $30 + shipping for a 15 capsule package!  That's almost a 4 day supply for triglyceride reduction.  So, it's $30 x 7.5 for a month supply.  That's $225/month!  However you slice it, it's actually less expensive to go with the prescription.  If you are covered by insurance, you will only come out of pocket at around $30-$40 per month for the FDA approved prescription.  Don't let "supplement" make you think it's better or less expensive

Lovaza is an ethyl ester of EPA not the actual EPA itself. It also includes DHA. However, the ester is supposed to significantly lower blood pressure and cholesterol far more than just plain old normal omega 3.

Gilles, just out of curiosity, do you consider me a “priest” of this “new religion of health data as the solution to all/most healthcare problems”? If not, what are you talking about? You read a lot more than I do but I don’t recall hearing anyone suggest that.

What really upsets me is that physician only supplement companies with high quality supplements and processing standards that meet or exceed GSK's are NOT allowed to make the claim that Omega 3's helps lower triglycerides. Simply because the FDA has not evaluated their product. Really?

The FDA is a joke. They approve unsafe drugs based on studies given to them from drug companies. Since the FDA does not require them to provide all of their research, drug companies are allowed to show them their studies that had positive results with little side effects, leaving out the incriminating studies. Some drugs are "fast tracked" through the approval process are then later pulled from the market due to a high number of deaths and side effects. If you think that the FDA protects us...think again.

Also note, that a majority of studies are only done on men. Women are excluded due to the risk of pregnancy and drugs are NOT tested on pregnant women in a lab. They use animals for this. While we are biologically similar to rats, we are NOT the same. But nevertheless there are many "approved" drugs that are deemed safe for pregnant women and are only restricted later after clinical usage has shown to cause birth defects.

When a drug is removed from the market everyone is upset at the drug companies. I say, stop blaming the drug companies for being what they are and are expected to be. How about we start blaming the FDA?! Let's hold them accountable for their actions. Suing the drug companies it ineffective. No, they don't want to lose money but let's face it...they don't won't go bankrupt and often settle. People need to wake up...just because something is FDA approved, does NOT make it safe!

Sorry to rant...but this really irks me.

Yes, i agree fish are high protein, but for the fish oil supplement, we should have to take care about the quality and contamination.

After read this post I think that fish oil is better to take as supplement because as I think that fish oil is more beneficial and also good for health. It is also gives prevention against many of decease.

I have read a few of the Article on your website now, and I really like your style of blogging.

You guys are all missing the point entirely. As can easily be seen from the commercial, Lovaza is manufactured in the future from a lab at the bottom of the ocean.  It requires a prescription because it must be shipped from the future to the present, which you can imagine is quite expensive (and dangerous).  The FDA regulates this process of transporting the drug through time.  The dietary supplement formulations of fish oil are actually smuggled through the time rift by rebels similar to those depicted in the Mad Max movies, starring Mel Gibson, thus explaining their cheaper price tag.

Fish oil supplements and liquid fish oil have been suggested by doctors for lowering triglyceride levels, but people who are allergic to fish should not take fish oil supplements.

@ safe supplements
I used to be allergic to fish.
I couldn't eat fish 2 days running because if I did I'd have a severe sore throat.
I found raising my anti-inflammatory status with omega 3, vitamin d and magnesium has eliminated my tendency to get allergic reactions to fish or anything else. So now I don't get hay fever either. It's now been some years since I last used an anti histamine.
Some fish allergic people may find Krill oil is less likely to cause a reaction but be aware some Krill oil capsules also contain fish oil.
There are also omega 3 formulations from algal-docosahexaenoic acid: effects on triglyceride levels and other cardiovascular risk factors. that you may want to consider but they are a lot more expensive when considering the amounts required to be effective.

Fish oil without doubt is highly beneficial, make sure you take the purest form available in the market.

Cardio passed all tests for peroxides, PCBs, dioxin, furans, dioxin-like PCBs, and heavy metals (arsenic, cadmium, lead, mercury) using criteria at least 60% more stringent than European Commission (EC) standards (EC standard <2 picograms/gm for dioxins and furans, PharmaNutrients <1 picograms/gm; EC standard <10 picograms/gm for dioxin-like PCBs, PharmaNutrients <3 picograms/gm). PCBs levels in particular are less than 0.009 ppm, 90% below the industry-wide purity standard of 0.09 ppm. Likewise, mercury is >90% lower than European Commission standards.

for years the fish oil products that we bought in vitamins stores contained a statement that " The FDA has not evaluated these statments". all of a sudden lovaza comes on the scene & its nowe okay. they say lovaza is purified. This raises the question that the FDA either is lying to us now or they were letting us be pisioned before. which one is it? the FDA in the most corrupt agency of the federal government. ask yourself this question. did you ever hear of restless leg syndrome until the FDA approve a prescription medication for it? if the drug companies pay the right people they can get anything approved.

I have been using fish oil supplements for years and so far I am very satisfied on its performance. Lovaza is very new to me. I am still looking for more info about it. This article will help he clarify everything.

I take EPA Xtra from Nordic Naturals

Two Serving:

EPA 1060 mg
DHA 274 mg

Cost Less than $30 per 60 capsule bottle. Just do your own research on quality and efficacy.

Lots of info to take in....I see the pros and cons written before me. but just tell me this!

"i could buy purity products sealogix pharmacuetical grade fish oil ---- 1.8g EPA & .9g DHA per teaspoon.

or..........

Loveza comes in at 1.8g EPA and 1.5g DHA per 4, 1 gram capsules

which one?

Fish oil is also a healthy alternative apart from the usual vitamins being used.

fish oil supplements for me. It's proven to our family because of its very rich benefits gives to our health condition such as Eases Depression, Lowers Cholesterol, Eliminates Joint Pain and so much more!

I definitely believe in the benefits of fish oil supplements.

I admire the valuable information you offer in your articles. I will bookmark your blog and have my children check up here often. I am quite sure they will learn lots of new stuff here than anybody else!

Nice information, valuable and excellent design, as share good stuff with good ideas and concepts.

They are useful. They have been known to support overall health, boost immune system, promotes healthy brain function and others.

vitamins canada

I dont know why everyone thinks lovaza is a rip off.  My prescription plan covers it and I pay less than $10 per/month and despite what some people on here have been saying, nothing, NOTHING, has anywhere near the EPA/DHA as lovaza....almost 3600MG daily dose

Hi everyone
           I started on Lovaza about a month ago, my doctor feeling this is a last resort to lowering my triglycerides as all other meds left me with with severe muscle soreness when using them. I've been reading as far back as I can go on this particular subject w/ using Lovaza and I'm confused. I have a couple of questions...1, is Lovaza a safe product with as much natural ingredient as possible? 2, or is it an artificial made product?

GSK made the financial investment to have the studies done.  What's stopping the supplement companies?  To answer your question, yes I did hear of retless leg syndrome before the FDA approved a prescription medicine for it.  I understand people's frustration with big pharma and the FDA and if you dislike them you are free not to utilize any FDA approved pharmaceuticals.

What a way to sell your supplements. Your a good hustler Doctor.

You haven't researched very much then. And it's not 3600 per 4 pill dose it's 3,360. Big difference.

Your an idiot if you need to ask "what's stopping the supplement companies from making the financial investment to have studies done. What supplement company has the money a pharm company has. Do you have any idea what a good study cost? I guess not.

Dude, stop reading the Health Ranger and Mercola. when you get cancer you'll be begging the Pharm company for there FDA approved drugs.

Hey Doc.,
Ok I have a question Doc. what fish oil brand do YOU say we should take? I got on here just to see what the diff. was between the two because our doc. said we should take Lovaza. I find it a little interesting that she said to take it along with our reg fish oil we've been taking...

I have 280 triglycerides I was prescribed Lovaza, but  my insurance denied it, my doctor told me to take  over the counter fish oil. I am undecided and confused I need help. Which brand and its purity etc

I was plagued by knee pain for years. It came and went in severity, but it was always there. When I ditched bread for weight loss, the pain went away, but it took several months (and a particularly bad recurrence when I went to France for two weeks) for me to realize what was happening.

Knowing the consequences of eating wheat makes it a lot easier for me to keep it out of my diet.

I can't figure out if the main problem is 1. wheat 2. carbohydrates 3. all grains 4. refined grains, or 5. overeating.  It certainly seems like lots of the countries that eat rice all day long (Japan, for instance)have a fraction of the heart disease we do, but that doesn't fully answer my question.

I have been reading your blog for some time, and I believe that wheat has a bad effect on my body. I've gone without wheat for about 2 weeks successfully, and admit I felt better at the end of it - clearer minded and noticeably less cravings. I've quit wheat over and over like an alcoholic trying to get sober. But all it's taken for me has been one unplanned day, one rushed afternoon, one span of time where I'm starving and have been caught out where there is nothing but wheat-related food, and I backslide. And then I am right back to square one or worse, wanting even more carbs/wheat.

These success stories are wonderful, and truly inspiring. But I want to see, or maybe need to see, someone come out with a book that explains what their day to day life of eating without wheat is like. What they do when they get up in the A.M. and have to take their breakfast to work, what they take for lunch, what they whip up for a family of 4 at 6 after working all day...and what they fill their shopping carts with. It is wonderful to hear how great these folks are doing, but it is discouraging because I cannot for the life of me see the how that would also help me. Do folks that have quit wheat carry a list with them of the 10 foods they can? How does one handle the social aspect of life that says you pay $5 for a burger and throw away everything but the .50 patty? My apologies for going on and on here, I do not mean to be confrontational. I enjoy your advice and knowledge, and have learned much. This cannot be as easy as 'just quitting' or people really would just quit.

Giving up wheat (and later all grains) made an enormous difference to me.  I had such brain fog while eating it I thought I had early onset Alzheimer's.  I had terrible IBS, running to the bathroom 15 times a day.  I had pain in every joint and a diagnosis of Ankylosing Spondylitis (without fusing).  

Giving it up the joint pain is gone, the IBS is vastly better and my brain feels like it used to... sharp and my memory is great!

I'm low carb too and that plays into it as well but wheat (gluten) was a major part of my problem.

I have been wheat free for 3 years now.

the meditteranean diet of Greece and other ocuntires of that region consume grains,and wheat, but yet are quite healthy with little evidence of heart disease.  Perhaps wheat is not the villian, but something else in the diet we eat such as as to much sugar/starch

Peter raises a very good point, one I hope can be addressed.  Since Dr. Davis brought up the wheat issue, I've done a lot of googling around, and while there seems to be some agreement of a correlation between too many (or too refined) carbs and CHD, I can't really find any peer-reviewed studies specifically singling out the cereal grain wheat as the culprit.  Of course, wheat is the most common refined grain, and the one we tend to eat the most, so if this is the connection, (too much wheat, especially as refined flour) than I get it.  But as one who answered "no" on the survey, and still eats wheat on occasion, I should explain.

A couple years ago I realized to my horror that my Body Mass Index was no longer in the "healthy" range, i.e. under 25.  I know there is some controversy about this arbitrary formula, but for me, looking in the mirror confirmed it.  Somehow, despite regular exercise and eating what I thought was a healthy diet, I had, over the years, put on 30 extra pounds.

I first experimented mostly with portion control, and had a bit of success.  Then I became familiar with Dr. Walter Willett, who recommends a Mediterranean-style diet.  After communication with Dr. Willett, I cut carbs even more, trying to raise my low HDL.  For me, cutting out all sugary beverages, most bread, baked sweets and snack foods, and severely restricting other sweets like candy to token amounts, made a huge difference.  I astounded myself by losing all 30 pounds, getting my BMI back into the "healthy" range.  All this without any starvation or deprivation.  So the lower-carb way has been a wonderful discovery.

Having said that, I find it difficult and probably unnecessary to eliminate all grain products, including wheat.  For breakfast I find that a bowl of whole oat groats, soaked overnight in hot water and mixed with fresh-ground flax and some chopped walnuts and dates is a wonderfully filling and not-too-sweet way to get me going.  At lunch I will sometimes have a piece of dense German rye bread.  When we have Chinese food, a little rice goes a long ways, but a stir-fry with absolutely no rice feels odd.

Every once in a while I bake bread from grain which I grind fresh.  Without wheat it is very hard to have enough gluten to allow the bread to rise, so I usually add some  hard red spring wheat to the mix.  I slice my loaves into very thin slices and savor every bite.  It's a completely different aesthetic experience from mindlessly chowing down on commercial bread or bakery products.  I also bake whole-grain waffles for my kids on special occasions, and have a square or two for old times' sake.

So for me, moderate intake of grains (in small portions and as little-processed as possible) is okay.  I have no celiac disease and have noticed nothing different when I throw some wheat berries into my morning oat porridge.  Call me skeptical, but it's just hard for me to believe that the cereal that built the pyramids and sustains the long-lived Hunzas is intrinsically any worse than any other grain, though I do understand Dr. Davis's message about wheat's ubiquity in our food culture.  If being categorically wheat-free helps some folks to stay strong, then I say more power to them, but for me it is just too wonderful a grain to give up.  And, as Peter as noted, millions, actually billions of folks have lived long and healthy lives eating grain, including wheat.  So until further peer-reviewed studies indict wheat and grains in general, I will keep eating a moderate amount of them.

On another thread we can discuss the role of grain in supplying simple calories--feeding people--across our wide planet.

I said that I included wheat in my diet because during my weekly cheat meal, I don't care what's in it, and more often than not, there's wheat.

As for the Japanese, the association with heart health has more to do with increased fish intake than their moderate intake of carbs (including rice).  The correlation with rice consumption is one of the classic examples of "correlation is not causation".

Is the problem with grains mainly because of fiber (15g in whole wheat flour per 120 g).
So is whole wheat even worse than refined flour?

There is evidence that the proteins in wheat, barley and rye can cause heart problems. Here is a link to the section on heart disease in The Gluten File. http://jccglutenfree.googlepages.com/heartdisease

In the current issue of Current Opinion in Clinical Nutrition and Metabolic Care there is an article "The emerging role of the gut in chronic heart failure". The abstract says "Recent studies suggest an altered morphology, permeability, and absorption of the digestive tract in chronic heart failure. " The PubMed abstract is 18685461

Gluten is one cause of problems with permeability and absorption of the digestive tract.

I am gluten free because gluten makes me sick. I am grain free as I feel my best without other grains. I am low carb to keep my blood glucose under control. What do I eat? I eat all the veges, proteins and fats I want. My shopping cart is filled with whole fresh foods. No, it is not easy, but my improved health is worth it. I don't crave wheat products now so I am not tempted when cakes and donuts are brought into work.

Twelve years ago, when I started having problems with CAD, I went on a low fat, AHA diet. I gained weight, triglycerides went up, I had SOB and pitting edema. I said "At least I don't have to give up bread. You might as well kill me if I ever have to give up my bread" Little did I know that it was the bread that was killing me. Yes, grain free for me is a small price to pay for good health.

Asymptomatic celiac disease is very common. A dramatic positive reaction to going wheatfree (or intense withdrawal issues) could justify testing at Enterolab.com (these tests can still be valid for about a year on a gluten free diet).

Why? you might want to avoid gluten in meds and supplements or you might want to share the test results with your children, etc.

Also - the GF/celiac community is well aware that many restaurants (IHOP, Denny's types) put pancake batter in their omelettes and even scrambled eggs. You'll need to inquire if you want to be certain.

Anne, your words are encouraging. Think back to when you were quitting wheat, everyone makes it sound so easy (which makes me feel like a failure for struggling so). I'm off fresh produce because of IBS symptoms. If eating wheat did the same thing fresh veggies and fruit did to me, it would be much easier to quit. I'm supposed to be off dairy for the same reasons, but have managed to consume some dairy without problem. That leaves cooked vegetables and meat, both of which I eat when I can, but it's difficult to eat cooked green beans when driving in the car. I have tried eating packaged lunch meat on the go, but when that is all I'm eating, it makes toast even more appetizing. Again, I appreciate everyone's successes, and I mean no offense, but from the still-addicted crowd, it starts to sound like those who've lost hundreds of pounds on morning TV shows who exclaim, "I exercise 3 hours a day everyday, but it's worth it to be thin!" What does one do when they truly do not have those metaphoric 3 hours of time in their life? It is as discouraging as it is encouraging...

However, congratulations on gaining control of your health.

I have taken your advice and am attempting to eliminate wheat from my diet.  If I take a break from it I notice immediately and I do feel tired and have cravings for a couple of days.  

I decided to go wheat free becaue my weight was going up and I couldn't seem to stop it.  Happily stopping wheat has made a big difference and my weight has started comming down.

Thank you.

In response to comments like "What about the Japanese who eat rice all day" and "those eating the mediteranean diet consume wheat and grains do not suffer heart disease so maybe wheat is not the culprit".
If the Japanese ate rice all day and the greeks at nothing but grains all day they would be dying in droves. Luckily, they eat very little rice and grain and a lot of fish, animal products, fat (yes even Okinawans eat lots of lard), liver pate, cream, butter, etc. The low intake of rice/grains and the high intake of protein and fat is what makes these cultures healthier than North American.And when the Japanese make sushi, I'm sure that the first and second ingredients are not rice and high fructose corn syrup like it is here.

At age 40, two and 1/2 years ago, I determined that wheat (gluten) was causing my anxiety attacks, depression, fatigue, joint pain and rapid weight loss (among other symptoms). My PCP had been suggesting statins for high cholesterol and anti-depressants for over a year. Six months gluten-free found me happy, 10 lbs. lighter, LDL down 40 pts, and HDL up 7 pts. Fasting blood glucose went from pre-diabetic to normal.
One year ago, after food allergy testing, I cut out dairy, yeast, corn, rice and all other grains. Seven months later my HDL was up 5 more points, my LDL down another 30 points.

While I am not strict as far as eating low carb, and procuring and planning meals can be challenging, I do eat well, and enjoy much better physical and mental health as a result of my dietary changes. Important to someone like me with heart disease and Type 1 diabetes looming large in my family medical history.

My PCP is amazed at the changes, and my case has prompted her to provide more dietary advice to her other patients. I'd like to see more medical professionals consider what goes into their patient's mouths before turning to meds as the only solution.

Oh, and I really like this blog-thank you!

Hi Dr. Davis:

Thanks so much for all the great informaion.  I too cut out carbs about 5 years ago, for the first time since I was 25 years old have regained my health.  Since I feel so great there is no temptation to go back.  Occasionally I eat cake at a social event, and it is enough to remind me of how lousy I use to feel, and makes me crave my day to day low carb diet.  
I was wondering if you have come accross any information on the effects of excess fluoride in the diet and heart disease.  I recently read that it can increase the risk of heart disease and increase lp(a).  Do you have any insights into the dangers of fluoride.  I have also eliminated all obvious fluoride overexposures (is tap water, tea) from my diet, and have more energy as a result.  Thanks again.
Olga

While I do believe and respect that eliminating wheat from the diet of many people has helped improved their health  in many ways (cholesterol panel, blood sugar, weight loss, etc), is it really that black and white?

I mean, are you suggesting that all people who eat wheat products will (or do) have these health issues.

Is it possible that *some* people can eat wheat products and be perfectly healthy?

Bonnie

As a 27-year-old male in what I would call the top physical condition of my life (14 hours of vigorous exercise per week . . . perhaps even TOO much, but I love playing sports too much), I find it extremely easy to stay relatively wheat-free, although I've never been a wheat addict.

I'm curious what some of you that have wheat cravings CRAVE, because I don't find it too terribly difficult to stay away.  Instead of a sandwich, I wrap my chicken in lettuce, or just eat the meat mixed with a bit of mayo and stone ground mustard.  Don't get me wrong, because I do eat a bit of wheat, but maybe once or twice a month, at most.  I just don't find that there are things with wheat in them that I just can't do without.

There has been a great discussion lately on wheat, carbs, & grains with a lot of scientific data on Stephan's Whole Health Source blog.  Check out some of the recent posts and comments.  

Peter's Hyperlipid blog has had some past discussion (posts and comments) that is pretty damning of wheat and grains, too, though is is pretty technical biochemistry usually.

What wheat can do in the body is fascinating and somewhat alarming.  Gyan, I think there may be some truth to the wheat fiber, in fact, being particularly damaging, perhaps making refined wheat the lesser of two evils.    But try explaining the nuances of that argument to a convinced wheatophile...especially one hooked on whole grain and bran cereal - it's an exercise in futility (and in fairness, it wasn't that many years ago I would have raised an eyebrow at the suggestion, too).  

Roger, if one is going to consume wheat, I think you are right to grind your own fresh, and soak or ferment the grain or flour.  That minimizes some of the issues with wheat.  Though I'm not sure I'd look to the Egyptians for inspiration on diet.  There's evidence of rampant dental problems, as well as obesity and diabetes in ancient Egypt, perhaps due the high intake of wheat.   The idea that agriculture was a not-so-good path in many ways is an interesting one.

And I'd take the Mediterranean Diet advice with a grain of salt, too.  It isn't duplicated well in non-Mediterranean cultures, anyway, because it's out of context and culture.    And just yesterday I read a newspaper article about the worry over too much processed food in Greece, which is causing all the same problems with young people that we are having, just a few paces behind us.  Japan is experiencing the same thing, as is India.  Traditional cuisines and food preparation techniques all over the world are being replaced with "convenience cuisine" and "machine cuisine", using starch and sugars as filler, and substituting industrial vegetable oils for the natural fats traditionally consumed.  It's telling that I've never been anywhere in the world where Coca-cola wasn't readily available.  Sad.

My experience in Italy this summer was that if one could cook for oneself, it was relatively easy to eat well and with controlled carbs (by focusing on fresh veggies, eggs, dairy, seafood, and meat, especially pork - pork was everywhere in all forms, especially salami).  But in out on the street and in cafés and restaurants, I saw entirely too much bread, sugar, and starch eaten, with limited alternatives, especially for breakfast.  And there were far more overweight and unhealthy-looking locals than we are led to believe.  Can't speak for other Mediterranean areas.  Others I know and other readers here have said it is better in Southern France, for instance.  

I didn't come to my conclusions from one article, one blog, or one book (though Taubes' book nailed the coffin shut on a few suspicions).  I've been puzzling through these issues for several years, and it is the preponderance of the credible evidence I keep finding that is so convincing.  This Heart Scan blog has been very helpful, too.  I'm always considering the contrary evidence, too, but it usually isn't very compelling or credible.

I'm more convinced than ever that wheat in particular, but grains in general (at least as they are conventionally consumed in contemporary industrial societies) are to be minimized, or even eliminated, along with modern industrial oils (PUFA  and hydrogenated vegetable oils such as soy, corn, canola, cottonseed, etc.).  If consumed, soaking/fermenting are essential and flour should be freshly ground, not pre-ground.  For those with an intact glucose metabolism, non-grain starches are probably ok, especially if consumed without modern PUFA vegetable oils, but unfortunately, my glucose control is impaired already so I have to refrain from most non-grain starches, too.

Nyn,

There are gobs of books that give meal suggestions and recipes that don't include wheat.  Some LC cookbooks are wheat-free but not all.  In fact, many LC recipes and products have added wheat gluten to make up for the lack of starch, so that is even worse.  Check out Mark's Daily Apple blog.  Mark has a paleo (stone age) way of viewing diet, which tend to be easy to manage.  

My main adjustment with wheat was getting over the food "transportation" issues.  If you think about it, bread, crackers, tortillas, etc., are often the "vehicle" for the good stuff, so we can eat with our hands.  In medieval times, people didn't even use plates, they used big slices of  bread for plates, which sopped up the juices and gravies of the meat (fresh veggies were fairly limited, btw).  Giving up wheat often means giving up eating with your hands.  I've just gotten used to using knives and forks more often.  It's tidier anyway.  

And I don't even think about tossing the bread way because of the cost, because it is just wrapping in my mind.  In most cases, if I can't afford to eat good food when out, then I eat at home or pack a meal.   Lately I've been finding that if I ask in advance to hold the bread, fries,  or whatever starch comes with the meal, a side salad ,  more veggies or fruit, or other option is offered as a substitute.  

Many of Dana Carpender's LC recipes are wheat-free, such as nut crusts for pies, etc. I also use Bruce Fife's books with coconut flour recipes.  I especially like his Butter Coconut cookies and have blogged about the recipe several times, with variations.  I have Fife's wheat-free low sugar coffee cake in the oven right now, for my son's birthday party tomorrow (also good because a number of his friends are gluten-intolerant or allergic).  But in general, I bake a lot less now and usually limit it to special occasions.  Home-made ice cream, baked egg custard, or super dark chocolate are more often our dessert if we are indulging.  Sometimes cheesecake with nut crust, if I feel like making ricotta cheese first.

Dropping the old habits, especially when under pressure, is much easier when you have given some thought to  adopting new habits and coping mechanisms, as well as advance preparation  (shopping lists, making over your pantry, pre-prepping ingredients, recipe support).  Otherwise it is too easy to go back to the old ways in moments of desperation.  Knowing why the change is a good one is also useful to stick to the plan.  Now that I know wheat issues are about more than just the carbs, it's harder to give in.

" it's difficult to eat cooked green beans when driving in the car."  

I'm really hoping you were joking about driving and eating.

If you were serious, I hope you don't take this the wrong way, but it's hard to drive while eating just about anything, not to mention very unsafe (distracted drivers are a huge cause of costly and deadly car accidents).  For many reasons, it's healthier to separate driving and eating.  

Besides, no matter what you eat or where, your meals shouldn't be eaten on the run day-in-day-out.  Stress hormones and the digestive system don't work well together.  

There is a lot to be said for sitting down to a relaxed and enjoyable meal, preferably with enjoyable company.  Even if dining alone, savoring the food, allows for far better digestion than gulping it down in a rush.  And if the food isn't worth savoring, then why eat it?

I don't mean to come across like a mom lecturing on how to eat or not eat, but I think in the US we've really developed a warped and unhealthy way of eating, mindless and rushed, often without companionship, not very nutritious food, and not very tasty unless it is doctored up with lab chemicals.  It's easy to see a difference if traveling outside the US.  In most European countries, school children eat real food, made from scratch,  on real plates in their cafeterias instead of starchy, cheap microwaved pre-cooked chicken-like substances or bean & cheese burritos.  If they can feed their kids like civilized human beings, why can't we?  

And I'm not saying it never happens, but I don't think that most Europeans make it a habit to eat their food in their cars very often, let alone while driving.  Many European model cars still don't even have drink cup holders.  One can't even sell cars in the US now without cup holders for every passenger.  In fact, it's hard to get coffee to go in Europe unless one goes to a McDonald's.  It might be hard to imagine, but there is something to be said for sitting down, relaxing a few minutes, even to have just a cup of coffee or tea, instead of lugging a paper cup, travel mug, or Big Gulp around.   This is one where I should follow my own advice more often - I too often prepare a beverage, even water, to go when I leave the house.  

Our lives are so rushed (often unnecessarily) and meals are one place where we really could make significant changes and reap health benefits (or at least not let our health suffer).  Even if eating fast food, going inside to sit and eat at a table has got  to be better on n a hormonal level than trying to stuff it in while driving or sitting in a parking lot with the engine idling.

Ok, I do sound like  a mom.    Guilty as charged.

"And if the food isn't worth savoring, then why eat it? "

Because we must eat - whether food is good or not, we must eat to survive. And while savoring food is a great and wonderful thing, it has caused me a great deal of heartache and difficulty. Is this not approaching the problem of weight and dieting with the idea that enjoying or 'savoring' food will make you want less of it because you made your taste buds happy?

I agree with everything you've said about taking the time to eat and enjoy and reduce stress, although Starbucks are all over the place and portable coffee/tea has long been a fav for our friends 'cross the pond. I recall my European cars having some form of holder for a drink, and now that I think about it, one of them was old enough to not have rear seat belts. But even if my memory is off, there's no point debating how much better and thinner Europeans are because they sit down and savor a meal. (Have you ever eaten British food? Savor???!)

I write this a bit flip and with a smile on my face, but honestly, if I had the time to sit down and enjoy a meal, gazing out the window and listening to classical music as I reflected on my day, I'd also have time to shop for, prepare, package, and savor every meal I ate, as well as burn it off in post-eating workouts. Yes we move too fast here, yes we are stressed and overworked, and yes we all need to slow down. But the fact of the matter is that's not going to happen any time soon. Not in my lifetime, and maybe not in my children's. In order for something to stick, I have to not only incorporate it into my life, but make it possible to incorporate.

I know you're trying to help, and your comments are appreciated. We'd all do well to take heed to it. However, I believe our solutions have to be bigger than our should haves for success.

Someone said:

"In response to comments like "What about the Japanese who eat rice all day" and "those eating the mediteranean diet consume wheat and grains do not suffer heart disease so maybe wheat is not the culprit".
If the Japanese ate rice all day and the greeks at nothing but grains all day they would be dying in droves. Luckily, they eat very little rice and grain and a lot of fish, animal products, fat (yes even Okinawans eat lots of lard), liver pate, cream, butter, etc. The low intake of rice/grains and the high intake of protein and fat is what makes these cultures healthier than North American.And when the Japanese make sushi, I'm sure that the first and second ingredients are not rice and high fructose corn syrup like it is here."

I very much agree with almost everything on this blog, but the above is simply false. I have lived in Japan and I can tell you that the Japanese do in fact eat rice at every meal and for snacks between meals too. What is so radically different from the standard US diet is mainly the PORTION size, which is TINY relative to the US size. In addition they eat a lot of foodstuffs that are unpalatable but undoubtedly very good for us, like natto (YEAUCH!!!). They also eat lots of raw fish and whole shellfish. But mainly, they eat sticky rice, which is white, not whole grain, and very glutinous. So much rice I wanted to SCREAM!

"And when the Japanese make sushi, I'm sure that the first and second ingredients are not rice...."

Well, the main ingredients in making sushi is water, japanese rice, japanese rice vinegar, and salt.

I am intrigued by your views on the harmful effects of wheat (I assume all wheat, including whole wheat). Can you point me to a medical reference, especially a peer-reviewed study to confirm this? Thaks.

Lonnie
http://www.ajcn.org/cgi/content/abstract/76/2/351
You are correct that further study is needed.

My story is that I had been on satins and experienced muscle damage.  My cardiologist and general doctor told muscle weakness was normal.  I went to another doctor who did a simple blood test for creatine kinase whiched showed that muscle cells were being damaged.  The cardiologist put me on niacin.  This helped with triglycerides.  but still not satisfied he prescribed zetia.  One look on the internet and I saw how pointless.  The other doctor advised me to try red rice yeast.  That helped.  On my own I quite buying bread.  Still eat it when I am on a holiday.  My triglycerides  plummeted and my LDL dropped 50 points.  My total cholesterol is now 150.  What can I say? It worked for me.

When I first set out to advise people to eliminate wheat, I did it because I reasoned that it would be a quick and simple way to get people to reduce blood sugars and help correct the ubiquitous metabolic syndrome that afflicts nearly 50 million Americans now. And it did indeed accomplish that simple goal. But I did not expect all the other benefits to develop, the dramatic weight loss, improved well-being, reduction in hunger, etc.