Does the American Heart Association diet reduce heart disease?

If you have a heart attack and land in the hospital where, invariably, you will have a heart procedure. Or, if you get a stent or coronary bypass operation, sometime before your discharge from the hospital, a well-meaning hospital staff dietitian will provide instruction in the American Heart Association (AHA) diet.

Does this diet reduce the risk of heart disease?

The answer depends on where you start. If you begin with a conventional American diet that is enormously influenced by convenience, food manufacturers like Nabisco, General Mills, Quaker Oats, ADM, and Cargill, or food distributors like McDonald’s, Pizza Hut, and Taco Bell, then the American Heart Association diet is indeed an improvement. But just a small one. If LDL cholesterol is the yardstick, the average reduction in LDL is between 10 and 15 mg/dl. This is the same amount of change you’d experience by adding 1 tablespoon of oat bran to your diet. Hardly worth boasting about. HDL, triglycerides, blood glucose, and body weight do not change.

The diet could be substantially better. After all, it’s become common knowledge that other diets, such as the so-called Mediterranean diet, the South Beach Diet, and similar broad projects result in far greater changes than the AHA diet dispensed by your hospital and cardiologist. These diets more effectively reduce LDL, raise HDL, reduce triglycerides, reduce C-reactive protein, reduce blood pressure. Diets like South Beach also yield substantial weight loss and reversal of diabetic tendencies, with the magnitude of benefit dependent on the amount of weight lost.

Why this stubborn adherence to the outdated concepts articulated in the AHA diet? Cardiologists would argue that insufficient data has been generated to permit widespread application of these diets. They also differ on whether they really work. Of course, the majority remain ignorant and dismiss them as fad diets.

A little digging into the financial disclosures of the AHA suggests another, more malignant influence: who is paying the bills? Until recently, drug manufacturers were major contributors to the AHA. However, more recently AHA administrators have become sensitive to the public perception that they might be nothing more than a voice box for the drug industry. They have since limited contributions from the drug companies to 8% of annual charitable revenues.

The drug manufacturers have been replaced by the food industry. In addition to food manufacturers that make the cereals on your grocery shelf, it includes the multi-national conglomerates that produce unimaginable revenues and carry enormous political clout, like ADM and Cargill. Ever wonder how it is that Honey Nut Cheerios received a “Heart Healthy” endorsement from the AHA?

The AHA diet does not provide the answers we’re looking for, not even close. It is a perversion from an organization that has its strings pulled by industry. The answers to health will not come from the AHA, AMA, the American College of Cardiology, the American Hospital Association, and it won’t come from your doctor. It won’t come from a titillating report on the evening news or Good Morning America. It will come from collective and expanding wisdom placed directly into the hands of the public. It will be untainted by the temptation of drug industry dollars. It will not be dirtied by million dollar contributions, or the multi-million dollar behind-closed-doors lobbying of the food manufacturers. It will come from the truth relayed to the healthcare-consuming public. I hope you recognize it when you see it.

If you want a healthy diet for your heart, throw away the pamphlets from the AHA unless you are partial to bread, breakfast cereals, corn, and the supporters of their misguided nutritional advice.
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10,000 units of vitamin D

10,000 units of vitamin D

Joanne started with a 25-hydroxy vitamin D level of 23 ng/ml--severe deficiency.

What made this starting value even worse was that it was drawn in August after a moderately sunny summer spent outdoors. (Last summer, not this summer.) It therefore represented her high for the year, since vitamin D levels trend lower as fall and winter set in. This suggests that her winter level was likely in the teens or even single digits. In addition, note that, at age 43, Joanne has lost much of her ability to activate vitamin D in the skin.

So I advised that she take 6000 units of an oil-based gelcap per day, a dose likely to generate the desired blood level, which I believe is 60-70 ng/ml.

Four months later, her 25-hydroxy vitamin D level: 39.9 ng/ml--still too low. So I advised her to increase her dose to 10,000 units per day. Several months later, her 25-hydroxy vitamin D level: 63.8 ng/ml--perfect.

However, on hearing that she was taking 10,000 units vitamin D per day, Joanne's primary care physician was shocked: "What? Stop that immediately! You're taking a toxic dose!" So Joanne called me to find out if this was true.

No, of course it's not true. It's not the dose that's toxic, but the blood level it generates. Although it varies, vitamin D toxicity, as evidenced by increased blood calcium levels, generally does not even begin to get underway until at least 120-130 ng/ml, perhaps higher. Rarely, a dose of 2000 units per day will generate a level this high. In others, it may require 24,000 or more units per day to generate such a high level.

So it's not the dose that's toxic, but the blood level of 25-hydroxy vitamin D it generates.

Provided you and/or your doctor are monitoring 25-hydroxy vitamin D blood levels, the dose is immaterial. It's the blood level you're interested in.

Comments (47) -

  • Pater_Fortunatos

    8/2/2010 8:06:19 PM |

    There is a romanian guy that promotes healthy life style with low carb and other paleo ideas.

    http://www.cristianmargarit.ro/

    On his forum, a schizo girl was asking about suplemments, but she was really amazed by Dr Davis prescriptions, 6000 UI/zi, she said that NowFoods recomand a 5000 UI gelcap /3 days.

    But Cristian (the body builder from the link) replies:

    "It happened that I had once 100.000 UI on a day of vitamin D. Yes, one hundred thousands! When you try to adjust the level for certain deficencies, the therapeuthical doses can be a lot higher than the usual doses, that look like jokes for healthy people."

    Readind the article that Dr Davis just published, I assume he has a point, but 100.000 on a day!?!

  • Anonymous

    8/2/2010 8:16:33 PM |

    hi Dr. Davis

    could you sum up the benefits of vitamin d for non heart patients?

    im in early twenties and have my vit d at 18!

    i feel normal. what can i expect with higher blood levels of this vitamin?

    i have some source naturals 2000 ui powdered caps is that effective?

    Thanks

  • enliteneer

    8/2/2010 8:49:12 PM |

    There is evidence to suggest a correlation between high circulating Vitamin D blood levels (>40ng/ml) and rare cancers (pancreatic, etc):

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2892544/?tool=pmcentrez&report=abstract

    http://cancerres.aacrjournals.org/cgi/content/full/66/20/9802

    http://cancerres.aacrjournals.org/cgi/content/abstract/69/4/1439

    http://aje.oxfordjournals.org/cgi/content/abstract/kwq114

  • Anonymous

    8/2/2010 9:05:48 PM |

    My Vit. D level 2 years ago was 42, I started supplementing with 6K per day.  I retested this spring and had decreased to 41.  

    I was amazed and confused.

    After some communications with the Vit. D council,  I found out that the Tretinoin Cream I was using for my splotching skin was interfering with absorption of Vit. D.

    I have since stopped the cream, increased to 12K per day and get 1 hour of sun without any sunscreen.
    I am sure my Dermatologist won't be happy with my tan.

  • aurelia

    8/2/2010 11:22:05 PM |

    Did you call her PCP?

  • steve

    8/3/2010 12:54:59 AM |

    2 questions about vitamin d. Should I take it in the summer months. I work outside all day long? Whats the differences between vitamin d with cod liver oil  and without ? thanks...

  • Tommy

    8/3/2010 1:11:35 AM |

    What about taking Vitamin A to counter balance Vitamin D?

  • Patricia Dillavou

    8/3/2010 3:45:24 AM |

    It has been determined that toxicity concerns for VD3 occur somewhere around 200 ng/ml.  (www.grassrootshealth.net)

    Vitamin D experts recommend between 70-90 ng/ml depending on the doctor.  Some even higher. For instance - Dr. Cannell of The Vitamin D Council (www.vitamindcouncil.org) recommends at least 90-100 ng/ml for cancer survivors.

    Dr. Cannell is also on the board of GRH - both non-profit advocacy groups promoting the health benefits of VD3.

    Grassroots Health is running a five year study on VD3 that is well worth joining.  Anyone can join - find the details at their website.

  • Patricia Dillavou

    8/3/2010 3:54:18 AM |

    Dr. Cannell warns that vitamin A "antagonizes the action" of VD3.  He says you don't need to supplement with vitamin A outside of a good diet.

    Not quite halfway down in this newsletter post:
    http://www.vitamindcouncil.org/newsletter/2008-june.shtml

  • Sara

    8/3/2010 4:07:00 AM |

    I read a study recently where they measured the actual amount of vit. D present in various name brands. They varied in strength from 1% to 82%.
    That's very weak on the mfgs. part and would only encourage the use of prescription D.
    Here is the link:
    http://www.medpagetoday.com/MeetingCoverage/CMSC-ACTRIMS/20522

  • Pat D.

    8/3/2010 4:08:36 AM |

    Enliteener - a quote from the study at the second link you provide:
    ( 7). Ecologic data are not supportive of a strong positive association between vitamin D and pancreatic cancer as sunnier regions do not have higher rates of pancreatic cancer. In fact, the opposite is true, in the United States, relatively high pancreatic cancer rates are observed in states where UV exposure is low.

  • vlado2020

    8/3/2010 11:46:08 AM |

    as much I respect dr. Davis he is like all the docs obsessed with numbers and stability and "safety". Unfortunatelly it ignores the basic properties of vitamin D which is an essential , perhaps most important hormone in all the living beings. First of all , vitamin D gets activated in kidneys first and if kidneys get saturated in tissues where all the healing properties of vitamin D occur. Second of all , there is a reason why oral supplementation is possible throughout life as opposed to simple skin synthesis. Then our bodies can absorb much more orally at once than through the skin which leads me to believe that we are designed to take much larger doses at once to correct deficiencies. Lastly vitamin D is fat soluble so it stays with you for 2 months at least. Having said all that , it doesn't make any sense to supplement every day with lesser doses than you can synthesize in the skin or to follow some magical numbers.
    I have dealt with a very stubborn case of psoriasis for 3 years but in a few days I am taking a big vitamin D experiment, 30 days / 500 000 IU daily, 15 million in a month. Indeed if you search google archives you can find newspaper clippings from 30's and 40's when doctors were more liberal and less obsessed with money of such doses reversing psoriasis and arthritis and other auto immune conditions.

  • MissPkm

    8/3/2010 2:16:13 PM |

    Dr Davis, A great post yet again. I guess that is the one single line I have forgotten to tell people "it is not the dose, it is the blood level that matter"!! GREAT! Thank you.

    Sara,
    There is a big concern for supplements on the market as they are not being checked by any agencies, and just like Dr Davis previous have been reporting on - some Vitamin D3 over the counter are not what they say they are. However in this study that you refer to (the part that I was able to read) they do not list the name brands or the type of Vitamin D (pill, gel cap, liquid) as that also plays a big role. I think it is a big separation from the message in the report of saying to only take Vitamin D2 (which is the prescription vitamin D) when we know D2 is not natural to us humans nor is it better. I suggest you read a little bit more about D2 and D3 before deciding what is best for you.

  • Ned Kock

    8/3/2010 5:00:11 PM |

    Hello Dr. Davis.

    Let me point out a few things based on research on vitamin D. Not all agree with what you said in your post, but then again you may well be right and the research wrong:

    - Indeed, toxicity signs do not seem to occur until one reaches the 50,000 IU/d level of intake.

    - Among the elderly (i.e., those aged 65 or above) pre-sunburn full-body exposure to sunlight is equivalent to an oral vitamin D intake of 218 µg (8,700 IU). That is close to 90 percent of what a 20-year-old would produce.

    - People on average will plateau at 130 nmol/L, after months of 10,000 IU/d supplementation. That is 52 ng/mL. Assuming a normal distribution with a standard deviation of about 20 percent the peak mean (a rough guesstimate), one would expect 68 percent of the population to be in the 42 to 63 ng/mL range. That might be the range most of us should expect to be in at an intake of 10,000 IU/d.

    As we know, some people are outliers. A person who is two standard deviations above the mean would be at around 73 ng/mL. Three SDs above the mean would be 83 ng/mL. These are outliers; non-average people.

    There are other factors that may have affected the results for this patient. Being overweight tends to reduce D levels. Sunscreen also does that. Excess cortisol may also be affecting D levels.

    Below are two links with more details:

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

    http://healthcorrelator.blogspot.com/2010/01/vitamin-d-deficiency-seasonal.html

  • stop smoking help

    8/3/2010 6:56:15 PM |

    I wonder what levels are found in smokers? I know smokers aren't supposed to supplement with beta-carotene as it statistically increases their risk of developing lung cancer.

    What about vitamin D? Is there any data on this as it relates to people who smoke cigarettes or other tobacco products?

  • Anonymous

    8/3/2010 9:57:45 PM |

    This is so off topic, but for some reason I cannot find the Pharmax website for fish oil. Can anyone help?  Thank you
    From an old person who is not tech savvy.

  • Matthew

    8/3/2010 11:01:03 PM |

    There is a graph of vitamin D blood levels on the video by Dr. Michael Holl+
    ick that shows the knee of the runaway blood levels is around 10,000 IU per day, and he recommends no more than that on an ongoing basis.

    For me, 5000 iu per day stopped my gums from bleeding when I brushed, and ended decades of dysthymia.

    http://www.youtube.com/watch?v=Cq1t9WqOD-0
    http://www.uvadvantage.org/

  • Anonymous

    8/5/2010 6:21:19 PM |

    Dr Davis,
    You are absolutely right that "it is not the dose, it is the blood level that matters”. But, what about the blood level of calcium? One of the causes of the toxicity of Vit D is that it may cause high calcium levels in blood. So, should we not measure also the calcium level, and if it is high then should we not stop taking D, even though  its blood level may be normal or low? Thank you.

  • Ganesh

    8/6/2010 8:17:05 AM |

    How does a dosage of Vitamin D3 supplementation totaling 2,260,000 IU over 56 days averaging daily to about 40,000 IU sound?? Resulting in a blood level of 239.0 ng/mL?? This is no fiction...but my personal experience...and I have never felt more better since then! I got rid of my pre-diabetes, Metabolic Syndrome and other fancy new-age potential diseases...  Read all about it at gkwellness.wordpress.com.

  • TedHutchinson

    8/6/2010 9:16:15 AM |

    Perhaps it would be well for others to read what Dr Cannell has to say about massive doses of vitamin D.

    Warning: If you intend to take massive doses of vitamin D based on this newsletter, which I highly recommend you do not, read the entire newsletter. In addition, accurate determination of side effects of massive doses of vitamin D was not available in the early 1930s, nor was accurate determination of the true amount in each pill possible.

    You'll find the Vitamin D Council newsletter at this link.
    Gary Null and Vitamin D Toxicity

  • Josh

    8/6/2010 12:44:21 PM |

    I've been taking 10,000 IUs a day for the last 3 months.  Got my results back today:  I went from 51ng/dL to 65 ng/dL.  I eat strictly paleo and I also get regular sun.  I expected a greater increase.  I also had a CMP run to check for hypercalcemia - all good.

  • Anonymous

    8/7/2010 1:03:50 AM |

    I recently went to a doctor for pre-diabetes and high cholestrol and found my vitamin d level is 17 and I am breastfeeding. Does anyone know what a safe amount would be for me to take. I am taking 5000 d3, liquid dropper full. I am very tan, and out in the sun...why am I not absorbing or making the hormone? My crp level was 24, they said that wasn;t normal. Could this be a effect of this wheat allergy I am reading about? What do you think Dr. Davis?

  • Jimmy Moore

    8/7/2010 11:12:16 AM |

    I too got the same reaction from my doctor when I told him I take 10,000IU daily.  But I HAVE to in order to reach that optimal level you're talking about.  Two years ago my D3 was 42, so I went on a 6-month Vitamin D3 gelcaps regimen to get it up to 68.  Wanting to find the balance of how much to take, I backed off to 6,000IU for about 8 months and my D3 level dropped back down to 50.  So I've been on 10,000IU daily again for the past 8 months and look forward to seeing my levels return into the 60s where they need to be.  THANK YOU Dr. Davis for leading the way on this important issue.  My wife Christine had a D3 level of 9 before starting 10,000IU herself--today her D3 is 54 and she's completely off of her Paxil medicine.  WOO HOO!

  • Anonymous

    8/8/2010 6:57:56 PM |

    I can't find the link but I recall reading something, possibly by Dr. Cannell urging people who are taking higher quantities of vitamin D to ALSO take extra Magnesium and Potassium to prevent kidney stones(which may occur with higher dosing of Vitamin D).

    If this is the case, how much mag and potassium should one take to prevent stones?

  • Neonomide

    8/11/2010 9:58:48 PM |

    Vitamin D3 decreased relapse rate by 50% in Crohn's disease patients in a 12 month randomized controlled trial:

    http://www.ncbi.nlm.nih.gov/pubmed/20491740


    I knew this for almost two years already and got to ditch my meds, just by taking enough Vitamin D3. If everything in healthcare was this simple we would not have major healthcare problems, yes ?

  • mike V

    8/21/2010 4:56:17 PM |

    Dr D.
    It has probably by now come to your attention that there is some evidence for a U shaped mortality curve with vitamin D in elderly men, esp cancer.

    Here is one report:
    *Plasma vitamin D and mortality in older men: a community-based prospective cohort study.*

    Michaëlsson K, Baron JA, Snellman G, Gedeborg R, Byberg L, Sundström J, Berglund L, Arnlöv J, Hellman P, Blomhoff R, Wolk A, Garmo H, Holmberg L, Melhus H.

    Am J Clin Nutr. 2010 Aug 18. [Epub ahead of print]PMID: 20720256 [PubMed - as supplied by publisher]Related citations

    My suspicion is that it may  be related to insufficent vitamin K2, which of course may relate to typical elderly diets.

    Please comment, and/or refer us to earlier comments you may have made.
    Thank you
    Mike V

  • TedHutchinson

    8/21/2010 10:39:36 PM |

    How to Optimize Vitamin D Supplementation to Prevent Cancer, Based on Cellular Adaptation and Hydroxylase Enzymology
    At the most northerly latitudes such as Sweden, where the study Mike V linked to was done and Finland where P Tuohimaa has reported similar findings, we have to appreciate the people with the highest vitamin D status probably have the largest changes in status over the year.
    Vieth provides a hypothesis that explains how people with extreme changes in status experience longer periods of imbalance between the forces controlling cell proliferation.
    Vieth suggests keeping 25(OH)D BOTH HIGH and STABLE is the safest option that way there is little or no CHANGE in status through the year, so no periods where dis-regulation of the counterbalancing forces could occur.

  • Anonymous

    8/22/2010 11:50:44 PM |

    Ted,

    If I'm reading what you posted correctly, Vieth is indicating that one should maintain higher serum d-levels year round as opposed to allowing them fluctuate?

  • Anonymous

    8/22/2010 11:53:29 PM |

    I'm sure this has been asked before but what's a suitable dosing strategy for someone who just flat out refuses to get their 25(OH)D3 levels checked? My brother is 28, I've convinced him to start supplementing with vitamin D but her refuses to go to the doctor to get blood drawn and when I suggested he order a kit online and do it himself he looked at me like I was crazy.

    I have him on average taking 5000 to 6000 units per day.

    Mike

  • TedHutchinson

    8/23/2010 9:39:52 AM |

    @ Vieth is indicating that one should maintain higher serum d-levels year round as opposed to allowing them fluctuate?

    Vieth says so long as serum 25(OH)D concentrations are in a phase of decline, there can be no full achievement of tissue 1,25(OH)2D to match its ideal set-point concentration.

    There have been a couple of papers recently showing ANNUAL vitamin D supplementation (raising status with high intakes before winter) only makes matters worse because it creates a longer period of declining 25(OH)D.

    Note also that because Ergocalciferol has a shorter half life than D3 it amplifies this problem so should be avoided.

    Supplementing DAILY or WEEKLY reduces the potential for fluctuation so are ideal but fortnightly or even monthly supplementation with D3 probably avoid the periods of declining status, if the person concerned really isn't capable of more regular dosing.

    The amount of vitamin D made in the skin varies with 25(OH)D status This reduces the summer rise in status but if you get lots of sun in summer (unlike the UK)it may be sensible to REDUCE (but not stop) vitamin D supplements while you are also getting near full body sun exposure, and then resume the full amount of supplementation as soon as sun exposure reduces.

    I think people who live furthest from the equator have to be particularly careful when taking winter sun holidays in the tropics.
    As Vitamin D is itself photoprotective it's worth supplementing with vitamin D before a winter sun break rather than relying on the holiday sun to raise status. Then reduce intake while sunning in the tropics but resume supplementation as soon as you return. Careful supplementation increases serum 25(OH)D concentrations and reduces the effect of the seasonal amplitude in 25(OH)D on the tissue fluctuations in 1,25(OH)2D.

  • TedHutchinson

    8/23/2010 10:11:13 AM |

    @ Mike
    Grassrootshealth graph of typical responses to various vitamin D intakes

    Startling Findings About Vitamin D Levels in Life Extension® Members

    The graphs at the above links show 5000~6000iu/daily gets most people above insufficiency status and doesn't raise status above a safe amount.

    The range of response to regular D3 supplements is about 100ng/ml so without a few 25(OH)D tests it's impossible for anyone to say if you're at the lowest or highest end of that response scale.

    If you're diabetic or celiac then it's likely you're a poor responder but there are people reading this with inflammatory conditions who've taken very modest vitamin D3 amounts but had extremely high 25(OH)D test results.

    It's so simple to put a couple of drops of blood on a test strip and post if off that I'm surprised everyone doesn't get it done.

    Once you've had a few tests done you can more or less predict what the result will be, but there have been instances where people have changed brands of D3, been tested and discovered problems.

    Only if you've had a test can you be certain the brand/batch/amount/dosing regime of D3 you are taking is working for you.

  • mike V

    8/23/2010 1:30:20 PM |

    Thanks for the helpful posts, Ted.
    Is it your interpretation that variability still remains important, even if one's 25(OH)D does not fall below say 30 or 40 ng/mL over the year, or do you think the the lower excursion limit would have to drop to a deficient level at least for a part of the year? It would seem to me that storage in body fat would be a consideration in minimizing variability.
    Have you come across any studies on U curve effects  performed at lower latitudes, or perhaps on those supplementing?

    I am a vintage Brit, living in the "Deep South", and whose last readings were between 60 and 70 ng/ml so I have no personal concerns.
    Last winter I was using 8000iu, but I drop back to 4-6000 in the Summer months, when we typically have highs between 90 and 100F.
    FWIW I have been gradually escalating my dose over a period of more than 10 years. Now in 75th year.
    regards
    Mike V

  • TedHutchinson

    8/23/2010 2:01:16 PM |

    @ It would seem to me that storage in body fat would be a consideration in minimizing variability. I agree.
    Bear in mind we don't see significant stored D3 reserves below 40ng/ml but at 50~60ng/ml reserves are measurable.
    I stay around 60ng/ml with 5000iu/d + regular full body UVB/SUN exposure.
    I'm not aware of any data on Ushaped curve at lower latitudes or with people maintaining a steady state 25(OH)D by avoiding declines in 25(OH)D.
    I'd be more than willing to participate in any trial, providing I'm assured of remaining on the high end arm of the study.

  • mike V

    8/23/2010 2:56:12 PM |

    Thank you.
    One more question.
    It appears that UVB/sun exposure is useful way to 'top off' supplementation in a natural or controlled way.
    Seems we evolved our African metabolisms getting a heavy daily full body dose.

    Are you aware of any data suggesting that UVB sourced D has any other advantages over presumingly well managed supplementation?
    Thanks again
    I appreciate your awareness of, and facility at quoting relevant studies.
    Mike V

  • Anonymous

    8/23/2010 6:42:53 PM |

    Ted, you bring up an interesting point regarding different dosing methods. Here's a study comparing daily vs. weekly vs. monthly dosing of D3.

    http://jcem.endojournals.org/cgi/content/full/93/9/3430

  • Anonymous

    8/23/2010 7:28:43 PM |

    Seasonal fluctuations may be of importance but the overall 25(OH)D levels still seem most important.

    The Framingham Study data and other papers have already pointed out that not only total mortality, but also bone health seems best in about 35-40 ng/ml, not more. Similarly, not-so-rare cancers like in prostate and pancreas (kills practically everyone) may well increase in susceptiple populations ie in smokers.

    There are also racial differences that may be of huge importance. Not only CHD risk and 25(OH)D does follow the skin color pretty closely, but native Africans also have rather low 25(OH)D levels which perhaps explains the association. Even doctor Cannell wrote previously about this:

    "Dr. Freedman and his Wake forest colleagues measured vitamin D levels and plaque (the build-up in your arteries) on 340 diabetic, obese (BMI 35) African Americans and found higher vitamin D levels were associated with more plaque build up in the arteries."

    http://www.vitamindcouncil.org/newsletter/vitamin-d-race-and-cardiovascular-disease.shtml


    Infants in Nigeria have much higher 25(OH)D levels, yet as Nigerian people get older, their 25(OH)D levels drop a lot.

    I'd imagine that tremendous UVB exposure for decades makes it progressively harder to make Vitamin D and that seems to be the simplest explanation. Elderly white-skinned people may on the other hand make a lot more Vit D as a recent study shows. I'd die to know if the same works out for native Africans as well - which I very much doubt.

    Vitamin D has tens of metabolites that form only in the skin. This may be the single biggest challenge to the claim that Vitamin D supplementation fixes "everything".

    A quick googling on a wide array of problems people have had when supplementing more than 2000 IU a day is dazzling. So D3 may be a wonder vitamin, but it's benefits are dose dependent and probably highly dependent of other nutriotional factors as well, since D3 affects the absorption of minerals, expression of hundreds of genes and so on.

    Food rep

  • TedHutchinson

    8/23/2010 10:47:56 PM |

    @ you bring up an interesting point regarding different dosing methods ...Comparison of Daily, Weekly, and Monthly Vitamin D3
    Perhaps that is because I regard the natural level at which humans produce vitamin D replete breast milk, achieve 25(OH)D equilibrium and maintain a stored reserve of vitamin d3 as ideal, not the level used in that study that barely ever provides sufficient even for basic daily needs.

    Health professionals may aim for a level that maximises health service interventions. I want a level that minimises my need to use those services.

    Bankers make more money from people who frequently use overdraft and loan services. I prefer to save up, keep a reserve of cash in an instant access savings account, only every pay cash and get discounted prices.

    You may be happy to manage your Vitamin D account without ever having any spare reserves available for emergency use but IMO that is neither prudent or safe.

    Why on earth would your skin produce 10~20000iu in a relatively short time if only 1500iu were required?

  • mike V

    8/24/2010 1:39:15 AM |

    Food Rep:
    Suggest you take as a baseline levels that are thought to be closer to the equatorial 25(OH)D blood levels we evolved with. Not minimal levels to mitigate some particular symptom or disease.
      Yes, achieving this goal largely by supplements, can be complicated depending on skin color, genetics, latitude, age, body fat, but in my judgment it is well worth achieving, and it will become easier as time goes on.

    IMHO, Ted and Dr Davis have it about right.

    Do you visit www.grassrootshealth.net?
    If not I recommend you do so... soon. IMHO there is not a more authoritative resource on this topic.
    Mike V
    By the way, vitamin D does not *cause* calcification. It does enable homeostasis.

  • Anonymous

    8/24/2010 2:51:38 PM |

    Ted,

    I only posted that study above to show that different dosing schedules (daily, weekly, monthly) all seem like viable approaches in maintaining 25(OH)D3 levels granted you are consistent with it. I wasn't trying to suggest that the actual doses they were administering were adequate.

  • Anonymous

    8/25/2010 4:45:49 PM |

    I just trying to have ripped abs.  I am not taking any supplements or anything like that but the literature here suggests that taking some substances could actually have an adverse affect on your body even though they are supposed to be healthy.

  • mike V

    8/26/2010 6:29:59 PM |

    Ted, Dr D.
    I suggest that vitamin 2K should be considered in association with Vitamin D where the cancer mortality curve is in question.
    **
    http://www.lef.org/magazine/mag2009/jan2009_Vitamin-K-Protection-Against-Arterial-Calcification-Bone-Loss-Cancer-Aging_03.htm
    **
    note: I believe I am right insaying that the first 15 references cited in this article relate to cancer.
    Mike

    Mike V

  • max

    9/25/2010 7:50:35 AM |

    good article.

  • Anonymous

    10/30/2010 4:40:15 PM |

    I recently did the Vitamin D Council blood spot test. It cost $70.00 including shipping I think. It was painful and two weeks later, my finger still hurts. If I ever do another blood spot test, I'll try to draw blood from my forearm, although the test requires at least 2 large blood drops. I have no results yet. I am 114 lbs and take 2400 IU a day (softgels). I don't really plan to test ever again, especially on my finger, so I'll play it safe and keep my level around 40. Obviously, I'll have to adjust accordingly, once I get the results. I don't have the luxury of a good doctor. Doctors around here are virtually useless.

  • Anonymous

    1/21/2011 5:19:23 PM |

    Hi there,
    Been researching Vit D here on the heartscan blog and others such as Vit D counsil, Dr. Ben Kims' site,getting good info to stay away from D2 of course.
      But this site, "The Peoples Chemist"- Shane Ellison and blog poster "Chuck" say we all should stay away from any man-made D3(sheep wool) included. They back it up stating specific chemical biological changes in the body.  They say it just isn't the same and can do more harm in the long run. The site states basically that we should be using only food for Vit D3. meats, eggs, cod-liver oil(w/o the vitamins depleted or added)ect...
       This is real important for all of us if this is true.  Please Heart scan Bloggers/Dr. Davis read the info @ Vit D on Shanes site... Thanks

  • Anonymous

    1/21/2011 5:19:47 PM |

    Hi there,
    Been researching Vit D here on the heartscan blog and others such as Vit D counsil, Dr. Ben Kims' site,getting good info to stay away from D2 of course.
      But this site, "The Peoples Chemist"- Shane Ellison and blog poster "Chuck" say we all should stay away from any man-made D3(sheep wool) included. They back it up stating specific chemical biological changes in the body.  They say it just isn't the same and can do more harm in the long run. The site states basically that we should be using only food for Vit D3. meats, eggs, cod-liver oil(w/o the vitamins depleted or added)ect...
       This is real important for all of us if this is true.  Please Heart scan Bloggers/Dr. Davis read the info @ Vit D on Shanes site... Thanks

  • Lynn D

    9/20/2012 10:32:05 PM |

    If our vite D levels show up low 20every year ,even when take 4000/day, then
    are we not absorbing or are we using it up. It sounds like some websearch showed up maybe
    additional testing such as also 1,25 OH in additon to the 25OH
    Thanks for any info

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Mediterranean diet and blood sugar

Mediterranean diet and blood sugar


Data such as that from the Lyon Heart Study have demonstrated that a so-called Mediterranean diet substantially reduces risk for heart attack.

But there are aspects of the Mediterranean diet and lifestyle that are not entirely sorted out.

For instance, what specific component(s) of the diet provide the benefit? Is it olive oil and linolenic acid? Is it red wine? Is it the reduced exposure to processed snack foods that Americans are indundated with? Is it their more slender builds and greater tendency to walk? How about exposure to the Mediterranean sun? What about the inclusion of breads, since in the Track Your Plaque program I advocate elimination of wheat products for many abnormalities?

Anyway, here's a wonderfully thoughtful set of observations from Anna about her experiences traveling Italy, trying to understand the details of the Mediterranean diet while also trying to keep blood sugar under control.


I just returned from a two week stay in Italy, doing a bit of my own "Mediterranean Diet" experiments. When practical, we sought out food sources and places to eat that were typical for the local area, and tried as much as possible/practical to stay away from establishments that mostly catered to tourist tastes. I was really curious to see how the mythical "Mediterranean Diet" we Americans are urged to follow compared to the foods really consumed in Italy.

The first week, we stayed in a rural Tuscan farmhouse apartment (agriturismo), so many, if not most of our meals were prepared by me with ingredients I bought at the local grocery store (Coop) or the outdoor market in Siena. In addition, I purchased really fantastic free-range eggs from the farm where we were staying. (Between some language issues and seasonality, eggs and wine were what we could buy from them - though I was tantalized by the not-quite-ripe figs heavy on many trees). Mostly, our meals consisted of simple and easily prepared fresh fruits and vegetables, rustic cured meats (salami, proscuitto, pancetta, etc.) hand-sliced at the deli down the road, fresh sausages, various Italian cheeses, plus plenty of espresso. It was a bit disappointing to find underripe fruit & tomatoes as well as old green beans in the grocery stores, not to mention too many low fat and highly processed foods, but all over Europe the food supply is becoming more industrialized, more centralized, and homogenous, so I'm not too surprised that it happens even in Italy. But even with the smaller grocery store size, the amount of in-season produce was abundant, yet one still was better off shipping from the perimeter of the store, venturing into the aisles only for spices, olive oil, vinegar, coffee, etc. Without the knowledge of where to go and the language to really talk in depth about food with people, I wasn't able to find truly direct and local sources for as many foods as I would have liked, but still, we ate well enough!

The first week I maintained blood sugar levels very similar to those I get at home, because except for the Italian specialties, we ate much like we always do. A few rare exceptions to my normal BG tests were after indulging in locally made gelato or a evening limoncello cordial, but even then, the BG rise was relatively modest and to me, acceptable under the circumstance. Even with the gelato indulgences, it felt like I might have even lost a few pounds by the end of the first week and my FBG didn't rise much over 100.

The second week we stayed in two cities (Florence & Rome), and I didn't prepare any of my own food because I didn't have a kitchen/fridge. I found it impossible to get eggs anywhere for breakfast, and the tickets our hotels provided for a "continental" breakfast at a nearby café/bar was always for a coffee or hot chocolate drink and some sort of bread or roll (croissant, brioche, danish, etc.). At first I just paid extra for a plate of salami and cheese if that was available - or went to a small grocery store for some plain yogurt, but then I decided to go off low-carb and conduct a short term experiment, though I didn't consume nearly as many carbs as a typical Italian or tourist would.

So I breakfasted with a brioche roll or plain croissant for breakfast with my cappuccino, but unfortunately no additional butter was available. I didn't feel "full" enough with such a breakfast and I was usually starving an hour or two later. Additionally, when I ate the "continental" breakfast, I noticed immediate water retention - my ankles, lower legs, and knees looked like someone else's at the end of a day walking and sightseeing, swollen heavy. Exercising my feet and lower legs while waiting in lines or sitting didn't seem to help.

Food is much more expensive in Europe than in the US, and the declining US$ made everything especially expensive (not to mention the higher cost of dining out rather than cooking at home), so we tried to manage food costs by eating simple lunches at local take-away places, avoiding the corporate fast food chains. I was getting tired of salami/proscuitto & cheese plates, but the typical "quick" option was usually a panini (sandwich). At first I tried to find alternatives to paninis, but the available salads were designed for side dishes, not main meals and rarely had any protein, and the fillings of the expensive sandwiches were too skimpy to just eat without the bread. So I started to eat panini, although I sometimes removed as much as half of the bread (though it was nearly always very excellent quality pan toasted flatbreads or crusty baguette rolls, not sliced America bread). So of course, my post-prandial BGs rose, as did my FBG. I also found my hunger tended to come back much too soon and I think overall I ate more than usual in terms of volume.

Then we deviated from the "Italian" lunch foods and found a better midday meal option (quick, cheaper, and easier to customize for LC) - stopping at one of the numerous kebab shops and ordering a kebab plate with salad, hold the bread (not Italian, but still Mediterranean, I guess). I felt much better fueled on kebab plates (more filling and enough protein) than paninis, though I must say I still appreciated the taste of caprese paninis (slices of fresh mozzerella and tomato, basil leaves, mustard dressing on crusty, pan-toasted flat bread). If I followed my appetite, I could have eaten two caprese paninis.

We had some great evening dinners, at places also frequented by locals. This often was a fixed price dinner of several courses ("we feed you what we want you to eat"). Multi-course meals included house wine, and invariably consisted of antipasta (usually LC, such as a cold meat and cheese plate), pasta course (much smaller servings than typical US pasta dishes), main course plus some side vegetables, and dessert/coffee. These were often the best meals we experienced, full of local flavor and tradition (sometimes with a grandmotherly type doing the cooking), and definitely of very good quality, though we noticed the saltiness overall tended to be on the high side. I ate from every course, including some of the excellent bread (dipped in plenty of olive oil) and usually about half of the pasta served (2 oz dry?), plus about half of the dessert. After these meals I always ran BGs higher than usual, varying from moderately high (120-160 - at home I would consider this very high for me) to very high (over 180). By late in the week, my FBG was into the 115 range every morning (usually I can keep it 90-100 on LC food). Nearly everything that week was delicious, well-prepared food, but the high carb items definitely were not good for my BG control in the long run.

And most days I was doing plenty of walking, sprinting for the Metro subway trains, stair climbing (4th and 5/6th floor hotel rooms!), etc. but since I didn't have my usual housework to do, it probably wasn't too different from my usual exertion level.

So it was very interesting to experience the "Mediterranean Diet" first hand. Meats and cheeses were plentiful, fruits and vegetables played a much more minor role (main courses didn't come with vegetables other than what was in the sauce, but had to be ordered as additional items), but the overall carbs were decidedly too many. As I expected, it wasn't nearly as pasta-heavy as is portrayed in the US media/health press, but it is still full of too much grain and sugar, IMO. Low fat has become the norm in many dairy products, sadly, and if the grocery stores are any indication, modern families are gravitating towards highly processed, industrial foods. Sugar seems to be in everything (I quickly learned to order my caffe freddo con panno or latte sensa zuccero - iced coffee with cream or milk without sugar) after realizing that adding lots of sugar was the norm).

And, after several days of breakfasting at the café near our Rome hotel (where carbs were the only option in the morning), I learned that our very buff, muscular, very flat-stomached, café owner doesn't eat pasta (said as he proudly patted his 6 pack abs). I probably could have stuck closer to the carb intake I know works better for my BG control, but I figured if I was going to go off my LC way of eating and experiment, this was the time and place.

And yes, there were far fewer really obese people than in the US and lots of very slender people, but I could still see there were *plenty* of overweight, probably pre-diabetic and diabetic Italians (very visible problems with lower extremities, ranging from what looked like diabetic skin issues, walking problems, acanthosis nigricans, etc.). Older people do seem to be generally more fit than in the US (fit from everyday life, not exercise regimes), but there were plenty of "wheat bellies" on men old and young, even more young women with "muffin tops", and simply too many overweight children (very worrisome trend). So it may well be more the relaxed Italian way of living life (or a combination of other factors such as less air conditioning, strong family bonds, lots of sun, etc?) that keeps Italian CVD rates lower than the American rates, more than the mythical "Mediterranean diet".

Comments (6) -

  • Zute

    7/30/2008 8:42:00 PM |

    Even between the Italian countryside and city you can see the broad difference in a "Mediterranean diet" but what about between Sardinia and Italy or Greece or the many other regions.  I think in Greece it is a lot of lamb and fish and veggies and not much in the way of grains.  

    To me, this whole concept is just another silly thing generated by misguided doctors and greedy marketeers.  I'm sure we'll be seeing "Mediterranean Diet Approved" labels on breakfast cereals someday.  *sigh*

  • Alan

    7/30/2008 9:09:00 PM |

    G'day Anna, via Dr Davis

    You brought back memories of my own wanders in Europe while managing BGs, thanks.

    Just a brief comment on definitions. You wrote "Then we deviated from the "Italian" lunch foods and found a better midday meal option (quick, cheaper, and easier to customize for LC) - stopping at one of the numerous kebab shops and ordering a kebab plate with salad, hold the bread (not Italian, but still Mediterranean, I guess)."

    That is part of the difficulty; the various papers recently are based on an American understanding of the "Mediterranean" diet. Some are based on old studies from Crete, others from Corfu, others simply add olive oil or wine as Dr Davis notes. The Mediterranean littoral has diets which vary enormously from Moroccan to Libyan to Egyptian to Turkish to Greek to Albanian to Italian to French to Spanish and all the small nations and islands nearby.  

    I think you sensed the real Mediterranean difference, and that is disappearing. The rustic Mediterranean diet, with local produce, locally farmed and killed animals and local processing and production of cheeses, sausages and breads eaten by people who walk to work is part of that. That diet isn't just Mediterranean, it's simply rural. It has also mostly disappeared from our own cultures.

    Of course, we can't turn back the clock because the reduction in farm production would lead to famine. However, one thing we can do is start reducing our personal purchases of over-processed foods in the supermarket and start searching a little harder for local products such as free-range eggs, fresh fruits and farm-fresh vegetables in season, range-raised animals and similar products.

  • Jonathan Shewchuk

    7/31/2008 4:41:00 AM |

    What specific component of the Lyon Heart Study diet provided the cardiovascular benefit?  The most likely explanation I've seen is that it was the higher ratio of omega-3 to omega-6 fats in the "Mediterranean Diet", largely on account of a special margarine that was provided by the researchers to the Mediterranean dieters.  Details here:

    http://high-fat-nutrition.blogspot.com/2008/01/mediterranean-france.html

    I've seen lots of writing pointing out the disparities between what Americans (and researchers in Lyon) conceive to be the "Mediterranean diet" and what's actually eaten around the Mediterranean.  One example:

    http://www.proteinpower.com/drmike/uncategorized/a-tuscan-feast/

    Jonathan

  • Anne

    7/31/2008 9:13:00 AM |

    I enjoyed Anna's account of her experiences of the Mediterranean diet whilst on holiday on Italy. Such a shame she didn't pop over the border into France for a week or so. Having a house in France and relatives in Italy I can say from first hand experience that the food available in the stores, markets and restaurants in France is better than Italy when it comes to fresh fruit and veggies, meats, fish, and those lower carb foods which help our blood sugars (I am diabetic too) and hearts.

    The Coop where Anna shopped the first week made me smile. It reminds me how the Italians do not like, on the whole, to shop in supermarkets.  I don't think I've ever seen another supermarket chain other than the Coop in Italy ! Most Italian housewives shop in small local shops or in markets on market days, and that will explain the poor fruit and veggies in the Coop....a very dismal store. Go across the border to France and, although the French still like to shop at fresh markets and smaller shops, their supermarkets and hypermarkets are rather splendid for fresh fruit and veggies, and fresh fish and meat, as well as the usual things. The French too are increasing their intake of junk foods, but I don't think as much as the Italians who have always enjoyed bready things like paninis, cakes and sweets. The French do have their bread but it is much more crusty and full of air. Breakfasts in France are not suitable for a diabetic either being carbohydrate affairs as in Italy, but doing self catering, as in Anna's first week gets round that. Mind you, some French hotels are now providing self service breakfasts where you can help yourself to eggs, ham and fruit if you don't want the usual croissants and bread. French 'fast food', ie caféterias (caféterias are often attached to hypermarkets) or brasseries are excellent places to get good quality low carb food...freshly cooked steak with vegetables are easily obtained everywhere. I hardly ever have problems with my blood sugar in France.

    I believe the French have a lower incidence of heart disease than other Mediterranean countries...let's hope they keep it up. You see more fat French than there used to be but much fewer than in the UK (where I come from) and fewer than in Italy. There's a Mediterranean diet and a Mediterranean diet !

    Anne

  • Kevin

    7/31/2008 5:32:00 PM |

    As an army brat we spent a lot of time in Italy. Maybe it's different now but I remember whenever there was bread on the table there was also a bowl of olive oil.  Bread was torn into morsel sizes, dipped in olive oil and eaten.  I think on a weight-basis more olive oil than bread was consumed.

  • Anna

    7/31/2008 7:08:00 PM |

    zute, alan, jonathan, anne, & Dr. Davis,

    Why is it I can find so many people that "get it" online but hardly any in my own circles do (though I am gradually changing some minds)?  It's so frustrating to constantly hear the "Mediterranean diet" in the US inaccurately defined by Italy generically (and as some of you point out, largely excluding the other distinct diets that ring that area), and dominated by grain consumption, olive oil (with references to low animal fat & protein consumption, which is *not* necessarily accurate) and though produce is often mentioned and advocated, other than tomatoes, produce isn't isn't what most people load up on when they adopt "Mediterranean" ways.

    Zute, I fear you are correct, in that there is a huge profit motive in the over-marketing of many foods even remotely connected to the "Mediterranean" diet.  There certainly have been huge scandals over Italian olive oils for export (much of the Mediterranean olives are produced outside of Italy, but they go through Italy for pressing, bottling, and  distribution, and there is much fraud in the labeling/accuracy, especially with the pricier extra virgin OO designation).  I've no doubt there are numerous other ways various health claims are distorted for profit.  Dr. Davis has mentioned a number of them in several posts.  it takes a skeptical mind these days, doesn't it?

    Jonathan, I remember well the great, tantalizing photos of the low carb Italian food on Dr. Eades' blog last year, and often mentioned those to people who teased me prior to the trip about managing my low carb requirements while in Italy.  

    Being a short-term tourist brings about a necessary need to adapt standards to a certain degree, which is why we shopped more in Coops/Pam supermarkets (Pam was farther but open on Sundays) while we were preparing our own meals (easier to find and saved time for sightseeing and family visiting) instead of local markets, and we dined out while in hotels.  The kitchen in the farm apartment didn't even have a decent cheese grater or sharp knife so I purchased those and left them behind for future tourist tenants.  And of the 6 adults (of 9 family members), I was the only one interested in doing any cooking while we were in the countryside (a role I gladly took on).  One of my SILs is a chef in Norway, and she understandably wanted a vacation from cooking.

    My other SIL lived in Paris for 14 years (now back in London 12 years) and she many times said the Italian produce we encountered (she especially complained about the underripe fruit) didn't compare to French produce, which echos what Anne describes, as well as my own experiences during earlier travels to Brittany and Paris.  I never know where our next trip will be (usually determined by my husband's meeting locations or invitations from his friends and colleagues), but I always enjoy going to France, despite the complete inadequacy of my junior high school French level.  Haven't been to the southern part yet, though.

    And I think Alan hit the nail on the head with his description of the so-called various Mediterranean diets being "simply rural" diets (which to me implies local, seasonal, varied, and produced more in harmony with nature no matter where in the world), much like my rural Pennsylvanian great-grandmother's diet (I'm quite sure she never saw olive oil, gorgonzola, or an eggplant).  It was nice to reinforce that I can and already do create a largely "rural diet" for my family in my own locale (Southern California), which in many ways is similar to many parts of the Mediterranean region.   My small fig tree is now loaded with fruit, and the first one ripened just two days ago!  I have the chevre and walnuts ready!  Now that I have seen how small they can be, I  plan to get a olive tree or two, for the olive fruits as much as the beauty of the tree (plus I am a lazy gardener of edibles!).

    BTW, we only really had one "dud" dinner meal that was an expensive mistake (ordering "traditional" dishes), at a restaurant in Florence.   It was hard to determine quality based on price, as nearly all dinners were on the expensive side.  Our other full restaurant dinners were excellent (although I recommend skipping the pasta course).  If anyone is interested, I have recommendations for some places a tiny bit off the beaten track:  one in Florence, one in Siena (where the 9 of us had a celebratory dinner for my MIL's 80th year near the incomparable Il Campo square), and two in Rome (one specialized in "the fifth quarter" for those who appreciate that).  All were in the Rick Steve's italy book (but so was the "dud").  I'll probably be posting the names and locations on my own blog, along with meal photos sometime in the next week or two.

    Anyway, nice to read your comments on my experiences.  Good to know I am not the only one who explores the world with my stomach, too. Smile

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Victim of Post-Traumatic Grain Disorder

Victim of Post-Traumatic Grain Disorder

Heart Scan Blog reader, Mike, shared his story with me. He was kind enough to allow me to reprint it here (edited slightly for brevity).



Dr. Davis,

I was much intrigued to stumble onto your blog. Heart disease, nutrition, and wellness are critically important to me, because I’m a type 2 diabetic. I’m 53 and was diagnosed as diabetic about 5 years ago, though I suspect I was either diabetic or pre-diabetic 5 years before that. Even in a metropolitan area it's next-to-impossible to find doctors sympathetic to any approach beyond the standard get-the-A1c-below 6.5, get LDL <100, get your weight and blood pressure normal, and take metformin and statins.

I’m about 5’10-and-a-half and when I was young I had to stuff myself to keep weight on; it was an effort to get to 150 pounds, and as a young man, 165 was the holy grail for me. I always felt I’d look better with an extra 10-15 pounds.
I ate whatever I wanted, mostly junk, I guess, in my younger years.

When I hit about age 35, I put on 30 pounds seemingly overnight. As I moved toward middle age I became concerned with the issue of heart health, and around that time Dr. Ornish came out with his stuff. I was impressed that he’d done a
study that supposedly showed measurable decrease in atherosclerotic plaque, and had published the results of his research in peer-reviewed journals. It looked to me as though he had the evidence; who could argue with that? I tried his plan on and off, but as so many people note, an almost-vegan diet is really tough. It was for me, and I could never do it for any length of time. But given that the “evidence” said that I should, I kept trying, and kept beating up on myself when I failed. And I kept gaining weight. I got to almost 200 pounds by the time I was 40 and have a strong suspicion that that’s what caused my blood sugar to go awry, but my doctor at the time never checked my blood sugar, and as a relatively young and healthy man, I never went in very often.

I’ve had bouts of PSVT [paroxysmal supraventricular tachycardia, a rapid heart rhythm] every now and again since I was 12 or so. I used to convert the rhythm with Valsalva, but as I moved into my forties, occasionally my blood pressure would be elevated and it made me nervous to do the procedure because it was my understanding that it spikes your blood pressure when you do it. So I began going to the ER to have the rhythm converted, which they do quite easily with adenosine. On one of my infrequent runs to the ER to get a bout of PSVT converted, they discovered my blood glucose was 500 mg/dL, and I’d never experienced any symptoms! They put me in the hospital and gave me a shot of insulin, got it town to 80 mg/dL easily,
diagnosed me as diabetic, and put me on 500 mg. metformin a day.

I was able to get my A1c down to 7, then down to 6.6, and about that time I read a number of Dr. Agatston’s books, and began following the diet, and pretty quickly got my A1c down to 6.2, and my weight down, easily, to 158. That was fine with my doctor; he acted as though I was in good shape with those numbers. Soon I ran into Dr. Bernstein’s material, and came face to face with a body of research that suggested I needed to get the A1c down to below 5! That was both discouraging and inspiring, and frankly it’s been difficult for me to eat as lo-carb as I appear to need to, so I swing back and forth between 6.2 and 6.6. I know I need to work harder, be more diligent in my carb control, and I see with my meter that if I eat low-carb I have great postprandial and fasting blood sugars, but since I don’t particularly get any support or encouragement from
either my doctor or my wife for being so “radical,” it’s hard to pass the carbs by.

One thing that always confused me was that though I saw on my meter that BG [blood glucose] readings were better with a lo-carb diet, and though I saw the preliminary research suggesting that lo-carb could be beneficial in controlling CVD, I didn’t understand why Ornish had peer-reviewed research demonstrating reversal of atherosclerosis on a very-lowfat diet. How could two opposing approaches both help? I wondered if it were possible that one diet is good for diabetes, and the
other good for heart health. That would mean diabetics are screwed, because they always seem to end up with heart disease.

From time to time I’d look for material that explained this seeming contradiction. I was determined to try to stay lo-carb, simply because I saw how much better my blood sugars are when I eat lo-carb; but it’s hard in the face of this or that website that tells you about all the dangers of a lo-carb diet and that touts the lo-fat approach. That tends to be the conventional wisdom anyway.

Finally in one of those searches I came across your material, and saw you offer what was at last an explanation of what Ornish had discovered--it wasn’t a reversal of atherosclerotic plaques he was seeing; it was that his diet was improving endothelial dysfunction in people who had had high fat intakes.

Odd as it may seem to you, that little factlet has been enough to allow me to discard entirely the lingering ghost of a suspicion that I ought to be eating very-lowfat. In fact, I was very excited to see your claim that your approach can reverse atherosclerotic plaque.

It would be nice to find a doctor who’d be supportive of your approach. My doctor isn’t much interested in diet or
nutrition. He just wants my weight in the acceptable range, my blood pressure good, and my LDL 100 or below (which I know isn’t low enough). He’s not particularly interested in getting a detailed lipid report. I hope I can talk him into ordering one so that it’s more likely I can get it covered by my insurance.

I very much appreciated the links you gave to Jenny’s diabetes websites, and I’ve resolved to get even better control of my BG by being more diligent with my diet. I’m planning on joining your site, reading your book, and following your advice. I just have this sort of deflating feeling that it would have been better if I’d stumbled upon this before I had diabetes. Still, it’s nice to have a site that offers to laypeople the best knowledge available concerning how to take care of their heart.



Mike is yet another "victim" of the "eat healthy whole grains" national insanity, the Post-Traumatic Grain Disorder, or PTGD. The low-fat dietary mistake has left many victims in its wake, having to deal with the aftermath of corrupt high-carbohydrate diets: diabetes, heart disease, and obesity.

We should all hope and pray that "low-fat, eat healthy whole grains" goes the way of Detroit gas guzzlers and sub-prime mortgages.

Comments (14) -

  • Gretchen

    6/20/2009 2:03:19 PM |

    I don't think Ornish has ever shown that his diet results in plaque regression. What he showed was that his total program, including diet, exercise, stress reduction, giving up smoking, and lots of peer support reduced plaque. Then everyone ascribes the results to the diet alone.

    This is analogous to the studies that lump red meat into a diet group that includes cold cuts, sausages (including chicken sausage) and a lot of other things and then blame the red meat for the poorer results.

    You never see headlines saying "Chicken (sausage) is bad for you."

  • Peter

    6/20/2009 3:05:10 PM |

    I appreciate that letter, because I also try to keep on current research and it's hard to know which research to believe, since there's a fair amount of research that supports whole grains and a fair amount that supports a low carbohydrate diet.  I'm not a true believer type, so I'm looking forward to better research.  I notice that in Gary Taubes's book he says there has been no trustworthy research comparing the low carb and the whole food/whole grain diets, and I'm looking forward to it when it comes out.

  • Tom

    6/20/2009 5:44:16 PM |

    Yes, my guess is that *stress reduction* is key to the Ornish plan. The other components are really just contributors to this overall result, with the exception of the vegetable diet, which probably doesn't help.

    I don't write an excellent blog or care for any patients. Perhaps I may therefore indulge my speculations, safe in the knowledge that those who wish to ignore me will feel free to do so:


    Stress is normally thought of as something unpleasant that we try to avoid. And indeed it is, partly we do try to avoid it.

    But in truth we are addicted to stress. We interpret a rapidly beating heart, high blood pressure, racing thoughts, etc, as pleasurable.

    And they are. Or at least they seem to be (hangovers aside), from the perspective of the part of us that experiences them.

    Trouble is they are damaging to the whole. For example, pleasure/stress numbs subtle feelings which might otherwise yield clues to solving our personal problems. Our immune systems our temporarily dampened (presumably an evolutionary adaptation).

    Only relaxation and meditation (which we all do to a certain extent, whether we realise it or not), allow the mind to re-integrate and experience the deeper, forgotten joy of being alive.

    I believe that here, and not in calorie burning, lies the secret benefit of exercise: diverting attention into the body and away from the frenetic mind.

    I have no evidence for this that I can share, only a limited amount of fallible personal experience. But let me say that I have *felt* my blood pressure go down after a meditation session.

    And upon standing up afterwards, I've become dizzy, which is a symptom of hypotension!

  • Anne

    6/20/2009 6:36:35 PM |

    In a totally uncontrolled study of one, here are the results.

    While on the American Heart Association diet my lipids peaked in 2003. I even tried the Ornish diet for a short time, but found it impossible.
    Total Cholesterol: 201
    Triglycerides: 263
    HDL: 62
    LDL: 86

    After I stopped eating gluten(I am very sensitive) my lipid panel improved slightly. This past year I started eating to keep my blood sugar under control by eliminating sugars and other grains. Now this is my most recent lab:
    Total Cholesterol: 162
    Triglycerides: 80
    HDL: 71
    LDL: 75

    Not perfect, but getting there. I think I had a very serious case of post traumatic grain disorder.

  • TedHutchinson

    6/20/2009 9:39:05 PM |

    Gary Taubes recent lecture
    For those who haven't yet read
    Gary Taubes Good Calories Bad Calories
    this talk is based on just a fraction of the research he discusses in greater detail in the book.
    There are earlier version of this lecture online, this version is slicker, more jokes, and you can use the thumbnail slides to move around faster.
    Slides 41~49 are the crux of the matter.
    Interesting to hear what he says right at the end of slide 48.

  • Dr. William Davis

    6/21/2009 2:24:20 AM |

    Anne--

    I love it!

    I'd like to post your numbers in a future Heart Scan Blog post.

    Thanks for sharing. Your experience is bound to help others also "see the light."

  • Kateryna

    6/21/2009 3:24:36 AM |

    Dr. Davis:

    I'm 59 years old, was very sick, and if I had waited as others do for scientists to come to a consensus about diet and nutrition and for studies to be done, I would have died 13 years ago.

    If you value your health a short 1 month trial of a grain free diet will tell you immediately if it's right for you especially if you have health issues. Don't be afraid to experiment.

    As I said, I'm 59 and I'm still overweight, but I have resolved almost all my health issues by eliminating all sugar, processed foods and all grains and here are my latest lipids:

    Total: 182
    LDL: 95
    HDL: 65
    Trigs: 104
    Ratio: 2.6

    Also not perfect, but I know it will only get better as it has been for years.

  • Anonymous

    6/21/2009 4:25:40 AM |

    Some of the readers of this blog should be gluten free and not just wheat free. How to find which ones?
    IMO, Mike's difficulty in keeping on weight as a younger man indicates he should consider further testing for gluten intolerance or perhaps other food intolerances.

  • Anne

    6/21/2009 12:46:12 PM |

    Dr. Davis, you have my permission to post my numbers, use my name and use my picture.

    Thank you for thinking outside the box. I have coronary artery disease and had bypass in 2000 and I don't want to do that again ever. By incorporating TYP guidelines into my life, I feel I have greatly decreased  my odds of having more heart problems.

  • Anonymous

    6/21/2009 5:33:26 PM |

    I tried moving back to meat and giving up wheat/grains.  My blood lipid chemistry did not improve and I have to remind myself, a meat based diet is how I got here in the first place (2002) and why my father and his brothers had heart attacks at relatively young ages.

    Until I see a pier reviewed study showing grains are causal to heart disease, I'm going back to what has kept me from suffering the same fate as my father. No animal products in my diet.

    I'm off to make a few seitan steaks for the bbq

  • Grandma S.

    6/22/2009 12:11:12 AM |

    Anne,
    I am very impressed with your results.  Having trouble getting my husband's & my LDLs that low.  Would like to know in more detail how you are doing it, can you email me? Thank You!

  • Dr. Usha C

    7/22/2009 7:02:29 PM |

    Homeopathy Diet Planning
    Homeopathy together with proper diet can make wonders in medical field creating ability to treat most diseases effectively.

    For more information log on to
    http://homeopathydiets.blogspot.com/

  • simvastatin side effects

    5/23/2011 7:41:44 AM |

    Only relaxation and meditation (which we all do to a certain extent, whether we realise it or not), allow the mind to re-integrate and experience the deeper, forgotten joy of being alive.

  • Vegan4life

    5/8/2013 10:49:01 AM |

    Well said, Anonymous!  Going VEGAN (and not merely vegetarian) is best for ones health, mind and spirit - and vital for anyone who has heart and/or weight problems, type-2 diabetes, high blood pressure, bad cholesterol, asthma, etc., or a family history thereof.

    "Anonymous says:

    June 21, 2009 at 11:33 pm

    I tried moving back to meat and giving up wheat/grains. My blood lipid chemistry did not improve and I have to remind myself, a meat based diet is how I got here in the first place (2002) and why my father and his brothers had heart attacks at relatively young ages.

    Until I see a pier reviewed study showing grains are causal to heart disease, I'm going back to what has kept me from suffering the same fate as my father. No animal products in my diet... "

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