The “Heart Healthy” scam

27. July 2008 William Davis (1)
Like many scams, this one follows a predictable formula.

It is a formula widely practiced among food manufacturers, ever since food products began to jockey for position based on nutritional composition and purported health benefits.

First, identify a component of food, such as wheat fiber or oat bran, that confers a health benefit. Then, validate the healthy effect in clinical studies. Wheat fiber, for instance, promotes bowel regularity and reduces the likelihood of colon cancer. Oat bran reduces blood cholesterol levels.

Second, commercialize food products that contain the purported healthy ingredient. Wheat bran becomes Shredded Wheat, Fiber One, and Raisin Bran cereals and an endless choice of “healthy” breads. Oat bran becomes Honey Bunches of Oats, Quaker’s Instant Oatmeal, and granola bars. Even if many unhealthy components are added, as long as the original healthy product is included, the manufacturer continues to lay claim to healthy effects.

Third, as long as the original healthy ingredient remains, get an agency like the American Heart Association to provide an endorsement: “American Heart Association Tested and Approved.”

The last step is the easiest: just pay for it, provided the product meets a set of requirements, no matter how lax.

You will find the American Heart Association certification on Quaker Instant Oatmeal Crunch Apples and Cinnamon. Each serving contains 39 grams carbohydrate, 16 grams sugar (approximately 4 teaspoons), and 2.5 grams fat of which 0.5 grams are saturated. Ingredients include sugar, corn syrup, flaked corn, and partially hydrogenated cottonseed oil. Curiously, of the 4 grams of fiber per serving, only 1 gram is the soluble variety, the sort that reduces cholesterol blood levels. (This relatively trivial quantity of soluble fiber is unlikely to impact significantly on cholesterol levels, since a minimum 3 grams of soluble fiber is the quantity required, as demonstrated in a number of clinical studies.) Nonetheless, this sugar product proudly wears the AHA endorsement.

Thus, a simple component of food that provides genuine benefit mushrooms into a cornucopia of new products with added ingredients: sugar, high fructose corn syrup, corn starch, carageenan, raisins, wheat flour, preservatives, hydrogenated oils, etc. What may have begun as a health benefit can quickly deteriorate into something that is patently unhealthy.

There’s a clever variation on this formula. Rather than developing products that include a healthy component, create products that simply lack an unhealthy ingredient, such as saturated or trans fats or sodium.

Thus, a ¾-cup serving of Cocoa Puffs cereal contains 120 calories, no fiber, 14 grams (3 ½ teaspoons) of sugar—but is low in fat and contains no saturated fat. Proudly displayed on the box front is an American Heart Association stamp of approval. It earned this stamp of approval because Cocoa Puffs was low in saturated, trans, and total fat and sodium. Likewise, Cookie Crisp cereal, featuring Chip the Wolf, a cartoon wolf in a red sweater (“The great taste of chocolate chip cookies and milk!”), has 160 calories, 26 grams carbohydrate and 19 grams (4½ teaspoons) of sugar per cup, and 0 grams fiber—but only 1.0 gram fat, none saturated, thus the AHA check mark. (Promise margarine, made with hydrogenated vegetable oil and therefore containing significant quantities of trans fats, was originally on the list, as well, but removed when the trans fat threshold was added to the AHA criteria.)

It is this phenomenon, the sleight of hand of taking a healthy component and tacking on a list of ingredients manageable only by food scientists, or asserting that a product is healthy just because it lacks a specific undesirable ingredient, that is a major factor in the extraordinary and unprecedented boom in obesity in the U.S. Imagine the chemical industry were permitted such latitude: “Our pesticide is deemed safe by the USDA because it contains no PCBs.” Such is the ill-conceived logic of the AHA Heart-Check program the "Heart Healthy" claims.

It’s best we keep in mind the observations of New York University nutritionist and author of the book, Food Politics, Marion Nestle, that “food companies—just like companies that sell cigarettes, pharmaceuticals, or any other commodity—routinely place the needs of stock holders over considerations of public health. Food companies will make and market any product that sells, regardless of its nutritional value or its effect on health. In this regard, food companies hardly differ from cigarette companies. They lobby Congress to eliminate regulations perceived as unfavorable; they press federal regulatory agencies not to enforce such regulations; and when they don’t like regulatory decisions, they file lawsuits. Like cigarette companies, food companies co-opt food and nutrition experts by supporting professional organizations and research, and they expand sales by marketing directly to children, members of minority groups, and people in develop countries—whether or not the products are likely to improve people’s diets.”

Qualms over just how heart-healthy their products are? Doubtful.
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Comments (1) -

  • jimray

    7/28/2008 3:26:00 PM |

    I want to print this out and post it on the wall of my office.  You have made clear what I have been trying to articulate for years. The labels do not always tell the truth. And ultimately it goes back to money. Thank you.

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"Flying in the fog"

"Flying in the fog"

2. March 2008 William Davis (3)
I received this wonderful response to The Heart Scan Blog post Hammers and Nails:

I am 65 years old. I had a stent inserted in the "widow-maker" artery (80% blockage) a year ago. I had passed out a couple of times (heart rate dangerously low - 30s). I rode to the hospital in an ambulance. Tests revealed short LBBB episodes; mild mitral regurgitation, mild tricuspid regurgitation. Catherization showed 3 vessel CAD. I was told that a medicated stent was absolutely necessary given the situation; regardless, I have to accept that. A pacemaker was installed to prevent bradycardia and keeps heart rate from dropping below 60. I have 20% L distal main blockage and 90% lesion of the high first obtuse marginal at the takeoff. The right coronary had 60% posterior lateral branch stenosis.

Since then I have reduced TG from 360 to 60, LDL from 89 to 82 (although a few months ago it was in the mid-70s), and increased HDL from 30 to 46. I went from 265lbs to 190lbs and hope to eventually get to 180lb this Spring. I did it by progressing from walking to trotting (slow run) and dietstyle changes (low-GI veggies, fruits, etc.) .













On a recent visit the cardiologist said the the LDL needs to be 70 or below to "freeze" the 90% blockage and gave me a prescription for Lipitor. I asked if there were alternatives, like diet, supplements, etc. He admitted that he did not know about those alternative but did know Lipitor. When the only tool you have is a hammer then everything is a nail. I understand that the 90% blockage is important but will not take the Lipitor to achieve the 12 points reduction. Seems like an overkill.

I asked him if there was a way to evaluate my current condition. I was told there was no way. Basically, if I have no symptoms, good. If I have symptoms then it will have to be evaluated. Death could be the only symptom. I swear he was about to say bypass surgery ($$$$$$!) was inevitable. Something is wrong with this "fly-in-the-fog-and-hope-you-don't- hit-a-mountain" approach. Hope is not a strategy!

I am confident that I can reduce LDL to below 70 based on eliminating wheat-products in my diet plus increasing oat bran in my diet. I also take fish oil daily (EPA/DHA-2g). I am looking for a new cardiologist. I just recently purchased your book and find it very instructive. In the meantime I have an appointment with my primary care physician to discuss implementing the Track Your Plaque program. I realize that the one stent will skew the scan numbers but can be used as a baseline number.


Phenomenal weight loss! That alone has likely cut this man's risk in half. But is that it? Is the cardiologist correct--take Lipitor and hope for the best?

Of course not. There are many additional strategies to employ. Eliminating wheat from the diet is an excellent idea: HDL will skyrocket, triglycerides drop even further, small LDL will drop like a stone, blood sugar and blood pressure will drop. He will have more energy, get rid of afternoon energy slumps, sleep better.

He has already added fish oil. If his cardiologist did not mention this, I would say he was guilty of malpractice. The data supporting the addition of fish oil to the treatment program of anyone with heart disease is overhwelming. GISSI Prevenzione: 11,000 participants--28% reduction in heart attack, 45% reduction in death from heart attack. The Japanese JELIS trial of 18,645 participants--19% reduction in dangerous heart events. It's also clear that omega-3 fatty acids from fish oil also compound the benefits of statin agents, should this man choose to begin Lipitor.

Vitamin D brought to normal blood levels is his next "secret weapon" that will further boost his lipids and lipoproteins further into not just "normal" territory, but beyond belief. Even though we aim for 60-60-60 for LDL-HDL-triglycerides in the Track Your Plaque program, adding vitamin D can yield numbers you've never seen before. It's not uncommon, for instance, to see a 10 or 20 mg/dl jump in HDL.

Identify all other hidden causes of coronary plaque. If all the causes have not been fully identified, how can anyone hope to gain full control over coronary plaque growth?

Re: LDL cholesterol of 89 mg/dl at the start. Of course, this is a calculated value, not measured. Because HDL was low and triglycerides high at the start of his program, this means that true LDL--if actually measured--was probably more like 180 to 250 mg/dl, and it was probably nearly all small. So his cardiologist might have advised a helpful treatment, though for the wrong reasons.

Our reader has gone a long way on his own in creating his own prevention program. But there's yet more to do, particularly if the goal is reversal. It is shocking to me that a man like our reader, clearly articulate and motivated, gets virtually no advice beyond "take Lipitor" after all the procedural benefits have been reaped.

Even though one artery can no longer be "scored" due to the presence of the metallic stent, a heart scan would still be invaluable for long-term tracking purposes, just as we advocate in the Track Your Plaque program.



Copyright 2008 William Davis, MD
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Comments (3) -

  • Anonymous

    3/2/2008 6:04:00 PM |

    Dr. Davis -

    I am the "anonymous" reader who posted the "flying in the fog" comment.  Thank you for commenting on my adventure!  However, there is one correction I would like to point out and that is my weight.  I typed "365" and that is a typo; it should be 265.  

    Here is before-after pix.  'Before' was about 5 years ago; complete with wheat-belly.  'After' is recent after playing catch with my adult son.  Note the shirt is the SAME.   http://s88082351.onlinehome.us/oldnew.png

    I have to say that after the stent was inserted the only advice I received was to walk daily for at least 45 minutes and follow AMA recommend diet.   I asked how this kind of thing can be prevented from happening again and was told that the walking and exercise would help -- that was IT.  If not for an acquaintance in California who completely reversed his plaque growth I would have been left to think that it was hopeless and just wait for a disaster.  I had the occasion to visit the man in California last June.  It was absolutely mind-boggling learning experience.  He is my age and was overweight when he began his program 5 years ago that he and his cardiologist developed.  What struck me was that he did not look his age but 20 years younger!  

    I am very, very grateful that you have this blog.  I discovered your blog by accident and, as I mentioned, purchased your book.  I plan to join your forum site as well.  Where does one go when a cardiologist does not offer or volunteer information or when trying to get answers to questions seem like trying to chisel granite for a response?   Horrific.  This blog serves as a beacon especially to those like me that discover they have been abandoned -- left in the desert to fend for themselves with no place to go.  

    Thank you, Dr. Davis!  

    Have a great week.

  • Dr. Davis

    3/3/2008 11:51:00 PM |

    Thanks for you wonderful story. I've gone back and added your photo directly into the post.

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Victim of Post-Traumatic Grain Disorder

Victim of Post-Traumatic Grain Disorder

20. June 2009 William Davis (14)
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.
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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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