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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  • 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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Stents, defibrillators, and other profit-making opportunities

Stents, defibrillators, and other profit-making opportunities

16. April 2006 William Davis (2)
As a practicing cardiologst, every day I receive a dozen or more magazines or newspapers targeting practicing physicians, not to mention the hundreds of letters, postcards, invitations to "talks", etc. that I receive. All of these materials share one common goal: To get the practicing cardiologist/physician to insert more of a manufacturer's stents, defibrillators, prescribe more of their drugs, etc.

This is a highly effective and profitable area. Pfizer's Lipitor, for instance, generated $12.2 billion just last year alone. This kind of money will fund an extraordinary amount of marketing.

I'm on the www.heart.org mailing list, a website for cardiologists. I'd estimate that 90% or more of their content is device-related: discussions of situations in which to insert stents, the expanding world of implantable devices, the ups and downs of various drugs. Rarely are discussions of healthy lifestyles, exercise, nutritional supplements, part of the dialogue.

How can you protect yourself from the brainwashed physician, flooded with visions of all the devices he can put in you, all the drugs that can "cure" your disease? Simple: information. Be better informed. Ask pointed questions. The idiotic lay press tells you to ask a doctor about his education. That's not generally the problem. Some of the best educated doc's I know are also the most flagrantly guilty of profiteering medicine.

Ask your doctor about his/her philosphy about the use of medications, devices, etc. If their word is God, take it or leave it, run the other way.
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  • Anonymous

    4/22/2006 12:28:00 AM |

    Dr. Davis,
    You are truly amazing!  Let me ask you, why in the world are you the only one doing this stuff? Your intelligence and writing syle make these blogs so much fun to read.

  • Anonymous

    2/16/2010 9:23:05 PM |

    Your blog keeps getting better and better! Your older articles are not as good as newer ones you have a lot more creativity and originality now. Keep it up!
    And according to this article, I totally agree with your opinion, but only this time! Smile

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The ultimate “bioidentical” hormone

The ultimate “bioidentical” hormone

2. July 2009 William Davis (19)
There has been a lot of debate over whether or not “bio-identical” hormones, i.e., hormones identical to the human form, are superior to non-human forms dispensed by the drug industry.

The FDA is currently taking steps to clamp down on availability of bioidentical hormones and their claims of superiority, despite a groundswell of grassroot support for them. The argument has pitted anti-aging practitioners and the public, as well as the likes of Oprah and Suzanne Somers, against Big Pharma and the FDA, the two forces trying to squash the bioidentical hormone movement.

Regardless of what heavy-handed approach the FDA takes, we already have access to hormones identical to the original human form. It requires no prescription and yields downstream hormones that the human body recognizes as human.

That "bioidentical" hormone is pregnenolone.

Pregnenolone is the first biochemical step in the conversion of dietary cholesterol (yes-cholesterol!) to numerous other hormones. Pregnenolone is the source of the hormones that lie at the center of the bioidentical hormone controversy: estrogens, progesterone, and testosterone. We therefore already have our own over-the-counter, non-prescription form of bioidentical hormones.

Supplemental pregnenolone increases estrogens (mildly), progesterone, and testosterone. Prenenonlone supplementation simply provide more of the basic substrate for hormone production. The increase in hormones is usually modest, not as vigorous as direct hormone replacement like, say, testosterone or progesterone topical creams. But pregnenolone can be useful when small to moderate increases are desired, such as for reduction of Lp(a). A theoretical downside is that pregnenonlone can also convert to cortisol, the adrenal gland hormone that regulates fluid and blood pressure. However, I've not seen any measurable increase in cortisol with low doses of pregnenonlone and limited data suggest that it does not. Pregnenolone also converts to the other adrenal gland hormone, DHEA; I call DHEA "the hormone of assertiveness," since some people who take too much pregnenolone (or direct DHEA) acquire excessive assertiveness.

The key to pregnenolone supplementation is to proceed gradually and begin with a small dose, e.g., 5 mg every morning. Hormonal assessment is best conducted periodically to assess the effects and to determine whether a dose adjustment is in order.
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Comments (19) -

  • Jenny

    7/2/2009 12:46:09 PM |

    Dr. Davis,

    I have tried  "bioidentical" female hormones from a compounding pharmacy and ended up with sky high blood pressure and blood sugar. I do very well on the pharmaceutical yam-based estrogen. So I would caution people not to assume these hormones are benign.

    I also have supplemented pregnenolone for a while and had to stop as I also started to see bad results with blood pressure and a hint of masculinizing.

    So I would warn older women to be very careful with these hormones. The doses seem to be set very high and some of them may be optimized for males.

  • Nancy LC

    7/2/2009 4:36:31 PM |

    Dr. Davis, do you recommend any particular brand of pregnenelone?

  • billye

    7/2/2009 9:06:47 PM |

    Dr. Davis,

    Ordinarily I would have no interest in the ultimate " bioidentical" hormone" but, my daughter is going through her changes and is having a bad time with them.  Could pregnenelone be used to alleviate problematic symptoms? She is dead set against hormone therapy because she has a fear of  cancer.

  • Anonymous

    7/3/2009 3:04:08 AM |

    Bioidentical hormones have been a godsend for me... after "toughing out" a particularly long and difficult perimenopause I was in pretty dire straits.  I found a doctor who uses both mainstream Big Pharma hormones and bioidenticals in his ob/gyn practice, depending on the patient and their needs.  He is board certified, highly skilled, and compassionate.  After some trial and error and numerous blood tests, we arrived at compounded estrogen and progesterone as the best for me.  Gone are many horrible symptoms, so of course I would be very upset if the FDA were to "crack down" on "bioidenticals" in favor of manufactured Big Pharma products.

    That being said, if the FDA is so inclined... I will roll with it.  There are several prescription estrogen products, both oral and topical that could meet my needs.  They are for the most part manufactured from soy (as are most bioidenticals).  There are also some progesterone products manufactured by Big Pharma companies... and I am betting we can figure out how to get to the combination and dosage I require to feel good and normal.

    What won't I take?   Well Premarin and Prem-Pro for starters.  They're not bioidentical... in fact they are foreign to the human body.  Equilin,  derived from pregnant mares urine, or manufactured from soy, is not a requisite of the human body and IMO doesn't belong there. Give women a foreign hormone substance for years and wonder why the alarming results?  Hummm...

    As for pregnenolone, I don't think so, at least not for me.  At this late date, I doubt that my body would be efficient in utilizing it, or sending it down the correct pathway.  Why not just use the real things?

    madcook

  • Anonymous

    7/3/2009 3:42:55 AM |

    DHEA can cause substantial hair loss in men, it did suddenly and acutely in me.

  • pmpctek

    7/3/2009 4:42:09 AM |

    I'm no expert but it's my understanding that pregnenolone is the raw material for the production of DHEA, which is the raw material for the production of testosterone, estrogen, and progesterone.

    It's also my understanding that it's always best to try and supplement "bioidentical" hormones that are closest to the natural target hormone.

    If that's true and if pregnenolone is low and DHEA normal (say through supplementation) what's the point of taking pregnenolone at all?

  • Anonymous

    7/3/2009 2:15:38 PM |

    I've been on bioidentical hormones (progesterone) for 18 months and have had incredible success. I'm under the care of a MD who specializes in bioidentical hormones. Bioidenticals are safe and effective if the supplementation is medically supervised.

  • Anna

    7/3/2009 5:27:29 PM |

    At 47 yo, still cycling regularly but definitely perimenopausal the past few years.  New cycles start every 14-20 days (normal in every other way) if I don't use progesterone, but with progesterone, cycles are closer to normal length, every 21-28 days.  

    I've been using bioidentical OTC progesterone cream for a little over two years with very good results and no side effects that I can detect.  Just this week I switched to a higher prog dose via compounded Rx, as symptoms were returning/increasing the past couple months (especially midcycle extreme breast tenderness and increased lumpiness- negative ultrasound and mammograms though thermogram was suspicious, plus last exam indicated return of uterine fibroid - all suggestive of high estrogen/low progesterone imbalance).  

    A recent luteal phase test of estradiol showed it to be twice as high (549 pg/ml) as the upper end of the ref range, which explains the dramatically increased symptoms.  Guess those ovaries are screaming in protest during their decommissioning!  Progesterone levels were in the tank.  So was 8am cortisol level.  

    BTW, I've always avoided any supplemental phytoestrogens such as soy, "menopause" herbs, etc.  Numerous lood tests over the past 15 years have indicated no lack of estradiol (esp in recent years), but in fact, chronically low progesterone, despite regular cycles.  

    Along with years of undiagnosed hypothyroidism, I think low progesterone and a slightly shortened luteal phase were likely reasons why I had trouble conceiving 8-15 years ago (despite two infertility work-ups and "expert" review of my tests).  Wish I knew then what I know now (don't we all?)

    This backlash against biodidentical hormones, orchestrated by Wyett and other Big Pharma patent holders is very disturbing.  Like any other drug, the skill, experience, and knowledge of the doctor is crucial in prescribing them for the best effective treatment.  

    I've been cautious about self-treating with OTC hormones without some experienced guidance, including pregnenolone, because I wasn't sure it wouldn't convert to more estradiol instead of the progesterone and testosterone I needed.  But it took a long time to find an MD which the right experience.  Of course, she's not in my HMO-subscribed system so I have to pay out of pocket for office visits or compounded Rx, but it's worth it.  She writes the lab orders on a Rx form, which I take to the HMO lab, so insurance covers any of the lab tests they do.  Results are faxed to the ordering MD, even though she isn't in the system.

  • Jim, Guacamole Diet

    7/5/2009 3:41:40 AM |

    I guess I'm just an ignorant old Luddite, but I'm skeptical of all substances that don't come in natural foods. No prescription or OTC stuff for me if I can avoid it.

  • homertobias

    7/9/2009 3:39:50 PM |

    Anna,

    Late 40's are a rough time of life, kind of like being a 13 year old girl in reverse.  Ovaries are cranky as they rev up and as they rev down.  Next they start behaving like loose lightbulbs. They turn off for a month or three then they turn right back on.  It is hard to relie on hormone levels in that phase because things just keep changing.
    Late 40's usually screams progesterone deficiency.  First up to treat is usually vitex 500mg whole fruit daily.  Takes 3 months for full effect. Dirt cheap.  It works as a prolactin inhibiter and a progesterone booster.  Second is progest cream.  Third compounded progesterone or prometrium.  Route of prometrium varies with symptomatology.  Can't sleep?  Progesterone needs to be oral.  Still can't sleep?  Take it with food at bedtime to enhance absorbtion or up the dose.  Hung over in the morning?  Take it earlier.  Sleep not an issue but can't stand those early periods?  Use the progesterone vaginally at night.  Just shove it in as high as it will go.  The gelatin capsule dissolves and it goes straight to the uterus.

  • Elizabeth

    7/14/2009 9:58:46 PM |

    From my experience, bioidentical hormones really do work! After hearing so many people, like Susanne Somers and Oprah, talk about the
    benefits of hormone replacement
    therapy, I decided to give it a try. I looked around a lot, and I
    finally chose VieNue
    Bioidentical Testosterone Cream. All I have to say is, IT WORKS! My mood
    is so much better. I feel healthier. I have a healthy love life again - I
    used to always feel so "not into it." Now my husband and I are connecting
    again like we did years ago. Definitely give VieNue Bioidentical Testosterone
    Cream a try, you won't regret it. Here's the link vienue bioidentical testosterone cream

  • Anonymous

    7/26/2009 7:09:24 PM |

    You need to do a lot of reserach before starting hormone therapy... You should always have your hormones tested first! Saliva test is the best way to test your hormones levels. Also you need to use a compounding pharmacy that you can trust and a good doctor. This website helped to show why to choice bioidentcal hormones and you can even find a doctor in your area: http://www.bodylogicmd.com/research/safety-of-bioidentical-hormones

  • Amir

    8/21/2009 1:27:30 AM |

    I have been researching the bioidentical hormone therapy topic for a while and would like to see what people's opinions on the health benefits of bioidentical hormones like the reduction of breast cancer as explained in this article,

    http://bodylogicmd.com/hormone-articles/review-of-hormones-and-breast-cancer-can-we-use-them-in-ways-that-could-reduce-the-risk

  • Gloria Ives

    8/24/2009 4:01:45 AM |

    Can you address the cardiovascular risks associated with bioidentical supplementation as compared to typical pharmaceutical hrt?

  • Bioidentical Hormones UK

    9/24/2009 7:21:21 PM |

    Bioidentical hormones are products that are chemically identical to what's made in a woman's body.
    Some are approved as medications; others are supplements. Learn more about it from professionals in the field.

  • Anonymous

    9/25/2009 2:36:53 AM |

    Why not simply increase dietary cholesterol?

  • Lance Chambers

    3/1/2010 1:51:02 AM |

    I have watched the video and it's sad that corporate pharmaceutical industries have to chemically alter a natural substance in order to get patent for synthetic medicine or synthetic hormones but I think synthetic hormone should not have been approved for human use in the first place. It must have helped many people but in the long run it did more harm than good.

  • Lance Chambers

    3/1/2010 2:02:38 AM |

    Bioidentical hormones refer to hormones that are identical to the chemical structure of the hormones produced by a woman’s body therefore it is better and safer than synthetic hormones. Understanding your symptoms will also help you prepare for it and modification of lifestyle issues like healthy diet of organic foods to resist minor signs, light exercise to improve blood circulation level can help regulate the symptoms of hormone imbalance. Compounded bio-identical hormones are pills, creams, gels, suppositories, injectables, sublingual drops or lozenges that are prescribed by health care providers who tailor the dose to a woman’s individual symptoms and concerns.

  • buy jeans

    11/2/2010 8:16:26 PM |

    Pregnenolone is the first biochemical step in the conversion of dietary cholesterol (yes-cholesterol!) to numerous other hormones. Pregnenolone is the source of the hormones that lie at the center of the bioidentical hormone controversy: estrogens, progesterone, and testosterone. We therefore already have our own over-the-counter, non-prescription form of bioidentical hormones.

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