Do you happen to know if there's anything to adult stem cells & heart disease? My take so far has been that they do not work in a stem cell way (bona fide regeneration) and any benefits can be attributed to local secretion of growth factors or other molecules.

Absolutely incredible!  Good for them!

In Nov 2007 my lab tests showed blood calcium too high. Further tests showed parathyroid hormone too high. I had ultra sound and various scans ordered by the endo. In June 2008 I had one parathyroid gland removed. During this time my Vit D was 25 and 27. The endo was not concerned because "it was winter". I talked my PCP into OKing 1000 iu of Vit D but she said she had never seen the supplement increase the Vit D levels in any of her patients. No advice re D2 vs D3 or tablets vs get caps. Following your advice I am taking 1000 iu D3 gel caps. After some months I increased it to 2000 iu. Of course, I am wondering if the low Vit D might have had some bad affect on the parathyroid. Also I would like to know how much Vit D3 I should be taking but don't have a doc who seems knowledgeable. Any suggestions?

BettyB

Bettyb,

Doctor Davis doesn't often have time to answer questions posted at his blog. If you really want to know about how much vitamin D to take and how to get tested, you can learn more at the Vitamin D Council:

www.vitamindcouncil.org

Congratulations on your magnificent article "Halt on Salt Sparks Iodine Deficiency" for
October's Life Extension Magazine.  It should be required reading for all Doctors.  
Iodine is looking like the last piece of the puzzle for me reaching 60/60/60 without statins.  Thanks
for fighting the hard fight.

Matt W.

I have heard that excitement is a risk for heart patients. But this funny Cartoon says it excitment can kill anybody. See this cartoon

Thought I'd share this article from the UK about Vitamin D. I remain shocked some in the medical profession (or should that be industry) still do not understand the importance of D3 for children, and of course adults.

http://www.telegraph.co.uk/health/children_shealth/3350394/Why-vitamin-D-is-so-vital.html

I was very interested to read this post because I too have a congenital heart defect (not nearly as bad as this boy) which has led to aortic valve stenosis and I've been keen to know how much vitamin D might help with this since 2007 when I first started following Dr Davis' blog.

I live in the UK and I'm lucky that I have both a good cardiologist and good endocrinologist. My endocrinologist is keen for me to supplement with vitamin D3, both for my heart and for osteoporosis, which I also have, and I get regular 25(OH)D tests. I take 2,000 IU of D3 gelcaps per day and my level of 25(OH)D varies between 125 nmol/L (50 ng/dl) and 250 nmol/L (100 ng/dl), once rising as high as 384 nmol/L (154 ng/dl) so it's lucky a close eye is kept on these levels so my dosage of D3 can be adjusted. Lab error was thought, but every time the 25(OH)D has risen too high my alkaline phosphatase levels (bone specific) have also risen above normal, and every time the 25(OH)D is lower they are in the normal range.

My cardiologist is also supportive of the D3 as well as supportive of me using omega-3 fish oil and he prescribes it for me since it works out cheaper on prescription here in the UK than it does from a health food store.

The pressure gradient across my heart is increasing gradually and I will need an aortic valve replacement at some point...but who knows, things might have got worse faster without the D and the fish oils.

Anne

Bettyb,
I started on 1000iu of vitmain D3 then upped it to 2000, 5000 and 10000iu per day. At this dose my vitamin D results had achieved the magic 50 level. It is now six months since being on 10000iu and I am feeling fine. No side effects that I am aware of.

It's no wonder there is nutritional ignorance among MDs worldwide as they have only 1-2 nutrition classes during their training.  

We need to empower those who do have the training and education by expanding their resources and accessibility to patients.  Nutrition needs to be recognized as a vital part of healthcare, needs required post-graduate training for specialization in various disease states, and needs to be covered by insurance.

I agree that ignorance about nutrition is mainstream, however the problem seems to run deeper than this.

Taking supplements of any kind is thought to be unnatural and a compromise of some kind. Only nutrients from fresh food (preferably organic, local produce) are considered valid by the progressive class here in the UK. Supplements are pills and therefore are evil 'chemicals' and products of greedy pharmaceutical companies.
One or two vitamins/nutrients no doubt *are* poorly absorbed when isolated in pill form. This argument is used to condemn all supplements. Repeated headlines appear in the MSM which intimate that taking vitamins is actually harmful.

I'm trying to explain the feelings that cause many otherwise thoughtful people not to supplement. If it sounds vague and illogical that's because it is.

For example, in the cases of at least four of the most helpful supplements (vitamin d3, iodine, magnesium, vitamin k2), for most people it simply isn't feasible to obtain optimum amounts *without* supplementation.

Yet fashionable orthodoxy tends to prevent them from supplementating.

The importance of Omega-3 fatty acids is more widely accepted. If you examine it carefully, mainstream advice recommends averaging 2-3g per day without supplementation. It's very hard to take this seriously.

The weight of mackerel and oily fish you would have to eat is staggering.

It's a kind of doublethink.

Hi, Kismet--

This post wasn't meant to endorse nor critizie stem cell therapy for heart disease, something I have no experience nor strong opinions about.

Here's a paper on it:

http://www.ncbi.nlm.nih.gov/pubmed/19274033

Betty--

You really need to find a helpful healthcare provider who can coach you through the vitamin D and calcium issues. This is something you shouldn't do without assistance when calcium issues are involved.  

However, we have seen many cases of "secondary" hyperparathyroidism improve with vitamin D supplementation. Dosing is by blood levels, particularly important in your situation.

Michaela,
I read a post today that you should be interested in.  It is relative to ejection fraction and how blueberries increased EF by 82%.  You will find it at "nephropal.blogspot.com".  Dr. T is a nephrologist who is the author of the blog.  He is one of those brave hearts like Dr. Davis who is interested in helping people.

Safe Remedy for Heart Patients:Tashi Cardio Pro Capsules developed by face doctor is really a great help for most of the heart patients.

How cool to be able to give that to someone, to change their life with an email.

wew. it's not a good story..

Hi, Tom--

This is why we need to stage a "revolt" in the form of self-directed health, putting many strategies, including access to nutritional supplements, out of conventional healthcare and in the hands of everybody. This includes access to lab services, even diagnostic testing.

Off-topic, Dr. Davis, but this will be your new favorite photograph:

http://www.frigginrandom.com/images/beer-belly-master/

Lifting of Calcium Scan Ignorance?

http://www.sciencedaily.com/releases/2009/09/090930102536.htm

The ScienceDaily Press Release article is below.  You probably already knew this, but, just in case.

Calcium Scans May Be Effective Screening Tool For Heart Disease

ScienceDaily (Oct. 1, 2009) — A simple, non-invasive test appears to be an effective screening tool for identifying patients with silent heart disease who are at risk for a heart attack or sudden death. Coronary artery calcium scans can be done without triggering excessive additional testing and costs, according to the multi-center EISNER (Early Identification of Subclinical Atherosclerosis by Noninvasive Imaging Research) study, led by investigators at the Cedars-Sinai Heart Institute.

The findings appear in the September 30 issue of the Journal of the American College of Cardiology.

Coronary artery calcium scans that detect plaque in the coronary arteries have been shown to be more effective than standard cholesterol and blood pressure measurements in identifying patients who are most vulnerable to heart disease. Currently, these scans are not covered by private insurance carriers, in part because of concerns that detection of low levels of cardiovascular disease will result in unnecessary and expensive further testing, including exercise imaging and invasive cardiac catheterization procedures. "Over half of patients who suffer heart attacks have no warning that they have heart disease until the heart attack occurs. If we knew the patients were at risk, current treatments could prevent the majority of these unnecessary events. We had to address the concerns about unnecessary testing and costs related to this potentially lifesaving procedure," said Daniel S. Berman, M.D., the study's principal investigator and chief of Cardiac Imaging at Cedars-Sinai's S. Mark Taper Foundation Imaging Center in Los Angeles.

In the EISNER study, supported by The Eisner Foundation, researchers performed coronary calcium scans on 1,361 volunteers at intermediate risk for coronary artery disease, and followed them over a four-year period, from May 2001 to June 2005. The objective was to determine the relationship between coronary artery calcium scores and subsequent cardiac events and to evaluate the performance of additional cardiac diagnostic testing. Coronary artery calcium scores of 0 indicate no plaque, 1-9 minimal, 10-99 mild, 100-399 moderate, 400-999 extensive, and 1,000 or more very extensive plaque.

SNIP
Recent evidence has demonstrated that screening with coronary artery calcium is a better prognosticator of risk than the Framingham Risk Score—the traditional way of assessing risk based on blood testing and blood pressure--in middle aged and elderly patients. Yet controversy surrounds expansion of cardiac screening to include coronary calcium scanning imaging because of concerns that the extra costs may not outweigh the benefits. The findings of the EISNER study, the researchers note, is the first direct evidence that coronary artery calcium scanning could be an acceptable cost-effective screening test for coronary artery disease, since it is able to identify high risk subgroups in need of aggressive medical treatment, and patients who undergo additional testing constitute only a small fraction of the screened population.

You forgot agave syrup, which a lot of people are using as an "all natural" low-glycemic replacement for HFCS. In fact, it contains more fructose than HFCS.

One manufacturer's products include “low glycemic monosacharide.” Gosh, I wonder what that is.

It would be a service, if you (or someone) posted a "fructose" content list which includes all the common fruits and berries. I eat a lot of berries and have wondered if that is such a good idea. A list would help us define "good calories" regarding these possible fructose bombs.

Thanks for the visuals and labels on fructose...I am very aware of fructose contents and fruit -- especially since I have experience with fruit and gout attacks that may or may not be supported in literature.  I will only add that every time you purchase a product DO NOT ASSUME CONTENTS ARE THE SAME as when you last purchased.  For example, Classico pasta sauces which I used as base for soups and stews (all LC) has started adding sugar.  CostCo Kirkland brand marinated artichoke hearts (again LC) started out using olive oil, now uses cannola oil. My experience as label-reading shopper is food producers are now adding sugars including fructose to just about everything because the buying public perceives sugar to be tastier...even the rotisserie chickens most grocery delis have now...be careful if you very LC to whether the spice rub has sugar in it.

What don't you find it in?

Finding it hard to believe that an apple wouldn't have some other redeeming value that counteracts or balances the fructose content: soluble fiber, fiber, vitamins, minerals, etc.  Hopefully this is not an indictment of all fresh fruits?

It's all very well to measure fructose content, but it is meaningless unless we know what intake levels have to be before they become problematic.

In my own case, when I went "paleo" a couple of years ago, I swore off sugar, grain, and processed foods.  I lost 15 lbs over six months without trying.  Now this was before I heard about the fructose issue, and I was eating fruit like I never had before in my life, 3 to 4 pieces a day, and the sweet ones, too:  apples, bananas, grapes, dates, etc.  Surely I was ingesting more fructose than I had been before with a blob of ketchup here, steak sauce there...

Not to put too fine a point on it, but what you show as A.1. Steak Sauce is actually their marinade. Real A.1. Steak Sauce (at least my bottle) contains no HFCS, but does have 2g sugar per serving. Thank you for spending the time you do on this blog; you, along with some others, have given me the intellectual and scientific basis I needed to change my diet. The improvements, physical and mental, have been astounding.

The fructose info is interesting, but I agree with GK. We really need to know what is considered a safe level before condemning all fructose sources.

Fruits do have certain health benefits, some more than others, especially berries. There is also the possibility that by becoming super fructose-phobic and avoiding all fruits/berries,  that one could decrease their chances of heart disease, just to succumb to cancer instead.

Perkdoug, I have found that the web site "nutrition data" has a breakdown of sugars for things. Go to nutritiondata.com and type in the food you are interested in. Choose the right food and quantity and then go down to the section on carbohydrate and click the see more details. When I did that for dates, 1 medjool has about 7.6 grams of fructose (eek!). Like many folks I am cutting down on my fructose consumption so use this table a lot.

How about the king of HFCS--Soft drinks and candy.

As someone else asked, "what don't you find it in?"

Fructose can be found in many vegetables too.  One sweet onion has 6.69 grams, a half head of cabbage has 6.58 grams, a head of lettuce has 5 grams, a cup of chopped red peppers has 3.37 grams, a medium sized cucumber has 2.62 grams.  In fact nutritiondata.com lists 138 vegetables which have some amount of fructose in them (albeit many having very small amounts.)

So, if one's goal is to avoid all sources of fructose and still maintain any semblance of good health, well good luck.

@Nameless: Well put!

I think tossing fruit is a bit of the baby out with the bathwater.Fruit has the most wonderful spectrum of bright tastes and flavors of any food we have on the planet. "Healthy" vegetables encompassed the bitter, the flat, and the algae like part of the flavor spectrum. Me, is meet and nice in small to medium quantities but when eaten in low-carb volumes, it just becomes something you shovel in to make hunger go way.

Fruit is a wonderful gift. Adding a little sugar and heating some berries produces this wonderful sauce you can pour over pancakes or creps (if my diabetes let me have crepes). Some fat, flour, and salt makes a wonderful crust that you wrap around sliced and spiced fruit. Cold cherries crunch between your teeth dribble juice around your tongue while you roll the stone around your mouth cleaning off the last of the fruit meat. Peaches with ginger, peach blackberry, blueberry pie. Sliced and cored apples cooked in red-hot cinnamon sauce on the stove and then chilled before serving on Christmas Eve. On a hot August day, wandering through an orchard and dodging Yellowjackets when picking a beautifully ripe peach off the tree.  Pulling a crisp apple out of winter store in November and tasting what will become cider.

On a more practical level, I also need to make the decision on how much fruit versus how much bulk  laxative? If I eat one piece every days, I'm looking 8+ tablespoons of Metamucil.  bleck.  I'd rather starve myself in  other areas to make room for the delightful sweetness of fruit.

Who said throw fruit out?

I believe you are reading things that aren't there.

I disagree.  without giving a threshold of "bad", your presentation implies that all fructose at any level is bad.  I read some comments as expressing fear or doubt that they were eating too much fruit.  others like me what to know the threshold of bad.

just between you and me, I'd give up living before I gave up fruit.  no joke.  the flavours of fruit are that important to me.  I've already lost enough food ground with diabetes, I'm not giving up any more.

According to Dr. Richard Bernstein, fruit does not have to be a part of a healthy diet. Here is what he says in his book, Diabetes Solution:

"Although eliminating fruit and fruit juices from the diet can initially be a big sacrifice for many of my patients, they usually get use to this rapidly, and they appreciate the effect upon blood sugar control. I haven't eaten fruit in almost forty years and I haven't suffered in any respect. Some people fear that they will lose important nutrients by eliminating fruit, but that shouldn't be a worry. Nutrients found in fruits are also present in the vegetables you can safely eat."

Dr. Bernstein has had T1DM for about 50 years and advocates a very low carb diet to help normalize blood sugars. http://www.diabetes-book.com/

Because of blood sugar problems I have eliminated all sources of HFCS and have greatly limited my fruits. I find I can eat a few berries or a bite or two of other fruits without raising my blood glucose, but I mostly stick with colorful low carb veges.

Dr: Davis -- "Who said throw fruit out? I believe you are reading things that aren't there."

Yet you start this post with a photo of an apple. Although perhaps it wasn't  your intention, it certainly implies that fruit is bad.

National estimates of dietary fructose intake increased from 1977 to 2004 in the United States.
high-fructose corn syrup percentage of sweeteners increased from 16% in 1978 to 42% in 1998
Since 1978, mean daily intakes of added and total fructose increased in all gender and age groups, whereas naturally occurring fructose intake decreased or remained constant.
If you can't get the full text at least read the abstract. The full text has some interesting charts presenting the data more clearly.
It isn't eating naturally sourced fructose from whole fruit driving increased obesity. Increases in fruit consumption are dwarfed by greater increases in total daily energy and carbohydrate intakes.

RE: Comment by Nameless (“Yet you start this post with a photo of an apple. Although perhaps it wasn't your intention, it certainly implies that fruit is bad”)
-------------------------------------------------------------------------------------------

The good doctor is merely demonstrating in effective graphic terms that
too much of a good thing is not good. The numbers (ie gms of fructose)
are important guidelines. There’s no point in getting your nuts in wringer over it!

Bernstein developed Diabetes at age 12. He was born in 1934, so at age 75, he has been diabetic for 63 years. No diabetic complications. Normal blood sugar for all!!

I think its more helpful to express sugar content (and fructose if known) as a percentage rather than an amount per (varying) serve.  It makes it easier to compare apples to apples (scuse pun).  I've prepared a few listings of various food groups (several hundred items in each) on this basis at www.howmuchsugar.com if you are interested.

Some people suffer from fructose malabsorption. One source states that it is found in approximately 30-40% of the population of Central Europe. If one has that condition, then it would be prudent to avoid all fructose, even the fructose found in fruit. I love the taste of fruit, but it is destroying my health due to malabsorption issues. Fortunately, we know that some cultures lived very healthy lives without eating fruit (e.g. Eskimos).

I don't get it. What am I not seeing?

How much high fructose corn syrup is in a serving of the BBQ sauce? How much in a serving of the steak marinade?

You state such figures for a serving of apple (1 medium), and for a serving of honey (2 Tablespoons).

I had to give up fruit to prevent further beta cell damage (above 140 apparently for pre-diabetics, and maybe everyone, I don't know). Fruit and many veggies are toxic to people with glucose intolerance. I had to give up veggies for now, until I can find one that I can tolerate. Cabbage was too hard on my blood sugar. I am slowly trying to figure out what I can eat and how to minimize the glycemic impact. Unfortunately, I might have to damage my beta cells to find out what works. The system told me I was fine, even though I told them I had sugar problems. I gave up on doctors 10 years ago, since they were useless. I finally bought a meter and started testing, and the truth is painful.

In addition, since I have been involved with cardiac CT for now nearly 24 years, the PLC also affords me an opportunity to develop a CT coronary angiography training program for cardiologists and radiologists (www.cardiaccta.us). Together, these new efforts are merely an extension of my interests in prevention, patient care, and teaching.