Wow, sounds good but that is a LOT of Truvia.  The same amount of real stevia would render that inedible.  I've never tried Truvia, so maybe it isn't as sweet as the real stuff.  I like KAL brand stevia.

BTW, i was excited to learn that you're going to be on Oz on Monday.    I think your message should be carried to all the Land.  i hope it does get thru (i know TV shows have a tendency to edit so that the message gets diluted or even lost).  Best wishes!  (Well, i suppose it has already been filmed, still.)

Ah Christ, it seems I ate to much fiber yesterday!  Not to take the lords name in vain this Sunday morning just the fiber rich foods have me run down this morning.  But with that said, I think the defective gut will be alright.  That's a nice change!  The gut will thump and pulsate, and make all kinds of fussing through out the day I'm sure, but the typical sickness I would experience seems to be fading on the latest diet.  Kind of nice, to say the least.  Figure eventually fiber foods will be possible for me to eat again.  Not that I'm all that excited about this, a carrot or cucumber doesn't excite, but it would be oh so nice to broaden the monotone diet a bit more from what it currently is.  

Congrats on the success of the books!  Very nice and wonderful that word is making its way out to "alternative" ideas to improve ones health, particular with the problems that wheat can have on ones health.  Alterative might not be the correct word to use anymore.  These ideas seem to be becoming more mainstream.  There are a good number of unhealthy people out there, that want help, and are motivated to try new ideas.  As can  be seen with your book, many are finding relief from condition they were all to often told by other health care professionals that their condition could not be treated and must be dealt with for life.  For me personally a big motivation for why I spread the word to others about dietary ideas to address heart disease, and now other health issues, was desperation.  I can remember how very sick I was at one time, home bound largely, in a great deal of pain, and desperate for relief.  Back in the internet days often times I would finding myself not wanting to approach others with dietary information to help with conditions.  It was information that would seem foreign to them.  Then simply I would often think of what I've gone through, how sick I had been, and believe maybe this information can help.    

Well, it's time for me to move on to new pastures.  With being slightly healthier and having more energy here of late, there are other items on the mind.  I've had people seem to suggest ways to make a living continuing this work/hobby, but to be honest I do not believe that possible.  I never have carried much for the attention.  And there are safer hobbies to participate in.  Possibly I can get into cloths tailoring, making my own cloths.  That would be fun I would have to imagine.  

Oh, I guess to mention too, someday you might hear about me again.  If I do recover there is a good chance I'll write a book, pamphlet, web sight, what have you, detailing about how I solved my stomach issues and hopfully heart plaque also.  It's a shame that from my experience hospitals seem to care so little about dietary ideas.  It isn't strictly correct, but often times I feel as if I've had to invent the wheel for addressing my gut condition.  In an ideal world, that shouldn't have been the case.

Has this blog died?  It used to be interesting. the last few entries seem just to be over-sweet recipes..
Sad, really..

This is what I hate about medicine: one size fits all. Thyroid treatment should be based on symptom relief using labwork to make sure there isn't overtreatment. And all thyroid supplements should be available to the patient. Not just what the doctor gets paid (oops!) to use.

Hi Dr. Davis,

Check this link out...  The doctor at the link references your work.  Not sure if you're familiar with his.

I've saved the link on two lines that need to be combined to paste into the browser.

http://jeffreydach.com/2008/06/26/
saving-tim-russert-and-george-carlin-by-jeffrey-dach-md.aspx

The interesting thing about the article for me was this...

I have previously noticed about 1/3 of my eyebrows had gotten thinner.  And I also have wondered about the puffiness around my eyelids.

Sheesh...

What do you think about that site?  If you don't answer here in comments perhaps you could address in your Special Report or at your blog?

Thanks for all you do.

wccaguy

Why expensive Zetia. Niacin appears to outperform Zetia.

http://www.webmd.com/cholesterol-management/news/20091116/niacin-tops-zetia-in-cutting-artery-plaque

While in this study the expensive Niaspan was used, you can by Slo-Niacin dirt cheap.

http://www.costco.com/Browse/Product.aspx?Prodid=11118583

Why do insurance companies pay for Lovaza? They are usually very picky and Lovaza would seem an obvious "soak" job?

How did it get on approved drug lists?

Dr. Davis,

Your correspondent should tell his brother to ditch the Zetia too. The research makes it clear it does not prevent heart attack and may worsen health. Statins appear to be helpful because of their impact on inflammation, not because they lower LDL cholesterol. Zetia lowers cholesterol in a mechanical way that has no impact on inflammation.

Why is a 44 year old being subjected to open heart surgery? Quacks.

As an internist not categorically opposed to statins (although I agree with starting with nutrition first, which is why I read this blog), there are generic alternatives for this person's brother. If my patients need Western drugs, I start with cheap generics whenever possible. Zetia has dubious benefits of ANY kind, and costs a fortune. And of course Dr. D is right that there are many cheaper sources of fish oil; I usually point my patients in that direction.

I often feel "standard" American-style medical practice is intended to waste as much money as possible. People need to be able to trust their docs to execute plans that are not only based on the research evidence, but are cost effective. There is no culture of cost-effective medicine in this country, because health care was defined by the Americans as a for-profit arena.

"Prescribe unto others as you would have them prescribe unto you."

Lovaza fills a void created by bad government and insurance policy. According to IRS rules, over the counter supplements cannot be covered by many insurance handlers. My work's HSA is like this. Fish oil / omega-3 is technically considered an over the counter supplement. The folk making Lovaza more than understand the benefits of omega-3 and want to sell it to the folks who want their insurance to pay for it. So they made it into a "drug" and sell it as such. It's a brilliant marketing plan and it seems to be working for them. The sad part is that it is working! It shouldn't! Same thing goes with Lovastatin. Why not take a good red yeast rice? Oh well... you pay for what you don't know.

-- Boris

Your post, Dr Davis, seems more a call for better health care, the kind we here in the United Kingdom get under our National Health Service, than a call for different fish oils or different meds.

The NHS does have it's problems, sure, but they're nothing like the problems this person you describe has.

It's ironic that her brother is trying to be a "good" American by paying his bills and not filing bankruptcy.
If only his doctors, insurance companies, and drug mNUFcturers had a similar ethic.  It seems that for them, being a good American is maximizing their income regardless of who they take it from.
Ordinary Americans have been sold this "good" American concept from birth.  It's propaganda.  Far too many special interests have used it to enrich only themselves.

Your brother should not be paying anything for drugs to lower cholesterol.

Cholesterol is not the enemy, nor is saturated fat.

The real enemy is chronic inflammation that comes from several sources but mainly from a high grain diet (too much omega 6).

Please, read http://www.omega-3-fish-oil-wonders.com/good-fats.html

Best wishes,
Alfredoe

I have read with interest the comments concerning Lovaza. I was put on it in 2008. I have tried numerous times to ask GSK through emails & ph calls the calorie make up in the gelcap. No one seems to know! Not the Doctor who put me on it, the pharmacist, or anyone from GSK!!! As a diabetic who has lost 140 lbs, following my diet plan is very important to me. Any suggestions on who can make them give up the big calorie secret?
Thanks,
Beverly

Had this reader not been aware that her brother could take fish oil as a nutritional supplement, he likely would have been denied the benefit of omega-3 fatty acids in slashing the risk for recurrent cardiovascular events. You and I can buy wonderfully safe and effective fish oil as a nutritional supplement, but there won't be a sexy drug representative to sell it, nor an expensive dinner and payment for a trip to Orlando to hear about it.

Beverly,
A rough estimate for the caloric content of each Lovaza capsule would be approximately 8-10 calories.  Since each capsule contains roughly 1 gram of total fat.

Is there any difference in fructose by source?  I know that natural fructose has a molecule that is  either right-handed or left-handed (can't remember which) and manufactured fructose is the opposite?  Could that account for a difference in how they're metabolized?

Yes, honey does contain fructose. But there is evidence that suggests that natural honey has a very different effect on the human body than an control that contains the same amount of fructose, glucose, etc.

The Effect of honey on serum cholesterol and lipid values. found that sugar did not raise LDL as a comparable sugar syrup did.

The study Natural honey and cardiovascular risk factors; effects on blood glucose, cholesterol, triacylglycerole, CRP, and body weight compared with sucrose. found that honey actually had beneficial effects on several risk factors.

See also: Natural honey lowers plasma glucose, C-reactive protein, homocysteine, and blood lipids in healthy, diabetic, and hyperlipidemic subjects: comparison with dextrose and sucrose.

In this study (Substituting honey for refined carbohydrates protects rats from hypertriglyceridemic and prooxidative effects of fructose.) it was shown that honey did not have the same effects as purified fructose, at least in rats.  

The research in this area is thin and conclusions should not be written in stone, but I think there is enough research to suggest that the effects of honey (or fresh fruit) in 'moderation' cannot be reduced to simply a mixture of sugars.

I believe we clearly evolved as omnivores and are intended to eat some fruit; we should be able to deal with the metabolic effects of some fructose. The explosion in health problems related to fructose is due to the fact that 1) the amount being consumed is so large, and 2) the fructose is highly refined and has been stripped of natural antioxidants and other phytochemicals that are present in natural honey or fruit.

Regardless of what honey does once it's been absorbed, for those of us who don't digest fructose well it is frequently a quick ticket to intestinal distress (as is agave nectar).

As Dr. Royal Lee pointed out in the 1920's. Honey is a complete food, containing proteins, vitamins, minerals, coenzymes, and cofactors; as well as the fructose. Eat too much of it (or any whole food) and the body will avoid it for months to years.

Processed foods have no such feedback mechanism.

Interesting references (I love honey), but what is the biological rationale for those findings? Some magical & so far unkown micronutrient in honey?

Even if the latter is the case, eliminating fructose while adding this nutrient X would be even healthier (that is assuming the fructose literature shows a convincing dose-response relationship, I haven't checked).

Not for *me*, because I'm diabetic, but for most people I think there *is* an advantage to using honey, molasses, sorghum and/or maple syrup instead of granulated sugar.  

It's not the minerals and vitamins, cause it's not enough to be significant.  If raw, there's some enzymes too, but again... really a salad and a cup of broth has way more micronutrients than any of these syrups.

But these all taste way stronger than sugar.  It's really easy to oversweeten things with white sugar, because the only taste there is "sweet".  If you're sweetening with a strongly-flavored syrup, it's a lot harder to overdo.  

It's easy for someone to put 2-3 tsp of sugar in a cup of coffee; much less likely for them to put in that dose of molasses.

In short, for people who do not have blood glucose issues, using the syrups for sweetening still cuts sugar consumption down a lot, which is a good thing.  

And for those of us with blood glucose issues, there's stevia.

However, honey will have the natural form of fructose, the D isomer, which can be converted to glucose and go through the glycolytic pathway. The chemical process which produces HFCS makes a significant amount of L-fructose which can only be processed by immeditately turning it into fat. This may account for Jonathan's studies showing good things from a non-industrial source of fructose. I suspect the same things would be shown with fructose from fruits.

Fascinating on honey (& possibly fruit). I've always been suspicious of equating HFCS, or purified lab fructose, with the fructose found in fruits and in honey. Do you have any references for the d isomer / l-fructose distinction?

Thanks

Well this is definitely going to make me think twice before using spoon-fulls of honey in my next camomile tea, lol. This is useful information that was surprising to me, so thanks for sharing! I work with a program called Chef's Diet, and we create meals used from fresh produce and lean meats, delivered to your door daily.  I find your post pertinent. If you or your readers are interested in healthy eating and are interested in Chef's Diet, check us out at http://www.mychefsdiet.com.

Jacob, this was my source for the L-fructose comment. Maybe not the most reliable source but an interesting premise. I have not gone to the original literature to verify.
http://www.westonaprice.org/modernfood/HFCSAgave.pdf

According to the Finnish National institute of health and welfare, honey contains only 41.4% fructose.  Even allowing for half of the 1.5% sucrose being converted to fructose, its still short of the 50% fructose for table sugar or the 55% for HFCS.

See http://www.fineli.fi/food.php?foodid=4&lang=en

"jon said...
As Dr. Royal Lee pointed out in the 1920's. Honey is a complete food, containing proteins...."

Are you referring to Royal "Jel" Lee?

Sorry. I could not resist.

from what I've been reading...mass produced honey where bees are under forced conditions to produce honey are fed fructose corn syrup and this leads to higher levels of fructose in our honey.  fructose corn syrup is the ultimate culprit and is something I avoid. when shopping for honey, the cheaper honey will most likely be the honey that is "spiked" with fructose corn syrup.  it is also referred to as "baker's honey".  you need to buy whole organic honey to get honey that doesn't contain the corn syrup.  also, most food that has honey as an ingredient will contain fructose corn syrup.  I used to buy the "golden blossom" brand of honey but discovered that is is packed with high fructose corn syrup.  I only buy organic now...its a bit more money but worth every penny

Ah, yes, the HFCS Big Lie: the artificial sweetener produced from agricultural starches. Despite its name, the fructose in HFCS is not the same as the L-fructose found in fruit and honey; instead it contains high concentrations of D-fructose, a naturally rare “mirrored” version of reversed isomerization and polarity.  In mammals (including humans), both isomers of fructose are not used directly for energy, instead being shunted by the liver for conversion primarily into blood triglycerides and body fat.

The two fructoses are not the same, and the HFCS industry is not inclined to look for possible secondary health effects; they just want their profits to continue.

Honey is a wholesome food eaten for millenia by humans, containing much more than simple sugars. HFCS has been around for mere decades. Why be a lab rat for ADM or Cargill?

"Is there any difference in fructose by source?"

I don't know.

"I know that natural fructose has a molecule that is either right-handed or left-handed (can't remember which) and manufactured fructose is the opposite?"

Fructose in nature exists in many forms depending on what has produced it.

Fructose can exist as a linear ketose, a six-member pyranose ring, or a 5-member furanose ring. These exist in left-rotating(D) or right-rotating(L) forms.

I don't see any specific pattern that would allow one to claim that fructose in corn syrup is somehow uniquely evil. It is even produced by a biological process with enzymes.

If you're going to do some more research on this, keep in mind that the notation can be a bit confusing. Small l and small d refer to which way it rotates plane polarized light(l is anti-clockwise/left and d is clockwise/right). But there is also big L and big D which refer to the different enantiomers; in fructose it happens to be that l-fructose is a D-fructose and vice versa.

"Despite its name, the fructose in HFCS is not the same as the L-fructose found in fruit and honey;"

No the most common kind in nature is D-fructose, also known as l-fructose(capitalization matters).

"[...]instead it contains high concentrations of D-fructose, a naturally rare “mirrored” version of reversed isomerization and polarity."

But it's not naturally rare. You won't usually find L-fructose in plants; but this does not prevent you from getting plenty of L-fructose in a "natural" diet.

Fruits contain not just fructose, but also lots of sucrose. When you eat this sucrose it will be broken down by acid hydrolysis into L-fructose.

Different plants, animals, bacteria or fungi that use enzymes instead of acid hydrolysis to break down sucrose use different enzymes, yielding either L-fructose or D-fructose.

L and D enantiomers does not cover all varieties of fructose that exist in nature.

I don't see any particularly sinister pattern here. It smells more like more like it is part of the long-running FUD campaign against the artificial and man-made by the technophobes. See the success of organic farming for the damage such long-running FUD campaign can do. Organic farming uses more land, more water, more energy and more pesticides. Which replaces "artificial" fertilizer such as mined potash, with "natural" fertilizer such as mined potash without the dirt removed(all this does is increase shipping costs).

The honey is really great for the skin, i usually use it in my face, is really wonderful. After my mask i feel my face smooth and clean. And my boyfriend always notice the difference, he simply love it. I feel more comfortable with my self and he is always with too much energy because he usually buy viagra

While the average per capita intake of honey is only a modest 1.29 lb per year (National Honey Board; 2008) and therefore contributes only 0.77 lb of fructose per year, there are people who, believing honey to be healthy, use it to excess and use far more than 1.29 lb per year.

For your body fructose is fructose - simple. The body has no way of differentiating. The outer shell is stripped off and what remains is FRUCTOSE. Fructose cannot be used for energy and will be shipped to the liver once processed and converted to fat - usually abdominal fat (note the expanding muffin tops of young girls drinking fruit juices as healthy options)!

Fructose is fructose to your body, whether you have to digest it or it's supplied to your processed.

You can see from this analysis and study that honey reduces your immune function, for instance, by nearly as much as pure fructose and by much more than glucose or starch:

http://www.second-opinions.co.uk/leukocytic_index.html

Anyone eating the recommended low-fat, high carb, high fibre diet and having those 5 small meals a day, will have impaired their immune function by 50% for pretty much the whole day!

For optimal health you have to eat a high fat diet, that's very low in carbs.

Follow my thread here:
http://www.godlikeproductions.com/forum1/message1156003/pg1

Research on mice shows that, for them, fructose causes insulin restance and obesity. Insulin resistance makes type 2 diabetes worse, converts pe-diabetes into type 2, and type 1 diabetes into type 1.5 (also known as double diabetes).

Does this also apply to humans?  The "expert" opinions vary so widely that they essentially prove little more than the need for similar research on humans.

Manufacturing processes seledom distinguish between the two isomers at all, and therefore starting with anything that does not have isomers would almost always produce a 50-50 mixture of the two isomers of fructose.

Manufacturing processes starting with one isomer of something would be much more likely to produce just one isomer of whatever their result is.

So far, research on humans has shown that fructose make your brain increase your appetite.  Also, your liver converts it into cholesterol and saturated fat.  The rest of your body has little use for it; it cannot be used for energy the same way glucose can.

Do D-glucose and L-glucose have different effects on your body?  I haven't found any research papers saying one way or the other yet.

One more comment:  The heating process used in manufacturing high fructose corn syrup, will, if overdone, turn some of it into a compound toxic to honeybees.

Does this also apply to humans?  So far, I haven't found any research papers saying that anyone has done any research into whether it does or not.