Fantastic blog!  Just what I was searching for when I found you via a blog directory (BlogFlux).

Question though....where is the "Track Your Placque" website that accompanies this blog?

Thanks.

Mike--

The website address is:

www.trackyourplaque.com

Dr. Davis

These tactics are consistent with the experiences I've had with the sales representatives from the company (when I used to actually talk to sales reps; my office is now barred from them). The reps very aggressively would urge me to consider having everyone take Plavix. No kidding.

Really? You're trotting out the anti-carnivore rant again?
Would you like to back up your claim that we somehow need fibre?
Or polyphenols and flavonoids, and tocotrienols, in the absence of the oxidised situations they counter?
Do you consider that Vitamin C is absorbed better when dietary glucose is minimised, as the two require the same uptake system and glucose will hog that system if it's present?
If we need Vitamin K1, why didn't the Inuit suffer debilitating deficiencies?
Why didn't they die young of bone fragility if their blood pH was truly so dangerously affected by acid load?

It seems like your ideas here are based on unproven theories, not practical, clinical scientific demonstrations. If you'd like to link to studies demonstrating how individuals following a carnivorous diet (preferably one based on pastured, wild animals) suffer in the manner you've outlined, I'd love to read them.

I really respect your blog and your efforts with helping your patients find lifestyles that work for them, but uninformed, unsupported posts like these are very disappointing.

Absolutely correct, as always.  I switched from the Standard American Diet 5 years ago to a raw, plant based diet of dark green leafy vegetables, nuts, seeds, healthy fats and lean protein... no low carb, highly processed or over cooked meats. Totally eliminated wheat and corn based foods, and especially anything with HFCS. My blood sugar has dropped to below 100 1 and 2 hour post prandial and my A1C is 4.5.  Also, triglycerides are 50 and VAP shows mostly large LDL.  It really works, and I have seen it work for others who have followed the same program.  I write about it at my blog: myoptimalhealthresource.blogspot.com. Having read Dr. Davis for years, I would like to thank him for his spot on information!

How about crushing a nice 10oz grass fed, organic, free range steak along with that salad, and then the whole debate of plant vs animal debate is moot?

It's a myth that eating a high animal protein low carb diet will cause bone loss. Studies do not support this.

http://www.ncbi.nlm.nih.gov/pubmed/16718399?dopt=Abstract

to include more plant-based options in anyone's diet, this blog post from Chris Masterjohn seems to contradict your 6th point.

So although I may arch an eyebrow at that point, I still agree that we shouldn't be consuming animal products ad libitum at the expense of plant-based options.

Randy Watson

Do we really need fiber? I recall a chapter in Taubes' book saying that fiber doesn't do much for you if you're not constipated. And Vilhjalmur Stefansson went for 2 years without eating vegetables and had no problems with scurvy. Apparently anti-nutrients in carbs up our vitamin C requirements. If I recall correctly it uses the same GLUT transporters glucose does.

Lots of Carbs and  O-6 in nuts;this is good?

No thanks.. I'll stick to the eggs meat and cheese and get plenty of Vit C in the process. You absolutely don't need plants in your diet, they aren't magic..

Vitamin-C can be supplied by raw green chillies.

Is Vitamin-K1 required? I thought all vitamin-K1 does is to convert to K2.

IS Fiber essential? if yes, then in what quantity?

Dr Davis, Do the plant foods you list in your suggested breakfast menus at the end qualify as low carb?

wow, I can just see the pro-animal fat nuts rushing to retort to this one... pardon the pun, but it's like red meat to a caged lion...

Actually, it wasn't UNTIL I ate more saturated fat (in the form of butter and coconut oil) that I saw a significant improvement in my HDL. Up until that point it was hovering around 50'ish. It shot up to 80 after incorporating the coconut oil. Unless you would consider coconut oil plant based even though it's mostly saturated fat?

I sincerely attribute my improved HDL to saturated fat.

but that... but that means we can't use low carb as an excuse to indulge in an orgy of gluttony with bacon, cheese mayo and steak.

Do you think eating a balanced plant/animal diet (low-carb) would be sufficient as an everyday diet/lifestyle?

I've been doing a similar low-carb ketogenic diet the last 4-5 months and never felt better. I'm planning on doing the ketogenic diet again but my doctor and my girlfriend her dietician said that this diet is very bad for the liver and the cardiovascular system.

The only drawback in my opinion is the lack of fruits in order to stay in keto.

What's your take on this?

Oops, forgot to include the link to the paper:

http://www.ajcn.org/cgi/content/full/71/3/682

I am on a fish diet where 50% of my calories are coming from it(wild salmon) and have finally gained an ideal weight but i also eat some fruits and dark chocolate as well.There is a lot to be said about acidity factor which means that we are meant to eat both heavy and light foods to balance. The most important omission from diet would be grains , processed foods and vegetable oils.

I thought that one of the observations that explorer Steffansson made on the health of his Inuit hosts was the lack of scurvy in the settlement.

I also believe that in the absence of plant food,it has been concluded that meat can supply sufficient Vitamin C to prevent scurvy.

It seems to me that to conclude " that humans were meant to eat lots of plants" is a conclusion too far.

I suggest that the "or" in your should not be read as "either/or" but the "logical or" meaning " one or both".

Utterly ridiculous suggestion. Regardless of all the details that have been covered by previous posters, do you consider eating modern fruit and vegetables to be 'in tune' with the way we were designed to eat?

A plant based diet is only possible through modern means, mainly transportation. I'm sure American olive oil is fantastic.

I really don't think you've thought this through. Where are the calories? Do you drink a pint of walnut oil a day? Keeping carbohydrates and  animal sources down leaves you incredibly limited.

Lastly, the idea of a 'side dish' of meat is absurd. Picture the scene: Hunter Tom in England kills an Auroch, begins gorging on the bountiful fat surrounding it's kidneys but then remembers: 'oh, better stop, I have boiled nettles awaiting'.

Get real, kids don't like vegetables for a reason.

With the Inuit argument you should consider whether they consumed the gut contents of the animals they ate.

So by this reasoning we should avoid fruits because of their citric acid content?

Too many people assume that anyone on a LC diet is pigging out out on huge amounts of fatty meats and cheese, with no vegetables. This is simply not true.

It's like criticizing someone on a low-fat diet by saying they're eating a breakfast consisting of two bowls of cereal, 3 cups of skim milk, 5 pieces of toast, 2 tablespoons of jam, and 3 glasses of OJ.

If I choose to eat bacon and eggs, I'd have one poached egg with a quarter of a pat of butter, and 1 slice of bacon. Maybe 2.

In your point 1 you're comparing spinach with meat. Apples and oranges. You need to compare a complete animal- protein-including meal with a complete animal-protein-lacking meal.

Re point No. 2: you can get vitamin C from uncooked meat. Does this mean we're meant to eat uncooked meat?

I eat plenty of LC vegetables. I just don't eat an all-vegetable meal because I need protein to stabilize my blood sugar and hold me until the next meal.

It's very difficult to do a vegetarian LC diet because we need protein, and the usual vegetarian protein sources like beans and rice are too carby. The only exception is tofu, and one cannot live on tofu alone.

I totally disagree. The points on vitamin K and vitamin C are startling- very much at odds with my layman's research. Certain organ meats are sky high in vitamin C. The need for C also goes down on a low sugar diet. Conversion from K1 to the all important K2 is very poor in humans eating a plant based diet. Where is K2 MK4 found? Pastured eggs and dairy, seafood, organ meats, etc.

Ah, the voice of reason.  How the hell did you get in here?  

Stuffing oneself with 5000 calories of fat every day made no sense when I was reading Atkins 15 years ago.  I think we evolved to be able to eat healthily using animal and vegetable sources.  Our modern health problems don't stem from anything more than excesses of everything.  Although it's much harder to ingest excess vegetables compared with meat.  

kevin

The major problem I see in this recommendation is that without calorically dense, starchy carbs and/or a lot more fat it would be hard to take in enough calories. I can deal with the fat. Even Mark Sisson champions the Big Ass Salad. And Stephan at wholehealthsource has started including more veggies & carbs. I do think animal protein/fat should make up the bulk of the diet though.

Yeah, fiber's over-rated. So is olive oil. Olive oil never did *anything* for my lipid profile. Olive oil makes you fat.

People evolves, even to feed on pasta: http://www.visitlimonesulgarda.com/index.asp?menu=13.58

Thinking we're the same animal that fed on mammoths 10k years ago and that we have to eat that makes little sense.

Thinking we all would react the same to an inuit diet, having inuits evolved for such a long time to survive where they live eating where they eat, makes no sense.

There are many people on the planet that live health and diets vary a lot.

Dr Davids, and anyone else for that matter, can only give pointers, but everyone has to find its own way to health and not expect it to be the same for every one and to be one single real truth.

We are 6 billion mutants with 6 billion different ideal diets

Now you're talking my language, Dr. D. Great post! I welcome more like this one. This reader wants to know everything you know on the subject of low carb plants vs high fat meat/dairy.

Jezwyn, you took the words right out of my mouth.

Let's see some proof for these claims.  You'll be hard-pressed to find it.

Tell the Masai and Inuit that you need a diet high in plant foods to be healthy.

I tend to believe that a diet with plant AND animal products is at least quasi-optimal, in part for evolutionary reasons:

http://healthcorrelator.blogspot.com/2010/02/lucy-was-vegetarian-and-sapiens.html

But on the acid-base blood balance argument, there are a number of other issues to consider:

- Lack of activity leads to bone demineralization, regardless of what you eat. Astronauts start losing bone mass soon after the start living in zero-gravity.

- Higher protein intake is associated with higher dietary calcium absorption.

- Higher serum levels of vitamin D are associated with increased serum calcium levels and bone mineralization. In fact, hypervitaminosis D leads to elevated serum calcium levels, even with low dietary calcium intake.

- The Inuit, on a traditional diet of animal meat and fat, have among the lowest (if not THE lowest) rates of tooth decay in the world - and bone mineralization is correlated with teeth health (although the correlation is not 1).

You describe my diet to a "t". Low animal products, lots of plant based. Low carb.So at 61, I am told I look in my 40's, rarely ( if ever) suffer from any of the common afflictions, and enjoy robust health. Gotta be something right about all this.
Confirmed heavy animal products in your diet lead to all sorts of problems. Minimize them and you minimize the problems.

Plants don't seem to help much in cancer prevention, so why heart disease? Fruit and vegetables have little effect on cancer risk, study finds.

Aw man, you lose credibility when you publish stuff like this...

I've been on a low carb diet for years, but my health was never so improved as when I finally cut all plant matter out of my diet.

-Amber

Is it my imagination or were the previous recommendations when I started reading this blog many months ago more evidenced-based pointing to specific studies, and lately they've been much shorter and more like "statements" of "fact" without any supporting documentation?

I don't get it.

Smells like someone's trying to court a little controversy to generate some buzz.

It's easy to forget the Stefansson all meat trial. It was supposed to answer all those questions and doubts about various deficiencies such as vitamin C or calcium. And it did in my view. So why does doubt still persist to this day?

If you believe that you should eat plants, then go ahead an eat them. But for a PSA, stick to the facts.

Sorry, in my haste to bring an argument in favor of an all meat diet, I forgot this argument against a plant based diet.

Dr Davis, you say "I believe a strong argument can be made that a low-carbohydrate but plant-based diet with animal products as the side dish is a better way to go."

It's already been weighed and measured and found to be lacking. In comes Ancel Keys and his semi-starvation experiment. It is exactly the kind of diet you propose: Low carb plant-based diet with animal products as the side dish. The result? Emaciation and neurosis. But that was a low calorie diet, you say. And probably lacked many nutrients, you say. Yes and yes. In comes the Biosphere 2 project which tried to fix one of those problems by administering the full RDA in vitamins and minerals every day. The result? Still emaciation and neurosis but admittedly to a lesser extent. Maybe it would work with ample calories?

I don't think it's merely a question of calories at this point. I think it's partly a question of essential nutrients found only in animal flesh. Or a question of the depleting nature of a high plant diet. In other words, eating a high plant diet requires more of those essential nutrients, including total calories, found only in animal flesh.

Ok. I just found your blog. Now I'm really confused. These two questions I'd like answered:

-Where do you agree/disagree with Esselstyn?

-What am I supposed to feed my three year old. He eats oatmeal and fruit for breakfast? (It's supposed to be healthy!)

Great post -- and to the vegetable naysayers -- there is more evidence to suggest than not that veggies are a healthy addition one's diet.

A low carb, non-veggie diet is an experiment -- "if" it turns out to be healthy, more power to it.

In the mean time -- I'm sticking with the decent epistemological studies out there that support the use of veggies/fruit the diet.

@ John Phillip,

I accomplished all those milestones, plus my HDL is over 70 mg/dl, all on a heavy carnivore dominant diet. John, you curiously did not divulge your HDL level.

@ Jenny,

Agreed.  Myths are hard to kill.  This acid/alkaline theory of disease is clearly a long standing one.  

Absence of renal and lung disease, the homeostatic mechanisms controlling the pH of our blood are incredibly robust and tightly regulated.  Even if you have poor regulation of bicarbonate concentrations in blood (dialysis patient) or you suffer from chronic respiratory acidosis (hyperventilation) it's not as though eating more plant foods and restricting meat and cheese will at all reverse the acidic condition these more serious underlying disturbances cause.

Even if meat and cheese yields a heavy acid load, all that may result is slightly more acidic urine.  There is no credible evidence that proves the act of intentionally alkalizing your own urine by dietary restrictions prevents or treats any disease, makes you feel better, or anything else.

The evolutionary evidence indicates our paleolithic (pre-agriculture) ancestors ate a LOT of meat. It doesn't make any sense that meat is unhealthy to humans.

And, the present-day evidence supports meat consumption, too.

In my case, I've been on a ~10% carb diet (mostly salad and vegetable carbs, no grains, very little fruits) for 5+ years. My blood stats are outrageously healthy (at 48 yrs old). HDL = 98, trigs 47, VLDL = 4, C-RP = 0.2. A1c = 4.8.  I can go on and on. I look 10 years younger than I am, my VO2 max is 52 (and I do not do any cardio), bodyfat = 10%, and I have no arterial plaque.

Sadly, I do not like seafood, so I eat red meat almost exclusively, plus a lot of coconut oil.

I also take over 40 supplements a day, including K2 (K1 is far less effective, not sure why you like it more, versus the animal version of K), tocotrienols (agree these are amazing), and numerous supps that reduce glycation, inflammation, and brain degeneration.

BTW, natural fed meats are greatly superior, but even grain fed meats are adequate. And red meat is healthier than chicken meat due to having significantly lower levels of polyunsaturated fatty acids.

I think in something so important as "nutrition", it is not possible to adopt an "one tooth paste menthality". It depends a lot on the environment, climate and hence the gut flora composition of each individual and the digestion issues.

During the past year of being part of the low-carb, paleo/primal community. I have observed for some people eating plants even in small quantities cause bloating , gut discomfort and eliminating them and a carnivoros diet has almost saved their lives , are much healthier . On the other hand some of the fittest members eat huge amont of animal food + huge amont of plant food.

As a mediterranean I am very used to eat plant food , and had concerns on eating VLC food due to acid/alkaline balance so did a bone densitometry through my traumatologist, to repeat it after 2 years feb 2010, and comparing the results ; there is a 10% bone density loss! Ofcourse in these 2 years of VLC I did a lot of mistakes with too much processed meat and LC junk foods at the beginning, and was an evolution towards the grass fed meat and realfood. And also the fact that a part from walking , I am quite sedentary too!

For me never felt right to leave out the plant food so drasticaly when I was doing VLC,I can enjoy a nice juicy beef steak , but with a side of salad or some steamed veg , the joy is even more and feels much better on my guts and the BG levels.

So is the matter of each personal biochemistry process and many factors influencing it.

It is a question of indivitual trial and error and listening to ones body needs. Then decide to be carnivoros, VLC, plant based, animal based , paleo or primal.

Dr. Davis,

I'd definitely be interested if you personally see results with any of your patients taken delta gold. I've been taking it a year now. I'm just trusting the small clinical trials, and hope they are legit.

Maasai are plant-eaters as well as meat-eaters.

Comment from Ethnobotany of the Loita Maasai   about the great "meat-eating Maasai" tribal culture:


"Animals are kept both for economic reasons
and as a source of food. Milk from cows, especially
fermented, is the main traditional food of the
Maasai. Herbal soup is an important part of the
diet for most people, men and women alike, but
especially for the warrior age group. It is taken as
a health food by ordinary people and as a drug by
warriors. Meat is usually eaten during ceremonies.
Wild food, especially fruits, tubers, resins and
roots, are still important, particularly to women
and those taking care of animals in the field."

Full-text here:http://unesdoc.unesco.org/images/0012/001266/126660e.pdf

David--

As we do not use tocotrienols in the program, we have no formal experience with it.

However, having had an extended conversation with Dr. Barry Tan, I have to say it is worth looking at again, though my in-depth interest dates back nearly 20 years.

The Masai may eat some animal foods, but they certainly aren't a "side dish" as you recommend.

Inuits eat lots of meats, but also eat plants.

Dr. Weston Price on observing the eating habits of the Inuits during the first 20 years of the 20th century (before substantial Western influence on the Inuit diet took root):

"The food of these Eskimos in their native state includes caribou, ground nuts which are gathered by mice and stored in caches, kelp which is gathered in season and stored for winter use, berries including cranberries which are preserved by freezing, blossoms of flowers preserved in seal oil, sorrel grass preserved in seal oil, and quantities of frozen fish. Another important food factor consists of the organs of the large animals of the sea, including certain layers of the skin of one of the species of whale, which was found to be very high in vitamin C."

Organ meats and the fat of cold water creatures are indeed richer in vitamin C than muscle meat that we consume. When is the last time you ate muktuk?

Oops, that should have read "The Masai may eat some plant foods, but they certainly aren't a side dish as you suggest."

I agree with a low carb diet based on animal and vegetal products, but I diagree with a so high fiber diet. See 'Fiber Menace' book, recommended by Weston Price Institute.

Help for the nut-allergic, please.

Dr David and all, you have a interesting tocotrienols report in Nutraceutical Magazine september 2009, its about newest tocotrienol supplement formulation, in page 42

http://www.nutraceuticalmag.com/NBT/pdf/2009/NBT_SO09.pdf

You're right. so all in all, the key is to balance everything and place more emphasis in eating plant-based foods than animal products, specifically meat. I've tried a low-carb diet upon my doctor's reccomendation due to my hypertension, and although it's not easy at first(coz I'm used to eating lots of carbs), I got used to it after some time.

You lost me on this one.

This is getting ridiculous. Carbohydrates are evil and animal products are bad. Yum, I'm looking forward to my dinner of olive oil, carrots and five different types of nuts! The Auschwitz diet, it really works!

We only became human because our ancestors included increasing amounts of meat and animal fat in their diet, which provided enough energy/EFAs for our brains to grow, which made us more intelligent and able to get even more meat and fat. Had they kept to their plant-based diet, we would still be swinging from the trees.

That, and cooked tubers. As in, potatoes.

What you are promoting on this site is anorexia and food phobias.I'm sure eating so little that your heart atrophies is super "heart healthy".

The article seems to be supported by vegan myths and our modern cultural bias/squeamishness against meat more than scientifically established facts.

Other skins such as those from large animals such as horse and smaller animals such as ... Plant-based parchment: Parchment paper. thanks for sharing the information.

That is a really interesting line of thought, and plus, I'm an on-and-off reader of your blog and really respect your opinions. I've been on the meat and cheese mostly diet, along with the occasional veggies, nuts, berries, melons, etc. Its a good way to eat, for me, but hey its a boring diet and I've been wanting some change and variety for quite some time. I'm going to take a crack at switching things up for a while, in the way that you are suggesting, and see how that goes for me. I certainly don't see any harm in giving it a shot. I'll comment back at some time in the future, probably on another post, and let you know how it goes. Thanks again for your insight. -- Mike

Jezwyn - were you going to just borrow my thunder or steal it?

Kidding - I could not have made those points as well or concisely as you did, thanks.

"Thinking we all would react the same to an inuit diet, having inuits evolved for such a long time to survive where they live eating where they eat, makes no sense."
No, it doesn't, but when it actually happened, euros who lived/ate with the inuit reported more than once that they thrived.  This was tested in a hospital setting and confirmed.  In other words, we've more EVIDENCE that the Inuit diet was not beneficial because they were some genetic mutant - it was beneficial for humans in general.  

Congnitive dissonance?  only if you've bought the unproved conjectures so rampant in the science of diet.

I think the reaction to this article was predictable. If an atheist tells a person of faith that they are wasting their time with prayer and they should just get on with making the most of this life, very few would expect a capitulation by the religious. IMHO, diet is a lifestyle, like religion, and generally ruled by a hefty dose of emotion.  Having view points out there for people to make up their own minds is terrific.  But in the end we have to decide what we believe in.

great work Dr. D. stay the course and the debate will be healthy..pun intended.

Anonymous said...
"I think the reaction to this article was predictable. If an atheist tells a person of faith that they are wasting their time with prayer and they should just get on with making the most of this life, very few would expect a capitulation by the religious. IMHO, diet is a lifestyle, like religion, and generally ruled by a hefty dose of emotion. Having view points out there for people to make up their own minds is terrific. But in the end we have to decide what we believe in."

I agree.  Unfortunately the emotion in any hotbutton issue leads the insecure to spew vitriole which makes it harder to stay connected to the dialogue.

I'm hoping the doctor continues to espouse his viewpoint here.

Just read thru all the posts and what a hilarious set of temper tantrums!  Since we live in modern times, we can easily supplement K2, D3, and omega 3 (I certainly do on plant based diet)(for omega 3 I take about 200 mg/day of plant source DHA drops).

There are studies and there are studies and you have to actually read the details to see what they are measuring.  A little more fruits and veg than the crappy SAD, as in the study cited above, will have relatively little benefit though even at the amounts in the study there was a slight benefit.  Many Masai in fact were found to have plenty arteriosclerosis, just huge arteries from much more exercise than you or I will ever do.  Inuit skeletons do show severe osteoporosis and they tended to died young from hard living in a very tough and unforgiving environment.  Look around the rest of the world, aside from Inuit and Masai, all traditional cultures ate very small amounts of animal based foods and mostly plants.

Personally, my blood sugars postprandial were running 175-200 for several hours. Switched to no animal fat and reduced fat and calories and they would still spike but stay up much shorter duration.  Currently I eat 100% plants, getting about 35% fat from unsalted, raw nuts and around 150-160 grams of carbs per day. Carbs and protein also coming from about 1 1/2 cups beans per day. Protein is about 15% of calories. My postprandial sugars stay under 110 and usually are under 100, even with a little fruit tossed in for dessert...  Everybody has to find their own way but you guys really need to read research more carefully.

I had a doc tell me once he seldom if ever talked diet w/ patients as getting them to change was likely harder than getting them to change their religion!  I think that was cop-out as it is so important but a lot of truth there as well.

Stefansson's meat only trial is not conclusive, X-rays were use to measure osteoporosis which only detects it once there has been a 30% reduction in bone mass. Obviously, you are not going to lose 30% of bone mass in a year. You can read more about it here: http://donmatesz.blogspot.com/2010/03/paleo-diet-ph-does-it-matter-part-vii.html

There are also frozen eskimo skeletons that show severe osteoporosis in women that are only 30 years of age.

Eskimos were pushed to a really extreme environment in which we certainly did not evolve. Why anyone would use their diet as a model diet blows my mind.

We evolved in East Africa with dry and wet seasons. Warm all year round. It allowed for plenty of vegetation to grow, and for plenty of animals to thrive.  Tribes living in that region have a diet high in both animal and plant products. It's low in fructose and most of the carbs are coming from tubers (yielding a net alkaline effect). Some nuts may be used as well but not to the extent it was used in this post.

Is there an association between meat consumption and calcium excretion?

Is there an association between calcium excretion and bone loss?

Is there an association between meat consumption and bone loss?

Depending on what studies you read, there is an association w/ higher protein intake and bone loss, particularly for animal protein though I think plant too.  Amino acids are acids and need buffering.  If necessary, body will take alkaline minerals from bone to do the job.

Indeed what about the evolutionary argument that our ancestors survived mostly on animal meat (and its fat) ?

You confuse me.

Yesterday I ate 4 eggs, a pint of cream, 4 tablespoons of butter, 3 pieces of bacon (with all the rendered fat), about 6 oz of fatty beef steak, and a tin of sardines. I also ate 1 serving of sprouted pumpkin seeds, 1 cup of orange juice, 1 serving of brussels sprouts and 2 servings of spinach. From this I got 97% of DRIs for vitamins and 91% of minerals (I use CRON-O-Meter) in under 2500 calories.  48 grams of carbs.

I'm not finding it at all difficult to exceed minimums for vitamins and minerals found mostly in plant foods while still eating a low-carb animal-based diet.

"Yesterday I ate 4 eggs, a pint of cream, 4 tablespoons of butter, 3 pieces of bacon (with all the rendered fat), about 6 oz of fatty beef steak, and a tin of sardines."

Bonnie, have you no concern about GMO diary (hormone forced milk production), nitrites/added hormones/stress hormones in bacon, GMO corn and petro chem and drug residue in beef, etc? Or are all these from organic, free-range animals fed their natural diets?

"Indeed what about the evolutionary argument that our ancestors survived mostly on animal meat (and its fat)?"

Contemplationist, read this

http://diabetesupdate.blogspot.com/2009/09/lets-not-twist-history-to-support-our.html

From looking at the diet of contemporary hunter gatherers, an argument could be made that the ancestral diet contained a great deal of plants, as well as insects, small birds, lizards, etc.  The meat eaten was not the bulk or even the majority source of calories and it was all very very lean.

His advice makes sense for the vegans and vegetarians and low-fatters.  A huge step up for them and, most importantly, it's very 'foodie' and will appeal to them.

The animal-based diet, on the other hand, appeals to people like me who are lazy and therefore used to eat the SAD diet.  Dinner: grilled hamburger topped with butter, sea salt and blue cheese on top of microwaved spinach.  Five ingredients.  Takes me five minutes.

The answer to "Plant-based or animal-based?" is "YES!"  Ditch the grains and we can discuss everything else later.

"The animal-based diet, on the other hand, appeals to people like me who are lazy and therefore used to eat the SAD diet. Dinner: grilled hamburger topped with butter, sea salt and blue cheese on top of microwaved spinach. Five ingredients. Takes me five minutes."

Took me about 15 max to make mine:  Pre-cooked beans from fridge plus huge pile of chopped veg in pressure cooker.  Up to pressure and run for 60-90 seconds.  Bring pressure down fast, dump in bowl, add some nuts/seeds, and eat.

We evolved as neither herbivores nor carnivores, we're omnivores.

It's always been normal for humans to eat BOTH plant and animal foods.

I think everyone should eat at least half their food, by volume, as nonstarchy vegetables and low-sugar fruits - a wide variety.  

That being said, meat, dairy and eggs, if raised on pasture, are darned healthy foods.

I think raw milk, pastured eggs and pasture-raised butter are some of the healthiest foods one could possibly eat.  

And besides being a health food in itself, butter makes getting your veggies in much more palatable, so... an artichoke dipped in butter ought to make all of us happy.  It certainly makes me happy.  ;)  

Bacon, if from healthy animals and just smoked as opposed to being pumped full of nitrites and nitrates, is a fine food.  

And if we all ate enough wild-caught shellfish, you'd be hard pressed to find all these iodine deficiencies you've been noticing.

Animal foods are not a problem so much as the US system of mass-raising animal foods in an extremely unhealthy manner is a problem.  

See http://www.eatwild.com to find good local sources of meat, dairy and eggs.  

IMO, the "right" answer to breakfast can be the omelet, cooked in butter, stuffed to overflowing with fried peppers,  onions and mushrooms, with a bit of grated cheese over the top.  

Eating plenty of vegetables does not preclude eating animal foods.

And really, you'd be pretty hard pressed to do low carb as a vegan and get anything like sufficient protein and fat.  A vegetarian, yes, if you eat lots of eggs and dairy, but a vegan, no.  

This isn't an either/or scenario, we do best eating both.

We could argue and fight for ever, Drstrange.
Stress hormones? As if the animals that humans used to kill went down happy and peaceful listening to Vivaldi. Are your vegetables all organic? And they do not contain any toxins or anti-nutrients, or nitrates, they also provide you with all the vitamins and minerals you need? Good for you. Oh, no, you need to supplement. Just as well you can afford to do it.

lightcan, not sure what you are going on about.  Really.  I was referring to the lifetime of tissues saturated in stress hormones of  industrial, factory raised animals which I have boycotted since the early 70's when I found out how they were being treated even then! And what does any of that have to do with supplements?  I take some because I am old and a bit paranoid but am quite sure I would be fine without (excepting B-12 and D).  As for organic, yes, probably 95% at least and since I don't buy meat which is expensive (especially free range/grass fed or wild caught which is only meat I would eat when eating it) but rather cheap organic beans instead, I can afford it.

Not fighting or arguing really at all. I have no "beef" against someone eating meat if they feel the need.  But the research I have read really does show that a diet based on bacon and butter and blue cheese is basically a death sentence.

I don't think that a diet based on butter, meat, fish, eggs and some greens is unhealthy. You think the opposite. I'm sure you can find studies that you think support your stance. That's why I said that there is a lot of debate going on, even between specialists, and asking people if their meat is organic and stress hormones free doesn't help.
Many people who care about their health (those that read these blogs, you and I included) are trying to do their best until the definitive answers come in. It's really hard for the majority of people to find quality food exactly because of those pervasive industrial food practices you talk about.
All the best.

I eat 100% plant foods and I feel the same as when I ate both plant and animal foods, except I feel much better stopping the toxic fish - way too much mercury for me. I think eating plant foods is much more convenient. I even eat soy, and don't understand why there's so much anti-soy stuff online.

That is very good comment you shared.Thank you so chat much that for you shared those things with us.Im wishing you chat sohbet to carry on with ur achivments.All the best .

Seriously, I am sick and tired of hearing "Low carb"  you don't mean low carb, you mean low grains don't you because plants are carbs..

Say what you mean, not what is popular

The biggest issue with these guidelines is NOT what they say to adults, but the fact that they're taught in school to children.  

I was in-between the 7 food groups and the pyramid, went to school with the 4 food groups myself.  Meat, dairy, grains, fruits & veggies.

People still think this way, have to remind hubby all the time that corn is a grain not a veggie.  Point being, we both "think" in the four food groups, and probably will our whole lives.  

We learned this stuff with our alphabet and arithmetic.

Anyways, the answer to the question is BOTH.  

We are OMNIVORES.  Look at your teeth: you're not a herbivore, and you're not a carnivore.

IMO, when you sit down to eat, half your plate should contain nonstarchy veggies.  In my opinion, NONSTARCHY vegetables is an entire food group.  If I'd designed the pyramid, that'd be at the bottom.  

This is not a veggie-based diet though.  Cause veggies are low calorie, and diets are defined as high fat or high carb or whatever, based on the percentage of calories.  So... you can eat EITHER a high carb or high fat diet with half your plate covered with nonstarchy veggies, as it depends on what's on the other half of your plate.

IMO, at least another quarter of your plate should be good protein - pastured beef, pork and poultry, free-range eggs, raw milk and yogurt and kefir and raw cheese, nuts and seeds, and (if you can tolerate the carbs) legumes.  I define "good" protein as ones that don't have bad fats with them - so largely saturated and monosaturated fats, with minimal PUFAs.

The only other "rules" are... do eat broth and other sources of gelatin, do eat fermented foods, don't eat HFCS and don't eat PUFAs/trans fats.  

The rest varies with the person - if bg issues, should stick to lower carb, etc, if not, eat french fries, whatever.

Cause... if you eat half your food as nonstarchy veggies and a quarter as good sources of protein, and get some good broth and fermented foods in weekly, eschew HFCS and PUFAs, even if the REST of your diet consists of nothing but hot fudge sundaes you'd be coming out ahead of the VAST MAJORITY of people.  

Course, you're BETTER off if you eat some starchy vegetables and fruit in this other 25%, but... veggies and protein sources with good fats... these contains the vast majority of the micronutrients any of us get.  

This is a simple enough system to teach to a small child, which is what I think the guidelines should be aiming for.

I almost missed this, coming between the Big Squeeze and the NIH petition (I signed and commented, BTW).  I'm very interested in this idea of yours, and have been musing on it since I joined TYP and first came across it.  But I've wondered why you singled out wheat from other carb-heavy grains/cereals, potatoes, etc. and if it's just that it makes up such an overwhelming percentage of the typical diet.  I have been low-carbing for several years, sometimes quite strictly and sometimes less so, but other than the difficulties of convenience and finding variety, and of changing ingrained (pun originally unintended, but I like it) habits, I had none of the "withdrawal" or cravings, or even the feelings of fatigue etc. when first starting, though I was sort of expecting and prepared to have them from reading the Dr.'s Eades.  Over the last couple of months, my husband is low-carbing with me  for the first time, and he finds it much more difficult than I, but mainly because he doesn't really like many vegetables, finding many that I love to be bitter, and the few he does like are primarily the starchy ones.  He may not choose to do this long term, as he says it works for him mostly because there is nothing to look forward to at meals, I'm assuming because he doesn't choose much variety.  He is sticking with it for now, because he has lost 15 pounds along with his lower back pain, has stopped snoring and is sleeping better,and he told me yesterday that he feels better than he has for years and years. He does still eat one slice of toast at breakfast, and I know he misses buns with hamburgers, etc., but even though by desire he would eat much more wheat, corn, potatoes, I don't think that he shows signs of cravings or withdrawal.  Do you think that wheat addiction, if it exists, can be easily separated from an overall craving for other carbs?  And if so, what percentage of people do you think are affected?  Do you think ethnicity plays any part?

I'm a long time Atkins eater and would like to know does the gluten in eggs do the same thing as the gluten in wheat, or in other words if the problem is giving up gluten "cold turkey" if you stop eating wheat products and added eggs ( which are high in gluten ) would that take care of the problem ?

Peter write a bit about this in his hyperlipid-blog.
http://high-fat-nutrition.blogspot.com/2008/01/casein-vs-gluten.html

And here´s some references on opioid peptides from the PubMed:
http://www.npif.no/forskning

Some collected articles from dr. Reichelt on the subject:
http://gluten-free.org/reichelt.html

Several times in the past year, I have gone through a two-three day "fugue state" around endurance exercise and being better about sticking to a low-carb, high-fat diet.

I agree that my mental state on the other side is positive, alert, and with plenty of energy, but the headaches, mental fog, bad mood, and mild depression make this a very frustrating time.  It's a particularly annoying side effect of coming back from a trip, or other occasion where I have to (or choose to) relax my dietary rules for a while and then "get back on the wagon".

I don't know that I'd choose to describe this as "wheat withdrawal".  When I had to describe it to my wife, I said it was "adaptation to a fat-burning metabolism".

Jenny--

These observations are purely from my anecdotal experience, though large.

Despite their anecdotal nature, I have seen this effect over and over and I do believe that somehow, for reasons I do not fully understand, wheat is unique. While all carbohydrates generate sugar effects, wheat seems to be unique in that a proportion--20%?--develop addictive patterns from it.

Anomyous, there is no gluten in eggs. Gluten refers to the proteins in grains. All grains have gluten but the grains involved in gluten intolerance are wheat, barley and rye.

As someone with a lifelong carbohydrate addiction problem, I do believe that there is something deadly about wheat, especially the combination of wheat and sugar.  There is no way that I could eat ten baked potatoes or ten rice puddings.  I could easily eat 10 donuts or 10 cookies.  

My personal theory is that it is a brain chemistry problem in susceptible people.  I base that on the fact that during the 5 years that I took phen-fen, I could eat moderate amounts of wheat with no problem.  I truly believe that the now banned "fen" part of the drug altered my brain chemistry so that wheat was not quite as intoxicating.

Hi Dr. Davis:

Thanks so much for your TYP book.  It was very interesting.  Have you read the book Good Calories Bad Calories by Gary Taubes.  It's an excellent book providing a review of the relevant science from the past 150 years with respect to diet and chronic disease.  He discusses carbohydrate whithdrawl in his book.

Olga

I still don't see the connection between wheat and heart disease.  What is the mechanism?  And why is it so beneficial to avoid wheat if one is not overweight and is consuming it in the form of fresh baked bread or home-made pastas versus cookies, donuts, or breakfast cereals?

I'm thinking the difference in our flours is significant.  Different varieties, grown for different types of cooking/baking, contain different amounts of the substances we react to.  I think our wheat has been altered over time to grow so it's easier to harvest, store and process (and to process and store once again once it gets to the bakery and stores)and is less geared toward human consumption.  I tried spelt for a while there and had much less g.i. reaction than I do with general wheat flours.

I am so glad to see a heart doctor aware of gluten addiction. I am a gluten addiction expert having seeing its impact on my own life, my family, and now my clients. The withdrawal is real and takes place on physical, emotional, and social levels. Wheat and gluten are everywhere in our culture, so care must be taken to address the entire lifestyle to ensure folks have adequate coping mechanisms and support to stay gluten free (and dairy and sugar free in most cases. An excellent book describing the opiate qualities of the gluteomorphin in gluten and the ensuing gluten withdrawal when gluten is eliminated in the newly published "The Gluten Effect" by Drs. Rick and Vikki Petersen: http://www.healthnowmedical.com/news/show_news.html?article=book_released

Gluten Withdrawal is SO very real. I have been gluten free for about one month now. The first week or so I felt wonderful and my intestinal symptoms had subsided. Then starting about the second week I started having what felt like wide blood sugar swings and incredible hunger. I worked at getting the good stuff in like nuts and protein and worked on not over dosing on the GF Carbs, but it has been quite difficult. I feel much more jittery and irritable that usual and it is comforting to know that this too will pass...Thank You for bringing Gluten Withdrawal out from the shadows...

i've recently discovered a wheat allergy and stopped. within days i felt the way i used to feel 15 years ago. that is: normal! however i'm on day 8 of no wheat and i'm having anxiety attacks today (anxiety was one of my wheat-allergy symptoms). do you think it's because i'm still withdrawing? looking forward to your response.

You'll recognize it in someone who previously ate bread and other wheat flour-containing products freely, then eliminates them. This is followed by extreme cravings, usually for bread, cookies, or cake; profound fatigue; shakiness; mental fogginess; blue moods. The syndrome can last for up to one week.

I gave up gluten about 14 days ago.  Felt depressed, jittery, shaky and starving!  Thought I must have some blood sugar problems.  I ended up eating four wheat cookies out of despair.  I felt very happy and not depressed after that.  Made me wonder if maybe I was having withdrawls.  Did a web search and hear I am Thanks for the info.

Anonymous you're on to something. I gave up wheat a year ago and the benefits are great including a 25 pound weight loss, more energy, motivation, etc.,etc. Eating wheat with a meal is the trigger that causes a craving later -sometimes 2-3 days later- and giving in to the craving closes the loup. In other words eating the craving meal does not trigger another craving. So, I started wheat-free eating and for two days had cravings which I simply indulged. On the third day the cravings were gone for good. No miserable withdrawl symtoms.

Yup.  "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 365lbs 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.

Anyway, onward . . .

As an ancient engineer, I often use your aphorism.
Your publicly expressed viewpoint must earn a lot of criticism from your colleagues, and undoubtedly there have been financial and other sacrifices on your part.
I would like to offer heart felt appreciation for what you do.
I assume that many colleagues share your point of view. Are there others who have the 'cojones' to speak out?  Is there any degree of cooperation?

I would like to know something of your perspective on potential solutions for cardiology in particular, and healthcare in general. In fact, on the whole "medical-pharmaceutical-insurance-government complex" (to paraphrase the warnings of Dwight Eisenhower).
I grew up under British socialized medicine, and while the delivery to the people is more even, it is not a  solution. Do you foresee some kind of compromise as workable? Should the solution be patient driven? Business driven? Govt. driven?
I recall that in the UK, doctors and the system tend to be viewed as almost god like in their authority, although a few individual Dr. rebels such as. Malcolm Kendrick come to mind.

Yes, I know. This is far too big a topic for your blog, but with the elections coming up, my curiosity just got the better of me!
Note: I promise not to ask any more difficult questions until next Feruary 29!
MikeV

I'd like to echo the comment by Mike V.  The current health care situation in the US is so "unsustainable", to borrow an agricultural phrase, yet having a good view of the UK's NHS (I have English in-laws) doesn't inspire me to wish all of that on myself or the US public, either.  My in-laws in Norway seem to have it better in many ways, but I see some dangerous aspects creeping in over there, too.  We need better options for our nations's healthcare, but I only seem to hear about how well our current system works (for some people) with all the costly high-tech procedures and diagnostics or else warmed-over versions of the UK and Canadian systems, which has some serious flaws, too.

I want healthcare that takes prevention and health promotion into account, not just "disease care" that catches disease "just in time".  I don't want "checkbook science" or "concensus science" dictating what options I have or what information is available to me.  I don't want a "nanny" nor do I want my care determined by healthcare industry lobbyists.  

There must be something better, that does a better job of balancing promotion of good health with treatment of disease, with balancing good intentions without nannyism, with balancing  access to care without over treatment.  We need a system that allows medical personnel to make the best decisions for each individual patient, with a better way of managing the associated costs and compensation for all participants.   It is very hard for physicians to "buck the trends" these days.

As an insider with an insightful view from the trenches of the healthcare industry, I'd love to read more of your thoughts on these issues in future posts, Dr. Davis (your busy schedule allowing, of course).  How can we reform healthcare without pushing the pendulum too far into another harmful direction, in a way that it beneficial to all - patients, medical personnel, medical institutions, medical research, etc?

And then, how do we make it happen?

Webmaster, I love your site. Thank you sooo much for working on it.

I am extremely skeptical of drug company boasts, but I do wonder if they have a point here.... since supplements are not regulated at all, how DO you know you're getting the right omega-3 and the right dosage? they could give you sugar and arsenic... how could you know?

Hi Doc:
Two questions please:

1  It's well known that cutting carbohydrates also lowers trigs. significantly.
Do you consider increasing omega 3s your primary attack?

2 In this case is controlling omega 6/omega 3 ratio an issue, as it is in controlling inflammation?

Thanks

Mike V

"But insurance covers it in most cases!"

I wonder how much of the rise in health care costs can be attributed to this mentality? Why use a cheap, effective, non-patentable alternative when you can get something more expensive "for free" through your insurance? I think insurance coverage has had the unintended effect of causing health care to cost more and more since there's been ready money from insurers to cover the costs.

Interesting ... I lowered by triglycerides from 344 to 106 mg/l in 6 weeks, but I'm not sure what the mechanism actually was.  I had been taking 1500mg of niacin per day for quite a while with little effect, but started a low carb diet (<30 grams of carbs per day) and taking 1600 mg of EPA in fish oil per day.  Within 6 weeks my test results showed the decrease.  

I've heard both low carb diets and fish oil help lower triglycerides.  I'm hesitant to change anything ... thinking perhaps that its a "magical mix" of approaches that is working.

I'm sure readers here will be aware of Vitamin D3 and it's role reducing MMP9's. Here are a couple of examples.
  Vitamin-D insufficiency is associated with increased circulating MMP2,9 and CRP, correctable by supplementation.

Vitamin D and its derivatives can evidently influence invasive processes by two means: (a) decreasing the expression and activity of cell invasion-associated serine proteases and metalloproteinases; and (b) inducing their inhibitors.
When one considers the role of MMP9's in other conditions as well as heart disease, such as MS and cancer, it makes you wonder why fish oil and vitamin D aren't even considered as potentially useful additions to treatment or prevention of conditions where MMP's wreak such havoc.
Both D3 and omega 3 are cheap and safe and there is good science explaining why they may help, so why the reluctance to correct deficiency states?

Thanks for the article Dr. By the way, does the fish oil increase Uric acid in (certain) individuals?

In my case, I noticed that when I started on fish oil capsules, Uric acid jumped from 5.5 to 8.0 and hence the concern.

Thanks

Venkat

We face similar ridicule from specialists. They not only get upset with us for managing our own patients (cardiology wants referrals for high cholesterol, psychiatry wants us to refer to them our average depressed patient, GI wants referrals for initial GERD) but they also very quickly dismiss our efforts to manage patients using generic medications and Vitamin D. We are family physicians. We MANAGE patients.

A rheumatologist stopped by our office the other day to meet our providers.

I witnessed his introduction to each provider (so I heard the same speech 5 times) and each time, the second or third sentence began with a list of 2-3 new drugs that the FDA just approved for treatment of XYZ condition, which he is already incorporating into his practice.

After allowing him the courtesy to make his case, two of our providers questioned his experience with Vit D. His tone turned sour (as did the conversation) and he very quickly rushed through D (commenting that the results of managing D are "mixed" and "the jury is still out on that").

He specifically asked how we manage patients who fail bisphosphonate therapy, to which one doc replied, "I haven't written for a bisphosphonate in almost 18 months, so I can't say that I've had any patients recently that fail a therapy I haven't put them on. I manage their osteo_____ by cranking up their D level. It's great! I've seen several patients with T-scores that increase 6-8%! Patients go from losing bone to making bone! We didn’t just slow their bone degeneration; we actually made new bone! With the bisphosphonates, you're preventing a natural process from occurring, plus the half life of at least 10 years doesn't sit well with most patients."

To which the specialist replied, "oh sure. Which is why each patient must go on a drug holiday after 5 years."

DRUG HOLIDAY? I'd never heard such a term.

My doc went onto discuss how his patients have been very successfully treated for many types of arthritis without the use of prescription drugs.

The conversation got especially tense when the specialist questioned how a patient could be “ethically” treated for osteo____ without the use of FDA approved pharmaceuticals.

Needless to say, the specialist concluded with a comment about how we could stand around and argue medicine all day but he would appreciate more referrals from us.

Yikes.

(He also mentioned on more than one occasion how he can see our patients same day. A same day rheumatology referral? I'm struggling to picture a rheumatology referral that would require same day access.....

He is also only 1 of 2 rheumatologists within 50 miles....and he has same day access and has been in the area for more than 2 years? Leads me to believe that maybe those services are becoming less needed due to D. Just a thought.)

-JL

Low carb, low glycemic index, also help reduce tryglicerides:

http://jn.nutrition.org/cgi/reprint/131/10/2772S.pdf
http://jcem.endojournals.org/cgi/reprint/85/9/3085.pdf
http://www.ebmonline.org/cgi/reprint/225/3/178.pdf

That is such a typical specialist reaction to the hormone D issue.  I experience this frequently.

BTW, Lovaza is marketed by GSK, not AZ.

In the migraine world, the concept of a "drug holiday" is pretty common. It isn't fun - you avoid all meds but it helps avoid rebound or medication overuse headaches.

JL--
Thanks for your great story! Tell us more.


Anonymous--

GSK, AZ--Can you tell the difference? I certainly cannot.

Their representatives are the same smiling-to-your-face, can-I-please-my-supervisor-and-make-my-bonus? sorts of people after one thing: their own career advancement--whether or not health is served.

Here is an interesting letter to congress from a former drug rep--

http://aging.senate.gov/events/hr190sa.pdf

I ran across a forum for drug reps, while randomly searching for info on a specific drug --

http://www.cafepharma.com/boards/forumdisplay.php?f=3

Their practices are scary and they basically come across, for lack of a better term, as evil. Sell their drug, whatever it takes.

I really appreciate this blog but seriously, some times it just scares me into a semi-anxiety attack.
( Oh where oh where is my valium, LOL)
TY Dr. Davis and all who provide such great information.  Keep up the good work!

Yes, and everyone wants the free samples.....So the beat goes on.  Doctors are well aware of the tactics that are being used. Most feel that perhaps their colleagues may fall for drug rep tactics.  Doctors underestimate their own vulnerability.  These days the most a drug rep can provide is a free take out lunch for the staff, free pens or a cup of coffee. Most docs don't realize that some drug reps and most of their supervisors make more money than the doctors do!  No wonder lovaza is so expensive.

My trigs roller coastered between 300 and 650.  I was on extreme diets, statins, and Lovaza.  Nothing touched it.  My cardiologist blamed it on genes and said there's nothing much more we can do.  The LAST time I visted him, we argued about it to the point he finally agreed to run a series of blood tests.  Hypothyroidism...  I've been on thyroid medicine for about 5 months and the last two cholesterol screens came back normal in ALL aspects!
Rich

Result! Send him to read this blog!

Yes there are stories of woeful undertreatment of thyroid. My current doctors are very proactive on it - a pleasant change - and report finding problems quite often, increasing with age and female gender but present in others as well.

This should be a relatively low incidence area - high selenium soil content and iodine from seafood - but there is a large (active) elderly population which might slant the numbers the other way - but they don't have comparative information from other areas to check due to diagnostic bias.

i have high triglycerides too.  i learned a lot from this website:
http://loweryourtriglycerides.blogspot.com/

Thanks Dr. Davis for your blog and efforts to make people healthy. I think you will find this blog (if you haven't seen it) by Dr. Mike Eades very interesting as it fits right in with your "Triglyceride buster" blog.

Four patients who changed my life. (blog by Dr. Eades)

Things are looking up.  This was posted on the CafePharma Board yesterday.
"Not to burst your bubble, but there are 120,000 reps out of work. Don't bother. Even people with GREAT credentials are finding nothing. Companies will continue to cut back. Access is harder than ever. The only reps that do well with getting even 2 minutes of time have some HOT sample with excellent formulary coverage. Device reps bust their ass and work from 6 am to 7 pm, 5 and even 6 days a week. I am hospital and leave at 6 am to 8 am and come home at 6 pm, on the road from 2 to 5 hours a day. It takes me 30 phone calls/emails to get ONE apppointment and when I show up, I better provide something valuable to the HCP or they will NEVER see me again. Hence, I spend my weekends studying and preparing for work. If I was under age 40, I would go back to school for a tech or nursing degree."

Being a nurse, I never thought I would see this day. Actual doctors (Dr. Davis and others) promoting alternative therapies that are really not alternative but wholistic in nature. I am just beginning my own journey with self directed preventive care and cannot say enough about the fantastic information available. Looking forward to seeing how this develops. So far my weight has dropped 35 pounds, triglycerides reduced from 323  to 151 and this is just the beginning.

Well I have heard plenty of stories about Omega-3's I have looked into them all including Lovaza and found that only one stands up to the test that truly helps triglycerides to be lowered. OceanBlueProfessional.com has their Omega-3 2100 product that has such a high potency of omega-3 if you take the suggested dosage it really works I take it every day and recommend it to everyone I know.

My father has a high level of Triglyceride, and we are all worried about him, I know he takes Omega-3 but I believe he should increase the dose.

I am continually surprised at the number of people with high triglycerides who are still treated with a fibrate drug, like Tricor, or a statin drug, when fish oil--widely available, essentially free of side-effects, with a proven cardiovascular risk-reducing track record--should clearly be the first choice by a long stretch.

I always understood that men should get a PSA test prior to starting DHEA. Is that not the case in your experience?

Peace

Joe E O

Well, if I'd been your patient, you would have seen gynomastia in me at 25mg/day after about a month.

It sure did help my energy and mood, though -- wouldn't I love to be able to take it!  

Breasts aren't a good look for me, though.

"No wonder: Any hormone taken in extraordinary, supraphysiologic doses will exert wacky effects. Imagine taking testosterone or estrogen at 50 times the usual dose."

Thats why some people are hesitant to take Vitamin D in larger than "usual" doses.

I take 10,000 IU/day of D3...hope I don't grow a mustache!

Are there any interactions between DHEA and any medicines, specifically beta-Blockers?

I take 5mg of DHEA because testing showed slightly low levels. I can't say I have noticed any difference with this small dose.

I read on the the internet the the largest study ever done on DHEA came up with 2 very interesting findings. This was a double blind study mind you. Finding number 1 supplementing with DHEA did indeed raise blood levels of DHEA in the body. Finding number 2 the ones that received the DHEA and increased their blood levels reported no more of the supposed "positives" than the placebo group. No "better mood, no more energy . . . Authors conclusion: while supplementing with DHEA can raise blood levels its of no use. For those of you out there thinking thtas ridiculus remember we've had examples of this before. Rememeber the big homcystene controversy from a few years back? The higher the homocystene levels the greater the risk of heart attack. We knew that by using Folic Acid among other things we could reduce Homocystene levels and we did. However it din't do anything to lessen the chance for a heart attack. Just manipulating blood levels of substances doesn't mean your doing any good in some cases. Dhea and Homocystene are 2 very good examples. But hey placebo effect can be very real. We just ruin everybodies fun with are silly double blind studies.

Anonymous, do you have a citation for the double-blind study that showed no benefit?  "I read on the internet" is a bit broad.

I'm sorry I didn't cite the citation I was making a brief comment to a message on a blog not my senior thesis. A simple check of DHEA and google takes about 30 seconds to come up with the information. Sorry next time I cite a study I will do the proper citation.

The earlier anonymous posting seems to be true, if you google DHEA there doesn't seem to be alot of supporting evidence for many of the claims made about DHEA, and he's right it took about 30 seconds to see that.

TYP: try Google Scholar...

I recently took a four-month course of DHEA at 3x/d 25mg (75mg total per day) since it's showing some promise in women over forty who have been dubbed "poor responders" without much explanation in previous IVF cycles.  

It's used to induce a physiological state of PCOS - trapping antral follicles in the ovaries so when ovarian stimulation begins, the number of follicles that mature increases.

Anyway, for me it did trap antral follicles, but that did not lead to an increase in mature follicular development in the IVF cycle...I remained a "poor responder" to the injectable gonadotropins.

The side effects were minor for the most part, but the most disturbing was the redistribution of body fat...I went from, without a change on the scale in weight, a classic pear/hourglass to an absolute apple in less than two months, then continued to accumulate abdominal fat for the remaining two months.  This is a known side-effect in women and any woman considering supplemental DHEA needs to consider the risk to benefit for waist-hip ratio and waist circumferance.  

Other side effects were a loss of hair on my head, slight peach-fizz hair along my face on my hair line and an increase in appetite...although as I said above, I didn't gain weight on the scale, but did wind up with abdominal fat and a loss of LBM as evidenced by my declining muscle tone in my legs and arms.

Just something to consider if one is thinking about supplementing - perhaps getting tested for levels before supplementing blindly is a better idea than going ahead and not knowing if you're even deficient?

Great observations! Thanks.

Dear Anonymous,

What is your 25(OH)D level?

The reason I ask is because vitamin D has been given to infertile men (low sperm count). And I bet it works for some women as well.  (In animal studies, both vitamin A and D are used to 'reverse' infertility).

Did you know that silent celiac disease can cause infertility (which was news to me!)? (I had an article that discusses silent celiac disease recently).

Regards, G

What is your 25(OH)D level?

The reason I ask is because vitamin D has been given to infertile men (low sperm count). And I bet it works for some women as well. (In animal studies, both vitamin A and D are used to 'reverse' infertility).

My levels were within normal when we tested it in October and since it was winter, I was supplementing daily with 2000IU fish oil derived D3....so the vitamin D was covered.

Did you know that silent celiac disease can cause infertility (which was news to me!)? (I had an article that discusses silent celiac disease recently).

Yes!  I recently stumbled on data about celiac and asymptomatic celiac associated with infertility.  At this point, I've totally eliminated all grain based foods and we're seeing what happens.  Thus far we things are looking up - when we did a scan recently to track my ovulation, it looks like this cycle may bear two mature follicles sans any drugs...at my age maturing and releasing more than one egg happens...and we're taking it as possibly a side-effect of the removal of all grains from my diet. Thanks for the heads up though, if I hadn't already stumbled on it as a possibility - it would have been very useful information for me!

I have heard about prostate enlargement by using DHEA.

I recently requested my hormone levels be tested after being prescribed Prozac (don't want it!!) for pain in my back - trigger points - and my DHEA Sulfate level came back at 21.  I'm 39. My progesterone was 3.2.  Would a 20% progesterone cream with additional 15% DHEA 15% Pregnenolone three weeks per month help me???  Thank you for any information!

The doses we use for the above benefits, including Lp(a) reduction, range from 25-100 mg per day; most people do fine with 50 mg. We also adjust doses to starting blood levels. In this dose range, I have never seen any of the above side-effects.

while i believe in this strategy with improvement in my own situation,probably due to genetics i have not experience any change in particle size although there has been a reduction in small particles from 1805 to 1305according to NMR with size at 18.7  Since trigs were only 20 and HDL was 54 up from 41 VitD only 38. Working to raise it.  Taking Lipitor at Doc request due to strong family history.  Only male in family not to have a coronary event. Would like not to take statin,but not sure there is an alternative. Any thoughts?

I normally ead very little wheat anyway, but you've piqued my curiousity

you wrote this:
>>> eliminate the foods that trigger small LDL

the interesting word here is "trigger"  - does it mean that only a small amount of wheat will cause lots of small LDL particles - that is, wheat changes the way you create LDL, and so a small amount of wheat turns a lot of LDL into small particles?


OR

is there a dose dependent response?  A small amount of wheat leads to low levels of small LDL particles, and more wheat leads to higher levels, and lots of wheat creates high levels.

Sam in Toronto

Steve, how many carbs per day are you eating and what is your percentage and type of fat you are eating? Are you eating any PUFAs? Do you consume much fructose (i.e. honey, agave nectar, fructans from sorbitol, xylitol and any poly-ol)? Do you eat pre-packaged or pre-prepared foods? How much and what are your protein sources each day?

Just wondering because I don't know that Dr. Davis is always able to answer personal questions?

Also, what form of Vitamin D are you taking and how much of it? How long supplementing?

Given my travel etc, I have been able to reduce but not totally eliminate wheat from my diet.  Dr. Davis, I think I have eliminated about 70% of wheat.  Does that help?  Also, is whole grain wheat OK or is it all wheat?    Thanks!!!

Very impressive.  What is your opinion about the likely mechanism for the LDL improvement related to wheat?  Less carbs?  Removal of possible immune response to gluten?  Removal of gluten intolerance?  All of the above?  Which factor is most important in your mind?  Are there others?  Thanks.

Pooti: In response to your inquiry.

i eat no sugar except in greek yougurt(2%) or in fruit which is limited to an apple or some berries. Rest of diet is fish beef, turkey,chicken, eggs(sometimes whites only,sometimes the whole egg)  No grains except tsp of metamuciel(psylium). Only use olive oil for salad, and eat no fried food at all.  i take fish oil.  Kinda think it is genetics but open to advise.

pooti wrote:

>>> Just wondering because I don't know that Dr. Davis is always able to answer personal questions?

Dr. Davis always answers personal questions at the Track Your Plaque forum.  But given his patient load and responsibilities for the Track Your Plaque program, he is not able to answer questions often here at the Heart Scan Blog.

Doc
How do you know it was the wheat that did it? What about the sugar or starch. Don't you have to isolate your variables?

Steve K,

You may be extraordinarily insulin sensitive to grains and sugars.

Are you using the drink or wafer forms of Metamucil?

Just one tablespoon of the original drink form of Metamucil has 9 grams of sugar (sucrose).

The "sugar free" drink versions of Metamucil will still give you a good dose of aspartame and maltodextrin.  Small amounts of chronic doses may result in unfavorable insulin resistance/response with some people.

The wafer form of Metamucil is even worse.  Each serving contains 6 grams of sugar, corn starch, fructose, and wheat.

Try to get a brand that only contains psyllium husk, like Konsyl.  Each serving has only 0.5 grams of available complex carbohydrates. It can be found at Walmart.

Yes, Greek yogurt has less lactose (milk sugar) than regular yogurt.  But, even a modest eight ounce serving of plain Greek yogurt can contain as much as 9 grams of lactose.  And if you are consuming chronic amounts, it very well may be affecting your insulin.

IMHO, investing in a glucose meter for home monitoring is not a bad idea for anyone who think they may be genetically sensitive to carbohydrates.

xenolith_pm :


i am thin and fasting glucose last measured was 79 which i am told is lower end of normal.  Were i super sensitive this and trigs(20) would i suspect be higher.  Thanks for input from all.

I'm jealous! Dropping the carbs decimated my trigs (literally) and doubled HDL. Initially my LDL *increased* but adding more sat fats seems to have reduced this back again. I wish I could get a proper test for the particle size, I have to guestimate from the trigs/HDL ratio.

Maybe I should eliminate the small amount of wheat I still eat, see if there's a threshold effect.

I am posting this here because I cannot, at this time, afford to join the forum so would appreciate anyone who could answer me.  I have avoided wheat for years because of its disastrous gastric effects but reading Mary Enig and Sally Fallon's Nourishing Traditions have been thinking about trying some sprouted wheat bread (Sunnyvale Organic).  Any opinions on this as the phytic acid is neutralised and the vits and mins are more bioavailable?

Susie

I have asked for a proposed mechanism several times.  I do not dispute the reported results, it just helps if a mechanism is proposed so people can understand why wheat or any other food impacts the particle size of LDL.

Trevor

This study found that wheat was a problem compared to oats but they were unable to reach a conclusion as to why.

http://www.39kf.com/cooperate/qk/American-Society-for-Nutrition/027602/2008-12-28-550490.shtml


"The reason for these unfavorable lipoprotein changes in the wheat group is not readily apparent; however, the mechanism by which these alterations are produced does not occur with increased oat consumption."

The only grain I eat now is oats prepared using the Weston Price method.

I think its hard to answer in detail allot of questions that come here, which is why we started the board as there were several of us just like you with all these questions.

It was our idea for a small fee, not Dr D idea to make money, he makes nada off this and gives gives gives!

....and there had to be a small fee otherwise we would need advertisers like drug companies and we wanted it to remain free of that brain washing.

The board is about $20 a few times a year and it has saved my life.

Cheap investment.I think I am worth that.

There is so much information there you would know that these blog posts are 110% backed up with good medical documentation.

Or maybe go back to the beginning of this blog and read it all in detail and allot of your questions will be answered.

I used to hang onto this blog for info as found it the most effective and so personal. Then we started the board and I can go there and read and educate myself from Dr D and hundreds of well educated folks like you and me who want to live longer and know traditional medicine is not helping us as much as it could with reversing our plague.

Now I hardly ever come here as all the info is at my finger tips.

Dr D makes no money from the board, it is to pay for band widths, web seminars etc.

It is created by volunteers from this group and if approx.$5 a month isn't affordable let me know and I will help you find a way to raise some funds to take good care of yourself.

I believe its our right to good health care info and thats what Dr D provides here and on the board.

I am serious, don't let the small fee make you die younger.

Anonymous,

Sprouting the grains may eliminate the gastric issues you've experienced with wheat. However, those gastric issues may have been an indication of gluten intolerance and gastric issues may not be the only symptom, just the most obvious or visible one.

Before adding wheat back to your diet in a large way, please research non-celiac gluten sensitivity and gluten intolerance on the web and at the public library.

http://www.glutensensitivity.net/ and http://jccglutenfree.googlepages.com/ are good places to start.

If you have questions re: gluten intolerance, there are several forums discussing this topic such as glutenfreeandbeyond.org/forum
or forums.glutenfree.com

Thanks for that, I was just asking as the wheat issues raised in the blog and the main site probably refer to modern wheat refining and baking processes whereas sprouted grain bread is made to an ancient recipe and contains no dairy or yeast.  I will certainly check out all options before deciding.  Thanks again.

Susie

Some diabetics can eat Ezekiel or similar sprouted grain breads, or breads made with wheat gluten and non-wheat flours, and I can handle other grains (in sufficiently small quantities) without the BG and presumably insulin spikes specific to wheat, but that's only one of the possible issues.

hey thanks.  I don't have an issue with the fee, just and issue with putting my creditcarddetails into an unsecure webpage.  I wrote the TYP and pointed out they should use https.... when it is fixed, I will join. Even this blog is https

I think that the problem you are suffering through is insulin sensitivity. Well i am still researching on this topic but till now the point which has been cleared is this one only.

In other words, 100% of Lee's LDL particles had shifted to the more benign large LDL simply with elimination of these foods---NO statin drug. (In addition to wheat elimination, she was also taking vitamin D and omega-3 fatty acids at our recommended doses.)

I'm probably way off here, but vitamin D derivatives are mainstays of topical therapy for chronic plaque psoriasis; I have to wonder if coronary plaque can form if vitamin D is deficient since vitamin D is involved with insulin regulation and insulin and hyperglycemia is also implicated in heart disease; often those with diabetes are found deficient in vitamin D, and they're a population most at risk for heart disease?  Makes you wonder, doesn't it?

You're absolutely right. There is solid evidence that vitamin D deficiency increases diabetic patterns, including higher blood sugar and insulin levels. Whether this is part of the reason why vitamin D might exert benefits on coronary plaque remains uncertain. I suspect that there are many reasons, this being a major one.

You may be interested in the following papers.
The case against ergocalciferol (vitamin D2) as a vitamin supplement.
http://www.ajcn.org/cgi/content/abstract/84/4/694
Risk assessment for vitamin D
http://www.ajcn.org/cgi/content/abstract/85/1/6
http://www.ajcn.org/cgi/content/full/77/1/204
Human serum 25-hydroxycholecalciferol response to extended oral dosing with cholecalciferol

Dr. Prendergast has posted today an astonishing story of benefit from D3. The patient was switched to D2 in an effort to move to generic alternatives and he went rapidly downhill toward death. The mistake was discovered, the patient was switched back to D3 and he immediately recovered.
Here's the link to the short video:
http://enews.endocrinemetabolic.com/2007/11/generic-wars.html

Thanks for the heads-up, Rich. It is truly an astonishing story.

Dr Davis!
   Sometime back I had posted a comment on your entry about wheat. And you had suggested that my Vitamin D3 levels might be low. Your diagnosis from 3000 miles away proved right! I had a 25-OH-D3 test and the value was less than 4ng/ml. I consulted my cardiologist and he brushed away the fact and asked me to drink more milk! I'm planning to switch doctors now.
   My copy of TYP reached me and I'm through cover to cover. The level of  details in the book is amazing and I've started correcting my lifestyle, food habits and medicines(of course, after discussing with the doctor).
   Many doctors here prefer a CT angiogram to a heart scan. My doctor was unable to give a good reason for why I should not have a heart scan but a CT angiogram. ("You are too young to have a heart scan"). So the situation here in India is no better.
  Many thanks!
-Neelesh

In addition to home kits we might create drop in health shops where healthy people are given a quick set of automated tests/scans and the results made available to them online.

This is a great tool as many of my clients mention their thyroids and wonder if there was a way to monitor it.  When will this be available in the UK?

I'm not sure getting tested is as big of an issue as getting a proper diagnosis and treatment.  I know lots of women who have their their thyroids tested (at least minimally with a TSH) but the results are not properly interpreted or treated.   Usually they end up with anti-depressant meds or are told to eat less and exercise more (or both).

My thyroid was tested for about ten years (mostly with just the TSH and total T4, not the full complement of thyroid tests) for more than ten years because of two infertility investigations and later, symptoms of fatigue, etc.  I didn't ask for these tests; they were routine as part of a panel or the doctor specified them.  

My HMO network doctors failed to see that my TSH was slowly slowly rising in that decade because they only looked at the recent result and not the trend (and there was a faster rate of increase after 7-8 years of testing).  They also missed that my results  were always in the "upper end" of the reference range (in late 2002 at least two national medical boards said the upper range was suspicious of development of mild hypothyroidism and the range should be adjusted downward).  Last year when I brought these AACE and NACL recommendations to the attention of the local HMO network lab supervisor, he was unaware of of the new range recommendations and promised to look into it.  I was pleased to note the ref range was somewhat adjusted down a few months later.

So for me, the lab tests were less an issue; I had numerous TSH and total T4 tests while my symptoms progressively increased, but with little good.  

The biggest difficulty was getting a correct diagnosis and the proper treatment, instead of attempts to suppress symptoms with other meds (I felt in my gut this was the wrong approach and I mostly resisted it).  

The best treatment I've tried to date has been desiccated thyroid hormone (I'm now taking 1 grain of Nature-throid daily); to get to this it took a full three years with a continual search to find a local doctor who would use and correctly interpret the right lab tests *and* take into account my symptoms.   I hear similar stories from other hypothyroid people.

Yes, absolutely correct, Anna. Getting tested is just the first step.

Once tested, understanding what they mean is the next step. But at least you know where you start. It's certainly better than not having any data at all.

Next hurdle: Getting treatment when you need it. A topic for future discussion!

Lincolb--It is available in the U.K. by ordering.

I guess that's how CA and NY can justify putting restrictions on their sale.  Sheesh!  Reminds me of when CA was on the brink of criminalizing home-schooling.

That's great! I will recommend that to my sister and friend who were always complaining that they might have thyroid problem.
See yah!

Cathy Young
http://fashionhotcelebs.blogspot.com/

I have also been able to get my doctors to do TSH tests, but since my labs ate at the upper end of normal, they also pooh pooh my suggestion  that treating the thyroid might positively impact other issues they care about, like my cholesterol levels and my asthma.  But they would rather give me statins (which I refuse to take) and advair (which I take only because I have to be able to function.)  I think they have it in my notes that I am hypochondriac and uncompliant. So much for being proactive for my own health care! Now they think I am a nutcase!

I agree with Anna. My doc has routinely tested TSH for years. This past check up I told her I wanted more info on the thryoid because of my lack of energy and other symptoms. She ordered T3 and T4 along with TSH but nothing else. My TSH came in at 4.5 on a scale going to 4.5 which is a full point jump since my last test. My T3 is almost abnormal on the low end. However since they are within the lab's normal range, she says I am fine. I am making an appointment with doc #2 in my search for someone that knows what they are doing. I sure hope it does not take the 3 years to find him/her it took Anna!

Laura,

I'd also like to add that much of that 3 years looking for better care was also spent educating myself (I must have read every book available on hypothyroidism to get a sense of all the perspectives), so developed a sense of when to seek out another doctor's care and when to settle for "good enough for now".  

For me, the hardest part was early on -  summoning the inner strength to get over my reluctance to find new care and thyroid hormone options.  I was acutely aware that my tactic might be viewed as "doctor-shopping" or hypochondria.   Each step wasn't always very far forward, but it was still progress in some way and far more therapeutic than stagnating (it didn't always feel like progress at the time, though).

Good luck in your quest for better care and more thorough assessment of your thyroid function.  Be sure to get tested for anti-thyroid antibodies.

Regular Doctors are always a crap shoot. If you don't mind switching Doctors, it is better to seek out a Doctor that you know will probably be receptive to alternative therapies right from the get go. Life Extension has a list of "Innovative Doctors" here:

http://www.lef.org/Health-Wellness/InnovativeDoctors/

Another good source for Doctors that would probably be receptive to taking a patients thyroid concerns more seriously can be found at the A4M site:

http://www.worldhealth.net/pages/directory

Likewise, if lipid disorders are your concern, you can find a Lipidologist at the following site:

http://www.learnyourlipids.com/resources.php

Hope this helps.

John M.

here is the site to find thyroid hormones friendly doctors.
http://www.armourthyroid.com/con_phLocator.aspx

Dr Davis, I don't think that you are on there? LOL

Another option when faced with uncooperative doctors: order thyroid from an overseas pharmacy.

You forgot the option of saying you look Healthy so the test is unnecessary and Ridiculing you -- but finally ordering the tests, because you wouldn't leave the room till he patronizingly agreed (hey, whatever works)... and it turns out I have multi-nodule goiter!!

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!

Although this was not asked in the poll, I believe that it is a safe assumption that you asked with good reason: you're abnormally fatigued, you have been gaining weight for no apparent reason or can't lose weight despite substantial effort, or you feel cold at inappropriate times.