Blame the gluten?

14. May 2010 William Davis (17)
Wheat is among the most destructive components of the human diet, a food that is responsible for inflammatory disease, diabetes, heart disease, several forms of intestinal diseases, schizophrenia, bipolar illness, ADHD, behavioral outbursts in autistic children . . . just to name a few.

But why?

Wheat is mostly carbohydrate. That explains its capacity to cause blood sugar to increase after eating, say, a turkey sandwich on whole wheat bread. The rapid release of sugars likely underlies its capacity to create visceral fat, what I call "wheat belly."

But neither the carbohydrate nor the other components, like bran and B vitamins, can explain all the other adverse health phenomena of wheat. So what is it in wheat that, for instance, worsens auditory hallucinations in paranoid schizophrenics? Is it the gluten?

First of all, what is gluten?

Gluten protein is the focus of most wheat research conducted by food manufacturers and food scientists, since it is the component of wheat that confers the unique properties of dough, allowing a pizza maker to roll and toss pizza crust in the air and mold it into shape. The distinctive “doughy” quality of the simple mix of wheat flour and water, unlike cornstarch or rice starch, for instance, properties that food scientists call “viscoelasticity” and “cohesiveness,” are due to the gluten. Wheat is mostly carbohydrate, but the 10-15% protein content is approximately 80% gluten. Wheat without gluten would lose its unique qualities that make it desirable to bakers and pizza makers. Gluten is also the component of wheat most confidently linked to immune diseases like celiac.

The structure of gluten proteins has proven frustratingly elusive to characterize, as it changes over time and varies from strain to strain. But an understanding of gluten structure may be part, perhaps most, of the answer to the question of why wheat provokes negative effects in humans.

The term “gluten” encompasses two primary families of proteins, the gliadins and the glutenens. The gliadins, one of the protein groups that trigger the immune response in celiac disease, has three subtypes: a/ß-gliadins, ?-gliadins, and ?-gliadins. The glutenins are repeating structures, or polymers, of more basic protein structures.

Beyond gluten, the other 20% or so of non-gluten proteins in wheat include albumins, prolamins, and globulins, each of which can also vary from strain to strain. In total, there are over 1000 other proteins that serve functions from protection of the grain from pathogens, to water resistance, to reproductive functions. There are agglutinins, peroxidases, a-amylases, serpins, and acyl CoA oxidases, not to mention five forms of glycerinaldehyde-3-phosphate dehydrogenases. I shouldn’t neglect to mention the globulins, ß-purothionin, puroindolines a and b, tritin, and starch synthases.

As if this protein/enzyme smorgasbord weren’t enough, food processors have also turned to fungal enzymes, such as cellulases, glucoamylases, xylanases, and ß-xylosidases to enhance leavening and texture. Many bakers also add soy flour to enhance mixing and whiteness, which introduces yet another collection of proteins and enzymes.

In short, wheat is not just a simple gluten protein with some starch and bran. It is a complex collection of biological material that varies according to its genetic code.

While wheat is primarily carbohydrate, it is also a mix of gluten protein which can vary in structure from strain to strain, as well as a highly variable mix of non-gluten proteins. Wheat has evolved naturally to only a modest degree, but it has changed dramatically under the influence of agricultural scientists. With human intervention, wheat strains are bred and genetically manipulated to obtain desirable characteristics, such as height (ranging from 18 inches to over 4 feet tall), “clinginess” of the seeds, yield per acre, and baking or viscoelastic properties of the dough. Various chemicals are also administered to fight off potential pathogens, such as fungi, and to activate the expression of protective enzymes within the wheat itself to “inoculate” itself against invading organisms.

From the original two strains of wheat consumed by Neolithic humans in the Fertile Crescent 9000 years ago (Emmer and Einkorn), we now have over 200,000 strains of wheat virtually all of which are the product of genetic manipulations that have modified the protein structure of wheat. The extraordinary complexity of wheat proteins have therefore created a huge black box of uncertainty in pinpointing which protein causes what.

But there's an easy cure for the uncertainty: Don't eat it.
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Comments (17) -

  • lindaharper

    5/14/2010 3:18:04 PM |

    Do you have the same destructive problem making bread from other grains instead of wheat, i.e. rice, barley, spelt? These are all useful for those with wheat intolerance, but I haven't heard you say about using other grains in making your own homemade bread.  I have also read that sourdough leavening is also less destructive.

  • Kevin

    5/14/2010 4:07:03 PM |

    Quote:

    "So what is it in wheat that, for instance, worsens auditory hallucinations in paranoid schizophrenics? Is it the gluten?"

    If wheat is associated with auditory hallucinations, is it also associated with olfactory hallucinations?  I've had them at least 20 years.  For me they go away if I take zinc regularly.  

    kevin

  • Anonymous

    5/14/2010 5:39:38 PM |

    I'd also be interested to know if there is any type of bread (gluten free) which you feel is safe to eat within moderation.

    Rice bread tends to be high-ish in carbs, but at least it avoids the gluten.

    Just wondering if rice bread and other gluten-free alternatives cause small LDL like wheat does.

  • Michael Barker

    5/15/2010 12:51:59 AM |

    What I've never understood is how the Italians have eaten pasta for so many years without, it appears, great problems.

  • Dr. William Davis

    5/15/2010 12:53:57 AM |

    Hi, Linda--

    If you subtract the gluten, you have (mostly) carbohydrates.

    It then boils down to how carb-sensitive you are gauged by, for instance, postprandial blood glucose or HbA1c.

  • Peter

    5/15/2010 11:45:29 AM |

    Another puzzling bit of information is the northern Indians who eat lots of wheat have a fraction of the heart disease of the rice eating southern Indians.

  • Anonymous

    5/15/2010 3:33:12 PM |

    Regarding pasta and Italians -- it was in North America, not Italy, where pasta graduated to main-course portions, probably because it's cheap.

  • Jim Purdy

    5/15/2010 9:24:29 PM |

    "But there's an easy cure for the uncertainty: Don't eat it."

    That makes sense to me.

    But if I have to give up Wheat Chex cereal, can I still eat Corn Chex and Rice Chex?

  • Anonymous

    5/15/2010 11:17:03 PM |

    We've recently gone gluten-free after suspecting gluten intolerance in me and my 3 yr old son. Wow what a difference. After one week off gluten, I gave him one piece of sourdough bread since we were low on groceries and I wasn't able to go out that day. I noticed immediate behavioral changes and changes on his skin (small bumps... my Naturopath says it's a sign he is deficient in certain vitamins, they were going away while he was off gluten). Our lifesavers are quinoa porridge (quinoa, water, milk, egg yolks) and buckwheat pancakes, the kids love them. Makes going grain-free a little easier for my carb-addicted preschooler (we've taken it one step further then gluten-free and eliminated all grains.) Buckwheat pancakes can be used to make sandwiches, as a substitute for bread.  - Valley Mom

  • Chris

    5/16/2010 3:39:29 PM |

    What plant or animal source of food has not been severely manipulated over the last 9,000 years? What if I'm sure I don't have Celiacs Disease or Schizophrenia and I control my daily blood glucose and HbA1C? Isn't wheat just another source of carbs/fiber/protein?

  • Dave

    5/16/2010 3:50:50 PM |

    Just to expand on your last sentence: if there's no upside to eating wheat, and even the remotest possibility of a downside, then the decision is easy.

    Of course there clearly is an upside, or else wheat wouldn't get eaten in the first place. The question is whether or not this upside represents an actual positive impact on health, or a misinterpretation by the brain of signals which normally indicate positive health outcomes. See my blog and ensuing discussion here:

    http://sparkofreason.blogspot.com/2010/05/why-do-you-eat-grains.html

  • Myron

    5/16/2010 6:35:24 PM |

    For People that make excuses or try to talk their way out of avoiding wheat or any other food item, that is the #1 sign of an allergy addiction.

    Take a look at the relationship between low Testosterone and metabolic syndrome and belly fat.

    It's not just a sugar thing, more  related to steroids and stress, IMHO

  • kris

    5/16/2010 8:06:02 PM |

    I do not see a single person around my family who doesn’t have some sort of health issue and they all have northern Indian background. Most of them are diabetics, have heart disease, wheat belly, puffy cheeks, unable to run a mile after the age of 30, hypothyroid, over weight. Just for this topic, if I think about all of the hundreds of people that I know who have northern Indian background, most of them have health issues and they all have high carbohydrate, high wheat based diet. Now there are people within the family who are changing their diet ever since they have seen me improving, about every one of them has made improvements after the change.
    Everyone is entitled to their opinion but,
    I for one believe that the wheat is the one of the biggest culprit in our diet.
    Carbohydrates might be the second in line along with iodine shortages and the list goes on.
    The high glycoside symptoms are very close to the hypothyroid symptoms.
    Every person should own a blood-sugar meter and should have the knowledge to their sugar/carbohydrate reaction profile.
      But I think that finally the time has come where free-will education is being shared in a positive manner which will eventually push the “wanna be Mr Right side” organizations to jump the band wagon sooner or later.
    By the way Dr. Davis, after giving up wheat, taking care of thyroid and weight management which helped me loose 40 some pounds, I am happy to report that after reading your blogs religiously and following that low carb diet, I have lost the last 10 pounds. I have never felt this way in my entire life.
    Keeping my blood sugar level between 4 and 5.5 almost all of skin problems go away which includes but not limited to 10 years old broken hand palm skin, bloody gums, skin inflammation on back of my head, red patch on the facial skin, less bloody shave etc.  Interestingly, if the after meal blood sugar level stays over 6 and around 8 for few days, then most these issues slowly begin to come back. This might explain why I had bloody stomach few years back. Introduction of more fat in my diet may have also helped in all of above.
    All of above is my personal experience so it may not be backed by any study.
    Please keep it up, you are The Doctor.

  • Anne

    5/17/2010 1:21:21 AM |

    Lindaharper - barley and spelt have gluten similar to wheat and need to be eliminated on a gluten free diet. A gluten free diet eliminates wheat, barley and rye and related grains.

    I have gluten intolerance and type 2 diabetes. I can keep my blood sugar in control by limiting carbs. I have not found any grain that will not raise my blood glucose to unacceptable levels. I guess I could eat tiny amount of grain, but why bother. I would rather get my few carbs from highly nutritious low carb veggies.

    Eliminating gluten gave me back my life. Eliminating grains in general further improved my health.

    A great site to read more about gluten is The Gluten File

  • Captain Mikee

    5/17/2010 2:41:49 PM |

    @Jim Purdy: Most breakfast cereals contain barley malt even if they don't have wheat. Barley also contains gluten.

    My family went through a couple months of substituting gluten-free grains before we decided it wasn't worth it and gave up all grains. Gluten-free substitute foods can help you break the addiction, but in the long run I don't think they're very healthy. In fact, in terms of pure nutrition (ignoring the anti-nutrition) no grain can beat wheat. Everything else is worse.

  • Anonymous

    5/20/2010 1:45:25 AM |

    General Mills brand Rice Chex and Corn Chex have been reformulated to remove the barley malt, so they are now gluten-free.  Some (but not all) Erewhon rice crispy cereals are also gluten-free.

  • Aleck H Alexopoulos

    7/20/2010 11:14:29 AM |

    Very interesting information.
    I wonder if there is a compounded problem with fructose consumption.

    I personally believe that we haven't had the time to evolve
    and adjust to the high-carb diets characteristic of agricultural societies.

    Some people are more susceptible to problems of increased carbs, refined-carbs, sugars, and fructose. This susceptibility
    can take a long time to manifest itself. Its not just insulin-resistance, but growth hormone levels, HTA-axis, and other
    hormonal controls but also there
    is a growing realization of the effect of refined carbs and sugars on the inflammation process which suggests connections to atherosclerosis, neuronal damage, and even autoimmune diseases.

    Last note:
    I find it very striking that cancer cells have such a "craving" for sugars that they represent the only cells - other than hepatocytes - that will readily uptake fructose from the plasma.

    Just my thoughts.

    Aleck H Alexopoulos

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Self-directed health: At-home lab testing

Self-directed health: At-home lab testing

29. March 2009 William Davis (20)
I have a prediction.

I predict that more and more healthcare can and will be obtained directly by the individual--without doctors, without hospitals, without the corrupt profit-at-any-costs modus operandi of the pharmaceutical industry. I predict that, given the right tools, Joe or Jane Q. Public will have the choice to manage his or her own health using tools that are directly accessible, tools that include direct-to-consumer medical imaging (CT scans, ultrasound, MRI, etc.), nutritional supplements (a loosely-defined term, to our advantage), and direct-to-consumer laboratory testing.

Done responsibly, self-directed healthcare is superior to healthcare from your doctor. While no one expects you to remove your own gallbladder, you can manage cholesterol, blood sugar issues, vitamin D, low thyroid, and others--better than your doctor.

As everyone becomes more comfortable with the notion of self-directed health, you will see new services appear that help individuals manage their health. You will see prices for direct-to-consumer medical imaging and lab testing drop due to competition, something that doesn't happen in current insurance-based healthcare delivery. People are being exposed to larger deductibles and/or draw money from a medical savings account and will seek more cost advantages. Such direct-to-consumer competitive pricing will meet those needs. Overall, the presently unsustainable cost of healthcare will decline.

To help accelerate the shift of human healthcare away from conventional paths and divert it towards the individual, we have launched a panel of direct-to-consumer at-home laboratory tests that we are making available on the Track Your Plaque website.

On your own (except in California, which requires a doctor's order or prescription; and NY, the only state in the nation that prohibits entirely), you can now test, in the comfort of your own home with no laboratory blood draw required, parameters including:

--Thyroid tests--Free T3, free T4, TSH
--Lipids
--C-reactive protein
--Vitamin D
--Testosterone
--Progesterone

and others.

As the technology improves, more tests will become available for testing at home. (Lipoproteins are not yet available, but will probably be available within the next few years. That would be an enormous boon to those of us interested in supercharged heart disease prevention and reversal.)

Anyone interested in our at-home testing can just go to the Track Your Plaque lab test Marketplace.

When I first began the Track Your Plaque program around 8 years ago, I saw it as a way for people to learn how to control or reverse coronary atherosclerotic plaque, and I'd hoped that physicians would begin to see the light and become patient advocates in this process. But I have lost hope that most of my colleagues are interested in becoming your advocate in health. They are too locked into the "call me when you hurt" mentality. I now see Track Your Plaque as a way for people to seize control over coronary plaque with minimal assistance from their doctors. Indeed, some of our Members have achieved reduction of their plaque in spite of their doctors.

This is just the tip of the iceberg of what's to come. Brace yourself for a cataclysmic shift in returning health to you and away from those who would profit from your misfortune.
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Comments (20) -

  • Jenny

    3/29/2009 4:14:00 PM |

    Dr. Davis,

    As someone who has used home A1c tests and home Cholesterol tests and found them to produce results so far off lab test results as to be worthless, I wondered if you could show us the data about the accuracy of these tests, some quite expensive, compared to tests run at a hospital lab.

    For example, the home A1c tests told you that the result was accurate to between plus or minus .5%, but you didn't learn this until you'd purchased the test, and that margin made the test useless to those of us who control our blood sugars. There is a huge difference between 6.0% and 7.0% but it was possible to have an actual, lab 6.5% and get either result with that home test.

    So what are the margins of error in the tests you provide?

  • JPB

    3/29/2009 4:23:00 PM |

    Excellent post!  I totally agree with your prediction but there are several things that will need to happen for it to occur:

    1.  People will need to take responsibility for their own health and decisions regarding maintaining that health.
    2.  The correct information needs to be available.  The amount of bad info and bias in nutritional recommendations is unbelievable plus the drug companies have been busy promoting and selling products that have questionable benefits at best.
    3.  The for-profit model of medical care must be abandoned. It is obscene for someone to profit from another person's medical problems. (I am not talking about paying decent salaries to doctors and medical care workers but rather, profits to shareholders and top executives.)  

    Our current medical care system is a disgrace but there will be many howls of protest from the vested interests when these changes are even suggested.  Unfortunately this system will fail unless reforms are made.  We cannot afford the relentless rise in costs anymore nor the overall deterioration of our citizens' health!

  • Anonymous

    3/29/2009 9:59:00 PM |

    I agree that this will catch on. Costs for self-directed testing are already coming down due to laboratory competition, and will fall even further with the rise of home testing.

    I think that taking control of your diet and overall health, a la Track Your Plaque, naturally leads to a desire for more information, without the added hassle and cost (and potentially, resistance or refusal) of a doctor's involvement up-front.

    How lucky am I then, to have moved from New York, where your home testing is not available, to California, where it's also not available.

    Fortunately, there are alternatives, at least in California, such as www.directlabs.com, www.mymedlab.com and www.medlabusa.com.  You have to go through an extra step of going in for a blood draw, but at least  you can get the testing.

  • rabagley

    3/29/2009 9:59:00 PM |

    When will LabCorp release the subfraction data to non-doctor requested NMR lipid panels?

    Supposedly it's the best lipid test out there, but I can't get to all of the results because of a policy that I'm completely and utterly unable to get to the bottom of.

  • Dr. William Davis

    3/29/2009 10:13:00 PM |

    Hi, Jenny--

    We've had the same problem with many of the at-home tests.

    For that reason, all the testing now offered is run at ZRT Labs with data and quality essentially identical to that obtained through conventional laboratories. In other words, while the samples are obtained at home as finger stick blots on paper, the tests are not run at home but at ZRT Labs.

    Their quality control policies are listed athttp://www.zrtlab.com/Page.aspx?nid=413.

  • Rich

    3/30/2009 1:27:00 AM |

    Jenny -

    While I've heard that a number of the home tests are not very accurate, there is a least one A1C test (which you mail into a lab) which is quite accurate.

    It is from Heritage Labs, and is sold as "ReliOn A1C" by Walmart for $9.00:
    www.walmart.com/catalog/product.do?product_id=10575934#ShortReviewTitleBar

    or by the name "Appraise Diabetes A1C Test" in other drug stores, such as CVS, etc. (usually around $19.00 - so Walmart is much cheaper).

    It is the same fingerprick test under both names.

    David Mendosa blogged about this test and its accuracy here:
    www.mendosa.com/blog/?p=339

    Heritage Labs is certified by the National Glycohemoglobin Standardization Program (NGSP), and they have only certified 78 labs worldwide.  Only 4 Quest labs in the US are certified (none that my blood goes to) and no Labcorp’s at all. The list of NGSP certified labs can be found here:
    www.ngsp.org/prog/labs.pdf

    I did the ReliOn bloodspot test and mailed it in to Heritage Lab in Kansas, and my 5.2 result was consistent with Labcorp and Quest A1c's from the past few years.

    During my appointments in the past with Dr. Bernstein, he tested my A1C using a device in his office also, but at the time I was still relatively diabetically-uninformed, so I did not take note of model he used.

    Rich

  • Anonymous

    3/30/2009 10:01:00 AM |

    I think this collection of tests are a wonderful addition to TYP.  Thanks for offering them.  I enjoy taking control of my health and when possible staying away from the doctor's office too.  It's frustrating going to the hospital.  Medical personal all to often try to make me feel like I'm the low man on the totem pole for my health care - even though I'm the customer!  I will be taking advantage of the home test.  

    I also enjoy spreading the word about TYP and had an idea about that.  Many companies offer company shirts.  It's basically free advertising for the firm.  Just a humble idea to pass along, thought it would be neat if TYP offered shirts that listed  different main concepts of the TYP program.

  • Dr. William Davis

    3/30/2009 11:32:00 AM |

    Thanks, anonymous. Great idea.

  • Anonymous

    3/30/2009 12:53:00 PM |

    Barkeater here.

    I would like to see more patient empowerment, and availability of good patient controlled testing is crucial.  Power to you, Doc.

    But, I am concerned that the future may not be bright.  California and New York have restrictions.  We are at this moment in a postion when more regulation seems like a great answer to all problems, rather than more freedom.  Certainly, that is coming in health care.

    The other 48 states probably have not made a careful decision to not regulate, but rather they are not as "advanced" in their thinking as Cal and NY.  

    Then, of course, there is the problem of insurance.  If only I could use my health care dollars as I see fit, but right now I spend $17k per year for insurance to participate in a system that often frustrates me.

    I can afford another few hundred to buy good health, but others aren't so lucky.

    Barkeater

  • Trinkwasser

    3/30/2009 3:25:00 PM |

    I once had the thought that if I won the lottery I'd start a business called The NHS PLC with a fleet of vans set up with lab test equipment which could come round door to door in the way that you can get your car serviced in your own drive.

    Yours is probably a better plan!

    They have just announced this

    http://news.bbc.co.uk/1/hi/health/7968734.stm

    almost certainly a cut off at the knees version, in many places the tests you supply are unavailable for cost reasons already, like officially I can only get TChol when I need the Full Lipid Panel, a friend can only get TSH when she needs T3 and T4.

    It seems these guys

    http://www.grassrootshealth.net/

    accept oversease customers, any chance of you doing the same?

  • mike V

    3/30/2009 3:56:00 PM |

    Dr Davis:
    My own doubts about the limits of curative medicine began to take root in 1962 when in hospital for six months (in the UK) with a fractured femur. There was a 13 year old boy in the ward who had in addition to polyomyelitis, a resistant Staph infection. (even then!)
    The treatment available was to cycle him through the available antibiotics of the time. He was given less than a year to live.
    My next need for a hospital came in 1993 when I needed to get rid of my gall bladder (some say this may have been one of the results of the "low fat" dietary era.)
    I realized around this time that I knew more about maintaining my high mileage cars than I did about personal nutrition and wellness, and resolved to make a change.
    I can report that since that time (1993) I have not had a single infection, and have reduced colds and flu essentially to zero. I have seen doctors only for "routine inspections".
    In my opinion, hospitals are one of society's  major health hazards, and here we all recognize that prescription drugs are a very slippery slope. (obviously one has to make exceptions for major trauma.)

    Many friends and contemporaries have been lost to or damaged by MRSA and other resistant infections in recent years.

    I very much appreciate the endorsement and weight you, your patients, and your members bring to healthy preventive measures, many learned independently over years by some of us.
    The close associations between heart disease, diabetes, auto-immune disease, Alzheimer's disease, hormonal disfunctions and lifestyle variables suggest that you are absolutely on the right track. Many of the responses to your blog posts reflect this.
    My close friend of 30 years now has simultaneous cardiomyopathy, diabetes, and AD with at times the mentality of a (terrible) 2 year old. What a difference TYP prevention might have made.

    Has it perhaps occurred to you that TYP may also be a surprisingly sensitive indicator of general health status?

    I would like you to know that your ethics and a genuine concern for your fellow man shine through, in all your writings.

    Thank You.
    Mike V

    Re: Home testing update. FYI:
    My first Grassroots Health 25(OH)D result was 50 after about 4+ months at 6000 iu Carlson's. Age 73. Location South Carolina. Winter UV exposure minimal.

  • Dawn

    3/30/2009 5:03:00 PM |

    Another option for ordering tests, where you go to a lab located near you is HealthCheckUSA. And for a few more dollars, you can also request a doc to do an interpretation of your results as well.

    http://www.healthcheckusa.com/

    BTW- LOVE LOVE LOVE your blog.

  • Dr. William Davis

    3/30/2009 6:18:00 PM |

    Thanks for the encouragement, Mike V and Dawn.

  • Anonymous

    3/30/2009 8:05:00 PM |

    Dr.
    This will never happen and will actually be illegal when this Universal Health care scheme becomes law.
    What you have described here Dr. Davis is about freedom and UH is the total opposite of freedom.

    Oh, and how long do you think it will be before nutritional supplements are illegal without government prescriptions? I predict within a year of UH as law.

  • Dr. William Davis

    3/30/2009 9:49:00 PM |

    Mike V--

    You make an important observation that we have also made in the TYP experience: Many of the strategies employed--vit D, omega-3 fatty acid supplementation, wheat elimination, etc.--lead to marvelously improved overall health, in addition to correction of cholesterol patterns and reduction of heart disease risk.

  • katherine

    4/1/2009 12:51:00 AM |

    Dr. Davis,

    I wanted to let you know about a positive experience with the Biotech brand D3 5000 IU capsules.  My latest test showed 80 ng/ml after supplementing for approximately 4 months with 10,000 IU daily (started with 5000, bumped it up to 10,000, will now go back to 5000 to maintain).  This is up from 34 ng/ml.  I know you generally recommend the gelcaps but these seem to get the job done as well.

  • Dr. William Davis

    4/1/2009 2:57:00 AM |

    Katherine--

    Thanks for the feedback. That's helpful.

  • darwinstable

    4/6/2009 4:36:00 AM |

    What a great post. I totally agree and in some respects have done that myself. I just turned against the mass media and did what I knew as an evolutionary biologist was the best thing to do. I can now see the results and this is something I could never have done with weight watchers, jenny craigs, current medical advice etc.

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    4/23/2009 5:04:00 AM |

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    1/6/2011 10:15:07 AM |

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HDL and vitamin D

HDL and vitamin D

22. February 2007 William Davis (5)
I know of no published reports on this question, but I've now seen numerous people experience significant jumps in HDL with raising blood vitamin D to 25-OH-vitamin D3.

Last week, for example, I had a man who had struggled with raising HDL from a starting level of 28 mg/dl. On niacin, exercise, weight loss, fish oil, red wine, and cilostazol (a prescription agent that I use occasionally that raises HDL), his HDL rose to 41 mg/dl--better, but hardly to our goal.

I added vitamin D, 4000 units, and raised his 25-OH-vitamin D3 level from 22 ng/ml to 53 ng/ml. Next HDL: 73 mg/dl! Small LDL improves along with a rise in HDL.

Not everybody's response is this dramatic. I see more typical rises of 5 to 10 mg/dl every day. I'm uncertain of why the response is inconsistent, though people who begin with lower vitamin D levels seem to experience a larger HDL increase. I wonder if the partial normalization of insulin and glucose responses is at work, or some anti-inflammatory effect.

Vitamin D provides so many other benefits, as well as HDL-raising. I hope you've gone to the effort to have your blood level checked to determine your replacement need. If not, now's the time. February represents your nadir (lowest point) for 25-OH-vitamin D3 blood levels.
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Comments (5) -

  • Mike

    2/22/2007 4:49:00 PM |

    If higher vitamin D levels increase HDL, then HDL levels should be higher in the summer and lower in the winter.

    I did a quick Google search and the first two studies that I found showed the opposite.

    http://cat.inist.fr/?aModele=afficheN&cpsidt=1059698
    http://findarticles.com/p/articles/mi_m2459/is_n4_v22/ai_13228867

  • Anonymous

    2/22/2007 6:20:00 PM |

    I am an RN with an interest in nutrition and heart dx. One of my son's has CAD, with blockage in LAD and was recently cardioverted due to persistant a.flutter 4:1 block.  Even though he is on statins, niacin, does exercise, has lost weight,takes fish oil, his HDL has only come up to 37.  

    I am going to suggest that he add the Vit D and maybe that will help.  Thank you for this information.

  • neil

    2/22/2007 11:54:00 PM |

    Hi Dr. Davis,

    It will be interesting to see if these results hold true for other patients, please keep us updated. It certainly sounds hopeful for those of us that struggle to keep our HDL up to a level of 60, and our HDL2 sub-fractions high as well.

    I ran across an article that shows perhaps a vitamin D pill treatment for cancer might be patentable!

    http://tinyurl.com/36dvb8

    Neil

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    Not everybody's response is this dramatic. I see more typical rises of 5 to 10 mg/dl every day. I'm uncertain of why the response is inconsistent, though people who begin with lower vitamin D levels seem to experience a larger HDL increase. I wonder if the partial normalization of insulin and glucose responses is at work, or some anti-inflammatory effect.

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What is "normal"?

What is "normal"?

1. May 2007 William Davis (2)
When it comes to laboratory values and medical testing, a common dilemma is knowing what is "normal." Let me explain.

First of all, when you receive a laboratory result for a test, a "reference range" or "normal range" is usually provided. Where did that range come from?

It varies from test to test. For instance, a low potassium is easy, because low potassium levels can lead to life threatening consequences, e.g., dangerous heart rhythms. High potassium likewise, because dangerous phenomena develop when potassium generally exceeds 5.5 mg/dl or so.

But what about something like HDL or LDL. Here's where confusion reigns. Often, "normal" is obtained by taking the average and saying that any value plus or minus two standard deviations (remember that painful class?) represents normal or reference range.

If that were true, what if we applied that principle to body weight. If we weighed several thousand adult women, the average would be in the neighborhood of 172 lbs (no kidding). Does that mean that 172 lbs plus or minus two standard deviations is normal? No, of course not.

There is therefore a distinction between "normal" and "desirable". For HDL cholesterol, your laboratory report might say that an HDL cholesterol of 40-60 mg/dl is normal. But is it desirable? I don't think so. The most frequent HDL level for a male with a heart attack is 42 mg/dl--hardly desirable.

Let's take triglycerides. The average triglyceride level in the U.S. is somewhere around 140 mg/dl. For those of us who do a lot of lipoprotein testing, we can tell you that triglycerides at this level, though generally regarded as being within the normal range, are associated with flagrant and obvious excesses of several abnormal lipoprotein particles that contribute to coronary plaque growth (VLDL and often IDL; small LDL; drop in HDL and shift towards small HDL).

So, always take the so-called "normal" or "reference" values on a lab report as crude guidelines that often have little or nothing to do with health or desirability. Unfortunately, many physicians are not aware of this and will declare any value within the normal or reference range as okay. An HDL of 40 mg is not okay. A triglyceride level of 140 mg is also not okay.

What is okay? What is desirable? That depends on the parameter being examined. From a basic lipid standpoint, of course, we regard desirable as 60-60-60. Desirability from a lipoprotein standpoint we will cover in a more thorough Track Your Plaque Special Report in future.
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Comments (2) -

  • Anonymous

    5/12/2007 10:15:00 PM |

    A brief aside, if I may. You speak about the dangers of serum potassium of over 5.5; I was diagnosed as a Type 2 diabetic in December, and my serum potassium is 6.0. What can I do? I know you can't diagnose someone online, but any suggestions would be hugely appreciated.

  • Dr. Davis

    5/13/2007 3:30:00 AM |

    A potassium of 6.0 is potentially life-threatening within a relatively short time. Medical attention is needed ASAP. Unfortunately, this is entirely unrelated to the issues we discuss here.

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My experience with the omega-3 index

My experience with the omega-3 index

8. October 2009 William Davis (23)
I just got back my own results from the Gene Smart laboratory reporting my omega-3 index and omega-6:omega-3 ratio.

My results:

Omega-3 index: 8.2%

Omega-6:omega-3 index: 3.2 to 1

Not too bad, but not as good as I'd expected. Hmmm.

Although the omega-3 index of 8.2% puts me in the lower risk category for sudden cardiac death, I was hoping for a level of 10% or slightly greater, the level that I believe is more likely to be related to plaque inactivation or reversal. I obtained this level of omega-3 averaging an intake of EPA and DHA of about 2500 mg per day.

I was somewhat disappointed by the omega-6:omega-3 index. Although it's clearly better than the American average range of 20:1, it is short of the ideal of 2:1 or even 1:1. Since I purposely avoid omega-6-rich sources like corn oil, vegetable oils, sunflower or safflower oils, I wonder if I've overdone the nuts. The two ways to improve the omega-6:omega-3 ratio are to 1) decrease omega-6, or 2) increase omega-3. I'm going to do both.

So I thought I was doing pretty well. But there's clearly room for improvement.

Remember: If just reduction of cardiovascular risk is your interest, then a lackadaisical attitude towards these issues might work. But if your interest is elimination of risk and reversal of atherosclerotic plaque, then it pays to go the extra mile. In this case, knowing your omega-3 index and omega-6:omega-3 ratio might tighten up your program.
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Comments (23) -

  • Stephan Guyenet

    10/8/2009 10:28:18 PM |

    Hi Dr. Davis,

    Adipose tissue also stores a lot of LA (proportional to long-term diet) and that will influence blood lipids.  The half-life of adipose LA is about 2 years, so changing that contribution is a long-term process.

  • William Trumbower

    10/9/2009 12:13:12 AM |

    I used the omega profile thru YFH.com.  My AA/EPA ratio was 1.39 on 7.5gm EPA+DHA (1 TBS EicoRx)daily  This dose also cured my asthma and almost eliminated my seasonal allergies.  EicoRx has GLA added, which pushes eicosanoid synthesis more toward the "Good Side".  One of the best basic fish oils is available thru the life extension foundation.  It is 60% pure (600mg EPA+DHA per 1000mg capsule) and contains sesame lignans and olive extract.  It is certified thru IFOS.  I got it on sale for under $10 for a bottle of 120!

  • karl

    10/9/2009 3:45:21 AM |

    I wonder if taking 6G of EPA+DHA/day - split as three separate dosages has any advantage over a single dose?

  • Dr. B G

    10/9/2009 3:57:37 AM |

    Dr. Davis!

    I like your n=1 experiment!

    Thank you for sharing your results. In all honesty, I think your Japanese blood demands more omega-3's.  That might in fact be genetic!!
      
    -G

  • Dr. B G

    10/9/2009 3:57:37 AM |

    Dr. Davis!

    I like your n=1 experiment!

    Thank you for sharing your results. In all honesty, I think your Japanese blood demands more omega-3's.  That might in fact be genetic!!
      
    -G

  • Anonymous

    10/9/2009 4:30:18 AM |

    What about the studies that Harvard's nutrition webpage cites that omega-3 and omega-6 were both beneficial and that they are not competition with each other?

    http://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/omega-3-fats/index.html

    The studies have citation numbers of 4 and 5 but i'll link them here anyway

    http://www.ncbi.nlm.nih.gov/pubmed/17876199?dopt=Citation

    "Adequate intakes of both n-6 and n-3 fatty acids are essential for good health and low rates of cardiovascular disease and type 2 diabetes, but the ratio of these fatty acids is not useful. Reductions of linoleic acid to "improve" this ratio would likely increase rates of cardiovascular disease and diabetes."

    http://www.ncbi.nlm.nih.gov/pubmed/15630029?dopt=Citation

    "n-3 PUFAs from both seafood and plant sources may reduce CHD risk, with little apparent influence from background n-6 PUFA intake."

  • Nameless

    10/9/2009 5:04:21 AM |

    I wonder if there are any other commercial labs doing Omega3/6 testing? Ideally, I'd like to get it a regular lab, through insurance, as I see enough doctors that I can get one to write a script.

    Any concerns about GeneSmart also selling Omega 3 supplements? It seems like a conflict of interest to me somehow. I would look at a VAP test differently if the same company sold statins direct to the consumer, for instance.

  • Jim Purdy

    10/9/2009 7:29:28 AM |

    Aw, shucks! Since dark chocolate is supposed to have good antioxidants, and nuts are supposed to have good fats, I thought that peanut or almond M&Ms would be the perfect health food.

  • Anonymous

    10/9/2009 12:32:33 PM |

    I'm currently taking 3600 mg EPA-DHA in 5 gels of PurPride fish oil at $.04 per gel...while equiv LEF fish oil would be 3 at $.17 per.

    I'm sure the LEF quality is better.

    Was wondering if 5 gels (3600 mg) was too much...looks like it might not be.

  • Roman

    10/9/2009 4:31:49 PM |

    Omega6s are one of the reasons I cut back on most nuts. Walnuts are the worst. The lowest amounts of omega6s are in macadamia nuts, so I still eat few of those. For this same reason I rarely eat avocados any more - they were throwing off my omega6/omega3 balance way too much, despite all the fish and supplements. Compared to most nuts and avocadoes even grain-fed beef is pretty benign from omega6 point of view.

  • PacRim Jim

    10/9/2009 4:54:06 PM |

    I wonder if any progress is being made in evaluating each person as a unique system. The same levels for everyone may not be appropriate.

  • Dave in Ohio

    10/10/2009 10:05:33 AM |

    I don't know how many nuts you're eating a week Doc, but 8 oz. of mixed nuts has about 25 g. 18:2 n-6 (LA).  Most nuts are high in LA, except for macadamia nuts.  Walnuts are the highest, with 38 g. LA per 100 g. of nuts.  Pecans are next at 20, peanuts at 15, almonds and pistachios at about 13.5, and cashews at 8.5. Macadamias have only 1.3 g. LA per 100 g. of nuts.

  • Anonymous

    10/10/2009 5:01:40 PM |

    Hello,

    I just purchased the omega 3/omega 3/6 ration test -

    what does the omega ratio test cover? The ratio in tissue? Blood? My understanding is that the ratio in tissue is what is the best identifier, but I believe it says that blood is tested?

    *confused*

  • Anonymous

    10/10/2009 5:26:45 PM |

    All the evidence suggests that dietary linoleic acid (plant-based omega 6) is perfectly healthy - it's the dietary arachidinoic acid (animal-based omega 6) that's problematic.

  • Dr. William Davis

    10/11/2009 12:09:36 AM |

    Omega-6 intake seems to be a tripping point. We'll discuss that in a future post.

  • Rick

    10/11/2009 9:25:18 AM |

    Dr Davis,
    If we order test kits from overseas, even if the kit arrives OK I'm worried about customs problems when sending back my own blood in order to get the results. Any idea how likely this is to be a problem?

  • Dr. William Davis

    10/11/2009 11:52:43 PM |

    Hi, Rick--

    To my knowledge, there should be no problem with international orders.

  • Anonymous

    10/12/2009 10:37:04 AM |

    I remember one of the marketing points made by krill sellers is that krill EPA/ DHA is absorbed better into the cell membrane verses regular fish oil.  It would be interesting to see if that is true.

  • Nameless

    10/13/2009 4:41:12 PM |

    Interesting comment about the krill, although to do a fair comparison the Omega 3 intakes would need to be equal (or in the same ballpark) for both fish and krill.

    To get to 1-2 grams of Omega 3s/daily from krill, it'd probably bankrupt you.

    I think krill may do a better job than fish oil as to  reducing c-reactive protein and probably does absorb better. But it's not so cost effective at large doses.

  • Sue

    10/14/2009 10:14:29 AM |

    Are you a vegetarian?  I think I read somewhere you don't like meat.  Perhaps this is contributing to your omega 3 index.

  • MarciaBrady

    10/15/2009 6:21:39 PM |

    Hi.  I just recently saw something on WebMD that said Fish Oil has been shown to worsen your risk of heart disease.  What do you think about that?

  • Anonymous

    10/15/2009 6:23:39 PM |

    I previously posted that I was taking 3600 mg O3s...when it is actually 1500 mgs...
    will be increasing to around 2900 mgs.

    Do have a question as far as the interaction of a pomegranate extract which I take...where this is also supposed to help clear plaque...any such thing as too much arterial clearing?

  • Rhino

    2/1/2011 2:01:53 PM |

    These companies that sell supplements and omega 3 index tests dont do the analysis.  
    The lab that created the Index, OmegaQuant, does the lab work and is blinded to patient information.

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