Well, since you touch on it, i'd be very interested in what you think about GF alternative flours.

I know you have said in various places to avoid wheat & "corn starch."  Also indications that oats are not very good for us either.  But there are so many other grains.  Amaranth & quinoa are both supposed to be high in protein. Buckwheat?  Corn meals?  Millet?  I could go on & on.

Are nut & coconut flours the only option to living low carb?  

I try to keep your recommendations in mind, but frankly, i struggle with giving up all grains.

Thanks.

Dr Davis, I certainly appreciate you looking for alternatives to the destruction wheat poses, but seems like this product may have issues as well?

Wouldn't the problems with soy greatly out weigh anything positive one could gain from using tofu?

This was taken from an article on Dr. Mercola's site concerning tofu. http://articles.mercola.com/sites/articles/archive/2008/09/18/what-s-so-bad-about-tofu.aspx

"Many health-conscious Americans, in an effort to improve their eating habits, have switched to eating tofu in place of meat or eggs. The soy industry would have you believe that this is a smart move for your heart health, but in reality processed soy, which includes tofu, is not a health food.

You are much better off eating organic eggs, grass-fed meat and raw dairy products than you are eating processed soy.

"Unlike in Asia where people eat small amounts of whole soybean products, western food processors separate the soybean into two golden commodities--protein and oil. There's nothing safe or natural about this,” Dr. Daniel says.

To Kent:  shirataki noodles are available WITHOUT soy, but you have to order those online, mostly the grocery store variety has soy.  The ones from MiracleNoodle.com are soy free.  I buy mine online at amazon.com, try this link: http://www.amazon.com/JFC-White-Shirataki-Noodles-16-0/dp/B002GDH5Y8/ref=sr_1_6?ie=UTF8&s=grocery&qid=1287069415&sr=1-6

I don't miss noodles enough to bother with these, but I have tried them.  They work best with Asian-style noodle dishes better than Italian-style dishes, IMO.  I used the noodles made without tofu, however, as I make antibodies to soy, so I avoid it.

One thing to note for those who try these noodles for the first time - when the package is first opened the aroma is slightly fishy.  They are NOT spoiled.  The smell will go away when they are drained and rinsed.  I tossed two packages before I discovered that was normal.  

Dana Carpender, a popular low carb cookbook author and blogger, had a post up on her Hold The Toast blog not long ago about these noodles.

Kathryn,

Quinoa, and maybe amaranth (I haven't looked at the protein content of that one)  IS higher in protein (and the protein is more complete) than the common grains, but I wouldn't say it is HIGH in protein.  It still has a considerable amount of starch.  That's probably fine if for those who have a robust glucose tolerance.   But I need to limit starches, so I still limit these foods.  I might toss in a handful of quinoa to a pot of stew to thicken it up, but per serving, that's not much at all.  

The longer I cook for my family with little or no without grains, the less I miss them.   I'd like my son to grow up without a huge craving for grain foods.

Anna, you beat me to the punch.

I call these noodles "FISH STRINGS"
They smell bad

I guess it's better then pasta, but all in all, it's still a pretty processed product.

Marc

Try Kelp Noodles sometime. I get them at Whole Foods, in the Deli case (refrigerated).  They're virtually tasteless and when cooked have a great noodle texture.

I much prefer them to Shirtaki noodles.

Sorry doc, But now you avoid the gluten from grains and you introduce the lectins from the legume soy. This leads to a leaky gut and autoimmune diseases http://bit.ly/a9Gvjk

soy noodles??!?! tofu....for real?

"Unlike in Asia where people eat small amounts of whole soybean products, western food processors separate the soybean into two golden commodities--protein and oil. There's nothing safe or natural about this,” Dr. Daniel says."

While I agree with the soy issue and stay away from processed soy (I do eat a little fermented soy tempeh) I am not sure about these reports I've read about the Japanese eating soy in small amounts. A Japanese friend of mine who recently came back to the U.S. after living in Japan for a few years says that there are actually Tofu stands on the street much like hot dog vendors in the U.S. He says they have tofu of all kinds (even flavored) and it is a popular snack. According to him Tofu is everywhere in Japan. He was puzzled when I mentioned the reports of low soy/tofu consumption in Asia.

I tried shirataki noodles for the first time and loved them. I agree Asian dishes would be absolutely delightful with these noodles.

@Kent. I have heard a fair amount about this Dr. Mercola you speak of. Sounds like he's not the most sciencific guy out there. Is he just out there trying to sell his products and really not caring about the science part of it?

See below:
http://www.sciencebasedmedicine.org/?p=2116

Dr Mercola is one of the only sane voices out there and he is right about soy.  And yes he IS science based, the difference is he tells the truth and doesn't hide the truth and just dole out pills like most doctors.

http://www.quackwatch.com/11Ind/mercola.html

of course the government tries to silence Dr Mercola, if they knew about the Heart Scan blog they'd try to silence its author as well since it doesnt recommend the food pyramid and tons of grains to support the US dept of Agriculture, LOL.  Its so obvious.

Tommy, if you are interested in good, alternative medicine & natural ways of healing, Quackwatch is NOT the place to get your info.  He is paid much money to present his very biased (in favor of conventional medicine) articles.  

If he doesn't yet have an article on what Dr. Davis does here, he probably soon will.

Let me add a qualifying comment.

This, and perhaps some other ideas and suggestions in future, are simply meant to help people who seek replacements for familiar wheat-based foods.

However, I believe that we should still focus primarily on real foods, not substitutes. Real eggs, real meats, real vegetables, real nuts, etc.

Foods like shirataki noodles are meant to be occasional fun dishes.

For the majority of people, I do not share Joe Mercola's fear of soy, provided you take an iodine source such as kelp tablets.

Hi, Kathryn--

Gluten-free foods are candy, unfortunately.

Here's my previous post on this issue: http://heartscanblog.blogspot.com/2010/07/what-increases-blood-sugar-more-than.html

Quackwatch busted:  http://www.gaia-health.com/articles251/000277-quackbusters-are-busted.shtml

I have never read or followed Quackwatch and have no interest. While Googling Mercola that popped up. Ionly  posted it only as a statement that for every claim of life saving/altering advice one can point out there are just as many who disagree with it and show data to support their disagreements with all these doctors and gurus, diets etc.

I continue to be amazed at the support "both" sides of all this diet stuff show; all with supporting data and studies.  It sort of reminds me of the Helmet law wars the bikers used to have with the Government. For every proof (with studies) of the safety of helmets there was  also a counter (with studies) of the danger.  It seems the same with diet.  I feel like I'm watching a tennis match...lol. My head goes back and forth, back and forth...

@Tommy
I totally agree! I've been on both sides and they both have their 'scientific' proof. Also, everyone seems to want to or have to lose weight. That too is quite frustrating for me since I've been slender all my life and have no high BP or triglycerides - just have to watch my blood sugar. And here too both sides have their proof that it works. UGHHH!!!

I've tried these and really have tried to give them a place but they taste like rubber. The worst.

Spaghetti squash. Problem solved.

Right on Carl, spaghetti squash rocks.

SHiritaki noodles with soy are typically about 20% soy so that's not going to be a ton of soy unless you eat them often.  The other 80% is fiber from a tuber.  You actually don't need to boil these noodles, just rinse well and then add to your dish at the last minute to heat them.  Over cooking makes them more rubbery.  YOu really only need to heat them.  They also will NOT soak up liquid so make sure your sauce is plenty thick before adding the noodles.  If anything the noodles tend to release a bit of water back into the dish.  I don't normally eat soy but am OK with the small amount in an occasional dish of shiritaki noodles.

I'm very sensitive to starches, and grains, pseudo-grains, and starchy tubers all spike and crash my blood sugar. Beans, however, do not. When I want to indulge in pasta, I buy mung bean fettuccine at the healthfood store. They're made from whole mung beans, not refined mung bean starch, like the translucent, mung bean based, Asian noodles.

I use zucchini and yellow squash as a great low-carb replacement for noodles. Not only do they lack carbs, but they are a decent source of some vitamins and minerals.

Check out miraclenoodle.com, they have the soy free and have tons of varieties, try the orzo!!!

What is your opinion of "Nia-Span"?  My former doctor insisted that this "by prescription only" drug was the only way to take niacin.  The cost per month was virtually the same as for a statin.  (BTW, I declined this product and continued with regular niacin.)

FYI: the Slo-Niacin link isn't working.

RDA for niacin is 18 mg/day - what is your opinion on that, sir?
BTW, do you guys in the States just go to a pharmacy and buy niacin and D3 without a prescription?

"Slo-Niacin" uses a "polygel" to delay release of the nicotinic acid.  I've been taking Carlson's "Niacin-Time" (also nicotinic acid) which uses brazil wax to delay release.

The Carlson's product is about a third the price of the Slo-Niacin.

I've been taking regular (not no-flush) niacin for a few months.  Dr Davis recommends "Slo-Niacin" but I got sick from taking timed-release niacin back in the 80s and "Slo-Niacin" sounds suspiciously like "Timed-Release".  I should know in January when I have bloodwork, if the regular niacin helps.

JPB: Niaspan releases over 6-8 hours and yes..it is prescription only. I substituted it for Endur-acin which is MUCH cheaper and non-prescription and also releases over 6-8 hours. No difference in my lipid profiles...just big savings in my pocket book.

Zbig: 18mg is probably sufficient as a RDA, but in order to achieve the lipid lowering affects from Niacin, one has to take larger doses of 500mg or more from what I understand. And yes, we can buy many supplements like (high dose) niacin, vitamin D3 & even DHEA without a prescription here in the USA.

Anonymous: I believe Carlson buys their "Niacin-Time" from Endur. I looked at the picture on the Carlson website and the tablets are the exact same shape as Endur-acin. Endur has been around since the late 1980's from what I understand. You can buy direct from Endur.

IggyDalrmple: Here is a link to an excellent article about (time-release) Niacin written by Doctor Davis himself:

http://www.lef.org/magazine/mag2007/mar2007_atd_01.htm

Hi, Id like to know what research supports flush free Niacin has no effect on the human body ?
I had/have horrible heart palpitations after a heart attack, and after taking Flush Free Niacin 2 to 3 times daily, control them, while time released I tried did not .. and Im afraid to take regular Niacin being so unstable.  I take several other things as well now, but not at the beginning.  I have Late Stage Lyme which has its own set of causal factors as well as the typical ones, but if it has no effect on the human body .. it wouldnt work period.  So, I would guess ..  like all else one thing might work for some, another substance for another depending on what I wish they would narrow down to "Cause".  I still have high Blood pressure, some medications work for a week or two, then stop being effective.  Areas of the brain control heart beat .. I have no clue if this is the whats causing high blood pressure or not .. Lyme can go any where and do anything .. Ive had it since I was a child with mild symptoms until my immune system got a faulty in mid thirties when it became aggressive.  No Doctors know how to treat other than antibiotics, dont treat symptoms like really bad hypercoagulation (thick blood) caused by being exposed to bacteria etc for a long period of time and the immune system becoming over active .. 2002 I had an attack which took me out almost completely .. No heart or other doctor even tried to diagnose and gave me a "hearts fine" .. 3 yrs later I had an almost deadly heart attack.  All these yrs, almost 10 .. spent trying to find help, treating symptoms on my own, having no family and absolutely No life, except for trying to survive. (people with Lyme ramble) Though its good to know info.... Question still remains about Flush Free Niacin...

"IHN is more effective than niacin in its hypocholesterolemic,
antihypertensive and lipotropic effects"
Welsh AL, Eade M. Inositol hexanicotinate for improved nicotinic acid therapy.
Int Record Med 1961;174:9-15.

"significant lipid-lowering effects of IHN at doses of 400 mg 3-4 times daily"
Dorner V, Fischer FW. The influence of m-inositol hexanicotinate ester on the serum lipids and lipoproteins. Arzneim-Forsch 1961;11:110-113.

Sommer H. Nicotinic acid levels in the blood and fibrinolysis under the influence of the hexanicotinic ester of m-inositol. Arzneim Forsch. 1975;15:1337

"IHN was found to be more effective than niacin in reducing hypercholesterolemia"
El-Enein AMA, Hafez YS, Salem H, Abdel M. The role of nicotinic acid and inositol hexaniacinate as anticholesterolemic and antilipemic agents.
Nutr Reports Int 1983;28:899-911.

"Derivatives of niacin have been examined for their ability to alter lipid levels as well as niacin. It would be advantageous if the niacin vasodilation (flush) were eliminated or removed. The main disadvantage of the niacin derivatives will be cost. Inositol hexanicotinate is an ester of inositol and niacin. In the body it is slowly hydrolyzed releasing both of these important nutrients. The ester is more effective than niacin in lowering cholesterol and triglyceride levels, Abou El-Enein, Hafez, Salem and Abdel (1983). I have used this compound, Linodil, available in Canada but not the U.S.A. (at the time this paper was written) for thirty years for patients who can not or will not tolerate the flush. It is very gentle, effective, and can be tolerated by almost every person who uses it."
From: Niacin, Coronary Disease and Longevity by Abram Hoffer, M.D., Ph.D.

Question:  at dinner took 500 mgm Slo-Niacin and within a few hrs had some stomach unpleasant...sensations might be the best description, then my glucose rose.  Fasting rose 25 pts (shock) and yesterday was marked with ravenous hunger and 15-20 pts higher glucose all day; today's fasting was still higher than usual.  Is this expected?  It's almost as if it is undoing the work of my 1500 mg metformin ER in reducing the production of sugar in the liver. This isn't going to wk with higher glucose.  Suggestions? Comments?
6/25/09 labs: TRI-119, calc LDL-150, HDL-57, D-35, TSH-4.5, AIC-6.4. Taking 12.5 mg Maxzide, 4K IU D3.
9/22/09 labs: TRI-145, calc LDL-147, HDL-60, D-41, TSH-5.5, AIC-6.5, ApoB-111. Taking 12.5 mg Maxzide, 8K IU D3.
Doc put me on 25 mcg levothyroxine (don't think this is enough or I need Armour).

I think my TRI is up from too much carb (eat super low, ate a bit more more berries over summer).  I think my LDL is up from my rising TSH (free T4 & T3 midrange), been rising since Sept08 when it was 2.8 (when I started taking vit D). Wt loss (obese) has been stalled until I started subbing eggs for hi-protein shake with 2-3 ozs coconut milk a month ago.  TSH was high in 2001 (4.7) with high amts of reverse T3 (doc won't test for it)& given 2 mcg Cytomel but my TC was 205 with TRI=100. Now what to do?  Try the 250 mgm SloNiacin & see what happens?  Or just concentrate on improving D levels and improving thyroid function and hoping they help normalize lipids? Just looking for suggestions, not treatment, all ideas will be run by doc. He said statins or niacin...I'm female no familiy hist of heart probs, why statins with no good studies for women? 'Cause he takes a statin *sigh*.

After my heart attack from Late Stage Lyme Disease causing hypercoagulation/thick blood .. after released from the hospital, I had/have severe heart palpatations .. and IM SORRY BUT, FLUSH FREE NIACIN DOES WORK!!  I have to take 2-500mg twice daily and it stops the heart palpatations .. its no gimmick or hype.  IT Works !!  Ive heard about the severe very uncomfortable flush rush with regular Niacin which I think would scare me and make me panick, if not make me ill with the fragile state my system is in.  Purchased at any store online or otherwise .. a lot less than and w/no side effects, I also take Argnine to help open my vessels, but is not needed to stop my heart palpatations. Obviously, something is wrong though if I or anyone is having heart palpatation, so you should keep looking or asking RN/head nurse until you find a heart doctor who will actually address the issue and find out whats going on!!  Once in a while with stressful event I do need to take a beta blocker to stop palpations, but only 3-5 times a yr.  NO SIDE EFFECTS like beta blockers...

Given her stormy procedural history, I urged Gwen to immediately drop all processed carbohydrates from her diet, including any food made from wheat or corn starch. (She and her husband were shocked by this, by the way, since she'd been urged repeatedly to increase her whole grains by the hospital dietitians.) I also urged her to begin to lose the 30 lbs of weight that she'd gained following the hospital dietitians' advice. She also added fish oil at a higher-than-usual dose.

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I hadn't used iodized salt in more than 15 years.  In recent years I have only purchased various sea salts, usually as unrefined as possible.  There are traces of iodine in unrefined sea salts, but probably not enough.

I've also heard that another cause of lowered iodine intake in recent years is a decline in the use of  iodine-based disinfectants when cleaning food manufacturing machines and equipment.  Traces of residual iodine would go into the food during processing, apparently.  Not sure what disinfectants are used instead now.

So I also have increasingly incorporated kelp into my cooking and seasoning.  I began with sprinkling kelp granules on our morning eggs with a bit of sea salt and ground black pepper, for instance, or adding kelp granules to homemade vinaigrettes, salad dressings, and sauces.  It sort of looks like medium grind black pepper, but without the spiciness.  

Additionally, I keep a jar of Ao Nori Flakes (natural sea vegetables) in my seasoning cupboard and I use it liberally like one might use finely chopped parsley or chives to add a bit of green garnish in soups, mashed cauliflower, etc.  No one even needs to know it's sea vegetables instead of minced parsley, if you catch my drift.

Toasted nori is a great snack, and can be cut or torn up to use as wrappers or platforms for other foods.   Kids often love nori, especially if introduced at a young age.  

Some specialty grocery stores (such as Whole Foods or ethnic markets) may stock fresh sea vegetables in the chill case (often stocked with fresh chilled pickles and raw sauerkraut).  The sea vegetables are packaged with salt crystals for longer storage, but the salt should be rinsed off before using.  Sea vegetables make a great salad accompaniment to seafood or sashimi, but if that's too exotic, try tossing just a small amount of chopped colorful sea vegetable into an ordinary tossed salad at first to get used to the soft-crunchy  texture (sort of like a good traditional raw sauerkraut's texture).  

Last, but not least, dried seaweed/sea vegetable kombu is very good for adding iodine to broths.  These larger dried sea leaves keep very well in a cupboard for a long time, and are easy to toss into simmering water to create a delicious, nutritious broth for seafood  recipes.  The kombu leaves are removed and discarded after the broth is made.

More information about how to use kelp, nori, sea vegetable, and kombu is easy to find online, too (the WAPF website www.westonaprice.org  is also a good resource).  Using these items regularly in your cooking adds a delicious slightly savory accent as well as iodine and other trace nutrients to your diet.  Strange as "seaweed" might seem at first, only the fresh sea vegetables and nori will even be noticed by your family members, and even nori isn't so exotic with the rise in familiarity with sushi and sushi-like rolls.   The kelp granules, flaked dried sea vegetable, and kombu can be your secret if necessary  .

Nori and kelp granules can be often be found with the Asian foods on the international or ethnic aisle of conventional grocery stores. Kelp granules are sometimes stocked with spices, herbs, and seasonings, too.  More variety of choices may be found at specialty grocers.  I like the Ohsawa brand (Japanese, family-owned, traditionally prepared foods, distributed in the US by Gold Mine Natural Food Co. of San Diego - no affiliation to either company-just a customer).

Kelp can also be taken in tablets or gelatin capsules for those who wish to take more or not use it in cooking.  That form of kelp is usually stocked in vitamin and supplement departments.

Wow!

Thanks for the great advice, Anna.

My mother was Japanese, so I can tell you that I, too, find it easy to add a variety of seaweed products to meals. I'm impressed with your seaweed enthusiasm!

Thank you Anna for all that information!  I have been trying to incorporate more kelp and sea vegetables into our family's diet - but for another reason.  Many autism-boards believe that algin found in seaweed chelates heavy metals, and it's also been suggested that kelp will battle the strep virus.  Although our family's experience is anecdotal, we are seeing tremendous grounds with our child.  She wouldn't eat the kelp tablets (in gelatin form), but readily makes her own dipping sauce for boiled eggs (mixing wheat-free soy sauce with kelp granules and Gomasio - sesame seeds mixed with sea vegetables).  There is also a liquid-kelp form I got when we were exposed to the strep virus; I put a dropper-ful into a shot of juice.

I am so excited that there are people like Anna who is living the life and willing to share, and Dr. Davis who is putting himself out there and sharing this information.  18 mos ago I didn't know that heart disease was reversible.  And I was exhausted caring for a child that was mildly on the the spectrum.  Now, through radically changing our diets (including supplementation), not only is my health on the up-and-up, but my child is recovered and says and does amazing things.

From the bottom of my heart I thank you.  - M

Great post on Iodine.

How much Iodine is safe and how much should be taken daily?

Thanks!!!

Big thanks to Anna from over here in the UK too. In Wales we have Laver bread made from seaweed and here on the east coast we get samphire (glasswort) which is like saline asparagus but has a short season (damn, I'm drooling now!)

Following your post I've discovered a source of different sea vegetables and (dried) seaweed with which I'm currently experimenting. Tasty stuff!

My doctor has me take it in liquid form, I buy it here in Australia from a compounding chemist and it contains important minerals for thyroid health each 5ml dose has 15mg zinc, 100mcg chromium, 100mcg
selenium, 150mcg molybdenum, 100mcg iodine, 2.5mg manganese, 2mg boron. Doesn't taste the nicest in juice though

Many thanks for your advice Anna, I am very interested in alternative health.

I was surprised to learn that food processors use plain salt without iodine.

Been eating sea veggies, cereal grains, vegggies, etc since the late 70's, along with occasional wild foods (I live in rural area). I began with the Macrobiotic way of life, and have morphed it to suit my needs, as well, that diet has made important evolutionary steps over the decades. I have recently incorporated fish oil, due to my medittranean heritage, i.e. hyperlipdemia, so my hdl's are 39, my ldl's 135, and tri's 80, cholesterol 198. I suspect fish oil (using Now foods Molecularly Distilled 4k-6k IU's) with intake of 5-6 days a week, ought to improve the next blood report stats.

Here is a site I use, for sea vegatbles.

http://www.seaveg.com

So iodine deficiency in early 20th century America was a big problem. How to solve this enormous public health problem in a large nation without television, few radios, no internet, with a largely rural and often illiterate population?

Even more evidence that CVD confusion reigns supreme among PCPs.

http://www.theheart.org/article/1020935.do

Dr. Davis,

In June you kindly profiled my "near-miss" CT angiogram, where I had to take charge and make sure I was getting only a CT calcium score scan.

The good news was that my score was a zero.  I can't really explain that; while I was a vegetarian for many years, I also ate too many refined carbs and until recently was carrying a few too many pounds. There is heart disease in my family.  I am 54 years old.

Is it genes, luck, or inadvertantly prudent lifestyle?   How often should folks with low scores be re-tested?  I know you probably cover this at TYP but I'm sure the blog readers would also find it informative.  Thanks again for reporting my story.

Roger

Hi, Roger--

Genes enter into the equation in a big way. Lifestyle is important, but it is not everything.

For people starting with a score of zero, I generally suggest waiting 3-5 years before thinking about another scan.

I'll second the motion about catherizations being malpractice!

My mom died three years ago in a cath lab!  After having chest pains after a chemical stress test, she was hospitalized overnight and the next day had a catherization with two stents implanted.  

Something went wrong during the procedure, and an artery was torn. She became unconscious, she stopped breathing, and they were unable to insert a breathing tube.  They did an emergency tracheotomy but it was too late.  No cardiac surgeon was in the facility at the time.

The cardiologists explination to us was that "she had very small arteries".

I would think it would be reasonable for a patient to request that a cardiac surgeon be "in the house" during this procedure.

My dad about hit the roof when he saw the cause of death listed on her death certificate as "myocardial infraction". He requested that the coroner check the circumstances, after which he changed the cause to "cardio-pulmenary arrest due to long term heart disease".  Sorry, but it should have read: "Due to complications during catherization procedure".  

Not a benign procedure folks!  Ask whether drugs can perhaps be used in lieu of this invasive (and very lucritive for the hospital) action.