The World Health Organization changed impaired fasting glucose levels from 6.9 to 6.1 in 1999.  The curve used to illustrate the incidence of diagnosed type 2 diabetes indicates a steepening at this time.  If data would have been collected for all patients prior to 1999 and utilized as a retrospective for type 2 diabetes in the population, the incidence rate prior to 1999 would likely have been significantly higher.

Very true, Dr. Davis.  Wheat consumption is up since 1970.  The strange thing is, it was much higher in the 19th century...something like 225 pounds per capita.

historical wheat consumption

Maybe we were eating fewer total carbs then, or expending more energy, if in fact the recent increase in diabetes is wheat-related.

I think since so much wheat is eaten in products that are mixtures of wheat, sugar, and vegetable oil, there's no way to know what the culprit is.

Well the reason is that wheat is the most important factor for our lives.

Hi, Anon--

Yes, indeed. Human life was different for at least rural people.

Also, wheat has changed. This is a crucial, crucial point that explains much of this phenomenon, I believe.

It would be interesting to plot diabetes rates against various possible culprits (pointing out on the graph when diagnostic cutoff changed): wheat, all carbohydrates, size of sodas, computer ownership, average size of restaurant meals, bicycle ownership, hours spent commuting, population older than 65, exposure to Agent Orange, service in Gulf War, and some really silly things like hair length and popular nailpolish colors.

If only wheat consumption seemed correlated, this would be suggestive.

Wre there ads for All Bran bars and wheat links on this site?

Wheat is ingrained in us, beginning with bread as the "staff of life."

correlation does not equal causation.

I don't eat wheat, I suffer from all of the problems you describe and it's also related to my psoriasis.  Good hypothesis with all your measurements of post consumption measurement of blood sugars, but someone needs to do a mass study.

The graph on this post is also very educational:
http://www.gnolls.org/1086/the-lipid-hypothesis-has-officially-failed-part-1-of-many/

The concentrations of zinc, iron, copper and magnesium remained stable between 1845 and the mid 1960s, but since then have decreased significantly, which coincided with the introduction of semi-dwarf, high-yielding cultivars.
at the same time
wheat breeding may have contributed to increased prevalence of celiac disease. and other conditions.
Perhaps other readers are not aware that MAGNESIUM deficiency increases iron absorption so there is increasing danger of Iron Behaving Badly and resulting damage to mitochondrial function.

Hi, Ted--

Great find!

I wasn't aware of these data. Yet another way that increased yield comes at a price.

Dramatic changes in the slope of a curve are easy to see if you're looking for them, but you've displayed an arithmetic, not a logarmitic axis.  Your point would be better made if you could switch the axis and if we still see the association between the variables.

Gretchen - Well said.

I think many things in our modern environment play a role in tipping the scales toward diabetes - including disrupted circadian cycles and environmental toxins, such as fire retardants, plasticizers, and pesticides.  (I don't have time right now to find links from stuff I've read on this - but try Googling these things - the research is there.)  

Jenny Ruhl claimed a short time ago that while prediabetes has risen, actual diabetes has not.  She is a good resource and I would take her arguments on most things diabetes pretty seriously.  Check her blog if interested:  Diabetes Update.  

As a mother of a kid with celiac disease, and for other reasons, I am hardly pro-wheat or pro-gluten, but I'm not convinced grains have caused a rise in diabetes.  My daughter's gastroenterologist, however, has Type I diabetes and says that eliminating gluten has greatly improved her glucose control.

When I eyeball this figure, it looks like the change occurs around 1993-1996.

Helen has a point that under counting of who is "pre-diabetic" is quite possible skewing the data. The CDC changed it's diabetes diagnosis criteria; 1985 wasn't when they did that however.

CDC took their raw 1995 - 1997 data and in 1998 decided to only use fasting glucose, and not the old standard oral glucose tolerance test, as the CDC diabetes template. For all individuals  whose data was showing greater than ( or equal to) 126 mg/dl fasting glucose they were then counted as diabetic by the CDC.

This methodology caused CDC to say U.S.A. diabetics went from 8 million in 1995 to 10.3 million diabetics in 1997; a statistically massive 2 year jump of diabetics. And furthermore, the number of un-diagnosed diabetics was claimed to have gone down (in same period of time); they cut out a whole slew of "pre-diabetics", so to speak.

The other criteria CDC website shows from 1998 is, that when non-fasting glucose hits 200  mg/dl (or more) they are considered diabetic. The reproduced graph Doc posted shows an exponential climb upward right at the time CDC  began using it's altered criteria.

"Note that, from 1958 until 1985, the curve was climbing slowly. After 1985, the curve shifted sharply upward."

As I look at the presented graph, from 1986 to about 1991 the trend decelerated slightly, then resumed its prior long-term value, then accelerated in about 1997

However, I must admit that 1997 is "after 1985."

Other suspects that became prevalent in the food stream in the 1980s were high-fructose corn syrup and artificial trans-fatty acids, both of which are linked to hepatic insulin resistance and metabolic syndrome.

I think of all the intelligent, scientifically-reasoned arguments all lead back to the commonsensical notion "Don't eat junk." To start, anything with enriched (aka processed) flour, partially hydrogenated oils, or high fructose corn syrup qualifies as junk. Which isn't to say all disease eminates from just those three ingredients, but I believe completely eliminating those three ingredients would yield a large health benefit to most Americans.

It takes years for type 2 diabetes to develop. A shift in the rate at which people are diagnosed with it would be caused by something that happened some time before the shift.

1960 to 1970 is also the time frame that chemical fertilizer came into the mainstream. On the farm I was raised on, along with chemical fertilizers came mineral supplements for the hogs that were living on the fertilized barley. They "failed to prosper" on fertilized barley, where they did just fine on unfertilized barley. By the why, fertilized barley produced over twice the volume of grain, and I assume the same mineral absorption. You can blame the grain, but I believe it could be the fertilizer.

@  justdoinglife
You can blame the grain, but I believe it could be the fertilizer.
Does early-life exposure to organophosphate insecticides lead to prediabetes and obesity?
Slotkin TA.

The chart for the growth of the national debt looks the exact same. I wonder if there is a correlation between the advance of socialism and the cultural ascendancy of the Lipid hypothesis? I'd bet the ranch that the destruction of American health and the destruction of the American economy is not a coincidence.

Duke university 2008 study fed new born rats 0.1 mg/kg body weight of the organophosphate pesticide parathion, for 4 days. When the rats were adults and fed a high fat diet they noticed a different response among the sexes.

In the adult females the high fat diet resulted in a 30% higher weight gain ( vs. high fat fed males' 10% weight gain) over controls (according to respective sex) on the same diet. This type of pesticide exposure to young children may be part of how obesity is rising; the standard western fare is high in generic fat content.

For the parathion early exposed adult male rats fed on a normal diet (ie: not high fat) the results also seem troubling. They gained weight, glucose levels rose, fat break down was inhibited and they were pre-diabetic; as compared to male controls.

Counter-intuitively, another group of male new born rats fed parathion at 0.2 mg/kg body weight (4 days) when fed a normal diet as male adults actually weighed less than their male controls. Whereas, the female rats (fed normal diet in this case) who got both 0.1 & 0.2 mg/kg parathion (4 days) all weighed less than their female controls. Mothers, don't try this at home.

Another culprit:

SSRIs.  Prozac was first marketed in 1988.  (It was not the first, however - some came on the market slightly earlier that decade.)  SSRIs impair glucose tolerance and are associated with an increased risk of diabetes.  

I think there are some modern-day smoking guns more convincing that increased grain consumption for increased obesity, insulin resistance, and risk of diabetes.  Although they are a neolithic food some of us may not be exquisitely adapted for, they have been around for 5,000 years, while the obesity epidemic is quite recent.

Hi Helen,
In 1938 there was a U.S.A. National Conference of Governmental Industrial Hygienists ; since 1941 the word national was replaced by "American" (ie: now is the ACGIH). 1946 the ACGIH set maximum limits on 148 compounds; which in 1956 became their "Threshold Limit Value", (TLV).

TLV is not saying "x" level is always safe; just what is supposedly tolerable exposure for most "healthy" adults. ACGIH lays their TLV data out for industrial hygenists to use in their field, not for laymen's general use.

2-butoxy-ethanol TLV (as a gas or evaporating vapor) is set at 20 ppm. This chemical is the favorite solvent in household spray and wipe cleaning products.

It makes me wonder if the U.S.A. adult female house cleaner suffers metabolic syndrome at a higher rate than other individuals. If so then might not close decades of breathing 2-butoxyethanol droplets have had/has epigenetic synergy?

1971 O.S.H.A. took 470 TLVs from ACGIH data and now calls those TLV by the phrase "Permissible Exposure Limit" (PEL). Meanwhile, as of 2010 there are 642 TLVs set out by ACGIH.

The European Union has a registry of 143,000 chemicals in use (or used); and there are +/- 50,000,000 chemicals known to exist (as per Chemical Abstract Service Registry). The EPA has more details; for searching if you're curios: www.epa.gov/grtlakes/toxteam.
pbtrept/pbtreport.htm

2012 the European Union is set to report on chemical testing of all chemicals manufactured in excess of 1,000 tons annually. You'll see that as data reported from "REACH" (Registration, Evaluation, Authorization and Restriction of Chemical Substances).

If you want to track down what chemical is in a product then search out the manufacturers "MSDS" (material safety data sheet). Some claim "trade secret" ingredients and then you can only guess on what is involved.

I love the triglyceride posts as I have been working on mine for a number of months.  Was well over 1000.  On low carb, virtually no grains, tricor (200mg), and a healthy dose of fish oil I was still at 233.  I am wondering if it will take my body/metabolism some time to heal before I can get lower.  As you might imagine I am sporting an HDL below 25.  I am working it diligently, have lost a ton of weight and get healthier by the day.  I should be sending Dr Davis a stipend for my improvement!

Dr. Davis,
please kick out of your spam filter the post I just sent on the 12th saying "Hi Helen,". It had resources for her interest in modern chemicals.

To Helen,
If my 12th post doesn't show up soon (2 days?) and you request it on this thread I will try to recreate it here. Maybe you've moved on to newer threads; I don't usually monitor old threads, but I will this for a few days.

Unfortunately, it doesn't seem like this ascent is going to slow down anytime soon.  Even if people in recent years seem to be taking a more health-savvy approach to their eating habits, it wouldn't be surprisingly to see this trend continue regardless.

Western countries have also seen a rise in sugar consumption along with wheat consumption over the same time period.

Taubes has just published a piece
"Is Sugar Toxic" and winds his way through diseases of Western cultures from sugar causing metabolic syndrome to sugar be implicated in cancer formation.
http://www.nytimes.com/2011/04/17/magazine/mag-17Sugar-t.html?pagewanted=1&_r=2&ref=magazine

No where was there any mention of wheat..I don't think we can isolate wheat as the primary culprit in Diseases of Civilization.  Wheat Plus Sugar, the double whammy.

One step forward, two steps back.

Chocolate Cheerios are good for the heart. If you don't believe this go here http://www.cheerios.com/ourCereals/ChocolateCheerios/ChocolateCheerios_home.aspx

I had a bowl of bran flakes and checked my blood sugar. 141. Yikes!

I have been down on wheat family of grains for a long time, but for other reasons than the health consequences tied to peak blood sugar elevations [and consequent hypoglycemic phases].  I'm down on the inflammatory oils and the allergy aspects.

Have you investigated HEMP SEED?  It is high in protein and packed with good oils.   How does it rate with your diet suggestions?    Would it be good to run some trials?

CEREAL FACTS This site has some interesting factsheets about the different cereals.

In particular I found this The influence of high vs. low sugar cereal on children’s breakfast consumption shows what kids will eat away from home and provided with sugary cereals or not.
These are the cereals most heavily promoted to kids
and here is their sugar content.

AHA Nutritional Criteria for Certified Foods

"they have blundered big time by pushing low-fat ... it is time to quietly start backpedaling."

They're backpedaling all right, but it's not because they are abandoning the low fat message.  The average consumer is not quite ignorant enough to believe Cocoa Puffs are healthy, and they don't want that 60% that are affected by their check mark to drop.

Just got an AHA solicitation in the mail this week.  Like so many other organizations, they do not act in the best interest of the people they claim to serve.  My money and time are better spent pursuing the more promising preventative practices such as those promoted by TYP.

A colleague eats a Quaker oatmeal square for breakfast every morning.  Among the ingredients listed on the label is partially hydrogenated soybean oil, not enough, apparently, to bump the transfat content above .5 grams, so the nutrition label lists 0 grams of transfat.  No amount of transfat is healthy, yet this product has the AHA seal of approval. I used to eat granola bars when I thought they were healthy.  I read labels and noticed that quite a few use partially hydrogenated oils, including brands that boast of high fiber or Omega 3 content.

Maybe the people at Cocoa Puffs stopped writing checks. Who needs an endorsement when your product contains wheat, sugar and chocolate and is marketed to kids in an I-want-to-be-my-child's-friend mileau?

As if these cereals aren't bad enough...
KFC is selling their fried chicken in Pink "Buckets for the Cure" for Breast Cancer fund raising.
It left me speechless.
I've said it before... we're on our own.

http://www.cnn.com/2010/LIVING/homestyle/04/28/kfc.pink.bucket.campaign/

The site Ted linked to (www.cerealfacts.org) has a list of Top 10 Cereals by Nutrition Score.  None of those top 10 are on the AHA list of heart-healthy cereals.

Scientific American Magazine - April 27, 2010, Title: "Carbs against Cardio: More Evidence that Refined Carbohydrates, not Fats, Threaten the Heart"

Dr Davis,

This question is off the topic. I read your book Track your plaque a month back and had been to AZ heart institute and got my plaque measured.

I am a Type 2 Diabetic for the past 11 years and am actively low carbing (<30g carbs per day) and 100% grain avoiding since May 2008.

My calcium score was 0.

But the staff was not able to say whether the machine they used was EBT/MDCT. They said it is newer than EBT. The machine had GE 64 slice VCT printed on it. Can you confirm if this is the one you are asking people to have it calcium scored?

I live in Phoenix, AZ and had been to AZ Heart Institute (got the information from "Track your plaque" book).

Please let me know if I got calcium score done in a machine in which I am supposed to do.

Thanks for all the help.

Thanks

Venkat

IS VERY GOOD..............................

> I had a bowl of bran flakes and checked my blood sugar. 141. Yikes

It is a great idea to check blood glucose levels after meals, just bear in mind that they can vary rather erratically:

http://healthcorrelator.blogspot.com/2010/05/blood-glucose-variations-in-normal.html

Oats, oats, oats is the common thread of the "survivors." Either the oat industry is doing an excellent coordinated marketing attack or there is something to the claim that oats are good for cardiovascular health.

I don't eat cereal of any kind. Have no desire to. A much healthier choice altogether would be cottage cheese with fruit or just fruit, scrambled eggs or even bacon cooked extra crispy.

There are  thousands of websites which provides information  about  
how is angioplasty done.
But dilseindia is one  of the websites where one can get good info about the  angioplasty.

Thanks for this article.

I can't accept NPR's statement that 25% of firefighters have no health insurance. I think that all permanent public employees everwhere in the US have health insurance. A firefighter's union would certainly secure this benefit.

Dr. Davis, I agree Tom has hit on something HUGE with his film FAT HEAD which is why I asked him to join us on the cruise to show his film.  THANK YOU for your incredible contributions during the conference and I am grateful to you for your generous donation of time to join us.

The low-carb manifesto tries to convince you that fat doesn't matter and therefore calories don't matter.  LC books pander to the people who can't or won't control their appetites, telling them, 'It's not your fault, have some brie instead of a cookie'.

But ingested fat being twice the calorie density of carb or protein does eventually add to the fat stores.  Those LC dieters who lose weight and maintain have CCK's effect on satiety to thank.  

kevin

Tom Naughton's diet related blog is also worth keeping an eye on.
Always interesting, sometimes extremely funny, he believes in straight talking so doesn't mince his words.
Tom's other blog is also interesting

This is great! Check out my blog post on blood sugar and metabolic syndrome...http://tinyurl.com/y9tr8va

It is a good film and the animation of how fats get into cells made it easier to understand. Tom's blog is always an entertaining and educational read. http://www.fathead-movie.com/

I so wish I could have been on the cruise - maybe next time.

Hi Dr. Davis,
this is a comment for your fish oil article.  I have a curious case: one has very high triglycerides (above 1000 mg/dL) and recurrent acute pancreatitis since 20s, have been taking 9grams of omega-3 in combination with 145mg tricor, 40mg simvastatin and niacin (1g) per day for 1 year and haven't successfully lowered the triglycerides.  His LDL and cholesterol are both normal with very low HDL (<20). No liver, kidney, pancreas or thyroid disease.  Underweight, not drinking, follow a strict low fat, complex carb, good protein, high veggie diet.  What do you recommend?

freyal, just wondering what your goals are with your patient?  If you are trying to kill him, you are doing a good job.  

A low-fat, high "complex" carb diet will keep the triglycerides high and the HDL low, as you have proven.  It doesn't matter how much fish oil, statins, or niacin you add, until you re-align your thinking with regard to diet, you are never going to help this guy.

Have you actually read this blog?  Because your question is ridiculous if you have.

Thanks for your response!  I actually just started reading this blog more extensively after posting my comment above.  I see Dr. Davis's point on limiting carb.  So do you recommend low-fat low carb diet?  He actually tried low-carb high protein diet sometime ago but without much success.  Because it is hard to just eat protein (will be very high protein here for 2000-cal daily intake) without fat and carbs.  Maybe the failure was because he couldn't limit fat as strictly as in the low-fat, carb+protein diet.  His TG is very sensitive to dietary fat too.  But now we will try low fat, low carb and high protein diet and see if there is a reduction.


Another problem is, what do you recommend for the "gas" problem associated with high protein diet?  Thanks for your help!!

Freyal, so you are saying his chylomicrons don't get cleared from the blood within reasonable time?

freyal, no, high-protein/low-fat is not good either (look up "rabbit starvation").  Use a very low-carb/ moderate-protein/high-fat diet.  The best fats to raise HDL and lower triglycerides are saturated fats like butter, tallow and coconut oil.  Stay away from vegetable and most nut oils, especially because they are high in inflammatory omega 6 oils.

Gas (usually caused by fermentable carbohydrates, including lactose if he is eating dairy) may not be much of a problem when you correct the diet but if it is, try digestive enzymes and betaine HCL.  

Check out some other blogs on Primal or Paleo diets.  http://www.paleonu.com/ is one of the best, click on "Get Started" to see the diet then check out the rest of the blog!

Hi Anna,
yes.  His TG remains above 1000 with healthy diet and TG lowering medications.  His TG would only come down to normal level after several days of fasting during hospitalization due to acute pancreatitis.

Hi Anonymous,
thanks for the rabbit starvation info.  I thought high protein-low fat-low carb would be lacking a lot of essential nutrients.  

But about your point that "The best fats to raise HDL and lower triglycerides are saturated fats like butter, tallow and coconut oil.", I have never heard about this and could not find any source.  Could you please point me to some studies that support this claim?  Thanks!

freyal - is the patient gluten free instead of just wheat free?

Hi,
he is not gluten free or wheat free.  He tried moderate-fat, low carb, high protein diet, and also low-fat, moderate complex carb + moderate protein diet.  Both did not work to lower his TG.  He is not allergic to gluten I believe.

Someone above mentioned high saturated fat (butter palm oil etc) works better to lower TG.  I'm not sure about this approach.  Even if there are studies supporting this (I only found one so far),they were all done with normal people.  He is not normal in terms of TG, he has genetically very high TG and is very sensitive to dietary fat (be it saturated or unsaturated) and would get acute pancreatitis every time following a large heavy greasy meal.  
I appreciate all your comments, please leave more if you have thoughts about this patient, thank you!

freyal - start with the PaNu blog and then look at the following blogs http://high-fat-nutrition.blogspot.com/, http://drbganimalpharm.blogspot.com/. http://www.nephropal.blogspot.com/ - you will see hundreds of studies analyzed.

the niacin is too low.  it should be 3gms/day.  ensure it is niacinic acid.

http://www.lipidsonline.org/slides/slide01.cfm?q=niacin

and

McKenney JM, McCormick LS, Schaefer EJ, et al. Effects of niacin and atorvastatin on lipoprotein subclasses in patients with atherogenic dyslipidemia. Am J Cardiol 2001;88:270-274.

Not sure exactly what you were eating. As a chef for the last 30 years here is what I eat now.
Maybe worth taking a look.

http://www.newtaste.com

I've read that Ornish scored zero on the heart scan.  As long as we're speculating about anecdotal evidence, I have to wonder if that's because of his stance against sugar and flour.

But obviously Dean Ornish's program seems to work in order to reverse heart desease. Of course it consists of more than just a change in your diet, so my question is: Do you think that if Dean Ornish would apply a diet that is high in fat and low in CHO - in addition to his stress management program and exercise and so on - it would work to  heart desease?

Ditto this.  Exactly.

Huh? For a minute, I thought you were writing about my exact experience. Yup, I was a vegetarian all my life until a year ago. Followed Dean Ornish's advice and saw my glucose and lipids behave exactly like yours. In the last one year, I have started eating eggs, fish and fat (butter, olive oil) and my blood sugar is normal and lipids are 110 total and 66 LDL. However, I am on statins and my doctor doesn't want to take me off of it yet. I wish my HDL was as high as yours but it's hovering around 35 and 40.

I keep wondering how many people's health is affected by all the quackery that goes in the name of medical research and science.

Oh yes, I can relate to that.  I followed my then doctor's advice on diet (yes, it was low-fat, high carb).  In a year, I gained 12 pounds effortlessly and 50 points total cholesterol plus my blood glucose was inching up....
When is the truth about low-fat going to come out?  There seem to be too many well-entrenched powers out there!!

"I ate only low-fat products like low-fat yogurt and cottage cheese..."

I would love to know actual percentage of calories from fat in the diet.  "Low-fat" dairy can really add to quite a bit!  I know that Ornish now has a "spectrum" of diets depending on how healthy you want to be, to coax people on board, but his original diet (and his sort of ultimate one on the spectrum) is around 10% total fat calories.  Many or most who use the term "low-fat" really mean closer to 20% or even 30% calories from fat....

so how does your diet look now? great results after you switched!

If it were the case that a low fat/high carb diet causes obesity and diabetes in most people, the Japanese would be fat and diabetic, but they have far less obesity and diabetes than we do.  Probably other factors besides the ratio of fats and carbs are more decisive in determining who gets sick and who doesn't.

Thanks for sharing your personal experience Dr. Davis.  Very interesting.

My theory confirmed.  Once the "community standard of care" or even the experts in traditional medicine fail in treating a doctor-patient's concerns and that doctor-patient has to self-treat then we lay folks get the benefit of their learning how to take care of themselves.  Love it and am grateful you found a way to treat yourself so we all could benefit from that knowledge.

". . . he "reversed" coronary disease using a low-fat, no added oils, no meat, vegetarian diet"

This is often stated, but in fact even Ornish never "reversed" CVD by diet alone. He did what he did with a complete program that included diet, stress reduction, I think smoking cessation, and immense peer support.

Hi DR. Davis,

You certainly had a horrifying experience.  But, your end result was very positive.  You are lucky that you did not continue longer, because, your out come might have mirrored mine.  I too went to a Dean Ornish lecture and bought in to his program.  I didn't stop with that, I followed many other Doctors programs over a 30 year period.  They all failed. I too had diabetes type 2, hypertension, Lipid problems, and last but not least chronic kidney disease. Of course, I ballooned up to 240 pounds.

What we had in common, as all of those with diseases of the metabolic syndrome do, is the fact that every program was locked into
the so called "healthy eating" dogma first presented and proselytized by Dr. Ancel Keys and his low fat and high carbohydrate hypothesis.  It still pervades medicine,even today.


It took me 50 years to finally get it.  My awakening came when I read Garry Taubes best seller, Good Calories Bad Calories.  I then followed on with Barry Groves Trick and Treat.  These two books educated me as to what a health supporting program could be, and started me on the way to recovery.  I also followed up with your fine blog along with some others.  

I am happy to report that my diabetes type 2 is now cured, without medication, and always <100mg/dl.  While I know that CKD can not be cured, my nephrologist Dr. Tourgeman says "he is amazed that there is a huge improvement in my kidney function".  My latest VAP test HDL 63, TRIG 63, LDL 154, all without statens.  But, my Real LDL size are pattern A large bouyant and fluffy, which is a huge change from what they used to be 11 months ago.  I am taking SLO-NIACIN to reverse my high LDL.  My diabetes induced hypertension is a problem, but we will see, because I have about 40 pounds to lose yet.  I am now 185 pounds.  All of this because I listened to my doctor who told me to switch to high saturated fat and low carbohydrate.  What a miracle this is.  I also supplement with vitamin D3, 8000IU, and high dose fish oil.
Billy E nephropal.com

Gretchen is correct: The Ornish program consists of more than a low-fat diet. However, the diet is a crucial component of the program, one that cannot be ignored given its potentially destructive effects in a large proportion of people, especially those who are non-ApoE4.

Also, I would argue that Dr. Ornish NEVER showed reversal of coronary atherosclerosis. He showed reversal of ENDOTHELIAL DYSFUNCTION, which, by the methods used, provide the appearance of reversal of disease. They are two different things.

As a non-cardiologist and using 20th century technology, perhaps we can forgive him this faux pas.

Dr Davis,
What was your blood sugar prior to going on low-jfat diet?

"Dr. it's not the red meat that's bad for you it's the green meat", one carnivore commented. "HaHa", he said.

It's not the no fat it's the no bad fats that count.   Cancer is a cell membrane disease and a disease of the mitochondria cell membrane.   Feed the membrane, feed the mitochondria and Cancer can go away.
Live longer feel better eat live leaf juices foods.    Sure you should get your vitamins from food--that's what I'm talking about--solar powered leaf juice.

I began on the Ornish diet after my heart scan almost a year ago. In four months, I went from 183 to 167 lbs, and my LDL cholesterol dropped 40%. Triglycerides and fasting blood sugar remained unchanged. My HDL did drop about 10%, to 50. I've since increased my intake of healthy fats, but my experience with the Ornish diet was very positive, especially as it showed me that I could control my cholesterol with diet, something my doctor didn't believe was possible.

I do think genetics are involved, especially given the discrepancy between our results.

Dr Ornish is a public danger. Be sure.

I dont know how a doctor who recommends so terrible diet is 'famous'.

He has to use exercise and meditation in order to balance the disaster of his diet in his patients. So sad.

Kurt's different response might be explained by being an ApoE4 homo- or heterozygote. I am an ApoE3 homozygote. In addition, there are genetic variants in CETP, hepatic lipase, lipoprotein lipase, and others that can modify the response.

My point here is that, with extreme unnatural limitation of fat, a substantial proportion of people (probably 70% or more) will experience adverse effects.

Also, the initial response is determined to a large degree by the diet PRIOR to the diet change.

I am diabetic- I was over weight and my sugars ran high. I followed the ADA diet (much like Ornish program)- low fat with moderate to high carbs- certainly high at the end of the day's tally I took all the meds and insulin prescribed – did cardio and some gym work.  Rarely snacked and always hungry. Gained 40 lbs in three months.  Discovered Atkins- then other low carb diets. Added high fat – lose 70 lbs  this last year.  Cholesterol fell to 130- Trigs are better then perfect. No more meds for diabetes. Blood pressure under control for the first time. I do NO cardio just strength training I am never hungry and avoid all grains and starches. Soy is a major never no-no.  I’m so glad I read Taubes  and Bernstein and did a little research on my own.  High fat and Low carb saved my life.

It reminds me of a Vogue (a highly scientific publication, I know) article I read a few days ago. A woman went on a "cleansing" grapes-only diet promoted by yuppie-type Frenchwomen. She lost 1 lb each of water and muscle...and gained a pound of fat. Unfortunately the epiphany eluded her...

Ornish may be modifying his views: he now recommends daily consumption of fish oil!

Dr. Davis,

Its interesting you posted this. I am a Indian vegetarian before and now also, I used to run 7 days a week for nearly 15yrs. I was a pretty fast runner too keep 7-8min per mile competing in races until I got a heel spur and couldn't run at all but I got it fixed with homeopathic medicine but I digress. I used to be low fat, high carb, whole grain diet which lead a cholesterol profile of which I have records for 15yrs:

HDL: ranges 50-58
TriG: lowest was 130 to 275
LDL: lowest was 130 to 250

My most recent reading a 9months back:

HDL: 58
LDL: 158
TriG: 250

My latest reading 2 weeks old:

HDL: 63
LDL: 114
TriG: 90

What did I do ? For one I stopped doing any form of aerobics do only weight training 4 times a week for 15-20mins of intense weight training. I lost few pounds not much, lost a fat percentage points, I started eating a lots of salads, lots & lots of walnuts, pecans, fish oil, vitamin d supplement. My take I think the weight training improves insulin sensitivity along fish oil, walnuts and vit-d supplementation do the trick.

My eye opener was Gary Taubes book the chapter on Cholesterol where he talks about Dr. John Gofman research on cholesterol and trigs. I am no longer afraid of fat, I consume a lot, no fat free milk, lots of walnuts, lots of olive oil and I don't see myself gaining any weight at all.

I have to give thanks to Art Devany Evolutionary Fitness and your advice in this blog for my achievement.

-White

Dr Davis:

Thanks for this eye opener experience. What is your opinion of supplements like r-alpha lipoic acid, pycnogenol and acetyl L-carnitine for the treatment of glucose metabolization problems ?

Thanks

FMJ

Is your 91 blood sugar level optimal?  Mine dropped from 95 or 96 down to 71 when I eliminated wheat.

A new large, 90,000 people comprising European 10-yrs follow-up study EPIC (European Prospective Investigation into Cancer and Nutrition)does not support the use of low-fat diets to prevent weight gain.
http://www.ajcn.org/cgi/content/abstract/90/6/1632

from:  http://www.ajcn.org/cgi/content/abstract/90/6/1632

"Mean total fat intake as a percentage of energy intake ranged between 31.5% and 36.5%"

Sorry, that is not a low fat diet!  Low fat means approx 10% calories from fat.

I'm confused.  I thought diabetes was a permanent condition that could not be cured or reversed?

Type 1 diabetes is indeed permanent.  Type 2 is often completely reversible with appropriate diet and exercise.  If it is too far advanced in destroying the beta cells via high sugar and high insulin inflammation then the person may still need to supplement insulin but much lower amounts w/ above diet and exercise.

I had a similar experience to Dr. Davis - I followed AHA low fat diet - still didn't lose weight - so I cut the fat even further - and gained weight. I would go to bed hungry as it was better than feeling the hunger in the day.  

As soon as I read Taubes book, I went low carb and quickly lost weight - switching to mostly non saturated fat - I lost even more weight - and it wasn't hard. I'm now at 14% body fat.

ok already. i will give an animal/fish, low grain diet another try...... I need to count calories this time as the last time I eliminated wheat and went Paleo, I put on 10lbs

more mechanisms please.  I find that helps me believe

I have a friend who said he did Ornish religiously. The few times they had us over for dinner, they had what appeared to be pure Ornish type dishes. The man lost an enormous amount of weight (which was one of the strongest motivations for his wanting to do the  diet).

However, lab tests confirmed that his cholesterol was moving in the wrong direction (triglycerides were in the 4 digits) and his doctor told him to start eating more meat and to cut back on the carbs!

The quote from his doctor? "We tend to see this with people doing Ornish; your case is not unique."

Yikes.

Can you devote some posts to the dietary modifications needed for an ApoE 4... I know that fat has more of an effect, but is it saturated and trans fat only, or all fat.  Should ApoE 4 still take fish oil?

I'm a 55 year old woman.  I reversed a bad lipid profile by researching and then creating my own diet based on what, how, and why I eat.

My before lipids
LDL < 100
HDL < 50
TRIG > 300
Blood sugar fasting 107
weight, close to 180 lbs (I'm 5'3")
waist 40"



I set a goal, to consume 1500 calories a day, allowing for 1800 2000 on high activity days(>1 hr bicycling or salsa dancing, for example), with the calorie distribution 30% fats, 50% carbs, 20% protein.  Trans fats were never an issue, I don't eat fast food or much processed food.

I kept a rigorous food diary (note: nutritiondata.com is a great place to get info), and for the 1st 6 weeks eliminated every added sugar I could think of - no cookies, candy, soda, etc.  I developed a list of "go to" foods: oat bran, 1% cottage or ricotta cheese, a serving of legumes every day, low-sodium V8 juice, almonds, and all the green vegetables my heart desired.  I supplemented with 6 caps of fish oil (~ 6 gm), and 4 inulin fiber tablets aday, which had the advantage of tasting like giant Sweetarts.  I included 30 minutes minimum of exercise/high activity a day, and weights 15 minutes 4 times a week.

After 6 weeks my doc was stunned:

LDL < 93
HDL 63
TriG 98!
Blood sugar 96
weight:163
waist: 37"

Th thing is, i can stick to this diet because it didn't depart that far from my usual cooking.eating preferences.  I had always eaten the good stuff; trouble was I topped it with dessert all too often.

I now allow myself a little added sugar in the form of 1 oz 70% dark chocolate (5-9 gm depending on brand), and an occaisional Stella D'Oro anisette toast - while their serving size is 3 pieces I have one with my coffee, all of 4 gms sugar!

My carb choices are whole grains, mostly not wheat: oat bran, hulled (not pearled) barley, quinoa, as well as beans and yellow/orange vegs like sweet potato & squash.  Here's the thing: I keep a measureing cup on my counter and limit myself to 1/2 cup servings, maximum twice a day.

Proteins: fish at least twice a week, ricotta and cottage cheese, eggs, whole and whites.  Limited meat and poultry, which is just a preference.  Bison when I can get it.  Legumes.

Fruit: twice a day, mostly whole
Vegs; plan my meals around them.  Unlimited of green leafy, tomatoes, cukes, mushrooms, summer squash, cruciferous/ I love a good salad, and always measure the dressing - 1 Tb max commercial (no low fats - yecch!), or 1 tsp olive oil plus lemon juice or vinegar.  Again, the measuring spoon is always within reach.



My motto; have that, but halve that.  I enjoy small portions of high fat dairy, for instance.

Snacking:  I put out 1/4 cup of nuts in a dish, along with my daily chocolate or a bit of dried fruit. That is what I nibble on.

I am headed to my goal of keeping the lipids/blood sugar good, 140 lbs, < 35" waist.


Hope this is helpful.

Well, not to knock the approach advocated here, but  I've had a very different experience on Ornish.  I've been following the original Ornish recommendations which are closer to what Dr. Esselstyn promotes as a result of his 20 year study.  I lost 50 pounds effortlessly, lowered total TC from 160 to 90, and TG steady at 80 and have stayed there for over three years.  

Perhaps the difference is in the details.  I see a lot of people here saying they followed Ornish and ate low fat cookies, low fat dairy and such, but Esselstyn shows that that you really need to cut out all processed foods, all animal products, and watch those small amounts of oil.  It's a very different diet I suspect than many of you tried.  Esselstyn did show reversal of disease, as well as mortality, not just endothylium function, by the way.  I haven't seen published comparable results from Dr. Davis' regime here.

If Ornish was such a horrible diet, you'd see terrible disease rates in Okinawa, other parts of Asia, or in many of the other societies, Seventh day adventists for that matter, around the world where they essentially eat the same diet.  But, of course you don't.  It's very easy to slam a diet that you're not really following, and anyone who says they were following the ADA diet and thinks it's the same as the original Ornish diet clearly doesn't know what the Ornish diet is.  ADA is 30% fat, Ornish is 10% fat, for starters, and as I mentioned, if you really want to do it right, Esselstyn has the details down.

I do wonder about the heavy use of the calcium score here when you have recent studies questioning the value of these scores such as this:

http://www.theheart.org/article/1035927.do

Coronary calcification progression doubted as a CV diagnostic
DECEMBER 17, 2009 | Reed Miller
Editor's note: The headline for this story has been revised to more accurately reflect study findings.
Royal Oak, MI - Coronary artery calcification (CAC) progression is not a suitable end point for trials of cardiovascular-disease therapies, and the usefulness of tracking CAC progression over time is still in doubt, according to researchers who analyzed previous randomized trials that tracked CAC for at least a year [1].

I got fat by eating low-fat/high-carb for years starting in my teens into my early 30's.  Weight loss programs like Weight Watcher's only made me more obese and made me clinically sicker (low HDL and very high triglycerides).  

Following Atkins way of eating (now moving to PaNu) has completely turned everything around for me.  I have lost over 100lbs and kept it off and my labratory results are, in my doctor's words, "enviable."  My diet is < 10% carbs and > 60% healthy fat (mostly saturated).  I started a vitD and Omega-3 regiment as well and I will get lab results from that in about 2 weeks.

The lab results are great, but the feeling of complete control over my eating is even better.  When I an hungry it is because my stomach is empty, and the feeling can be sustained until I can grab something to eat.  When I was low-fat/high-carb, I was constantly hungry and food-obsessed and the only way I could lose any weight was from sheer deprivation which is unsustainable.

Just eating "low fat/high carb" can easily be a terrible diet.  CocaCola and Entenmann's fat free pasteries would qualify here.  What McDougall, Ornish, etc are recommending is low fat/high carb consisting ONLY of minimally processed, whole foods, from plants.  That means the green "plants" not the factories "plants". AND it is crucial for the diet to work that you aren't sneaking in little bits here and there of junk food and highly processed foods that claim to be low fat but have a lot of fat hidden by labeling claims.

If you only eat from the produce section, whole/intact grains, whole legumes, and moderate fruit, maybe an ounce of flax or walnuts per day the diet will work wonders!

I tried reducing fats as well. Rice, baked vegetables, potatoes, salads with fat-free dressing, you name it. At 5'8" tall, I got up to 210 lbs. and a 38" waist. Fat was the "bad guy". Diet soda, diet foods, water, walking...then the numb fingers, blurry vision, and even peeing my pants hit me because I could not get out of the bathroom. The Dr. said diabetes; it took 2 weeks to get in to him. In the meantime, my boss was on Atkins and dropping weight and feeling GOOD. In just 2 weeks, when I was tested, my urine was still "a disaster area" but BG after fasting and walking several blocks in was 75. Now it is usually always below 100. I dropped about 60 lbs. in less than 6 months! My last A1C was 5.4. I do not take meds of any kind. I have a 'safe list' of carbs to eat, all of them low GI and avoid corn syrup, flour, and sugar. I eat a LOT of nice, red, fat meat. Pretty much, if it's a "dead animal", I'll eat it. If it's green or colorful, I eat it. Nothing "white" or high GI. That was 3.5 years ago. I do not have a need for statins, insulin, nothing. Grandpa is fat-free, high carb, etc. - oats, rice, you name it. He's not obese, but his cholesterol is over the moon and I can't get him to get a BS test.

My experience was very similar in terms of the numbers, although I followed a slightly different diet modification path:

Before: LDL: 156, HDL: 38, triglycerides: 188.

After: LDL: 123, HDL: 66, triglycerides: 46.

I included more details on the post below, if you are interested:

http://healthcorrelator.blogspot.com/2009/12/refined-carbs-sugar-and-cholesterol-my.html

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This is often stated, but in fact even Ornish never "reversed" CVD by diet alone. He did what he did with a complete program that included diet, stress reduction, I think smoking cessation, and immense peer support.

I have lost 51 pounds on the Ornish low fat diet, avoiding most sweets, and exercising 6 days a week, that included weights and cardio.

Slamming Ornish is easy but it seems some do because the diet fails because it is not followed properly.

Eating sugars such as cookies and carbs such as white flour will make you gain weight. I only eat whole grains and measure my portion.

Its also interesting that Ornish does say that blood levels such as HDL will increase on a high fat diet because your body needs more protection.

But the diet is not a cure all. As he has pointed out, even people with lower cholesterol can die if they dont change their attitude and habits.

i eat a lot & never exercise  and i am 22 yrs, no disease has dared to touch me..

Max   At  22 no disease has had time to develop.  It is quite natural to have a fairly distorted sense of time and lack of awareness of your own mortality.  Most everyone can do as you have been doing and feel fine and not "see" damage.  Yet. But continue as you are and it is almost guaranteed you will end up w/ either diabetes, some form of cardiovascular disease, or both.  By the time you are in your 40's you will be a fat, old man, panting to walk up a flight of stairs, with high blood pressure, high blood sugar, and dyslipidemia.  You can pretty much take that to the bank!

Posts like this will teach me to take a long weekend offline, and off of the newsreader.

Do you think that if Dean Ornish would apply a diet that is high in fat and low in CHO - in addition to his stress management program and exercise and so on - it would work to heart desease? b

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I eliminated all oils; I removed all meat, eggs, and fish from my diet. I shunned all nuts. I ate only low-fat products like low-fat yogurt and cottage cheese; and focused on vegetables, fruit, and whole grains. Beans and brown or wild rice were a frequent staple. I loved oatmeal cookies--low-fat, of course!

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