The supplement business, completely unregulated, is a magnet for scoundrels. The label is nothing compared to the deceptions they practice in what they put into the capsule and pill. Over and over again lab testing shows the pills either don't contain what you are paying for or contain dangerous contaminants.

This probably explains why so many studies find that taking vitamin supplements increases mortality in large populations. The toxic load of the pills is probably to blame.

This is a good point, and one I've certainly seen.  

On a side note, 670mg of EPA/DHA  per capsule is higher than pretty much anything I can find.  500 is more like the upper limit.  Can anyone provide brand guidance about where to find these super potent versions?  

And another thing I've long wondered is if there are any significant differences between one fish oil and another?  For example, some tout that the fish oil comes from wild salmon, which is better because... ?

Interesting article. I have some articles that I've written on fish oil too on my website http://myherbalsupplement.com - I'd love if you checked it out.

Dr. D,

A bit off this topic, but I was wondering what your thoughts are on the latest research posted yesterday on Crestor.  They are now recommending Crestor for those with normal lipids who have "other" factors for potential heart disease.  It was shown to prevent heart attacks and strokes for those participants. Is this another BIG PHARMA scam?

what would be an eqivilant dose of Flax seed oil if one is currently taking fish oil (2,600IU's of EPA+DEA )

I've noticed this too, Dr Davis.  There is some justification with regard to splitting doses in order to make the capsule size more palatable.  But, oftentimes there does appear to be deliberate obfuscation in order to make the purchase price appear more attractive.

Gsbuck--

3 gallons.

Just kidding. So little of the linolenic acid in flaxseed oil is converted to DHA that it's impossible to raise your blood level of EPA + DHA using flaxseed oil.

The claims made by some marketers of flaxseed oil as an omega-3 fatty acid source are simply untrue.

Nonetheless, flaxseed oil is a wonderful oil with benefits all of its own, just not EPA or DHA blood levels.

"I don't know why some manufacturers or distributors do this."

Profit optimization / discriminatory pricing.  Charge illiterates a higher price than literates.

And what about the claims that     Omega3 from algae is just as good ? They claim fish have DHA because they get it from algae anyway, so why not go direct? If nothing else it has less environmental impact, and if cold-subtracted potentially less oxidized :
http://www.v-pure.com/

I take it myself and I never have those "fish burps" from it although it tastes exactly like all other fish-oils.

I've only recently started following your blog and I dunno if this is the most appropriate place to ask, but what (generally speaking) would be a recommended daily EPA/DHA (or total Omega-3) dosage?

I've been taking a krill oil supplement for several months, but the dosage is a fraction of that offered by the capsule you used for an example in this post.  So that makes me wonder if I'm taking enough of the supplement to even make a real difference.

This helps to explain my pet peeves about the supplement industry - as Jenny says, it's a completely unregulated industry.

In fact, there is no legal requirement for what's listed on the label to even match what's actually inside the capsule.  As long as manufacturers don't claim to 'cure disease', they can pretty well say what they like, at least until proposed industry regulation hits in the next two years - unless the industry's very powerful lobby groups are successful in squashing regulation, as they are of course trying to do.

How can one enjoy raw Almonds and Hazelnuts (my fave) without overdosing on Omega 6?

Also, any thoughts on whether monocytes reflect too much Omega 6?  I read something on this by Dr. Glen Aukerman regarding lipomas.  He claims lipomas and uterine fibroids are caused by excessive Omega 6 and recommends no nuts at all, no flaxseed, no poultry.  My monocytes tested at 10 which was not flagged as abnormal -- he claims 3.5 is ideal.  I have lipomas and fibroids. My CRP is so low it does not register and ESR was zero. I've never heard this monocyte theory before.

The key with nutritional supplements is to be an informed consumer.

The WRONG response is: Because I can't always trust the supplement manufacturers, I'll turn to prescription agents (like prescription fish oil).

I'd personally only turn in the direction of prescription fish oil if I were interested in STICKING IT TO MY FELLOW HEALTHCARE CONSUMERS! I am not, so I prefer that we all educate ourselves on what preparations are reliable and safe.

Dear Author heartscanblog.blogspot.com !
Clearly, I thank for the help in this question.

It's really important to look closely at the labels to determine exactly how much ingredient you're getting per dose.  The same applies to food labels as these can be misleading if one doesn't analyze the label closely.

Dr Davis

It is worse than that.  Alot of brands, (Costco is the worst), not only trip you up on serving size but also do the following: Total omega 3: (including DHA/EPA) 375mg.
So how much DHA/EPA here?  Who knows!  When you look down at the ingredients you will find anchovies, Vit E, and SOY.  Which is cheaper, anchovies or ALA from soy.  And who knows how much Omega 6.

Also be on the lookout for labels that don't mention the EPA/DHA ratios. I've seen some cheaper brands just list 'Omega 3s', with no breakdown.  And if interested in form used (ethyl ester vs triglyceride) you'll have to read the label closely too -- but quite often this isn't even mentioned.

Although that leads to another point: what is the optimal EPA/DHA ratio as far as reducing heart disease risks?  I don't think this has really been studied that closely.

I read so much on nutritional interventions for CHD and atherosclerosis that I sometimes lose the source of my information. Sorry if this is the wrong attribution but I think it was Art Ayers (might have been Stephen Guyenet) who blogged about the dangers of using fish oil as a source of Omega 3s. One caveat is that  fish oil oxidizes very easily on the shelf and is likely to also do so in the warm temperatures within the body--therefore it could contribute to inflammation rather than prevent it. If this is true, it is a serious consideration for those who already have atherosclerosis and are attempting to reverse it by using anti-inflammatory foods and supplements. What do you think about this? Should we be getting our omega 3s and 6s from other sources? If so, which?

I also wonder about disturbing the appropriate balance of omega 3s and 6s by eating either walnuts, almonds, or sunflower seeds daily to help eliminate excessive plaque. So many conflicting ideas--what is one to believe and do?

Thanks for all the information you generously provide.

"Vitamin D up to 10,000 IU per day has been found safe. Some individuals require up to 12 fish oil capsule per day to experience relief from symptoms."qute ART AYERS

It's Stepan that suggests REDUCING OMEGA 6 intake is MORE IMPORTANT than raising omega 3 intake.

In the long run Stephan is right that it is daft to try to overpower the inflammatory effects of too much omega 6 with ever increasing amounts of omega 3 when we know that omega 6 displaces omega 3.

But such is the pro inflammatory state of most US adult(with UK adults catching up fast) that in the short term, with people facing imminent tragic consequences, it is important not only for mental health but also to prevent suicide and violence against others, that at least 2g of omega 3 is used daily to correct current plasma imbalance.

You will understand better why I am so emphatic about the immediate need for higher omega 3 intake in the short term if you invest the time watching all the presentations at this link. The session I think are MOST IMPORTANT are in bold.
Fundamentals of Omega-3 Fatty Acids: Biochemistry and Health Sheila Innis
Omega Fatty Acids and Aggression, Suicide and Psychiatric Distress
CAPT Joseph R. Hibbeln, M.D.
Omega-3 Fatty Acids and Stress-Immune Interactions/Wound Healing
Omega-3 Fatty Acids and Cardiometabolic Health

Omega-3 Fatty Acids in Surgical, Respiratory and Intensive Care Issues Robert G. Martindale, M.D., Ph.D.

Omega-3 Fatty Acids, Bleeding and Suicide Tomohito Hamazaki, M.D., Ph.D.

I think if you spend sufficient time (it's an all day conference I have linked to) you will grasp the idea that we are in a crisis situation and when we know it may take 2yrs of concentrated effort to  reduce omega 6 intake to under 4% of calories and change the omega 3<>omega 6 ratio to below 1 n3<> 4 n6 but just 5 days  2g/d omega 3 improves outcomes if surgery/stroke/accident or suicide attempts occur.

In the long run, once we have ditched industrial vegetable oils such as corn, soybean, safflower and sunflower oil, and everything that contains them. This includes most processed foods, especially mayonnaise, grocery store salad dressings, and fried foods. and our tissue ratio's of omega 6<> omega 3 have changed back to an acceptable ratio See Dr Davis Omega-3 Index, Omega-6:Omega-3 Ratio test it may indeed be possible to manage on a lower omega  3 intake. But such is the state of current omega 6 levels that there is an immediate need for effective omega 3 intake levels to improve immediate outcomes.

Is there a search function on this site?

Ted, Thanks very much for your detailed and informative post. I intend to follow-up by reading your suggested list. Your post is very helpful in clearing up some confusion I was experiencing.Just rereading Stephan's posts go a long way to solidify my understanding of inflammatory processes resulting from chronic overindulgence in excess omega 6s, refined carbs,etc. Ironically, I have been conscientiously attempting to follow the best advice and practices concerning CVD since my father died in the 1970s at the age of 48 after 2 heart attacks and a series of strokes.

Unfortunately, it turns out that the "best advice" was almost all certainly wrong and in some cases fraudulent. I succumbed to the very disease I thought I was avoiding by my "healthy" lifestyle. The best thing I had going for me had been a  complete  avoidance of doctors until my totally unexpected heart attack last year. At that point my life was saved by Western medicine but I was literally hijacked by the medical system. Because I had insurance I was given an unnecessary $17,000 helicopter ride, two angioplasty procedures, a week's confinement in a hospital and 4 stents--(one of them to replace a botched procedure that caused a vessel dissection). Subsequently, I was placed on statins,plavix, ace inhibitors, and beta blockers for at least a year.

My intent is to get off of these as soon as possible and to that end I'm seeing an integrative medicine D.O. at the University of Maryland in addition to my cardiologist. She is supportive of my anti-inflammatory diet, antioxidents, vitamin D3  and amino acids, Q-10, and  NO enhancers. I've made her my primary care doctor so she can help me communicate with my cardiologist who I overheard saying (while I was being wheeled in on a gurney "here's a person who should never eat another egg for the rest of her life". How can these MD's be so indoctrinated and misinformed? It is mind-boggling to me. However, once a captive within the system it is extremely difficult to extracate oneself. I was told before I left the hospital that if I missed one dose of Plavix I could cause a clot to form and could die. I was not told that there are other natural platelet anticoagulants that work very well. I was also told that it is virtually impossible to reverse atherosclerosis by nutracueticals and lifestyle changes. It has been an eye opening process to learn differently from doing my own research.
Again. . . thanks for the information. It will keep me busy for the next little while. Cee

Dear Dr Davis, I have seen some people criticize your TC scan program because of this might increase cancer risk. So I believe you may be interested in an opposite view, since low dose radiation can be healthy and good based on the phenomenon of hormesis – "a dose response phenomenon whereby a substance that in a high dose inhibits, or is toxic to, a biological process will, in a much smaller dose, stimulate (or protect) that same process."

CT Scans May Reduce Rather than
Increase the Risk of Cancer
http://www.jpands.org/vol13no1/scott.pdf

@ Judy B
If you go to the Heartscanblog home page you will find on the left hand side of the black bar at the very top of the page, a searchbox.

But that only searches Dr Davis blogs.
It doesn't search the comments.
Some of the readers here are very informed and often there are interesting points raised in the comments that add to the valuable information in the blog.
So to search the blog and the comments I use
Google advanced search and enter the Heartscanblog URL
http://heartscanblog.blogspot.com/
in the search filter box
Search within a site or domain:

If you are searching for a post or comment that was recent then select an option from the
Date, usage rights, numeric range, and more filter menu.

To speed up searching through the results for the information you want then using you keyboard keys
Ctrl F brings up a new searchbox, enter the word/phrase you are looking for in this box and then you can quickly skim through each of the occasions that word/phrase appears here.

Link to recent interesting full text paper.
Correlation of omega-3 levels in serum phospholipid from 2053 human blood samples with key fatty acid ratios
Omega-6/omega-3 ratios <4.5 were
estimated to support a ‘lower risk’ category with 95% confidence for the risk of coronary heart disease while AA/(EPA+DHA) ratios <2.1 would be expected to provide a corresponding lower risk category for fatal ischemic heart disease.

Regarding Rob's question (way up at the top) about fish oil dosages, I too have been wondering about that.  I did find a very fascinating compilation summarizing the opinions of experts on proper dosages which I have bookmarked at (see http://www.buy-fish-oil.com/how-much-fish-oil-dosage-per-day-should-i-take/ )  It was particularly instructive to learn how fish oil has been used in extreme cases of brain failure, heart failure, kidney failure and liver failure such as the treatment and remarkable recovery of the coal miner who survived the Sago mine disaster.  Fascinating.

I recently bought one out of necessity. It has Caramel Coloring added!!!! CARAMEL COLORING???!!!!

I am indeed perturbed.

"The supplement business, completely unregulated, is a magnet for scoundrels. The label is nothing compared to the deceptions they practice in what they put into the capsule and pill. Over and over again lab testing shows the pills either don't contain what you are paying for or contain dangerous contaminants."

As a recent subscriber to http://www.consumerlab.com/ I find that for the most part supplements have in them what they claim...and are free of contaminants.  You COULD generally buy supplements from certain dependable sources and be safe doing so.  I don't work in the industry.

I notice that the composition, or "Supplement Facts," lists the contents of two capsules Rather than the usual one capsule contents, this product label lists two capsules.

Definitely worth buying a good quality fish oil supplement from a manufacturer you trust - and, ate least, taste the oil thats in your capsule before gobbling them down.

Reference gsbuck's question above, it is difficult to create an exact equivalent between fish oils and flaxseed oils because of the way they are handled in the body. Flaxseed provides a lot of ALA, a plant omega-3s, which needs to be converted in the body into EPA/DHA, the 'active' omega 3s. In healthy people, around 16% of ALA is converted into EPA/DHA. So if you take 10g flaxseed oil, thats 8000mg of ALA, converts to 1280mg EPA/DHA. This is what you would find in around 4 grams of normal fish oil. But... older people, those with chronic disease, those with nutritional deficiency, etc, will never convert very effectively and require fish oils.

I have discussed the benefits of fish oils vs flaxseed oil here.

nice post. thanks.

Hi im new on here, I stumbled upon this forum I find It absolutely useful & it has helped me alot. I hope to give something back and guide other users like its helped me.

Thank You, See Ya Around.

Hi-ya i am fresh on here, I hit upon this forum I have found It very accessible and it has helped me out a lot. I should be able to give something back & assist other users like it has helped me.

Thanks, See Ya Later

What's Happening i am new here. I came accross this forum I have found It positively accommodating and it's helped me out a great deal. I hope to contribute & help others like its helped me.

Thank You, See You Around

Howdy i am fresh on here, I came accross this board I find It very accessible and it's helped me out so much. I hope to give something back and help other users like its helped me.

Thank You, Catch You Around.

I don't know why some manufacturers or distributors do this. However, I have seen many people tripped up by this kind of labeling, taking half the omega-3 fatty acids they thought they were taking. This can be important when you are trying to obtain a specific dose of EPA + DHA to reduce triglycerides, reduce Lp(a), control abnormal heart rhythms, reduce bipolar mood swings, or other important effects.

Well, it seems to me that this is the label of the fish oil I consume. Maybe I am a little naive, but I just interpreted this label as a strong recommendation to take 2 softgels a day at a minimum and that they would have done a twice greater softgel if it could still be swallowed.

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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