Scare tactics

19. February 2008 William Davis (17)
Does the media engage in scare tactics?

Read the headlines in local newspapers, and you'd believe that your friends and neighbors are dropping like flies, all victims of heart attacks.

I occasionally peruse the headlines run in newspapers and magazines around the U.S. by subscribing to a feed service through Google. For the phrase, "heart attack," you can get a sample of what is being said around the country about people having heart attacks.

What continues to impress me is just how far off a truly constructive and helpful message the media provides every day. Not only are they guilty of delivering a flawed message, they also favor headlines and stories that scare the heck out of people. "This could happen to you!"

Is it just the quest for headlines that grab readers' attentions? Is there some complicity with the medical systems that pay significant advertising revenues for their heart disease programs and hospitals?

I doubt such complicity exists to any substantial degree. But the fact remains: Every day across the U.S., the media does an effective job of scaring the heck out of the public--enough for you to run to your doctor or hospital to find out if you, too, could fall victim to heart disease. A stress test, perhaps heart catheterization, three stents or bypass often results.

In effect, these headlines make great hospital PR, an inducement that flushes out the patient highly motivated to pursue further costly heart testing--whether or not it's needed.

A sampling:

Stress test could help prevent sudden heart attack

DAWN ZERA Times Leader Correspondent

Bob Schultz, 67, was feeling a persistent pain in his back, which he was pretty sure was caused by working on a deck for his son’s home.

But after the deck was finished, the pain was still there.

“It was nagging, but not enough to hurt,” Schultz said.

He visited his primary care physician, thinking maybe some muscle relaxants would be prescribed. The doctor sent him to a clinic in Tunkhannock to do a complete body CAT scan, and then had Schultz do a stress test. The on-site cardiac stress testing at a Geisinger Medical Group office in Tunkhannock showed that things did not look good: Schultz had a blockage. He was scheduled for a cardiac catheterization.

It was a surprise; a heart problem had not even crossed Schultz’s mind as a possible cause of his back pain.

“I had good cholesterol, have been the same weight for years, and had excellent blood pressure,” Schultz said.

He went for the catheterization at Geisinger Wyoming Valley, and there doctors discovered Schultz’s condition was even more serious. He had three blockages – 99 percent, 95 percent and between 80 and 90 percent.

“It shocked the living daylights out of everyone. It was surreal,” Schultz said.

The catheterization turned into open heart surgery that very same day.

The surgery was on a Tuesday, and he was home by Sunday. He never even had time to fully think about having the operation. And he had never experienced the typical warning signs of a heart problem, such as chest pain or shortness of breath.

“The doctors said I had the worst alarm system they’d ever seen,” Schultz said. “They probably saved my life, with me not knowing I had a problem.”

It also made him think about his brother, who had had been in good health but suddenly died in his 40s of a suspected heart attack.

“We never had any heart problems in our family, so we never believed it. But now I think, geez, it probably was true,” Schultz said.

His experience has served as a cautionary tale for friends and family. Just this past month, a friend specifically requested a stress test for himself.

“It sets off alarms in your circle. People think ‘if it can happen to him, it could happen to me,’ ” Schultz said. “It triggered people to think about what could happen to them.”



Firefighter Saves Heart-Attack Victim on D.C. Court

ABC News

A 30-year-old man suffered a heart attack while playing basketball on a D.C. court.

That's when a Brian Long's firefighter training kicked into action. The 25-year-old D.C. firefighter's team had just finished their pick-up league game Friday evening at Lafayette Elementary School's basketball court when the man stumble to the ground.

"He ran a few feet and collapsed again so I turned him over and I looked at him his eyes rolled back and he just stopped breathing," Long said.

Long began performing chest compressions and soon he was joined by Anthony Gadson, a pharmaceutical sales representative, who learned CPR years ago and starting assisting with mouth to mouth resuscitation.

"If that were me, somebody would've done the same thing for me, so I feel like I did what I was supposed to do," Gadson explained.

While Long and Gadson worked to keep the victim's heart going, all the players and spectators, including teammate and league commissioner Bob Johnson, gathered around the lifesaving effort.

"We gathered in a circle and one of the wives of one of the players just led us in this huge prayer," said Johnson.

"It makes me feel great," Long told ABC 7/NewsChannel 8. "I am just glad that I am a D.C. Firefighter."



Free Drugs After Heart Attack Would Save Money, Lengthen Lives
More patients would take recommended medications, study says

By Ed Edelson

MONDAY, Feb. 18 (HealthDay News) -- Eliminating the cost of medications for people who have heart attacks would lead to longer lives and lower overall medical costs, new research suggests.

"These are highly effective medications that are relatively inexpensive, and the events they are designed to prevent are extremely expensive," said study author Dr. Niteesh K. Choudhry, a researcher in the division of pharmacoepidemiology and pharmacoeconomics at Brigham and Women's Hospital in Boston and an assistant professor at Harvard Medical School. His report is published in the Feb. 19 issue of Circulation.

The study covered four drugs commonly prescribed after heart attacks -- aspirin, beta blockers, ACE inhibitors or angiotensin receptor blockers (ARBs), and statins. Use of those drugs is relatively low under the current system, in which people share the cost with Medicare or other health insurance plans, Choudhry said. For example, only 46 percent of people take beta blockers after heart attacks, and only 50 percent take cholesterol-lowering statins. Less than 20 percent of heart patients used all four of the medications, according to the study.

The model set up by Choudhry and his colleagues doesn't assume a major increase in compliance with prescriptions, because "cost is just one reason why patients do not take medications," he said, adding that relying on previous studies of drug cost and use, the model assumes an increase of about 14 percent, with perhaps 64 percent of people taking the medicines if they were free.

The result would be an increase in average survival after a heart attack, from the present 8.21 quality-adjusted life years to 8.56 years. "That is small in an absolute sense, but in an aggregate sense, it is very large," Choudhry said.

And medical costs over a lifetime would go down, from the current $114,000 to $111,600, the study added.

"This study adds to a growing body of research showing how important it is to reduce or eliminate patient co-payment for drugs," said Robert M. Hayes, president of the Medicare Rights Center in New York. "Medicare should take the lead in forging the creation of drug coverage that allows patients to get the medications their doctors consider vital."

"It certainly makes sense from the medical point of view," said Dr. Richard A. Stein, a professor of medicine at New York University. "Studies have shown that giving even middle-income people free drugs improves outcome. The greatest benefit will go to people in the lower socioeconomic and immigrant population."

But the study is theoretical, Stein noted. "One would like to see some real-world trial to determine whether this works in fact, whether providing free drugs without co-payment would make a difference, he said.

Such a study has begun at Harvard, Choudhry noted. His group is working with a major health insurer, not Medicare, in a trial that assigns some people to get medications without cost, while others will get the standard co-payment.

"It will take several years for us to get answers," Choudhry said. But similar investigations are being started by other medical insurers and corporations, he added.

The idea is potentially applicable to some other chronic conditions, such as congestive heart failure and diabetes, Choudhry noted. And, if the use of recommended medications after a heart attack goes up more than predicted by the model, "the cost savings would be phenomenal," he said.

More information

To learn about how to stay on your statins, consult the National Heart, Lung, and Blood Institute.




Heart Attack Threatens Young, Old

BAKERSFIELD, Calif. -- Nearly 1.2 million men and women suffer a heart attack every year in the United States, according to the American Heart Association. However, not all of the victims are old.

Brian Connell considers himself a lucky guy. At the age of 39, he's physically active, he has a high-level job, and he is also a heart attack survivor. "I know I was overweight and obviously had some other risk factors against me," said Connell. "I wish I did more to prevent it, certainly."

Connell is doing plenty of things now. He met with a nutritionist and changed his diet. He gets regular exercise and takes medication to control his cholesterol. He also gets regular checkups.
Click here to find out more!

Cardiologist Jeffrey Popma said it's not unusual to see younger heart attack patients. "We have dozens of patients in our system every year who have been under 40 years old who have suffered a major heart attack," said Dr. Popma.

Popma said getting medical help quickly is the key to survival. Connell said that is what made all the difference for him. And when people ask him if that was his first heart attack, Connell said he is quick to tell them it was his last heart attack.

Copyright 2008 by TurnTo23.com. The Associated Press contributed to this report. All rights reserved.


The messages I take from such stories:

1) Get yourself to a hospital ASAP for any symptoms even vaguely suspicious of heart disease, because they will know what to do. You'll be doomed if you don't.

2) Hospitals and doctors are expert at saving you from the brink of disaster. The process, once you enter, is rapid and smooth and you will be eternally grateful.

3) Medicines save lives. You're going to die if you don't take medication.


As I've often said, one of the toughest battles of all in health and heart disease is sorting out fact from fiction. Unfortunately, the media continues to propagate the scare tactics that support the status quo of procedural heart care. Wittingly or unwittingly, they serve a $400 billion dollar a year gargantuan industry that remains hungry for growth.

Lost in the headlines are the messages that could have been included, like:

Heart disease detectable decades before disaster

Or:

"Heart disease preventable, reversible, and--curable?"



Copyright 2008 William Davis, MD
Tags :

Comments (17) -

  • Knight

    2/19/2008 3:46:00 PM |

    I believe the media does over-hype almost all health related issues, including drug drug interactions and adverse reactions.  With regards to taking your medication though, there have been several reports that confirm if you are non-adherent to your medication, you raise the risk of having another heart attack and possibly dying.

  • Anonymous

    2/20/2008 1:43:00 AM |

    Since I am the subject of your blog, I'd be happy to comment.  The point of the story is that there are things you can do to prevent heart disease and an MI.  I don't believe this was spun by the media and I was happy to be part of it.  In fact I am confident that if people take this advice on warning signs seriously they have a better chance of survival and it could even save lives.  I'm happy I took part in the article, you should stop your scare tactics of the industry that albeit profitable is saving lives.

    Brian Connell

  • Dr. Davis

    2/20/2008 2:05:00 AM |

    I'll be damned if I stop criticizing the status quo in heart care.

    You are entitled to your opinions. People are entitled to continue submitting their lives and health to the endless appetites of a procedure-obsessed health care system. I personally would rather seize control over my health and be provided truly effective preventive strategies. You clearly have not been provided this information.

  • stress

    2/20/2008 6:26:00 AM |

    I felt that your post was highly enlightening. http://www.howtorelievestress.org
    has a lot of tips on managing your stress! I find this website very useful.It definitely helped me, and I can see an improvement in my condition already.

  • Bob

    2/20/2008 4:56:00 PM |

    Yes - the media hypes almost everything to excess whether it be the weather, economy or health related procedures. I find it highly unlikely that prevention will ever be hyped in the mainstream since prevention is not a money maker and is not "exciting". Too much pharma revenue would be lost even if people took the simple step of normalizing vitamin D levels let alone any other "provocative" measures such as reducing sugar intake etc.


    Bob

  • mike V

    2/20/2008 5:13:00 PM |

    Surely there is a place for education in both prevention and emergency treatment. The problem is achieving a balance of emphasis.
    While I have clearly benefited from the preventive approach, (0  score at 72) my wifes maternal uncles all died of MI in their 40's and 50's except for the one who made it to 60's inspite of a stroke. Her mother made it to 90following two MI's and with conventional treatment including two cabg's.
    Until the better preventive approaches are given equal time, and a couple of generations have benefited, we will need both kinds of awareness.
    Typical media articles (and cardiac advice) reflect the lifestyles, errors and distortions of the past 30 years. Dr D's advice is excellent, and I appreciate his frustrations at the long uphill battle.
    mikeV

  • g

    2/20/2008 7:31:00 PM |

    Mr. Connell,

    (You're the second Brian to blog and start some *umm* drama) I'm sorry to hear about your event but I agree with you, it's good to get the news out.  

    By generous measures, according to the statistics, you life will require 'saving' yet again in approx 15 yrs if you follow 'conventional' wisdom and your docs in Bakersfield (no doubt there adequate but not as good as DR. Davis and TYP -- Track Your Plaque program).  

    (you are aware i hope that statins won't save your life, right?)

    Good luck.

    (FYI ask your Bakerfield docs to check: lipoprotein (a), homocysteine, and glucose -- you need to improve these to prevent those native vessels, bypassed vessels and stents from clogging up)

    g

  • Anonymous

    2/20/2008 9:55:00 PM |

    Hey Mike V., what have your preventitive measures been these past 72 years?

    Thanks, Daniel

  • Anonymous

    2/21/2008 2:35:00 AM |

    Hello g,

    Not trying to start controversy, quite the opposite. My doctors are in Boston, not California, and the article that was posted by this ABC affiliate was never viewed by me, it was their edit of the AP.

    Here's the real story URL:

    http://www.cnn.com/2008/HEALTH/conditions/02/18/hm.young.heart.attack/

    I participated in this article to provide a hopeful message which I believe is a much more positive headline and message and aired on CNN Headline news this past week.

    All the best to all of you with your efforts for heart health and heart disease prevention.

    Brian Connell

  • Dawn Zera

    2/21/2008 7:13:00 PM |

    Dr. Davis --
    Interesting discussion.
    I assure you that I take my job as a journalist as seriously as you take your job as a doctor. I would never presume to assume that your motives were anything other than to do your job well.
    While I may agree with many of your points (i.e. procedure-obsessed health care system, preventive health care strategies), I take issue with your assumptions of how I go about my work as member of "the media" -- IN NO WAY was my intention to over-hype anything.
    The area we live in has an unusually high number of people with heart problems and heart attack deaths.
    Is there no value in this story?

  • mike V

    2/23/2008 3:49:00 AM |

    Nothing too surprising Daniel.

    About 10 years ago I lost faith in the 'prevention' of the time which was low fat. I needed gall bladder surgery inspite of my 15 to 20 miles per week walking/running to offset sedentary profession.
    Moved away from excessive carbs, and towards whole foods. Supplement a few places where diet and lifestyle still don't quite make it. Independently ended up surprisingly close to Dr D's recommendations emphasizing fish oil (3Gm), vitamin D3 (4000iu  depending on season), magnesium citrate, CO Q10.  
    Diet leans toward mediterranean.
    Oils: Limited to ev olive 20%, light olive and canola 40% ea. No other.
    Wine: Pinot Noir. Tea: green and black.

    Plenty of greens, small berry fruit, citrus.
    Big on cheeses. Esp strong flavored, fermented varieties.
    Omega 3 eggs
    Throw in some spices, cocoa, walnuts, p-nuts,
    I try to maintain variety, and not to get too hung up on any one nutrient.
    My HDL moved from low 30's in my 40's to about 50 now.
    No long term meds. except thyroid. Have not had a cold or flu this year. Tendency to tendonitis sometimes limits excercise to treadmill. Resting pulse 50.

    FWIW My father passed with MI @ 76 (had signs of prior MI) Mother passed @ 92. Chief complaints: CHF, ARMD

    Hope this is helpful.
    MikeV

  • jpatti

    2/23/2008 6:19:00 PM |

    You summarized one of the main ideas propogated by this type of media: "1) Get yourself to a hospital ASAP for any symptoms even vaguely suspicious of heart disease, because they will know what to do. You'll be doomed if you don't."

    I had "heartburn" for a week before I went to the ER, got an EKG and blood workup and was sent home with some antacids, feeling foolish for overreacting.  Two days later, after spending the whole night alternating puking and screaming, hubby took me back to the ER and they decided to transport me in an ambulance to another hospital for an emergency angio, which was followed up by a CABG.  In short, two days after a "good" EKG, I needed two surgeries to repair my heart.

    I asked our internist to refer my husband for a heart scan and he wrote referrals for an EKG and stress test instead.  We skipped them and the heart scan is next month.  

    A stress test doesn't show anything unless there's an actual *blockage* - a heart scan shows arteriosclerosis before it gets to that point.  And my own experience is that an EKG doesn't show anything even two days before an MI.  To hell with that.  

    If hubby gets anything other than a zero calcium score, next step is a VAP lipid test to begin correcting his issues.

    The whole *point* of the exercise is for him to *avoid* what happened to me.  Yes, it's wonderful they can do angios and bypasses, but... it's been EIGHT MONTHS since mine, and I still can't go back to work!

    So yes, I'm alive and all, but it'd be damned preferable had I gone at it from a prevention standpoint a few years earlier.

  • Anonymous

    2/24/2008 8:16:00 AM |

    Thanks Mike V, That's intersting - but it sounds like until you were 62 you practiced the low fat diet? Daniel

  • Rick O'Shay

    11/4/2008 7:25:00 PM |

    I didn't really have the scare tactics.  My heart attack was out of the blue.  I was in perfect health.  Or so I thought.  My PCP did say I had High cholesterol and was on meds for that.
    2 weeks before I had my first MI(in the gym no less ) I had been going to my PCP with nausea.
    I've been wondering if this was a precursor to the MI.
    2 months latter I had a massive heart attack (the widow maker as you say ) causing a lot of damage to the heart muscle.  My EF was 25 it is now around 30.  My cardiologist reccomended an ICD which I have now.
    I have devoted my blogg to helping people with their feelings in dealing with CHF and other heart problems, by telling my story.  It's very theraputic for me.
    But I may be giving wrong advise.
    I am no Dr. just a patient with heart problems.
    Thank you for taking time with your blogg and for the information.
    Some time when you have nothing to do, which I'm sure is rare. Check out my blog @ www.richosea.blogspot.com
    I might have a lot of missinformation.  I also have an article coming out this month in EP Digest.  "A patient's perspective"
    Thanks again
    Rick O'shea

  • Mark D.

    8/18/2012 8:00:56 PM |

    Over a decade ago, I was diagnosed with coronary artery disease.  I was told I needed a multiple bypass operation.   I was threatened with likely death if I did not agree to surgery.  Actually, I probably was close to having a plaque rupture, but I knew that surgery was not the answer.  I knew I had to get my dietary habits under control.  Because of metabolic syndrome, I also needed some additional medication.  

    I got my diet under control.  My wife and I focused on home cooking with fresh foods rather than processed foods.  I have taken a truckload of pills during the past decade.  I began exercising regularly.  I changed careers to reduce my stress levels.  I had my cardiologist do check-ups on me quarterly.  But, I have been steadfast about declining stents and bypass surgery.  

    Most recently, my wife and I have eliminated wheat and wheat flour from our diets, after reading Dr. Davis' book, "Wheatbelly".  This step actually substantially eliminated my exercise induced angina!  

    I look forward to many more years of improved health.  I particularly enjoy sending some of my early interventional cardiologists annual Christmas cards containing greetings along the lines of the old Timex commercials, "Takes a licking and keeps on ticking."

  • Dr. Davis

    8/23/2012 2:02:11 PM |

    That's excellent, Mark!

    You bucked the hungry revenue-generating medical system.

  • Bill Treat

    6/19/2013 3:04:04 AM |

    Hi Mark:  Bravo on your choices.  I am being pressured to have a cath by a pushy cardio nurse.  My choice at this point is to have a C-RP test, since I have NO symptoms, just what the cardio MD SAYS showed up on the EKG, and 2 short episodes when I was wearing the heart monitor.  I don't like fear-mongering.  Not my style, and I'm inclined to push against that.

    Any comments/suggestions will be appreciated.  I have, since a stroke @ 59, 14 years ago, made a living as a very active, ladder climbing painting contractor.

    Bill in Charlotte

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More on blood sugar

More on blood sugar

25. January 2010 William Davis (36)
Take any of the following foods:

One chicken breast
Quarter-pound ground beef
6 oz salmon steak
½ cup raw almonds
3 eggs scrambled in olive oil

How much is blood sugar increased by any item in the above list?

If you said virtually zero, you’re correct. Eat any of these foods, regardless of portion size, and blood sugar won’t change substantially. If you started with a blood sugar of, say, 90 mg/dl, 1-2 hours later it would be 90 mg/dl. It might go up or even down a few milligrams, but for all practical purposes it remains substantially unchanged.

How much is blood sugar increased by the foods in this list:

2 slices multigrain bread
1 whole wheat bagel
4 oz high-fiber breakfast cereal
2 whole grain pancakes, 2 oz maple syrup

The foods in this list are a different story from the first. Depending on your body weight, exercise habits, and other factors, a typical blood sugar response in an otherwise healthy non-diabetic person would be 120 mg/dl to 160 mg/dl. In someone with diabetes, it could easily exceed 200 mg/dl.

That isn’t good. Large blood sugar excursions to 140 mg/dl have been clearly associated with greater risk for heart attack, progression to diabetes, inflammatory responses, and other adverse health effects. In fact, blood sugars as low as 100 mg/dl after eating have been associated with increased cardiovascular risk.

Then why are the USDA, American Heart Association, the American Dietetic Association, and the American Diabetes Association telling us to eat more of the foods that shoot blood sugar up to such high levels? “Eat more healthy whole grains”?

To see how much the issue of exaggerated blood sugars after eating applies to you, a simple blood sugar check 1-2 hours after eating can show you. Either your doctor can have the test drawn or you can purchase your own inexpensive glucose meter (e.g., Walmart, Wagreens).

My prediction: You will be very surprised at blood sugar responses after common foods, including “healthy whole grains.” And, by the way, keeping blood sugar excursions to a minimum will facilitate weight loss.
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Comments (36) -

  • Anonymous

    1/25/2010 5:20:16 PM |

    Dr. Davis,

    Does the context of a mixed meal blunt the impact of some of those grain choices listed? For example, if you have someone who consumes a lean source of protein and some fibrous vegetables at a meal but also happened to add a bagel or a slice or two of bread, would there be the same exaggerated response or would it be lessened on account of the protein and added fiber?

    Or in the case of protein and a source of quality, undamaged fat, would this also mitigate the impact at all?

    I'm not looking for a license to eat grains and such, just curious if the impact is at all close to what it is in someone who ate the grains or the pancake/syrup combo as a standalone as a standalone.

    ~Ralph Backstrom

  • Laura

    1/25/2010 7:10:51 PM |

    I started checking my post meal glucose last Saturday.  So far, the only thing that raised it was the diluted cup of fruit juice.  I don't drink juice any longer and this provided some evidence as to why.

    Thanks for the wisdom!

  • Anonymous

    1/25/2010 7:35:04 PM |

    Behold the power of the dominant paradigm.  Go to Google and you find:

    2,160,000 for "whole grain"
    1,770,000 for "healthy whole grain"
    502,000 for "heart-healthy whole grain"

    4,980,000 for saturated fat/fats
    524,000 for "limit saturated fat"
    245,000 for "artery-clogging saturated fat"
    206,000 for "unhealthy saturated fat"

    And the voices in the wilderness
    152,000 for "healthy saturated fat"

    Freya

  • Anonymous

    1/25/2010 7:50:31 PM |

    Alas, this is only true for someone who doesn't already have T2 diabetes.  I am a small woman, 5'2", weighing about 120 pounds.  If I ate 6 oz of salmon at one sitting my blood sugar would easily go to 130 at the least, and would stay high for awhile --and I'd be insulin resistant for a day or so after. I can handle only 3 ounces of protein food at a time, and even then I get some rise.

    But your point is well taken for someone who can handle larger portions.

  • lindaharper

    1/25/2010 7:57:56 PM |

    You are so correct.  I really try to eat properly for my diabetes doing this very thing and testing what raises it and what does not.  I recently got home from a trip with family where I could not control my eating but I still kept track of my blood sugars.  I was shocked at what changing my diet did to me for those few days (while still taking some diabetic medication).  I am so glad to be home so I can eat properly!

  • Kurt

    1/25/2010 9:12:40 PM |

    And checking your blood sugar helps you determine your individual response to different foods. For example, my blood sugar increases more when I eat rice than when I eat potatoes, even when the amount of carbs is the same.

    Using a glucose meter, I have been able to keep my postprandial glucose under 120 mg/dl. Thanks for the suggestion.

  • I Pull 400 Watts

    1/25/2010 9:39:53 PM |

    What are your thoughts on fruit and veggies. With their effect on BG and a low carb diet, are you recommending lowering those as well? The only problem I have with a low carb diet is it may mean low fruit and vegetables as well.

  • Dr. William Davis

    1/25/2010 11:43:42 PM |

    Hi, Ralph--

    It does indeed. However, the effect of the precise mix of foods and portions can be best gauged by checking your postprandial blood sugars to be certain.

  • Dr. William Davis

    1/25/2010 11:44:18 PM |

    Hi, Freya--

    That's fabulous!

    It offers an interesting insight into what the "masses" are thinking.

  • Katelyn

    1/26/2010 1:25:16 AM |

    We don't need fruits and vegetables at all, particularly the former. Fruit are sugar bombs with trace nutrients.

  • steve

    1/26/2010 1:39:08 AM |

    is it really necessary to do this if you do not eat grains except ground flax with a diet of vegetables, meat fish, chicken and Greek yogurt such as Fage and only a handful of berries a couple times a week with a Whey protein shake?

  • Anonymous

    1/26/2010 5:45:09 AM |

    I think some of us are going a bit overboard on the anti-fruit/vegetable crusade here.  It is impossible to eat too much kale, broccoli, and other greens.  Vegetables are the healthiest things you can eat, and I've made them the center of my diet.  Fruit jucies are dangerous, definitely.  (I wish I knew that when I was younger.)  But fruits, I think, are much, much better, because of the fiber content. Really, eating a bowl of blueberries, and apple, and a banana is not going to give you diabetes, and will do far more good than harm.  

    - Vladimir

  • Anonymous

    1/26/2010 11:30:17 AM |

    So what about 4 oz of rolled oats?

    I avoid 95% of grains except for oats.

    Here they claim that oats are low- glycemic...

    http://blog.nutritiondata.com/

    Others say that oats do not have gluten...or at least not the same type as in wheat.

    If one would avoid all fruits...vegs...grains...that would be a carnivore's diet?

  • Kamila

    1/26/2010 1:40:09 PM |

    Dr Davis,

    You have been writing about the benefits of a low-carb diets for yeears.  So why is only now that it "mainstream" doctors are catching up.  This article from BBC News:

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

    Low-carb diet 'heart benefits'
    A low carbohydrate diet, like Atkins, is better at cutting blood pressure than weight loss drugs, according to US research.

    In this related article, the efficacy of the "high-carb" DASH diet when used alone for the control of high blood pressure is questioned:

    http://www.reutershealth.com/archive/2010/01/25/professional/links/20100125clin014.html

    Weight management needed for DASH diet to optimize heart health

    In overweight individuals with hypertension, the health benefits of the DASH (Dietary Approaches to Stop Hypertension) diet can be substantially increased by weight loss and exercise, according to early results of the ongoing ENCORE study.

    National guidelines for controlling high blood pressure (BP) recommend the DASH diet, which is high in low-fat dairy products, fruits and vegetables, lower in fats, and rich in fiber. However, studies in "real life" situations have questioned its value independent of other lifestyle changes.

  • Dr. William Davis

    1/26/2010 2:10:32 PM |

    Anonymous--

    Please don't regard to "no fruits and vegetables" as my advice. I believe that vegetables and SOME fruit should be the core of your diet.

    You can always know whether a specific carbohydrate food is good for you if you check your one-hour after eating blood sugar. That will tell you for certain.

  • Laurie

    1/26/2010 8:58:30 PM |

    So, I have been eating very low carb for a few months now.  I don't have type 2 diabetes, but I am trying to lose weight, and my research is leaving me with NO doubt as to the importance of low carb eating.  My son is type 1 diabetic, so we have several meters lying around, unused.  

    Since starting low carb, I haven't really checked my blood glucose readings.  But, when I read your last two blog posts, I had just eaten a low carb lunch about an hour previous.  So, I checked my blood glucose and it was 79 mg/dl.  Perfect!

    I was curious how high it would be if I ate a high carb meal.  But since I hardly ever do that anymore, I didn't know when I'd get a chance.

    Today I got my chance.  I went out to eat with my husband to a Japanese restaurant.  I ate rice, tempura shrimp, and a salad dressing that had some sugar in it.  So, after I got home, I checked my blood glucose at 1 hour postprandial, and guess what it was...167 mg/dl!  I was very surprised to see it that high!  I checked again at 2 hours postprandial, it had dropped to 140 mg/dl.  

    So, are those pre-diabetic numbers?

    In any case, I'm glad that I'm not eating that way anymore.  I'm down almost 20 lbs, and I feel great.  I'm totally convinced that the world needs to hear your message!

  • Flowerdew Onehundred

    1/27/2010 12:24:17 AM |

    Bought a blood sugar meter on your recommendation, and it's been informative.  I found out why I can't do intermittent fasting without feeling like crap - BG was 63 before my meal!!!

  • Anonymous

    1/27/2010 1:15:01 AM |

    Laurie, I'm not an expert, but I don't think you've got enough data to know.  If you began eating rice daily, and your numbers didn't normalize, then yes, there's a problem.  However, I'm uncertain what, if anything, you'd need to do about it, given that your typical way of eating probably doesn't spike glucose.

    Yesterday's high readings are probably the result of 2 things: (1) an unprepared pancreas, and (2) physiologically insulin resistant muscle tissue.  

    Your pancreas uses the past as a predictor of the future.  On a low carb diet, your pancreas assumes that it won't need much insulin for the next meal.  It doesn't have a large stockpile waiting just in case you decide to eat high carb one day.  

    So a pancreas used to a VLC diet won't be prepared to prevent a blood sugar spike if you eat an unusual meal.  

    However, if you ate higher carb for a few days, a healthy pancreas would start making more insulin.  At that point, the spike from a rice & tempura meal would (hopefully!) be lower.

    Also, when your diet is low enough in carbs, your muscles become insulin resistant.  This is referred to as physiological or peripheral insulin resistance, which is not the same as pathological type II diabetes-causing insulin resistance.  

    When VLC, your muscles are being fueled by fatty acids, and they don't need much glucose, so they stop accepting it from your bloodstream.  Muscle insulin resistance may also help to conserve scarce glucose for your brain and red blood cells.

    Assuming that you're nondiabetic, if you ate higher carb for a while, that type of insulin resistance should reverse.

    Clear as mud?  Laughing

  • Anonymous

    1/27/2010 3:02:35 PM |

    I have a question pertaining to what the above poster said about about physiological or peripheral insulin resistance.  I believe that this is what I experienced while on a low-carb diet.  After several months, my fasting blood sugars had risen to readings in the upper 110s and even low 120s.  Throughout the course of the day, they would hover around 100.  Previous to beginning the low-carb diet, my fasting blood sugars were typically in the upper 80s to low 90s, but my one-hour postprandial sugars would rise to 140 or higher with a meal containing a moderate to high amount of carbs.

    So my question is, if this type of insulin resistance can occur even when keeping carbs to a minimum, how can that be healthy in the long-term if even sugars in the 100s can cause problems?

  • Anonymous

    1/27/2010 4:41:29 PM |

    (Apologies if this is a duplicate submission.  I got an error the first time I hit the publish button.)

    Peter over at Hyperlipid has written about physiological insulin resistance and fasting blood sugar.

    http://high-fat-nutrition.blogspot.com/2007/10/physiological-insulin-resistance.html

    He's written other posts on the topic as well, which you can find by scrolling down to the labels section on the right hand side of the blog.

    Peter's argument may explain your fasting blood glucose, but that doesn't necessarily mean everything is okay.

    What is your HbA1c?  If your A1c is at or above 6%, you might want to refer to an older post on this forum (link below) and/or Bernstein's book on diabetes.

    http://heartscanblog.blogspot.com/2008/04/low-carb-eating-for-diabetes.html

  • Anonymous

    1/27/2010 10:15:51 PM |

    I think you should clarify things a bit. Protein certainly does get converted to glucose via gluconegenesis, and the incretin process will give you a bit of a sugar rush as well per Dr, Bernstein. Us type 1's attempting low carb lifestyles know very well that BGs most definately are affected by all consumed foods.

    John

  • Vladimir

    1/28/2010 8:42:23 AM |

    I am really confused here now.  Dr. Davis' post says that eating beef won't raise blood sugar.  But Drs. Oz & Roizen, the authors of the "You" series, and who strike me as learned and straightforward fellows, not captured by any particular industry, say that *saturated fat* -- whether from animals or coconuts or palm trees --  causes insulin resistance.  If that's right, then eating beef and other saturated fats will reek havoc on blood sugar -- if not now, then later.  

    So what gives?  Who is right?  Is the science just hopelessly confused at this point?

  • Fred

    1/28/2010 4:22:45 PM |

    For T1 and T2 diabetics:

    See Dr. Richard Bernstein's book "Diabetes Solution" for the ultimate low carb eating plan.  He advocates 30 grams of carbs per DAY - sounds extreme but he's been living with T1 diabetes (juvenile, insulin dependent) for 64 YEARS!

    Good luck

    Ed

  • malpaz

    1/29/2010 7:58:20 PM |

    im consfused too... so if saturated fat causes insulin resistance(which precedes or follow leptin resistance), and protein will spike blood sugar...

    makes meat sound like the WORST of both world... im so confused

  • Dr. William Davis

    1/30/2010 2:31:16 PM |

    A clarification: Protein and fats, including saturated fats, DO increase blood sugar. However, the magnitude of effect is much smaller than that of carbohydrates.

  • Vladimir

    1/30/2010 6:03:42 PM |

    Now I'm starting to understand why you're against grazing, Dr. Davis!  It seems like not eating for several hours -- i.e., sticking to meals -- would be quite helpful in keeping blood glucose down.

  • stcrim

    1/30/2010 8:34:43 PM |

    Dr. Davis,

    I've heard and read that sprouting grains (and beans) changes their starch content into a vegetable sugar making them much safer.  Some examples are 100 percent sprouted breads like Ezekiel Bread.

    Any truth to this that you know of???

    Steve

  • Kamila

    1/31/2010 12:51:52 AM |

    Dr Davis,

    Another article on the dangers of a "low-fat" diet:

    http://www.dailymail.co.uk/news/article-1247216/The-Big-Fat-Lies-Britains-obesity-epidemic.html

    "While we've all been brainwashed into thinking that fat is the killer we must avoid and food manufacturers bring out more and more profitable 'low-fat' versions of foods, starch - in the shape of pasta, bread, cereals, potatoes and rice - has been quietly adding on the pounds, while we are being told that it's good for us."

  • Kamila

    1/31/2010 12:57:40 AM |

    The article title is:

    The Big Fat Lies about Britain's obesity epidemic

    "While it showed some benefits from cholesterol-lowering drugs, the assumption made by the researchers was that if you eat a diet low in cholesterol, that would have the same effect as taking cholesterol-lowering drugs.

    This conclusion prompted various agencies in the U.S. to start a campaign to lower the amount of saturated fats in our diet.

    At no time did this study look at the effect of saturated fats on heart attacks or heart disease.

    So, on the basis of a study looking at drugs lowering cholesterol, we ended up with a message to eat less saturated fat.

    This plea for sanity over the advice on fats is not a lone cry.

    Several very influential experts such as Dr Laura Corr, consultant cardiologist at Guys and St Thomas' Hospital in London, and Dr Michael Oliver, from the National Heart and Lung Institute, have asked those in power to stop propagating an unproven message.

    Where does the FSA find such certainty among the pile of published science which is not conclusive in its findings?

    In fact, there are some statistics showing quite the contrary, especially when mixed with a low- starch and low-sugar diet.

    One report looked at 27 individual studies into the link between fats and heart disease and no link could be found."

  • stcrim

    2/2/2010 1:14:44 AM |

    The following are my cholesterol and Triglyceride numbers from 1-13-10 and 1-30-10 (dates are when the reports were issued.

    I am a male 54 year of age and considered myself in fair shape at 5’8” and 184lbs.   My starting total cholesterol was 295, LDL was 200, HDL was 46 and my VLDL was 49.  Triglycerides were 242.  Two weeks later my total cholesterol is 156, LDL is 102, HDL is 32, and VLDL is 22.  My Triglycerides are 109.

    My doctor is a huge fan of Dr. Davis.  Dr. Brock outlined a program for me that includes 10,000IU of Vitamin D (my values 2 weeks ago were 28.6, was not taken this time), one tablespoon of Carlson’s Fish Oil, K and K2 complex and magnesium.  There are several other nutrients such as mixed Vitamin E included

    On top of that I have modified my diet to a more plant based, lower saturated fat plan.

    This is where is may become a little controversial.  From what I understand, none of the above could account for a Drop from 295 t o156.

    Though my Doctor, like Dr. Davis feels the jury is still out, I decided to take 1400mg of disodium EDTA every morning and have those 2 weeks.  My goal in taking the EDTA was not to clean out calcium.  I understand that it doesn’t do that as far as anyone knows.   I had read multiple times that it lowers cholesterol and normalizes blood platelet aggregation.  

    Since there appeared to be little or no risk it seemed worth a try.  I can’t say that EDTA was the reason for such good numbers now but I also can’t find any other reason for them.  The only cholesterol test I had done before those 2 was 7 years ago and my total was 270.  295 two weeks ago and 156 today.

    I’m not posting this to drive the EDTA controversy.  I believe the second chance I have been given is a combination of Dr. Davis and Dr. Brocks research for which I am hugely grateful.  If EDTA had anything to do with the numbers so far, I also have Dr. Garry Gordon to thank for his research.

    A year from now I plan to have a second CT scan.  As you might guess my CT score was not go.  I was in the top 10 percent for my age.  Scary given that my grandfather died in 1932 of “acute indigestion” (wink) and my father died in 1989 of a heart attack.

    Thank you Dr. Davis.  By the way, Dr. Brock would not let me leave is office without a copy of “Track Your Plaque”.

    Steve

  • Santiago

    2/5/2010 1:46:59 AM |

    I bought the onetouch mini today and Im gonna do some pre-post eating tests next week.
    One thing I noticed is the manual says that after a meal the samples taken from a finger can be as much as 70 mg/dl higher than samples taken in a lab. Adding this to the 20% accuracy means that getting a 150 mg/dl after a meal with this device could be 50 mg/dl if tested in a lab

  • jpatti

    2/6/2010 3:13:47 PM |

    Protein raises bg.  I use insulin and have to use half as much for protein as for carbs; i.e. 1 unit Novolog covers 5g carb or 10g protein.

    Both protein and fat can be converted to glucose via gluceoneogenesis.  

    However, in practical experience, fat has no effect except to slow the raise caused by carb and protein (the "peak" bg after a fatty meal occurring later than for a lower-fat meal).

  • Anonymous

    3/29/2010 12:20:48 AM |

    Whoa! Not only does protein raise BG (via gluconeogenesis), but for someone on a low-carb diet, their average BG (and A1C) will be dominated by the glucose produced by protein. In fact, this is why advanced diabetics cannot ultimately control their condition by low-carb diets alone - the protein they need to survive is enough to raise their BGs to unacceptable levels.

  • C. Holesterol

    6/28/2010 6:47:14 AM |

    Stress is always a very big factor in stimulating all diseases as they arise from the mind.salt and sodium in excess also leads to many diseases of the body.

  • buy jeans

    11/3/2010 3:18:01 PM |

    That isn’t good. Large blood sugar excursions to 140 mg/dl have been clearly associated with greater risk for heart attack, progression to diabetes, inflammatory responses, and other adverse health effects. In fact, blood sugars as low as 100 mg/dl after eating have been associated with increased cardiovascular risk.

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