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.

Coumadin is considered a Natural Medicine having been derived from mold acting on Sweet Clover.

Most Pharmaceutical Drugs have a Natural Basis.

What about using heparin derivatives as a replacement of Marevan / Coumarin?

As mentioned in Wikipedia, low molecular weight heparin (LMWH) is used in pregnancy. It should be possible to change Marevan / Coumarin with LMWH.
http://en.wikipedia.org/wiki/Marevan#Pregnancy

Heparin can not be taken orally, so you have to get injections if you decide to change medication.

Yes, indeed.

But anyone who has taken low-molecular weight heparin injections will tell you it's no picnic. The injections can be painful and leave a bruise. After a few weeks, you can feel like a pincushion and be riddled with bruises. Not a happy alternative.

Hi Dr. Davis,

Great, although somewhat depressing, post.

What is the point of taking the K2 when K2 interferes with the therapy (as Vermeer's group showed) and the dose will have to be adjusted?  The drug interferes with the recycling of vitamin K so it should affect both forms equally.  Are you hoping it may shift the balance of residual vitamin K activity towards the bones and blood vessels?  That seems to make some sense if there is substantial residual vitamin K activity.

Chris

Chris, I think you are going down the right path with your thinking.  Some K2 survives warfarin therapy as evidenced here:


"In conclusion, our study indicates that in a rat model
arterial media calcification is prevented by a high dose of
MK-4."

http://content.karger.com/ProdukteDB/produkte.asp?Aktion=ShowPDF&ProduktNr=224160&Ausgabe=229786&ArtikelNr=75344

The question then becomes how high a dose is therapeutic in humans and can you get it from diet alone?

I'm a prisoner of life long warfarin therapy and have consciously shifted my K intake to K2 by eating lots of eggs, cheese and grass fed/finished beef instead of green leafy vegetables because of the way warfarin hammers conversion of K1 to K2.  Sure green leafy vegetables have health properties but they won't help with warfarin driven arterial calcification and osteoporosis.  So far I have avoided taking a K2 supplement and adjusting warfarin dosage because I don't have confidence in the consistency of the K2 in a supplement form.  It becomes another wildcard.  But the bottom line is I really don't know if there is enough K2 to make a difference from food alone.

Dr. Davis, do you have any thoughts on arginine supplementation as a driver of nitric oxide production for the purpose of blood vessel dilation?  I am showing signs of venous insufficiency from a blood clot in my leg suffered over a decade ago.  You mention aspirin and Plavix as platelet inhibitors that don't impact venous clotting.  Arginine also affects platelet activity and I can't find anything definitive about whether or not that is an issue with warfarin.  Arginine is also associated with mitigating atherosclerosis which would seem to make it a good choice for people on warfarin.

Dr davis

after reading your blog two things have stuck in my mind. one about the role of vaccines in development of disease. and two role of GM foods in destroying health.

kindly shed light on it. im splitting my hair over it

This topic has to be of great interest to the many people on Warfarin for atrial fibrillation,  particularly the issue of warfarin-induced calcification and osteoporosis.  This article http://bloodjournal.hematologylibrary.org/cgi/content/full/109/8/3607 suggests that levels of 45mcg of K2 supplementation would be safe, but what is a therapeutic dose and how does it work with Warfarin? (One of the authors has ties with Natto Pharma, seller of K2; they also suggest it is a safe dose.) Until specific studies are done, we will not know how it works.

Will one of the newer anticoagulants in the pipeline, such as Dabigatran, which I understand is not a vitamin K agonist, be approved soon and will it be effective?

Dear Dr. Davis:

This topic is really distressing.  My father has been on Warfarin for 10 years due to atrial fib. I can't help but wonder if his increasingly worsening calcium scores were due in part to Warfarin. It seems to be an extremely nasty - but necessary - drug.

Over the past year he has been increasingly tired and two months ago had a triple bypass. He has been on a low carb diet, lost 25lbs and started taking fish oil and 5,000 i.u Vitamin D3. He is not taking any K2, but he does eat green vegetables every day. He recently started taking 10,000 i.u. of D3.  Should anyone taking larger D3 doses who is also on Warfarin be worried about arterial calcification? How does one find a doctor in Milw. or elsewhere who has knowledge about K2 and Warfarin? What else can Warfarin users do about their heart disease?

Sadly, there are no data--none, zero, zip--that address the end result of taking vit K2 in any dose or any form while on warfarin.

No doubt: It will drive INR down, driving warfarin need up. But there are no data on what effects will result at the bone or artery level.

I wish that weren't true, but we cannot invent data where it doesn't exist. It also cannot be extrapolated from existing data or experiences without incurring substantial risk.

Sometimes, we just need the data.

How does Omega3 supplementation help?
I have read that Omega6 is one of the agents that triggers blood clotting.
Also I read that coumadin actually works by inhibiting action of K1/K2.
So adding K1/K2 will actually be against the coumadin therapy.

But since Omega6 is required for the signalling that causes blood clots. If you reduce the Omega6 and increase the Omega3 then the blood clots should not happen naturally.
It will be like the Inuits.
Their arteries are in a bad shape but they never get a heart problem, because they do not get blood clots in their blood.
The only problem is that they don't get blood clots while bleeding also.
So if you use excess Omega3 with very little Omega6 you will be doing the same. But the side effect is that you have to be careful about bleeds.
I would think that the same problem will be there for coumadin

Dear Dr. Davis:

The FDA Advisory Council is meeting regarding Dabigatran on September 20th and word is that its approval is expected by the end of the year or early 2011. I have even seen Boehringer-Ingelheim ads on the online JACC to the effect of "Coming Soon - Pradaxa" (the brand name).

Will this be the paradigm-shifting Warfarin alternative for AF patients?  As Dabigatran is not a Vitamin K agonist, will its users be able to also use food and supplemental sources of Vitamin K2?

Apart from the supposed reduction in bleeding risk, will Dabigatran be a preferable anticoagulant for long-term Warfarin users?

Dear Dr. Davis,

Did you mean that there are no data on whether K2 will protect against the heart valve calcification that occurs on these drugs, or that there are no data showing its effect on INR?

Vermeer's group compared vitamin K2 as MK-7 to K1 and showed that it is much more potent at driving down the INR value:

http://bloodjournal.hematologylibrary.org/cgi/content/full/109/8/3279

By the way, since you are a fan of K2, if you haven't already seen it, you might enjoy the large review I wrote on it back in 2007, which argued that it was the "Activator X" discovered by Weston Price:

http://www.westonaprice.org/abcs-of-nutrition/175-x-factor-is-vitamin-k2.html

Love your blog!

Chris

Anonymous, I have seen that study but I don't think it shows how much residual activity of K2 there is, or to what extent it can protect against calcification for someone on warfarin.

The reason is that K2 potently interferes with these drugs.  In the study, they used a massive dose without cranking up the warfarin proportionately.  However, if you take K2 and you actually need to be on these drugs, your doctor will have to adjust the dose of the drug according to the dose of K2 you are taking.  So it is not very apparent that it is actually possible to obtain the beneficial effects of K2 while taking these drugs.

(As a side point, the massive dose of K2 could provide enough K2 in these studies to allow each molecule to act once and then get converted to the epoxide form without being recycled, and actually exert a meaningful effect.  Off memory, I don't remember whether they did calculations to show whether there was residual reductase activity (i.e. activity of the enzyme that recycles vitamin K, which is the target of warfarin), but the principle that high dose K2 protects against calcification does not show that the dose of warfarin used allowed residual activity of the enzyme, necessariliy.)

Chris

Sounds as if AF patients should ask their physicians to change them to Dabigatran as soon as it comes out. Less bleeding risk, no constant monitoring and, importantly, the ability to avail oneself of good nutrition without worrying about INR's. The British Heart Foundation is campaigning for the drug to replace Warfarin.  

Used widely to get rid of rat infestations in post-Katrina New Orleans, maybe Warfarin will soon be relegated to only killing rats.

Anonymous,

Good points -- warfarin was actually developed specifically as a rat poison, so if it came back into fashion post-Katrina, that's nothing new.

Chris

I spent 18 unhappy months on Warfarin after a DVT/pulmonary embolism episode due to oral contraceptive use (I have Factor V leiden).  Happily, my physician took me off blood thinners last year after a doppler scan to confirm all of my clots were gone.

If you really need a blood thinner (artificial heart valve, active blood clot, severe prolonged a-fib, homozygous Factor V leiden), there's just no good alternative to Warfarin at the moment.  Several alternatives have been tested and rejected due to severe side effects.

A lower-risk propensity to blood clotting (hterozygous Factor V leiden, mild, short-duration a-fib, etc.) might respond to vitamin E.  I started taking it while on Warfarin and my INR readings shot up from 2 to 4.5.  See study by Harvard researcher Robert Glynn, published in September 25, 2007, issue of Circulation journal

Surely the answer is to take the nattokinase, keep a close watch on the INR & if it goes up significantly titrate the warfarin down.

Hello Doc,

I have the same conflict as many here. I take Coumadin for my mechanical heart valve but I do eat green veggies such as broccoli, spinach, or a small salad everyday. I also take Omega 3 daily. My PT INR is usually around the required goal of 2.0. As long as I have this consistent INR reading, is it safe to continue to to have all the above mentioned in my body? I am hoping that my Coumadin dosage can be lowered with the same INR results.

Please Advise