Why are heart attacks still happening?

I'm a cardiologist. I see patients with heart disease in the form of coronary artery disease every day.

These are people who have undergone bypass surgery, received one or more stents or undergone other forms of angioplasty, have survived heart attacks or sudden cardiac death, or have high heart scan scores. In short, I see patients every day who are at high-risk for heart attack and death from heart disease.

But I see virtually no heart attacks. And nobody is dying from heart disease. (I'm referring to the people who follow the strategies I advocate, not the guy who thinks that smoking a pack of cigarettes a day is still okay, or the woman who thinks the diet is unnecessary because she's slender.)

Two high-profile deaths from heart attacks occurred this week:

Davy Jones--The iconic singer from the 1960s pop group, the Monkees, suffered sudden cardiac death after a large heart attack, just hours after experiencing chest pain.

Andrew Breitbart--The conservative blogger and controversy-generating media personality suffered what was believed to be sudden cardiac death while walking.

It's a darn shame and it shouldn't happen. The tools to identify the potential for heart attack are available, inexpensive, and simple. The strategies to reduce, even eliminate, risk are likewise available, inexpensive, and cultivate overall health.

The followers of the Track Your Plaque program who

1) get a heart scan that yields a coronary calcium score (for long-term tracking purposes)
2) identify the causes such as small LDL particles, lipoprotein(a), vitamin D deficiency, and thyroid dysfunction
3) correct the causes

enjoy virtual elimination of risk.

Comments (10) -

  • Alexandra

    3/4/2012 1:02:04 PM |

    Just read this about Davy Jones:
    http://blog.sfgate.com/dailydish/2012/03/01/micky-dolenz-bewildered-by-davy-jones-death/

  • nina

    3/4/2012 9:30:09 PM |

    I saw some recent photos of Davy Jones and thought ''wheat belly''.  Sad, but avoidable.

  • PeteKl

    3/4/2012 11:00:30 PM |

    I don''t claim to entirely know the answer to this question, but I am willing to venture a guess to what might be part of the answer.  My suspicion is that in the end, for better or worse, most people value the opinions of their social group more than they value their health.  Currently Doctor, your recommendations are just too far from mainstream opinion and sadly will be ignored by all but the most thoughtful people.

    As anyone who has tried to modify their diet has probably discovered, the greatest challenge often isn''t dealing with cravings for a missing food.  Instead it is dealing with the social backlash to your lifestyle change from friends and family.  

    At first everyone is interested in knowing why you have made the change and they attempt to accommodate your choice.  However eventually they become annoyed as they realize the change you made is permanent.  I can''t tell you how many times I have heard some variation on the following when deciding where to eat with friends (usually given with a thinly veiled snide tone of voice):

    “I would really like to check out that new Italian restaurant, but Pete won''t eat pasta, so I guess we have to go back to the usual place.”

    It doesn''t matter how many times I tell people that I can always find something to eat no matter where we go.  Someone will still insist on making an issue of my dietary choices.  Things aren''t always this blatant, but it is frequent enough that I eventually start wondering whether I should change my eating habits or stop eating with friends.

    While dietary modifications elicit the most direct response, these types of responses seems to occur with almost any health related change.  If your friends and family aren''t themselves doing something or think the change is a dumb idea (no matter how flimsy the reasoning), most people will avoid making a change.  

    Even my own partner, whose father died suddenly of a heart attack last month and whose relatively young mother has been diagnosed with chronic heart failure ignores my suggestions (which are based on your recommendations).  He has asked me several times for advice that might help his mother and the response to my suggestions is always that it won''t work.

    I finally realized that he simply doesn''t want to challenge the rest of the family.  His older brother, a pharmaceutical representative, is viewed as the “expert” on family health issues and my partner refuses to butt heads with him despite what is at stake.  So I keep quiet and wish his mother the best.

    Much of this is understandable.  Humans are social animals and we have evolved to depend on our social group for survival.  On a savannah in Africa 50,000 years ago this made perfect sense.  But in a modern world of science and technology these natural social instincts are increasingly an obstacle to our health and many of us know it.

    Yet it still takes a strong, independent personality to ignore these impulses.  While I have been able to make a number of changes in my life based on your recommendations, it has still been difficult to consistently follow through.  

    Just a few days ago I was invited over to someone''s house to celebrate a birthday.  So what was on the menu?  Several wheat pizza''s, of course.  So did I tell the host that because of my heart problems I no longer eat wheat?  Sorry Doctor, I didn''t.  Instead I shut up, ate the pizza and  proceeded to raise my small LDL particle level for the next week (http://www.trackyourplaque.com/blog/2011/11/friday-is-my-bad-day.html).

  • Robert

    3/5/2012 7:42:48 PM |

    Since adopting a paleo/low carb diet in the last year, I am looking into getting an NMR lipoprofile test to get a baseline of how my particle count looks.  Under the section of treatment options on this particular site, the first line of start with eating right reads "Eat more whole grains, fruits and vegetables."  The very first thing listed is whole grains.  This is so frustrating to see on a site promoting a very useful tool in CVD risk evaluation.  I have read "wheat belly" and "track your plaque", both very good books.  I am also reading primal body, primal mind.  Heart disease runs heavily in my family and I''m pretty much going against what most people in my famliy do by following low carb/paleo eating habits.  I just dont understand why these larger blood test companies, even with all the evidence continuing to pile up, still suggest foods that will worsen the problem the tests are evaluating in the first place.  I guess you have to have confidence in the test they provide (NMR), but just ignore what they say are the best options for treating abnormalities of that test?

  • Dr. William Davis

    3/6/2012 3:47:32 AM |

    It is unbelievable, isn''t it, with all their insights?

    Give them time and they''ll catch on. In the meantime, ignore this nonsense, Robert.

  • Julie

    3/6/2012 6:40:58 AM |

    Dr. Davis,
    What would you recommend for someone who had recently one stent put in and is currently on a statin and plavix post -op?
    Is it necessary to take statins in this case? Any additional supplements etc.?

    Thank you in advance for your help!
    P.S. Loved your book!

  • Catherine

    3/7/2012 12:41:32 AM |

    Dr. Davis,
    Could you please consider changing your "categories" back to the old way you had them organized--single file, alphabetical and one type size? Although it may give a more creative look to the website, it is harder to find the material being sought. I send many new people to your site and they often complain about it.

  • Dr. William Davis

    3/10/2012 3:51:20 PM |

    Hi, Julie--

    This is precisely what the Track Your Plaque program is about.

    In a nutshell:

    1) Identify the causes specific to you, including lipoprotein abnormalties/lipoprotein(a)
    2) Supplement and normalize vitamin D and iodine/thyroid status
    3) Supplement omega-3 fatty acids
    4) Do the diet

  • [...] patients so that they avoid having a cardiac.   "Why are heart attacks still happening?"  Why are heart attacks still happening? | Track Your Plaque Blog     I’m a cardiologist. I see patients with heart disease in the form of coronary artery [...]

  • margaret

    5/25/2013 6:05:53 AM |

    Dr Davis
    Just found your interesting website.  I am trying to get my partner to cut out wheat (overweight, high chol and high BP).  Unfortunately, I can't find a doctor who conducts the tests you recommend.  Do you know of such in Australia (particularly Western Australia)?  

    Many thanks and I'll continue reading till we catch up down here!!

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In search of wheat

In search of wheat

Many people ask: "How can wheat be bad if it's in the Bible?"

Wheat is indeed mentioned many times in the Bible, sometimes literally as bread, sometimes metaphorically for times of plenty or freedom from starvation. Moses declared the Promised Land "a land of wheat, and barley, and vines, and fig trees, and pomegranates; a land of oil olive, and honey" (Deuteronomy 8:8).

Wheat is a fixture of religious ceremony: sacramental bread in the Eucharist of the Christian church, the host of the Holy Communion in the Catholic church, matzoh for Jewish Passover, barbari and sangak are often part of Muslim ritual. Wheat products have played such roles for millenia.

So how can wheat be bad?

What we call wheat today is quite different from the wheat of Biblical times. Emmer and einkorn wheat were the original grains harvested from wild growths, then cultivated. Triticum aestivum, the natural hybrid of emmer and goatgrass, also entered the picture, gradually replacing emmer and einkorn.

The 25,000+ wheat strains now populating the farmlands of the world are considerably different from the bread wheat of Egyptians, different in gluten content, different in gluten structure, different in dozens of other non-gluten proteins, different in carbohydrate content. Modern wheat has been hybridized, introgressed, and back-bred to increase yield, make a shorter stalk in order to hold up to greater seed yield, along with many other characteristics. Much of the genetic work to create modern wheat strains are well-intended to feed the world, as well as to provide patent-protected seeds for agribusiness.

What is not clear to me is whether original emmer, einkorn, and Triticum aestivum share the adverse health effects of modern wheat.

Make no mistake about it: Modern wheat underlies an incredible range of modern illnesses. But do these primitive wheats, especially the granddaddy of them all, einkorn, also share these effects or is it a safe alternative--if you can get it?

I've ordered 2 lb of einkorn grain, unground, from Massachusetts organic farmer, Eli Rogosa, who obtained einkorn seed from the Golan Heights in the Middle East. We will be hand-grinding the wheat and making einkorn bread. We will eat it and see what happens.

Comments (43) -

  • Narda

    5/26/2010 3:53:55 PM |

    Wow! Thank you, so much for that link! That farm is only a few towns from us! We'll be sure to check it out! Smile

  • Matt Stone

    5/26/2010 4:00:20 PM |

    Interesting experiment.  I certainly know that wheat was held in very high regard by Robert McCarrison, Weston A. Price, and others that witnessed entire populations thriving off of wheat.  The Maycoba of Northern Mexico (Mexican Pima) would be another example.  

    This has always left me with some cognitive dissonance about the wheat issue, and a strong feeling that wheat intolerance in the modern world was a result of weak intestinal strucure and altered gut flora caused by non-wheat factors (such as refined sugar, nutrient-poor food, etc.).

  • Shady Lady

    5/26/2010 4:32:21 PM |

    Just curious if you plan to sprout it first. Can einkorn be tolerate by people with Celiac?

    I'm looking forward to the results.

  • Catherine

    5/26/2010 4:34:36 PM |

    Is this a religious or Christian blog? (Serious question.) I don't follow the reasoning that if something is mentioned in the Bible it wouldn't be unhealthy. Lots of things that people ate or practiced in the ancient world were very unhealthy.

  • StephenB

    5/26/2010 4:49:18 PM |

    Nothing like a little hands-on experimentation -- I like the spirit.

  • Anna

    5/26/2010 4:50:34 PM |

    Being in the Bible isn't much of a recommendation, IMO.

  • Anonymous

    5/26/2010 5:31:54 PM |

    It'd be interesting to see the results of your wheat test there.

    What about the other ancient wheat, Emmer? I think it can be found in Italian  pasta form, called Farro.

  • Helena

    5/26/2010 6:08:35 PM |

    Very interesting and important angle to speak about since those questions comes up very often... especially the "but we have been eating wheat for millenniums"... now we have a good answer! Thank you!

  • Richard A.

    5/26/2010 6:29:26 PM |

    Recently, I have discovered bread that is made from sprouted grain. How healthy this bread is relative to whole grain bread I do not know. The only store I can find this bread at is Trader Joe's.

  • Rob

    5/26/2010 6:29:26 PM |

    Short of growing and milling your own eikorn wheat, is there a viable option for the rest of us?  Is there an acceptable commercially-available (i.e. found at larger grocery stores) product like hard red spring or buckwheat that would be a better alternative with fewer of the downsides of the more traditional wheat flours?

  • Michael

    5/26/2010 6:58:24 PM |

    Looking forward to the results!  Thanks for the great content.

    MH

  • Ghost

    5/26/2010 7:02:26 PM |

    I look forward to the report, both on how the bread turns out, and how you react to eating it.

  • Thomas

    5/26/2010 7:26:06 PM |

    Fascinating. I will be very interested to hear what your experiences with this experiment will be.

  • babblefrog

    5/26/2010 8:10:47 PM |

    A quote from http://www.hort.purdue.edu/newcrop/proceedings1996/v3-156.html

    "The gluten of the einkorn accession had a gliadin to glutenin ratio of 2:1 compared to 0.8:1 for durum and hard red wheat."

    If that means anything.

  • Stan Ness

    5/26/2010 8:43:43 PM |

    Our preliminary studies have not determined that all types of einkorn can be universally tolerated by those with gluten intolerance.  Please use caution if you have celiac or some form of gluten intolerance.  On the plus side, Einkorn is one tasty, healthy grain…it just doesn’t yield as much as modern (hexaploid) bread wheat, so agribusiness is reluctant to plant it.  I'm posting studies about the health benefits of einkorn and including all findings on my website at einkorn.com.  I'm very interested to see how you like the taste Smile

  • Dr. William Davis

    5/26/2010 9:05:36 PM |

    Hi, Catherine--

    No, this is not a religious blog.

    I raise this issue because I hear this from patients.

  • Dr. William Davis

    5/26/2010 9:08:26 PM |

    Stan said exactly what I was going to say: There are insufficient experiences to know whether the gluten sequences in einkorn will activate the celiac response.

    Eli Rogosa tells me that she also has seen several celiac people tolerate einkorn.

    However, none of this should be construed as a clinical study.

  • nonzero

    5/26/2010 10:59:29 PM |

    Stoning people to death and slavery are in the bible, how can they be bad?

    *rolls eyes*

    Lately this blog has really become hit and miss.

  • Thrasymachus

    5/27/2010 12:08:30 AM |

    To neolithic humans wheat must have seemed to be a miracle food. It could be stored for long periods and transported long distances. They could grow it, store it, or trade for it. No longer did they need to worry every day about finding something to eat. They could wait out the winter with full stomachs and calm minds, and some small portion of the population could freed from food production. To do what? As it turned out art, culture, religion, scholarship, everything we think of as civilization.

    They may have even noticed that their primitive neighbors, who still hunted and gathered wild plants to eat, were larger and healthier. If they did, they probably regarded the greatly reduced fear of starvation and the ability of at least some to have some leisure probably seemed like very worthwhile tradeoffs.

    It is only very recently- this century, even for advanced civilizations- that worrying about what you eat has been an option.

  • Dr. William Davis

    5/27/2010 12:41:22 AM |

    Thrasy--

    Excellent perspective.

    No doubt: Agriculture permitted specialization of occupation and the trappings of culture to develop. Wheat facilitated this cultural evolution.

    Did it come at a price?

  • Rick

    5/27/2010 1:03:04 AM |

    Great post. Thanks for the open-minded approach. Nonzero, I think you're missing the point. Dr Davis isn't saying that something must be good because it's in the Bible, but he's saying that some people do ask that question, so it's appropriate that he should try to answer it.

    For you and me, perhaps he could just as easily ask: "Wheat has been used for millennia and has been the foundation of great civilizations; perhaps we shouldn't be too hasty to conclude that it's bad?"

  • HSL

    5/27/2010 3:36:07 AM |

    Weston A Price also observed that traditional cultures that consumed wheat did so after the wheat was soaked & sprouted or fermented in some way.  These processes are rarely used anymore and certainly not on a large commercial scale so the question isn't simply whether wheat has good or bad effects, but what has been done to it as well.

  • Anonymous

    5/27/2010 4:55:23 AM |

    Would you please clarify what exactly you mean by "we will eat it and see what happens"? Are you going to do a blood test after consuming the bread?

  • Anonymous

    5/27/2010 7:11:03 AM |

    The things one finds in the bible...Check this:

    In  Genesis  , Chapter Four, Eve bears Cain and Abel. 'And Abel was a keeper of sheep, but Cain was a tiller of the ground.' That 'but' in the middle of the sentence is the first clue to disapproval. This disapproval is confirmed by verses three to five. Abel and Cain bring offerings to God: Abel of his sheep and Cain, the fruits of the ground. God, we are told, had respect for Abel's carnivorous offering, but He had no respect for Cain's vegetarian one.

  • Abe

    5/27/2010 12:30:16 PM |

    Thrasy - I believe you're incorrect about the leisure comment.  Hunter/gatherers have been shown to have had far more leisure time than agriculturalists - it's just that they didn't need the trappings of society, since they did not produce anything that required customers.  And the oldest art in the world definitely existed before farming did...

  • DiegoCenteno

    5/27/2010 4:34:40 PM |

    My biggest concern with wheat is we are eating the seed and not the product of the seed. If you take a look and think about what a seed it makes sense.
    The seed is a body shield/ armor to protect the information inside to ensure the plant continues to survice. Now we are taking that very complex material made up of many proteins such as Lectin that they body simply can not digest, so it aggravates the lining of your digestive system.
    Not only does it not get absorb, but it also creates a auto-immune response as well as prevents nutrients the body is trying to absorb.

  • Anonymous

    5/27/2010 4:41:54 PM |

    regardless if you can tolerate ancient strains of wheat over current strains, what is the value add that you can't get from a normal diet of meats, veges, and some fruits eaten seasonally?? what is so special that u think u need to have wheat in ur diet in the first place?

  • girl

    5/27/2010 5:05:13 PM |

    The good and bad aspects of grain as a product of agriculture are thematic in the early Old Testament. Remember that Cain and Abel are one generation out of the Garden of Eden. Adam and Eve were gatherers until the fall; the first sin is plucking the forbidden fruit. At the time of the fall, God is the first to kill an animal, and at the same time, institutes agriculture through a curse upon the ground.

    When Cain kills Abel, it's the first murder. Why can't the farmer and the cowboy be friends? Because the farmer always wins.

    It's grain that saves Jacob's family of herdsmen when Joseph convinces the Egyptian pharaoh to stockpile reserves for times of famine. After the Egyptian enslavement, the Israelites are gatherers during the Exodus, but gathering manna doesn't satisfy them, so God later sends quail. But their goal is the land of milk and honey, an agricultural land -- a land that is only wrested from the Canaanites through violent, genocidal warfare.

    The food cleanliness restrictions of the Mosaic law center on avoiding foods contaminated by the cursed ground (i.e., cloven hoofs exposed an animal to the ground, but chewing cud is cleansing, so cows are okay but not pigs; similar distinctions apply to seafood).

    The association of the adoption of agriculture with war and oppression is an aspect of the story of the fall as well as the Exodus story (even later, King David is a shepherd) -- the writers of the Old Testament side with agricultural development, urbanization, and the advance of civilization, but they also show a deep cultural awareness of the cost.

    The theme never goes away; in the Christian New Testament, Jesus is both the Lamb of God, and the Bread of Life: the sacrifice of Cain as well as the sacrifice of Abel. In short, there many reasons to think that the Biblical story isn't simply that wheat is the best thing since sliced bread, even if Biblical wheat had a better effect on blood sugar.

  • Robert

    5/27/2010 5:40:27 PM |

    Judging by the number and severity of Western diseases ancient Egyptians had, I would not be in any hurry to mimic any of their dietary patterns. That said, I encourage patients to give up the grains altogether. Without any nutritional pros and quite a number of cons, the continued use of grains is only a matter of custom and addiction; neither of which contribute to health or longevity.

    Dr. C

  • Anonymous

    5/27/2010 7:02:10 PM |

    myths are often centered around varying methods of food production and often change as methods change.  A hunter gatherers religious myths will be much different than an agricultural society's myths. I think that bread is mentioned in the bible because it is primarily a collection of myths of an agricultural society.

  • Anonymous

    5/27/2010 7:56:43 PM |

    After decades of worsening hip pain, I stopped eating any wheat about five days ago, and am now pain-free.  Before, I could barely rise from my chair and could barely walk!  Now I rise up quickly and stride off with no thought of restriction.  I had abandoned weekly hard sprints last year due to the hip pain, but I may try again.  I had been eating two slices of sprouted, fermented whole wheat, and about two or three additional servings of other whole wheat products such as muffins, etc, each day.  I dropped the wheat after reading the recent post about a 25-year old man who gave up wheat with similar results.

  • Hoste

    5/27/2010 8:34:27 PM |

    "I don't follow the reasoning that if something is mentioned in the Bible it wouldn't be unhealthy. Lots of things that people ate or practiced in the ancient world were very unhealthy."

    Can you cite any examples staple foods of that time that were unhealthy? Wheat, maybe, but the awful foods of our modern times were not invented yet. I doubt we'd have the Diabetes and heart-disease epidemic if people stuck to a Biblical diet from a young age onward. Lentils too are a food that is mentioned in the Bible and (unlike Wheat) it has a negligible effect on my blood glucose.

    "
    And Jacob gave Esau bread and pottage of lentils. And he did eat and drink, and rose up, and went his way.  Genesis 25:34"

    I wonder if the large amount of fiber in the lentils might have reduced the hyperglycemic effect of the bread.

  • Chuck

    5/28/2010 1:13:40 PM |

    Genesis is one of our oldest history accounts written down from oral history that is much older. In summing up the large trends of the sweep of history as they knew it then, you can see them refer to the primal world and the original tribe in the garden of Eden and supported by nature but man, who decided to live in cities and who embraced knowledge and rules of society and agriculture, was considered to be "cast out" and God condemns them saying that Childbirth would now be painful etc.

    Now match that with what we know about the skeletal degradation of the Egyptians compared to the people a few hundred mile up the Nile still living Paleo and it fits.
    The story of Cain and Abel with God accepting meat and rejecting grains is consistent.

    These are our oldest stories, and as an likely Atheist, I think they correlate in an interesting way.
    http://www.amazon.com/Book-Genesis-Illustrated-R-Crumb/dp/0393061027

  • Murray

    5/28/2010 1:15:17 PM |

    Dr Davis,
    It's sad that you have patients that ask such inane questions. I can't believe there are people living in this century with such outdated belief systems. It must be difficult to deal with.

  • Meredith

    5/28/2010 2:00:00 PM |

    Hi Dr. Davis,  I can't wait to hear about your results from the einkorn grain you plan to make into bread!  I sure do hope it turns out well!  If it does then I will buy some and make bread at home and also turn it into  pastry floor to make deserts since I am a baker as well.

    Looking forward in great anticipation to the results of you experiments!  Thanks so much for your efforts in locating it!!!

    Sincerely,  Meredith

  • Bobber

    5/28/2010 2:26:24 PM |

    As Thrasy pointed out, clearly there were bad effects of the early grains.  The stature changed for one thing.  And longevity for another.  I guess I don't understand the primes of your research here.

  • Joe D

    5/28/2010 3:37:26 PM |

    Ya know what? I like you; you're a scientist/scholar in the classical sense. You dig into an issue and keep digging and searching until you find the answers, no matter how complex or simple.

    In the 1950's-60's the highest compliment we could pay someone was to say "You're cool". Well, you are. hehe. (Don't blush, we know you're old as the hills, just like me.) Keep up the good work Doc.

  • Dr. William Davis

    5/28/2010 5:30:42 PM |

    The question I'd to find answers for are:

    Is all wheat bad, ancient einkorn and emmer included? Or, is modern wheat that emerged in the last 40 years bad, while its predecessors were no worse than other carbohydrates like rice and potatoes?

    Because wheat is a readily-digested carbohydrate source, it is at least on a par with other carbohydrates. The question is where, how, and why it accumulated these other potential adverse characteristics.

  • Anonymous

    5/30/2010 1:24:52 PM |

    well it might not be an issue according to this news about wheat fungus;

    http://www.scientificamerican.com/article.cfm?id=virulent-wheat-fungus-africa

    Trev

  • Andy

    6/2/2010 11:46:16 AM |

    homemade bread? Sounds good!

  • Eli Rogosa

    6/4/2010 11:20:12 PM |

    Fascinating comments. Bill's research is exciting for all.  Thank you Bill!

    Years ago I found wild wheat growing in the Galilee when I was hiking. As an artisan baker and seed-saver, I began collecting, growing and baking with the vast biodiversity of heritage wheats, most of which are on the verge of extinction!

    Modern wheat is bred to be dependent on agrochemicals,  an empty harvest. In contrast, ancient and heritage wheats have evolved over millennia to have high nutritional value, are well-adapted to organic systems, have deep roots that absorb organic nutrients and are tall for good photysynthetic activity.  

    As for baking methods, sprouted, sourdough einkorn bread is delicious and full of life. I offer baking workshops and sell small amts of heritage grains so folks can grow your own.   Folks are welcome to visit our 12 acre seed conservation farm and bakery.   Email: growseed@yahoo.com

    Green Blessings,
    Eli Rogosa

  • Anna

    6/10/2010 3:52:24 PM |

    I used to buy TJ sprouted "flourless" bread, too, thinking it was a good choice for my grade school aged son, who was the only person in our family still eating bread.  I only bought 1 or 2 loaves a month for him, which he would consume within a few days (bread *is* an easy to prepare item for kids), so some weeks he had no bread or wheat at all.   I began to notice there was a marked difference in his behavior and moods when he ate bread vs the weeks when he didn't.  He had difficulty concentrating and quickly became frustrated with difficult tasks (whether schoolwork or something fun, but difficult,  like building a complex Lego structure).  I paid attention to his behavior and moods and other factors and determined the "sprouted" bread was a significant trigger.  

    Nearly all TJs whole grain breads have added gluten to boost dough performance and (rising and softer texture).   Truly fermented sourdough breads (with a long fermentation) are probably a better choice that simply "sprouted" wheat (who knows what "sprouted"  means with commercial bread anyway?), because long fermentation partially breaks down the gluten protein, which is difficult for humans to digest.  Sprouting merely neutralizes the phytate/phytic acid anti-nutrient content, but does nothing to the high gluten content of the wheat and added gluten ingredients (which are added to nearly any "soft" whole wheat bread as a dough enhancer).      

    My son didn't exhibit the negative behaviors when he ate a true sourdough bread that was long fermented  (many sourdoughs are imposters with sourdough flavoring or only weakly fermented for a short time).  I purchased that locally made bread at another "natural food store", not TJs.

    Nonetheless, for the past year+ we are a wheat and gluten-free family now, after my son and I tested positive with Enterolab for anti-gluten antibodies and other indications that gluten was provoking an undesirable immune response (as well as two copies of HLA genes that predispose to gluten intolerance and/or celiac and in my son's case, also fat malabsorption).

    I used to buy a lot of our food from Trader Joe's.  I still shop there regularly, but mostly for simple foods and ingredients for meals I prepare at home with local CSA subscription produce, meat puchased in bulk (or wild game from my sister the hunter), and "back yard"  eggs I buy direct from the producers.  Too much of TJ fare is still highly processed food that is little better than the stuff at the conventional supermarkets.  

    Also, someone mentioned Weston A. Price valuing wheat as a food.  True enough, but again, the point is that wheat has changed dramatically in just the past few decades.  The wheat of Price's time is not what is commonly available now.  Also, Price advocated freshly ground whole wheat.  Is commercial bread likely to be made with freshly ground wheat, or warehoused, fumigated, long-distance trucked stale flour that was ground who-knows when?

  • buy jeans

    11/3/2010 12:26:04 PM |

    think of the healing humans, but not of blogging

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No more cookies

No more cookies

Jeanne enjoyed her Christmas holidays. She especially liked sharing the cookies she made for her grandchildren, sneaking 2 or 3 every day over a couple of weeks. On top of this, she enjoyed the Christmas candy, egg nog, leftover stuffing and cranberry sauce, topped off with a night of nutritional debauchery on New Year's Eve.

Lipid panel in October:

Total cholesterol 146 mg/dl
LDL cholesterol 72 mg/dl
HDL cholesterol 64 mg/dl
Triglycerides 49 mg/dl

Lipid panel in early January:

Total cholesterol 229 mg/dl
LDL cholesterol 141 mg/dl
HDL cholesterol 59 mg/dl
Triglycerides 147 mg/dl


I call the holidays The Annual Wheat and Sugar Frenzy. It's the carbohydrates, especially those from products made of wheat and sucrose, that caused the marked shifts in Jeanne's lipid patterns. Let's take each parameter apart:

--Triglycerides go up due to de novo lipogenesis, liver conversion of carbohydrates into triglycerides. Triglycerides enter the bloodstream as VLDL particles which, in turn, interact with LDL and HDL.

--LDL goes up because carbohydrate exposure increases VLDL, followed by conversion to LDL. The triglyceride-rich LDL created is converted to small LDL particles. Had we measured small LDL changes in Jeanne, we likely would have measured something like an increase (by NMR) from 800 nmol/L to 1600 nmol/L, a carbohydrate effect.

--The increased VLDL also makes HDL triglyceride-rich, cause more rapid degradation of HDL particles. (It also makes them smaller, like LDL.) Given sufficient time (a few more months), HDL would drop into the 40's.

--Total cholesterol changes reflect the composite of the above numbers. (Total cholesterol = LDL cholesterol + HDL cholesterol + Trig/5) (Note that, as HDL drops, so will total cholesterol; that's why this value is worthless and should be ignored.)

So don't be surprised by the above distortions after a period of carbohydrate indulgence. Although your unwitting primary care doc will see such changes as opportunity for Lipitor, it is nothing more than the cascade of effects from a carbohydrate-driven distortion of lipoproteins.

Comments (13) -

  • Michaelf

    1/15/2011 2:59:27 PM |

    Why so many lipid panels?

    Doesn't cholesterol naturally ebb and flow?  Or does it only ebb and flow when we feed it?

    For my taste the second panel is better, other than the HDL.  I'd say she did a good job getting her Cholesterol up over the holidays....

    One of the highlighted lines in my Taubes book is the piece about the lower the cholesterol the higher the incidence of cancer.  Correlation I know but wasnt all the science about cholesterol a well choreographed dance around correlation.

    My father was a cancer patient and a heart patient.  He "naturally" had cholesterol in the 150-160 range and was sick his whole life.  

    IMHO that womans cholesterol is doing what it does to save her life.  Rising to wrangle up the garbage she's dumping down her throat.  

    My fathers never rose to combat the garbage he was dumping down his throat.  What are your thoughts on that?

    If this stuff happens as you say, a fairly simple pattern, then why the differences?

  • Brent

    1/15/2011 3:22:09 PM |

    Dr. Davis - This is off topic for this particular post, but I want to suggest the next blog post for you.  

    First, cudos for keeping this blog informational only, without a hint of commercialism in in.  However, I and perhaps others who read it have seriously considered contacting your office for an appointment to become patients, even though we live in other parts of the country.

    Would you consider posting a topic on the blog of how this could work?  My thoughts are to have necessary tests done in advance of a visit, so that things which normally take 2-3 visits could be accomplished in one. Is a list of these things something that could be determined by a phone interview with your office staff when the appointment is being made?  Can your office arrange for heart scans to be done in Milwaukee in the AM for a PM appointment with you?

    Important question: Is a heart scan at a closer facility (Still 3 hours away) & track your plaque membership (not yet done because I've not had a scan yet) just as good as a visit to your office once a year or would I get additional benefits becoming a patient? i.e., can you rely on scan scoring done by others if I wanted your opinion on the results?

  • Lori Miller

    1/15/2011 4:38:56 PM |

    Two other things all those carbs will do to susceptible people is give them bloating and acid reflux. The posts on that subject have been my two most popular over the past month.

    Re: cholesterol, mine is 140. The total didn't change much when I cut way back on the carbs, but the ratio of HDL:LDL improved. If I'm sick or riddled with cancer, I'm afraid it's escaped my notice. My liver must be making all I need.

  • Anna

    1/15/2011 5:16:45 PM |

    I don't miss the cookies, overly sweet eggnog, and Christmas candy at all, since I revised my diet in early 2004.  I don't gain holiday weight anymore; in fact, some years I lose a couple pounds between Thanksgiving and New Years.

    When I celebrate during the holidays with food, I do indulge (if you can call it, that because my indulgences tend to be nutrient-dense and very satisfying, too) with rich paté, lovely artisan cheeses, fish roe (caviar) and deviled eggs, fresh veggie slices, and bacon-wrapped scallops and shrimp, etc.  I make egg nog that isn't nearly so sweet as well as super easy homemade truffles with very dark chocolate, which has just a small amount of sugar.

  • revelo

    1/15/2011 5:21:24 PM |

    I eat a high carb diet (60% typically, lots of oats, beans, potatoes) and just got back my first test result:

    Cholesterol, Total   152
    Triglycerides         39
    HDL Cholesterol       70
    VLDL Cholesterol calc  8
    LDL Cholesterol calc  74

    I'm lean (16% body fat according to my electronic scale, 12% according to a formula I found on the internet) and get plenty of moderate exercise (yoga and walking). So it appears all those carbs are NOT turning to Triglycerides in me.

    Rather, when I eat carbs, the glucose goes into the muscles. After I finish my last meal for for the day, the body gradually burns off this stored glucose so that the muscles are mostly depleted by the next morning, when I break my nightly fast. Isn't this how the body is supposed to work? I have to disagree with this notion that the muscles can only store a couple of hundred grams of glucose. I think that amount of glucose that can be stored increases in lean people who exercise and routinely eat large amounts of carbs.

  • Michaelfgu

    1/15/2011 5:33:52 PM |

    Brent, You have been reading my mind! Yes, Dr Davis please tell us how best this could best be accomplished as per Brent's comment!

  • Might-o'chondri-AL

    1/15/2011 7:05:52 PM |

    Bit over simplified; unless holiday indulgences (prior to patient's Jan. lab test) were made rich tasting without using any fat &/or cholesterol content
    (and wasn't over eating, nor lazing around).

    Clinic patients are presumably often already suffering with metabolic syndrome. An absolute admonishment is going to become rote patient visit after patient visit.

    Is a prevention strategy for everyone, or just the sedentary and geneticly pre-disposed? One's adult health may be doing well with a contrary diet. By middle age Doc's restrictions might be a pre-emptive strategy for countering metabolic changes to come.

  • shutchings

    1/15/2011 8:26:23 PM |

    So if Jeanne returns to restricting sugar and flour from her diet in January, her profile improves.  Did she leave lasting damage?  Is the risk only that disease will develop during her holiday relapse?

  • Dr. William Davis

    1/15/2011 10:26:20 PM |

    Anna--

    I love the gourmet-bent you've taken with your diet. That's a great direction to go.


    Brent and Michael--

    You can call my office at 414-456-1123 to arrange an out-of-town visit. Alternatively, call the same number to arrange a video teleconference to review lipoproteins or your coronary prevention program. (Video teleconference is not covered by insurance, however.)

  • Anonymous

    1/15/2011 10:54:00 PM |

    I treat so much cholesterol in my patients with bio-identical hormone therapy in addition to nutritional biochemistry / blood test to help rebuild the adrenals and help the body convert the excess cholesterol into the LDL and then into the next hormone called pregnenolone. Most people who have high cholesterol have silent adrenal dysfunctions/ burn out / PTSD whereby the cholesterol does'nt convert into the next hormone.
    Most MD's won't look to check the adrenal and sex hormones in conjunction with and cholesterol test.
    What an oversight eh !

  • Marc

    1/16/2011 7:57:03 PM |

    I used to have very lows trigs (35-45 range), I start eating high fat low carb & 6 month later my trig went up to 79.

    Carbs = elevated trigs??
    Not for me.

      My lowest trigs were in my vegetarian days eating whole wheat, oats, beans etc...when I started upping the fats & meat my trigs went up (even when cutting down wheat, which I dont eat it anymore)

    Could you provide an answer to this mr Davis?

  • Sophie

    1/24/2011 10:49:24 AM |

    I agree that holidays is a season to increase weight gain. Uncontrollable eating can risk our health. There is no any guarantee how long can our body take the cholesterol we're feeding. So proper self-discipline is needed. Low carbohydrate diet is the best diet for those who want to lose weight especially for diabetic people.

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