More Andy Kessler

15. September 2007 William Davis (2)


I can't help but quote a few more passages from Andy Kessler's irreverent but nonetheless insightful book, The End of Medicine. I find his quotes irresistible because I believe that he is (unintentionally) describing precisely what we are doing in the Track Your Plaque program:


"Maybe the jig is up on the cholesterol conspiracy. Any real scientist running studies on cholesterol drugs would not just check to see if participants in the study had a heart attack. You would scan, check for plaque, provide drugs, scan again, see if the plaque increased or decreased, repeat. Instead, we have a multibillion-dollar statin business based on vagaries and deception."


Kessler cuts to the chase on that one. Except we do it with a lot of things beyond drugs.


"256-slice scanners, faster than your heartbeat, just might be the magic pill of diagnosis. It's as if doctors will be saying I was blind before i could see. . . Six blind doctors feeling around an elephant and describing a wall, spear, snake, tree, fan and a rope. Looking for clues in all the wrong places. Measuring cholesterol and blood pressure is like reading the outside temperature and humidity from inside your house and guessing if it's raining. Open the window, stick your goddamn hand outside and know for sure.

How much do these scans have to cost to become widespread? $500? $100? $20? It almost doesn't matter. The savings come over time. Spread the R&D over millions and you get scale. It works.

. . . what if the spending was on detection instead of intervention? With some breakthrough, the economic consequences can be staggering. if medicine as we know it is replaced by health monitoring, hmmmm . . ."


Get beyond his humor and you see that Kessler shares our appreciation of the futility of cholesterol testing for predicting your heart's future. He advocates early detection, no surprise.


And lastly:

"I go to conferences about wikis and Wi-Fis, podcasts and blogs, and I always leave with an empty feeling, bored to tears. It's all great stuff, but technology somehow seems gripped with incrementalism. It's all really neat and cool and wow, but somehow predictable. Gee, in five years we'll have cheap terabyte drives so that we can, what, watch Simpsons reruns and shop more efficiently?

Forget that. It's all about taking control. One by one, industries are being democratized. Power is shifting from producers and service providers to users. . . Power to the people--everywhere except medicine . . . With the right tools, we'll all take control."


Amen. He's right. Taking control of health care out of the hands of the doctors and putting it in your own hands. But you are going to need better tools, more information, and guidance.

I couldn't have said it any better.
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Comments (2) -

  • Rich

    9/17/2007 12:44:00 AM |

    Dr. Davis:
    Thanks for highlighting this interesting book. I too was impressed with many of his insights. The more Kesslers we have out there getting the buzz going, the more that solution-seekers will find enlightened approaches, of which Dr. Willaim Davis and the TYP program are the clear leaders.
    -Rich

  • Dr. Davis

    9/17/2007 12:18:00 PM |

    Thanks, Rich.

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When MIGHT statins be helpful?

When MIGHT statins be helpful?

7. April 2011 William Davis (17)
I spend a lot of my day bashing statin drugs and helping people get rid of them.

But are there instances in which statin drugs do indeed provide real advantage? If someone follows the diet I've articulated in these posts and in the Track Your Plaque program, supplements omega-3 fatty acids and vitamin D, normalizes thyroid measures, and identifies and corrects hidden genetic sources of cardiovascular risk (e.g., Lp(a)), then are there any people who obtain incremental benefit from use of a statin drug?

I believe there are some groups of people who do indeed do better with statin drugs. These include:

Apoprotein E4 homozygotes

Apoprotein E2 homozygotes

Familial combined hyperlipidemia (apoprotein B overproduction and/or defective degradation)

Cholesteryl ester transfer protein homozygotes (though occasionally manageable strictly with diet)

Familial heterozygous hypercholesterolemia, familial homozygous hypercholesterolemia

Other rare variants, e.g., apo B and C variants

The vast majority of people now taking statin drugs do NOT have the above genetic diagnoses. The majority either have increased LDL from the absurd "cut your fat, eat more healthy whole grains" diet that introduces grotesque distortions into metabolism (like skyrocketing apo B/VLDL and small LDL particles) or have misleading calculated LDL cholesterol values (since conventional LDL is calculated, not measured).

As time passes, we are witnessing more and more people slow, stop, or reverse coronary plaque using no statin drugs.

Like antibiotics and other drugs, there may be an appropriate time and situation in which they are helpful, but not for every sneeze, runny nose, or chill. Same with statin drugs: There may be an occasional person who, for genetically-determined reasons, is unable to, for example, clear postprandial (after-eating) lipoproteins from the bloodstream and thereby develops coronary atherosclerotic plaque and heart attack at age 40. But these people are the exception.
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Comments (17) -

  • Might-o'chondri-AL

    4/8/2011 12:21:11 AM |

    I don't know how individuals with mis-sense SNP for gluco-kinase regulatory protein (ex: GCKR rs780094) fit into the pattern. They get more liver steatosis (fat build up) with attendant elevated LDL and triglycerides, despite less fasting glucose and less fasting insulin numbers; while their 2 hour blood glucose runs high (GCK gene is very determinate of 2 hour glucose levels), showing down-regulation of the homeostatic model for Beta cell function (HOMA-B).

    Normally GCKR regulates triglycerides and determines persons glycemic traits by governing how glucose is stored and how it is dispersed. GCKR also geneticly regulates the availablility of substrate used for de-novo lipo-genesis.

    Gene SNP of protein phosphatase 1regulatory (inhibitor) subunit 3 B (PP1R3B rs4240624) manifests increased liver steatosis  and both elevated LDL and elevated HDL; with low fasting glucose. PPP1R3B codes for controling protein and modulates the break down of glycogen (storage glucose moleccule).

    Together PPP1R3B and GCKR are integral to blood sugar dynamics and the levels of lipids in circulation.

    If Doc's regimen counter-balances individual missense genetic workings, like those above, then that is impressive corrrection achieved through intervention . I presume for people with liver steatosis missense mutations (ie:  SNPs like above) elevated LDL treatment using statins would be bad for their liver.

  • Dr. John

    4/8/2011 1:10:14 AM |

    Statins might be helpful if you have bacterial pneumonia:
    http://www.bmj.com/content/342/bmj.d1907.extract?sid=f762e55c-1a0b-4ef3-81c4-f31cc472a372

    That's because the rapidly growing pneumococcal bacteria are very susceptible to HMG-CoA reductase inhibitors (statins). The bacteria have similar cholesterol compounds (hopanoids) in their membranes, essential for their membrane function. With the statins blocking the hopanoids, they die....very quickly.

    All bacteria have a mevalonate pathway.  The HMG-CoA reductase enzyme is inhibited in bacteria and are VERY toxic to bacteria. So thus, you have a "statin-benefit" because it kills the bacteria, before it kills or injures the patient.

    Statins can essentially inhibit biological life forms.
    Dr. John

  • Dr. William Davis

    4/8/2011 1:11:01 AM |

    HI, Might--

    As usual, you've come out of left field with a totally unexpected issue!

    I'm not sure how this genetic variant fits into this argument. It is, to my knowledge, a very rare diagnosis.

  • Might-o'chondri-AL

    4/8/2011 6:40:15 PM |

    I don't envy Doc trying to sort out who needs what treatment. Genetic high cholesterol entails over 50 amino acid variations out the jumble of 692 amino acids assembled into relevant complexes.

    Pro-protein convertase subtilisin/kexin-9 (PCSK9)is involved in familiar hyper-cholestemia. Those who make too much PCSK9 (in the liver and small intestine) rapidly degrade their cholesterol receptors and can't pluck much LDL out of circulation; plasma cholesterol rises.

    Should one's genetics foster making too little PCSK9, then cholesterol receptors don't degrade. This promptly shunts cholesterol into the liver lysosome (an organelle inside a cell)for break down; thus they  measure low cholesterol in the blood.

    I speculate Doc's diet, in "normal" genetic people up-regulates cholesterol reception. Which means his program has the epigenetic effect (from diet dynamics) on "normal" liver/small intestine genes in a way that less PCSK9 is expressed

    The caucasian anglo-saxon PCSK9 D374Y mutation causes 4 times the normal cholesterol in patients. Their risk factor for pre-mature death is 10 years earlier than even more benign PCSK9 mutations; so Detective Doc Davis is willing to prescribe statins for people like them.

  • Anonymous

    4/9/2011 2:59:55 AM |

    I might be one of these poor souls.

    Eating a strict diet, one Dr Davis would be very proud of... I'm lean as can be, feel great, but my cholesterol shot through roof (while HDL dropped).    

    Frown

  • Might-o'chondri-AL

    4/9/2011 4:53:48 AM |

    Hi Annon.,
    Internet self-diagnosing shouldn't replace a good medical consultant. My comments are not qualified medical assesments; am a layman.  

    My favorite cousin has had her cholesterol testing well over 300for several decades, and is now in her late 70s. Like Doc chided me earlier, there are "genetic variant" being "very rare diagnosis."

  • Lucy

    4/9/2011 11:47:29 AM |

    What do you think about KIF6?   I was tested and found to be a non-carrier, and I was subsequently told that statins would likely not benefit me as much as diet/lifestyle changes (I'm ApoE 3/4 as well).  Does that also mean that niacin would not help?

  • Anonymous

    4/9/2011 12:52:56 PM |

    To say the least, I am very disappointed in Dr. Davis' stance regarding ApoE 4 & statins. There is abundant evidence suggesting statins are counterproductive to brain health, which is much more pronounced in Apo E4's who are already at high risk for alzheimers disease. It isn't only about lipids, there is a larger picture to consider. The brain requires cholesterol.  Also, high cholesterol levels are associated with longevity in the elderly.

  • Might-o'chondri-AL

    4/9/2011 7:44:42 PM |

    Alzheimers and the relationship of ApoE4 is different than other ApoE isoforms (like ApoE 2 & 3). In normal people ApoE is integral to clearing amyloid Beta from the brain; it forms a conjugate (ApoE/AmyloidB)that is moved out across the brain blood barrier by LRP-1 (lipo-protein related protein 1).

    ApoE4 is acted upon (cleaved) in brain neurons, yielding rump fragments with unique Carbon- terminals; and,  ApoE4 degrades easier than ApoE 2 &/or 3. These ApoE4 fragments, when in a brain cell's cytosol, influence that cell's mitochondria hydro-phobic pattern of lipid binding.

    The ApoE4 fragment properties  do 2 unwanted things to the brain cell mitochondria. It decreases the mitochondria ability to perform tasks involved in glycolysis (glucose energy). And is antagonistic to PPAR gamma; PPAR gamma is what would otherwise promote adequate mitochondria bio-genesis.

    ALzheimer lesions show higher amounts when measured in individuals with concurrent Type II diabetes and the ApoE4 isoform. The ratio of insulin in the cerebro-spinal fluid to the amount of insulin in the blood also shows a difference depending on the specific ApoE geno-type.

    Alzheimer brains are using less glucose; patients show less receptors for insulin-like growth factor and insulin, as well as less insulin degrading enzymes. It is postulated that depending on the individual's ApoE variation there is a different amyloid Beta response to brain insulin.

    Normally one goes from glucose intolerance to hyperglycemia and then elevated insulin circulating as become diabetic. Yet experiments show that giving insulin improves diabetic neuro-pathy in the brain; it seems to be a way peripheral insulin resistance causes different tissues to respond.

    In Alzheimer experiments with supplemental insulin (nasal, etc.)administration cognitive function improved. This response was more significant in those with the ApoE4 allele (compared to other ApoE types with Alzheimers, who also improved cognition ).

    So, the Alzheimer enigma seems to involve energy format dynamics for ApoE isoforms more than specific levels of cholesterol. This is not a comment on ApoE homo-zygote genes relationship to cardio-vascular risk factors, or brain lipid metabolism.

  • homertobias

    4/11/2011 3:36:34 PM |

    Mito
    You sound like Suzanne Craft.  I like her work.

  • Medicomp INC.

    4/12/2011 4:06:52 PM |

    You make an excellent point here:

    ...eat more healthy whole grains" diet that introduces grotesque distortions into metabolism

    We are encouraged by transient sources that this is almost always the best alternative for other fattening foods, yet people never really delve deep into the cons of this transition either.  It truly does take dedication to be well-informed about the dietary changes you make in your lifestyle.

  • Anne

    9/18/2011 5:58:38 PM |

    I had a body scan a few years ago, and my plaque count was 1050, when they told me that 150 was considered high, I thought  I would implode at any moment, I went to a lot of different cardiologists and had all kinds of tests and they said to exercise and not  worry about the plaque. One Dr. put me on lipitor and 3 days later I could hardly walk from the muscle pain, he told me to stop taking it and I tried niacin and red rice with the same results. I don't know how to reduce the plaque, the Dr's all said it was hereditary . I am open to any advice.

  • Dr. William Davis

    9/20/2011 12:43:37 PM |

    Hi, Anne--

    Note that this is the blog that accompanies the Track Your Plaque program that focuses on just this issue. It means 1) identify all causes of plaque, then 2) correct them, preferably using natural means.

  • JK

    10/30/2011 4:52:34 PM |

    Dr. Davis,
    I don't know if you have already addressed this topic in prior posts but allow me to suggest that in lieu of consuming statin drugs, even for the aforementioned outliers, it is possible to achieve reduced LDL cholesterol and increased HDL cholesterol by supplementing with magnesium.
    (All the ensuing statements below I humbly attribute to Mildred S. Seelig and Andrea Rosanoff, "The Magnesium Factor," pages 139-147.)
    1. Statins (Lipitor, Zocor, Baycol, Mevacor, etc.) are designed to lower cholesterol by inhibiting HMG-CoA reductase, which is the enzyme responsible for the synthesis of cholesterol.
    2. These drugs when studied, not only lower cholesterol, but also reduce total mortality, cardiac mortality, the total incidence of heart attacks, angina, and other non-fatal cardiac events. (p.140.)
    3. They also made the blood platelets less sticky, they slowed the progression of plaques and stabilized them, and they reduced inflammation in the blood vessel tissue. (ibid.)
    All these results, and more, Seelig further informs the reader, are a result of reduced mevalonate in the cells, which is the direct result of an inhibited HMG-CoA reductase, which is the enzyme that statins are designed to inhibit.
    Now stay with me for a second because here is where it gets interesting.
    4. Magnesium is a natural inhibitor of HMG-CoA reductase. Here magnesium and statins are comparable (p. 141.)
    5. Magnesium also acts on two enzymes, phosphatase reductase and phosphohydrolase which reactivate HMG-CoA reductase. By its effects on these enzymes, which contrast one another, magnesium can either stop cholesterol formation or allow it to continue depending on the body's needs.
    6. Magnesium also activates another enzyme, lecithin cholesterol acyltransferase (LCAT) which, through this action, converts LDL cholesterol to HDL cholesterol -- increasing HDL and reducing LDL.  (Statins cannot do this.)
    In the interest of brevity, I'll conclude by saying that whereas statins are known to reduce cholesterol and perhaps achieve other cardiovascular benefits, this is due in large part to their suppression of mevalonate, brought about by their inhibition of HMG-CoA reductase.
    In contrast, magnesium not only inhibits HMG-CoA reductase, meaning that it would achieve the same results as statins in "1, 2, and 3 above," but it also converts LDL cholesterol to HDL cholesterol, achieved by its activation of LCAT, which is something that statins do less consistently.
    Further, instead of poisoning HMG-CoA reductase as statins do, magnesium inhibits it in ways that can be reactivated by other (magnesium dependent) enzymes so that the body can naturally make the mevalonate and cholesterol it needs.
    This is important because vitamin D is synthesized from cholesterol (when using the sun's rays), and cholesterol is also the precursor to testosterone, estrogen, and other steroids.
    So I encourage you to consider using Magnesium for those Apo-B cases that cannot be addressed by carbohydrate restricted diets.

  • JK

    10/30/2011 4:58:10 PM |

    Sorry, meant to say Apo-E cases.

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The American Heart Association has a PR problem

The American Heart Association has a PR problem

2. March 2011 William Davis (17)
The results of the latest Heart Scan Blog poll are in. The poll was prompted by yet another observation that the American Heart Association diet is a destructive diet that, in this case, made a monkey fat.

Because I am skeptical of "official" organizations that purport to provide health advice, particularly nutritional advice, I thought this poll might provide some interesting feedback.

I asked:

The American Heart Association is an organization that:

The responses:
Tries to maintain the procedural and medication status quo to benefit the medical system and pharmaceutical industry for money
240 (64%)

Doesn't know its ass from a hole in the ground
121 (32%)

Is generally helpful but is misguided in some of its advice
79 (21%)

Accomplishes tremendous good and you people are nuts
6 (1%)


Worrisome. Now, perhaps the people reading this blog are a skeptical bunch. Or perhaps they are better informed.

Nonetheless, one thing is clear: The American Heart Association (and possibly other organizations like the American Diabetes Association and USDA) have a serious PR problem. They are facing an increasingly critical and skeptical public.

Just telling people to "cut the fat and cholesterol" is beginning to fall on deaf ears. After all, the advice to cut fat, cut saturated fat, cut cholesterol and increase consumption of "healthy whole grains" in 1985 began the upward ascent of body weight and diabetes in the American public.

Believe it or not, my vote would be for something between choices 1 and 3. I believe that the American Heart Association achieves a lot of good. But I also believe that there are forces within organizations that are there to serve their own agendas. In this case, I believe there is a substantial push to maintain the procedural and medication status quo, the "treatments" that generate the most generous revenues.

I believe that I will forward these poll results to the marketing people at the American Heart Association. That'll be interesting!
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Comments (17) -

  • Tuck

    3/1/2011 11:46:38 PM |

    Did the monkeys get to vote? ;)

  • reikime

    3/2/2011 12:11:04 AM |

    I would LOVE to read a response from the AHA!

  • Anonymous

    3/2/2011 12:15:46 AM |

    Come on Doc, these statistics are obviously bias. That's like asking the readers of an vegan/animal-rights blog, "Do you think meat is murder?" and trying to transpose the results as being all encompassing.

  • Rick

    3/2/2011 1:32:30 AM |

    I have to agree with Anonymous here. Nothing surprising in the fact that the majority of readers of a blog that regularly criticizes the AHA have a critical stance towards the AHA.

    Move along, these are not the droids you're looking for.

  • Harold

    3/2/2011 2:34:28 AM |

    I think you are being a bit generous to them. I certainly agree about the ADA. They seem to be in it for the money and they are getting plenty of it from drug companies. I am a physician and a diabetic and if I followed their advice my blood sugars would be out of control. As it is I am on a very low carb life style and in excellent control!
    Thanks for your posts.

  • Real Food RD

    3/2/2011 4:13:16 AM |

    certainly it's not a random sample, but nonetheless, I would have to agree that all of these organizations and government agencies are losing credibility with the public and fast.  As a health professional myself, I can only hope my colleagues may begin to soften their stance before our credibility is completely shot with the public.

  • Anonymous

    3/2/2011 1:14:17 PM |

    Tuck, the monkeys must make up the extra 18%.

    Doctor, I truly appreciate your blog, read it religiously and follow much of your advice, but before forwarding to the AHA, you might want to check the numbers.

  • renegadediabetic

    3/2/2011 1:59:02 PM |

    I think the AHA has done a lot of good in the treatment of heart attacks and keeping people alive.  However, I was thinking mainly of the "prevention" side when I voted "Tries to maintain the procedural and medication..."

    Likewise, the ADA and other diabetes orgs are no doubt doing some good research into causes and prevention of type 1 diabetes, but their nutritional approach is a disaster.  Again, just maintaining the status quo for so long that they would be afraid to admit they were wrong if they finally did see the light.

  • Might-o'chondri-AL

    3/2/2011 5:24:44 PM |

    Their heart is in the right place. In another 40 years scientists will be deriding the intriguing bloggosphere theories.

  • reikime

    3/2/2011 5:53:19 PM |

    I just dislike these organizations jumping on a bandwagon d'jour, and trying to apply it to everyone blanketly.

    People are not a " one size fits all " species!  When will the AHA, ADA, etc, stop aligning with big agriculture and pharma and think of individual people and their specific needs?  Is that just a pipe dream?

  • Tara

    3/2/2011 11:20:06 PM |

    Real Food RD, I'm with you!

    I was going to throw the other ADA in that stack too.  I've let them know several times how I feel about their corporate sponsors and partners.  Disgusted.

  • Brian Vickerman

    3/3/2011 2:12:54 AM |

    To be honest... after promoting such a lifestyle for so many years... wouldn't a sudden change in opinion open them to law suits?

    How can they respond to that?

  • reikime

    3/3/2011 3:14:54 AM |

    Great point Brian. I hadn't even thought of it.

    Wouldn't it be the same with any condition that current medical research might up- end the treatment protocols?
    ie..remember when patients with gastric ulcers were advised to drink milk and cream and avoid spicy foods etc?  
    Then enter H. Pylori...albeit some 10 years after published studies and much derision from U.S. gastros. Treatment standards changed dramatically. Never heard of lawsuits over that.

  • Anonymous

    3/3/2011 3:16:21 AM |

    Could people leave more than one response?  The percentages add up to more than a hundred.
    Bob

  • Bob

    3/3/2011 3:27:57 AM |

    OK, I did the math.  Apparently about 375 unique respondents, with 70 or so choosing more than one answer.

  • mongander

    3/3/2011 4:05:38 AM |

    My impression is that 'disease associations' exist primarily to ensure their continued existance.

    I have heard good reports on the Muscular Distrophy Assoc.

  • Anonymous

    3/3/2011 8:37:54 PM |

    Dr D, I don't think the AHA is sending you a Christmas card this year

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Small LDL: Simple vs. complex carbohydrates

Small LDL: Simple vs. complex carbohydrates

4. May 2010 William Davis (17)
Joseph is a whip-smart corporate attorney, but one who accepts advice at his own pace. He likes to explore and consider each step of the advice I give him.

Starting (NMR) lipoprotein panel on no treatment or diet change:

LDL particle number 2620 nmol/L (which I would equate to 262 mg/dl LDL cholesterol)
Small LDL 2331 nmol/L--representing 89% of LDL particle number, a severe dominance of small LDL

I advised him to eliminate wheat, cornstarch, and sugars, while limiting other carbohydrate sources, as well. Joseph didn't like this idea very much, concerned that it would be impractical, given his busy schedule. He also did a lot of reading of the sort that suggested that replacing white flour with whole grains provided health advantages. So that's what he did: Replaced all sugar and refined flour products with whole grains, but did not restrict his intake of grains.

Next lipoprotein panel with whole grains replacing white refined flour:

LDL particle number 2451 nmol/L
Small LDL 1998 nmol/L--representing 81.5% of LDL particle number.

In other words, replacing white flour products with whole grain products reduced small LDL by 14%--a modest improvement, but hardly great.

I explained to Joseph that any grain, complex, refined, or simple--will, just like other sugars and carbohydrates, still provoke small LDL. Given the severity of his patterns, I suggested trying again, this time with full elimination of grains.

Next lipoprotein panel with elimination of whole grains:

LDL particle number 1320 nmol/L
Small LDL 646 nmol/L--48.9% of total LDL particle number, but a much lower absolute number, a reduction of 67.6%.

This is typical of the LDL responses I see with elimination of wheat products on the background of an overall carbohydrate restriction: Big drops in precisely measured LDL as LDL particle number (i.e., an actual count of LDL particles, not LDL cholesterol) and big drops in the number of small LDL particles.

You might say that wheat elimination and limitation of carbohydrate intake can yield statin-like values . . . without the statin.
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Comments (17) -

  • medeldist

    5/4/2010 8:26:52 AM |

    Interesting. I'm looking through my screening results (I'm in Europe) and there is no mention of LDL, but I have two other values, P-Apo A1 (1.77 g/L) and P-Apo B (1.09 g/L). Is there a relation between these and LDL/HDL?

  • tom

    5/4/2010 1:02:12 PM |

    It is good to have positive feedback via blood testing to show changes one is making to their body. I wonder what is a good interval between tests to show cholesterol changes?

    On a similar note, I have been eating low carb for 4 months using my blood meter to reduce both blood sugars and insulin resistance for pre-diabetes. I am still thinking about your slo-niacin suggestions and how the bad increase in blood sugar and insulin resistance vs the good cholesterol effects would affect me. I am waiting to get results from my first NMR lipoprofile to make a decision.

  • Ned Kock

    5/4/2010 3:49:58 PM |

    Indeed, restricting carbohydrates is more similar to taking statins than many people think. With the advantage that it does not have the side effects of statins, and is not costly at all.

    Many people do not know that carbohydrates stimulate the production of VLDL, suppressing the production of free fatty acids and ketones. Our liver then pumps out small VLDL particles at a high rate, and these end up as small-dense LDL particles. The potentially atherogenic type, in the presence of other factors (e.g., chronic inflammation).

    Low carbohydrate dieting stimulates the production and release of free fatty acids and ketones, suppressing the production of VLDL. Our liver then pumps fewer VLDL particles into the bloodstream (since FFAs and ketones are already doing a good job at feeding muscle and brain tissue), and when it does it lets out big VLDL particles, which end up as large-fluffy LDL particles prior to re-absorption by the liver.

    If anyone wants to see what these particles look like, the figure in the post below may be useful:

    http://healthcorrelator.blogspot.com/2010/02/large-ldl-and-small-hdl-particles-best.html

    Ketones are not shown because they are water soluble:

    http://healthcorrelator.blogspot.com/2010/04/ketones-and-ketosis-physiological-and.html

  • Anonymous

    5/4/2010 4:01:31 PM |

    Do you have any comments on oatmeal? I've noticed that for me personally, it doesn't significantly spike my blood sugar, and I've heard a lot about how oatmeal can improve cholesterol -- but of course this is often just focused on total cholesterol or general LDL amount.

  • Anonymous

    5/4/2010 5:05:47 PM |

    Hi Dr. Davis
    I'm really hoping to hear your opinion on this study:
    http://www.pnas.org/content/early/2009/08/21/0907995106.abstract?sid=

  • Dr. William Davis

    5/5/2010 1:38:40 AM |

    Hear, hear, Ned!

    I agree: Carbohydrate restriction is the unsung hero of VLDL and LDL reduction, though actual measurements are required to appreciate this effect.

  • Dr. William Davis

    5/5/2010 1:40:35 AM |

    Oatmeal anonymous--

    It's all about individualizing your food choices.

    Checking postprandial blood sugars is an excellent way to know if these issues apply to you or not, or to what degree.

  • Jeff

    5/5/2010 11:56:35 AM |

    What are your thoughts on Amlamax for the reduction of LDL?

  • Lucy

    5/5/2010 3:41:11 PM |

    OK, so here's my question... I am young (late twenties), thin (BMI: <20.2), and active (run, bike).  However, I still have almost all small, dense LDL.   I'm an ApoE 3/4, which I understand means I need to limit the amount of fat in my diet.  However, if grains also contribute to small LDL, what am I supposed to eat?   I don't eat much wheat as it is (my husband is celiac), but I do enjoy oats, rice, and the occassional piece of bread when we eat out, etc.  Would cutting all grains from my diet and living on only vegetables, some fruits, and lean meats be acceptable? Sounds like a boring and sad diet...

  • pjnoir

    5/5/2010 9:58:04 PM |

    Oatmeal reducing Cholestral is a joke. If I eat Oatmeal for breakfast( even a 1/2 cup) my BG numbers stay HIGH all day. Oatmeal is not a food I have on my breakfast table ever.

  • Anonymous

    5/9/2010 3:08:36 PM |

    Over what time period were these
    panels taken or in other words, how many weeks or months in-between test?
    Love the blog!
    CB

  • Conrad

    5/11/2010 2:28:43 PM |

    Who knows where to get an (NMR) lipoprotein panel in Toronto/Mississauga?

  • holym

    5/12/2010 6:36:06 PM |

    You say, "LDL particle number 2620 nmol/L (which I would equate to 262 mg/dl LDL cholesterol)"

    Why would you equate 2620 nmol/L to 262 mg/dl? The conversion factor given at http://jama.ama-assn.org/content/vol295/issue1/images/data/103/DC6/JAMA_auinst_si.dtl is roughly 1mmol/l = 39mg/dl.

  • Dr. William Davis

    5/12/2010 10:21:43 PM |

    Holym--

    I believe you are confusing Friedewald calculated LDL in nmol/L and LDL particle number--two entirely different things.

    My simple conversion is meant to yield a "Friedewald-like" LDL cholesterol from LDL particle number.

  • Dolly.G

    5/14/2010 3:34:18 AM |

    I do agree!!

  • Anonymous

    5/22/2010 11:06:37 PM |

    Where can I find the peer reviewed research upon which you base your advice? Thanks

  • David M Gordon

    6/15/2010 1:18:55 AM |

    My lab results are in, and they are,  on balance, not much improved. I think.

    The changes I effected since my prior panel panel 3 months ago:
    1) Lost 20 lbs
    2) Ingest 6,000mg of fish oil for a total of 1200mg (total) of DHA and EPA/day
    3) Ingest 500mg of Slo-Niacin/day (with 125oz of water/day)
    4) Ingest 6,000mg of Vitamin D/day (Changed to the proper Vitamin D soy capsule from the powdered tablet)
    5) Eat a large handful of almonds/day
    6) Exercise hard (weight training and cardio intervals for a minimum of 90 minutes/day).

    The (worsened) numbers:
    1) Total Cholesterol: 269 (from 267)
    2) LDL Cholesterol: 186 (from 175)

    The (improved) numbers:
    3) Triglycerides: 201 (from 280)
    4) HDL Cholesterol: 43 (from 36)

    Unfair to ask you, I know, but I am frustrated. What do I do wrong? What can I do more? I am VERY reluctant to take a statin, as I have tried many, all with terrible side-effects. And, fwiw, I started today on my wheat-free diet.

    Thank you for your guidance,
    David

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Calling all super-duper weight losers!

Calling all super-duper weight losers!

9. July 2011 William Davis (12)





Have you lost at least 1/2 your weight, e.g., 300 lbs down to 150 lbs? If you have, I have a major national magazine editor looking to talk to you.

If you have gone wheat-free and/or followed the dietary advice offered here in The Heart Scan Blog or through the Track Your Plaque program and would be willing to share your story, please let me know by commenting below. While losing half your body weight is not necessarily a requirement for health, it makes an incredibly inspiring story for others.

If we use your story, I will set aside a copy of my soon-to-be-released book, Wheat Belly.

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Comments (12) -

  • John Phillip

    7/9/2011 3:48:38 PM |

    Hi Dr. Davis:

    I have been a follower of your blog for a number of years now.  It ha been an inspiration as i have fought to regain my health over the past 9 years.

    After suffering a mild MI in 2002 and being diagnosed as diabetic, I was placed on the standard allopathic protocol of statins, Ace inhibitors/beta blockers and low-fat diet. Needless to say, they didn't help me.  I did manage to lose weight, but blood sugar and blood pressure remained problematic.

    In 2005, I realized from doing extensive research on sites such as yours that eliminating all refined carbs, sugars and trans fats was the key to my success. I have lost 180 pounds and maintain a weight of 165 lbs. with a height of 6' 1". I am 53 years old, and definitely feel younger than I was in my 30's.

    I supplement with fish oil and DHA, vitamin D and a number of other nutrients to provide a baseline of building blocks to help my cells regenerate and avoid chronic disease. Eliminating wheat is the most significant element in regaining my health and dramatically lowering risk form a second heart attack.

    I would enjoy discussing my journey, and thank you for all your dedicated work.

  • NoGlutenEver

    7/10/2011 9:45:59 PM |

    Any updated information on heartscans in people who've already had a bypass, a 4x bypass?  Would a scan yield any useful info?

  • Justin Willoughby

    7/11/2011 8:08:11 PM |

    I am new to your website, and I am interested in it. I once weighed 800 pounds, and am now down to 215 pounds. You can check my website for more information. www.justinwilloughby.com

  • Dr. William Davis

    7/12/2011 12:24:42 PM |

    Hi, John--

    Fabulous results!
    Could you provide contact info here: http://typ.trackyourplaque.com/contact.aspx
    I appreciate your help on this. It will make a fascinating story!

  • Dr. William Davis

    7/12/2011 12:26:45 PM |

    Hi, Justin--

    Incredible!
    However, I am looking for stories in which elimination of wheat was the principal strategy. Is this what you did to lose the 600 lbs (!!!)?

  • Might-o'chondri-AL

    7/14/2011 4:40:07 AM |

    All I get is "500 Internal Server Error" when try to comment.

  • Might-o'chondri-AL

    7/14/2011 4:43:40 AM |

    Web site server is no good at all ... previous thread rejected my comments more than twice on several days, so I tried this thread and post came right through.
    Doc - you are not getting your moneys worth despite your page looking pretty .

  • Might-o'chondri-AL

    7/14/2011 4:53:20 AM |

    Just went back to previous thread to try and post since see 2 above went through and got the same "server error"  boot a couple of minutes after my 2 above. Something not working right here.

  • Dr. William Davis

    7/15/2011 1:48:11 PM |

    Sorry, Might. Still working out glitches.
    I will discuss with IT people.

  • Felix Jaber

    7/17/2011 7:49:41 PM |

    Dr. Davis
    I have been batling weight for my whole life and by the age of 45 I weighted 290 lbs and was a heavy drinker until I quited drinking and started exercising with a low fat mid protein and high carb diet and due to the fact that I stoped drinking I started to loose weight also as the weight droped I exerciced more till the point that I started to train for a half Ironman there is where the fat lost stoped and I plateaued at 230 lbs and no matter how hard I trained I couldnt lose more and aproaching the half Ironman I even gained weight so shortly after finishing the race my coach sugested me to visit your blog and sent me the link of your post on wheat belly,
    that was like the turning poin of my life and shortly I was following your advices and trying to live a more primal life and practically becoming a caveman the results I lost 60 more pounds and gained a vitality like I have never experienced today after 6 more half Ironman races and 1 full Ironman I try to live wheat free and visit regularly your blog not to mention that I follow most of your blog roll!!!
    Everytime that I find myself eating wheat I feel terrible my inmune function suffers and I almost get sick I say almost as I haven't get sick in almost 2 yers that I have been following a mostly primal life and as I feel a sickness coming I just get back to being wheat free and low carb all around!!

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    8/27/2011 4:37:40 AM |

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