Almonds are the new wheat

Once you eliminate this genetically-altered Frankengrain called modern wheat, the diet should center around vegetables, nuts, healthy oils like olive and coconut, fish, meats, cheese, olives, avocados and other real whole foods. This is, in fact, the diet that I have advocated in my heart disease prevention practice, as well as my online program for prevention and reversal of heart disease.

But what if you'd like a piece of cheesecake or a nice slice of dessert bread---but you don't want to gain two pounds, spend 48 hours in the bathroom suffering with diarrhea and cramps, 3 weeks of joint pains and leg swelling, wade through mental "fog," anxiety, and rage just because you had that momentary indulgence---as you would with wheat?

That's why I've been focusing on recipes that allow you to have something familiar, e.g., chocolate coconut bread or biscotti, but using ingredients that will not generate the metabolic contortions triggered by wheat.

On perusing these recipes, you will notice that there are recurring ingredient themes. Many of the same ingredients pop up time and again. Among the most frequent, versatile, user-friendly, and tasty: Almonds.

You can use almonds as ground whole almonds, ground blanched almonds for a finer texture, ground roasted almonds, almond butter (though, for maximum health benefits, I prefer the ground whole almonds). Ground almonds allow you to recreate muffins, breads, scones, pizza crust, pie crust, biscotti, and cookies with health benefits that exceed that of whole wheat---but with none of the downside: no weight gain, no high blood sugar, no triggering of small LDL particles (#1 cause of heart disease in the U.S.), no accumulation of visceral fat, no appetite stimulation.

In short, you just have your chocolate almond biscotti or mocha cupcake and enjoy it, no health price to pay. So I call almonds the new wheat, except better.

Being regular is dangerous to your health

No, I'm not referring to your daily morning ritual in the bathroom. I'm talking about heart rate.

Counterintuitively, a perfectly regular heart rate is a marker of poor health. People with perfect regularity of heart rate have more heart attacks, for instance.

Regularity of heart rate occurs more commonly in people with hypertension and other metabolic derangements, and it signals increased risk for both heart attack and death. A perfectly regular heart rate, i.e., no variation in the time interval from beat to beat, suggests that the parasympathetic nervous system, the component of automatic ("autonomic") nervous system control that is associated with the relaxation response, feelings of well-being, quiet, and relaxation, is weak. It also means that the opposing sympathetic nervous sytem that regulates the "fight or flight," adrenaline-like response is allowed to be dominant. Dominance of the sympathetic over the parasympathetic system generates regularity of heart rate. Heart rate also tends to be faster, e.g., 85 beats per minutes rather than 55 or 60 beats per minute. So perfect regularity, as well as increased rate, is undesirable.

What we want is irregularity of heart rate. But not irregularity that occurs chaotically with no rhyme or reason. More precisely, we want variability in heart rate. And we want variability to occur in synchrony with breathing, i.e., the respiratory cycle.

The ideal response is:

1) increase in heart rate with inspiration

2) decrease in heart rate with expiration.

Heart rate in healthy people typically varies 15-20 beats per minute within the respiratory cycle, e.g., 60 bpm at end-exhalation, 80 bpm at end-inspiration.

Restoration of increased heart rate variability is associated with reduced blood pressure, reduced blood sugars (HbA1c), reduced inflammatory markers and cortisol (associated with stress), even an increase in DHEA levels. Feelings of well-being and calm also develop.

Among the strategies to consider to restore heightened heart rate variability and slowed heart rate include:

--Omega-3 fatty acid supplementation
--Exercise
--Weight loss
--Deep breathing exercises
--Meditation, prayer, and biofeedback

For our Track Your Plaque purposes, we are folding in the HeartMath strategies, i.e., use of a heart rate monitor that calculates heart rate variability in the context of respiratory cycle. If you've not already done so, take a look at the two Special Reports devoted to this topic on the Track Your Plaque website.

You mean weight loss is hazardous to your health?

In my last Heart Scan Blog post, What is this wacky thing called weight loss?, I discussed how weight loss is associated with distortions in cholesterol and blood sugar values that can be very confusing, often leading your doctor to wrongly and unnecessarily prescribe drugs--since he/she likely rarely sees weight loss.

Blog reader, Donald K., posted his enlightening story:

I experienced this very thing.

After losing serious weight from the eliminating wheat, processed, and sugary foods (1 year in total) I lost 130 pounds. When I was nearly finished I went to see my doctor. He wanted to put me on statins. I explained to him how the data does not support application to me (no evidence of heart disease) and I got the mantra about standards of practice, etc, etc. I held my ground and decided I am much happier eating dairy, eggs, grass fed beef, wild caught fish, and as much raw foods (nuts, veggies, fruits) as my body desires to treat my health parameters.

Maintaining weight, it is easy. My BMI (23 down from 40) has remained constant for a few months now. You are right: metabolic processes definitely change. I no longer have sensations of glucose fluctuations or an uncontrolled appetite. I can only imagine the improved hormone regulation and metabolic communication going on inside my body.

The symptoms from obesity, all gone. Goodbye sleep apnea, hypertension, hemorrhoids, arrhythmias, gastroinestinal disruptions, smelly body, chaffing thighs, and others not mentioned. The positive effects are just as dramatic, but I don’t want to ramble on.

Weight loss? What is it? Getting your life back!


Brace yourself: If you are following the nutrition advice posted here and in the Track Your Plaque program, or the discussion I've initiated in Wheat Belly, then you may find yourself in the very same health predicament as Donald. Arm yourself to protect yourself against the drug-wielding ways of doctors. No, weight loss to achieve ideal weight is definitely not bad for health. But your doctor's misinterpretation of its effects can be!

What is this wacky thing called "weight loss"?

I've discussed this before, but it has proven such an (encouragingly!) frequent issue that I thought it was worth discussing once again.

What happens when you lose weight?

The process of weight loss is characterized by multiple shifts in metabolic patterns that can be confusing. To the uninitiated eye, weight loss can look like a disastrous distortion in metabolism. The naive doctor on seeing your lab values, for instance, might insist you take a statin drug, a fibrate like Tricor (to reduce triglycerides or increase HDL), or simply berate you for your bad health habits--when it's actually a good thing you've accomplished.

So when you lose weight, say, 30 pounds in 3 months, what have you accomplished?

Energy stored as fat, especially from visceral fat stores, is mobilized into the bloodstream. It floods the bloodstream as fatty acids and triglycerides. These fatty acids and triglycerides don't occur in isolation, but interact with other particles and metabolic patterns. The resulting blood patterns include:

--Increased triglycerides--An increase in triglycerides, for instance, from 90 mg/dl to 200 mg/dl in the midst of weight loss is common.

--Reduced HDL--The flood of triglycerides leads to increased degradation of HDL, thus a drop. A drop in HDL from, say, 40 mg/dl to 27 mg/dl--very frightening to people--is exceptionally common.

--Increased blood sugar--The flood of fatty acids and triglycerides results in insulin resistance, leading to higher blood sugars. It is not uncommon for someone with pre-diabetes to develop diabetic-range blood sugars, or a non-diabetic to show pre-diabetic blood sugars.

--Increased small LDL particles--Though small LDL is highly variable during weight loss. When it does happen, it's probably from the interaction of VLDL (triglycerides) with LDL particles and the reaction that overloads LDL particles with triglycerides and conversion to small LDL particles.

So why don't doctors often recognize these patterns when a patient loses weight? Because they rarely see it. Most of my colleagues are accustomed to having patients come back with weight gain, getting heavier and heavier each time. Lose weight? Impossible! So they just don't recognize weight loss effects when they see it. As followers of The Heart Scan Blog know, a frequent conversation around here is "Am I too skinny?" or "How do I stop losing weight?"

The solution: Be patient. Be patient and wait about two months after a weight plateau has been achieved. That's when the numbers "settle down" and you see marked drops in triglycerides, increases in HDL, drops in blood sugar, reductions in small LDL.

As with many things, it's all about timing.

Why small LDL particles are the #1 cause of heart disease in the US

Ask your doctor: What is the #1 cause of heart disease in the US?

Let's put aside smoking, since it is an eminently modifiable risk and none of those crazies read this blog anyway. What will your doctor say? Most like he or she will respond:

High cholesterol or high LDL cholesterol

Too much saturated fat

Obesity

Pfizer, Merck, AstraZeneca and their kind would be overjoyed to know that they can add your doctor to their eager following.

I'd tell you something different. I would tell you that small LDL particles are, by far and away, the #1 cause for heart disease. I base this claim on several observations:

--Having run over 10,000 lipoprotein panels (mostly NMR) over the past 15 years, it is a rare person who does not have a moderate, if not severe, excess of small LDL particles. 50%, 70%, even 90% or more small LDL particles are not rare. Over the course of a year, the only people who show no small LDL particles are slender, athletic, pre-menopausal females.

--In studies in which lipoproteins have been quantified in people with coronary disease, small LDL particles dominate, just as they do in my office. Here's a 2006 review.

--Small LDL is largely the province of people who consume carbohydrates, such as the American population instructed to "cut fat and eat more healthy whole grains." Conventional diet advice has therefore triggered an expllosion in small LDL particles.

--When fasting triglycerides exceed 60 mg/dl, small LDL particles increase as a proportion of total LDL particles. This includes the majority of the US population. (This ignores postprandial, or after-eating, triglycerides, which also contribute to small LDL formation.)

If you were to read the data, however, you might conclude that small LDL affects a minority of people. This is because in most studies small LDL categorize it as either "pattern B," meaning exceeding some arbitrary threshold of percentage of small LDL particles, versus "pattern A," meaning falling below that same arbitrary threshold.

Problem: There is no consensus on what percentage of small LDL particles should mark the cutoff between pattern A vs. pattern B. In many studies, for instance, people with 50% small LDL particles are called "pattern A."

If, instead, we were to set the bar lower to identify this highly atherogenic (atherosclerotic plaque-causing) particle at, say, 20-30% of total, then the number or percentage of people with "pattern B" small LDL particles would go much higher.

I see this play out in my office and in the online program, Track Your Plaque, every day: At the start eating a low-fat, grain-filled diet with lots of visceral fat ("wheat belly") to start, they add back fat and cut out all wheat and limit carbohydrates. Small LDL particles plummet

Even moore from Jimmy Moore

The ubiquitous and irrepressible Jimmy Moore posted even more commentary about the Wheat Belly phenomenon here, what he calls "The Wheat Belly Bonanza."

Is low-carb really, at its core, little more than elimination of wheat? Sure, corn, rice, and sugar exert deleterious effects. But the dominant effect--by far--is the elimination of wheat. So is the low-carb movement really, at its core, a wheat-elimination movement?

Food (non-wheat-containing, of course) for thought.

Heart Scans: An Interview with Jimmy Moore

My friend, Jimmy Moore, of The Livin' La Vida Low Carb Show, posted this video of an interview I did with him.

I provide some background on how heart scanning came about and how it led to the creation of the Track Your Plaque program.

It reminds me how far we've come over the 8 years since the program got started. From its modest start as just an information resource to help people understand their heart scan score, to a comprehensive program that helps followers gain incredible control over coronary plaque and coronary risk that has now expanded to over 30 countries. High-tech heart procedures still dominate public consciousness, but the tremendous power of real heart disease prevention efforts are gaining more and more attention as each day passes.

Wheat Belly #5 on New York Times Bestseller list!

The New York Times just released its bestseller list due for release September 18th, 2011 . . . .

Wheat Belly is #5!! (That darned Jane Fonda woman elbowed me out for the #4 spot!

[caption id="attachment_4452" align="alignright" width="574" caption="Wheat Belly hits #5 on New York Times Bestseller List--in 1st week!"][/caption]

Interview with Jimmy Moore of Livin' La Vida Low-Carb

Here's my podcast interview with Jimmy Moore, host of the Livin' La Vida Low-Carb Show. (If you want to fast forward to the interview, go to time marker 41:20 on the slidebar.)



In the podcast, I talk about how the Track Your Plaque program and its focus on lipoprotein testing, along with the need to reverse the incredible epidemic of diabetes and pre-diabetes, led to elimination of all wheat from the diet and the book, Wheat Belly.

An open letter to the Grain Foods Foundation

Readers: Please feel free to reproduce and disseminate this letter any way you see fit.


To:

Ms. Ashley Reynolds
490 Bear Cub Drive
Ridgway, CO 81432
Phone: 617.226.9927
ashley.reynolds@mullen.com


Ms. Reynolds:

I am writing in response to the press release from the Grain Foods Foundation that describes your effort to "discredit" the assertions made in my book, Wheat Belly: Lose the wheat, lose the weight and find your path back to health. I'd like to address several of the criticisms of the book made in the release:

" . . . the author relies on anecdotal observations rather than scientific studies."
While I do indeed have a large anecdotal experience removing wheat in thousands of people, witnessing incredible and unprecedented weight loss and health benefits, I also draw from the experiences already documented in clinical studies. Several hundred of these studies are cited in the book (of the thousands available) and listed in the Reference section over 16 pages. These are studies that document the neurologic impairment unique to wheat, including cerebellar ataxia and dementia; heart disease via provocation of the small LDL pattern; visceral fat accumulation and all its attendant health consequences; the process of glycation via amylopectin A of wheat that leads to cataracts, diabetes, and arthritis; among others. There are, in fact, a wealth of studies documenting the adverse, often crippling, effects of wheat consumption in humans and I draw from these published studies.


"Wheat elimination 'means missing out on a wealth of essential nutrients.'"
This is true--if the calories of wheat are replaced with candy, soft drinks, and fast food. But if lost wheat calories are replaced by healthy foods like vegetables, nuts, healthy oils, meats, eggs, cheese, avocados, and olives, then there is no nutrient deficiency that develops with elimination of wheat. There is no deficiency of any vitamin, including thiamine, folate, B12, iron, and B6; no mineral, including selenium, magnesium, and zinc; no polyphenol, flavonoid, or antioxidant; no lack of fiber. With regards to fiber, please note that the original studies documenting the health benefits of high fiber intake were fibers from vegetables, fruits, and nuts, not wheat or grains.

People with celiac disease do indeed experience deficiencies of multiple vitamins and minerals after they eliminate all wheat and gluten from the diet. But this is not due to a diet lacking valuable nutrients, but from the incomplete healing of the gastrointestinal tract (such as the lining of the duodenum and proximal jejunum). In these people, the destructive effects of wheat are so overpowering that, unfortunately, some people never heal completely. These people do indeed require vitamin and mineral supplementation, as well as probiotics and pancreatic enzyme supplementation.


I pose several questions to you and your organization:

Why is the high-glycemic index of wheat products ignored?
Due to the unique properties of amylopectin A, two slices of whole wheat bread increase blood sugar higher than many candy bars. High blood glucose leads to the process of glycation that, in turn, causes arthritis (cartilage glycation), cataracts (lens protein glycation), diabetes (glycotoxicity of pancreatic beta cells), hepatic de novo lipogenesis that increases triglycerides and, thereby, increases expression of atherogenic (heart disease-causing) small LDL particles, leading to heart attacks. Repetitive high blood sugars that develop from a grain-rich diet are, in my view, very destructive and lead to weight gain (specifically visceral fat), insulin resistance, leptin resistance (leading to obesity), and many of the health struggles Americans now experience.

How do you account for the psychologic and neurologic effects of the wheat protein, gliadin?
Wheat gliadin has been associated with cerebellar ataxia, peripheral neuropathy, gluten encephalopathy (dementia), behavioral outbursts in children with ADHD and autism, and paranoid delusions and auditory hallucinations in people with schizophrenia, severe and incapacitating effects for people suffering from these conditions.

How do you explain the quadrupling of celiac disease over the last 50 years and its doubling over the last 20 years?
I submit to you that, while this is indeed my speculation, it is the changes in genetic code and, thereby, antigenic profile, of the high-yield semi-dwarf wheat cultivars now on the market that account for the marked increase in celiac potential nationwide. As you know, "hybridization" techniques, including chemical mutagenesis to induce selective mutations, leads to development of unique strains that are not subject to animal or human safety testing--they are just brought to market and sold.

Why does the wheat industry continue to call chemical mutagenesis, gamma irradiation, and x-ray irradiation "traditional breeding techniques" that you distinguish from genetic engineering? Chemical mutagenesis using the toxic mutagen, sodium azide, of course, is the method used to generate BASF's Clearfield herbicide-resistant wheat strain. These methods are being used on a wide scale to generate unique genetic strains that are, without question from the FDA or USDA, assumed to be safe for human consumption.

In short, my view on the situation is that the U.S. government, with its repeated advice to "eat more healthy whole grains," transmitted via vehicles like the USDA Food Pyramid and Food Plate, coupled with the extensive genetic transformations of the wheat plant introduced by agricultural geneticists, underlie an incredible deterioration in American health. I propose that you and your organization, as well as the wheat industry and its supporters, are at risk for legal liability on a scale not seen since the tobacco industry was brought to task to pay for the countless millions who died at their product's hands.

I would be happy and willing to talk to you personally. I would also welcome the opportunity to debate you or any of your experts in a public forum.

Wiliam Davis, MD
Author, Wheat Belly: Lose the wheat, lose the weight and find your path back to health (Rodale, 2011)
How far wrong can cholesterol be?

How far wrong can cholesterol be?

Conventional thinking is that high LDL cholesterol causes heart disease. In this line of thinking, reducing cholesterol by cutting fat and taking statin drugs thereby reduces or eliminates risk for heart disease.

Here's an (extreme) example of just how far wrong this simpleminded way of thinking can take you. At age 63, Michael had been told for the last 20 years that he was in great health, including "perfect" cholesterol values of LDL 73 mg/dl, HDL 61 mg/dl, triglycerides 102 mg/dl, total cholesterol 144 mg/dl. "Your [total] cholesterol is way below 200. You're in great shape!" his doctor told him.

Being skeptical because of the heart disease in his family, had a CT heart scan. His coronary calcium score: 4390. Needless to say, this is high . . . extremely high.

Extremely high coronary calcium scores like this carry high likelihood of death and heart attack, as high as 15-20% per year. So Michael was on borrowed time. It was damn lucky he hadn't yet experienced any cardiovascular events.

That's when Michael found our Track Your Plaque program that showed him how to 1) identify the causes of the extensive coronary atherosclerosis signified by his high calcium score, then 2) correct the causes.

The solutions, Michael learned, are relatively simple:

--Omega-3 fatty acid supplementation at a dose sufficient to yield substantial reductions in heart attack.
--"Normalization" of vitamin D blood levels (We aim for a 25-hydroxy vitamin D level of 60-70 ng/ml)
--Iodine supplementation and thyroid normalization
--A diet in which all wheat products are eliminated--whole wheat, white, it makes no difference--followed by carbohydrate restriction.
--Identification and correction of all hidden causes of coronary plaque such as small LDL particles and lipoprotein(a)

Yes, indeed: The information and online tools for health can handily exceed the limited "wisdom" dispensed by John Q. Primary Care doctor.

Comments (32) -

  • Jan

    8/17/2011 6:36:25 PM |

    Time to stop bashing primary care docs, doc. Online sites are full of B.S.
    Show me the evidence that testing with CAC improves outcomes (Sure it predicts risks, not the same as actually preventing disease, especially in those at lower risk of CAD.)

  • Might-o'chondri-AL

    8/17/2011 8:11:19 PM |

    Hi Jan,
    Since you accept plaque showing up as being a cardio-vascular risk factor then if Doc reports he has treated some patients whose measurement of plaque has diminished using his protocol would you also accept the proposition that those patients have reduced one of their cardio-vascular risk factors?
    If Doc has patient records showing diminished plaque and therefore one less risk might that not be considered preventative due to his patient following his protocol ?
    As for those individuals with hypothetically lower risk of CAD (ex: the 63 year old low cholesterol example Doc gave) are they not going to undergo changes as they age ?  
    A primary care physician is valuable and yet older westerners are increasingly engaging specialists for good reasons.  Doc has a self-professed specialty tracking plaque  that he wants to impart; sure, his blogging tone may not always be mellow.

  • Jan

    8/18/2011 2:52:13 AM |

    Dear Might,
    Your comment is akin to those who report the association of statin use with lowered risk of MI. A correlation does not prove causation until valid  scientific research confirms.
    How do we know treating CAC lowers risk of MI until a study proves this? Docs have been wild to accept the association of statin use lowering cholesterol components as the mechanism of effectiveness for prevention of MI, ignoring studies in which dietary measures that did the same were ineffective. Just pointing out the need for caution in going so far as to treat a test without evidence that the intervention is working on the test findings (rather than something else).
    Perhaps there are studies that are underway or perhaps the evidence, er association, is just considered too strong, (Bradford-Hill criteria) to ethically justify a trial. My concern is for individuals who score in the lower range of abnormal. At what cost do we label and treat those?

  • joel oosterlinck M.D.

    8/18/2011 9:21:42 AM |

    just remembret the lyon heart study, by  Renaud & de Lorgeril demonstrating the efficacy  of mediterranean diet in lowering the risk of recurrent MI in French patients. although cholesterol levels were higher with diet than with statins. Dietary measures seem there to demonstrate  efficacy

  • Dr. William Davis

    8/18/2011 12:15:43 PM |

    Not only is it NOT time to stop bashing primary care docs, but it's time to begin accepting that their role is outdated. In fact, an average nurse practitioner or physician's assistant can do an equal, if not better, job than most primary care physicians. How health care is dispensed is going to undergo dramatic transformation, just as the business of travel agents and real estate have been transformed by rapid information exchange.

    In our program, we see virtually NO heart attacks. Not a randomized clinical trial, but watching heart attacks drop from a weekly event to almost never is good enough for me to not accept the status quo and continue to work along a path that, from every indication, works exceptionally well.

  • JC

    8/18/2011 12:49:19 PM |

    If high crab diets are considered unhealthy then why do some cultures like the rural Chinese live long healthy lives on nearly 100% crabs,mostly rice and vegetables?

  • majkinetor

    8/18/2011 2:16:50 PM |

    Isn't the best thing for calcium on wrong places vitamin K2 ?
    In my country doctors even prescribe it for calcification issues.
    Dose is around 100mcg/day for 6-12 mo.

  • Marlene

    8/18/2011 4:06:07 PM |

    Read Gary Taubes' "Good Calories, Bad Calories" to find several instances of other cultures eating the typicial high carb food yet seemingly stay within the healthy range.

  • Jan

    8/18/2011 4:22:12 PM |

    Trust my care (or a family members care) to a NP or PA who does not have the capability of complex medical decision making - no thanks. NP's actually are complimentary to physicians with different skill sets. So glad to know your level of knowledge about them. PA's are nothing but junior medical students with enormous salaries. Working 9 to 5 - oh, yeah!

    I'm certain your referral network of primary care docs would be interested in your belief system.

  • Joe

    8/18/2011 4:49:51 PM |

    Dr. Davis:
    I don't know if you've seen this new video yet, but I think you'll want to.
    http://www.youtube.com/watch?v=3vr-c8GeT34&feature=player_embedded
    If you do watch it, I have a question. This doctor thinks sugar (by itself) plays a huge role in causing plaque to rupture and cause heart attacks, etc. If after watching the video you agree with him, would you please tell me how (biologically) it does this?
    Thanks!

    Joe

  • Might-o'chondri-AL

    8/18/2011 8:51:08 PM |

    Hi Jan,
    True correlation does not necessarily equate to causation. As for statins, it seems that statins act to lessen inflammatory processes; and it is this dynamic, rather than numerically lowering cholesterol, that is a crucial way that statins correlate with reduced risk. Which, to me,  seems to further support Doc's contention here in this posting that  low cholesterol levels doesn't  tell one if they have abnormal plaque (ex: patient above with "exceedingly high" score) .

    I will accept Doc's data, as given ,that very high plaque is a 15-20% risk factor since many other published sources cite even carotid plaque as a risk factor . As far as who to test for what, and when, I am not qualified to make recommendations. I do know that time can remodel some cellular dynamics and the aging cardio-vascular system is vulnerable to alterations.  Doc's got my attention because no one at all in my paternal male ancestral line lived past their late 50's due to heart problems and I am 60; while my 61 year old brother already was hospitalized from transient ischemic attack  .

  • Might-o'chondri-AL

    8/18/2011 9:33:17 PM |

    Mediterranean diet's efficacy for heart health is probably due to the % of poly-amines per calorie consumed and of course isn't in keeping with Doc Davis' detestation of modern wheat (among other protocols). As we age our poly-amine levels decrease and Mediterranean diet supplies lots of poly-amines.

    Poly-amines ( molecules inelegantly named spermine, spermadine and putrescine) are all anti-inflammatory, especially spermine; in our body we synthesize poly-amines from arginine. Mediterranean diet's high poly-amine levels spares the amount of arginine our body uses in synthesizing poly-amines; and thus we can more readily produce the vaso-dilator signalling molecule NO (nitric oxide) from body's arginine. NO is valuable to keep oxygenated blood reaching the heart muscle cells; NO keeps vessels from constricting dangerously.

    Poly-amines lower inflammation and in the context of age associated problems the less low grade inflammation the better.  Inflammation leads to defectively functioning cells and molecular processes; with time the  over stimulation of immunological responses (both innate and adaptive immunity) leaves the body burdened with unknown clones of T cells (both memory and effector types). Eventually the build up of  T cell clones limits new variants and what occurs is more macrophages circulating; once an over abundant macrophage stage reins the body is essentially always in low grade inflammation , and prone to various age associated pathology (including cardio-vascular).

  • Dr. Johns

    8/19/2011 12:25:40 AM |

    @jan....
    A vast majority of primary care doctors are extremely limited in their abilities to treat/advise patients for CVD risks. They don't understand nutrition, effects of supplements upon serum biomarkers, nor effective diagnostic testing for heart disease.
    CAC is a much better biomarker for who is at greater risk of CVD than serum markers:
    http://www.eurekalert.org/pub_releases/2011-08/jhmi-sfc081611.php

    I seriously doubt even 1:100 primary care docs see studies like the aforementioned one.
    And I seriously doubt the one doc would understand it....
    Dr. John

  • Gene K

    8/19/2011 1:48:19 AM |

    An interpretation of the same study for a broader audience just appeared at http://www.webmd.com/heart-disease/news/20110818/is-calcium-test-the-best-way-to-check-for-heart-risk.

  • Thomas White

    8/19/2011 2:09:49 AM |

    I'd accept a bashing of physicians in general.   But to single out primary care physicians - overwhelmed with paperwork and patients with multiple problems, and vastly underpaid and underappreciated, and continually put down by "Partialists" - Really ? Cardiologists are superior? Really ?

    Forget my support and admiration henceforth.

  • Might-o'chondri-AL

    8/19/2011 5:43:43 AM |

    CRP (C-reactive protein), an inflammation marker surrogate, does not directly correlate with whether there is coronary artery calcium (CAC), or the degree of CAC severity. CRP is also subject to variables of race and age, so it loses some potential as a predictive marker. Yet looking at CAC along with CRP is considered useful for complex insight into a patients pathology.

    Analysis of the Multi-Ethnic Study  of Atherosclerosis (MESA) involving 6,800 men & women seems to indicate that inflammatory markers (ex: CRP) relate to the physiology of pathological processes other than CAC laid down; possibly because plaque undergoes morphological changes over time. The CRP level is proposed, by some, to relate more to the stability of plaque from rupturing and the incidence of blood clotting in a thrombosis.

    The inflammatory marker of Interleukin-6 (IL-6) anti-bodies seems to be better than CRP and fibrinogen for correlating an individual's trend toward CAC. Thus the cytokine IL-6 is a better indicator of sub-clinical atherosclerosis; Doc likes to cut to the chase, eyeball the plaque and track it with current technology ( that is not available worldwide).

  • David

    8/19/2011 6:16:33 AM |

    Is it typical for someone with such low ldl and high hdl to have such a high CAC score? Had he previously had a higher LDL and then been placed on a statin?

  • TT

    8/19/2011 12:36:37 PM |

    The energy expenditure of the rural Chinese is very high.  They don't drive, they walk, or ride bicycles.  They don't sit in office from 9am to 5pm, they work hard in the rice field from 5am to 9pm.  They can eat anything without gaining weight.
    For the urban Chinese, it is a different story.  They have the same life sytle as ours, and they are getting heavier every year.  More and more people become diabetic, even young kids.

  • Dr. William Davis

    8/19/2011 1:51:32 PM |

    K2 is indeed a fascinating nutrient. There are extensive discussions about it on the Track Your Plaque website.

  • Dr. William Davis

    8/19/2011 1:53:33 PM |

    Thanks, Joe. I watched the entire thing and was impressed with Dr. Diamond's grasp of the issues.

    I'm going to post this on the main page because I think his overview was extremely effective.

  • Dr. William Davis

    8/19/2011 1:55:24 PM |

    Sorry you see it that way. This was a comment directed at the system of primary care in general.

    I reread the post and I didn't see the name "Dr. Thomas White" mentioned anywhere. If you choose to feel slighted in some way, that's your choice.

  • Kent

    8/19/2011 3:20:32 PM |

    Jan, I would certainly trust my care (or a family members care) to a NP or PA who looks outside just the pharma driven medical journals which primarily support a diagnose & drug philosophy.  And I'll take an NP or PA who actually uses some common sence rather than being a puppet given to the pushy drug rep.

    I live in a family of MD's, and they have made it clear as to their terribly limited training and knowledge they gain from med school on the level of building and supporting the body from within.  Example, I have an Aunt that is currently suffering from stage 4 cancer. Due to the chemo treatment that she's instructed to not spend time in the Sun. Her Dr. has not even checked her for vitamin D levels. This is not the exception, but the norm when it comes to common sence treatment, pathetic.

  • Joe

    8/19/2011 6:56:14 PM |

    Okay, Dr. Davis.  I'll be looking for it. When you do, please take a moment and explain how you think that sugar might be responsible for plaque rupture.
    Thanks again!

    Joe

  • steve

    8/19/2011 7:06:59 PM |

    Sugar is just one part of the equation.  As Dr. Davis has covered on this website, small LDL is also a villian and needs to be minimized as much as possible.

  • Might-o'chondri-AL

    8/19/2011 8:05:24 PM |

    Hi Joe,
    Thanx for the video ... maybe the following answers you.

    Regarding sugar: see 59:33 into presentation, where diagram shows "sugar" blurb  - lecturer is using compact word sugar to represent how glucose's glycation end products alter the artery and make the artery vulnerable. It is not a molecule of sugar acting all by itself; lecturer explains slide when talks of how glycation is a problem (another of  Doc Davis'  peeves).

    Follow up at 1:01 into presentation: see diagram's top left  where the various adverse influences on artery  are specified as "modified lipoprotein", "hemodynamic insult" (includes, but is not limited to blood sugar's  glycation end products affect on artery), "reactive oxygen species" (ROS) and "infectious agents".

  • Thomas White

    8/20/2011 12:22:15 PM |

    Thank you for all your hard work and dedication to your web site and education.

    I apologize for cluttering up the discussion with a personal statement.

    TRW

  • Joe

    8/20/2011 4:13:56 PM |

    Thank you, Might. I guess I'm going to have to do some research on glycation before I can fully understand what you're saying above.

    I didn't even notice the PowerPoint Presentation that was included with Dr. Diamond's video presentation.  Sigh.

    Thanks again!

    Joe

  • Jim

    8/20/2011 7:55:03 PM |

    AMEN! Right on target.

  • Louis

    8/23/2011 2:05:01 PM |

    I don't know if you're aware of the differences between calculated test that most doctors use and NMR that Dr. Davis uses. When your diet consists of mostly carbohydrates leading to chronic high blood sugar level, it tends to raise your SMALL DENSE LDL level but calculated cannot measure it accurately. It often greatly underestimate it.  Dr. Davis has covered it many times. Dig through his website for it.

  • Louis

    8/23/2011 2:16:27 PM |

    Optimal vitamin D level helps lower IL-6. It can be a big problem with black people as they tend to have the lowest vitamin D level of any races. Dr. Cannell mentioned that in his new book called Athlete's Edge Faster Quicker Stronger with vitamin D with the hope that the word about vitamin D would spread out faster if more and more professional athletes started using it to gain some advantage over opponents much like what East Germany and formerly USSR used to do in 1960 and 1970s at the Olympic games and other world events.

  • live-healthcare

    8/27/2011 4:31:48 AM |

    Yes Joe i have seen the video you linked. That's right i also think the same.

Loading