Vitamin D for $200?

What if vitamin D cost $200 rather than $2?

In other words, what if cholecalciferol, or vitamin D3, was a patent-protectable agent that would sell for an extravagant price, just like a drug?

Vitamin D would be the hot topic. There would be TV ads run during Oprah, slick magazine two-page spreads with experts touting its outsized benefits, insurance companies would battle over how much your copay should be.

The manufacturer would host large fancy symposia to educate physicians on how wonderful vitamin D is for treatment of numerous conditions, complete with dinner, a show, and gifts. They would hire expert speakers to speak, scientists to have articles ghost-written, give out knick knacks with the brand label inscribed--just like Lipitor, Actos, Vytorin, ReoPro, Plavix . . .

After all, what other "drug" substantially increases bone density (up to 20% in adult females), enhances insulin responses 30% (equivalent to the TZD drugs, Actos and Avandia), and slashes colon cancer risk?

But it's not a drug. That is both vitamin D's strength and its weakness. It's a strong point because it's natural, phenomenally helpful across a variety of conditions, and inexpensive. It is also a weakness because, at $2 a month, no one is raking in the $12 billion annually that Pfizer makes for Lipitor that allows it to fund an enormous marketing campaign.

Vitamin D is a "discovery" of huge importance for health, including making reductions of CT heart scan scores far more likely for more people. And it comes without a prescription.

Comments (2) -

  • Edward

    3/14/2007 8:34:00 AM |

    http://www.ajcn.org/cgi/content/abstract/85/3/860
    This recent research shows the poor Vitamin D status of most UK white residents. 87% lower than ideal in Winter and 60% remain so throughout the year. Goodness knows what the situation is for those with brown or black skins but it will inevitably be worse as it takes longer for darker skins to make the same amount of D3.

  • Neil

    3/15/2007 12:42:00 AM |

    Poster Edward and Dr. Davis, I have been reading quite a lot about vitamin D, the subject to me is absolutely fascinating. Edward, your thought about darker skin pigmentation and low vitamin D status is verified throughout medical literature and news articles. Like this...

    "...92 percent of African-American babies and 66 percent of white infants found to have inadequate vitamin D concentrations in their blood at birth." Link… http://tinyurl.com/2xpjse

    This especially gives one pause when you then consider the rate of cardiovascular disease, cervical, colorectal, lung, and prostate cancers, hypertension, fibromyalgia, Alzheimer's, and diabetes run much higher in the African American community, sometimes as much as 100-200% higher for some of these diseases.  Since these are all conditions strongly associated with vitamin D status, could it be all they need is this inexpensive vitamin supplement on an ongoing basis? And these strong associations with vitamin D status and rate of these serious diseases hold true for other racial backgrounds. One study of Southeast Asians living in England found they had a low Vitamin D status as well.

    To quote Dr. Davis from the other day "The whole vitamin D "discovery" sometimes worries me. Vitamin D has proven to be an unbelievable, remarkable, dramatic boon to health, including facilitation in dropping CT heart scan scores. Yet the answer was always right in front of us. It worries me that you and I might have the answer to important questions right within our grasp all along--but don't know it. What if the same were true, say, for cancer? That is, a profound answer is right there, but our eyes just pass right over it."

    In my recent reading I have run across so many articles on vitamin D that are just so stunning that I saved them.

    "Vitamin D deficiency is a major contributor to chronic low back pain in areas where vitamin D deficiency is endemic." Link...  http://tinyurl.com/2u4ayp

    “…...the vitamin plays a role in shutting down or activating at least 100 genes, many of which are involved in preventing diseases....family members of the Alzheimer's patients reported how well they were performing and acting within weeks of being put on large doses of prescription vitamin D, said lead author Robert Przybelski, an associate professor of geriatric medicine at the University of Wisconsin.”We hypothesize that good vitamin D levels might prevent or mitigate the disease," Przybelski said.”  Link… http://tinyurl.com/2uk2hy


    “…the deadliness of the 1918 killer flu could have been largely a result of vitamin D deficiency. Worldwide, an estimated 25 million people died from that flu.” Link… http://tinyurl.com/33ogga

    “…With respect to the modulation of cardiovascular effects by 1 ,25-(OH)2D3, further investigations are needed that could eventually lead to novel pharmacological approaches to manage hypertrophy, restenosis, and atherosclerosis or remodel the cardiovascular system.” Link… http://tinyurl.com/36897n

    “…71% of patients with severe PAD had serum 25-hydroxyvitamin D [25(OH)D] levels that were below 9 ng/mL” Link…  http://tinyurl.com/2gqe3r

    How could a two dollar a month supplement do all this!!! Pretty incredible stuff.

    My own family tree is littered with victims of cancer, heart attack (leading to sudden death MI’s in my Uncle and Grandfather both at the age of 52), stroke, Alzheimer’s, ALS, etc. Could vitamin D have been a strong contributing factor to their deaths??? Considering my own vitamin D level was EXTREMELY low and I now have to take about 6,000 IU daily just to normalize it, and I as well had a heart attack at 46, I consider this idea at least as a possible common factor.

    Dr. Davis...Thanks for keeping us informed on your patient experiences and your latest thoughts on Vitamin D and all the other treatments you are exploring. Your daily observations through your blog have helped me a great deal in becoming healthier. Reading your blog and webpage are constant sources of inspiration as well.

    Neil

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Goodbye, fructose

Goodbye, fructose

A carefully-conducted study by a collaborative research group at University of California-Berkeley has finally closed the lid on the fuss over fructose vs. glucose and its purported adverse effects.

The study is published in its entirety here.

Compared to glucose, fructose induced:

1) Four-fold greater intra-abdominal fat accumulation--3% increased intra-abdominal fat with glucose; 14.4% with fructose. (Intraabdominal fat is the variety that blocks insulin responses and causes diabetes and inflammation.)

2) 13.9% increase in LDL cholesterol but double the increase for Apoprotein B (an index of the number of LDL particles, similar to NMR LDL particle number).

3) 44.9% increase in small LDL, compared to 13.3% with glucose.

4) While glucose (curiously) reduced the net postprandial (after-eating) triglyceride response (area under the curve, AUC), fructose increased postprandial triglycerides 99.2%.


The authors propose that fructose specifically increases liver VLDL production, the lipoprotein particle that yields abnormal after-eating particles, increased LDL, and provides building blocks to manufacture small LDL particles. The authors also persuasively propose that fructose metabolism, unlike glucose, is not inhibited (via feedback loop) by energy intake, i.e., it's as if you are always starving.

Add to this the data that show that fructose increases uric acid (that causes gout and may act as a coronary risk factor), induces leptin resistance, causes metabolic syndrome (pre-diabetes), and increases appetite, and it is clear that fructose is yet another common food additive that, along with wheat, is likely a big part of the reason Americans are fat and diabetic.

Fructose is concentrated, of course, in high-fructose corn syrup, comprising anywhere from 42-90% of total weight. Fructose also composes 50% of sucrose (table sugar). Fructose also figures prominently in many fruits; among the worst culprits are raisins (30% fructose) and honey (41% fructose).

Also, beware of low-fat or non-fat salad dressings (rich with high-fructose corn syrup), ketchup, beer, fruit drinks, fruit juices, all of which are rich sources of this exceptionally fattening, metabolism-bypassing, LDL cholesterol/small LDL/ApoB increasing compound. Ironically, this means that many low-fat foods meant to reduce cholesterol actually increase it when they contain fructose in any form.

When you hear or say "fructose," run the other way, regardless of what the Corn Refiners Association says.

Comments (35) -

  • Anna

    7/12/2009 4:32:48 PM |

    Don't forget agave syrup/nectar.  That is the latest "low glycemic" sweetener temping sugar addicts, particularly to those interested in health.  Agave sweeteners are VERY high in refined fructose, with some brands much more fructose than HFCS (I've seen figures as high as 92% fructose).

    Even more worrying, agave sugar products  are labeled as safe for diabetics, who are particularly prone to damage from frequent consumption of concentrated fructose.

    The people I see using or recommending agave sweetner products seem to think that because they can't detect an immediate post-prandial BG rise, that agave syrup is somehow better (therefore healthier) than sugar and safe for liberal and/or frequent use.  Not so.  All refined/concentrated sugars need to be limited in both quantity and in frequency, including concentrated fructose.

    I see "moderation" used a lot in reference to sugars and agave products whenever criticism of sugars is made.  But what is "moderation"?  Do we even have a reference point anymore in our sugar-drenched culture?  "Moderation" in the 21st century is still at least a hundred pounds per capita more sugars than most humans consumed just a few hundred years ago, and much more than our paleolithic ancestors consumed. Even "moderation" needs to be considered in moderation.

  • Nameless

    7/12/2009 7:21:03 PM |

    Wow, that's really interesting.

    In the past I've wondered if something real simple (like removal of soda/sugary drinks) from society would have a major impact on both heart and general health.  Apparently it would.

    It's also weird how cardiologists (in general) overlook sugar intake almost completely. When I last saw my cardiologist, I was sort of baffled that they were offering the patients waiting for infusion therapy snacks while they wait. The nurse commented how  the patients go  first for the peanut butter/jelly sandwiches and they run out fast. And I'm there thinking... are they crazy, giving  sugary food to heart patients?  Then I remembered most cardiologists tend to be fat intake oriented only.

    Question for Dr. Davis -- what amount of fructose, daily would you consider safe? Is any amount  safe? As certain fruits do provide health benefits even if they do contain fructose. Berries are still acceptable? What gycated hemoglobin level do you aim for with your patients and have you noticed any differences in plaque progression based solely on this value?

  • Rick

    7/13/2009 3:33:37 AM |

    Hi Dr Davis,
    Could you tell us more about beer? Do you mean that beer has fructose added to it? Or that it contains a lot of fructose naturally? In general, how high up is beer on your list of things that we shouldn't eat? I ask because I'm having some success cutting down on sweet things and on wheat, and beer is one of my chief culinary pleasures. I don't mean that I drink a lot or that I drink everyday, just that I thoroughly enjoy the 3 or 4 beers a week I do have. (I generally drink brews made with 100% barley malt.)

  • pmpctek

    7/13/2009 3:40:40 AM |

    So low glycemic fruits (which are high in fructose) like apples, apricots, berries, cherries, grapefruit, plums, and prunes can be hazardous to our health...

    I'm starting to run out of things I can eat.

  • Cynthia1770

    7/13/2009 1:27:47 PM |

    Hi,
    Thank you for the link to the JCI
    study. I can hardly wait to see how the CRA will militantly respond. As a former research technician I am driven crazy when the CRA claims that sucrose and HFCS are essesntially similar. Take the variant HFCS-55. To the casual observer the 55% fructose: 45% glucose composition looks 5% different than the 50:50 ratio found in sucrose. That is, until you do the math.
    55%:45% = 55/45 = 1.22.
    This means in every can of Coke
    (bottled in the USA) there is, compared to glucose, 22% extra fructose. The CRA can't deny the math; they designed the ratio. To your health.

  • homertobias

    7/13/2009 3:17:12 PM |

    Did anyone notice that one of the authors of the article is RM Krauss? I love chasing his articles on pubmed.  His saturated fat articles from a few years back are particularily interesting.  I think of him as "small dense krauss" in the age,rage and ldl series on Peter's blog.

  • Curious

    7/13/2009 7:02:44 PM |

    Dr. Davis - there's so much great information here, but when we ask questions to try to understand the information, you don't answer them!

  • Dr. William Davis

    7/14/2009 12:43:22 AM |

    Thank you, Curious.

    But most of my time is spent in my more-than-full-time cardiology practice, consulting to the nutritional supplement industry, research, and the practically full-time website, Track Your Plaque, in which I engage in discussions with your wonderfully savvy Members. So I have to triage my time accordingly.

  • Dr. William Davis

    7/14/2009 12:44:41 AM |

    Also, I read the comments and I try to cover as many of the points as possible in future posts or in the content we post on Track Your Plaque.

    Remember: As I post prominently on the blog: The Heart Scan Blog accompanies Track Your Plaque; it is not meant to be a standalone source of information.

  • Anonymous

    7/14/2009 2:46:29 AM |

    Dr, D.  Those of use who TYP ( "track your posts") on this Blog may not be as "bought in" as the members of your track your Plaque members.

    If fructose is added to beer, it will be converted to alcohol so none left in the final product.  If wheat is used in the beer grist, the starches that are extracted are converted (mostly) to alcohol so no residual "toxins" to cause swelling.

    It isn't high fructose corn syrup consumption or prepared meals that makes Americans one of the most overweight nations in the world, its eating more calories that you need; it comes down to pure physics

  • Jammer

    7/14/2009 7:41:45 PM |

    I'd like to see a post about the lie of Calories. Fat is calculated at 10 kcal/gram because if burns (bomb calorimeter) better than sugar (calculated at 4kcal/g, the same as fiber).

    But of course sugar is much more available to our bodies as energy than fat or fiber.

    This makes the Calorie a big lie and emphasizes even more the low-fat diet (because fat would obviously be easier to cut by calorie than carbs).

    When people try to talk about the "physics of losing weight", they need to address the underlying assumptions that make the whole system a lie.

  • Anonymous

    7/15/2009 3:11:32 AM |

    Jammer, Please, it is a fundamental law: you can not create or destroy energy.  Mechanistically the body may deal with fats, sugars and proteins differently but unless you live in an alternate dimension, calories absorbed by the gut are either expended as energy or stored in the body in one form or another.  Belief in some magical effect of being able to "eat all the xyz without putting on weight" is a matter of faith and faith is neither fact nor science.

  • Apolloswabbie

    7/16/2009 7:28:23 PM |

    Anonymous, on the contrary, you are expressing faith in but one interpretation of the Laws of Thermodynamics (LoT).  When tested, results often show that one can eat more calories on a restricted carb diet and be less hungry and lose more weight.  The reasons are many and I refer you to Good Calories Bad Calories should you wish to learn more.  The body is not a closed system, and your interpretation of the LoT imply that it is.  What do I mean?  â€œCalories in = energy expended + fat accumulated/depleted” is correct, but only if one realizes that some calories drive hormonal responses which have an effect on the equation.  Eat more protein, feel less hunger, be more active, thus expend more energy.  Eat more carbohydrate (measured by glycemic load in particular), feel more hunger and behave like hungry people do - rest more, thus expending less calories.

    Do teenagers grow because they eat too much or because their bodies are responding to the complex interaction of hormones?

    Do pregnant ladies gain weight because they eat too much or because their bodies are responding to the complex interaction of hormones?

    Do post-menopausal ladies gain weight more easily because they suddenly begin to eat too much, or because their bodies are responding to the complex interaction of hormones?

    Do tall thin people (ectomorphs) just magically match their consumption and expenditure (thus remaining slender despite what appears to be high food intake)?  Or are they genetically programmed to a different hormonal response than endomorphs?  

    If you met two people, one tall and thin and the other shorter, wider, with a large pelvis and heavy bones – don’t you already know that one will struggle more with their weight than the other?  You do, and you know it long before you know which one is the least disciplined in the non-food arenas in their lives.  

    Are you aware of the research that shows, repeatedly, that the obese consistently eat less than many or most of those who are not obese?

    Do those who are heavier than we think they should be eat too much, or are they responding to the hormonal mileu they have created by eating foods which we are not designed to eat?  I think the later.  Obesity is not the result of a character flaw, it is a result of widespread consumption of foods (primarily cereal gains, sugar and agricultural products which have exceptionally high carb content) we are not genetically adapted to.  These foods drive a hormonal response the results in energy accumulation as fat.

  • Anonymous

    7/19/2009 12:01:19 AM |

    Aplloswabbie,notwithstanding the impact on what drives people to consume or expend energy at different rates, all excellent info., the equation is still balanced in the end.

  • Apolloswabbie

    7/19/2009 4:37:21 PM |

    Anon, agreed, but the significance of our agreement on that fact is low, as it provides little utility in assisting ourselves or others with their health.  For me, the realization that "low fat" diets are unnatural and drive metabolic derangement gave me a chance to eat good food to satiety, but avoid the high body fat that plaques my family.  Best regards.

  • JLL

    7/20/2009 1:57:42 PM |

    How much fructose does beer have then? From what I could find, the fructose content of barley malt is significantly lower than other sugars.

  • stern

    7/29/2009 9:50:44 PM |

    how about mal;tose from tapioca syrup?

  • Anonymous

    7/31/2009 8:51:33 PM |

    Now if you could get Congress to drop the high tariffs on sugar so it becomes less expensive than HFCS, we all could live longer.

  • trinkwasser

    8/3/2009 12:32:58 PM |

    Not much longer, we predominantly have sugar from local beet rather than HFCS in the UK, yet our stats aren't much better. IMO there's little difference in the relative toxicity between sugar and HFCS within the context of a high wheat diet

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  • Anonymous

    2/8/2010 8:08:00 PM |

    So fruit, in moderate portions, is bad for me?
    *snort*
    I understand targeting HFCS just as you would large amounts of sucrose.  It's the AMOUNT of these substances that can be a problem.  The other nutrients I get from a piece fruit can far outweigh any possible negative of small amount of fructose in the piece of fruit.  Decisions are all about risk vs. benefit. I imagine there are no risk-free food choices.

  • Anonymous

    8/8/2010 8:41:07 PM |

    No risk-free food choices, Anon?  Whole fruits and vege have little risks!

    Very good post that busts everything that http://betterworldcookies.blogspot.com/2010/06/why-i-use-agave-nectar-examination-of.html says!

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  • buy jeans

    11/2/2010 7:37:08 PM |

    Fructose is concentrated, of course, in high-fructose corn syrup, comprising anywhere from 42-90% of total weight. Fructose also composes 50% of sucrose (table sugar). Fructose also figures prominently in many fruits; among the worst culprits are raisins (30% fructose) and honey (41% fructose).

  • Anonymous

    1/24/2011 5:52:58 PM |

    A point that Robert Luskin makes in his video "Sugar, the Bitter Truth" is that biochemically fructose does not produce Leptin in the body, the "stop eating" hormone.

    A great ingredient for corporate food products - the more fructose, the more you eat/drink before feeling "full". Given that the calorie surplus that makes the US one of the fattest countries in the world is only 20 calories per day, high fructose corn syrup could account for that all by itself.

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Statin stupid

Statin stupid

If we followed the lead of the pharmaceutical industry and my cardiology colleagues, we would all subscribe to the "statins for all" philosophy. There is now $2 billion of clinical "research" to back up this "evidence-based" practice.

I do not endorse this "statins for all" philosophy. I believe it is a product of the raw profiteering of the pharmaceutical industry, who are adept at recruiting physicians to their cause.

But lost in the confusion of tainted studies and over-the-top media saturation is the fact that there are small groups of people who likely do obtain benefit from statin drugs. They would certainly benefit from better informed scrutiny of their lipoprotein and metabolic abnormalities. But treatment may involve statins.

This is entirely distinct from the "statins for all" argument, the simpleminded rule that primary care physicians and cardiologist are told to follow.

Groups who may indeed benefit from statin therapy include:

Homozygous or heterozygous familial hypercholesterolemia--Lacking a receptor for LDL particles, LDL piles up to very high levels in these people. LDLs of 300+ are common and lead to heart disease and stroke at relatively young ages.

Combined mixed hyperlipidemia--Among the one or more genetic defects underlying this condition involves excessive production of apoprotein B and VLDL particles. This leads to high risk for heart disease.

People unable to follow a diet to correct their lipid disorder--I have 80+-year old patients, for instance, who say, "I've eaten this way for 82 years. I'm not going to change now!" In the absence of diet and other efforts (e.g., omega-3 fatty acids from fish oil), drugs may be the answer.

In other words, of the $27 billion annual bill for statin drugs, perhaps a tiny fraction is truly necessary. The majority of people taking statin drugs would not really need them if they had the real answers. But don't let that confuse us: There are some people who do indeed benefit.
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Blast small LDL to oblivion

Blast small LDL to oblivion

Here's a graphic demonstration of the power of wheat elimination to reduce small LDL particles, now the number one cause for heart disease in the U.S.

Lee had suffered a stroke due to an atherosclerotic plaque in a brain artery. She also had plenty of coronary plaque with a heart scan score of 322.

Lee began with an LDL particle number (the "gold standard" for measuring LDL, far superior to conventional calculated LDL) of 2234 nmol/L. This is exceptionally high, the equivalent of an LDL cholesterol of 223 mg/dl (drop the last digit). Of this 2234 nmol/L, 90% were abnormally small, with 1998 nmol/L of small LDL particles.

Lee eliminated wheat products from her diet, as well as cutting out sugars and cornstarch. Six months later, her results:

LDL particle number: 1082 nmol/L--a 52% reduction from the starting value and equivalent to an LDL of 108 mg/dl. Small LDL: zero--yes, zero.

In other words, 100% of Lee's LDL particles had shifted to the more benign large LDL simply with elimination of these foods---NO statin drug. (In addition to wheat elimination, she was also taking vitamin D and omega-3 fatty acids at our recommended doses.)

While not everybody responds quite so vigorously due to genetic variation, nor does everyone try as hard as Lee did to eliminate the foods that trigger small LDL, her case provides a great illustration of the power of this strategy.

Comments (21) -

  • Steve K

    4/5/2009 3:33:00 PM |

    while i believe in this strategy with improvement in my own situation,probably due to genetics i have not experience any change in particle size although there has been a reduction in small particles from 1805 to 1305according to NMR with size at 18.7  Since trigs were only 20 and HDL was 54 up from 41 VitD only 38. Working to raise it.  Taking Lipitor at Doc request due to strong family history.  Only male in family not to have a coronary event. Would like not to take statin,but not sure there is an alternative. Any thoughts?

  • Anonymous

    4/6/2009 12:31:00 AM |

    I normally ead very little wheat anyway, but you've piqued my curiousity

    you wrote this:
    >>> eliminate the foods that trigger small LDL

    the interesting word here is "trigger"  - does it mean that only a small amount of wheat will cause lots of small LDL particles - that is, wheat changes the way you create LDL, and so a small amount of wheat turns a lot of LDL into small particles?


    OR

    is there a dose dependent response?  A small amount of wheat leads to low levels of small LDL particles, and more wheat leads to higher levels, and lots of wheat creates high levels.

    Sam in Toronto

  • pooti

    4/6/2009 12:50:00 AM |

    Steve, how many carbs per day are you eating and what is your percentage and type of fat you are eating? Are you eating any PUFAs? Do you consume much fructose (i.e. honey, agave nectar, fructans from sorbitol, xylitol and any poly-ol)? Do you eat pre-packaged or pre-prepared foods? How much and what are your protein sources each day?

    Just wondering because I don't know that Dr. Davis is always able to answer personal questions?

    Also, what form of Vitamin D are you taking and how much of it? How long supplementing?

  • bolderbob

    4/6/2009 3:46:00 AM |

    Given my travel etc, I have been able to reduce but not totally eliminate wheat from my diet.  Dr. Davis, I think I have eliminated about 70% of wheat.  Does that help?  Also, is whole grain wheat OK or is it all wheat?    Thanks!!!

  • toddhargrove

    4/6/2009 6:37:00 AM |

    Very impressive.  What is your opinion about the likely mechanism for the LDL improvement related to wheat?  Less carbs?  Removal of possible immune response to gluten?  Removal of gluten intolerance?  All of the above?  Which factor is most important in your mind?  Are there others?  Thanks.

  • Steve K

    4/6/2009 7:13:00 PM |

    Pooti: In response to your inquiry.

    i eat no sugar except in greek yougurt(2%) or in fruit which is limited to an apple or some berries. Rest of diet is fish beef, turkey,chicken, eggs(sometimes whites only,sometimes the whole egg)  No grains except tsp of metamuciel(psylium). Only use olive oil for salad, and eat no fried food at all.  i take fish oil.  Kinda think it is genetics but open to advise.

  • wccaguy

    4/6/2009 10:51:00 PM |

    pooti wrote:

    >>> Just wondering because I don't know that Dr. Davis is always able to answer personal questions?

    Dr. Davis always answers personal questions at the Track Your Plaque forum.  But given his patient load and responsibilities for the Track Your Plaque program, he is not able to answer questions often here at the Heart Scan Blog.

  • Scott09

    4/7/2009 7:03:00 PM |

    Doc
    How do you know it was the wheat that did it? What about the sugar or starch. Don't you have to isolate your variables?

  • xenolith_pm

    4/7/2009 8:02:00 PM |

    Steve K,

    You may be extraordinarily insulin sensitive to grains and sugars.

    Are you using the drink or wafer forms of Metamucil?

    Just one tablespoon of the original drink form of Metamucil has 9 grams of sugar (sucrose).

    The "sugar free" drink versions of Metamucil will still give you a good dose of aspartame and maltodextrin.  Small amounts of chronic doses may result in unfavorable insulin resistance/response with some people.

    The wafer form of Metamucil is even worse.  Each serving contains 6 grams of sugar, corn starch, fructose, and wheat.

    Try to get a brand that only contains psyllium husk, like Konsyl.  Each serving has only 0.5 grams of available complex carbohydrates. It can be found at Walmart.

    Yes, Greek yogurt has less lactose (milk sugar) than regular yogurt.  But, even a modest eight ounce serving of plain Greek yogurt can contain as much as 9 grams of lactose.  And if you are consuming chronic amounts, it very well may be affecting your insulin.

    IMHO, investing in a glucose meter for home monitoring is not a bad idea for anyone who think they may be genetically sensitive to carbohydrates.

  • Steve K

    4/8/2009 2:00:00 AM |

    xenolith_pm :


    i am thin and fasting glucose last measured was 79 which i am told is lower end of normal.  Were i super sensitive this and trigs(20) would i suspect be higher.  Thanks for input from all.

  • Trinkwasser

    4/8/2009 6:59:00 PM |

    I'm jealous! Dropping the carbs decimated my trigs (literally) and doubled HDL. Initially my LDL *increased* but adding more sat fats seems to have reduced this back again. I wish I could get a proper test for the particle size, I have to guestimate from the trigs/HDL ratio.

    Maybe I should eliminate the small amount of wheat I still eat, see if there's a threshold effect.

  • Anonymous

    4/9/2009 8:41:00 AM |

    I am posting this here because I cannot, at this time, afford to join the forum so would appreciate anyone who could answer me.  I have avoided wheat for years because of its disastrous gastric effects but reading Mary Enig and Sally Fallon's Nourishing Traditions have been thinking about trying some sprouted wheat bread (Sunnyvale Organic).  Any opinions on this as the phytic acid is neutralised and the vits and mins are more bioavailable?

    Susie

  • Anonymous

    4/9/2009 11:35:00 AM |

    I have asked for a proposed mechanism several times.  I do not dispute the reported results, it just helps if a mechanism is proposed so people can understand why wheat or any other food impacts the particle size of LDL.

    Trevor

  • Kiwi

    4/9/2009 10:45:00 PM |

    This study found that wheat was a problem compared to oats but they were unable to reach a conclusion as to why.

    http://www.39kf.com/cooperate/qk/American-Society-for-Nutrition/027602/2008-12-28-550490.shtml


    "The reason for these unfavorable lipoprotein changes in the wheat group is not readily apparent; however, the mechanism by which these alterations are produced does not occur with increased oat consumption."

    The only grain I eat now is oats prepared using the Weston Price method.

  • Anonymous

    4/10/2009 3:17:00 PM |

    I think its hard to answer in detail allot of questions that come here, which is why we started the board as there were several of us just like you with all these questions.

    It was our idea for a small fee, not Dr D idea to make money, he makes nada off this and gives gives gives!

    ....and there had to be a small fee otherwise we would need advertisers like drug companies and we wanted it to remain free of that brain washing.

    The board is about $20 a few times a year and it has saved my life.

    Cheap investment.I think I am worth that.

    There is so much information there you would know that these blog posts are 110% backed up with good medical documentation.

    Or maybe go back to the beginning of this blog and read it all in detail and allot of your questions will be answered.

    I used to hang onto this blog for info as found it the most effective and so personal. Then we started the board and I can go there and read and educate myself from Dr D and hundreds of well educated folks like you and me who want to live longer and know traditional medicine is not helping us as much as it could with reversing our plague.

    Now I hardly ever come here as all the info is at my finger tips.

    Dr D makes no money from the board, it is to pay for band widths, web seminars etc.

    It is created by volunteers from this group and if approx.$5 a month isn't affordable let me know and I will help you find a way to raise some funds to take good care of yourself.

    I believe its our right to good health care info and thats what Dr D provides here and on the board.

    I am serious, don't let the small fee make you die younger.

  • Anonymous

    4/10/2009 5:43:00 PM |

    Anonymous,

    Sprouting the grains may eliminate the gastric issues you've experienced with wheat. However, those gastric issues may have been an indication of gluten intolerance and gastric issues may not be the only symptom, just the most obvious or visible one.

    Before adding wheat back to your diet in a large way, please research non-celiac gluten sensitivity and gluten intolerance on the web and at the public library.

    http://www.glutensensitivity.net/ and http://jccglutenfree.googlepages.com/ are good places to start.

    If you have questions re: gluten intolerance, there are several forums discussing this topic such as glutenfreeandbeyond.org/forum
    or forums.glutenfree.com

  • Anonymous

    4/11/2009 4:32:00 PM |

    Thanks for that, I was just asking as the wheat issues raised in the blog and the main site probably refer to modern wheat refining and baking processes whereas sprouted grain bread is made to an ancient recipe and contains no dairy or yeast.  I will certainly check out all options before deciding.  Thanks again.

    Susie

  • Trinkwasser

    4/12/2009 2:21:00 PM |

    Some diabetics can eat Ezekiel or similar sprouted grain breads, or breads made with wheat gluten and non-wheat flours, and I can handle other grains (in sufficiently small quantities) without the BG and presumably insulin spikes specific to wheat, but that's only one of the possible issues.

  • Anonymous

    4/16/2009 9:54:00 PM |

    hey thanks.  I don't have an issue with the fee, just and issue with putting my creditcarddetails into an unsecure webpage.  I wrote the TYP and pointed out they should use https.... when it is fixed, I will join. Even this blog is https

  • particle size reduction

    4/3/2010 3:17:59 PM |

    I think that the problem you are suffering through is insulin sensitivity. Well i am still researching on this topic but till now the point which has been cleared is this one only.

  • buy jeans

    11/3/2010 7:00:57 PM |

    In other words, 100% of Lee's LDL particles had shifted to the more benign large LDL simply with elimination of these foods---NO statin drug. (In addition to wheat elimination, she was also taking vitamin D and omega-3 fatty acids at our recommended doses.)

Loading
Plant-based or animal-based?

Plant-based or animal-based?

The ideal diet for heart and overall health restricts carbohydrate intake. I say this because carbohydrates:

Make you fat--Carbohydrates increase visceral fat, in particular.
Increase triglycerides
Reduce HDL
Increase small LDL particles
Increase glycation of LDL
Increase blood pressure
Increase c-reactive protein


Reducing carbohydrates reverses all the above.

But here's a common mistake many people make when following a low-carbohydrate diet: Converting to a low-carb, high-animal product diet.

It accounts for a breakfast of a 3-egg omelette with cheese and butter, 4 strips of bacon, 2 sausages, cream in coffee. Low-carb? It certainly is. But it is a purely high-animal product, no-plant-based meal.

I believe a strong argument can be made that a low-carbohydrate but plant-based diet with animal products as the side dish is a better way to go.

Consider that:

1) Animal products have little to no fiber, while plant-based products like spinach, avocado, and walnuts and other raw nuts have substantial quantities.

2) Plant products are a source of polyphenols and flavonoids--This encompasses a large universe of nutrients, from epigallocatechins in tea, polymeric procyanidins from cocoa, to hydroxytyrosol from olives, and anthocyanins from red wine and eggplant. The inflow of these beneficial compounds needs to be frequent and generous, not piddly amounts taken infrequently.

3) Vitamin C--While it's easy to obtain, the fact that you and I need to obtain vitamin C from frequent ingestion of plant sources suggests that humans were meant to eat lots of plants. While it may require a few months of deficiency before your teeth fall out, imagine what low-grade deficiency can do over a long period.

4) Vitamin K1--Rich in green vegetables, vitamin K1 is virtually absent in animal products.

5) Tocotrienols--I've been watching the data on this fascinating family of powerful oil-soluble antioxidants unfold for 20 years. Tocotrienols come only from plants. (I recently had an extended conversation with the brilliant biochemist, Dr. Barrie Tan, who is incredibly knowledgeable about tocotrienols, having developed several methods of extraction from plants, including his discovery of the highly concentrated source, annatto. Be sure to watch for future conversations about tocotrienols.)

6) Meats and dairy yield a net acid load--While plant foods are net basic. At the very least, this yields risk for osteoporosis, since acids are ultimately buffered by basic calcium salts from the bones. Tissue and blood pH is a tightly regulated system; veering off just a teensy-weensy bit from the normal pH of 7.4 to an acidic pH of, say, 7.2, leads to . . . death. In short, pH control is very important. A net acid challenge from animal products is a lot like drinking carbonated soda, a huge acid challenge that leads to osteoporosis and other health issues.

Conversely, a pure plant-based diet has its own set of problems. Eating a pure plant-based diet can lead to deficiencies of vitamin B12, omega-3 fatty acids (no, linolenic acid from flaxseed will NOT cut it), vitamin K2, carnitine, and coenzyme Q10.

So, rather than a breakfast of 3-egg omelet with bacon, sausage, cream, and cheese, how about a handful of pecans, some blueberries, and a 2-egg omelet made with basil-olive oil pesto? Or a spinach salad with walnuts, feta cheese, and lots of olive oil?

Comments (78) -

  • Jezwyn

    4/19/2010 12:02:43 AM |

    Really? You're trotting out the anti-carnivore rant again?
    Would you like to back up your claim that we somehow need fibre?
    Or polyphenols and flavonoids, and tocotrienols, in the absence of the oxidised situations they counter?
    Do you consider that Vitamin C is absorbed better when dietary glucose is minimised, as the two require the same uptake system and glucose will hog that system if it's present?
    If we need Vitamin K1, why didn't the Inuit suffer debilitating deficiencies?
    Why didn't they die young of bone fragility if their blood pH was truly so dangerously affected by acid load?

    It seems like your ideas here are based on unproven theories, not practical, clinical scientific demonstrations. If you'd like to link to studies demonstrating how individuals following a carnivorous diet (preferably one based on pastured, wild animals) suffer in the manner you've outlined, I'd love to read them.

    I really respect your blog and your efforts with helping your patients find lifestyles that work for them, but uninformed, unsupported posts like these are very disappointing.

  • John Phillip

    4/19/2010 1:10:41 AM |

    Absolutely correct, as always.  I switched from the Standard American Diet 5 years ago to a raw, plant based diet of dark green leafy vegetables, nuts, seeds, healthy fats and lean protein... no low carb, highly processed or over cooked meats. Totally eliminated wheat and corn based foods, and especially anything with HFCS. My blood sugar has dropped to below 100 1 and 2 hour post prandial and my A1C is 4.5.  Also, triglycerides are 50 and VAP shows mostly large LDL.  It really works, and I have seen it work for others who have followed the same program.  I write about it at my blog: myoptimalhealthresource.blogspot.com. Having read Dr. Davis for years, I would like to thank him for his spot on information!

  • Mike

    4/19/2010 1:29:43 AM |

    How about crushing a nice 10oz grass fed, organic, free range steak along with that salad, and then the whole debate of plant vs animal debate is moot?

  • Jenny

    4/19/2010 1:29:43 AM |

    It's a myth that eating a high animal protein low carb diet will cause bone loss. Studies do not support this.

    http://www.ncbi.nlm.nih.gov/pubmed/16718399?dopt=Abstract

  • Anonymous

    4/19/2010 2:21:11 AM |

    to include more plant-based options in anyone's diet, this blog post from Chris Masterjohn seems to contradict your 6th point.

    So although I may arch an eyebrow at that point, I still agree that we shouldn't be consuming animal products ad libitum at the expense of plant-based options.

    Randy Watson

  • sr

    4/19/2010 3:57:51 AM |

    Do we really need fiber? I recall a chapter in Taubes' book saying that fiber doesn't do much for you if you're not constipated. And Vilhjalmur Stefansson went for 2 years without eating vegetables and had no problems with scurvy. Apparently anti-nutrients in carbs up our vitamin C requirements. If I recall correctly it uses the same GLUT transporters glucose does.

  • PRIDE MAFIA

    4/19/2010 4:23:35 AM |

    Lots of Carbs and  O-6 in nuts;this is good?

  • Alan

    4/19/2010 4:26:28 AM |

    No thanks.. I'll stick to the eggs meat and cheese and get plenty of Vit C in the process. You absolutely don't need plants in your diet, they aren't magic..

  • Gyan

    4/19/2010 5:35:30 AM |

    Vitamin-C can be supplied by raw green chillies.

    Is Vitamin-K1 required? I thought all vitamin-K1 does is to convert to K2.

    IS Fiber essential? if yes, then in what quantity?

  • Rick

    4/19/2010 5:58:42 AM |

    Dr Davis, Do the plant foods you list in your suggested breakfast menus at the end qualify as low carb?

  • David

    4/19/2010 6:40:59 AM |

    wow, I can just see the pro-animal fat nuts rushing to retort to this one... pardon the pun, but it's like red meat to a caged lion...

  • Ellen

    4/19/2010 9:52:51 AM |

    Actually, it wasn't UNTIL I ate more saturated fat (in the form of butter and coconut oil) that I saw a significant improvement in my HDL. Up until that point it was hovering around 50'ish. It shot up to 80 after incorporating the coconut oil. Unless you would consider coconut oil plant based even though it's mostly saturated fat?

    I sincerely attribute my improved HDL to saturated fat.

  • Torquemada

    4/19/2010 10:09:53 AM |

    but that... but that means we can't use low carb as an excuse to indulge in an orgy of gluttony with bacon, cheese mayo and steak.

  • Joachim

    4/19/2010 10:16:21 AM |

    Do you think eating a balanced plant/animal diet (low-carb) would be sufficient as an everyday diet/lifestyle?

    I've been doing a similar low-carb ketogenic diet the last 4-5 months and never felt better. I'm planning on doing the ketogenic diet again but my doctor and my girlfriend her dietician said that this diet is very bad for the liver and the cardiovascular system.

    The only drawback in my opinion is the lack of fruits in order to stay in keto.

    What's your take on this?

  • SamAbroad

    4/19/2010 11:14:39 AM |

    Oops, forgot to include the link to the paper:

    http://www.ajcn.org/cgi/content/full/71/3/682

  • Vlado

    4/19/2010 11:21:02 AM |

    I am on a fish diet where 50% of my calories are coming from it(wild salmon) and have finally gained an ideal weight but i also eat some fruits and dark chocolate as well.There is a lot to be said about acidity factor which means that we are meant to eat both heavy and light foods to balance. The most important omission from diet would be grains , processed foods and vegetable oils.

  • LeonRover

    4/19/2010 11:47:37 AM |

    I thought that one of the observations that explorer Steffansson made on the health of his Inuit hosts was the lack of scurvy in the settlement.

    I also believe that in the absence of plant food,it has been concluded that meat can supply sufficient Vitamin C to prevent scurvy.

    It seems to me that to conclude " that humans were meant to eat lots of plants" is a conclusion too far.

    I suggest that the "or" in your should not be read as "either/or" but the "logical or" meaning " one or both".

  • Tom M

    4/19/2010 1:29:13 PM |

    Utterly ridiculous suggestion. Regardless of all the details that have been covered by previous posters, do you consider eating modern fruit and vegetables to be 'in tune' with the way we were designed to eat?

    A plant based diet is only possible through modern means, mainly transportation. I'm sure American olive oil is fantastic.

    I really don't think you've thought this through. Where are the calories? Do you drink a pint of walnut oil a day? Keeping carbohydrates and  animal sources down leaves you incredibly limited.

    Lastly, the idea of a 'side dish' of meat is absurd. Picture the scene: Hunter Tom in England kills an Auroch, begins gorging on the bountiful fat surrounding it's kidneys but then remembers: 'oh, better stop, I have boiled nettles awaiting'.

    Get real, kids don't like vegetables for a reason.

  • Anonymous

    4/19/2010 1:41:04 PM |

    With the Inuit argument you should consider whether they consumed the gut contents of the animals they ate.

  • Stargazey

    4/19/2010 2:34:46 PM |

    So by this reasoning we should avoid fruits because of their citric acid content?

  • Gretchen

    4/19/2010 2:36:12 PM |

    Too many people assume that anyone on a LC diet is pigging out out on huge amounts of fatty meats and cheese, with no vegetables. This is simply not true.

    It's like criticizing someone on a low-fat diet by saying they're eating a breakfast consisting of two bowls of cereal, 3 cups of skim milk, 5 pieces of toast, 2 tablespoons of jam, and 3 glasses of OJ.

    If I choose to eat bacon and eggs, I'd have one poached egg with a quarter of a pat of butter, and 1 slice of bacon. Maybe 2.

    In your point 1 you're comparing spinach with meat. Apples and oranges. You need to compare a complete animal- protein-including meal with a complete animal-protein-lacking meal.

    Re point No. 2: you can get vitamin C from uncooked meat. Does this mean we're meant to eat uncooked meat?

    I eat plenty of LC vegetables. I just don't eat an all-vegetable meal because I need protein to stabilize my blood sugar and hold me until the next meal.

    It's very difficult to do a vegetarian LC diet because we need protein, and the usual vegetarian protein sources like beans and rice are too carby. The only exception is tofu, and one cannot live on tofu alone.

  • zach

    4/19/2010 3:05:36 PM |

    I totally disagree. The points on vitamin K and vitamin C are startling- very much at odds with my layman's research. Certain organ meats are sky high in vitamin C. The need for C also goes down on a low sugar diet. Conversion from K1 to the all important K2 is very poor in humans eating a plant based diet. Where is K2 MK4 found? Pastured eggs and dairy, seafood, organ meats, etc.

  • Kevin

    4/19/2010 3:05:36 PM |

    Ah, the voice of reason.  How the hell did you get in here?  

    Stuffing oneself with 5000 calories of fat every day made no sense when I was reading Atkins 15 years ago.  I think we evolved to be able to eat healthily using animal and vegetable sources.  Our modern health problems don't stem from anything more than excesses of everything.  Although it's much harder to ingest excess vegetables compared with meat.  

    kevin

  • Christopher Robbins

    4/19/2010 3:31:42 PM |

    The major problem I see in this recommendation is that without calorically dense, starchy carbs and/or a lot more fat it would be hard to take in enough calories. I can deal with the fat. Even Mark Sisson champions the Big Ass Salad. And Stephan at wholehealthsource has started including more veggies & carbs. I do think animal protein/fat should make up the bulk of the diet though.

  • Ellen

    4/19/2010 4:26:19 PM |

    Yeah, fiber's over-rated. So is olive oil. Olive oil never did *anything* for my lipid profile. Olive oil makes you fat.

  • Anonymous

    4/19/2010 4:44:00 PM |

    People evolves, even to feed on pasta: http://www.visitlimonesulgarda.com/index.asp?menu=13.58

    Thinking we're the same animal that fed on mammoths 10k years ago and that we have to eat that makes little sense.

    Thinking we all would react the same to an inuit diet, having inuits evolved for such a long time to survive where they live eating where they eat, makes no sense.

    There are many people on the planet that live health and diets vary a lot.

    Dr Davids, and anyone else for that matter, can only give pointers, but everyone has to find its own way to health and not expect it to be the same for every one and to be one single real truth.

    We are 6 billion mutants with 6 billion different ideal diets

  • Christine

    4/19/2010 4:46:00 PM |

    Now you're talking my language, Dr. D. Great post! I welcome more like this one. This reader wants to know everything you know on the subject of low carb plants vs high fat meat/dairy.

  • Chris Kresser

    4/19/2010 4:50:51 PM |

    Jezwyn, you took the words right out of my mouth.

    Let's see some proof for these claims.  You'll be hard-pressed to find it.

    Tell the Masai and Inuit that you need a diet high in plant foods to be healthy.

  • Ned Kock

    4/19/2010 4:56:23 PM |

    I tend to believe that a diet with plant AND animal products is at least quasi-optimal, in part for evolutionary reasons:

    http://healthcorrelator.blogspot.com/2010/02/lucy-was-vegetarian-and-sapiens.html

    But on the acid-base blood balance argument, there are a number of other issues to consider:

    - Lack of activity leads to bone demineralization, regardless of what you eat. Astronauts start losing bone mass soon after the start living in zero-gravity.

    - Higher protein intake is associated with higher dietary calcium absorption.

    - Higher serum levels of vitamin D are associated with increased serum calcium levels and bone mineralization. In fact, hypervitaminosis D leads to elevated serum calcium levels, even with low dietary calcium intake.

    - The Inuit, on a traditional diet of animal meat and fat, have among the lowest (if not THE lowest) rates of tooth decay in the world - and bone mineralization is correlated with teeth health (although the correlation is not 1).

  • Alan S David

    4/19/2010 5:03:46 PM |

    You describe my diet to a "t". Low animal products, lots of plant based. Low carb.So at 61, I am told I look in my 40's, rarely ( if ever) suffer from any of the common afflictions, and enjoy robust health. Gotta be something right about all this.
    Confirmed heavy animal products in your diet lead to all sorts of problems. Minimize them and you minimize the problems.

  • Dave, RN

    4/19/2010 6:18:31 PM |

    Aw man, you lose credibility when you publish stuff like this...

  • Anonymous

    4/19/2010 6:42:45 PM |

    I've been on a low carb diet for years, but my health was never so improved as when I finally cut all plant matter out of my diet.

    -Amber

  • schubie

    4/19/2010 7:09:33 PM |

    Is it my imagination or were the previous recommendations when I started reading this blog many months ago more evidenced-based pointing to specific studies, and lately they've been much shorter and more like "statements" of "fact" without any supporting documentation?

    I don't get it.

    Smells like someone's trying to court a little controversy to generate some buzz.

  • Martin Levac

    4/19/2010 7:40:56 PM |

    It's easy to forget the Stefansson all meat trial. It was supposed to answer all those questions and doubts about various deficiencies such as vitamin C or calcium. And it did in my view. So why does doubt still persist to this day?

    If you believe that you should eat plants, then go ahead an eat them. But for a PSA, stick to the facts.

  • Martin Levac

    4/19/2010 8:01:39 PM |

    Sorry, in my haste to bring an argument in favor of an all meat diet, I forgot this argument against a plant based diet.

    Dr Davis, you say "I believe a strong argument can be made that a low-carbohydrate but plant-based diet with animal products as the side dish is a better way to go."

    It's already been weighed and measured and found to be lacking. In comes Ancel Keys and his semi-starvation experiment. It is exactly the kind of diet you propose: Low carb plant-based diet with animal products as the side dish. The result? Emaciation and neurosis. But that was a low calorie diet, you say. And probably lacked many nutrients, you say. Yes and yes. In comes the Biosphere 2 project which tried to fix one of those problems by administering the full RDA in vitamins and minerals every day. The result? Still emaciation and neurosis but admittedly to a lesser extent. Maybe it would work with ample calories?

    I don't think it's merely a question of calories at this point. I think it's partly a question of essential nutrients found only in animal flesh. Or a question of the depleting nature of a high plant diet. In other words, eating a high plant diet requires more of those essential nutrients, including total calories, found only in animal flesh.

  • Anonymous

    4/19/2010 8:16:03 PM |

    Ok. I just found your blog. Now I'm really confused. These two questions I'd like answered:

    -Where do you agree/disagree with Esselstyn?

    -What am I supposed to feed my three year old. He eats oatmeal and fruit for breakfast? (It's supposed to be healthy!)

  • Aaron

    4/19/2010 8:21:16 PM |

    Great post -- and to the vegetable naysayers -- there is more evidence to suggest than not that veggies are a healthy addition one's diet.

    A low carb, non-veggie diet is an experiment -- "if" it turns out to be healthy, more power to it.

    In the mean time -- I'm sticking with the decent epistemological studies out there that support the use of veggies/fruit the diet.

  • pmpctek

    4/19/2010 8:50:19 PM |

    @ John Phillip,

    I accomplished all those milestones, plus my HDL is over 70 mg/dl, all on a heavy carnivore dominant diet. John, you curiously did not divulge your HDL level.

    @ Jenny,

    Agreed.  Myths are hard to kill.  This acid/alkaline theory of disease is clearly a long standing one.  

    Absence of renal and lung disease, the homeostatic mechanisms controlling the pH of our blood are incredibly robust and tightly regulated.  Even if you have poor regulation of bicarbonate concentrations in blood (dialysis patient) or you suffer from chronic respiratory acidosis (hyperventilation) it's not as though eating more plant foods and restricting meat and cheese will at all reverse the acidic condition these more serious underlying disturbances cause.

    Even if meat and cheese yields a heavy acid load, all that may result is slightly more acidic urine.  There is no credible evidence that proves the act of intentionally alkalizing your own urine by dietary restrictions prevents or treats any disease, makes you feel better, or anything else.

  • Scott Miller

    4/19/2010 10:52:37 PM |

    The evolutionary evidence indicates our paleolithic (pre-agriculture) ancestors ate a LOT of meat. It doesn't make any sense that meat is unhealthy to humans.

    And, the present-day evidence supports meat consumption, too.

    In my case, I've been on a ~10% carb diet (mostly salad and vegetable carbs, no grains, very little fruits) for 5+ years. My blood stats are outrageously healthy (at 48 yrs old). HDL = 98, trigs 47, VLDL = 4, C-RP = 0.2. A1c = 4.8.  I can go on and on. I look 10 years younger than I am, my VO2 max is 52 (and I do not do any cardio), bodyfat = 10%, and I have no arterial plaque.

    Sadly, I do not like seafood, so I eat red meat almost exclusively, plus a lot of coconut oil.

    I also take over 40 supplements a day, including K2 (K1 is far less effective, not sure why you like it more, versus the animal version of K), tocotrienols (agree these are amazing), and numerous supps that reduce glycation, inflammation, and brain degeneration.

    BTW, natural fed meats are greatly superior, but even grain fed meats are adequate. And red meat is healthier than chicken meat due to having significantly lower levels of polyunsaturated fatty acids.

  • thania

    4/19/2010 11:15:16 PM |

    I think in something so important as "nutrition", it is not possible to adopt an "one tooth paste menthality". It depends a lot on the environment, climate and hence the gut flora composition of each individual and the digestion issues.

    During the past year of being part of the low-carb, paleo/primal community. I have observed for some people eating plants even in small quantities cause bloating , gut discomfort and eliminating them and a carnivoros diet has almost saved their lives , are much healthier . On the other hand some of the fittest members eat huge amont of animal food + huge amont of plant food.

    As a mediterranean I am very used to eat plant food , and had concerns on eating VLC food due to acid/alkaline balance so did a bone densitometry through my traumatologist, to repeat it after 2 years feb 2010, and comparing the results ; there is a 10% bone density loss! Ofcourse in these 2 years of VLC I did a lot of mistakes with too much processed meat and LC junk foods at the beginning, and was an evolution towards the grass fed meat and realfood. And also the fact that a part from walking , I am quite sedentary too!

    For me never felt right to leave out the plant food so drasticaly when I was doing VLC,I can enjoy a nice juicy beef steak , but with a side of salad or some steamed veg , the joy is even more and feels much better on my guts and the BG levels.

    So is the matter of each personal biochemistry process and many factors influencing it.

    It is a question of indivitual trial and error and listening to ones body needs. Then decide to be carnivoros, VLC, plant based, animal based , paleo or primal.

  • David

    4/20/2010 12:14:26 AM |

    Dr. Davis,

    I'd definitely be interested if you personally see results with any of your patients taken delta gold. I've been taking it a year now. I'm just trusting the small clinical trials, and hope they are legit.

  • Dr. William Davis

    4/20/2010 12:50:56 AM |

    Maasai are plant-eaters as well as meat-eaters.

    Comment from Ethnobotany of the Loita Maasai   about the great "meat-eating Maasai" tribal culture:


    "Animals are kept both for economic reasons
    and as a source of food. Milk from cows, especially
    fermented, is the main traditional food of the
    Maasai. Herbal soup is an important part of the
    diet for most people, men and women alike, but
    especially for the warrior age group. It is taken as
    a health food by ordinary people and as a drug by
    warriors. Meat is usually eaten during ceremonies.
    Wild food, especially fruits, tubers, resins and
    roots, are still important, particularly to women
    and those taking care of animals in the field."

    Full-text here:http://unesdoc.unesco.org/images/0012/001266/126660e.pdf

  • Dr. William Davis

    4/20/2010 12:52:24 AM |

    David--

    As we do not use tocotrienols in the program, we have no formal experience with it.

    However, having had an extended conversation with Dr. Barry Tan, I have to say it is worth looking at again, though my in-depth interest dates back nearly 20 years.

  • Chris Kresser

    4/20/2010 12:52:24 AM |

    The Masai may eat some animal foods, but they certainly aren't a "side dish" as you recommend.

  • Dr. William Davis

    4/20/2010 1:18:04 AM |

    Inuits eat lots of meats, but also eat plants.

    Dr. Weston Price on observing the eating habits of the Inuits during the first 20 years of the 20th century (before substantial Western influence on the Inuit diet took root):

    "The food of these Eskimos in their native state includes caribou, ground nuts which are gathered by mice and stored in caches, kelp which is gathered in season and stored for winter use, berries including cranberries which are preserved by freezing, blossoms of flowers preserved in seal oil, sorrel grass preserved in seal oil, and quantities of frozen fish. Another important food factor consists of the organs of the large animals of the sea, including certain layers of the skin of one of the species of whale, which was found to be very high in vitamin C."

    Organ meats and the fat of cold water creatures are indeed richer in vitamin C than muscle meat that we consume. When is the last time you ate muktuk?

  • Chris Kresser

    4/20/2010 1:19:22 AM |

    Oops, that should have read "The Masai may eat some plant foods, but they certainly aren't a side dish as you suggest."

  • Adolfo David

    4/20/2010 11:46:16 AM |

    I agree with a low carb diet based on animal and vegetal products, but I diagree with a so high fiber diet. See 'Fiber Menace' book, recommended by Weston Price Institute.

  • Helen

    4/20/2010 2:11:43 PM |

    Help for the nut-allergic, please.

  • Adolfo David

    4/20/2010 7:23:12 PM |

    Dr David and all, you have a interesting tocotrienols report in Nutraceutical Magazine september 2009, its about newest tocotrienol supplement formulation, in page 42

    http://www.nutraceuticalmag.com/NBT/pdf/2009/NBT_SO09.pdf

  • Maris

    4/21/2010 2:37:41 PM |

    You're right. so all in all, the key is to balance everything and place more emphasis in eating plant-based foods than animal products, specifically meat. I've tried a low-carb diet upon my doctor's reccomendation due to my hypertension, and although it's not easy at first(coz I'm used to eating lots of carbs), I got used to it after some time.

  • PJ

    4/22/2010 1:48:05 AM |

    You lost me on this one.

  • Marius

    4/22/2010 5:22:24 AM |

    This is getting ridiculous. Carbohydrates are evil and animal products are bad. Yum, I'm looking forward to my dinner of olive oil, carrots and five different types of nuts! The Auschwitz diet, it really works!

    We only became human because our ancestors included increasing amounts of meat and animal fat in their diet, which provided enough energy/EFAs for our brains to grow, which made us more intelligent and able to get even more meat and fat. Had they kept to their plant-based diet, we would still be swinging from the trees.

    That, and cooked tubers. As in, potatoes.

    What you are promoting on this site is anorexia and food phobias.I'm sure eating so little that your heart atrophies is super "heart healthy".

    The article seems to be supported by vegan myths and our modern cultural bias/squeamishness against meat more than scientifically established facts.

  • Cotton Yarn Manufacturer

    4/22/2010 7:55:47 AM |

    Other skins such as those from large animals such as horse and smaller animals such as ... Plant-based parchment: Parchment paper. thanks for sharing the information.

  • Mike Turco

    4/22/2010 4:13:11 PM |

    That is a really interesting line of thought, and plus, I'm an on-and-off reader of your blog and really respect your opinions. I've been on the meat and cheese mostly diet, along with the occasional veggies, nuts, berries, melons, etc. Its a good way to eat, for me, but hey its a boring diet and I've been wanting some change and variety for quite some time. I'm going to take a crack at switching things up for a while, in the way that you are suggesting, and see how that goes for me. I certainly don't see any harm in giving it a shot. I'll comment back at some time in the future, probably on another post, and let you know how it goes. Thanks again for your insight. -- Mike

  • Apolloswabbie

    4/23/2010 2:10:26 AM |

    Jezwyn - were you going to just borrow my thunder or steal it?

    Kidding - I could not have made those points as well or concisely as you did, thanks.

  • Apolloswabbie

    4/23/2010 2:15:42 AM |

    "Thinking we all would react the same to an inuit diet, having inuits evolved for such a long time to survive where they live eating where they eat, makes no sense."
    No, it doesn't, but when it actually happened, euros who lived/ate with the inuit reported more than once that they thrived.  This was tested in a hospital setting and confirmed.  In other words, we've more EVIDENCE that the Inuit diet was not beneficial because they were some genetic mutant - it was beneficial for humans in general.  

    Congnitive dissonance?  only if you've bought the unproved conjectures so rampant in the science of diet.

  • Anonymous

    4/25/2010 2:14:00 PM |

    I think the reaction to this article was predictable. If an atheist tells a person of faith that they are wasting their time with prayer and they should just get on with making the most of this life, very few would expect a capitulation by the religious. IMHO, diet is a lifestyle, like religion, and generally ruled by a hefty dose of emotion.  Having view points out there for people to make up their own minds is terrific.  But in the end we have to decide what we believe in.

    great work Dr. D. stay the course and the debate will be healthy..pun intended.

  • Kevin

    4/25/2010 6:08:13 PM |

    Anonymous said...
    "I think the reaction to this article was predictable. If an atheist tells a person of faith that they are wasting their time with prayer and they should just get on with making the most of this life, very few would expect a capitulation by the religious. IMHO, diet is a lifestyle, like religion, and generally ruled by a hefty dose of emotion. Having view points out there for people to make up their own minds is terrific. But in the end we have to decide what we believe in."

    I agree.  Unfortunately the emotion in any hotbutton issue leads the insecure to spew vitriole which makes it harder to stay connected to the dialogue.

    I'm hoping the doctor continues to espouse his viewpoint here.

  • DrStrange

    4/25/2010 8:24:23 PM |

    Just read thru all the posts and what a hilarious set of temper tantrums!  Since we live in modern times, we can easily supplement K2, D3, and omega 3 (I certainly do on plant based diet)(for omega 3 I take about 200 mg/day of plant source DHA drops).

    There are studies and there are studies and you have to actually read the details to see what they are measuring.  A little more fruits and veg than the crappy SAD, as in the study cited above, will have relatively little benefit though even at the amounts in the study there was a slight benefit.  Many Masai in fact were found to have plenty arteriosclerosis, just huge arteries from much more exercise than you or I will ever do.  Inuit skeletons do show severe osteoporosis and they tended to died young from hard living in a very tough and unforgiving environment.  Look around the rest of the world, aside from Inuit and Masai, all traditional cultures ate very small amounts of animal based foods and mostly plants.

    Personally, my blood sugars postprandial were running 175-200 for several hours. Switched to no animal fat and reduced fat and calories and they would still spike but stay up much shorter duration.  Currently I eat 100% plants, getting about 35% fat from unsalted, raw nuts and around 150-160 grams of carbs per day. Carbs and protein also coming from about 1 1/2 cups beans per day. Protein is about 15% of calories. My postprandial sugars stay under 110 and usually are under 100, even with a little fruit tossed in for dessert...  Everybody has to find their own way but you guys really need to read research more carefully.

  • DrStrange

    4/25/2010 10:29:42 PM |

    I had a doc tell me once he seldom if ever talked diet w/ patients as getting them to change was likely harder than getting them to change their religion!  I think that was cop-out as it is so important but a lot of truth there as well.

  • jandro

    4/27/2010 6:33:52 AM |

    Stefansson's meat only trial is not conclusive, X-rays were use to measure osteoporosis which only detects it once there has been a 30% reduction in bone mass. Obviously, you are not going to lose 30% of bone mass in a year. You can read more about it here: http://donmatesz.blogspot.com/2010/03/paleo-diet-ph-does-it-matter-part-vii.html

    There are also frozen eskimo skeletons that show severe osteoporosis in women that are only 30 years of age.

    Eskimos were pushed to a really extreme environment in which we certainly did not evolve. Why anyone would use their diet as a model diet blows my mind.

    We evolved in East Africa with dry and wet seasons. Warm all year round. It allowed for plenty of vegetation to grow, and for plenty of animals to thrive.  Tribes living in that region have a diet high in both animal and plant products. It's low in fructose and most of the carbs are coming from tubers (yielding a net alkaline effect). Some nuts may be used as well but not to the extent it was used in this post.

  • Martin Levac

    4/27/2010 6:52:18 PM |

    Is there an association between meat consumption and calcium excretion?

    Is there an association between calcium excretion and bone loss?

    Is there an association between meat consumption and bone loss?

  • DrStrange

    4/28/2010 1:05:51 AM |

    Depending on what studies you read, there is an association w/ higher protein intake and bone loss, particularly for animal protein though I think plant too.  Amino acids are acids and need buffering.  If necessary, body will take alkaline minerals from bone to do the job.

  • Contemplationist

    4/28/2010 6:10:17 AM |

    Indeed what about the evolutionary argument that our ancestors survived mostly on animal meat (and its fat) ?

  • Bonnie

    5/2/2010 8:49:36 PM |

    You confuse me.

    Yesterday I ate 4 eggs, a pint of cream, 4 tablespoons of butter, 3 pieces of bacon (with all the rendered fat), about 6 oz of fatty beef steak, and a tin of sardines. I also ate 1 serving of sprouted pumpkin seeds, 1 cup of orange juice, 1 serving of brussels sprouts and 2 servings of spinach. From this I got 97% of DRIs for vitamins and 91% of minerals (I use CRON-O-Meter) in under 2500 calories.  48 grams of carbs.

    I'm not finding it at all difficult to exceed minimums for vitamins and minerals found mostly in plant foods while still eating a low-carb animal-based diet.

  • DrStrange

    5/4/2010 12:41:14 PM |

    "Yesterday I ate 4 eggs, a pint of cream, 4 tablespoons of butter, 3 pieces of bacon (with all the rendered fat), about 6 oz of fatty beef steak, and a tin of sardines."

    Bonnie, have you no concern about GMO diary (hormone forced milk production), nitrites/added hormones/stress hormones in bacon, GMO corn and petro chem and drug residue in beef, etc? Or are all these from organic, free-range animals fed their natural diets?

  • DrStrange

    5/4/2010 12:49:18 PM |

    "Indeed what about the evolutionary argument that our ancestors survived mostly on animal meat (and its fat)?"

    Contemplationist, read this

    http://diabetesupdate.blogspot.com/2009/09/lets-not-twist-history-to-support-our.html

    From looking at the diet of contemporary hunter gatherers, an argument could be made that the ancestral diet contained a great deal of plants, as well as insects, small birds, lizards, etc.  The meat eaten was not the bulk or even the majority source of calories and it was all very very lean.

  • Anonymous

    5/4/2010 2:50:16 PM |

    His advice makes sense for the vegans and vegetarians and low-fatters.  A huge step up for them and, most importantly, it's very 'foodie' and will appeal to them.

    The animal-based diet, on the other hand, appeals to people like me who are lazy and therefore used to eat the SAD diet.  Dinner: grilled hamburger topped with butter, sea salt and blue cheese on top of microwaved spinach.  Five ingredients.  Takes me five minutes.

    The answer to "Plant-based or animal-based?" is "YES!"  Ditch the grains and we can discuss everything else later.

  • DrStrange

    5/5/2010 1:42:01 AM |

    "The animal-based diet, on the other hand, appeals to people like me who are lazy and therefore used to eat the SAD diet. Dinner: grilled hamburger topped with butter, sea salt and blue cheese on top of microwaved spinach. Five ingredients. Takes me five minutes."

    Took me about 15 max to make mine:  Pre-cooked beans from fridge plus huge pile of chopped veg in pressure cooker.  Up to pressure and run for 60-90 seconds.  Bring pressure down fast, dump in bowl, add some nuts/seeds, and eat.

  • jpatti

    5/7/2010 6:59:53 AM |

    We evolved as neither herbivores nor carnivores, we're omnivores.

    It's always been normal for humans to eat BOTH plant and animal foods.

    I think everyone should eat at least half their food, by volume, as nonstarchy vegetables and low-sugar fruits - a wide variety.  

    That being said, meat, dairy and eggs, if raised on pasture, are darned healthy foods.

    I think raw milk, pastured eggs and pasture-raised butter are some of the healthiest foods one could possibly eat.  

    And besides being a health food in itself, butter makes getting your veggies in much more palatable, so... an artichoke dipped in butter ought to make all of us happy.  It certainly makes me happy.  ;)  

    Bacon, if from healthy animals and just smoked as opposed to being pumped full of nitrites and nitrates, is a fine food.  

    And if we all ate enough wild-caught shellfish, you'd be hard pressed to find all these iodine deficiencies you've been noticing.

    Animal foods are not a problem so much as the US system of mass-raising animal foods in an extremely unhealthy manner is a problem.  

    See http://www.eatwild.com to find good local sources of meat, dairy and eggs.  

    IMO, the "right" answer to breakfast can be the omelet, cooked in butter, stuffed to overflowing with fried peppers,  onions and mushrooms, with a bit of grated cheese over the top.  

    Eating plenty of vegetables does not preclude eating animal foods.

    And really, you'd be pretty hard pressed to do low carb as a vegan and get anything like sufficient protein and fat.  A vegetarian, yes, if you eat lots of eggs and dairy, but a vegan, no.  

    This isn't an either/or scenario, we do best eating both.

  • lightcan

    5/7/2010 2:39:10 PM |

    We could argue and fight for ever, Drstrange.
    Stress hormones? As if the animals that humans used to kill went down happy and peaceful listening to Vivaldi. Are your vegetables all organic? And they do not contain any toxins or anti-nutrients, or nitrates, they also provide you with all the vitamins and minerals you need? Good for you. Oh, no, you need to supplement. Just as well you can afford to do it.

  • DrStrange

    5/8/2010 7:20:11 PM |

    lightcan, not sure what you are going on about.  Really.  I was referring to the lifetime of tissues saturated in stress hormones of  industrial, factory raised animals which I have boycotted since the early 70's when I found out how they were being treated even then! And what does any of that have to do with supplements?  I take some because I am old and a bit paranoid but am quite sure I would be fine without (excepting B-12 and D).  As for organic, yes, probably 95% at least and since I don't buy meat which is expensive (especially free range/grass fed or wild caught which is only meat I would eat when eating it) but rather cheap organic beans instead, I can afford it.

    Not fighting or arguing really at all. I have no "beef" against someone eating meat if they feel the need.  But the research I have read really does show that a diet based on bacon and butter and blue cheese is basically a death sentence.

  • lightcan

    5/11/2010 10:42:55 AM |

    I don't think that a diet based on butter, meat, fish, eggs and some greens is unhealthy. You think the opposite. I'm sure you can find studies that you think support your stance. That's why I said that there is a lot of debate going on, even between specialists, and asking people if their meat is organic and stress hormones free doesn't help.
    Many people who care about their health (those that read these blogs, you and I included) are trying to do their best until the definitive answers come in. It's really hard for the majority of people to find quality food exactly because of those pervasive industrial food practices you talk about.
    All the best.

  • Anonymous

    10/30/2010 11:53:05 PM |

    I eat 100% plant foods and I feel the same as when I ate both plant and animal foods, except I feel much better stopping the toxic fish - way too much mercury for me. I think eating plant foods is much more convenient. I even eat soy, and don't understand why there's so much anti-soy stuff online.

  • mirckur

    2/8/2011 3:49:28 AM |

    That is very good comment you shared.Thank you so chat much that for you shared those things with us.Im wishing you chat sohbet to carry on with ur achivments.All the best .

  • Anonymous

    2/22/2011 4:44:33 PM |

    Seriously, I am sick and tired of hearing "Low carb"  you don't mean low carb, you mean low grains don't you because plants are carbs..

    Say what you mean, not what is popular

  • jpatti

    6/18/2011 10:08:09 PM |

    The biggest issue with these guidelines is NOT what they say to adults, but the fact that they're taught in school to children.  

    I was in-between the 7 food groups and the pyramid, went to school with the 4 food groups myself.  Meat, dairy, grains, fruits & veggies.

    People still think this way, have to remind hubby all the time that corn is a grain not a veggie.  Point being, we both "think" in the four food groups, and probably will our whole lives.  

    We learned this stuff with our alphabet and arithmetic.

    Anyways, the answer to the question is BOTH.  

    We are OMNIVORES.  Look at your teeth: you're not a herbivore, and you're not a carnivore.

    IMO, when you sit down to eat, half your plate should contain nonstarchy veggies.  In my opinion, NONSTARCHY vegetables is an entire food group.  If I'd designed the pyramid, that'd be at the bottom.  

    This is not a veggie-based diet though.  Cause veggies are low calorie, and diets are defined as high fat or high carb or whatever, based on the percentage of calories.  So... you can eat EITHER a high carb or high fat diet with half your plate covered with nonstarchy veggies, as it depends on what's on the other half of your plate.

    IMO, at least another quarter of your plate should be good protein - pastured beef, pork and poultry, free-range eggs, raw milk and yogurt and kefir and raw cheese, nuts and seeds, and (if you can tolerate the carbs) legumes.  I define "good" protein as ones that don't have bad fats with them - so largely saturated and monosaturated fats, with minimal PUFAs.

    The only other "rules" are... do eat broth and other sources of gelatin, do eat fermented foods, don't eat HFCS and don't eat PUFAs/trans fats.  

    The rest varies with the person - if bg issues, should stick to lower carb, etc, if not, eat french fries, whatever.

    Cause... if you eat half your food as nonstarchy veggies and a quarter as good sources of protein, and get some good broth and fermented foods in weekly, eschew HFCS and PUFAs, even if the REST of your diet consists of nothing but hot fudge sundaes you'd be coming out ahead of the VAST MAJORITY of people.  

    Course, you're BETTER off if you eat some starchy vegetables and fruit in this other 25%, but... veggies and protein sources with good fats... these contains the vast majority of the micronutrients any of us get.  

    This is a simple enough system to teach to a small child, which is what I think the guidelines should be aiming for.

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Let's make it a lot easier

Let's make it a lot easier

The American Heart Association just released a new set of consensus guidelines on heart disease prevention in women: Evidence-Based Guidelines for Cardiovascular Disease Prevention in Women: 2007 Update

For those of you following the Heart Scan Blog and the Track Your Plaque program, there will be little new in the guidelines. In fact, you'll wonder if the date on the front of the report should be 1987, rather than 2007. Did you know that you should exercise and eat healthy?

Take a look at the list of risk factors for coronary vascular disease (CVD) listed in the report:

Major risk factors for CVD, including:
Cigarette smoking
Poor diet
Physical inactivity
Obesity, especially central adiposity
Family history of premature CVD (CVD at <55>

Progress: You'll notice that buried inside the list is "Evidence of subclinical vascular disease (e.g., coronary calcification)". Just a few short years ago that wouldn't have even been included.

The Track Your Plaque contention is that, for the great majority of women, this list could be shortened to one item: coronary calcification. As time goes on, the people who argue and draft these guidelines will come to the realization that coronary calcification is the disease--it's not a risk for the disease, a predictor of the disease. Coronary calcification is the disease itself. The other items on the list recede way into the background when you know whether or not coronary atherosclerosis is present, i.e., you know your heart scan score (of coronary calcium).

The report goes to say such things as taking a little bit of fish oil is a good idea, maintaining a normal blood pressure is desirable. . . yada yada yada. You've heard this all before.

A major part of the treatment guidelines are devoted to LDL cholesterol reduction with statin agents. You shouldn't be surprised. It's amazing what $22 billion dollars in revenues will buy.

A closing paragraph reads:

'Population-wide strategies are necessary to combat the
pandemic of CVD in women, because individually tailored
interventions alone are likely insufficient to maximally prevent
and control CVD. Public policy as an intervention to
reduce gender-based disparities in CVD preventive care and
improve cardiovascular outcomes among women must become
an integral strategy to reduce the global burden of
CVD.'


Say that again? If you understood that bit of gobbledygook, you're a lot smarter than me.

Don't look to the American Heart Association report for any new ideas. It reminds me of the politician who reminds everybody of what a devoted family man he is: It has nothing to do with his policies. It just makes him look good. If compared to prior report, the 2007 report does indeed represent progress--but just oh so little.
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More on being wheat-free

More on being wheat-free

Reducing or even eliminating the wheat in your diet can dramatically enhance the phenomenon of insulin resistance.

Insulin resistance is the evil process that lies behind low HDL, high triglycerides, small LDL particles, and VLDL and IDL. It’s also the process that makes us tired after meals, heightens inflammation that raises your risk of heart disease, stroke, diabetes, and caner. Insulin resistance is the culprit behind the bulge hanging over some 100,000,000 American belts.

Show me a person with a protruding abdomen and I’ll show you a bread lover, or some other form of wheat.

Why do I pick on wheat so much? Many of you among the more nutrition-minded would point out that wheat is just one group of food items among many other high-glycemic index foods, i.e., foods that yield a vigorous surge in blood sugar (glucose), followed by a sharp decline. Wheat enjoys the high-glycemic index company of corn, rice (white and brown), potatoes, among others.

I pick on wheat because, for most Americans, wheat is 90% of the high-glycemic index problem. (I’m assuming you’ve at least eliminated or dramatically reduced highly-processed sweets like candy, cookies, soft drinks, cakes, etc. That’s a no-brainer.) It’s not uncommon to have a wheat-based product with every meal, a wheat-based snack, 7 days a week. But few people have corn products (i.e., corn starch products) three times a day. Or rice three times a day.

Wheat has traded places with saturated fat sources as the chief scourge of diet. In 1985, we had dinners of spare ribs, cheeseburgers, French fries, and butter on our mashed potatoes. Hardly anybody eats that like anymore, at least amongst the web-savvy set.

Wheat has assumed the previous exalted role as chief scourge as a consequence of the low-fat consciousness of the 80s and 90s. It has since ballooned in importance in diet and, as a result, skyrocketed as a cause of obesity, insulin resistance, and coronary plaque growth.

What if you're already slender and have none of the above issues, especially small LDL particles? Then don't sweat the wheat issue.

Note: My comments on being wheat-free should not be confused with gluten sensitivity or celiac disease. These are allergies to wheat gluten that, if undiagnosed, wreak havoc on health to extremes. This phenomenon is separate and distinct from the far more prevalent issue I’m discussing.

Comments (5) -

  • Anonymous

    4/22/2007 12:35:00 AM |

    You're wrong about corn.  There are ingredients made of corn in almost everything that comes in a box or cellophane even a lot of cans.

  • Dr. Davis

    4/22/2007 3:08:00 PM |

    You're absolutely right. What I should have said is starch derived from corn.

  • Anonymous

    4/23/2007 1:05:00 PM |

    Are you recommending eliminating *all* wheat or only wheat in the form of flour?  Wheat in its whole form (not to be confused with whole wheat flour) is packed with all kinds of heart-healthy vitamins, fiber, and protein.  From what I understand, it's flour from *any* grain that can be the bad guy.  Thank you for your blog.  I love it!

  • Dr. Davis

    4/23/2007 5:48:00 PM |

    I generally gauge the intensity of your effort in reducing/eliminating wheat products by the severity of patterns. If, for instance, HDL is 37, triglycerides 330--severe abnormalities--a very serious effort at reducing wheat products is in order. If your HDL is 45, triglycerides 110, then a modest effort can be all that is required. So, it depends.

    You're also right on the nutrient issue. There are indeed many healthy nutrients in grain products. But if over-reliance on wheat has made you overweight, diabetic, with the entire spectrum of blood distortions, you can still get all the fiber and B vitamins from other sources.

  • Anonymous

    1/5/2011 7:18:18 PM |

    "Reducing or even eliminating the wheat in your diet can dramatically enhance the phenomenon of insulin resistance. "

    Don't you have that reversed? I certainly don't want to enhance insulin resistance!

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Vitamin D toxicity?

Vitamin D toxicity?

"My primary care doctor said to stop the vitamin D because it's toxic. So I stopped it and I just take a multivitamin. He said that a multivitamin and two glasses of milk a day was all I needed."

So proclaimed Eleanor to me. This happens around once every week by doctors frightened of the vitamin D.

So I reminded Eleanor that, before starting vitamin D supplementation, her blood level of 25-OH-vitamin D3 had been 17 ng/ml--severe deficiency.

On 4000 units per day (oil-based gelcap), her blood level had been 37 ng/ml--still deficient, below the desirable range of 50-60 ng/ml. That's the dose Eleanor's doctor had declared "toxic."

When exactly does deficiency develop? There's not full agreement on this, but Dr. Michael Holick of Boston University, among the most experienced and insightful authorities on vitamin D, states that toxicity is more likely when blood levels exceed 150 ng/ml (Nutr Clin Pract. 2007 Jun;22(3):297-304).

In other words, Eleanor and her doctor should not be concerned with toxicity, but with the persistent levels of deficiency she is suffering.

Some authorities call the behavior of vitamin D "bi-phasic": Deficiency is toxic, excessive levels are toxic. We're really just trying to achieve a middle ground in vitamin D levels that are above deficiency but below toxicity.

In reality, deficiency is exceptionally common. In fact, it's the rule around here (northern U.S.), with >95% of everybody we check severely deficient in winter, mildly-moderately deficient in summer. Very few people approach normal levels year round without supplementation.

Toxicity, on the other hand, is exceedingly rare. I have seen it once in a woman who was taking a toxic dose of 50,000 units a day on the instructions of her (mis-guided) doctor. Thankfully, no ill-effects developed from this little "experiment."

So, it's not toxicity that is the overwhelmingly common worry, but deficiency, severe and sustained.

Comments (3) -

  • Anonymous

    6/1/2007 7:48:00 PM |

    Thank you ! I dont know if your message could be any  clearer, but unfortunately it may take even more hounding on this as there is alot of resistance and ignorance to overcome on this subject. So please keep up this effort on vit d !  

    Thank you !

  • Mo

    11/10/2007 8:33:00 PM |

    Toxicity had worried me as my brother was taking 50,000 D2 twice a week for 6 months when he should've been taking 10,000 D2 twice a week (GP mixed up 0.25 with 1.25MG and we didn't have the knowledge to realise this until much later!)...But he's alright after that. No tests done, but no symptoms were evident too.

    Certainly if he was deficient, he'd be suffering from seizures and leg weakness again.

    In D's case, it's probably better to drink a bath full of water than die of dehydration.

  • Dr. Davis

    11/10/2007 11:16:00 PM |

    Uh,oh.

    Before you assume that your brother is toxic, however, keep in mind that he is taking vitamin D2, not the HUMAN form D3. D2 is inefficiently converted to D3. In my experience, in fact, very little is converted. In my opinion, prescription D2 is an utterly worthless preparation.  

    Why would a drug manufacturer distribute D2? I don't know for certain, but I suspect it originally was the same reason women are prescribed horse, rather than human, estrogens: profit, pure and simple. D2 is, in my view, miserably ineffective for replacing the truly active human form of vitamin D--D3.

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Why ATP-3 is B--- S---

Why ATP-3 is B--- S---

A Heart Scan Blog reader posted the link to this very excellent presentation by Dr. David Diamond, a neuroscientist at the University of South Florida.

ATP-3, or Adult Treatment Panel-3, is the set of cholesterol treatment guidelines as established by the National Cholesterol Education Panel, the guidelines used by practicing physicians nationwide. They are also the metric by which the "quality" of care is being judged by agencies like Medicare, health insurers, and other parties interested in policing healthcare. Dr. Diamond ably recounts how we ended up in this mess, the conflagration of "cut your fat, reduce cholesterol, and take a statin drug."

I was very impressed that, in his closing comments, he briefly discusses the pivotal role of glycation in heart disease causation. You will see in coming conversations how important an understanding of glycation is to create a healthy diet and lifestyle.

Comments (8) -

  • G_Man

    8/20/2011 5:35:25 PM |

    Hi Dr. Davis.
    I’m actually both pleased and troubled with the link to Dr. Diamond’s presentation that you’ve provided.

    On the “pleased” side, Dr. Diamond’s analysis is:
    •  An excellent/very well done presentation
    •  Fact based (e.g. cites numerous studies, documented references, named experts, etc.)
    •  Spans the test of time (e.g. references from the 1800’s thru the present day)
    •  Ferrets out the major drivers of our present-day obesity epidemic & debunks other commonly held beliefs
    •  Synchs with some of the Track Your Plaque (TYP) tenants (e.g. TYP guidance on triglycerides, diet, sugars, etc.)
    •  â€œFlags” potential issues like conflict of interest which might have a tendency to creep into the science on occasion (e.g. the Keys report, the errant conclusions resulting from the NCEP report and supporting studies, etc.)

    On the “troubled” side, Dr. Diamond’s analysis seems to:
    •  Fly in the face of some of the foundational tenants of TYP
    •  His analysis/conclusions, and that of other experts he cites, is that cholesterol of any kind is NOT correlated with Coronary Heart Disease (CHD) – at least as a root cause of heart disease (see Myth #2 and Dr. Diamond’s related analysis)
    •  That LDL cholesterol – and although not stated by Dr. Diamond I’m inferring – the “sticky kind”, i.e. the small particles that actually adhere to artery walls (not the fluffy LDL particles that bounce away), are actually good!! On his “Final Issues 2” slide, and later in his related pictorial slides (entitled “What Causes Coronary Heart Disease?”), he makes reference to [LDL] cholesterol as a “Misunderstood Hero”?
    •  That small, sticky LDL particles actually help the body recover from the damage created by the real culprits… sugars that work in concert with certain bacterias to create micro-tears in our artery walls
    •  That small, sticky LDL actually results in the belt-and-suspenders, Rube-Goldberg “spackle” [which again I infer from Dr. Diamond’s presentation ultimately becomes plaque], that fixes (admittedly in a suboptimal and too-late manner) the damage already done by the artery-tearing, sugar/bacteria combo.  Plaque caused by LDL is actually the ‘finger in the dike’, last ditch effort, to fix the artery tears!  Kind of the last line of defense. [see slides on page 53 and Dr. Diamond’s related YouTube discussion.]

    As a result, just curious about your thoughts on Dr. Diamond’s hypotheses.  
    1.  Am I getting Dr. Diamond’s message(s) right?
    2.  If yes, do you concur with – or tend toward – the theory(-ies) supported by Dr. Diamond and other cited experts about the role of cholesterol in CHD?  I gather from your blog post that you sympathize with his glycation theory(-ies), but how about the rest?
    3.  If yes again, does that change some of the TYP direction?  For example, a significant part of the TYP approach is to reduce, as much as possible, small LDL particles. If LDL – and thus the resulting plaque – is indeed a suboptimal last line of defense, does reduction of LDL particles lead to a sub-optimization of the body’s last-ditch defense/“back-up plan” to deal with arterial microtears?
    4.  Also, knowing that plaque/“spackle” is admittedly a suboptimal last ditch effort, what consequence does reversing plaque ultimately have given that the real damage – the tears in the artery walls (the seemingly real CHD culprits) – has already occurred. Are we pulling the finger out of the dike… without addressing the real root cause of the problem?  â€¦and if yes, what’s the back-up plan to the body’s back-up plan? If we reduce LDL and plaque, and the arterial damage is already done due to years and years of sugar abuse, what plugs the dike then?  I’m not talking about the preventive approaches of avoiding glycation in the first place… obviously that seems to be the real, preventive answer. I’m referring to those of us – for whom preventative measures are too late because the microtears are already there – who might be already living with the consequences of years of potentially errant diet/health guidance (by Keys, NCEP, etc.) and thus “spackle” in our arteries?  If the "spackle" is removed, does the dike start leaking again?

    Although I thought I was “on the path to CHD righteousness”, I’m now confused again as a result of Dr. Diamond’s insights. Thanks for any clarifications Dr. Davis!

  • Joe Lindley

    8/21/2011 2:33:55 PM |

    Dr. Davis,
    I'm also anxious to hear what you think of the "hero" role of LDL in plaque.  I'm hoping he didn't go too far off the reservation on this point because the entire hour long presentation was so well done (comprehensive, well-explained, and credentialed) that it will be a powerful aid in spreading the word on both carbohydrates and how messed up the typical GP is with cholesterol treatment (not their fault - but the ATP-III as you say).  It was the tipping point for me.  I'm going off Lipitor now, which I"ve been on for years and will look into your TYP program to ensure I'm doing the right thing.

  • Dr. William Davis

    8/21/2011 3:27:30 PM |

    HI, Joe--

    This "hero" thing, to my knowledge, is extrapolation and supposition. It is an interesting notion. I, too, was impressed with his presentation, but I think that the "hero" thing paints LDL as an entirely innocent player and I don't believe it is. We have only to look at people with heterozygous familial hypercholesterolemia who can have heart attacks in their 30s with pure large LDL to know that there is more to LDL's behavior than a protective function.

  • Dr. William Davis

    8/21/2011 3:31:20 PM |

    Hi, G--

    By providing the link to Dr. Diamond's wonderful talk, I didn't mean to suggest that everything he says should be taken as gospel.

    Virtually everything he said up until the "spackle" I do agree with. The spackle argument is pure supposition. It makes sense, but only to a degree and ignores the quantitative (e.g., heterozygous familial hypercholesterolemia) and qualitative (small, oxidation- and glycation-prone LDL particles with unique conformations that differ from larger LDL) differences in LDL particles.

    Nonetheless, Dr. Diamond's recounting of how this mess was created was enlightening and well-presented and I still enjoyed it.

  • Brian

    8/21/2011 5:53:07 PM |

    Dr. Davis,

    I watched Dr. Diamond's presentation in its entirety.  I agree that he's done some great investigative medicine, especially looking into long-established research on carbohydrate intake, and, more recently, digging into questions of research funding and conflicts of interest.

    His presentation leaves me with a major question about the role of cholesterol.  Diamond claims that high cholesterol levels are not harmful, so long as they are below 300 mg/dL, and that cholesterol has a helpful role.  It is used by arteries to repair themselves after the arterial lining is torn, infected by bacteria, or otherwise damaged.  This is why, he says, we find cholesterol in atherosclerotic plaques, together with white blood cells and dead bacteria.  Yet, we know from your reports and others that an elevated LDL particle number *is* correlated with coronary events.

    What's going on here?  Is cholesterol itself harmful, or is high particle number just another symptom of high carbohydrate intake, which causes glycation and loss of elasticity in the arterial walls, leading to damage?

  • Brian

    8/21/2011 6:03:20 PM |

    I just read the other comments, so the above question has been answered.  Thanks for all the info!

  • Dr. William Davis

    8/23/2011 11:57:16 AM |

    Hi Brian--
    While I truly enjoyed Dr. Diamond's presentation, I think this particular path leads us down a dead end.

    I don't think cholesterol per se is harmful; I believe that the particles that contain, among many other things, cholesterol can be harmful, especially small, oxidation-prone, glycation-prone LDL particles. I believe it would be an incredible stretch to say that small LDL particles are somehow protective.

  • Joan Phillips

    7/29/2012 7:47:06 PM |

    I have inherited cholesterol and just learned from my health store guy that all the grains I have been eating are likely responsible for the high numbers of my small LDL(527) particles.  I thought oatmeal and other whole grains would squeege-mop the bad guys out of my system.  This news is also likely why I haven't  lost any weight (I eat lots of veggies and apples, fibrous fruits and protein.)  I do not use processed foods at all.  I walk a mile to work each day and I am still 10-20 # overweight (and yes it is right in my middle.)  My health guy is the one who directed me to this blog.  Any other information is most welcome.  I am trying to figure out what to fix everyday (supper/dinner) is the hardest.
    Joan phillips

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