The “Heart Healthy” scam

27. July 2008 William Davis (1)
Like many scams, this one follows a predictable formula.

It is a formula widely practiced among food manufacturers, ever since food products began to jockey for position based on nutritional composition and purported health benefits.

First, identify a component of food, such as wheat fiber or oat bran, that confers a health benefit. Then, validate the healthy effect in clinical studies. Wheat fiber, for instance, promotes bowel regularity and reduces the likelihood of colon cancer. Oat bran reduces blood cholesterol levels.

Second, commercialize food products that contain the purported healthy ingredient. Wheat bran becomes Shredded Wheat, Fiber One, and Raisin Bran cereals and an endless choice of “healthy” breads. Oat bran becomes Honey Bunches of Oats, Quaker’s Instant Oatmeal, and granola bars. Even if many unhealthy components are added, as long as the original healthy product is included, the manufacturer continues to lay claim to healthy effects.

Third, as long as the original healthy ingredient remains, get an agency like the American Heart Association to provide an endorsement: “American Heart Association Tested and Approved.”

The last step is the easiest: just pay for it, provided the product meets a set of requirements, no matter how lax.

You will find the American Heart Association certification on Quaker Instant Oatmeal Crunch Apples and Cinnamon. Each serving contains 39 grams carbohydrate, 16 grams sugar (approximately 4 teaspoons), and 2.5 grams fat of which 0.5 grams are saturated. Ingredients include sugar, corn syrup, flaked corn, and partially hydrogenated cottonseed oil. Curiously, of the 4 grams of fiber per serving, only 1 gram is the soluble variety, the sort that reduces cholesterol blood levels. (This relatively trivial quantity of soluble fiber is unlikely to impact significantly on cholesterol levels, since a minimum 3 grams of soluble fiber is the quantity required, as demonstrated in a number of clinical studies.) Nonetheless, this sugar product proudly wears the AHA endorsement.

Thus, a simple component of food that provides genuine benefit mushrooms into a cornucopia of new products with added ingredients: sugar, high fructose corn syrup, corn starch, carageenan, raisins, wheat flour, preservatives, hydrogenated oils, etc. What may have begun as a health benefit can quickly deteriorate into something that is patently unhealthy.

There’s a clever variation on this formula. Rather than developing products that include a healthy component, create products that simply lack an unhealthy ingredient, such as saturated or trans fats or sodium.

Thus, a ¾-cup serving of Cocoa Puffs cereal contains 120 calories, no fiber, 14 grams (3 ½ teaspoons) of sugar—but is low in fat and contains no saturated fat. Proudly displayed on the box front is an American Heart Association stamp of approval. It earned this stamp of approval because Cocoa Puffs was low in saturated, trans, and total fat and sodium. Likewise, Cookie Crisp cereal, featuring Chip the Wolf, a cartoon wolf in a red sweater (“The great taste of chocolate chip cookies and milk!”), has 160 calories, 26 grams carbohydrate and 19 grams (4½ teaspoons) of sugar per cup, and 0 grams fiber—but only 1.0 gram fat, none saturated, thus the AHA check mark. (Promise margarine, made with hydrogenated vegetable oil and therefore containing significant quantities of trans fats, was originally on the list, as well, but removed when the trans fat threshold was added to the AHA criteria.)

It is this phenomenon, the sleight of hand of taking a healthy component and tacking on a list of ingredients manageable only by food scientists, or asserting that a product is healthy just because it lacks a specific undesirable ingredient, that is a major factor in the extraordinary and unprecedented boom in obesity in the U.S. Imagine the chemical industry were permitted such latitude: “Our pesticide is deemed safe by the USDA because it contains no PCBs.” Such is the ill-conceived logic of the AHA Heart-Check program the "Heart Healthy" claims.

It’s best we keep in mind the observations of New York University nutritionist and author of the book, Food Politics, Marion Nestle, that “food companies—just like companies that sell cigarettes, pharmaceuticals, or any other commodity—routinely place the needs of stock holders over considerations of public health. Food companies will make and market any product that sells, regardless of its nutritional value or its effect on health. In this regard, food companies hardly differ from cigarette companies. They lobby Congress to eliminate regulations perceived as unfavorable; they press federal regulatory agencies not to enforce such regulations; and when they don’t like regulatory decisions, they file lawsuits. Like cigarette companies, food companies co-opt food and nutrition experts by supporting professional organizations and research, and they expand sales by marketing directly to children, members of minority groups, and people in develop countries—whether or not the products are likely to improve people’s diets.”

Qualms over just how heart-healthy their products are? Doubtful.
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Comments (1) -

  • jimray

    7/28/2008 3:26:00 PM |

    I want to print this out and post it on the wall of my office.  You have made clear what I have been trying to articulate for years. The labels do not always tell the truth. And ultimately it goes back to money. Thank you.

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"Flying in the fog"

"Flying in the fog"

2. March 2008 William Davis (3)
I received this wonderful response to The Heart Scan Blog post Hammers and Nails:

I am 65 years old. I had a stent inserted in the "widow-maker" artery (80% blockage) a year ago. I had passed out a couple of times (heart rate dangerously low - 30s). I rode to the hospital in an ambulance. Tests revealed short LBBB episodes; mild mitral regurgitation, mild tricuspid regurgitation. Catherization showed 3 vessel CAD. I was told that a medicated stent was absolutely necessary given the situation; regardless, I have to accept that. A pacemaker was installed to prevent bradycardia and keeps heart rate from dropping below 60. I have 20% L distal main blockage and 90% lesion of the high first obtuse marginal at the takeoff. The right coronary had 60% posterior lateral branch stenosis.

Since then I have reduced TG from 360 to 60, LDL from 89 to 82 (although a few months ago it was in the mid-70s), and increased HDL from 30 to 46. I went from 265lbs to 190lbs and hope to eventually get to 180lb this Spring. I did it by progressing from walking to trotting (slow run) and dietstyle changes (low-GI veggies, fruits, etc.) .













On a recent visit the cardiologist said the the LDL needs to be 70 or below to "freeze" the 90% blockage and gave me a prescription for Lipitor. I asked if there were alternatives, like diet, supplements, etc. He admitted that he did not know about those alternative but did know Lipitor. When the only tool you have is a hammer then everything is a nail. I understand that the 90% blockage is important but will not take the Lipitor to achieve the 12 points reduction. Seems like an overkill.

I asked him if there was a way to evaluate my current condition. I was told there was no way. Basically, if I have no symptoms, good. If I have symptoms then it will have to be evaluated. Death could be the only symptom. I swear he was about to say bypass surgery ($$$$$$!) was inevitable. Something is wrong with this "fly-in-the-fog-and-hope-you-don't- hit-a-mountain" approach. Hope is not a strategy!

I am confident that I can reduce LDL to below 70 based on eliminating wheat-products in my diet plus increasing oat bran in my diet. I also take fish oil daily (EPA/DHA-2g). I am looking for a new cardiologist. I just recently purchased your book and find it very instructive. In the meantime I have an appointment with my primary care physician to discuss implementing the Track Your Plaque program. I realize that the one stent will skew the scan numbers but can be used as a baseline number.


Phenomenal weight loss! That alone has likely cut this man's risk in half. But is that it? Is the cardiologist correct--take Lipitor and hope for the best?

Of course not. There are many additional strategies to employ. Eliminating wheat from the diet is an excellent idea: HDL will skyrocket, triglycerides drop even further, small LDL will drop like a stone, blood sugar and blood pressure will drop. He will have more energy, get rid of afternoon energy slumps, sleep better.

He has already added fish oil. If his cardiologist did not mention this, I would say he was guilty of malpractice. The data supporting the addition of fish oil to the treatment program of anyone with heart disease is overhwelming. GISSI Prevenzione: 11,000 participants--28% reduction in heart attack, 45% reduction in death from heart attack. The Japanese JELIS trial of 18,645 participants--19% reduction in dangerous heart events. It's also clear that omega-3 fatty acids from fish oil also compound the benefits of statin agents, should this man choose to begin Lipitor.

Vitamin D brought to normal blood levels is his next "secret weapon" that will further boost his lipids and lipoproteins further into not just "normal" territory, but beyond belief. Even though we aim for 60-60-60 for LDL-HDL-triglycerides in the Track Your Plaque program, adding vitamin D can yield numbers you've never seen before. It's not uncommon, for instance, to see a 10 or 20 mg/dl jump in HDL.

Identify all other hidden causes of coronary plaque. If all the causes have not been fully identified, how can anyone hope to gain full control over coronary plaque growth?

Re: LDL cholesterol of 89 mg/dl at the start. Of course, this is a calculated value, not measured. Because HDL was low and triglycerides high at the start of his program, this means that true LDL--if actually measured--was probably more like 180 to 250 mg/dl, and it was probably nearly all small. So his cardiologist might have advised a helpful treatment, though for the wrong reasons.

Our reader has gone a long way on his own in creating his own prevention program. But there's yet more to do, particularly if the goal is reversal. It is shocking to me that a man like our reader, clearly articulate and motivated, gets virtually no advice beyond "take Lipitor" after all the procedural benefits have been reaped.

Even though one artery can no longer be "scored" due to the presence of the metallic stent, a heart scan would still be invaluable for long-term tracking purposes, just as we advocate in the Track Your Plaque program.



Copyright 2008 William Davis, MD
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Comments (3) -

  • Anonymous

    3/2/2008 6:04:00 PM |

    Dr. Davis -

    I am the "anonymous" reader who posted the "flying in the fog" comment.  Thank you for commenting on my adventure!  However, there is one correction I would like to point out and that is my weight.  I typed "365" and that is a typo; it should be 265.  

    Here is before-after pix.  'Before' was about 5 years ago; complete with wheat-belly.  'After' is recent after playing catch with my adult son.  Note the shirt is the SAME.   http://s88082351.onlinehome.us/oldnew.png

    I have to say that after the stent was inserted the only advice I received was to walk daily for at least 45 minutes and follow AMA recommend diet.   I asked how this kind of thing can be prevented from happening again and was told that the walking and exercise would help -- that was IT.  If not for an acquaintance in California who completely reversed his plaque growth I would have been left to think that it was hopeless and just wait for a disaster.  I had the occasion to visit the man in California last June.  It was absolutely mind-boggling learning experience.  He is my age and was overweight when he began his program 5 years ago that he and his cardiologist developed.  What struck me was that he did not look his age but 20 years younger!  

    I am very, very grateful that you have this blog.  I discovered your blog by accident and, as I mentioned, purchased your book.  I plan to join your forum site as well.  Where does one go when a cardiologist does not offer or volunteer information or when trying to get answers to questions seem like trying to chisel granite for a response?   Horrific.  This blog serves as a beacon especially to those like me that discover they have been abandoned -- left in the desert to fend for themselves with no place to go.  

    Thank you, Dr. Davis!  

    Have a great week.

  • Dr. Davis

    3/3/2008 11:51:00 PM |

    Thanks for you wonderful story. I've gone back and added your photo directly into the post.

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Victim of Post-Traumatic Grain Disorder

Victim of Post-Traumatic Grain Disorder

20. June 2009 William Davis (14)
Heart Scan Blog reader, Mike, shared his story with me. He was kind enough to allow me to reprint it here (edited slightly for brevity).



Dr. Davis,

I was much intrigued to stumble onto your blog. Heart disease, nutrition, and wellness are critically important to me, because I’m a type 2 diabetic. I’m 53 and was diagnosed as diabetic about 5 years ago, though I suspect I was either diabetic or pre-diabetic 5 years before that. Even in a metropolitan area it's next-to-impossible to find doctors sympathetic to any approach beyond the standard get-the-A1c-below 6.5, get LDL <100, get your weight and blood pressure normal, and take metformin and statins.

I’m about 5’10-and-a-half and when I was young I had to stuff myself to keep weight on; it was an effort to get to 150 pounds, and as a young man, 165 was the holy grail for me. I always felt I’d look better with an extra 10-15 pounds.
I ate whatever I wanted, mostly junk, I guess, in my younger years.

When I hit about age 35, I put on 30 pounds seemingly overnight. As I moved toward middle age I became concerned with the issue of heart health, and around that time Dr. Ornish came out with his stuff. I was impressed that he’d done a
study that supposedly showed measurable decrease in atherosclerotic plaque, and had published the results of his research in peer-reviewed journals. It looked to me as though he had the evidence; who could argue with that? I tried his plan on and off, but as so many people note, an almost-vegan diet is really tough. It was for me, and I could never do it for any length of time. But given that the “evidence” said that I should, I kept trying, and kept beating up on myself when I failed. And I kept gaining weight. I got to almost 200 pounds by the time I was 40 and have a strong suspicion that that’s what caused my blood sugar to go awry, but my doctor at the time never checked my blood sugar, and as a relatively young and healthy man, I never went in very often.

I’ve had bouts of PSVT [paroxysmal supraventricular tachycardia, a rapid heart rhythm] every now and again since I was 12 or so. I used to convert the rhythm with Valsalva, but as I moved into my forties, occasionally my blood pressure would be elevated and it made me nervous to do the procedure because it was my understanding that it spikes your blood pressure when you do it. So I began going to the ER to have the rhythm converted, which they do quite easily with adenosine. On one of my infrequent runs to the ER to get a bout of PSVT converted, they discovered my blood glucose was 500 mg/dL, and I’d never experienced any symptoms! They put me in the hospital and gave me a shot of insulin, got it town to 80 mg/dL easily,
diagnosed me as diabetic, and put me on 500 mg. metformin a day.

I was able to get my A1c down to 7, then down to 6.6, and about that time I read a number of Dr. Agatston’s books, and began following the diet, and pretty quickly got my A1c down to 6.2, and my weight down, easily, to 158. That was fine with my doctor; he acted as though I was in good shape with those numbers. Soon I ran into Dr. Bernstein’s material, and came face to face with a body of research that suggested I needed to get the A1c down to below 5! That was both discouraging and inspiring, and frankly it’s been difficult for me to eat as lo-carb as I appear to need to, so I swing back and forth between 6.2 and 6.6. I know I need to work harder, be more diligent in my carb control, and I see with my meter that if I eat low-carb I have great postprandial and fasting blood sugars, but since I don’t particularly get any support or encouragement from
either my doctor or my wife for being so “radical,” it’s hard to pass the carbs by.

One thing that always confused me was that though I saw on my meter that BG [blood glucose] readings were better with a lo-carb diet, and though I saw the preliminary research suggesting that lo-carb could be beneficial in controlling CVD, I didn’t understand why Ornish had peer-reviewed research demonstrating reversal of atherosclerosis on a very-lowfat diet. How could two opposing approaches both help? I wondered if it were possible that one diet is good for diabetes, and the
other good for heart health. That would mean diabetics are screwed, because they always seem to end up with heart disease.

From time to time I’d look for material that explained this seeming contradiction. I was determined to try to stay lo-carb, simply because I saw how much better my blood sugars are when I eat lo-carb; but it’s hard in the face of this or that website that tells you about all the dangers of a lo-carb diet and that touts the lo-fat approach. That tends to be the conventional wisdom anyway.

Finally in one of those searches I came across your material, and saw you offer what was at last an explanation of what Ornish had discovered--it wasn’t a reversal of atherosclerotic plaques he was seeing; it was that his diet was improving endothelial dysfunction in people who had had high fat intakes.

Odd as it may seem to you, that little factlet has been enough to allow me to discard entirely the lingering ghost of a suspicion that I ought to be eating very-lowfat. In fact, I was very excited to see your claim that your approach can reverse atherosclerotic plaque.

It would be nice to find a doctor who’d be supportive of your approach. My doctor isn’t much interested in diet or
nutrition. He just wants my weight in the acceptable range, my blood pressure good, and my LDL 100 or below (which I know isn’t low enough). He’s not particularly interested in getting a detailed lipid report. I hope I can talk him into ordering one so that it’s more likely I can get it covered by my insurance.

I very much appreciated the links you gave to Jenny’s diabetes websites, and I’ve resolved to get even better control of my BG by being more diligent with my diet. I’m planning on joining your site, reading your book, and following your advice. I just have this sort of deflating feeling that it would have been better if I’d stumbled upon this before I had diabetes. Still, it’s nice to have a site that offers to laypeople the best knowledge available concerning how to take care of their heart.



Mike is yet another "victim" of the "eat healthy whole grains" national insanity, the Post-Traumatic Grain Disorder, or PTGD. The low-fat dietary mistake has left many victims in its wake, having to deal with the aftermath of corrupt high-carbohydrate diets: diabetes, heart disease, and obesity.

We should all hope and pray that "low-fat, eat healthy whole grains" goes the way of Detroit gas guzzlers and sub-prime mortgages.
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Comments (14) -

  • Gretchen

    6/20/2009 2:03:19 PM |

    I don't think Ornish has ever shown that his diet results in plaque regression. What he showed was that his total program, including diet, exercise, stress reduction, giving up smoking, and lots of peer support reduced plaque. Then everyone ascribes the results to the diet alone.

    This is analogous to the studies that lump red meat into a diet group that includes cold cuts, sausages (including chicken sausage) and a lot of other things and then blame the red meat for the poorer results.

    You never see headlines saying "Chicken (sausage) is bad for you."

  • Peter

    6/20/2009 3:05:10 PM |

    I appreciate that letter, because I also try to keep on current research and it's hard to know which research to believe, since there's a fair amount of research that supports whole grains and a fair amount that supports a low carbohydrate diet.  I'm not a true believer type, so I'm looking forward to better research.  I notice that in Gary Taubes's book he says there has been no trustworthy research comparing the low carb and the whole food/whole grain diets, and I'm looking forward to it when it comes out.

  • Tom

    6/20/2009 5:44:16 PM |

    Yes, my guess is that *stress reduction* is key to the Ornish plan. The other components are really just contributors to this overall result, with the exception of the vegetable diet, which probably doesn't help.

    I don't write an excellent blog or care for any patients. Perhaps I may therefore indulge my speculations, safe in the knowledge that those who wish to ignore me will feel free to do so:


    Stress is normally thought of as something unpleasant that we try to avoid. And indeed it is, partly we do try to avoid it.

    But in truth we are addicted to stress. We interpret a rapidly beating heart, high blood pressure, racing thoughts, etc, as pleasurable.

    And they are. Or at least they seem to be (hangovers aside), from the perspective of the part of us that experiences them.

    Trouble is they are damaging to the whole. For example, pleasure/stress numbs subtle feelings which might otherwise yield clues to solving our personal problems. Our immune systems our temporarily dampened (presumably an evolutionary adaptation).

    Only relaxation and meditation (which we all do to a certain extent, whether we realise it or not), allow the mind to re-integrate and experience the deeper, forgotten joy of being alive.

    I believe that here, and not in calorie burning, lies the secret benefit of exercise: diverting attention into the body and away from the frenetic mind.

    I have no evidence for this that I can share, only a limited amount of fallible personal experience. But let me say that I have *felt* my blood pressure go down after a meditation session.

    And upon standing up afterwards, I've become dizzy, which is a symptom of hypotension!

  • Anne

    6/20/2009 6:36:35 PM |

    In a totally uncontrolled study of one, here are the results.

    While on the American Heart Association diet my lipids peaked in 2003. I even tried the Ornish diet for a short time, but found it impossible.
    Total Cholesterol: 201
    Triglycerides: 263
    HDL: 62
    LDL: 86

    After I stopped eating gluten(I am very sensitive) my lipid panel improved slightly. This past year I started eating to keep my blood sugar under control by eliminating sugars and other grains. Now this is my most recent lab:
    Total Cholesterol: 162
    Triglycerides: 80
    HDL: 71
    LDL: 75

    Not perfect, but getting there. I think I had a very serious case of post traumatic grain disorder.

  • TedHutchinson

    6/20/2009 9:39:05 PM |

    Gary Taubes recent lecture
    For those who haven't yet read
    Gary Taubes Good Calories Bad Calories
    this talk is based on just a fraction of the research he discusses in greater detail in the book.
    There are earlier version of this lecture online, this version is slicker, more jokes, and you can use the thumbnail slides to move around faster.
    Slides 41~49 are the crux of the matter.
    Interesting to hear what he says right at the end of slide 48.

  • Dr. William Davis

    6/21/2009 2:24:20 AM |

    Anne--

    I love it!

    I'd like to post your numbers in a future Heart Scan Blog post.

    Thanks for sharing. Your experience is bound to help others also "see the light."

  • Kateryna

    6/21/2009 3:24:36 AM |

    Dr. Davis:

    I'm 59 years old, was very sick, and if I had waited as others do for scientists to come to a consensus about diet and nutrition and for studies to be done, I would have died 13 years ago.

    If you value your health a short 1 month trial of a grain free diet will tell you immediately if it's right for you especially if you have health issues. Don't be afraid to experiment.

    As I said, I'm 59 and I'm still overweight, but I have resolved almost all my health issues by eliminating all sugar, processed foods and all grains and here are my latest lipids:

    Total: 182
    LDL: 95
    HDL: 65
    Trigs: 104
    Ratio: 2.6

    Also not perfect, but I know it will only get better as it has been for years.

  • Anonymous

    6/21/2009 4:25:40 AM |

    Some of the readers of this blog should be gluten free and not just wheat free. How to find which ones?
    IMO, Mike's difficulty in keeping on weight as a younger man indicates he should consider further testing for gluten intolerance or perhaps other food intolerances.

  • Anne

    6/21/2009 12:46:12 PM |

    Dr. Davis, you have my permission to post my numbers, use my name and use my picture.

    Thank you for thinking outside the box. I have coronary artery disease and had bypass in 2000 and I don't want to do that again ever. By incorporating TYP guidelines into my life, I feel I have greatly decreased  my odds of having more heart problems.

  • Anonymous

    6/21/2009 5:33:26 PM |

    I tried moving back to meat and giving up wheat/grains.  My blood lipid chemistry did not improve and I have to remind myself, a meat based diet is how I got here in the first place (2002) and why my father and his brothers had heart attacks at relatively young ages.

    Until I see a pier reviewed study showing grains are causal to heart disease, I'm going back to what has kept me from suffering the same fate as my father. No animal products in my diet.

    I'm off to make a few seitan steaks for the bbq

  • Grandma S.

    6/22/2009 12:11:12 AM |

    Anne,
    I am very impressed with your results.  Having trouble getting my husband's & my LDLs that low.  Would like to know in more detail how you are doing it, can you email me? Thank You!

  • Dr. Usha C

    7/22/2009 7:02:29 PM |

    Homeopathy Diet Planning
    Homeopathy together with proper diet can make wonders in medical field creating ability to treat most diseases effectively.

    For more information log on to
    http://homeopathydiets.blogspot.com/

  • simvastatin side effects

    5/23/2011 7:41:44 AM |

    Only relaxation and meditation (which we all do to a certain extent, whether we realise it or not), allow the mind to re-integrate and experience the deeper, forgotten joy of being alive.

  • Vegan4life

    5/8/2013 10:49:01 AM |

    Well said, Anonymous!  Going VEGAN (and not merely vegetarian) is best for ones health, mind and spirit - and vital for anyone who has heart and/or weight problems, type-2 diabetes, high blood pressure, bad cholesterol, asthma, etc., or a family history thereof.

    "Anonymous says:

    June 21, 2009 at 11:33 pm

    I tried moving back to meat and giving up wheat/grains. My blood lipid chemistry did not improve and I have to remind myself, a meat based diet is how I got here in the first place (2002) and why my father and his brothers had heart attacks at relatively young ages.

    Until I see a pier reviewed study showing grains are causal to heart disease, I'm going back to what has kept me from suffering the same fate as my father. No animal products in my diet... "

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The Paleo approach to meal frequency

The Paleo approach to meal frequency

24. November 2009 William Davis (12)
Furthering our discussion of postprandial (after-eating) phenomenona, including chylomicron and triglyceride "stacking" (Grazing is for cattle and Triglyceride and chylomicron stacking), here's a comment from the recent Palet Diet Newsletter on the closely related issue, meal timing and frequency:


We are currently in the process of compiling meal times and patterns in the worlds historically studied hunter-gatherers. If any single picture is beginning to emerge, it clearly is not three meals per day plus snacking ala the typical U.S. grazing pattern. Here are a few examples:

--The Ingalik Hunter Gatherers of Interior Alaska: 'As has been made clear, the principal meal and sometimes the only one of the day is eaten in the evening.'
--The Guayaki (Ache) Hunter Gatherers of Paraguay: 'It seems, however, that the evening meal is the most consistent of the day. This is understandable, since the day is generally spent hunting for food that will be eaten in the evening."
--The Kung Hunter Gatherers of Botswana. "Members move out of camp each day individually or in small groups to work through the surrounding range and return in the evening to pool the collected resources for the evening meal."
--Hawaiians, Tahitians, Fijians and other Oceanic peoples (pre-westernization). 'Typically, meals, as defined by Westerners, were consumed once or twice a day. . . Oliver (1989) described the main meal, usually freshly cooked, as generally eaten in the late afternoon after the day’s work was over."

The most consistent daily eating pattern that is beginning to emerge from the ethnographic literature in hunter-gatherers is that of a large single meal which was consumed in the late afternoon or evening. A midday meal or lunch was rarely or never consumed and a small breakfast (consisting of the remainders of the previous evening meal) was sometimes eaten. Some snacking may have occurred during daily gathering, however the bulk of the daily calories were taken in the late afternoon or evening. This pattern of eating could be described as intermittent fasting relative to the typical Western pattern, particularly when daily gathering or hunting were unsuccessful or marginal. There is wisdom in the ways of our hunter gatherer ancestors, and perhaps it is time to re-think three squares a day.


In other words, the notion of "grazing," or eating small meals or snacks throughout the day, is an unnatural situation. It is directly contrary to the evolutionarily more appropriate large meal followed by periods of no eating or small occasional meals.

I stress this point because I see that the notion of grazing has seized hold of many people's thinking. In my view, grazing is a destructive practice that is self-indulgent, unnecessary, and simply fulfills the perverse non-stop hunger impulse fueled by modern carbohydrate foods.

Eliminate wheat, cornstarch, and sugars and you will find that grazing is a repulsive impulse that equates with gorging.


The full-text of the Paleo Diet Newsletter can be obtained through www.ThePaleoDiet.com. You can also read and/or subscribe to the new Paleo Diet Blog, just launched in November, 2009.
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Comments (12) -

  • Kevin

    11/24/2009 3:18:05 PM |

    I can't rememeber exactly when but several years ago a melting glacier uncovered a 5000 year old man in the Pyranees area. He was dubbed 'Oetzi'.  Since he carried a bow and arrow and kit with seeds he was certainly a hunter-gatherer.   It's logical that he was hunting and carried seeds to sustain him during the day.  But he died of an arrow attack so possibly he was killed for the game he had found, or perhaps by a tribe mate wanting to move up the social ladder.  Who knows.  

    kevin

  • Adolfo David

    11/24/2009 4:10:24 PM |

    And what about 3-4 small high fat (Omega 6 free) low carbs (no glycemic) meals during the day? Its for example my case

  • KENNY10021

    11/24/2009 5:23:26 PM |

    Plus grazing would result in higher levels of digestive acid present in the stomach more often. More acid, more often.......This too is unhealthy...is it not?

  • Richard Nikoley

    11/24/2009 7:58:11 PM |

    Excellent data, doc.

    I rarely eat anything big during the day, and almost never before 10am. It's now 12:00 noon and I'll be headed for an intense workout at 12:30 lasting for 30 minutes and will include a lot of pushing weight around. I may eat a bit in the afternoon, but most probably will have a large meal this evening.

    This approach has worked wonders in terms of body comp and especially, hunger. I'm just almost never ravenous as I was with all the junk, which I think is the root cause of the grazing dysfunction.

    Also, note that it's probably far easier for them to keep their minds off food when they're busy hunting and gathering it.

  • UofMWolverine81

    11/24/2009 9:54:10 PM |

    ting caught up on what meal frequency or timing is "best" and shift the focus toward ensuring an adequate micro and macronutrient intake that supports your goals and lifestyle?

    If I am highly active and making quality food choices that fall in line with that activity level, it seems like there wouldn't be anything inherently wrong with eating 4-6 small meals/snacks per day .  That's not to say that 1 or 2 relatively larger meals wouldn't work as well, but I can't see there being much overall difference provided overall daily intake is roughly equivalent (if not the same) and and the focus is on undamaged fat sources, lean protein sources, plenty of vegetables, and a modest intake of fruit (especially things like berries).

    Some folks find that various styles of intermittent fasting work best for them when it comes to controlling intake, and others have found that a higher number of smaller feedings work better. So while I do not dispute the wisdom in observing patterns from various hunter-gatherers, I don't feel that mirroring their patterns is something that fits my lifestyle and individual tendencies.

    Of course I could be living with my head in the sand and the joke is on me, but I figured I'd just offer up my general thoughts.  I am far from being an expert on these issues.

    In any event, thank you for sharing this post, Dr. Davis.

  • Helen

    11/25/2009 12:21:24 AM |

    I'm against grazing (especially since it's usually crap that people graze on), but I do have a question about this.  I recently read that the rate of strokes increases during Ramadan, which mirrors this pattern - a large evening meal every day.  

    http://www.thaindian.com/newsportal/world-news/does-ramadan-fasting-increase-risk-of-stroke_10038409.html

    My father used to just eat one big meal a day at night.  He had a massive heart attack in his 50s.  He ate a lot of meat, butter, eggs, and bacon grease.  I doubt that all of that caused it - I think the primary cause was his two-pack-a-day unfiltered Camels habit.  But all of that didn't prevent it, either.

  • The Mick Solomons Experiment

    11/25/2009 1:59:47 AM |

    I've found going down to 2 main meals a day, and only eating between 11am and 6pm that my body fat has dropped considerably.  

    I was stuck on about 70kgs for 12 months after starting a high fat, low carb diet, since I've started IF I've dropped nearly a kg of body fat a week for the past 6 weeks (you can see photos on my blog) And I know its body fat because I'm maintaining and even increasing the amount of weight i'm lifting at the gym.

    I also feel great too Smile

  • Kathryn

    11/25/2009 2:44:44 AM |

    Then, why the insistence, heard over & over that breakfast is so important?  My body just doesn't seem to want something early in the day, & i've been trying to trust instinct.  But then i wonder if it is just a habit i've gotten into?  

    I'm not eating a lot of calories & i eat no wheat (on rare occasion i break this, but have been 95% gluten-free for about 4 years or more).  But no weight loss.  I sometimes wonder if it is because i'm resistant to having breakfast.  

    I really don't understand.

  • PERKDOUG

    11/25/2009 4:18:43 PM |

    I borrow here from the Diabetes community. Blood sugar spikes may be the root cause of or a major contributor to Type 2 diabetes. The bigger the meal the bigger the spike. Most of us that have endured the SAD for most of our lives are well on our way to Type 2 (in my opinion) even after taking to the Low Carb WOE. Thus we are damaged goods and probably would be well advised that if we eat fewer meals per day, we should test the effects on our blood sugar. I do this. Blood meters are dirt cheap. Low carbing no doubt helps but does not assure "no spikes".

  • Methuselah

    12/3/2009 2:16:43 PM |

    Kathryn, the answer to your question "then why the insistence" is because the people who are doing the insisting are basing their advice on little or no real evidence, just pseudo science and old-wivery. Don't confuse exposure with validity. Bad ideas very often get more air time than good ones and the world of medicine and nutrition is rich with examples.

  • buy jeans

    11/3/2010 6:40:00 PM |

    I stress this point because I see that the notion of grazing has seized hold of many people's thinking. In my view, grazing is a destructive practice that is self-indulgent, unnecessary, and simply fulfills the perverse non-stop hunger impulse fueled by modern carbohydrate foods.

  • mike

    5/29/2012 7:35:12 PM |

    If the typical hunter-gatherer tribe eats only once a day and if humans can only absorb around 35g of protein at one time, this would mean that even H-Gs eating very high protein diets would ACTUALLY be on very low protein diets. This is huge no?

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When LDL is more than meets the eye

When LDL is more than meets the eye

18. November 2006 William Davis (0)
Jerry wanted to know what to do with his LDL cholesterol of 112 mg/dl. "My doctor said that it's not high but it could be better."

So I asked him what the other numbers on his lipid panel showed. He pulled out the results:

LDL cholesterol 112 mg/dl

HDL 32 mg/dl

Triglycerides 159 mg/dl


I pointed out to Jerry that, given the low HDL and high triglycerides, his calculated LDL of 112 was likely inaccurate. In fact, if measured, LDL was probably more like 140-180 mg/dl. LDL particles were also virtually guaranteed to be small, since low HDL and small LDL usually go hand-in-hand (though small LDL can still occur with a good HDL).

So Jerry's LDL is really much higher than it appears. To prove it, Jerry will require an additional test, preferably one in which LDL is measured, such as LDL particle number (NMR), apoprotein B, or "direct" LDL.

It's really quite simple. Jerry likely has a high number of LDL particles that are too small. This pattern confers a three- to six-fold increased risk for heart disease.

Treatment requires more than just reducing LDL. Small LDL--an important component of this pattern, responds, for instance, to a reduction in processed carbohydrates like wheat products (breads, breakfast cereals, pretzels, etc.), NOT to a low-fat diet. Weight loss to ideal weight, especially loss of abdominal fat, will yield huge improvements in these numbers. Niacin may be a necessary component of Jerry's treatment program, since it increases LDL size and raises HDL.

For more discussion on measures superior to LDL cholesterol, see my upcoming editorial, Let Dr. Friedewald Lie in Peace (an expansion of a previous Heart Scan Blog). It will be posted on the Cardiologist on Call column on the Track Your Plaque website within the next week.)
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Postprandial blood sugar: Almonds vs. whole wheat bread

Postprandial blood sugar: Almonds vs. whole wheat bread

22. January 2010 William Davis (0)
Here's my postprandial (after-eating) blood glucose demonstration.



I tested raw almonds vs. 100% whole wheat bread, matched for calories. (Full nutritional composition below.)



Blood sugars:

Raw almonds

Start:

One-hour after eating:





2 slices 100% whole wheat bread

Start:

One-hour after eating:





100% whole wheat bread, 2 large slices

Water (g) 24.69

Energy (kcal) 158

Protein (g) 8.29

Fat, total (g) 2.14

Carbohydrate (g) 26.43

Sugars, total (g) 3.56

Fiber, total dietary (g) 4.4

Cholesterol (mg) 0

Saturated fatty acids, total (g) 0.478

Monounsaturated fatty acids, total (g) 1.022

Polyunsaturated fatty acids, total (g) 0.384





23 almonds, raw



Energy (kcal) 159

Protein (g) 5.86

Fat, total (g) 13.64

Carbohydrate (g) 5.98

Sugars, total (g) 1.07

Fiber, total dietary (g) 3.4

Cholesterol (mg) 0

Saturated fatty acids, total (g) 1.03

Monounsaturated fatty acids, total (g) 8.525

Polyunsaturated fatty acids, total (g) 3.331



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The most important weight loss tool

The most important weight loss tool

4. March 2010 William Davis (15)

Question: What is the most effective tool available to help you lose weight? 


A pedometer (walk 10,000 steps, etc.)?

A treadmill? 




A bicycle?






No. None of the above. 

The most important tool you can use to achieve weight loss is your glucose monitor:



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Comments (15) -

  • Emily

    3/4/2010 5:43:01 PM |

    Dr. Davis,
    would you please explain, in layman's terms, why chiceking blood glucose can be so important for not only keeping track of blood sugar but for weight loss? I think I get it, but my mother, who was recently diagnosed as "pre-diabetic", says she is going to return the glucosometer she based bought upon my suggestion, as she is going to eat low-carb and track calories, etc.  Help me help my mom out!  Thanks so much,
    emily

  • Larry

    3/4/2010 6:24:28 PM |

    Dr Davis, thanks for the site.

    There's a history of Diabetes in my family.
    My dad and his father were both Diabetics and they both died of Pancreatic Cancer in later years.
    They never watched any of their habits though.
    My dad's doctor used to call him a "food and lifestyle" liar. Dad shrugged it off.. and kept on lying.

    Yes, I know about the genetic odds here.
    I do watch what I eat, Vit D3, no cigarettes and I exercise and live life.

    I've never seen a conclusive study relating Diabetes and Pancreatic Cancer.
    Any thoughts on that ?
    I'm not Diabetic. FBG today of 89.
    But I still watch myself and I have started to use a BG monitor to watch post-prandial numbers.
    It's interesting how different foods affect everyones's BG differently.
    I'm continually learning.
    Thanks again for the site.

  • Anonymous

    3/4/2010 7:43:43 PM |

    I'm new to all this but have a question if anyone is willing to indulge me an answer...

    I frequently fall to sleep after lunch and/or after dinner, just "nod off" type of thing.  Is this a result of high BG and then the insulin response driving sugar low?

    I am not diabetic and try to eat reasonable healthy meals, moderates amount of lean meat, vegetable and starch like rice or potato.  I wonder if I have insulin insensitivity...guess I need a meter. Thanks

  • Sam

    3/4/2010 7:43:43 PM |

    Thanks for explaining why.

  • Derek S.

    3/4/2010 8:35:18 PM |

    Could you maybe elaborate a little?

  • Lori Miller

    3/5/2010 2:11:12 AM |

    Carbs cause blood sugar to rise. Indulge in excess carbs, and you can walk, run and bike till you drop and not lose an ounce.

  • Anonymous

    3/5/2010 2:27:50 PM |

    Awesome post Dr. Davis. I check my post-prandial BG constantly and have eliminated many so called low glycemic foods. ALso, nice simple explanation Lori.

  • TedHutchinson

    3/5/2010 2:53:27 PM |

    @ Larry said...
    I've never seen a conclusive study relating Diabetes and Pancreatic Cancer.
    Any thoughts on that ?
    It's not a straightforward connection, they are still arguing about it.
    This abstract suggests  
    the development of diabetes in subjects prone to pancreatic cancer could be a red flag for malignancy.

    And this full text article
    Is Type 2 Diabetes a Risk Factor for Pancreatic Cancer? explains why it's difficult to definitively identify type 2 diabetes mellitus as a risk factor for pancreatic cancer.

    Worth pointing out for those with Diabetes who are concerned about the threat of Pancreatic cancer that Metformin monotherapy carried the lowest risk of cancer. However that was comparing medical diabetes treatments, so didn't include people using Dr Bernstein's or similar approaches to controlling diabetes through diet, exercise.

    I found this paper Cancer as a metabolic disease worth studying. It's not specifically about pancreatic cancer. It makes the point that Reduced glucose availability will target aerobic glycolysis and the pentose phosphate shunt; pathways  required  for  the  survival  and  proliferation  of many  types  of  tumor  cells.
    Maybe it isn't just the risk of heart disease that is reduced by lowering circulating  glucose levels.

  • TedHutchinson

    3/5/2010 3:21:19 PM |

    @  Emily
    Please try to persuade your mum the glucose meter is an essential tool to understand which foods really raise BG levels.
    I thought, a bit like your mum, that because I followed a Low carb eating plan I wouldn't have a problem with high glucose.
    Only after readingTo get low-carb right, you need to check blood sugars did I get a meter and start checking.
    Despite eating almost exclusively low carb I was regularly spiking up to 199.8 ~ 11.1.
    Adding into my diet a variety of things to slow gastric emptying has reduced the height of 1hr after meal spikes and I've now gone a week under 133.2 ~ 7.4 and the trend is towards lower numbers mostly under 108 ~ 6

    I've not restricted my calorie intake nor am I able to exercise much but I have, unintentionally, lost weight. A month ago I was 168lbs and am now 163 lbs.

  • Steve

    3/5/2010 4:24:51 PM |

    I went out and bought a glucose meter yesterday.  I bought the one Dr. Davis recommended, the OneTouch mini purchased at Walgreens.

    In hindsight though, it turned out to be an expensive choice.  I had to buy the OneTouch test strips as well, and they are fairly pricey.

    For anyone considering buying a glucometer, buy the Walgreen's version.  I think it had a mail-in rebate, cost a bit less than the one touch, and also, the generic Walgreen's test strips are half as much as the One Touch.

    And thank you Dr. Davis for this great blog.

  • Elenor

    3/12/2010 3:07:36 AM |

    Consumer Reports magazine recommended the ReliOn Ultima and their strips. The meter is, like, $9 and the strips are very inexpensive (compared to "branded" ones). (I'm pre-diabetic.) I don't have any hesitation checking my b.g. anytime, because the strips are cheap.  (No insurance, I have to pay for all my supplies.)  If you have insurance but they limit your strips (as with my nephew, a Type 1), you can use the  cheap one to fill-in your testing.

  • Anonymous

    3/28/2010 6:26:15 PM |

    From my research and experimentation, the Accuchek Aviva shown in picture is the most accurate and precise meter currently available.  Over the long run, an accurate and precise meter will save you money and a lot of trouble, versus one whose results are not as reliable, and which forces you to test more.

    btw, most precision issues are due to the strips, and cheap strips will simply result in lots of unnecessary holes in your fingers if you're serious about knowing what's going on with BGs.

  • Anonymous

    6/21/2010 9:56:20 AM |

    thanks

  • Robababababa

    1/2/2011 8:45:07 PM |

    if you are looking for a guide to help you lose weight

    i really lost weight and got fit by using this guide..

    I was skeptical but i was surprised as i never expect these things to work!!

    <a href="http://0e8008qijy8s5zbfv8fiwl4vbl.hop.clickbank.net/> Click here for the link!</a>

  • visalus

    1/14/2011 2:59:06 AM |

    I wish that I can have all those weight loss tool. I am sure if I have all those my weight loss program is going to be more effective.

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Have You Had Your Prebiotics Today?

Have You Had Your Prebiotics Today?

11. July 2014 Lisa G (0)


Prebiotics and resistant starch may be the missing link to your digestive health. Indigestible fibers that allow healthy bowel flora to proliferate and thrive are often called prebiotics. They are also known as resistant starches, because they are resistant to human digestion. I recently had a client call the addition of resistance starch to her diet, “the missing link my body needed”.

A starch that resists digestion and reaches the large intestine becomes food for the healthy bacteria in the large intestine. These bacteria can break down and “feed on” the resistant starch thus providing the friendly bacteria with the fuel they need to survive.

Imbalance of the quantity and type of bacteria species present in the gut contributes to gastrointestinal illness, blood sugar imbalance, obesity, mood disorders, and immune system challenges.

Green unripe bananas and plantains are one of best sources for prebiotic fiber content with 27 to 30 grams of fiber in one medium banana. Green bananas are essentially inedible. They are most easily incorporated into diet by blending into a smoothie.

One mistake frequently made incorporating prebiotic fibers from bananas is consuming bananas that are too ripe. Once the banana ripens the resistant starch is degraded and become a digestible starch. Thus, no longer a good prebiotic fiber source. In fact, the riper the banana becomes the higher the glycemic (blood sugar) response.

It can be difficult to find bananas that are very green. I made several trips to my local grocery store to find these bowel flora champions. I find it helpful to ask the produce clerk to take a look at the shipment that just arrived, noting the day the shipment arrives, for the best chance to gobble up these green beauties.

In an effort to keep green bananas green I tried a few strategies. One that sounded promising was wrapping the end of the banana to prevent the ethylene gas, which ripens the fruit, from dissipating. You can see from the image this clearly did not work. After a mere two days the green bananas were no longer green. What I found works best is placing the green bananas in the fridge. This halts the ripening process. The skin of the banana will turn brown, which is normal, but the fruit inside is still good. I’ve kept bananas in my fridge for up to 8 days and they hold up well other than the brownish black discoloring that develops on the skin. The banana will be firm and require a knife to cut the skin off the banana.

If you’d like to learn more about prebiotics and strategies to support resolution of common gastrointestinal complaints read the recently release Cureality Guide to Healthy Bowel Flora by Dr. Davis. This guide is one of the many valuable resources available exclusively to Cureality.com members.
---Lisa Grudzielanek, MS, RDN,CD,CDE
Cureality Nutrition Specialist

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Drama with the Dr. Oz Show

Drama with the Dr. Oz Show

11. April 2010 William Davis (27)
A producer from the Dr. Oz show recently contacted my office. They asked whether we could supply them with a volunteer patient from either my practice or the Track Your Plaque program who would be willing to appear on the show and discuss heart disease prevention. They needed someone to commit within 24 hours.

Despite the short notice, we identified a volunteer. He flew to New York the following week where he was interviewed along with several other men and women, all of whom had heart disease (heart attacks, stents, etc.). However, as this young man is very slender and follows most of the Track Your Plaque principles (e.g., vitamin D and omega-3 fatty acid supplementation; no wheat, cornstarch, or sugars, no restriction of fat, etc.), he apparently received less attention than the overweight, I-know-nothing-about-diet interviewees.

Then there was an odd turn of events: Dr. Dean Ornish, apparently a friend of Dr. Oz, will be providing the dietary counseling. The producer had made no mention of Dr. Ornish.

Now that's an odd collision of philosophies: Our Track Your Plaque version of low-carb with the guru of low-fat, Dr. Ornish.

The following week, Dr. Ornish called me and graciously asked whether I was okay with this. I'm not sure just how much he knew about the philosophy I advocate, nor how much I have bashed his program as a destructive approach to diet, nor whether he knew that I gained 30 lbs on the Ornish diet, along with a drop in HDL to 27 mg/dl, increased triglycerides to 350 mg/dl, and type II diabetes that I've talked about on this blog and the Track Your Plaque book and website. I suspect he knew little to none of this.

Anyway, I tried to diplomatically explain that my patient's cause for coronary plaque was small LDL particles that he expressed despite his very slender build, likely from excessive carbohydrates, controlled with carbohydrate restriction. Dr. Ornish maintained his usual arguments: Grains are good, provided they are whole grains, heart disease is "reversed" with his diet program, etc. (I didn't want to challenge him in a phone call and tell him that he never actually reversed coronary plaque, but just reversed endothelial dysfunction. But, as Dr. Ornish is not a cardiologist, I wasn't sure how far his understanding of these issues went.)

We agreed to disagree. This leaves my poor patient in an odd position: Being asked by Dr. Ornish and the Dr. Oz show to follow a low-fat program for the sake of entertainment, or adhering to the advice we follow that has so far served him well, given his small LDL particle size tendencies.

We'll see where this little drama leads.
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Comments (27) -

  • preserve

    4/11/2010 2:10:12 PM |

    This can be very educational.  We can find out the effects of Dr. Ornish's diet, directly prescribed by him.  This provides a pretty comparison test.

  • Anne

    4/11/2010 3:12:55 PM |

    If I had been the person flown to NYC for the show and was told they wanted me to follow the Ornish plan, I would have told them "No way." and walked out.

    I tried the Ornish diet when I first started having problems with CAD and multiple stents. I found the diet very difficult and it left me hungry. I did the meditation too.  I don't know what my lipid levels were at that time. I then went to the AHA diet that caused my triglycerides, cholesterol and weight to all rise and the answer was to get on statins and I went on to have bypass.

    In 2008 I started following a TYP lifestyle plan. Here is what happened http://heartscanblog.blogspot.com/2009/06/beating-heart-association-diet-is.html

  • Ned Kock

    4/11/2010 3:54:15 PM |

    Interesting, particularly the involvement of Dr. Ornish. Dr. Oz seems to be changing his tone lately - less critical of fats or more of refined carbs.

    By the way, you mentioned several times on your blog that the  Friedewald equation is very imprecise, providing a fictitious measure of LDL, particularly as TGs go down.

    What is your opinion of the Iranian equation? It seems to be more precise for those with low TGs, and maybe more precise in general, as its parameters were estimated through multiple linear regression:

    http://healthcorrelator.blogspot.com/2010/04/friedewald-and-iranian-equations.html

    Of course, a VAP or equivalent test would be better, but a lot of people would like to have a more precise number based on their standard lipid profile results.

  • JD

    4/11/2010 3:57:26 PM |

    Dr. Oz's wife Lisa is a vegetarian and IIRC a producer of his radio show. Dr. Oz has been quoted as saying that "everything he knows about nutrition he learned from his wife". Given his source of nutrition education I am not surprised he is on good terms with Dr. Ornish. As Dr. Eades says, "Jesus wept".

  • Mark

    4/11/2010 4:06:06 PM |

    Subjects on Dr. Oz are chosen w/entertainment value in mind.  Dr. Oz consistently gives contradicting advice at different times aimed at large audiences with the air that one size fits all. I will stay with my individualized TYP approach and leave him and his advice to entertain the masses.

  • Alcinda (Cindy) Moore

    4/11/2010 5:25:48 PM |

    If it was me, no contest. I'd stick with you! I am not a fan or Oz....and can't stand Ornish!

  • Rantin' Rog

    4/11/2010 5:31:38 PM |

    While I don't agree with Ornish, I think this is an exciting development.  Maybe he will learn something from your patient!  Any common ground and exchange of ideas is a good thing.

  • Brett

    4/11/2010 9:08:37 PM |

    Why didn't Oz or Ornish simply invite you, Dr. Davis, to be on the show? You're (cough) down with the low-fat program, right?

  • pjnoir

    4/12/2010 2:13:45 AM |

    AMBUSH. Low FAT will always win the debate because they set the facts- its just like Alice in Wonderland. Nothing good can come of this. I saw Doc OZ pour some cooking oil in his hand and say to a women- see,image this running through your veins. If thats the case- Id hate to see what Oatmeal looks like in those veins. And don't get me started on DO.

  • Gina

    4/12/2010 4:17:48 AM |

    This is the reason I turned my TV off for good over 9 years ago!
    Oz and Ornish and entertainment...why do people believe every word theses guys say? Oh maybe because Oprha says they're the best. Good God, with a computer and internet available to almost anyone who can view a TV why don't they ask some questions and do some research. Oh maybe because this is all in the name of entertainment.
    Keep up the great work Doc. I love the blog!

  • Dr. William Davis

    4/12/2010 11:31:47 AM |

    I remind myself that Dr. Ornish et al are all trying to work towards the same goal: reduction of heart disease risk. It's just that we disagree on how we get there. I think his heart is in the right place, but I worry that he perpetuates a message that is outdated and, in many cases, destructive.

    Ned--

    The "Iranian equation" is definitely an improvement, despite being nothing more than a manipulation of numbers. However, it does not uncover the hidden sources of risk that are NOT expressed by the basic lipid numbers, no matter how much you massage them.

  • Peter

    4/12/2010 11:47:49 AM |

    I don't think your disagreements with Ornish are as black and white as you suggest: he has been telling people for thirty years to stop eating sugar and other refined carbohydrates, he thinks well enough of heart scans to have one himself (scored zero), and both you and he choose whole foods over processed foods in a heartbeat (that was a joke about heartbeat.) This is not to say that your views are the same.

  • Dr. William Davis

    4/12/2010 11:58:05 AM |

    I agree, Peter.

    While the differences are fundamental, there is perhaps 70% overlap. And we are indeed aiming for the same goal.

  • George

    4/12/2010 5:03:09 PM |

    Dr. Davis, Hopefully something good will come from this. I would love to see status updates of what develops here. Beginning/Ending lipid profiles, what changes your volunteer makes in their diet based on Ornish, etc. Very, very interesting, looking forward to see what happens. Do we know when this will possibly air?

  • Anonymous

    4/12/2010 5:38:02 PM |

    pjnoir is correct.  It is an ambush.

    Ornish is not 'growing', and Oz is not about to admit he's been wrong all this time.

    You are about to be mocked and held up as a quack.

    It is a shame that they have the megaphone and you don't, but that is our perverted medical/money/fame/power system.

  • Health Test Dummy

    4/12/2010 8:07:33 PM |

    Not that I think these types of doctors are 'dumb', per-say, however, it angers me as to their 'ignorance'. I have absolutely the highest respect for all doctors who search for the 'proactive' solution. I think anyone who sticks with the 'lemmings-style' mantra, in regards to science, is only asking for humiliation and self-destruction down the road. The Ansel Keys-inspired lipid hypothesis, I believe, has been absolutely shot down by CORRECT scientific methods for analyzing it's true health benefits. Throwing together some generalized 'meta-analysis' and touting it as 'truth' for the past 50 years shows us just how 'lemming-like' we truly are as a society. This information is a type of regurgitated (telephone game) bit of information that sticks to everything like glue, due to bad media and doctors who refuse to proactively search for alternative solutions based on true scientific formulas (have we all forgotten the 7th grade science class teachings of 'control group' and other forms of scientific analysis?).

    Anyway, it blows my mind. Meanwhile, I will continue to be mocked and viewed upon by my peers as 'weird' or 'out there', whilst they are all 10% + bodyfat % above me.

  • John

    4/12/2010 9:45:40 PM |

    I can vouch for the wisdom of Dr. Davis, I recently switched cardiologists to one that would listen to me about how I changed my diet since November of last year alas with the recommendations on this website I was so fortunate to come across.

    In November  
    Total Cholesterol 295
    LDL 191
    HDL 56
    TG 235
    I was immediately put on 5 mg of Crestor daily.

    Now today... after changing my diet (no wheat, no HFCS, low carbs) ( I cheat every once in awhile  but rarely, sushi with rice is my weakness..but one meal a week if at all) and still take the Crestor... after getting bloodwork from new cardiologist.

    New Numbers
    Total Cholesterol 200
    LDL 121
    HDL 61
    TG 90

    And the best part... I dropped 27 lbs and dropped a pants size...not bad for a 45 year old guy. At 6'4" and 209 pounds I'm ecstatic. Goal weight is 195 lbs that I was 15 years ago when I got married.

    Best thing is... my new cardiologist told me to take the 5 mg of Crestor EVERY OTHER DAY NOW... very happy about that. He said what you're doing with your diet and some exercise is reaping positive changes. He finished with we'll see you in 6 months to reevaluate your progress and go from there. Obviously my goal is to get off the statin for good and I think I can accomplish that with eating the Dr. Davis way.

    Thanks for the great advice you give Dr. Davis.

  • Lou

    4/13/2010 12:01:39 AM |

    Hope your patient is well prepared to provide information why she/he is doing all of that that you had him/her doing. Hope it turns out well for your patient and you.

  • Dr. William Davis

    4/13/2010 1:45:20 AM |

    I'm told that the Dr. Oz show featuring our patient will be aired Wednesday, April 14th.

    I'm not too worried about any bad press it might create. I have always been confident that the truth will win out.

  • Rob

    4/13/2010 9:37:38 PM |

    That is unfortunate. It would have been a great study, but unfortunately Dean Ornish's diet has no evidence to support it is healthy. I would politely refuse to have anything to do with that low-fat diet crap.

    http://productreviewratings.com/2010/02/fat-and-cholesterol-are-good-for-you/

  • Anonymous

    4/14/2010 5:08:46 PM |

    I just checked my Tivo and found this particular Dr. Oz show will be aired on WFLD in Chicago on April 14th at 4:00 pm and then once again on April 15th at 10:00 am.

    David

  • kdhartt

    4/15/2010 1:10:21 AM |

    Just watched it. Fish oil made the cut, not pills even, but something to have with your salad. 30 min exercise. Some yoga for stress. Impressive animations of arteries and plaque and rupture. A lot of low-fat dogma. I must say I learned nothing.

  • rhc

    4/15/2010 3:17:18 AM |

    I just watched the show and I must say it was VERY convincing since Dr. Oz had photos of the improved arteries of two of the patients. In addition, one of Dr. Ornish's original patients  who had been on the heart transplant list 25 years ago was also there - looking quite radiant and healthy. They showed pictures of his heart before and after as well.

    It is all so confusing to me since both sides have their 'proof' and scientific evidence. And let's face it most people will believe the benefits of 'lowfat' over 'highfat' any day.

    Dr. Davis could you please explain your answer to Dr. Ornish:
    “(I didn't want to challenge him in a phone call and tell him that he never actually reversed coronary plaque, but just reversed endothelial dysfunction. But, as Dr. Ornish is not a cardiologist, I wasn't sure how far his understanding of these issues went.)”

    I have no medical training, so forgive my ignorance, but it seems to me that if a diet reverses heart disease it doesn’t matter wether it is by reversing plaque or by reversing a dysfunction – the end result is what counts…doesn't it?

  • Anonymous

    4/15/2010 4:27:47 PM |

    Well I watched the show and couldnt tell which guest was the one that Dr D recommended.
    But certainly heart disease reversal was the predominate theme. Interesting graphics were used to explain plaque build up and blockage. But nothing on the components of cholesteral or small LDL. Nothing about blood sugar monitoring. On reversal startegies, weight control and exercise were trotted out as important elements ... not particularly new or enlightening. But when it came to diet there was almost a whole hearted endorsement of carbs ... oatmeal with plenty of fruit for breakfast, whole grain bread, rice etc.   Curiously fish oils where mentioned only briefly (almost in passing), and there was nothng on Vitamin D or Niacin.
    Not even statins (pro or con) were mentioned.

    All in all not at all informative! ... perhaps even misleading by what was not said ... a very poor performance imho.

  • Dr. William Davis

    4/15/2010 6:36:25 PM |

    I've so far only been able to view some of the introductory dietary comments, the "whole wheat cereal for breakfast" and "low-fat granola bar" for a snack.

    That little bit made me shudder. It brought back memories of all the low-fat blunders we made 15 years ago until we saw that substantial numbers of people were made pre-diabetic or diabetic with this routine.

  • kdhartt

    4/15/2010 10:46:31 PM |

    There was a 70% carbs, 10% fat pie chart. Must do to reverse heart disease. Nutritious meal (for six) portrayed as a death wish. Ornish as god. Not our cup of tea.

  • Anonymous

    4/16/2010 6:37:28 AM |

    Hey, at least they didn't attack you, Dr. D.  That's what I was thinking would happen.

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What is this wacky thing called "weight loss"?

What is this wacky thing called "weight loss"?

20. September 2011 William Davis (41)
I've discussed this before, but it has proven such an (encouragingly!) frequent issue that I thought it was worth discussing once again.

What happens when you lose weight?

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

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

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

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

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

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

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

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

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

As with many things, it's all about timing.
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Comments (41) -

  • chuck

    9/20/2011 2:02:02 AM |

    Isn't the form of storage fat saturated fat?  maybe this is how they came up with the theory saturated fat is bad for you.  look at all those symptoms when all that sat fat is released into the blood ;)

  • Dee Miles

    9/20/2011 3:18:39 AM |

    Wow!  I'm so glad you explained this very topic because that's exactly what happened to me recently.  For the past 8 weeks I've not had any grains or sugars and I've kept my carb level about 20g per day. I've lost 15 lbs so far.  I visited my Dr. in May (prior to any weight loss, and maybe during some gain), and the lipid panel was like this: LDL 84, HDL 76, Trig 40.  When I had another blood test in early Sept, I was shocked to see the markers worse!  LDL 122, HDL 48, Trig 88.  Boy was I disappointed in those latest numbers.  Thank you for explaining how this works while losing weight.  At one point recently I was really discouraged but now I'm really glad about the timing of the tests and your post.  My next blood draw is scheduled for 3 months out from last week, at the request of my Dr.  Maybe then the numbers will have shown some improvement.
    Also, glad to hear the you will be on the low carb cruise in May.  My hubby and I are looking forward to hearing you speak and hopefully meeting you then.

  • Donald Kjellberg

    9/20/2011 5:18:03 AM |

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

    Maintaining weight, it is easy. My BMI (23 down from 40) has remained constant for a few month now. You are right, metabolic processes definitely change. I no longer have sensations of glucose fluctuations or an uncontrolled appetite. I can only imagine the improved hormone regulation and metabolic communication going on inside my body. The symptoms from obesity, all gone. Goodbye sleep apnea, hypertension, hemorrhoids, arrhythmias, gastroinestinal disruptions, smelly body, chaffing thighs, and others not mentioned.

    The positive effects are just as dramatic, but I don't want to ramble on.

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

  • Dr. William Davis

    9/20/2011 12:30:01 PM |

    Excellent, excellent, excellent, Donald!

    I'm glad you got your life back and deprived Big Food and Big Pharma of revenues.

  • Dr. William Davis

    9/20/2011 12:31:07 PM |

    Yup, happens time and again. And your doctor will have no idea what this pink elephant is.

    Yes, see you on the cruise!

  • Buckaroo Banzai

    9/20/2011 1:45:43 PM |

    Would the same lipid response happen if one were replacing body fat with muscle and remain at roughly the same weight?

  • kathyj333

    9/20/2011 1:51:53 PM |

    When I lost a large amount of weight, I had a gallbladder attack. I had my cholesterol levels done during this time, and, yes, the LDL was high. Thanks for this post.

  • Jack Kronk

    9/20/2011 2:16:45 PM |

    Dr Davis,

    I began VLC back in Aug 2010 and transitioned until December. During that time, I went from a slightly pudgy and undefined 163 to a slim and muscular 148 (meaning that I likely lost more than 15 pounds of fat since I was gaining muscle at the same time.)

    My weight has remained stable but very graudally increased since December 2010 because I do heavy resistance weight training consistently and take a whey protein powder supplement. Currently I weigh in at about 155 and I have very little flab, if any.

    With respect to my lipid numbers, is my body still in some kind of transition phase?
    http://paleohacks.com/questions/64890/hack-jack-kronks-latest-lab-results-sept-2011

    Thanks,
    JK

  • Haggus

    9/20/2011 7:23:52 PM |

    I went through this back some 3 years ago and was put on a statin as a result.  While it seems out of fashion now with Dr. Davis, at least with those with blood sugar issues, I used oat bran to drive my LDL to 38 from 193mg/dl, thereby bettering Dr. Davis's 60/60/60 guidelines.

    Other effects: My trigs actually went down from 55 to 15mg/dl, my a1c increased from 4.8 to 4.9% and finally, I became anemic.

    Would I do it again if need be?  Yes, for me, life without the use of a statin trumps most everything else.  Thankfully, these days I still have better 60/60/60 numbers without the heavy use of oat bran which keeps my doctor and the blood bank happy.

  • Linda

    9/20/2011 9:20:57 PM |

    Dr. Davis................
    Another question regarding D3................
    Is there any benefit derived from taking D3 and glaucoma? Does it help relieve eye pressure in any way?

    [I am facing laser surgery, so I am really wondering if the D3 will help.]

  • Joe

    9/20/2011 9:31:43 PM |

    I don't think there's anything in the literature about D3 helping prevent glaucoma. There is some correlation between D3 and prevention of macular degeneration, but the jury is still out on it.

  • Dr. William Davis

    9/20/2011 11:05:11 PM |

    Sorry, Linda: Way out of my area of expertise.

    However, vitamin D is beneficial across so many aspects of health that it's worth doing regardless.

  • Dr. William Davis

    9/20/2011 11:25:13 PM |

    Hi, Jack--

    If your VAP doesn't reflect recent weight loss, consider:

    1) On the surface, your pattern looks like excessive carbohydrate intake for your genetic susceptibility (small LDL, low HDL, high triglycerides).
    2) Apo E2
    3) Another condition has entered the picture, such as kidney disease. Unlikely, thank goodness, but worth thinking about.

    Let me know what comes of this.

  • Dr. William Davis

    9/20/2011 11:25:38 PM |

    Yes, Buck, since the fat still needs to be mobilized into the bloodstream.

  • Ellen

    9/21/2011 2:47:16 AM |

    THANK YOU, Dr. Davis for posting this!   I've been trying to find supporting information on what happens during weight loss, because I get questions about changes in blood work from the readers of my websites.   It made sense to me that trigs would increase because of stored fat mobilization, but I searched all over pubmed and could not find a single paper to support that hypothesis.   Thanks again for confirming this!

  • Bob

    9/21/2011 3:37:37 AM |

    Dr. Davis, I posted last week about high numbers after being on a no carb, no sugar, no wheat diet for a year. You posted back that it could be weight loss and not to worry. I just heard back from two different doctors who looked at my last two VAP tests and they both suggested that I start statins as soon as possible. They are both doctors who specialize in lipids and also believe in not eating carbs sugar etc. They both want me to take a NMR test which would give them a clearer picture of what is going on. I have lost 25 lbs. over the last year. Do you think that after a year of losing weight it would still have an effect on my numbers? They are worried about apo B which I guess is why they want to see NMR. I don't mind taking the statin if I really need it but I am worried that if my apoB is high because of weight loss I am making a big mistake because once I start there will be reason to be taken off of them. I am also worried that if I don't take the statin now, if I wait another 6 months for another test, I am risking my health. I am 59 with two young children.
    Thanks

  • Jack Kronk

    9/21/2011 2:55:39 PM |

    ApoE2? I thought I was more in the running for ApoE4. Isn't 4 the one where it gets a bit dicey with dietary fats?

    Also, kidney disease? what makes you say that. I have had 7 kidney stones (all calcium oxalate. all "pre paleo").  I have several hypotheses about why I don't get them anymore, but my best guess is due to the increase in VitK2, since K2 sort of 'directs' where calcium goes. So I figured my kidneys were much happier with my new diet than with my SAD.

    As for excessive carbohydrate intake, yah that may be true, but I think you make an important reference about genetic susceptibility, as many people can do just fine with my carb intake as it does not produce these numbers for them.

    We have some interesting things brewing over there on PaleoHacks about what might be affecting my lipids. Travis Culp is kind of leading the charge right now and Dr K is in the mix as well.

    http://paleohacks.com/questions/66154/medium-chain-fatty-acids-appear-to-raise-vldl-triglycerides

    Thanks for your thoughts Doc.

    -JK

  • Dr. William Davis

    9/21/2011 9:36:04 PM |

    Hi, Jack--

    If the 150 grams carbohydrates mentioned in the blog post was referring to your intake, then that is definitely at least part, if not all. of the underlying cause.

    Apo E2 would serve to exaggerate this effect, mostly by way of delayed clearance of postprandial lipoproteins. This could be apo E4 but it would be a very atypical pattern, since there are low HDL/high triglycerides.

    Kidney stones in and of themselves would be insufficient; it would have to involve overt kidney dysfunction.

    Anyway, please let me know what comes of this.

  • Dr. William Davis

    9/21/2011 9:40:23 PM |

    Hi, Bob--

    It's not so much the period of time required to lose the weight, but whether the blood was drawn too soon (less than 2 months) after weight plateaued. If drawn too soon, it will yield confusing or alarming numbers to the weight loss-uninitiated.

    Getting an NMR is always a good idea, since it yields the most confident value, LDL particle number.

    Have you gotten a heart scan? Remember, it's more about coronary plaque than about calculated LDL or apo B.

  • Dr. William Davis

    9/21/2011 9:42:40 PM |

    Hi, Ellen--

    Surprising, isn't it? Perhaps it's something we should do!

    Anyway, it is critical to recognize this, else people get mad and throw things and think that the diet is destructive when, in reality, it works like crazy--if you know when to draw the blood sample.

  • Bob

    9/21/2011 10:28:03 PM |

    Dr. Davis,
    I had a heart scan thanks to your blog about 4 years ago with a score of zero. At the time I was on Lipitor following low carb diet but with little sat. fat. I was mostly eating skinless chicken, salmon with mayo. Now I am on high sat. fat diet. Beef and more beef. My weight is still dropping. I started at 186 and now I am 159. I have no idea when my weight will plateau. I feel I am in a bad position as two lipid doctors feel I should be on statins now yet I believe the numbers are not accurate because of the weight loss. If I wait for weight loss to stop I may be putting myself at risk but I don't want to go on statins if not necessary.
    Tomorrow I am planning on the NMR test.
    Thanks

  • Gene K

    9/22/2011 2:25:42 AM |

    Since I consistently get a server error trying to post this comment to the small LDL post, I am posting it here.

    Dr Davis,

    Do you think at some point you will drop the TYP target for LDL to be 700 or less in favour of a target amount or percentage of small LDL?

    Thank you.

  • Kat

    9/22/2011 8:38:16 PM |

    I've got to show this article to my mom. My mom has struggled with her weight for a long time. Her doctor told her she would give her 6 months to try and improve her numbers through diet and exercise. If they didn't go down she would have to start taking statins which my mom did not want to do. My mom did manage to lose a considerable amount of weight (about 50 pounds) in that 6 months period. She went to see her doctor, had a lipid panel done and the doc said her lipid panel numbers were worst than before. The doctor blamed her for not eating the right stuff  and said she needed to start statins now or die. It really scared my mom and she got frustrated. She ended up taking the statins because she didn't feel she had a choice and reverted back to her old lifestyle. Maybe if she knew this information she wouldn't have been so discouraged.

  • Dr. William Davis

    9/23/2011 12:35:53 AM |

    Oh, boy, Kat. It sounds like this is precisely what happened.

    I truly find it incredible that weight loss for my colleagues is such an uncommon thing that they don't even recognize it.

  • Dr. William Davis

    9/23/2011 12:37:46 AM |

    Hi, Gene--

    Yes, I am trending in that direction. However, it remains unclear what the safe threshold is for LDL particle number or apo B when small LDL is minimized or eliminated. BIG question with no current answer.

  • Dr. William Davis

    9/23/2011 12:47:36 AM |

    Hi, Bob--

    Be careful: Even the NMR is subject to the confusing and transient changes that occur during weight loss. In fact, you can observe these effects in ALL lipoprotein testing techniques.

    I know of no way to subtract the effect of weight loss except to be patient and wait for weight to plateau.

  • Dr. William Davis

    9/23/2011 12:49:06 AM |

    Donald--

    I loved your comment so much I'd like to make it the focus of a blog post!

  • Tom

    9/24/2011 3:17:32 PM |

    I' ve cut out wheat from my diet and my wheat belly has disappeared. Unfortunately there is still fat around the hips/thighs. Still, I'm very pleased. Thanks!

  • Dr. William Davis

    9/25/2011 12:08:12 AM |

    Great, Tom!

    Just be patient. It tends to come with time.

  • Suze

    10/2/2011 1:31:41 PM |

    This post brought tears to my eyes. Thank you SO VERY MUCH for posting this. I have been going crazy trying to figure out what the heck is going on.
    I went to see my doc in mid-June, who put me on lovastatin (added to blood pressure meds, Ambien, and Prilosec). He had done labs and was unhappy with my cholesterol.
    I went on low carb in early June, about a week before the doc visit. I have done low carb before and knew it would drop my cholesterol, but went along for now. For 6 weeks all was fine and I lost nearly 20 pounds. Started feeling better - was able to get off Ambien and sleep better. Was able to stop the Prilosec also (my GERD disappeared). Because I was trying to get into ketosis to burn fat, I was monitoring my blood sugar. At about 6 weeks into it, I hit a stall and have had to fight like heck to keep losing any weight. But the worst part (for me) was my glucose level. Inexplicably, my fasting glucose crept up just over 100 and stayed there most days. I was horrified - I was not eating any excess sugars, in fact, trying to stay under 20-30 carbs a day. I am a nurse and I know what a fasting glucose over 100 will get me diagnosed with - diabetes. My goal is to get OFF all meds, not get labeled with diabetes and put on more of them. To top it off, my doc wanted new labs after 6 weeks on lovastatin, and I refuse to go until I figured out what the heck was going on with my glucose and fixed the problem. My doc is nice, but I highly doubt he is evolved enough to listen to this argument. He still subscribes to the high cholesterol theory of heart disease, after all.
    I Googled my head off and tried to figure it out. Lots of theories out there. I tried all kinds of supplements supposed to regulate your glucose, and experimented with timing of food and activity. Even stranger, my glucose would RISE after exercise in the morning (still fasting!), but lower if done in the afternoon. I thought maybe I wasn't eating enough carbs and my liver was kicking out glycogen during the night. The day I came home from work after a just-over-100 fasting that morning and checked my glucose and it was 90 (!) 4 hours after lunch, I wanted to go get the damn labs done, but they were closed.
    I knew blood pressure, cholesterol levels and glucose are all tied together, but it had not occurred to me that losing weight mobilized fats into the bloodstream and may be behind my glucose being a pain. Makes me wonder what the lovastatin did for the 60 days I was on it, lol. But my dilemma is that to find out, if I go with an elevated glucose, I will be hosed. :-( So I guess I'll go find a home cholesterol kit and see, and be patient on the glucose issue.
    I also found some interesting info on low stomach acid - I had been on Tums, Zantac and then Prilosec for some time, and I found my glucose issues started around the time I *stopped* taking that stuff... More food for thought.
    Anyway, thank you so much for posting this - at least I am not in a panic at the moment. I am not done yet, though - I still have about 45-50 pounds to go. I am not sure I can hold off the labs that long. I plan to keep an eye on my fasting (97 this morning) and when it's well under 100 will try to get the damn labs done.

  • Dr. William Davis

    10/2/2011 2:32:28 PM |

    That's great, Suze!

    Yes, we have to be properly armed against our doctors!

  • Kelly

    10/9/2011 1:09:15 PM |

    What defines a weight plateau? I was diagnosed with gestational diabetes while pregnant. I left the hospital 20 pounds lighter than I was pre-pregnancy thanks to a lower-carb diet. Over the next 6 months, I lost an additional 25-30 pounds. I'm not losing weight drastically any longer -- I'm now well within the "normal" range for my BMI. However I am still dropping a pound or two every month or so (still breastfeeding). When I tested my blood sugar about 4 months ago, my fasting number was 104. I'm now 11 months postpartum, so its been about 5 months of very gradual weight loss. Would this still change my numbers because I'm technically still losing weight?

  • Dr. William Davis

    10/9/2011 10:59:32 PM |

    Probably not, Kelly.

    I don't know why, but weight loss that has "decelerated" to this degree seems to not be associated with distortion of metabolic markers. It doesn't mean that continued weight loss won't yield further improvement, but that the current numbers are indeed true.

  • DanD

    10/12/2011 4:48:46 PM |

    Donald, congratulations on these tremendous improvements.  Your experience makes me think that I can do the same if I keep at it.

  • Wanda E

    10/18/2011 1:59:06 PM |

    Dr. Davis, I really appreciate all the work you put into the Wheat Belly book.  It is an eye opener.  I have a question.  My husband is diabetic (2 shots per day) also he has Mysenthia Gravis.  Do you have any information regarding Mysenthia Gravis.  Will  eliminating wheat help get rid of or lessen the effects of this disease.  My husband and I are deleting the wheat and i already feel better.  Thank you.

  • Dr. William Davis

    10/19/2011 1:28:44 AM |

    Thanks. Wanda.

    There are, unfortunately, no formal clinical observations that combine wheat/gluten elimination with markers for myasthenia gravis.

    On the most anecdotal level, I have one patient with myasthenia gravis who tells me that her symptoms are substantially improved, though not entirely relieved, with wheat elimination. This seems to be true of nearly all neurologic phenomena that do not have wheat as their original cause: at least partial improvement.

    It is certainly worth trying for this as well as a host of other reasons.

  • Jo

    10/22/2011 2:25:09 AM |

    Thank you for posting this. I think I'm going through this right now. I've lost 63 lbs since being diagnosed with DM last Nov and my A1C is down to 5.5 from over 13.3.  My weight loss has slowed to about 5 lbs per month now and I have low thyroid symptoms but all my doctor cares about is putting me on statins. I'm seeing a new doc next month to try to get more than a TSH test but I know he's going to be concerned about my lipid profile, too. I'm going to ask for either a VAP or NMR test. I don't know how bad these numbers really are but they made the last doctor flip out. I keep under 30 carbs per day, am off all wheat now, and walk at least a mile a day. Here are the most recent numbers and the change from 8 months ago:
    Total: 338 (+58)
    Trigs: 138 (-39)
    HDL: 50 (+10)
    VLDL: 35 (+4)
    LDL: 253 (+44)
    %HDL: 15 (+1)
    Chol:HDL Ratio: 7 (no change)

    I'm not sure what to do in the meantime while I wait for the next appointment, other than be patient, but I'm going to print this post out, anyway.

  • Dr. William Davis

    10/22/2011 12:42:39 PM |

    Very nice result on your weight and diabetes, Jo!

    It looks like you have a genetically-determined pattern, either familial heterozygous hypercholesterolemia and/or apo E4. Sadly, in this situation, diet efforts cannot fully disable the impaired handling of fats that arises from these genetic variants. Statins in this case may not be a bad idea. You may be the occasional exception. Statins are overused and abused, but your situation is one in which they may be appropriate.

  • Suze

    10/23/2011 3:34:55 PM |

    Well, I finally went to get the labs done, and it's a mixed result. After 4 months on low carb and nearly wheat-free:
    cholesterol - 368 to 282 (-86)
    HDL - 40 to 61 (+21 :-D)
    LDL - 287 to 185 (-102)
    ratio - 9.2 to 4.6 (cut in half!)
    VLDL - 41 to 36 (-5)
    triglycerides - 207 to 179 (-28)
    Pretty good improvement in 4 months, I think. The first two months I was on lovastatin, and the last two months, all diet/exercise. I really do not want to go back on statins.
    However, my fasting glucose was 104, despite my efforts to get it lower before getting labs. Now I will have to argue with my doc, I am sure. I got an A1c and it was 5.2, which is totally normal, so at least I am armed with something!!!
    Suze

  • Suze

    10/23/2011 4:04:17 PM |

    P.S. - I have also lost almost 30 pounds!
    And - I just ordered Wheat Belly to read on my Nook. I can't wait! I think you are SO right about all of this!

  • Dr. William Davis

    10/23/2011 11:46:11 PM |

    Wow, Suze!

    Stupendous progress! Keep going.

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