Dr. Dwight Lundell on omega-3s and CLA



An interview with Dr. Dwight Lundell, cardiac surgeon and author of the new book, "The Cure for Heart Disease."


Dr. Lundell comes to us with a unique pedigree. He is a cardiothoracic surgeon practicing in the Phoenix, Arizona, area. Despite having performed thousands of coronary bypass operations, including numerous "off-pump" procedures earning him a place in the Beating Heart Hall of Fame and a listing in Phoenix Magazine’s Top Doctors for 10 years, more recently Dr. Lundell has turned his attentions away from traditional surgical treatment and towards prevention of heart disease and.

In particular, Dr. Lundell is a vocal advocate for omega-3 fatty acids from fish oil and conjugated linoleic acid, or CLA.

When I heard about Dr. Lundell’s unique perspectives, I asked him if he’d like to tell us a little more about his ideas. Here follows a brief interview with Dr. Lundell.



You’re a vocal advocate of the role of omega-3 fatty acids from fish oil in heart disease prevention. Can you tell us how you use it?

In my book, I recommend 3 g of fish oil daily. This would normally yield about 1000 mg of EPA and DHA depending on the concentration of the supplement. This is approximately the dose that reduced sudden cardiac death by 50%, and all cause death, by 25% in patients with previous heart attack.

In patients with signs of chronic inflammation such as heart disease, obesity, arthritis, metabolic syndrome or depression or in those patients with elevation of CRP, I would recommend higher doses, 2000 to 3000 mg per day of EPA and DHA. The FDA has approved up to 3400 mg for treating patients with severely elevated triglycerides.

I personally take a 2000 mg EPA and DHA per day because I have calcium in my coronary arteries.




Of course, in the Track Your Plaque program we track coronary calcium scores. Do you track any measures of atherosclerosis in your patients to chart progression or regression?

Carotid ultrasound with measurement of IMT [intimal-medial thickness] has been shown to be a good surrogate marker for coronary disease, as has vascular reactivity in the arm. CT scanning with calcium scoring is a direct marker of coronary disease. CT does not differentiate between stable or unstable plaque but there is no good noninvasive way of doing this.

The dramatic value of CT scan calcium scoring is to demonstrate to people that they actually do have coronary disease and to motivate them to make the necessary lifestyle and nutritional changes to reduce it. CT scan with calcium scoring is a direct way to measure the progression or regression of coronary artery disease. If there is a choice between a direct measurement and indirect measurement, always choose the direct method.

Every patient treated with CLA in my clinic, experienced significant reductions in C-reactive protein. These patients were also on a weight-loss program, so I can't prove whether it was the CLA or the weight-loss that improved their inflammatory markers. In the animal model for arteriosclerosis, CLA has a dramatic effect of reducing and preventing plaque. This has not yet been proven in humans.

Normally, when people lose weight 20% or more of the loss is lean body mass (muscle) this lowers the metabolic rate and frustrates further weight-loss. My patient, from teenagers to retirees, lost no lean body mass and continued to have satisfactory weight-loss when CLA was used as part of the plan.



In reading your book, your use of conjugated linoleic acid (CLA) as a principal ingredient struck me. Can you elaborate on why you choose to have your patients take CLA?

My enthusiasm for CLA is based on:

1) Safety?this is of paramount importance. Animal toxicity studies have been done, as well as multiple parameters measured in human studies, both of these are well reviewed recently in the American Journal of Clinical Nutrition (2004:79(suppl)1132s). CLA, a naturally-occurring substance, is not toxic or harmful to animals or humans. The only negative report is by Riserus in Circulation (2002), where he found an elevated c- reactive protein; however, he used a preparation that is not commercially available and not found in nature as a single isomer.

2) Effectiveness?also critically important. A recent meta-analysis [a reanalysis of compiled data] in the American Journal of Clinical Nutrition (2007; 85:1203-1211) demonstrated the effectiveness of CLA in causing loss of body fat in humans. The study also reconfirmed the safety of CLA.

Since we now know that atherosclerosis is an inflammatory disorder, any strategy that reduces low-grade inflammation without significant side effects would seem to be beneficial in the treatment and prevention of atherosclerosis. CLA not only has antioxidant properties, but it modulates inflammatory cascade at multiple points. CLA reduces PGE2 (in much the same way as omega-3) CLA also has been shown to reduce IL-2, tumor necrosis factor-alpha and Cox–2. It reduces platelet deposition and macrophage accumulation in plaques. It also has some beneficial effect in the PPAR [peroxisome proliferator-activated receptors, important for lipid and inflammatory-mediator metabolism] area.

Part of the effect of CLA may be because it reduces fat mass and thus the amount of pro-inflammatory cytokines produced by fat cells.

I reiterate and fully admit that CLA has not been shown to have any effect on atherosclerosis in human beings. However, the results in the standard animal models for atherosclerosis (rabbits, hamsters,APO-E knockout mice) are very dramatic.

From all I know, it appears that the effective dose for weight loss and the animal studies in atherosclerosis would be equal to about 3 g of CLA per day. The anti-inflammatory properties of CLA seem to work better in the presence of adequate blood levels of omega-3.



I’m curious how and why a busy cardiothoracic surgeon would transform his practice so dramatically. Was there a specific event that triggered your change?

The transition from a very busy surgical practice to writing and speaking about the prevention of coronary disease has not been particularly easy, but it has been very interesting. I can't really point to any specific epiphany, it was a general feeling of frustration that we were not making any progress in curing heart disease, which is what I thought I was doing when I began my medical career.

Of course, I enjoyed the technical advances, the dramatic life-saving things that you do and I did on a daily basis. American medicine is spectacularly good at managing crises and spectacularly horrible at preventing those crises.

The lipid hypothesis is old and tired, even the most aggressive statin therapy reduces risk of heart attack by about 30% in a relatively small subset of people. It's interesting that we're now looking at statins as an anti-inflammatory agent.


Thanks, Dr. Lundell. We look forward to future conversations as your experience with CLA and heart disease prevention and reversal develops!


More about Dr. Lundell's book, The Cure for Heart Disease can be found at http://www.thecureforheartdisease.net.


Note: We are planning a full Special Report on CLA for the Track Your Plaque website in future.

Comments (15) -

  • Anonymous

    9/6/2007 8:46:00 PM |

    Do you know much about the diet he recommends to decrease inflammation and heart disease?
    Thanks!

  • Dr. Davis

    9/6/2007 9:56:00 PM |

    He uses a low processed carbohydrate diet. I'm afraid I did not get too far into that aspect of things with him.

  • Anonymous

    9/6/2007 11:22:00 PM |

    Thanks for the reply. I assume by "low-processed" you mean whole grains?
    Greg

  • Dr. Davis

    9/7/2007 1:45:00 AM |

    Although I read Dr. lundell's book, I remain unsure about how tightly he advises processed carbohydrate control. He is clear on minimizing sugars and sugar-equivalents like sodas and fruit drinks. However, on questions like some grains, I remain unclear.

  • Anonymous

    9/7/2007 10:20:00 PM |

    I was under the impression that CLAs only exist in animal products and that beef is particularly rich in CLAs.  I also understood that CLAs are a form of transfat, although perhaps a beneficial form, if there is such a thing.  Do you think that adding CLA is helpful for regression of plaque?  Does TYP recommend doing so?  If so, should the CLA be via a supplement and what dosage is typical?

  • Dr. Davis

    9/8/2007 1:07:00 AM |

    We are putting together a clinical trial to examine this issue. I don't have any preconceived notions over whether CLA will work or not. The animal data for reversal of atherosclerosis is fabulous, almost too good to believe.

    The human data on weight loss is, in aggregate, modestly promising. But will it reverse atherosclerosis in humans? We're going to try and find out.

  • Jill Doss

    6/5/2008 12:40:00 AM |

    It is my understanding that CLAs are a derivative of Parent Omega 6. I have read that the correct proportions are two parts omega 6 to one part omega 3.  This is referred to as Essential Fatty Acids (EFAs).  Lack of EFAs impede the use of oxygen and oxygenation is crucial to the miochondria of a cell.  I'm interested to see what your comments are on EFAs.

  • Anonymous

    1/8/2009 12:56:00 AM |

    Are you aware Dr. Lundell's medical license was revoked in 2008 by the Arizona Medical Board?  Go here to read about him: www.azmd.gov

  • David

    4/20/2009 1:08:00 PM |

    It's true.
    http://azmd.gov/GLSuiteWeb/Repository/0/0/1/4/97d47a09-71b9-4f30-8bfe-78428be876c4.pdf

  • Jim

    8/18/2009 4:38:47 PM |

    @anon & David,

    I didn't read the whole report of the deliberations, but from reading the first one, several observations can be made:
    -Dr Lundell had retired from thoracic surgery at the time of the hearings.
    -The hearings concerned complaints about certain high risk surgeries done by Dr Lundell, as they are done by all thoracic surgeons.
    -None of this has anything to do with a nutritional approach to halting and reducing CVD.

  • Anonymous

    1/9/2010 8:48:17 PM |

    Hi! How about fresh juiced carrots? It's hec of carbo thing but is it slow, fast, should I just eat vegetables and fruits and not juice them?

  • buy jeans

    11/4/2010 5:14:15 PM |

    In my book, I recommend 3 g of fish oil daily. This would normally yield about 1000 mg of EPA and DHA depending on the concentration of the supplement. This is approximately the dose that reduced sudden cardiac death by 50%, and all cause death, by 25% in patients with previous heart attack.

  • pammi

    11/9/2010 9:50:34 AM |

    Heart  disease is one of the most  dangerous disease which takes thousands of life every years all over the world. If we know its symptoms and Treatment for heart disease. We can prevent is to large extent.

  • MIKE

    8/11/2011 6:39:19 AM |

    I've been taking fish oil since 2005.Went to a cardioligist who wrote me out a script for lipitor after my cholesterol test was a little high.Being skeptical i then went hom and researched this horrible medication and realized i could take a much healthier,cheaper and much better alternative.Well that alternative was fish oil and i'm so glad i did my research first before blindly accepting my fate.

  • Brian

    11/24/2011 11:59:44 PM |

    Given the blood-thinning properties of fish oil, is it advisable to take it along with blood thinners such as Plavix or Coumadin?

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Carrot Cake

Carrot Cake

This is among my favorite recipes from the Wheat Belly book. I reproduce it here for those of you who read the Kindle or audio version and therefore didn't get the recipes.

I made this most recently this past weekend. It was gone very quickly, as even the 13-year old gobbled it up.

(I reduced the sour cream in this version from 8 to 6 oz to reduce cooking time. Also, note that anyone trying to avoid dairy can substitute more coconut milk, i.e., the thicker variety, in equivalent quantities.)

Makes 8-10 servings



 

 

 

 

 

 

Ingredients:
Cake:
2 cups carrots, finely grated
1 cup chopped pecans
1 cup coconut flour
1 tablespoon ground flaxseed
2 teaspoons ground cinnamon
1 teaspoon allspice
1 teaspoon nutmeg
1 teaspoon baking powder
2 tablespoons freshly grated orange peel
Sweetener equivalent to ½ cup sugar (e.g., 4 tablespoons Truvia)
½ teaspoon sea salt
4 eggs
1/2 cup butter or coconut oil, melted
2 teaspoons vanilla extract
½ cup coconut milk
6 ounces sour cream

Icing:
8 ounces cream cheese or Neufchâtel cheese, softened
1 teaspoon lemon juice
1 tablespoon Truvía or 1/8 teaspoon stevia extract powder or ¼ cup Splenda

Preheat oven to 325° degrees F. Grate carrots and set aside.

Combine coconut flour, flaxseed, cinnamon, nutmeg, baking powder, orange peel, sweetener, and salt in large bowl and mix by hand.

Put eggs, butter or coconut oil, vanilla coconut milk, and sour cream in mixing bowl; mix by hand. Pour liquid mixture into dry pecan/coconut flour mixture and blend with power mixer until thoroughly mixed. Stir carrots and pecans in by hand with spoon. Pour mixture into greased 9- or 10-inch square cake pan.

Bake for 60 minutes or until toothpick withdraws dry. Allow to cool 30 minutes.

Place Neufchâtel cheese in bowl. Add lemon juice and sweetener and mix thoroughly. Spread on cake.

Comments (14) -

  • Sue

    10/5/2011 1:03:36 PM |

    Thanks for posting this.  My Kindle edition did include recipes, carrot cake included.

  • Pater Fortunatos

    10/5/2011 4:18:02 PM |

    Hi !
    Great recipe, thank you ! But where could we find "clean" orange peel these days ? Only if you have acces to an organic orchard.
    Offtopic> You have an outdated link  - Dr.Davis' Blog

  • Heidi

    10/5/2011 10:45:51 PM |

    I made this cake earlier today (it became my dinner, lol) and it was heavenly. I didn't have any nutmeg, allspice, or orange peel on hand, so I omitted them and I also had to omit the icing. Still a delicious cake! I can't wait to try out the icing next time. Thanks for mentioning this recipe; I've got lots more to try out from your book.

  • Dr. William Davis

    10/6/2011 12:20:10 PM |

    Carrot cake for dinner--can't beat that!

    The spices can really add pizzazz, as does the orange peel. You'll like it even better when you add these components.

  • MARY PAT GALLIVAN

    10/7/2011 3:45:33 AM |

    Wonderful recipe but Doc - PLEASE - no never no splenda!!!!!!  We all know why!

  • Teresa

    10/7/2011 3:19:25 PM |

    While on the subject of recipes, my mom used to make these sesame crackers for my dad.  It is from the cookbook 'Very Basically Yours', by the Human Ecology Study Group of Chicago, circa 1980.  

    Sesame crackers

    Grind toasted or raw sesame seeds (1lb.), about a cup at a time in a blender.  Add 2 oz. sunflower or sesame oil and 2 oz. water, and blend with a fork.  Add 1T. oregano and scant T. salt.  Mix well, pat into a shallow baking dish, cutting into squares and pricking squares with a fork.  Bake at 375 degrees, (10-15 min.).

    Please don't fuss about the sunflower oil - don't use it if you don't want to.  I'm not sure what size pan to use, but the dough should be about 1/4" thick or less.  Use a non-stick pan or parchment paper.  These don't cut well after baking.  If you forget, just break apart.  Pricking with a fork keeps them from bubbling up.  Keep an eye on them for the last few minutes.  They can go from done to burned quickly.  I haven't made these myself, but I can remember after 30 years how good they were!

  • Dr. William Davis

    10/7/2011 11:01:57 PM |

    Sounds delicious, Teresa!

    I'm going to try with a little tweaking. Thanks for posting.

  • Dr. William Davis

    10/8/2011 2:21:31 AM |

    Hi, Mary Pat--

    Because individual experiences with sweeteners vary, I try to specify something like "sweetener equivalent to 1/2 cup sugar." You might choose stevia, you might choose erythritol, some might choose sucralose. So I'm not telling anybody to choose just one, but suggesting a choice among several.

    By the way, if you are referring to the rat study in which bowel microorganisms were reduced by sucralose, if true it means to me that perhaps we should not consume this sweetener habitually but only occasionally. Avoiding wheat is, I believe, a much more potent way to maintain normal bowel bacteria.

  • Babs

    10/28/2011 3:39:51 AM |

    I would really love to try the carrot cake. Can you tell  me what the stats/caloric/nutrient content is?

  • Louise

    10/28/2011 9:41:07 PM |

    Thanksgiving is approaching!  I am thinking of roasted turkey, pureed cauliflower, salad, green beans..Now what about stuffing?  Can you come up with a nongrain stuffing  type of thing for us to make?  And oh, what about a cranberry dish?

  • Dr. William Davis

    10/29/2011 10:47:27 PM |

    Will do, Louise! You are thinking along the same lines as I am.

  • Dr. William Davis

    10/29/2011 10:52:43 PM |

    No, sorry, Babs, I intentionally left it out to convey the notion that calories and fat content are NOT important.

  • Susan

    12/18/2011 4:56:27 AM |

    Hello, I've just finished reading Wheat Belly and want to try some of the delicious sounding recipes.  I'm a cook and baker, and as such have several ideas of my own, but first a question about the flaxseed contained in many of the recipes.  Does ground flaxseed = flaxseed meal?  I've been eating and using flaxseed meal in dishes for years, so I really hope they are one and the same.  Smile

    Thanks, Dr. Davis, for producing such wonderful sounding recipes along with the eye-opening book.  Have you considered writing a recipe book?  I imagine it would be well received.

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