The five most powerful heart disease prevention strategies

You've seen such lists before: 5 steps to prevent heart disease or some such thing. These lists usually say things like "cut your saturated fat," eat a "balanced diet" (whatever the heck that means), exercise, and don't smoke.

I would offer a different list. You already know that smoking is a supremely idiotic habit, so I won't repeat that. Here are the 5 most important strategies I know of that help you prevent heart disease and heart attack:

1) Eliminate wheat from the diet--Provided you don't do something stupid, like allow M&M's, Coca Cola, and corn chips to dominate your diet, elimination of wheat is an enormously effective means to reduce small LDL particles, reduce triglycerides, increase HDL, reduce inflammatory measures like c-reactive protein, lose weight (inflammation-driving visceral fat), reduce blood sugar, and reduce blood pressure. I know of no other single dietary strategy that packs as much punch. This has become even more true over the past 20 years, ever since the dwarf variant of modern wheat has come to dominate.

2) Achieve a desirable 25-hydroxy vitamin D level--Contrary to the inane comments of the Institute of Medicine, vitamin D supplementation increases HDL, reduces small LDL, normalizes insulin and reduces blood sugar, reduces blood pressure, and exerts potent anti-inflammatory effects on c-reactive protein, matrix metalloproteinase, and other inflammmatory mediators. While we also have drugs that mimic some of these effects, vitamin D does so without side-effects.

3) Supplement omega-3 fatty acids from fish oil--Omega-3 fatty acids reduce triglycerides, accelerate postprandial (after-meal) clearance of lipoprotein byproducts like chylomicron remnants, and have a physical stabilizing effect on atherosclerotic plaque.

4) Normalize thyroid function--Start with obtaining sufficient iodine. Iodine is not optional; it is an essential trace mineral to maintain normal thyroid function, protect the thyroid from the hundreds of thyroid disrupters in our environment (e.g., perchlorates from fertilizer residues in produce), as well as other functions such as anti-bacterial effects. Thyroid dysfunction is epidemic; correction of subtle degrees of hypothyroidism reduces LDL, reduces triglycerides, reduces small LDL, facilitates weight loss, reduces blood pressure, normalizes endothelial responses, and reduces oxidized LDL particles.

5) Make exercise fun--Not just exercise for the sake of exercise, but physical activity or exercise for the sake of having a good time. It's the difference between resigning yourself to 30 minutes of torture and boredom on the treadmill versus engaging in an activity you enjoy and look forward to: go dancing, walk with a friend, organize a paintball tournament outdoors, Zumba class, plant a new garden, etc. It's a distinction that spells the difference between finding every excuse not to do it, compared to making time for it because you enjoy it.

Note what is not on the list: cut your fat, eat more "healthy whole grains," take a cholesterol drug, take aspirin. That's the list you'd follow if you feel your hospital needs your $100,000 contribution, otherwise known as coronary bypass surgery.

Comments (39) -

  • Ty

    1/23/2011 10:27:46 PM |

    It's too bad that there is not a randomized, controlled trial to show the superiority of this strategy.  

    Aside from assimilating scattered studies with surrogate endpoints, what would it take to definitively show that this strategy actually does improve cardiovascular morbidity and mortality?  

    If Dr. Davis can convince many in the "thinking" public, surely someone in the health care industry or NIH would be interested in pursuing this.

  • Andrew

    1/24/2011 2:13:50 AM |

    Magnesium and Chromium are also important minerals.  Neither are particular common in most diets.  Perhaps, they would fit into a top 10 list.

  • revelo

    1/24/2011 2:25:11 AM |

    I think regular testing is the most important strategy. If your tests come out okay, then there is no reason for anything else. If the test show problems, then address the problems in a methodical.

    Many people don't appear to have any problems with wheat. I'm 50 and spent perhaps 10 years in my 30's getting most of my calories from pasta, and another ten years in my 40's getting most of my calories from oats. I was never more than 10 lbs overweight and I haven't visited a doctor in 30 years, other than for an ear wax buildup about 20 years ago. My test scores recently were good and I have good glucose tolerance according to the glucose monitor I recently bought (reli-on from walmart).

    The reason I started investigating diet issues is that I felt lousy during two months on the Appalachian Trail this past fall. My diet on the trail consisted of nothing but a pound per day of instant rice and another pound of dry-roasted peanuts plus a multivitamin, and then a gallon of ice cream and a package or two of cookies and maybe some candy bars and cheese whenever I stopped off at town. Like most of the other hikers, my problem was not gaining weight but rather losing too much. Those binges on ice cream made me feel very sick afterwards. I began to have cravings for oats, which I think helps to keep the blood vessels clear. Now that I've gotten back to civilization, I've been eating lots of vegetables and oats and my blood pressure is typically under 100/70 (I bought a sphygomanometer as soon as I got home from the trail and my initial BP was 120/70). I think people who exercise as much as a typical backpacker have no problems with complex carbs. A gallon of ice cream and a full package of iced oatmeal cookies at one sitting is another story.

  • Anonymous

    1/24/2011 5:31:31 AM |

    I found this blog after a search in April 2008 because my Fasting glucose had broken 100 (105) and I was worried I would end up a type 2 diabetic like my 90 year old dad. I began following the advice here: almost no wheat or grains, little sugar/fructose, added 8000 Vit D3, 12.5mg Iodoral, 2800mg omega-3 fish oil.  Now, my fasting glucose is 97, my Vit D went from 13(!) to 75.  I quit my statin and although my LDL went from 111 to 135, my HDL went from 60 to 74 and Trig from 108 to 62.  Lost 10 lbs without trying and now need to wear a beltSmile.  The only thing I can complain about is my BP seems to stay around 130/74. Otherwise I'm convinced. Thank you, Dr. Davis.
    Jay in CA.

  • Anonymous

    1/24/2011 6:23:10 AM |

    Hi Dr. Davis

    i've looked around your blog but did not find information on buckwheat flour, chickpeas flour and water chestnut flour.

    i understand they are safe for celiacs to consume but how far are they consistent with the heart-good diet i've picked up from your blog so far? e.g. consumption amount per day if they are fine? things to watch out.

    Thanks

  • Paul

    1/24/2011 6:26:47 AM |

    revelo,

    Have you had an NMR lipo test done? By your own description, being on such a high carb diet, your LDL particle numbers might shock you.

    And don't fall into the same trap that most prototypical thin men fall into.  Just because you are thin and active does not give you a pass on following these strategies.  Look at this blog post by Dr. Davis:

    Here's the prototypical male with lipoprotein(a)

    "Several features stand out in the majority of men with lipoprotein(a), Lp(a):

    Slender--Sometimes absurdly so: BMIs of 21-23 are not uncommon. These are the people who claim they can't gain weight.

    Intelligent--Above average to way above average intelligence is the rule.

    Gravitate to technical work--Plenty of engineers, scientists, accountants, and other people who work with numbers and/or technical details are more likely to have Lp(a).

    Enjoy high levels of aerobic performance--I tell my Lp(a) patients that, if they want to see a bunch of other people with Lp(a), go to a marathon or triathlon. They'll see plenty of people with the pattern among the aerobically-elite.

  • Anonymous

    1/24/2011 9:26:11 AM |

    I would recommend Nordic walking as an exercise.

  • Tony

    1/24/2011 11:33:05 AM |

    Do you have information about the interference of wheat (or other neolithic pathogens) on thyroid-function? I would guess that either phytates hinder the absorbtion of iodine (both in humans as well as in animals we eat), or that gluten/gliadins/etc directly interfere with thyroid function, or trigger an autoimmune reaction (or all of the above...).

    And from an similar area: You don't know by chance of any papers linking wheat with adrenal-gland problems?

  • Dr. William Davis

    1/24/2011 3:00:19 PM |

    Hi, Andrew--

    In fact, I contemplated a "six strategies" that included magnesium.

    I agree: magnesium is indeed near the top of the list for heart health.

  • Dr. William Davis

    1/24/2011 3:04:33 PM |

    Hi, Jay--

    Good news: With the favorable changes you've witnessed, the calculated (or what I call "fictional") LDL cholesterol increases, while the genuine measurement (e.g., NMR LDL particle number or apo B) drops.

    Of course, don't count on your friendly drug company to tell you this.


    Hi, Tony--

    The only connection I know of between wheat (gluten, in this case) and thyroid disease is that wheat exposure can activate (or at least be associated with) Hashimoto's thyroiditis, i.e., thyroid gland inflammation.

  • Anonymous

    1/24/2011 3:14:03 PM |

    dr davis,

    are you saying wheat mainly, that other carbs could be eaten and still some benefit could be had from just omitting wheat from diet?

  • Eric

    1/24/2011 5:16:37 PM |

    What kind of magnesium is best for those who have the old "Phillips Milk of Magnesia" effect with normal magnesium supplements?

  • Flavia

    1/24/2011 6:26:14 PM |

    This is craaaaazy!!! Four days ago my BP was 150/100- I took your recommendations to hear, along with other supplements (whey, blueberries, coQ10, magnesium, olive leaf) + low carb + exercise and my blood pressure has dropped to 129/90. I cannot believe this.

    What is most incredible is that all docs said my BP was 100% genetic and there was nothing I could do (probably b/c i'm thin and young).

    I am blogging my progress. The goal is to get off that goddamn atenolol once and for all.

    Here's a rundown of what I am doing. Any advice from anyone would be super welcome.

    http://superhighbloodpressure.blogspot.com/p/details-of-experiment.html

  • Flavia

    1/24/2011 6:28:45 PM |

    BTW the one thing I am NOT doing is supplementing with iodine. Is this necessary? How does one know if thyroid function is wack? Any recommendations on what type of iodine to take?

  • David M Gordon

    1/24/2011 8:21:32 PM |

    You ever tire of your Sisyphean struggles, Dr D? Many people in the medical industrial complex simply do not give credence to your findings.

    For example, I shared your point #1 (re wheat) with a research pathologist friend -- yes, the same fellow whose knowledge you believe might be circa 1985 Smile -- and he said...
    "The statements that you list are at best applicable under select circumstances.  I doubt there is any scientific evidence (study in a peer reviewed journal) to support your claims. If you stop eating, your triglycerides, weight, and  LDL will go down, nothing to do with stopping wheat. Similarly, in >99% of individuals, CRP levels are not related to diet, especially wheat eating. The only time eating wheat would make a difference is if you cannot tolerate wheat for any reason."

    Which brings me back to my opening question. "Peer reviewed journal"...? I mean, c'mon, that is akin to waiting until everyone is bullish and owns a stock before you finally buy.

  • Tony

    1/24/2011 9:44:40 PM |

    I found this abstract (with relation to celiac disease patients - poor bastards):

    The American Journal of Gastroenterology (2001) 96, 751–757; doi:10.1111/j.1572-0241.2001.03617.x
    Prevalence of thyroid disorders in untreated adult celiac disease patients and effect of gluten withdrawal: an Italian multicenter study
    http://www.nature.com/ajg/journal/v96/n3/abs/ajg2001173a.html


    OBJECTIVES:
    Many afflictions have been associated with celiac disease, but chance associations may exists. The aim of this study was to establish, by means of a multicenter prospective study, the prevalence of thyroid impairment among adult patients with newly diagnosed celiac disease and to evaluate the effect of a 1-yr gluten withdrawal on thyroid function.

    METHODS:
    A total of 241 consecutive untreated patients and 212 controls were enrolled. In 128 subjects a thorough assessment, including intestinal biopsy, was repeated within 1 yr of dietary treatment. Thyroid function was assayed by measuring the levels of TSH, free T3, free T4, thyroperoxidase, and thyroid microsome antibodies.

    RESULTS:
    Thyroid disease was 3-fold higher in patients than in controls (p < 0.0005). Hypothyroidism, diagnosed in 31 patients (12.9%) and nine controls (4.2%), was subclinical in 29 patients and of nonautoimmune origin in 21. There was no difference regarding hyperthyroidism, whereas autoimmune thyroid disease with euthyroidism was present in 39 patients (16.2%) and eight controls (3.8%). In most patients who strictly followed a 1-yr gluten withdrawal (as confirmed by intestinal mucosa recovery), there was a normalization of subclinical hypothyroidism. Twenty-five percent of patients with euthyroid autoimmune disease shifted toward either a subclinical hyperthyroidism or subclinical hypothyroidism; in these subjects, dietary compliance was poor. In addition, 5.5% of patients whose thyroid function was normal while untreated developed some degree of thyroid dysfunction 1 yr later.

    CONCLUSIONS:
    The greater frequency of thyroid disease among celiac disease patients justifies a thyroid functional assessment. In distinct cases, gluten withdrawal may single-handedly reverse the abnormality.

  • Anonymous

    1/25/2011 8:14:25 AM |

    You want to know, how to make exercise fun: check this one out: http://www.youtube.com/watch?v=2lXh2n0aPyw

  • Gillian

    1/25/2011 10:36:27 AM |

    Dr Davies

    What do you think about consuming the Swedish innovation Oatly (trademark) that is a special  oatmilk with an elevated amount of betaglucans?
    Professor Rickard Öste has developed this type of oatmilk.

  • Tom T

    1/25/2011 11:08:00 AM |

    Thank you for your efforts and blog.

    RE Omega 3s, you recommend fish oil.  Is that preferable to getting Omega 3s from walnuts and ground flaxseed, both of which I understand to also provide Omega 3s?  Is there a benefit to fish oil vs. these other options?

    Thank you.

    Tom

  • Dr. William Davis

    1/25/2011 12:50:15 PM |

    Hi, David--

    Great points.

    Perhaps your pathologist friend should consider spending some time with the living.


    Tom--

    Those are two different things. Walnuts and flax do NOT provide the same effects as the omega-3s from fish, just as the oil in your car's engine cannot be used to be put in the gas tank. Two different, though related, things.

  • Oatlover

    1/25/2011 1:07:50 PM |

    Ok, got'ca on the wheat, but what about oats? Same deal, or are they OK? I can cut out wheat without any problems, but I do like my oat porridge... ;)

  • Steve

    1/25/2011 2:08:24 PM |

    Niacin was near the top  of your protocol list earlier.  Has this fallen out of favour?  Or is it just the insurance abuse which keeps it off the list?

    I have recently been diagnosed with wheat & gluten IgE sensitivity.  So I will finally stop resisting the #1 rec.  After 4 days I am seeing some changes in eosinophilic esophaghitis, gingivitis, and rhinitis.

  • Dr. William Davis

    1/25/2011 10:49:43 PM |

    Oatlover?

    Oats are an entirely different issue. They cause blood sugar to skyrocket.


    Steve--

    The newer focus on strict elimination of wheat, cornstarch, and sugars has reduced reliance on niacin considerably.

  • Anonymous

    1/26/2011 5:59:41 AM |

    I'd put a caution note for the fish oil, we now know some of us get very bad opposite effect.

  • Oatlover

    1/26/2011 8:41:08 AM |

    Okay, I'm not really that hung up on oats. Smile But oat porridge is a main staple of mine. I'll take your advise and cut out wheat and oat for at least a few weeks and see what it's like.
    I'm healthy and have no heart problems or blood sugar issues of any kind, but as I'm not getting any younger (about to turn 40), I'm hoping to prevent any future problems by finetuning my diet.

  • Onschedule

    1/26/2011 11:33:01 PM |

    @Oatlover,

    I had been eating oats as part of what I thought was a "healthy diet," but stopped when I started tracking my blood glucose and watched it consistently soar afterwards. I found oat bran had the same effect on my blood glucose. Since giving them up, I no longer get the light-headed tired hunger that used to force me to take lunch early. Since giving up wheat as well, I've never felt better.

    Well wishes for your trial!

  • Anonymous

    1/27/2011 1:36:26 PM |

    Dr Davis,

    What you mean by: The newer focus on strict elimination of wheat, cornstarch, and sugars has reduced reliance on niacin considerably?
    What is the relationship between wheat/corn starch and sugar and niacin dosage?
    Is a lower dose of niacin efficient when wheat/corn and sugar are eliminated?

    Stelucia

  • Steve

    1/27/2011 7:13:16 PM |

    Here is the conventional wisdom of max 1,000 IU Vitamin D via the NYT: LINK

  • Anonymous

    1/29/2011 2:23:44 PM |

    BALANCED DIET

    Some time ago, I decided to try to understand the origin of the phrase "Balanced Diet". After a lot of Google searching, I landed on a page that sketched out the use of the term, and have since lost the link.

    The term became popular, evidently, in about the 1920's and it was associated with the rapid discovery of many vitamins in foods. At that time, vitamin discoveries would seemingly pop up out of the blue.

    One writer, the first in a chain, remerked that "under the circumstances (unknown vitamins lurking in the food supply), we should therefore eat as broadly as possible so as to take in as many potential vitamins as possible."

    "Balanced Diet", under this interpretation, arose out of dietary ignorance, not dietary fact.

  • Kevin Kleinfelter

    2/2/2011 8:01:31 PM |

    I understand that you don't like wheat and other grains.  Are beans good or bad?  

    Yes, they are carbohydrate, but they're low glycemic index.  Are they a food which both anti-grain and USDA pyramid can agree are good, or do they have a down-side (other than gas)?

  • Ari

    2/2/2011 9:49:57 PM |

    Could you replace wheat with oats or other grains?

  • Ari

    2/2/2011 11:49:35 PM |

    For that matter, how about quinoa or polenta?

    Thanks.

  • Dr. William Davis

    2/3/2011 3:06:30 PM |

    Hi, Ari--

    No, no, no, and no.

    These grains increase blood sugar to high levels in the majority of adults.

    I will be discussing such grains in an upcoming post.

  • Rob

    4/30/2011 8:29:37 PM |

    Hello DR WD.

    Today I have for the first time read  "The Heart-Scan Blog" and was interested to read of your recommendations as to the five most powerful heart disease prevention strategies.  In my case "prevention" is a little late in the day since I was diagnosed with severe Congestive Heart Failure  in the autumn of 2008. My EF at that time was just 15% to 20% and a considerable area of the heart muscle was  a-kinetic.   Although the usual heart drugs were prescribed,   after a few months of feeling lack-lustre and devoid of energy, I decided to stop taking them and instead changed my diet and supplemented,  primarily with Ubiquinol. From barely being able to shuffle 20 metres or so I now readily walk about 4 miles a day. The diet  has seen one or two changes along the way but has  for the best part of the last two years been grain free. Lean and fatty meats and eggs by the dozen  are consumed  each and every week  as are lots of vegetables  and  oily fish.  Coconut oil, natural sea salt,  apple cider vinegar,  turmeric, cayenne pepper and Italian tinned tomatoes  all go into delicious home-made salsas that spice up the blandest of vegetables.   Processed oils are avoided but raw butter enjoyed without any restriction whilst  British, French and Swiss unpasteurised cheeses   figure strongly on my menu. All I can add is that on that diet I feel wonderfully reinvigorated.

  • Zeal

    7/10/2011 9:08:00 AM |

    Now we know who the sesinlbe one is here. Great post!

  • Fleta

    7/10/2011 9:11:03 AM |

    I had no idea how to approach this before—now I’m locked and leoadd.

  • Darrance

    7/11/2011 5:21:05 PM |

    I found just what I was needed, and it was entertianing!

  • Margaretta

    7/11/2011 9:12:42 PM |

    Alaakzaam—information found, problem solved, thanks!

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Fat Head: Tom Naughton's manifesto for low-carb eating

Fat Head: Tom Naughton's manifesto for low-carb eating

I just got back from Jimmy Moore's low-carb cruise to the Bahamas.

Among the many interesting people I met on the cruise was the creator of the documentary film, Fat Head, Tom Naughton.

Tom brings both creative insights into low-carbohydrate eating as well as humor. Low-carb eating can be a pretty contentious issue, but Tom made it fun. He will make you laugh about many of the odd notions we have about diet.

Among the best parts of Fat Head is Tom's portrayal of the effects of carbohydrates on insulin and fat metabolism:






Fat Head joins the ranks of films like Food, Inc, that make nutrition information entertaining. For anyone interested in a unvarnished look at diet, weight loss, along with a few laughs along the way, Tom Naughton's Fat Head is worth viewing.

Comments (16) -

  • Jimmy

    3/12/2010 6:28:59 PM |

    Dr. Davis, I agree Tom has hit on something HUGE with his film FAT HEAD which is why I asked him to join us on the cruise to show his film.  THANK YOU for your incredible contributions during the conference and I am grateful to you for your generous donation of time to join us. Smile

  • Kevin

    3/12/2010 6:39:52 PM |

    The low-carb manifesto tries to convince you that fat doesn't matter and therefore calories don't matter.  LC books pander to the people who can't or won't control their appetites, telling them, 'It's not your fault, have some brie instead of a cookie'.

    But ingested fat being twice the calorie density of carb or protein does eventually add to the fat stores.  Those LC dieters who lose weight and maintain have CCK's effect on satiety to thank.  

    kevin

  • Dr. Isaac Eliaz

    3/12/2010 9:03:23 PM |

    This is great! Check out my blog post on blood sugar and metabolic syndrome...http://tinyurl.com/y9tr8va

  • Anne

    3/13/2010 1:53:51 AM |

    It is a good film and the animation of how fats get into cells made it easier to understand. Tom's blog is always an entertaining and educational read. http://www.fathead-movie.com/

    I so wish I could have been on the cruise - maybe next time.

  • freyal

    3/13/2010 2:32:02 AM |

    Hi Dr. Davis,
    this is a comment for your fish oil article.  I have a curious case: one has very high triglycerides (above 1000 mg/dL) and recurrent acute pancreatitis since 20s, have been taking 9grams of omega-3 in combination with 145mg tricor, 40mg simvastatin and niacin (1g) per day for 1 year and haven't successfully lowered the triglycerides.  His LDL and cholesterol are both normal with very low HDL (<20). No liver, kidney, pancreas or thyroid disease.  Underweight, not drinking, follow a strict low fat, complex carb, good protein, high veggie diet.  What do you recommend?

  • Anonymous

    3/13/2010 9:14:19 PM |

    freyal, just wondering what your goals are with your patient?  If you are trying to kill him, you are doing a good job.  

    A low-fat, high "complex" carb diet will keep the triglycerides high and the HDL low, as you have proven.  It doesn't matter how much fish oil, statins, or niacin you add, until you re-align your thinking with regard to diet, you are never going to help this guy.

    Have you actually read this blog?  Because your question is ridiculous if you have.

  • freyal

    3/14/2010 2:53:32 AM |

    Thanks for your response!  I actually just started reading this blog more extensively after posting my comment above.  I see Dr. Davis's point on limiting carb.  So do you recommend low-fat low carb diet?  He actually tried low-carb high protein diet sometime ago but without much success.  Because it is hard to just eat protein (will be very high protein here for 2000-cal daily intake) without fat and carbs.  Maybe the failure was because he couldn't limit fat as strictly as in the low-fat, carb+protein diet.  His TG is very sensitive to dietary fat too.  But now we will try low fat, low carb and high protein diet and see if there is a reduction.


    Another problem is, what do you recommend for the "gas" problem associated with high protein diet?  Thanks for your help!!

  • Anna Delin

    3/14/2010 6:07:00 PM |

    Freyal, so you are saying his chylomicrons don't get cleared from the blood within reasonable time?

  • Anonymous

    3/14/2010 8:58:48 PM |

    freyal, no, high-protein/low-fat is not good either (look up "rabbit starvation").  Use a very low-carb/ moderate-protein/high-fat diet.  The best fats to raise HDL and lower triglycerides are saturated fats like butter, tallow and coconut oil.  Stay away from vegetable and most nut oils, especially because they are high in inflammatory omega 6 oils.

    Gas (usually caused by fermentable carbohydrates, including lactose if he is eating dairy) may not be much of a problem when you correct the diet but if it is, try digestive enzymes and betaine HCL.  

    Check out some other blogs on Primal or Paleo diets.  http://www.paleonu.com/ is one of the best, click on "Get Started" to see the diet then check out the rest of the blog!

  • freyal

    3/15/2010 1:06:48 AM |

    Hi Anna,
    yes.  His TG remains above 1000 with healthy diet and TG lowering medications.  His TG would only come down to normal level after several days of fasting during hospitalization due to acute pancreatitis.

  • freyal

    3/15/2010 1:10:15 AM |

    Hi Anonymous,
    thanks for the rabbit starvation info.  I thought high protein-low fat-low carb would be lacking a lot of essential nutrients.  

    But about your point that "The best fats to raise HDL and lower triglycerides are saturated fats like butter, tallow and coconut oil.", I have never heard about this and could not find any source.  Could you please point me to some studies that support this claim?  Thanks!

  • Anonymous

    3/15/2010 2:00:17 AM |

    freyal - is the patient gluten free instead of just wheat free?

  • freyal

    3/15/2010 6:53:27 PM |

    Hi,
    he is not gluten free or wheat free.  He tried moderate-fat, low carb, high protein diet, and also low-fat, moderate complex carb + moderate protein diet.  Both did not work to lower his TG.  He is not allergic to gluten I believe.

    Someone above mentioned high saturated fat (butter palm oil etc) works better to lower TG.  I'm not sure about this approach.  Even if there are studies supporting this (I only found one so far),they were all done with normal people.  He is not normal in terms of TG, he has genetically very high TG and is very sensitive to dietary fat (be it saturated or unsaturated) and would get acute pancreatitis every time following a large heavy greasy meal.  
    I appreciate all your comments, please leave more if you have thoughts about this patient, thank you!

  • Anonymous

    3/15/2010 8:36:03 PM |

    freyal - start with the PaNu blog and then look at the following blogs http://high-fat-nutrition.blogspot.com/, http://drbganimalpharm.blogspot.com/. http://www.nephropal.blogspot.com/ - you will see hundreds of studies analyzed.

  • Anonymous

    3/17/2010 8:25:07 AM |

    the niacin is too low.  it should be 3gms/day.  ensure it is niacinic acid.

    http://www.lipidsonline.org/slides/slide01.cfm?q=niacin

    and

    McKenney JM, McCormick LS, Schaefer EJ, et al. Effects of niacin and atorvastatin on lipoprotein subclasses in patients with atherogenic dyslipidemia. Am J Cardiol 2001;88:270-274.

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Do the math: 41.7 pounds per year

Do the math: 41.7 pounds per year

Consumers of wheat take in, on average, 400 calories more per day. Conversely, people who eliminate wheat consume, on average, 400 calories less per day.

400 calories per day multiplied by 365 days per day equals 146,000 additional calories over the course of one year. 146,000 calories over a year equals 41.7 pounds gained per year. Over a decade, that's 417 pounds. Of course, few people actually gain this much weight over 10 years.

But this is the battle most people who follow conventional advice to "cut your fat and eat more healthy whole grains" are fighting, the constant struggle to subdue the appetite-increasing effects of the gliadin protein of wheat, pushing your appetite buttons to consume more . . . and more, and more, fighting to minimize the impact.

So, if you eat "healthy whole grains" and gain "only" 10 pounds this year, that's an incredible success, since it means that you have avoided gaining the additional 31.7 pounds that could have accumulated. It might mean having to skip meals despite your cravings, or exercising longer and harder, or sticking your finger down your throat.

400 additional calories per day times 365 days per year times 300,000,000 people in the U.S. alone . . . that's a lot of dough. Is this entire scenario an accident?

Or, of course, you could avoid the entire situation and kiss wheat goodbye . . . and lose 20, 30, or 130 pounds this year.

Comments (21) -

  • Keenan

    10/14/2011 3:56:07 AM |

    On Sept. 10 I stopped my consumption of wheat containing foods and multi-grain rice crackers. Two weeks later I began having aching elbows which have not bothered me for years. I'm a 65 yr old male, thin with a bit of a 'wheat belly'  which is shrinking but my muscle mass is also shrinking. Have you heard of anyone experiencing changes in joints after stopping wheat and grains?

  • David Klatte

    10/14/2011 10:58:16 AM |

    That math isn't right and it is pretty misleading because a person who ate 400 more calories per day would gain weight up until they reached an equilibrium. It would be better to use something like the Harris Benedict equation to get a sense of how bad that is.

    I did that for a six foot 180 pound male who is 30 years old who is lightly active. Such an individual would maintain their weight at about 2246 calories per day. If they instead consumed 2646 calories per day, you would expect their weight to top off at about 244.7 pounds after some period of time. About a 65 pound gain, so nothing to sneeze at.

  • Dr. William Davis

    10/14/2011 12:48:30 PM |

    Hi, Keenan--

    I've only seen relief from arthritis, not a triggering of arthritis. That's strange.

    Of course, we are all subject to conditions that fall outside of wheat. It will be interesting to see whether this persists.

  • Dr. William Davis

    10/14/2011 12:49:04 PM |

    Thanks, David.

    Yes, this was hardly a scientific analysis, just an argument to graphically illustrate what we are battling.

  • Philippa

    10/14/2011 12:51:54 PM |

    This would be actionable advice across the Atlantic in the UK, where the Health Minister landed himself in a controversy this week by annoucing the Brits need to cut 5 billion calories off their annual diet.
    http://www.dailymail.co.uk/health/article-2048738/Jamie-Oliver-blasts-Andrew-Lansleys-plan-tackle-obesity.html

  • Teresa

    10/14/2011 8:23:30 PM |

    I couldn't post this below about the drug companies.  

    While I agree that a person should not be made to take medications against their will, what am I to do for a patient with a blood pressure of 220/110, on several occasions?  I have had a few.  They refused meds, and also refused to make any diet or lifestyle changes that may have helped.  While I haven't discharged any patients because of this, I do make sure they know the potential consequences of severe hypertension, including death.  Or worse, complete paralysis on one side, requiring total care.  Sometimes it's a matter of lesser evils.

    More of my patients want the  pills, because they are unwilling to do anything else to help their condition, even though I encourage them, and offer referrals for further education.  I hear it's too complicated, or their insurance won't cover it and it's too expensive.  I doubt I could make a living in my community without a prescription pad.  I wish I could!  I'll keep trying.

  • Princess Dieter

    10/14/2011 9:29:06 PM |

    Just a heads up (although you may have already seen it) is that Gillian Riley, the UK expert on food addiction/breaking out of overeating, recommended WHEAT BELLY in her October newsletter. http://www.eatingless.com/archive-newsletters.html#

    I've often recommended Ms. Riley's books--EATING LESS ; BEATING OVEREATING; and WILLPOWER!--to fellow hyperconditioned overeaters.

    Not eating wheat/sugar  sure helps in the "not overeating" dept. Laughing And Gillian is on board with that.

  • Corey

    10/14/2011 9:42:55 PM |

    Love your site doctor, but this is a terribly naive and simplistic approach. Calorie numbers are irrelevant, it's the kind of calories. Yes, I understand that the 400 you mention would most likely be 400 calories of additional carbs, but calories in/calories out don't determine weight now, do they?

    Really shouldn't post anything reinforcing the outdated but still omnipresent "calorie equilibrium" theory (fairy tale is more like it) of weight gain.

    Otherwise, keep up the good work.

  • Rieland Rigg

    10/15/2011 1:30:51 AM |

    I guess that explains pretty clearly why I've been able to lose about 40 lbs so far in 9 months... Smile

  • Ted Hutchinson

    10/15/2011 9:14:49 AM |

    If you live in the Northerm hemisphere Vitamin D levels drop from September through to March unless effective strength supplementation is implemented.
    Also 65yrs old the natural production of the antinociceptive, anti-inflammatory, antibiotic, antioxidants melatonin and vitamin d will have declined (by age 75 only 25% of vit d capacity is possible if sufficient 7-dehydrocholesterol remains in skin) so everyone becomes far more sensitive to pain/inflammation (and infection).  You can replace the missing Vitamin D3, melatonin with at least 5000iu/D3/oil based gelcap and 3mg Time Release melatonin (Also pay strict attention to improving natural melatonin secretion by using Flux getting outdoors midday and total darkness while asleep. ) Search this site for good Vitamin D3 & Melatonin information.

  • Kris

    10/15/2011 12:11:25 PM |

    A few months ago I did an experiment and cut all wheat and sugar out of my diet.

    That is, if it would contain even a trace amount I would not touch it. I managed to follow this approach for two months, I didn't measure my food intake but my body fat dropped quite a lot and I could see much more muscle definition, especially in my abdominal area.

    Personally I think sugar and wheat are the two main contributors to obesity, and I think the "minimum effective dose" for optimal health would be to remove those two ingredients completely. And of course that doesn't allow any room for "cheat meals" like some people think.

  • Dr. William Davis

    10/15/2011 1:25:26 PM |

    Well said, Chris.

    I agree. In particular, I find that no wheat is far better than less wheat. I believe this is mostly due to the appetite-triggering effect of wheat gliadin.

  • Linda

    10/15/2011 1:27:22 PM |

    @Ted
    I am also living in the Northern Hemisphere [Iowa] and do not get nearly as much sunshine as I should.I tend to be a hermit and spend most of my day inside.  Also over 65. I am taking 5000 IU a day of Vit D, gelcaps.
    Without a lot of testing, is there a way to determine if I should take more and, if so, how much. My biggest concern is tightness in the hip area every morning.

  • Dr. William Davis

    10/15/2011 1:28:17 PM |

    Well, Corey, allow me to elaborate on my "terribly naive and simplistic approach."

    This is clearly not a scientific analysis, but a simple effort to illustrate what happens with simple math what could theoretically happen with an additional 400 calories per day intake but ignoring all other factors, such as proportion fat vs. carbohydrates.

    So of course this is simplistic. It just makes the point that the increased calorie consumption triggered by wheat gliadin has potentially huge effects.

  • Dr. William Davis

    10/15/2011 1:44:40 PM |

    Good to have friends in this battle, Princess!

    We are up against the incredible financial and lobbying might of vertically-integrated Agribusiness and Big Food, who have billions of dollars to allocate on lobbying, marketing, and pushing their agenda. We have social media, the internet, and our wits.

  • Dr. William Davis

    10/15/2011 1:46:00 PM |

    Hi, Dr. Teresa--

    That's all you can do: Keep on trying.

    I'm impressed that you DO try, since most of our colleagues pay no mind whatsoever to even considering genuinely effective dietary changes.

  • Dr. William Davis

    10/15/2011 2:16:54 PM |

    Hi, Philippa--

    Let's see: England, population 51 million times 400 calories per day, times 365 days per day, equals 7.446 x 10,000,000,000,000 calories, or several thousand times more than the Health Minister proposes.

    5 billion calories would be child's play.

  • Ted Hutchinson

    10/16/2011 8:41:41 AM |

    I don't think there is any way anyone can accurately predict their 25(OH)D level either from uvb exposure or daily supplement usage. It depends on individual response. The banner graph at GRASSROOTSHEALTH.ORG shows for any regular daily intake the 25(OH)D achieved varies up to 100ng/ml. Taking 5000iu daily D3 only increases your chances of staying around 50ng/ml  but you could be anywhere between 20ng/ml and 120ng/ml without testing you can't know. After you've had a few tests you get to the point where you can predict the result but it's still worth retesting annualy to make sure nothing's changed. You should be able to find a 25(OH)D test for $60.

  • Fat Guy Weight Loss

    10/16/2011 3:11:20 PM |

    I eliminated sugar and wheat from my diet just from the observation that the food did not keep me full as long compared to other foods of same number of calories.  Not only led to weight loss but also eliminated my ocassional GERD as well as frequent stomach discomfort.  Now I have even more reasons to stay off the stuff and now being 95% wheat free (indulge in ocassional small portion of dessert) I no longer crave these foods and feel great.

  • Dr. William Davis

    10/18/2011 12:52:08 AM |

    How about "Skinny Guy Weight Loss"? (I didn't feel right calling you "Fat Guy . . .")

    It's such a simple formula for returning to health. I, personally, experienced relief from the same gastrointestinal effects. With any small indulgence, I am provided a graphic reminder of how it used to be.

    Stay strong. Your body will be grateful!

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