Cheese and vitamin K2

6. June 2007 William Davis (5)
If you've been following the Track Your Plaque conversation, you know that, contrary to prevailing opinion among many cardiologists, there is an emerging notion that coronary calcification is an active process, a true part of the disease.

Vitamin D3 is an important aspect of this question. So is vitamin K2. Not to be confused with K1 that plays a role in blood coagulation, K2 has an important role in calcium metabolism. Thus, vitmain K2 deficiency is related to osteoporosis and to coronary calcification.

Getting K2, like getting D, is difficult from food sources. The choices for K2 sources includes:

--Natto--generally, an impalatable choice. I've had it and it was intolerably gooey and weird-tasting. It is, nonetheless, the most concentrated food source of K2.

--Pate--Though liver products have the potential for containing many other unhealthy things, like pesticide residues, since the liver acts as a filter for the blood.

--Fermented cheeses--Since K2 is a product of fermentation of cheese, as it is in Natto.


For years, we've advised people to avoid or minimize cheese because of saturated fat or cholesterol content. I think that there's reason to re-think this advice based on the emerging data.

How can you tell the difference between fermented and non-fermented cheese? First, look for the holes in the cheese. The holes are the remnants of gas pockets created during fermentation. Second, look for the word "cultures" on the label, meaning organisms for fermentation were added. If "processed cheese" is anywhere on the label, this is a dairy product that has been chemically coagulated and is not fermented.

Fermented cheeses are generally "gourmet" cheeses, not eaten a pound at a time on a pizza, but meant to be eaten in small portions.

How much fermented cheese is necessary for its presumed inhibitory benefits on coronary calcification and osteoporsis? Are some fermented cheeses better than others? These issues remain unsettled. Stay tuned.
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Comments (5) -

  • Anonymous

    6/5/2007 11:06:00 PM |

    Doc
    I am really confused on your recommendation on trying to get k2 from food or cheese. Since you mention there is no way to tell how much k2 you are getting. I do notice that you dont mention supplements as an option to this problem. Since you are not opposed to supplements and k2 supplements are available now, I would think you would at least mention this as the solution in the meantime.

  • Dr. Davis

    6/6/2007 1:53:00 AM |

    That's because this conversation was meant to supplement a full discussion on vitamin K2 posted on the website this Blog accompanies. In a full Special Report on www.trackyourplaque.com, we have a full conversation about nutritional supplements.

  • Brock Cusick

    11/26/2008 3:14:00 PM |

    There are two kinds of K2 - MK-4 and MK-7.  Natto is MK-7 and all animal sources are MK-4.  Further, Dr. Weston Price did not find any examples of healthy primitive cultures that relied on MK-7. Every one used MK-4 animal sources.

    The most concentrated sources of MK-4 are butter oil, fish liver oil and organ meats (such as foi gras). Cheese is a pretty dilute source by comparison.

  • buy jeans

    11/3/2010 3:19:33 PM |

    For years, we've advised people to avoid or minimize cheese because of saturated fat or cholesterol content. I think that there's reason to re-think this advice based on the emerging data.

  • Anonymous

    2/5/2011 5:46:07 PM |

    Did you do any research on cheese at all before you posted this blog? Look for cheeses that have holes in it because it is a product of fermentation... All REAL cheese is fermented. It does not need to have holes to be fermented. The holes are from fermentation or culturing by a specific type of bacteria- propionic bacteria. Also, processed cheese starts off as real cheese and is then processed with heat, mechanical means, chemicals, etc. While you should definitely stay away from it because of these chemicals and the creation of oxidized cholesterol, the assertion that it is not fermented is false.

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Can I eat quinoa?

Can I eat quinoa?

29. July 2011 William Davis (15)
. . . or beans, or brown rice, or sweet potatoes? Or how about amaranth, sorghum, oats, and buckwheat? Surely corn on the cob is okay!

These are, of course, non-wheat carbohydrates. They lack several crucial undesirable ingredients found in our old friend, wheat, including no:

Gliadin--The protein that degrades to exorphins, the compound from wheat digestion that exerts mind effects and stimulates appetite to the tune of 400 additional calories (on average) per day.
Gluten--The family of proteins that trigger immune diseases and neurologic impairment.
Amylopectin A--The highly-digestible "complex" carbohydrate that is no better--worse, in fact--than table sugar.

So why not eat these non-wheat grains all you want? If they don't cause appetite stimulation, behavioral outbursts in children with ADHD, addictive consumption of foods, dementia (i.e., gluten encephalopathy), etc., why not just eat them willy nilly?

Because they still increase blood sugar. Conventional wisdom is that these foods trend towards having a lower glycemic index than, say, table sugar, meaning it raises blood glucose less.

That's true . . . but very misleading. Oats, for instance, with a glycemic index of 55 compared to table sugar's 59, still sends blood sugar through the roof. Likewise, quinoa with a glycemic index of 53, will send blood sugar to, say, 150 mg/dl compared to 158 mg/dl for table sugar--yeah, sure, it's better, but it still stinks. And that's in non-diabetics. It's worse in diabetics.

Of course, John Q. Internist will tell you that, provided your blood sugars after eating don't exceed 200 mg/dl, you'll be okay. What he's really saying is "There's no need for diabetes medication, so you're okay. You will still be exposed to the many adverse health consequences of high blood sugar similar to, though less quickly than, a full diabetic, but that's not my problem."

In reality, most people can get away with consuming some of these non-wheat grains . . . provided portion size is limited. Beyond limiting portion size, there are two ways to better manage your carbohydrate sensitivity to ensure that metabolic distortions, such as high blood sugar, glycation, and small LDL particles, are not triggered.

More on that in the future.


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Comments (15) -

  • Jordi Posthumus

    7/29/2011 1:01:43 AM |

    This is exactly what Ron Rosedale said back in 2004.

  • Payam

    7/29/2011 4:45:07 AM |

    If the only problem is that they raise blood sugar then are they okay if you eat them with fiber/fat?  If not, please explain why..

  • Anne

    7/29/2011 12:44:09 PM |

    I found that all grains, even when eaten with fat, raise my blood sugar to unacceptable levels. Grains can easily get me to over 200. Get a glucometer and see what these grains do to your blood sugar. I also found that when I want to see what a food does to my blood glucose I have to test every 15-20 min after I eat. If I test only at 2 hours I might miss the spike and be falsely reassured that I can eat that food. My fasting is in the 80's and I try to keep postprandial spikes under 110 and even that may be too high.

    If you are gluten sensitive, it is very common to have problems with oats(even the ones that are certified gluten free). Corn also seems to be a a problem for a good number of people who can't eat gluten.

  • Renfrew

    7/29/2011 12:44:24 PM |

    Sorry for disgressing a bit. Here is an excellent discussion about NIACIN and its effectiveness for decreasing cardiac events:
    http://www.theheart.org/article/1231453.do
    Do we have to give up NIACIN?
    Renfrew

  • Might-o'chondri-AL

    7/29/2011 6:09:41 PM |

    Hi Renfrew,
    Statin used with niacin, anti-fungals, genfibrozil, cyslosporin and erythromycin are already known by Mayo Clinic to have the potential to trigger muscle breakdown, called rhabdo-myolysis. This sends a byproduct called myo-globin into the blood that when reaches kidneys and degrades causes kidney renal tubule obstructive damage.

    HDL traffics mainly with the Apoliprotein A-1 (ApoA1), which is key to bring cholesterol to HDL for binding cholesterol molecules to transport for recycling. Compromised kidneys create a uremic environment which depresses ApoA1 bio-syntheis,  while proteinuria physically overloads the kidney tubule cells; in other words HDL ends up just carrying more triglycerides around and  HDL is not properly performing desired reverse cholesterol transport (recycling).

    Statins , to be fair, are showing  good results in preventing post surgery human acute kidney failure and some other kidney cases.  Of course  niacin  in rats with chronic renal failure ameliorated hypertension, proteinuria, inflammation and oxidative stress (see 2009: Am. J. Physiol. Renal Physiol. 297, F106-F113 and follow similarly related 2010: "Niacin Improves Renal Lipid Metabolism and Slows Progression in Chronic Kidney Disease" in Biochim. Biophys. Acta 1800, 6-15) .  So my non-clinician take is that niacin use, such as Doc's, without co-administered statins is largely preventative of lipo-toxicity; whereas the experiment you read of  dosing statins plus niacin risked a potential drug interaction Mayo Clinic already warned about .

  • conrack

    7/29/2011 7:13:16 PM |

    Allow me to rephrase your question: If the only problem with eating glucose is that it raises your blood sugar then is it ok to eat glucose with fats & just eat donuts?

    Brilliant.

  • Buckaroo Banzai

    7/29/2011 8:57:46 PM |

    I've never heard of table sugar being rated on the glycemic index as low as 59.  Nutritiondata says 68 and I have read 70 in books.  http://nutritiondata.self.com/topics/glycemic-index#values

  • Payam

    7/30/2011 2:15:50 AM |

    Thanks for putting words in my mouth wise guy.  What I was saying is that if I eat a sweet potato with enough coconut oil that it doesnt spike my blood sugar, what is the problem.  Dr. Davis said in the article that it wouldnt " cause appetite stimulation, behavioral outbursts in children with ADHD, addictive consumption of foods, dementia, etc."  If the only problem is that it spikes blood sugar and you avoid that problem, then whats wrong with a sweet potato.  But you already knew what my question was.. you just wanted to take out your frustration on me...

  • steve

    7/30/2011 8:08:17 PM |

    Dr Davis:
    What is a safe level for post prandial glucose measurement?  Is it under 120, under 100 or what?  Also, are you advocating a zero carb-starch diet?

    Thanks,

  • conrack

    7/30/2011 9:50:10 PM |

    Thanks for giving me another opportunity to make fun of your insistence on eating anything made of glucose.  What you were saying is that if you eat a GLUCOSE potato with enough coconut oil that it BECOMES A DONUT, it WILL still spike your blood sugar, that is the problem. (ANY glucose + ANY fat = DONUTS!)  Dr. Davis said in the article "IF they don't cause (conditions & behaviors caused by high blood sugar)" and then said "That’s...very misleading." If you think the only problem (and it's NOT) is that it spikes blood sugar, and you THINK you can, but actually CAN NOT avoid that OR the other problems, then that's whats wrong with a glucose potato. But you already knew what the answer is.. you just wanted to justify & take out your glucose addiction on me…

  • conrack

    7/30/2011 9:58:58 PM |

    Oops, that should read (conditions & behaviors caused by wheat). Got lost in the cuts & pastes.

  • Payam

    7/30/2011 11:39:23 PM |

    Okay, so rather than speaking in generalities, answer this.  I just had a baked potato with cinnamon and melted coconut oil.  Measured my blood glucose every 30 mins for 2 hours and it didn't go over 100.  It could be and probably is because I am a triathlete and I worked out in the morning so my muscle glycogen stores were empty.  So, glucose would preferentially go to muscle.  But what is wrong with eating a baked potato after a workout.  In other words, what are these "other problems" that you mention. (I didn't eat the skin by the way, b/c of the glycoalkaloids).  

    I am not trying to get into an argument with you, I really dont care.  I am just trying to get more informed.  I understand however, that Dr. Davis's information applies more to diabetics and insulin resistant, so maybe for someone active like me, its not as big a deal.  But if a potato doesn't spike my blood sugar, why, specifically, should I avoid it? Thanks

  • Tim Dietz

    7/31/2011 8:40:53 PM |

    I've monitored this blog for quite a while now and either I"ve forgotten the reasons or I've never seen them, but could somebody point me to the article(s) that outline the effects of high post prandial glucose?

    Thanks,

    Tim

  • conrack

    8/5/2011 7:30:52 PM |

    The answer is in the second half of this article posted on August 5, 2011 here: http://www.trackyourplaque.com/blog/2011/08/carb-counting.html

  • Sami Paju

    8/12/2011 3:06:48 PM |

    Hello,

    I would like to add to the discussion one significant issue with quinoa; saponins. They are molecules that are supposedly a major gut-irritant, and when compared to e.g. plant and animal foods have a high likelihood to cause leaky gut and inflammation of the small intestine. And inflammation is rather counterproductive for anyone trying to lose weight.

    //sami

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A Tale of Two LDL's

A Tale of Two LDL's

15. January 2009 William Davis (10)
Kurt, a 50-year old businessman with a heart scan score of 323, had a :

--Conventional (calculated) LDL of 128 mg/dl
--Real measured LDL 241 mg/dl.


Laurie, a 53-year old woman who underwent a coronary bypass operation last year (before I met her), had a:

--Conventional LDL of 142 mg/dl
--Real measured LDL was 85 mg/dl.


(By "real, measured" LDL, I'm referring to LDL particle number in units of nmol/L obtained through NMR lipoprotein testing and dividing by 10, or just dropping the last digit to convert the value to mg/dl. This technique was arrived at by comparing the population distributions of these two parameters, LDL particle number and calculated LDL. This is the gold standard in my view. Similar numbers can be obtained by measuring apoprotein B, direct LDL, or calculated non-HDL, with diminishing reliability from first to last.)

In other words, Kurt's conventional LDL underestimated real LDL by 88%. Laurie's conventional LDL overestimated real LDL by 40%.

Interestingly, Laurie's doctor had insisted she take Lipitor for a high LDL cholesterol. Her real LDL was, in fact, low to begin with and benefits of a statin drug would be little to none. (Remember, in our Track Your Plaque approach, multiple other treatments are included, such as omega-3 fatty acids from fish oil, vitamin D normalization, and wheat elimination, strategies that yield benefits that others expect to obtain with statins.) Laurie's real cause of her heart disease proved to have nothing to do with LDL cholesterol, but involved lipoprotein(a) and thyroid issues.

Kurt proved to have a severe preponderance of small LDL particles--the worst kind of LDL, while Laurie had none--a benign pattern.

Then how can anyone make sense of the conventional, calculated LDL cholesterol that is generally (95% of the time) provided? If accuracy can stretch to plus or minus 80% . . . you can't. Conventional LDL is a miserably inaccurate number. The problem is that obtaining a superior number requires a step or two more testing and insight, something most busy primary care doc's simply don't have in the midst of a day filled with arthritis, bronchitis, diarrhea, belly aches, and seborrhea.

Yet conventional--I call it "fictitious"--LDL serves as the basis for this $27 billion (annual revenues) industry selling statin drugs.

This is meant to be neither an argument in favor of nor against statin drugs. However, it is plain as day that any study designed to reduce LDL cholesterol will be hopelessly clouded by calculated LDL imprecision. A calculated LDL of, say, 143 mg/dl might really be 187 mg/dl, or it might be 74 mg/dl--you can't tell by looking just at LDL. Yet billions of dollars of research and billions of dollars of healthcare costs are based on the treatment of this number.

This reminds me of the mark-to-market accounting magic that helped topple Wall Street.

I don't think that the statin world is poised for such a huge downfall. But I do see this as a source of enormous dilution of the effects of statin drugs. People who barely stand to benefit get the drugs, while others who might truly benefit are treated inadequately. It provides fuel to the growing idea that reducing LDL cholesterol fails to truly provide benefit.

I am no lover of statin drugs nor drugs in general. But I am a fan of knowing the truth. Despite my bashing of the drug industry (and make no mistake: the drug industry is a cutthroat, profit-seeking, do-anything-to-increase-sales industry), I do believe that there is a role for statin drugs (though far smaller than $27 billion per year). But the usual method of selecting people for treatment is pure fiction. The ATP-III cholesterol treatment guidelines? An anemic attempt to apply structure to meaningless values.

You and I do not need to subscribe to this sort of non-quantitative nonsense.
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Comments (10) -

  • renegadediabetic

    1/15/2009 3:22:00 PM |

    It's just part of big pharma's racket.  The public has been propgandized to fear cholesterol, statin prescriptions are based on an antiquated calculation, and the people who set cholesterol targets have financial ties to the drug companies.  This has created a big cash cow for big pharma.

    The only people to benefit from statins are middle aged men who have had a heart attack and even then, the benefit is small.  If statins were restricted to those who would truely benefit, it would mean a lot less $$$$ for big pharma.

  • Alan S David

    1/15/2009 3:31:00 PM |

    Today's news said millions more Americans over 60 could benefit from statins to combat the c-reative protein problem. How many more so called great things will statins do for us? Is this another terrific marketing ploy?

  • Zbig

    1/15/2009 8:52:00 PM |

    Dear Doc,
    all this NMR is black magic to me so far, besides I will wait for some advanced lipid measurements until I am at least 40.
    But I suspect that the LDL size can be guesstimated from e.g. triglicerides / HDL ratio - could you please supplement your post with the figures for both persons. I suspect there will be a difference there. TIA

  • Steve L.

    1/16/2009 3:36:00 AM |

    And if a million or so "Lauries" are given Lipitor for their 85 mg/dl  real LDL, I don't expect their all-cause mortality will IMPROVE .

  • Richard Nikoley

    1/17/2009 5:43:00 AM |

    Doc:

    My speculation is that this is merely an effect of the huge to-market costs pharmaceutical companies must endure, owing to FDA regulations.

    If people didn't have false-security -- as you have shown -- of FDA hurdles and implicit [expensively purchased] assurances, they might just take a bit more proactive, intelligent and informed approach to their own health, and maybe drug companies might go back to serving an informed consumer who no longer simply bows to an authority (the FDA) because they have the power to be who they are.

  • jean

    1/17/2009 5:57:00 AM |

    My neighbor is being lipitor by his internist because both his parents have alzheimers. At least that is what my neighbor told me.  I told him I'd never heard of that and he said he'd trust the doctor to know.

  • Robin

    11/2/2012 4:58:02 AM |

    Statins don't lessen the risk of heart disease by lowering cholesterol. They work by lowering inflammation which is not what  they were designed to do and was not expected. Happens a lot - drugs being created for one thing and being found to work for something else so are then subscribed for other conditions.

    Statins are powerful and dangerous drugs that block the production of cholesterol. Our bodies NEED cholesterol. By blocking its production, it also blocks Co Q10 and dolichols, and more. Side effects range from minor muscle pains to the complete destruction of muscles, kidney failure then death. Also transient global amnesia (TGA) which doesn't show up immediately and is dismissed when it does. They cause depression and violent behaviour. That's why people on statins have a higher morbidity from all other causes and not heart attacks.

    As renegadediabetic  above says, they show slight benefit for middle-aged men who have already had a heart attack. Oh yeah, tell us again why we need them?

  • Robin

    11/2/2012 5:00:24 AM |

    "morbidity"? Um, mortality.

  • Robin

    11/2/2012 5:01:59 AM |

    Darn. Message went to wrong place. Mortality is what I meant.

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What is Cureality all about?

What is Cureality all about?

27. May 2014 William Davis (1)

“Looking over your medical record, Nancy, I’m a bit concerned about your risk for osteoporosis and hip fracture. It looks like your mom had a hip fracture at age 67. Is that right? ”

“Yes, she did,” Nancy responded. “And her life was never quite the same for the 15 years she lived after that.

“You’re 53 year old. Bone thinning develops over many years. Let’s get you scheduled for a bone scan.”

Two weeks later:

“Your z-score is 1.5, Nancy. This means you’ve got a mild form of osteoporosis called ‘osteopenia.’ Here: This is a prescription for alendronate, what used to be called Fosamax.”

“Aren’t there side-effects with that drug? A friend of mine said that her mom had a leg fracture from it.”

“Well, yes. All prescription drugs have potential side-effects. They’re rare, but they can happen and we can’t predict it. Besides leg fracture, there’s something called jaw osteonecrosis in which the jawbone dies and has to be surgically replaced. But would you rather run the risk of a hip fracture?”

“Before we jump to drugs, aren’t there natural things I could do first?”

(Big sigh.) “You can take calcium, but that only helps a bit. You’ve got to make a choice: Take the drug or risk a hip fracture.”

“I’m going to explore some natural remedies on my own first.”

Nancy’s dialogue with her doctor is fictional but based on similar encounters that occur thousands of times every day nationwide. Identify a problem, prescribe a drug. Natural remedies? “They don’t work.” “I don’t know anything about that.” “None of that is proven.” “I only practice evidence-based medicine.” You’ve probably heard a few of these explanations yourself if you ever question the wisdom of conventional medical care.

Each of Nancy’s fictitious interactions were no more 10 minutes long. If she is like most people, she will have one or two such interactions over the course of a year, unless she develops some acute illness. So she’s got something like 20-30 minutes per year to compress all of her “health” advice into the time allotted. 20-30 minutes per year to discuss bone health, nutrition, blood sugar issues, cholesterol issues, blood pressure, female issues, and all the other facets of health. Perhaps she has developed some chronic gastrointestinal complaints, too, and an odd rash on her elbows, maybe headaches a few times per week that she didn’t have before. Regardless, she’s going to have to make do with those few minutes, likely receiving one or more prescriptions or imaging procedures for each.

Such is the nature of modern healthcare: Provide the minimum interaction, address only a few, perhaps no more than one, problem, then prescribe a drug. This is, more often than not, wrong. Plain wrong. Tragically, awfully, unethically, unnecessarily wrong.

Let’s pick up again with Nancy. Upon learning of her osteopenia and long-term risk for hip fractures of the sort that changed her mom’s life and health irretrievably, Nancy started searching for solutions. Not only did she discover that, yes, there are indeed a number of safe and effective ways to deal with osteopenia. She also learned that such strategies have even been examined in clinical trials, some of the strategies pitted head-to-head with drugs and performed on a par, sometimes better, than prescription drugs. She also found that there are online communities that she could join and discuss her health situation with people all sharing the same health interests. During one such interaction at the start of her effort, when she was still a bit unsure and tentative, a woman she didn’t know but who shared a similar interest in restoring bone health, commented to Nancy, “Don’t sweat it, Nancy. I was in your shoes a little over a year ago. I followed a program for bone health: vitamin D, vitamin K2, magnesium, I made sure that I included leafy green vegetables at least once or twice per day, and I added strength training for a few minutes twice per week. I started with osteoporosis. My most recent bone density test showed that I reversed it completely—it’s entirely normal! So hang in there and be sure to share your questions and concerns with us here.”

THAT is what Cureality is all about. Cureality fills the gap of knowledge in health that is not being provided in a few minute-long medical interaction. Cureality reveals the astounding amount of credible, safe, scientific information that allows you to participate, sometimes take over completely, various aspects of health. You don’t have to fire your doctor; these efforts supplement the information and advice you obtain (or don’t obtain) in the doctor’s office. While critics may sometimes say that this can be dangerous or that misdiagnoses and dangerous treatments might be risked, our experience is the exact opposite: People do better by taking the reins of health themselves, choosing to use the health care system for acute or catastrophic illness—but not necessarily for health.

Our fictional woman, Nancy, returns to her doctor one year later after undergoing a repeat bone scan. The doctor opened her chart, clearly expecting to scold her for her foolhardy and careless attitude. Instead, he was speechless. After a pause, he said, “I don’t know how you did it, but your bone density is now normal, the density of a healthy 30-year old woman. Just continue doing what you’re doing.” He closed the chart and walked out.

Yes: “Just continue what you are doing”—not “Please tell me what you did so that I might learn something new,” or “Where did you learn about such strategies? I knew nothing about this!” Just “do what you’re doing.” Too often, that is the response you get that defines what modern health care has become.

You don’t want that kind of health care. Sure, it’s reassuring to know that the doctor and hospital are there in case you injure yourself or develop pneumonia. But obtain day-to-day health advice of the sort that keeps you slender, keeps blood pressure normal, maintains normal insulin and blood pressure responses, helps keep bowel health ideal, can even be used to reverse conditions such as autoimmune joint pain, diabetes, osteoporosis, or skin rashes, while costing next to nothing and yielding health care benefits for you and your family in multiple areas of health? That is the kind of health care you want.

That’s why we developed Cureality.


William Davis, MD
Author of #1 New York Times Bestseller Wheat Belly: Lose the wheat, lose the weight and find your path back to health, The Wheat Belly Cookbook, and Wheat Belly 30-Minute (or Less!) Cookbook published by Rodale, Inc.  
Author, Track Your Plaque: The only heart disease prevention program that shows how the new CT heart scans can be used to detect, track, and control coronary plaque

Comments (1) -

  • LC

    6/30/2014 8:43:37 PM |

    Dr. Davis, You're a badass, one wonderful f**king badass!

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