Effect of wheat on irritable bowel syndrome- FreeTheAnimal

Looks Like Dr. William Davis Was Right in Wheat Belly

February 18th, 2014     

Well what do you know?

I've been following Dr. Davis for a long time and have really applauded a lot of the work he was doing over the years getting really good results for people, primarily by getting them off wheat and getting their vitamin D levels up. The results often showed up in significant reductions in heart scan calcification scores. Davis in a cardiologist. Since I was pretty hardcore Paleo at the time, it made a lot of sense, but I attributed that success mostly to the removal of grains period.

Then comes his book—Wheat Belly: Lose the Wheat, Lose the Weight, and Find Your Path Back To Health

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The above is a quote from here.


Below is a copy of the abstract from  a double-blinded randomised dietary intervention trial. The original can be found here.
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Effect of Triticum turgidum subsp. turanicum wheat on irritable bowel syndrome: a double-blinded randomised dietary intervention trial.

Sofi F¹, Whittaker A², Gori AM³, Cesari F³, Surrenti E⁴, Abbate R³, Gensini GF³, Benedettelli S², Casini A¹.

Abstract

The aim of the present study was to examine the effect of a replacement diet with organic, semi-whole-grain products derived from Triticum turgidum subsp. turanicum (ancient) wheat on irritable bowel syndrome (IBS) symptoms and inflammatory/biochemical parameters. A double-blinded randomised cross-over trial was performed using twenty participants (thirteen females and seven males, aged 18-59 years) classified as having moderate IBS. Participants received products (bread, pasta, biscuits and crackers) made either from ancient or modern wheat for 6 weeks in a random order. Symptoms due to IBS were evaluated using two questionnaires, which were compiled both at baseline and on a weekly basis during the intervention period. Blood analyses were carried out at the beginning and end of each respective intervention period. During the intervention period with ancient wheat products, patients experienced a significant decrease in the severity of IBS symptoms, such as abdominal pain (P< 0·0001), bloating (P= 0·004), satisfaction with stool consistency (P< 0·001) and tiredness (P< 0·0001). No significant difference was observed after the intervention period with modern wheat products. Similarly, patients reported significant amelioration in the severity of gastrointestinal symptoms only after the ancient wheat intervention period, as measured by the intensity of pain (P= 0·001), the frequency of pain (P< 0·0001), bloating (P< 0·0001), abdominal distension (P< 0·001) and the quality of life (P< 0·0001). Interestingly, the inflammatory profile showed a significant reduction in the circulating levels of pro-inflammatory cytokines, including IL-6, IL-17, interferon-γ, monocyte chemotactic protein-1 and vascular endothelial growth factor after the intervention period with ancient wheat products, but not after the control period. In conclusion, significant improvements in both IBS symptoms and the inflammatory profile were reported after the ingestion of ancient wheat products.

PMID: 24521561 [PubMed - as supplied by publisher]

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Read the complete articles here and here.

DHA: the crucial omega-3 - Davis

DHA: the crucial omega-3  

Of the two omega-3 fatty acids that are best explored, EPA and DHA, it is likely DHA that exerts the most blood pressure- and heart rate-reducing effects. Here are the data of Mori et al in which 4000 mg of olive oil, purified EPA only, or purified DHA only were administered over 6 weeks:


□ indicates baseline SBP; ▪, postintervention SBP; ○, baseline DBP; •, postintervention DBP; ⋄, baseline HR; and ♦, postintervention HR.

In this group of 56 overweight men with normal starting blood pressures, only DHA reduced systolic BP by 5.8 mmHg, diastolic by 3.3 mmHg.

While each omega-3 fatty acid has important effects, it may be DHA that has an outsized benefit. So how can you get more DHA? Well, this observation from Schuchardt et al is important:

DHA in the triglyceride and phospholipid forms are 3-fold better absorbed, as compared to the ethyl ester form (compared by area-under-the-curve). In other words, fish oil that has been reconstituted to the naturally-occurring triglyceride form (i.e., the form found in fresh fish) provides 3-fold greater blood levels of DHA than the more common ethyl ester form found in most capsules. (The phospholipid form of DHA found in krill is also well-absorbed, but occurs in such small quantities that it is not a practical means of obtaining omega-3 fatty acids, putting aside the astaxanthin issue.)

So if the superior health effects of DHA are desired in a form that is absorbed, the ideal way to do this is either to eat fish or to supplement fish oil in the triglyceride, not ethyl ester, form. The most common and popular forms of fish oil sold are ethyl esters, including Sam’s Club Triple-Strength, Costco, Nature Made, Nature’s Bounty, as well as prescription Lovaza. (That’s right: prescription fish oil, from this and several other perspectives, is an inferior product.)

What sources of triglyceride fish oil with greater DHA content/absorption are available to us? My favorites are, in this order:

Ascenta NutraSea
CEO and founder, Marc St. Onge, is a friend. Having visited his production facility in Nova Scotia, I was impressed with the meticulous methods of preparation. At every step of the way, every effort was made to limit any potential oxidation, including packaging in a vacuum environment. The Ascenta line of triglyceride fish oils are also richer in DHA content. Their NutraSea High DHA liquid, for instance, contains 500 mg EPA and 1000 mg DHA per teaspoon, a 1:2 EPA:DHA ratio, rather than the more typical 3:2 EPA:DHA ratio of ethyl ester forms.

Pharmax (now Seroyal) also has a fine product with a 1.4:1 EPA:DHA ratio.

Nordic Naturals has a fine liquid triglyceride product, though it is 2:1 EPA:DHA.

By Dr. William Davis
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Read the complete article here.

Heart disease, coronary calcification and preventative cardiology - IHDA

Please review this linked site for some super info and the latest on heart disease, coronary calcification and preventative cardiology.

http://ihda.ie/see-more/

I was especially interested in the presentation of Dr William Davis whose Track Your Plaque program I follow. Please listen to all of these speakers if you are concerned about this important topic.

Irish Heart Disease Awareness -

Dr William Davis was interviewed on the Dr Oz show

Cardiologist, Track Your Plaque founder and Wheat Belly author Dr William Davis was interviewed on the Dr Oz show tagged 'Are You Addicted to Wheat' on Monday Dec 3 2012. The complete show can be seen in three parts here.

http://www.doctoroz.com/episode/are-you-addicted-wheat

Non-Celiac Wheat Sensitivity: A New Clinical Entity

Non-Celiac Wheat Sensitivity: A New Clinical Entity
 A common response to the suggestion that wheat may be causing digestive or other problems is “I don’t need to worry about wheat because my doctor checked me and I don’t have celiac disease.”

Despite thousands of anecdotal reports of improved digestive health with wheat avoidance, most people, including most physicians, cannot recognize a wheat sensitivity outside of an official diagnosis of celiac disease.

To the mainstream medical establishment, negative celiac tests mean you do not have wheat sensitivity.
..

“Our data confirm the existence of non-celiac wheat sensitivity as a distinct clinical condition.”

As William Davis documents thoroughly in Wheat Belly, celiac disease testing does a very poor job of identifying those of us who are sensitive to wheat. Perhaps one day, clinicians, and mainstream public opinion, will catch up with the research.
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“As a whole group, the [non-celiac wheat sensitivity] group showed a higher frequency of anemia, weight loss, self-reported wheat intolerance, coexistent atopy, and food allergy in infancy than the IBS controls.”
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Read the complete article here.

Also read this and
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Here is part of another eye opening article about wheat titled
 The Problems with Modern Wheat

It’s less nutritious.

In 1843, agronomists at Rothamstead Research Station in Hertfordshire, England began what would become one of the longest-running continuous agronomic experiments in the world: the Broadbalk Winter Wheat Experiment. For the last two centuries, generations of scientists involved in the experiment have grown multiple wheat cultivars on adjacent plots of land and applied different farming techniques and fertilizers to study the effect on yield, nutritional content, and viability of the crop. They’ve rotated crops in and out, switched up fertilizers, and tracked the change in mineral content of both soil and wheat grain. It’s a stunning example of a well-designed, seemingly never ending (it continues to this day, as far as I can tell) experiment.

Between 1843 and the mid 1960s, the mineral content, including zinc, magnesium, iron, and copper, of harvested wheat grain in the experiment stayed constant. But after that point, zinc, magnesium, iron, and copper concentrations began to decrease – a shift that “coincided with the introduction of semi-dwarf, high-yielding cultivars” into the Broadbalk experiment. Another study found that the “ancient” wheats – emmer, spelt, and einkorn – had higher concentrations of selenium, an extremely important mineral, than modern wheats. Further compounding the mineral issue is the fact that phytic acid content remains unaffected in dwarf wheat. Thus, the phytate:mineral ratio is higher, which will make the already reduced levels of minerals in dwarf wheat even more unavailable to its consumers.

Increased yield leading to dilution of mineral density is one possible explanation for the reduction in wheat mineral content, but modern wheat has shorter root systems than ancient wheat, and longer roots allow greater extraction of minerals from the soil. Some people have proposed soil mineral depletion as the cause of reduced nutrient content of food, but – at least in the Broadbalk experiment – soil mineral content actually increased over time.

It’s more damaging to celiacs and gluten-sensitives.

One of the primary proteins in wheat, gluten provides the “viscoelastic properties” that allow wheat to be turned into bread, dough, pasta, and all sorts of processed foods. Gluten provides the chewiness of good bread, the bite of al dente pasta. Bakers, cooks, and foodies prize it – but some people fear it, and rightfully so. I wrote all about gluten sensitivity and celiac disease a few weeks back, but the basic gist is that for many people, consuming gluten inflames the body, perforates the gut, and opens them up to a whole host of health maladies.

So what’s the deal with modern wheat? Well, celiac disease is on the rise, and some researchers have suggested that this is caused by the prevalence of certain gluten proteins that predominate in the new varieties of wheat. Namely, a gluten peptide known as glia-α9, which is nearly absent in older wheats but prevalent in modern wheats, is the most reactive “CD (celiac disease) epitope.” In other words, a majority of people with celiac disease react negatively to glia-α9. It’s a common trigger, and older wheat doesn’t have as much of it.

Meanwhile, einkorn, an ancient variety of wheat, has been shown to cause less intestinal toxicity in patients with celiac. Einkorn and other related ancient strains of wheat still contain gluten, of course, but they do not appear to be as damaging to people sensitive to or completely intolerant of gluten and its related protein subfractions.

It’s prepared differently.

Consider how bread is made today:
With refined, old (often rancid) white flour instead of freshly ground wheat.

Using quick rise commercial yeast instead of slowly fermenting with proven sourdough cultures.
On an industrial scale instead of in the home.

Meanwhile, for the vast majority of our wheat-eating history, humans have been grinding whole wheat berries up fresh and fermenting them before baking and eating the stuff. Dr. Weston Price famously found several traditional cultures who thrived on wheat, but they weren’t eating refined white flour treated with quick-rising yeast. They were stone-grinding fresh wheat. They were fermenting it. They were doing all the things a person has got to do if they want to make wheat a staple of their diet and maximize the nutrition in the process. Later, Price conducted experiments in which he reversed dental decay and remineralized cavity-ridden teeth in refined white flour-eating people using wholesome, varied diets that included some freshly ground wheat. Fermentation effectively “pre-digests” the proteins in wheat, as I mentioned previously. If you have the right organisms, you can even break down wheat gluten to the point that celiacs can eat it without suffering symptoms.

That’s not to suggest you should go eat wheat. It’s simply to suggest that if you do, fresh, whole, ancient wheat prepared the old way is definitely healthier.

So, there you go: a few good lines of solid evidence showing why modern wheat – which is the only kind of wheat most people are ever going to encounter in the real world – should be avoided. Does that help? If you’re interested in more, check out Dr. Davis (of Wheat Belly fame), who’s made it something of his mission to rail against what he calls a “perfect, chronic poison.”


Read more here.

Book Review: Don’t Die Early - Rocky Angelucci (Naughton reviewed)

Sep062012

Book Review: Don’t Die Early

Posted by Tom Naughton

Lying on the gurney in the emergency room, I shielded my eyes from the glaring overhead lights and tried to remember exactly when my heart went wacko. I remember being anxious and out of sorts all evening. Looking back, I realized that during dinner my chest felt fluttery and strange inside, and I recall snapping at my wife, Laura, over nothing as I left the kitchen to go upstairs.

By the time I reached the top of the stairs, I knew something was very wrong— I could barely breathe and when I placed my fingers to the side of my neck, my pulse felt very unusual. Not the rhythmic beating I would have expected, but more like an indistinct, squishy fluttering. Walking into our spare bedroom, I retrieved the pulse meter from the shelf next to the treadmill. I slipped the meter on my finger and looked at the readout. The effort seemed exhausting. Sitting on the edge of the bed, I called for Laura. When she arrived a moment later, I handed her the pulse meter.

The display read 195 beats per minute and I knew my life had just changed forever. The old carefree way of taking care of my body that had worked fine in my youth and young adulthood wasn’t working anymore. I now had to become a conscious advocate of my own health.

That’s the opening from Don’t Die Early, an educational and very well-written book by Rocky Angelucci – who did nearly die early. Finding yourself lying on a gurney should certainly put a scare into you, but unfortunately many people respond to that scare by following their well-meaning doctor’s orders … you know, cut back on the eggs and saturated fats, eat your hearthealthywholegrains, etc.

Rocky didn’t go that route, partly (and I’m delighted to say this) because of Fat Head. As he explained in an email some months ago:

I have been a fan of yours since discovering a snippet of Fat Head on YouTube the evening I returned home from the hospital following a life-changing episode of atrial fibrillation. I was only 45 years old at the time, but had just been rudely awakened by the realization that the carefree lifestyle of my youth had become increasingly harmful. Fat Head’s discussion of insulin resistance and fat storage resonated very well with my pre-med college days studying life sciences and my experiences with the Zone diet and the hormonal implications of foods. Fat Head also catalyzed my growing displeasure at a procedure-driven medical system and gave substance to my vague feeling that politics, not science, has infiltrated medical care.

Because my underlying cardiac problem ultimately turned out to be an alarming plaque burden, my research quickly lead me to Dr. William Davis’ Track Your Plaque forum, where I have been a very active member for the past two years. I became so impressed with Dr. Davis that he has been my cardiologist for the past year. His warmth and prevention-minded attitude makes the journey from Dallas to Wisconsin entirely worthwhile. Thanks to my radical lifestyle changes, most of them flying in the face of conventional wisdom, I’m fortunate to be one of the TYP members who has shown dramatic plaque reversal, recently showing a 24% six-month decrease immediately following a horrific 83% increase the year before.

If I had heart disease, there’s no one in the world I’d rather have treating me than Dr. Davis. Rocky’s in good hands.

His email continued:
Emboldened by a background as a technical writer in the fields of software, nanotechnology, and medical devices, I’ve spent the past year writing a book on preventive health that captures what I’ve learned and applied to my own condition.

I read the book before it was published and again last week, and it’s excellent. When I consider recommending a book (publishers send me books I don’t recommend, by the way), I ask myself two questions: 1) Is the information useful to people who want to lose weight or become healthier? 2) Does it pass my “Aunt Martha” test … that is, could your Aunt Martha read it and understand it?
The answer to both questions in this case is an enthusiastic yes. Rocky has a gift for taking the science of nutrition and health and explaining it clearly, and it’s obvious from the many topics he covers and how well he covers them that he jumped into that science head-first. I learned more from this book than I thought I would, which is always a pleasure.

As the title indicates, Don’t Die Early isn’t about weight loss. It’s about how to live to a ripe old age and remain healthy along the way. Weight loss is covered in a section about dietary fallacies, but Rocky’s goals for the reader are the same goals he set for himself: 1) understand the true causes of heart disease, diabetes and inflammation; 2) learn how to reliably measure and track the instigators or markers of those diseases, such as LDL particle size and A1C; and 3) take specific actions to reverse disease or prevent it from developing in the first place.

That’s what Rocky did, and was rewarded with excellent results:
In the first six months after embracing a preventive lifestyle, I accomplished the following:

• Lowered my body fat percentage from 20% to 11%
• Lowered my inflammatory markers by as much as 75% (you’ll learn about inflammation later)
• Reduced my triglycerides by more than 90% (this happened in the first 30 days)
• Improved every measurable aspect of my cholesterol
• Improved my fasting glucose by 25%
• Improved my muscle tone and stamina
• Lowered my blood pressure from an average of 145/90 to an average of 115/70
• Reduced my resting heart rate by more than 13 points

As impressive as these results might appear, I’m not revealing them so that you’ll invite me to your next party. They are to show you what is very attainable for anyone who makes the proper lifestyle changes.

The book is divided into two parts. Part One, titled The Major Players, provides in-depth explanations of heart disease, diabetes and inflammation. The message Rocky pounds home in these chapters is that it’s important not only to understand what these diseases actually are and what causes them, but to know specifically what to measure so you can tell if you’re developing them. Sadly (but not surprisingly), the tests your doctor orders often add up to too little, too late:

Imagine having the following conversation with your child’s teacher:

You: How is my daughter doing in school this semester? Is she learning the required material?

Teacher: Based upon her age, and what we infer her socioeconomic status to be, as well as her assertions that she does homework on a regular basis, we believe she has a very high likelihood of having mastered this semester’s materials acceptably.

You: Excuse me? What does this mean? Have you tested her on the material?

Teacher: No, we compared her socioeconomic status, apparent nutritional health, and her testimony that she does her homework regularly to a statistical model we have and there’s a strong correlation between your daughter’s parameters and students who mastered the coursework. Oh, and we measured the callouses on her writing fingers and they indicate that she’s likely doing quite a bit of writing, which our statistical model shows increases by 22% her chances of having mastered the material. Overall, we feel very confident that she has mastered this semester’s material.

You: I don’t understand why you’re comparing her to a statistical model instead of testing her. Do you ever plan on testing her?

Teacher: Only if she shows clear signs of having failed to master the material would we test her. As long as her parameters correlate acceptably to the statistical models of a successful population, we will assume that she is mastering the material.

Does this sound like a school you would like your child to attend? Does estimating your child’s performance by comparing indirect parameters to a statistical model sound like an ideal way to gauge her mastery of the subject matter? It certainly doesn’t to me.

Yet this is how our medical culture typically measures the risk of coronary artery disease during routine preventive exams.

That’s why Rocky didn’t know he was developing plaque in his arteries. He quotes Dr. William Davis, who says that the traditional methods of identifying people at risk for heart disease miss 90 percent of the people who eventually have a heart attack. If you want to know if you’re developing plaque, you should (surprise!) measure plaque.

The standard test for measuring diabetes often misses those who are developing it as well:
Many of the clinical guidelines in use today encourage a physician to use fasting glucose as the sole indicator of one’s diabetic health. Seeing a fasting glucose level within the laboratory “normal” range, both patient and physician are satisfied that the patient is at low risk of Type 2 diabetes.

Now that you know more about how diabetes progresses, you can see that gauging the risk of Type 2 diabetes solely on fasting glucose is terribly ineffective. An abnormal fasting glucose is typically the last commonly used indicator to show the presence of diabetes. In fact, by the time your fasting glucose is no longer in the normal range, you are already diabetic.

Throughout these chapters, Rocky explains which health markers you should be actually measuring and which specific tests you can request from your doctor or order online and perform at home.
Fat Head fans will be familiar with much of material on heart disease and diabetes, including how much of the standard advice from so-called experts is wrong. But even though I’ve read quite a bit on those topics, I kept coming across information in Don’t Die Early that was either new to me or struck me as particularly well-explained. Here are a couple of sample bits:

Perhaps the biggest problem with insulin being a growth hormone is that not all of the tissues in the body become desensitized to increasing levels of insulin at the same rate. As a person becomes more and more insulin-resistant, cells that are much less affected continue to respond to the ever-increasing levels of insulin, growing and multiplying more rapidly as insulin levels increase. What cells exhibit this behavior? The endothelial cells that form the lining of your arteries, for one. As these arterial cells multiply more rapidly, the lining of an insulin-resistant person’s arteries thicken and grow inward, hastening coronary artery disease. This is one of the reasons why so many diabetics die from heart disease.
…
A typical cell membrane is composed of a lipid bilayer, which is just what it sounds like: two layers of fatty acid molecules, sandwiched together to give cell membranes their much-needed strength. This bilayer also forms an effective barrier to foreign substances, through the use of embedded receptors that are designed to transfer only specific things into and out of the cell. The impermeable lipid layers and their receptors serve as gatekeepers to help ensure the health of a cell by transferring only what the cell needs, in the right amounts, into the cell and removing unwanted substances from within the cell. Virtually anything that the cell consumes or produces is transported this way, ensuring that only the proper substances ever reach the interior of the cell.

As with most structures of the body, the cell’s lipid bilayer needs to be constantly maintained, which the body does by constantly replenishing the crucial fatty acids that comprise the cell membranes. What happens if a person eats a trivial amount of healthy omega-3 fatty acids and an abundance of unhealthy omega-6 fatty acid? Simple, the body does its best with what you give it and will use the omega-6 fatty acids instead.

What this means is that in addition to their role in promoting inflammatory chemical messengers, omega-6 fatty acids become incorporated into virtually every cell in your body.

Part two of the book, Lifestyle Changes, includes chapters on dietary truths and fallacies, setting goals, and taking action. Again, the chapter on diet covers ground that’s largely familiar for Fat Heads (Gary Taubes and Dr. William Davis are quoted several times), but it’s well written and worth the read.

In the final two chapters, Rocky urges the reader to do enough testing to establish several baseline measurements (blood sugar, fasting insulin, vitamin D concentration, LDL particle size, etc.), set specific and attainable goals for improving those markers, then work to meet them. If you’ve ever wondered what your fasting insulin level or vitamin D concentration should be (ideally, anyway) this chapter will tell you. Rocky also gives advice on how to improve your odds of meeting each goal. For example, to achieve optimum triglyceride levels:

In summary, the best approach to reducing one’s triglycerides is

• Eliminate grains, replacing them with vegetables, nuts, and berries.
• Minimize carbohydrates (especially fructose), eating them in sufficient moderation so as to never cause unfavorable glucose levels.
• Consider supplementing your diet with omega-3 fatty acids from fish oil.
• Speak to your physician about supplementing with niacin to help optimize your triglycerides.
• All of the above steps will very effectively control your fasting triglycerides. To really take it to the next level, buy a Cardio-Chek triglyceride meter to measure your body’s response to different types of meals to identify exactly how sensitive your body is to specific types and quantities of fats. If you perform a small series of these carefully controlled tests, you’ll have infinitely more clarity on how to optimize your diet for the best possible postprandial triglyceride production (this will be especially valuable in determining whether saturated fat is good for you and at what level).

Near the very end of the book, there’s a section I’m sure many of you will relate to … the sub-chapter heading is Prepare To Be An Outcast. Here’s chunk of that section:

You may find yourself biting your tongue every time you see a friend, colleague, or loved one wolf down a low-fat, grain-based meal, laden with vegetable oil, as they complain about having acid reflux or autoimmune disorders.

You may see friends and loved ones struggle with weight problems while they eat low-fat foods that constantly elevate their blood glucose level, ensuring that they live life as the “walking starving,” trying unsuccessfully to lose weight.

Even your more health-conscious friends may not appreciate your one-upping them on matters of health and nutrition. Responding to their enthusiasm for fish oil with “Yes, but do you track your daily intake of omega-3 and omega-6 fatty acids and have you ever checked your Omega-3 Index?” will make you sound like a know-it-all.

It’s painful to realize that some people just don’t want to hear that there’s a better future available to them if they just abandon the current thinking on what’s healthy and what’s not. Many refuse to believe that they could ever get bad advice from a physician or from a “trusted” source like the USDA, the American Dietetic Association, or the American Diabetes Association. In such cases, you may just need to silently watch them continue on their path.

Sadly, that’s true. But for people who are open to trying a new path to health, Don’t Die Early is an excellent guidebook.
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Read the full article here.

Among the most ignorant about wheat? Celiac experts!

Posted on September 11, 2012 by Dr. Davis

 

The University of Chicago Celiac Center’s Facebook page contained this response to my CBS This Morning interview from a Dr. Stefano Guandalini:

I was quite surprised to see that CBS news would provide unquestioned credibility to Dr. Davis, the author of Wheat Belly, on CBS This Morning on September 3rd, with no knowledgeable physician on the program to present a more accurate, balanced viewpoint on such an important issue as the role of wheat in nutrition and disease.

The assertions made by Dr. Davis (a cardiologist, not a nutritionist nor a gastroenterologist) are not grounded in fact, let alone any evidence-based research. Gliadin a new protein? Gliadin proteins are major components of gluten and their existence has been known since Dicke and Van de Kamer studied wheat in the 1940s. It is not a new protein created by genetic modifications; and it is indeed a poison, but only for those with celiac disease. Gliadin an opioid that binds to the brain? Sure this is a stunning statement. What is the evidence? Aside from an obscure article that appeared almost 30 years ago reporting an opioid-like activity for some gliadin fractions, nothing else is available in the literature and certainly no data are there to show any binding to the brain.

There is enough confusion around celiac disease, non-celiac gluten sensitivity and the issue of who benefits from a gluten-free diet (only those with wheat allergy, celiac disease or non-celiac gluten sensitivity, I might add). Regrettably, CBS This Morning has added to the confusion and did a disservice to its viewership to allow such questionable information be portrayed as fact.

I have no ties at all to the wheat industry, nor do I have any interest in “protecting” it. My interest, as a physician and specialist in celiac disease lies only in protecting my patients and the public from those who would perpetuate unsubstantiated health claims as fact.

Stefano Guandalini, MD
Professor and Chief, Section of Pediatric Gastroenterology
University of Chicago
Founder and Medical Director, Celiac Disease Center”

This is the nonsense that comes from an “expert” in celiac disease, the very same people who advocate that people with celiac disease or gluten sensitivity to consume gluten-free foods made with cornstarch, rice starch, tapioca starch, and potato starch.

Here’s the problem: It’s NOT about gluten, nor is my primary concern people with celiac disease or gluten sensitivty. I am primarily address the other 90% of people who have problems with:

1) The new forms of gliadin–Dr. Guandalini is correct on one account: Gliadin is not entirely new–it’s the forms of gliadin (the amino acid sequences) that are new. But we should not be surprised at his ignorance of this well-documented fact, as he would only know this if he were to read the agricultural genetics research and/or talk to agricultural geneticists. The gliadins of 2012 are NOT the gliadins of 1960, nor are they the gliadins of the 19th century, the Bible, or of pre-Biblical times.

2) Shall we ignore the opiate effects of the new gliadin proteins that stimulate appetite to consume 440 more calories per day? This has nothing to do with celiac disease nor gluten sensitivity. It just makes us eat and eat and eat, makes us hungry much of the day, and makes a major contribution to the diabetes and obesity epidemic. The very same new and unique gliadin proteins also cause behavioral outbursts in children with ADHD and autism, paranoia in schizophrenics, mania in bipolar illness, and food obsessions in people with susceptibilty to bulimia, anorexia, and binge eating. None of these people have celiac disease. Exposing his ignorance, Dr. Guandalini claims that only one study documented this effect 30 years ago. He must have missed the other several hundred studies, the very same studies that have explored the area of opiate/opioid brain receptors that has culminated in an FDA application for naltrexone, the opiate-blocking drug, for a weight loss and appetite-reducing indication.
 
3) How about the direct intestinal destruction wrought by the lectin protein in wheat, wheat germ agglutinin? Unlike the indirect immunologic activation triggered by gluten, wheat germ agglutinin directly damages the intestinal lining. That’s why experimental animals fed purified wheat germ agglutinin develop extensive destruction of the lining of the small intestine. And what about the Trojan horse effect of wheat germ agglutinin that allows foreign substances to gain entry to the bloodstream, likely underlying the activation of immunologic and inflammatory diseases like lupus, rheumatoid arthritis, polymyositis, polymyalgia rheumatica, and Sjogren’s disease? None of these people have celiac disease.

4) And what about the high glycemic index of wheat products that explain why two slices of whole wheat bread raise blood sugar higher than 6 teaspoons of table sugar? High blood sugar is followed by high blood insulin, the cascade that leads to insulin resistance, visceral fat accumulation, inflammation, and diabetes–no celiac disease required!

5) Shall we ignore the explosion in wheat allergies in children, likely due to the unique alpha amylase inhibitors of modern semi-dwarf wheat? These kids get rashes, diarrhea, asthma and other allergic phenomena–none have celiac disease.

In other words, I’m sure Dr. Guandalini is a very nice guy and means well. (“Protecting his patients”? Don’t know what the heck he’s getting at there.) But I fear he has blinders on and has fallen for the nonsense that whole grains like wheat are good for you and only pose a problem to people with celiac disease or gluten sensitivity.

Nope, sorry. Get your nose out of the gastroenterology books and open your eyes to the changes introduced into the entire plant. You will find that celiac disease and gluten sensitivity are only a small part of the problem. I am sure he is doing a capable job in “protecting his patients” from gluten. But I am talking to the other 90% of the population that he chooses to ignore and consign to a lifetime of wheat consumption.

Want wisdom on wheat? Don’t ask a celiac expert, because he will likely tell you to eat it. Wheat elimination is not only for the gluten-sensitive. Wheat elimination is for EVERYONE.
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Read the complete article here.

Triglycerides: Mother of Meddlesome Particles - Davis

Triglycerides: Mother of Meddlesome Particles



Triglycerides are a crucial risk factor for coronary plaque growth, even at levels previously thought to be normal. Dr. Davis discusses why and how this oft-neglected factor can be harnessed to strengthen your program.

While the world obsesses over cholesterol, a potent stimulator of plaque growth is frequently ignored—triglycerides. A subject of controversy in past, the data are now clear: triglycerides spawn unwanted lipoprotein particles that trigger plaque growth. Track Your Plaque members are advised that control of triglycerides is essential to everyone’s plaque control program.

Triglyceride control is crucial if you are interested in gaining control over coronary plaque. Triglycerides should be brought under control at the start of your program. If you are experiencing plaque growth (increasing heart scan scores), seriously reining in triglycerides should be considered.

How important are triglycerides?

 

For years, the relationship between coronary heart disease and triglycerides remained muddled by the confounding effects of low HDL. In other words, increased triglycerides tend to occur alongside low HDL. This caused many to dismiss the importance of triglycerides. To make matters even murkier, high triglycerides in some situations generated high risk for heart disease, while in others it appeared unrelated to heart disease, even when markedly elevated (in the thousands!).

Thanks to the evolving science of lipoproteins, the issues are crystallizing. One important fact has emerged: triglycerides are a critical risk factor for coronary plaque growth, even at levels previously thought to be normal. Yes, high triglycerides frequently occur with low HDL, but they also behave independently. High triglycerides are a common cause of heart disease, even in people with low or normal cholesterol values. It is crucial that you (and your doctor) pay close attention to triglycerides if you are to succeed in controlling your plaque. We urge Members to make triglyceride control a priority in their program.

 

Where do triglycerides come from?

 

The liver produces a particle called “very low-density lipoprotein”, or VLDL, packed full of triglycerides. The higher your triglycerides, the more VLDL you will have. Sometimes triglycerides are increased due to genetic factors. More commonly, triglycerides are high due to excess weight, indulging in processed carbohydrates, and resistance to insulin (metabolic syndrome).

VLDL is like that bad kid on the block you want your kids to avoid. VLDL particles in the blood come into contact with LDL and HDL particles and they’re never quite the same. When a LDL or HDL particle meet VLDL, the triglycerides of VLDL are passed on. The result: LDL and HDL become bloated with triglycerides. Triglyceride-loaded LDL and HDL are a ready target for a set of enzymes in the blood and liver that reconfigure these particles into smaller versions, small LDL and small HDL. Recall that both small LDL and HDL are highly undesirable particles that stimulate plaque growth.

Although “official” (ATP-III) guidelines suggest that triglycerides over 150 mg are undesirable, we regard any value over 60 mg as high. An ideal level for an intensive Track Your Plaque approach is <45 font="font" mg.="mg.">

 

How will I know if I have this pattern?

 

On a conventional cholesterol panel, increased triglycerides and low HDL are tip-offs that excess VLDL are available to contribute to coronary plaque growth. At what triglyceride level does this cascade begin to take effect and create this collection of particles? Levels of 45 mg/dl or greater. In the Track Your Plaque program, we aim for zero plaque growth or reduction, and so we target triglyceride levels of 60 mg/dl or less.

You’ll notice that low HDL and increased triglycerides are also patterns that characterize the metabolic syndrome. In our experience, over 50% of adults show at least some of the characteristics of the metabolic syndrome. In our society of inactive, sedentary lifestyles and packaged, processed foods, metabolic syndrome is rampant. That means increased triglycerides from VLDL are also running rampant. The result: a 3 to 7-fold increase in risk for heart attack. Eliminating the metabolic syndrome is another battle we need to fight to conquer plaque. (See Shutting Off the Metabolic Syndrome.)

 

How can triglycerides be reduced?

 

Our triglyceride target of 60 mg or less dramatically reduces triglyceride availability. Without triglycerides, LDL and HDL can’t be processed into undesirable small particles. Among the strategies we use to reach our triglyceride target of 60 mg or less:

• Fish oil—The omega-3 fatty acids in fish oil are our number one choice for substantially reducing triglycerides. Fish oil, 4000 mg per day, is a good starting dose (providing 1200 mg EPA+DHA); higher doses should be discussed with your physician, though we commonly use 6000–10,000 mg per day without ill-effect. Flaxseed oil, while beneficial for health, does not correct lipoprotein patterns. Consider a concentrated fish oil preparation (e.g., Omacor™, a prescription preparation, or “pharmaceutical grade” preparations from the health food store) if you and your doctor decide a high dose is necessary.
• Weight loss to ideal weight or ideal BMI (25). If achieved with a reduction in processed carbohydrates, the effect will be especially significant. Exercise will compound the benefits of weight loss, triggering an even larger drop in triglycerides.
• Reduction in processed carbohydrates—especially snacks; wheat-flour containing foods like breads, pasta, pretzels, chips, bagels, and breakfast cereals; white and brown rice; white potatoes. The reduction of high- and moderate-glycemic index foods is the factor that reduces triglycerides. High triglycerides are therefore a pattern that develops when someone follows a low-fat diet. For this reason, we do not advocate low-fat diets like the Ornish program. Reducing your exposure to wheat-containing snacks and processed foods is an especially useful and easy-to-remember strategy that dramatically reduces triglycerides.
• Elimination of high-fructose corn syrup—This ubiquitous sweetener is found in everything from beer to bread. High-fructose corn syrup causes triglycerides to skyrocket 30% or more.
• Niacin in doses of 500–1500 mg is an effective method of reducing triglycerides. Niacin also raises HDL, increases large HDL, reduces the number of small LDL particles, reduces VLDL, and modestly reduces total LDL. The preferred forms are over-the-counter Slo-Niacin® and prescription Niaspan®, the safest and best tolerated. Immediate-release niacin (just called niacin or nicotinic acid on the label) can also be taken safely, provided it is taken no more frequently than twice per day. Total daily doses of >500 mg should only be taken under medical supervision. Avoid nicotinamide and “no-flush niacin” (inositol hexaniacinate), neither of which have any effect whatsoever.
• Green tea—The catechins (flavonoids) in green tea can reduce triglycerides by 20%. Approximately 600–700 mg of green tea catechins are required for this effect, the equivalent of 6–12 servings of brewed tea. (Tea varies widely in catechin content.) Nutritional supplements are also available that provide green tea catechins at this dose. The weight loss accelerating effect of green tea may add to its triglyceride-reducing power.
• The thiazolidinediones (Actos®, or pioglitazone, and Avandia®, or rosiglitazone), usually prescribed for pre-diabetes or diabetes, can reduce triglycerides by 30%; Actos may be more effective than Avandia in this regard. However, these agents are accompanied by weight gain.
• The fibrate class of prescription drugs (fenofibrate, or Tricor®, and gemfibrozil®, or Lopid) reduce triglycerides 30–40%, i.e., almost as effectively as fish oil.

The evil influences of VLDL and triglycerides are therefore erased from your risk profile by achieving the Track Your Plaque target of triglycerides 60 mg/dl or less. One or more of these strategies are usually required to bring your triglycerides to target. 

        William Davis, MD


Selected references:

Packard CJ. Understanding coronary heart disease as a consequence of defective regulation of apolipoprotein B metabolism. Curr Opin Lipidol 1999; 10:237–244.

Otvos J. Measurement of triglyceride-rich lipoproteins by nuclear magnetic resonance spectroscopy Clin Cardiol 1999;22 (Suppl II) II-21–II-27.

Grundy SM. Hypertriglyceridemia, atherogenic dyslipidemia, and the metabolic syndrome. Am J Cardiol 1998;81(4A):18B–25B.

Zilversmit DB. Atherogenic nature of triglycerides, postprandial lipidemia, and triglyceride-rich remnant lipoproteins. Clin Chem 1995;41(1):153–158.

The David Korech of Medicine?

Tom Naughton's critical review of a critical review that must have been so off base, mis-leading, false etc. that the powers that be have removed it from the shelves.

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The Long Knives Are Out For ‘Wheat Belly’

from Fat Head by Tom Naughton

Look as if the grain-industry people have been trolling the internet attempting to trash Wheat Belly, the outstanding new book by Dr. William Davis. How else do you explain an Amazon review written under the title The David Korech of Medicine. Notice that the review doesn’t dispute any of the facts or science presented in Wheat Belly:
The author has no credentials, no credibility, just a small cult of terriby misinformed followers. Don’t be fooled by the high volume screech against wheat and grains.
I have to admit, it didn’t occur to me when I recommended Wheat Belly that Dr. Davis has no credentials. I assumed being a doctor who’s seen the benefits of a wheat-free diet in thousands of his own patients counted for something. I also figured that after poring over hundreds of studies on wheat’s health effects and thoroughly researching the history and genetic structure of wheat, Dr. Davis was qualified to write on the topic.
Allegations of “secret ingredients in wheat” to make you eat more, or comparisons to cigerettes. Seriously?!
Apparently the wheat lobby doesn’t require its job applicants to pass a spelling test. Are cigerettes similar to cigarettes?
Dr. Davis never claimed there are secret ingredients in wheat. He didn’t (as far as I know) don a Ninja costume or disguise himself as a plumber and break into the headquarters of Wheat , Inc. to pilfer documents. He simply described, based on published documents, how wheat has been modified during the past 50 years.
For over 8000 years wheat has sustained and grown human kind …
Eight-thousand years ago, humans (some of them, anyway) consumed Einkorn wheat. The main similarity between Einkorn wheat and today’s mutant wheat is they’re both called “wheat.” We also call both Thomas Jefferson and Adolph Hitler “humans,” but they produced rather different effects on other humans. What we ate 8,000 years ago has nothing to with the health consequences of eating a highly modified variety of wheat that’s only been around for the past 50 years.
And wheat didn’t “grow” humankind. Wheat shrunk humankind.

… oh and it tastes good when mixed with a little water and yeast.
That explains why nearly every brand of bread includes high fructose corn syrup high on the list of ingredients.
Every nutritionist and serious medical professional will tell you that bread is the most economical and safe source of essential nutrients.

Every one, seriously? That’s odd … I seem to recall a lot of conversations and interviews with nutritionists and medical professionals who agree wholeheartedly with Dr. Davis — who, despite having a good sense of humor, is a serious medical professional. So serious that he wrote a book about wheat.

In fact, bread is handed out in natural disasters because it sustains life without food safety issues or requiring refrigeration.

Tell ya what: if I’m ever starving because a tornado wiped out all the refrigerators within a 50-mile radius, I’ll eat some of the bread FEMA hands out. But the fact that bread doesn’t require refrigeration doesn’t in any way prove it’s good for us. Coca-Cola and heroin don’t require refrigeration either.
And now, suddenly it will kill you. Comical!
No, today’s mutant wheat doesn’t kill you suddenly. It’s more like slow torture.
This book is such a bone headed, misinformed way to just scare people into not eating.
Now wait a minute, Buster! Dr. Davis is 100% in favor of people eating. He just doesn’t want them eating a mutant grain product that will make them fat and sick.
As for secret ingredients, humm, apparently the author is ignorant of the food laws that regulate everything that goes into food and on food labels. Unlike some enforcement agencies, the FDA has some serious teeth behind its enforcement.
Well, that certainly negates all the studies demonstrating the negative effects of wheat that Dr. Davis cited in Wheat Belly. If the USDA and FDA are on the beat, mutant wheat (which is heavily subsidized by the same government that funds the USDA and FDA) simply has to be safe. That’s why they conducted all those tests on the stuff to make sure it wouldn’t cause any … no, wait a minute. Nobody ever conducted tests on mutant wheat to see if it’s fit for human consumption. Okay then, we’ll just have faith the USDA and FDA can tell if a food product is safe by looking at it. That works for me.
As for frankenwheat, again seriously?! Wheat, due to its ubiquitous presence in the world is treated as sacrosant from any GMO research or development.
I see. So when wheat went from being a wispy plant that couldn’t be harvested until it was five feet tall to a short, stubby little plant that’s harvested when it’s two feet tall — all in just the past 50 years – that was a natural mutation, was it? Boy, evolution works really, really fast. I wonder what all those plant geneticists on the Monsanto payroll are doing all day. They’re probably just sitting around, playing poker and thinking, “Geez, I wish they’d let us develop some kind of hybridized new seeds that the company could patent and then force farmers to buy by threatening to sue them if some of those seeds blow onto their farms and start growing even if the farmers didn’t want the seeds in the first place.”
If you need real, science based information on healthy eating, check out [...] and leave this book and its cult in the compound.
I’ll try to read [...], but when I searched for […] on Amazon, all that came up was a kids’ book titled “Dot and Dash play Dot-Dot-Dot.”
I was hoping the grain lobby wouldn’t find out about our cult. For those of you who haven’t been recruited yet, we have a secret handshake that requires a lot of flexibility in the fingers — that keeps out the grain-lobby infiltrators who are suffering from wheat-induced arthritis. At our meetings, Dr. Davis sacrifices a goat and then we all spend hours enjoying ritual dancing around a bonfire on our pain-free legs. Sometimes we even dance naked. It’s not a sexual thing, you understand … we just like showing off our rash-free skins.
I’m sure this campaign by the grain industry will succeed. Any day now, Dr. Davis will have a conversation with a patient something like this:
“So how do feel after being wheat-free for the past two months?”
“Well, Dr. Davis, I lost 25 pounds, my psoriasis cleared up, my arthritis went away, I’m sleeping better, I’m not depressed anymore, I think more clearly, and I stopped wheezing.”
“Excellent! So you’ll continue avoiding wheat?”
“Of course not.”
“But—“
“Wheat has sustaining humans for 8,000 years, Dr. Davis, so it has to be good for us. Besides, I don’t want to end up spending all day the airport banging on a tambourine and selling flowers to passengers.”
“But I never asked you to– why are you sticking your fingers in your ears?”
“What?”
“I said, WHY ARE YOU STICKING YOUR FINGERS IN YOUR EARS?”
“My de-programmers told me not to listen to you.”

Dr. Michael R. Eades endorses Wheat Belly

"Wheat Belly hit the New York Times Bestseller list shortly after it came out (and has been there for two weeks now), which I can tell you from experience, is not an easy thing to do. As a result (because being on the NY Times list means a book has had big sales numbers), the wheat producers have not taken their hits lying down. They’re fighting back with full venom, because a book like this one can do them serious economic damage."

Read Dr. Michael R. Eades complete review here.

Statins and the Cholesterol Hypothesis – Part I

Not a newly discovered article, rather one in my 'to be read' pile that I finally got to, but here it is in full (it was too hard to select just an exerpt). From Kurt G. Harris MD at his PāNu blog. There is a lot on his site I need to read.

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Statins and the Cholesterol Hypothesis – Part I


Wednesday, July 21, 2010 at 10:31AM

Reader Stephen is a young man I have corresponded with a few times on the subject of his diagnosis of FH (heterozygous Familial Hypercholesterolemia) and what he should do about it. His TC runs about 467 mg/dl and his LDL about 333 mg/dl. He has a CAC (calcium score) of 16, which is very high for a 24 year old man. This would be at about the 50th percentile for a 50 year old male on the SAD.

Stephen has of course given me permission to discuss his case here.

This is his most recent email to me:

Hi Dr. Harris,

It's been awhile since I last emailed you about any recent information regarding my heart scan. I also forgot to thank you for your last response and really appreciate the help you've given me. I recently had more lab work done and I am waiting to hear back for the results, although not much has changed since our last correspondence. However, now that I'm back in Dallas for my summer break I was able to get a proper heart scan at the Cooper Clinic. My CAC score was 16. I attended the Metabolism Society Symposium conference in Seattle a few months back and spoke with Jimmy Moore and a few others about my situation and they recommended I send Dr. Davis an email to get his advice on the matter. I recently heard back from him telling me basically that he strongly believes I go on statins while maintaining my current diet. Jimmy asked me to keep him posted about Dr. Davis' recommendations, so I emailed him, and he is now interested in posting a blog about it and asking others for suggestions since he is strongly against statin use. Anyways, I just wanted to update you, since you mentioned an interest in eventually making a post about this as well. If you're interested in having a look at the scan I can send another copy over to you as well as the results of the NMR profile I drew blood for a few days ago. If not, I completely understand as well, you have a lot on your plate as is. Let me know what you'd prefer and I'll do whatever works best for you. I look forward to hearing back from you.

Thanks again,

Stephen U.

By now you already know that I personally would avoid statins under any circumstances as they only work at all on heart attack risk via their effects on inflammation. Taking a sledgehammer to the entire cholesterol machinery has all kinds of negative knock-on effects, including promotion of cancer and interference with muscle and liver function, in addition to the accidental side benefit of reducing inflammation. It’s a crude approach, it has side effects that make all cause mortality over long periods of time likely to be worse, and the only group with any demonstrated benefit is men with established disease. The vast majority of those taking statins have no scientific basis for taking them. The rest, including those who have had an MI already, could likely accomplish far greater improvements in health with non-drug dietary measures like improved glucoregulatory control, and avoidance of the Neolithic agents of disease.

Let me summarize what we know about statins

1) A few older trials show an all-cause mortality benefit to statins in secondary prevention IN MEN (not women). The relative risk reduction is at most about 30% and the maximum absolute risk reduction is about 1% per year. (This means you still have about 70% of the relative risk of dying you had before the drug. Is it possible dietary changes could decrease your risk more substantially? I think so.) Secondary prevention means you have already had a heart attack or been proven to have coronary artery disease (CAD). If you only have high TC or LDL, this does not include you, and this does not include the majority of those now taking statins.

2) Other trials, especially more recent ones, are less likely to show a benefit, even in secondary prevention

3) For primary prevention, there is no demonstrated mortality benefit to taking statins.

4) When there are decreased deaths from cardiac events in primary prevention, there are more deaths by other causes. You may well be trading your heart attack for cancer. Because of the long lead time for cancer deaths, there are good theoretical reasons to believe that over periods of time - much longer than a few years (the length of the typical drug trial) all cause mortality could easily be higher when taking a statin for primary prevention.

5) When statins do work, they work by accident via their effects on inflammation. The side effects may be related to the lowering of LDL, but the benefits are not. Trials have failed to show the linear relationship between LDL lowering and cardiac end-points that one would expect if the effect were due to the LDL level.

I do not believe in any of the versions of the lipid hypothesis, ranging from Ancel Keys' original idea that cholesterol or dietary fat clogs the arteries, to the currently fashionable one that “small, dense” LDL particles are like microscopic rodents that are designed to burrow under the intima of your blood vessels and kill you.

Neither cholesterol nor any of the lipoproteins nor LP(a) is a "cause" of CAD (coronary artery disease). There is no evidence that “fixing” these numbers is of benefit other than by accident and there is plenty of evidence that you can kill people by trying to do so.

HDL, particle numbers, particle sizes, LP(a) are all parameters that are more or less associated with CAD. If they respond positively to changes in diet, then they are just covariant with decreased risk of CAD or MI due to the changes you made in your diet. They are not necessarily, and not usually the direct mediators of the decreased risk.

They may track the positive changes you make in your diet, but they are not causing heart attacks any more than shoe size causes height!

You cannot decrease your stature by amputating your toes. Believing any of the lipid hypotheses or the cholesterol hypothesis is the intellectual equivalent of amputating toes to decrease height because shoe size causes stature.

Correlation is not causation. Causation can cause a correlation to occur, but proof of correlation is not sufficient to prove causation. None of the lipid hypotheses are biologically plausible, and all have failed to be proven despite decades of research and billions in expenditure.

Say you observe that the neighborhoods that have the most numbers of police on patrol have more crime. A neighborhood in downtown Milwaukee has more than 8 times the per capita police presence than in Sturgeon Bay 120 miles to the north. The crime rate in downtown Milwaukee is also more than an order of magnitude higher. Say the calculated correlation coefficient is .85 – with 0 being no correlation and 1.0 perfect correlation. Is it reasonable to propose we reduce the number of police in Milwaukee in order to effect a lower crime rate? There is a very high (and statistically significant) correlation, but if we think of mechanisms, and how police presence relates to crime, we would probably think that the police are there in response to the crime and are not likely causing it. We might go a step further and say that it might be dangerous to reduce the number of police, as for all we know the city has put them there for good reason, and the crime differential between our two towns might become even greater without them.

In the same way, although high HDL indeed correlates with lower risk of MI (heart attack or myocardial infarction) and CAD (coronary artery disease), when we understand the biology of HDL production, we might be wary of approaches that attempt to increase HDL as if HDL is the agent protecting your heart. It might well matter how we alter HDL. It might be that HDL is high in response to whatever lowers heart attack risk.

It might be (In fact I think it is) that a diet high in saturated fat protects against atherosclerosis and also affects the numerical value of HDL (most of you know it does because you see it happen to you), such that the association of HDL and lower MI risk is because they are caused by the same thing (diet) instead of because one “causes” the other.

Consider the particle du jour of LP(a). Measured Lipoprotein (a) has a correlation with MI risk. It’s not really that high as a risk factor (not even remotely close to glycated hemoglobin or calcium score), but there is a positive correlation. In an individual human, Lipoprotein (a) could be high as an adaptive response to having lots of oxidized LDL and thereby may indicate you have an atherogenic diet, like the crime ridden neighborhood that has a substantial police presence. Or you could be just born with high levels of LP (a). In the same way a somewhat paranoid and wealthy community has lots of policemen on patrol even though the crime rate is low, you might have patrol cars of LP (a) cruising around even though you do not have intimal damage occurring.

Sidenote: I admit I have a bias towards this interpretation. My Lp(a) level is 85 yet my CIMT* measurement would be normal for someone 15 years younger and my CAC score is zero. Lp(a) levels can be highly heritable, and longevity and freedom from atherosclerosis runs in my family. As Peter would say, some of us may just be born with more sticking plasters, and some of us make more sticking plasters because we have more damage. It should be noted that the best way to decrease LP (a) is increasing saturated fat intake, but also that although there is positive correlation of LP(a) with disease on a population level, there is not yet a shred of evidence that any intervention to modify your LP(a) level modifies your risk.

The point is that just by observing more police patrols or more Lp(a), even in the context of a true correlation between crime and police and Lp(a) and MI, you cannot necessarily tell why the police are there or why the Lp(a) is elevated. More importantly, the idea that reducing the number of police will reduce crime or that pharmacologically altering Lp(a) will reduce risk may be not only false, but dangerously false. Some neighborhoods need their police, and some humans may need their Lp(a), just like some humans may have more heart attacks when we “help” them by pharmacologically jacking up their HDL.

This is in fact precisely the story of torcetrapib. This drug cost Pfizer over 800 million dollars to develop. Torcetrapib is an inhibitor of CETP - cholesterol ester transfer protein. CETP facilitates the transfer of cholesterol from HLD to VLDL or LDL. Now, if you believe version 3.0 of the lipid hypothesis, there are these things called “good” and “bad” cholesterol. This is cardiologist shorthand for lipoprotein-cholesterol complexes that cause or prevent heart disease. HDL is the good one and we want it to be high, so it can hoover up the cholesterol from arterial plaque (a ridiculous idea that as Malcolm Kendrick pointed out defies physical chemistry – Ornish’s “garbage trucks”) and shrink them. LDL is the bad one and we want it to be low, as it is constantly fighting to transport cholesterol to the arterial plaque.

Cardiologists and Pfizer actually believe that LDL is trying to kill you and HDL is trying to save you at the same time. They figured, why not throw our pharmacological weight into the fight? If we inhibit CETP, the level of HDL will rise, and the level of LDL will fall. They actually combined torcetrapib with an extant statin (atorvastatin or Lipitor) to really, really get the LDL down as well as the HDL up.

So how did it work? Well, it worked spectacularly. HDL levels soared and LDL levels went down. I mean, we are talking HDL to LDL ratios that epidemiologists and cardiologists would say should reduce the risk of heart attack to zero. There was a glitch, though. Although the HDL and LDL went exactly the way they wanted, the risk of death in the group that got the torcetrapib was 60% higher. The trial was halted early.

Sidenote: We could belabor the police metaphor by saying pharmacologic elevation of HDL with torcetrapib was a bit like recruiting Alex’s droogs into the police in “Clockwork Orange”. The crime rate would go up with more police recruited from among those who are themselves criminals.

So do you think it is plausible that LDL causes heart disease and HDL saves us from it? Or is it more likely that these laboratory numbers are merely epiphenomena to the real primary process?

Is it really plausible that our bodies evolved to simultaneously create two substances that are like some perverse yin and yang, with good HDL trying to save us from the LDL that is furiously trying to clog our arteries with cholesterol?

Or is this all a bunch of biologically implausible nonsense?

Taking all the evidence in its totality, I’ve see no compelling use for statins for anyone if they have truly optimized their diet, and very little even if they haven’t. The benefits of statins are unrelated to their effects on “cholesterol” or lipoprotein levels, are small and are accidental.

The risk/benefit ratio and effect size of dietary modifications are likely to be superior to any of the current statin drugs.

I do believe there are dietary ways that we can minimize the risk of atherosclerosis and other inflammatory processes, minimize the risk of acute plaque rupture and thrombosis if we do have atherosclerosis, and minimize the risk of a fatal arrhythmia if these upstream steps fail

I don’t believe once you have taken these steps, that pharmacology targeted to “cholesterol” or lipoproteins has anything to add.

I suggest:

1) Avoidance of excess PUFA in the diet that leads to oxidized LDL and possible endothelial damage
2) Avoidance of all the causes of leaky gut that may lead to the suite of inflammatory processes known as the metabolic syndrome – avoid excess PUFA (esp. linoleic acid), wheat, and fructose
3) Plenty of saturated fat intake
4) If your glucoregulation is impaired, reduce carbohydrate consumption to whatever is necessary to minimize glycation and endothelial damage. Minimize glycated hemoglobin (Hemoglobin A1c) to the degree possible
5) Replacement of essential micronutrients that may be deficient on the SAD. Magnesium, sunshine, pastured butter for Vit K2.

Those are my general recommendations for everyone.

So what if you have FH? Are the recommendations different?

More discussion in the next post.

*CIMT is carotid intima/media thickness - easily measured noninvasively with ultrasound and a more sensitive measure of early atherosclerosis than CAC (calcium score) in men under 40 and women under 50

The five most powerful heart disease prevention strategies

Here is a summary of the strategy from Dr Davis's blog.
Please read his complete article here.
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The five most powerful heart disease prevention strategies
from Heart Scan Blog by Dr. William Davis


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
2) Achieve a desirable 25-hydroxy vitamin D level
3) Supplement omega-3 fatty acids from fish
4) Normalize thyroid function
5) Make exercise fun
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.

Fructose is a stealth poison

From the blog of Dr. William R. Davis
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Restaurant eating: A fructose landmine from Heart Scan Blog by Dr. William Davis


3 people liked thisThere is no remaining question that fructose is among the worst possible things humans can consume.
Followers of the Heart Scan Blog already know this, from conversations like The LDL-Fructose Disconnect, Where do you find fructose?, and Goodbye, fructose.

But fructose, usually as either high-fructose corn syrup (44%, 55%, occasionally higher percentage fructose) or sucrose (50% fructose), is ubiquitous. I've seen it in the most improbable places, including cole slaw, mustard, and dill pickles.

It's reasonably straightforward to avoid or minimize fructose exposure while eating at home, provided you check labels and focus on foods that don't require labels (like green peppers, salmon, and olive oil, i.e., unprocessed foods). But when you choose to eat at a restaurant, then all hell can break loose and fructose exposure can explode.

So what are some common and unsuspected fructose sources when eating at a restaurant?

Salad dressings--Dressings in all stripes and flavors are now made with high-fructose corn syrup and/or sucrose. This is especially true of low-fat, non-fat, or "lite" dressings, meaning oils have been replaced by high-fructose corn syrup. It can also be true of traditional non-low-fat dressings, too, since high-fructose corn syrup is just plain cheap.

Olive oil and vinegar are still your safest bets. I will often use salsa as a dressing, which works well.
Sauces and gravies--Not only can sauces be thickened with cornstarch, many pre-mixed sauces are also made with high-fructose corn syrup or sweetened with sucrose. Barbecue sauce is a particular landmine, since it is now a rare barbecue sauce not made with high-fructose corn syrup as the first or second ingredient. Sauces for dipping are nearly always high-fructose corn syrup-based.
Ketchup--Yup. Good old ketchup even is now made with high-fructose corn syrup. In fact, you should be suspicious of any condiment.
Highball, Bloody Mary, Margarita, Daiquiri, beer--Even the before-dinner or dinner drink can have plenty of fructose, particularly if a mix is used to make it. While Blood Marys seem the most benign of all, adorned with celery, pickle, and olive, just take a look at the ingredient label on the mix used: high-fructose corn syrup.
Fructose is a stealth poison: It doesn't immediately increase blood sugar; it doesn't trigger any perceptible effect like increased energy or sleepiness. But it is responsible for an incredible amount of the health struggles in the U.S., from obesity, to diabetes, to hyperlipidemias and heart disease, to arthritis, to cataracts.

Preventing and Reversing Heart Disease, Part Three

A Man with Progressive Coronary Artery Disease Unresponsive to Statins  by Jeffrey Dach MD

62 year old Jim came to see me after his third cardiac stent in 10 years. About a year ago, Jim noticed a "tight feeling" in his chest radiating to his throat, was rushed to the ER, and doctors found he was having a heart attack. A coronary angiogram showed extensive coronary artery disease with irregular plaque formation virtually everywhere in his arteries. For the past 10 years, Jim had been under the care of top cardiologists who prescribed a statin cholesterol drug, and Jim's cholesterol was kept below 140 all this time. Jim's heart disease progressed relentlessly in spite of the low total cholesterol numbers clearly showing another cause at work here. It's obviously not the total cholesterol.
,,,
Our Approach


I must preface these remarks with our approach to prevention and reversal of heart disease which is outlined in Part One and Part Two of this series. We credit and rely heavily on the "Track Your Plaque Program " by William Davis MD.
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Read the full article here.

I was so interested in this article because it had many similarities to my own situation. Please read all articles in Dr. Dach's series. Part 1, Part 2, Part 3.