Category Archives: 10. Reversing Heart Disease

Calcium Heart CT Scoring Can Improve your Statin Decision Making

Heart Calcium Scoring and Statin Use

Reference: New York Times, Journal of the American College of Cardiology Oct 2015

The use of statins for reduction of risk in coronary artery disease is controversial, in part because of the appearance of commercial conflict of interest.   It is BIG business in BIG medicine. And lots of folks have pretty horrible side effects.   And you have to treat 1000 people to prevent 7 heart attacks a year, for which you have one death.   Hmmm.   Math seems to be a bit dubious at times.   And your doctor is graded and paid “quality assurance” bonuses based on the percentage of patients in his or her practice that are taking statins when they meet guidelines.   It is all well intentioned, as a method of promoting quality, but it results in a certain intensity of persuasion and coercion when you say you don’t like the side effects.

With all that emotion and coercion, is there a better tool that might refine the ability to make a decision?   What would happen if you could get an additional risk scoring procedure done for $ 99 that showed you didn’t need to be on a statin? Wouldn’t that be handy?

That’s what this study asked.  The MESA study is 6,814 multiethnic folks between 45 and 84 without evidence of coronary artery disease who were whittled down to a pure group of 4,758 folks without confounding items like missing data, or complete lack of lousy LDLs, etc.   They were followed for 10.3 years and observed for the development of coronary artery disease events.   The new cholesterol/statin guidelines were applied to this group, of whom 2,377 qualified to be on them.   The majority of them (77%)qualified because according to the ACC risk calculation tables, they had a greater than 7.5% risk of having a heart attack/event over 10 years.   Was that really their risk?   From that group who were supposedly meant to be on statins, 41% had a calcium score on CT scan of “0”. That was ZERO.   No calcium in their arteries.     They did have heart attacks.   Yes, they did. At a rate of 1.5% per 1,000 years. Pretty small.   More than lightning, or shark attacks.  But not enough to take on the risk of statins.     And not at the 7.5% rate that is the acknowledged rate for being enough risk for taking a statin.

What are the risks of taking statins? Well, Mayo’s opinion is measured and valid. At the other end is Dr. Mercola, who would be less measured, but possibly more honest because he’s not in the system and there by maybe speaks a bit more honestly, albeit off the walls.   Or just read the FDA’s concerns.

What does the CT scan find?   Well, it can add up the calcium in plaque in your arteries and actually find calcium that is in the wall of the arteries rather than just bulging out. It takes years for calcium to build up, so it is old plaque. Recent new, raw dangerous plaque is not seen on calcium scanning. It get missed. And the CT does find all sorts of other tidbits, like lung nodules that you don’t know what to do with. But on balance, it’s information.

WWW. What will work for me. I’m dancing a jig. I’m thrilled. I’ve been doing this for four years and I now have literature support that what I’m doing makes sense. Now, if you have risk, you want to know how to turn it off.   That’s were it gets really interesting.   The fine art of getting rid of LDL’s actually isn’t that hard. I can show you how in about a month. And then there is TNF-α, CRP, sdLDL, HDLs and other blood cytokine and risk factors that can show you how to improve your score and get out of risk, without the statins. If you are interested, start by not eating sugar and white flour, and come let me show you how. I’ve been on vacation for a week here in Italy. The gelato has been wonderful. I’m going to measure my HDLs when I get home. I think I just accumulated a bit of risk. Stay tuned.   I’m back in the saddle.



Pop Quiz

  1. You can measure your risk of heart attack by an inexpensive CT scan of your heart that measures your calcium load? T or F

That’s it.

  1. If your score is zero you have a greater than 10 % risk of having a heart attack in 10 years. T or F

Are you kidding? You didn’t read the column. Go back. Read it again. Score of zero means your have a 1.5% chance in 1,000 years. That’s low.

  1. Current ACC guidelines say it is worthwhile to treat you is your risk is greater than 7.5% chance in 1,000 years.


  1. About 50% of people who currently meet the current guidelines for statins have a calcium score of zero.   T or F

True. (Makes you feel pretty confident in those guidelines, doesn’t it)

  1. You get some radiation from a CT scan of your chest.

Also true. But in the world of risk benefit, I’ll take that risk over taking statins for 1,000 years.




The Devil in Milk: The A1 Casein vs A2 Conundrum

The Devil In Milk: the A1 vs A2 Protein Story

Sept 21, 2015

Reference: The Devil in Milk by Keith Woodford Diabetologia Elliott

Did you know that there are several forms of milk? The protein casein is not the same in every cow. Most European cows have what is called A1 casein. Most Asian cows have A2 casein. Casein is about 30% of the protein in human milk, but 80% in cows’ milk. At position 67, A1 milk has a histidine amino acid, A2 has a proline amino acid.   Beta-casomorphine-7 (BCM-7) is a 7 amino acid peptide that is released when you eat A1 milk, but not when you eat A2 milk.   BCM-7 is a morphine type chemical that can be blocked by naloxone.

Now, there is all sorts of interesting epidemiology around milk. For example, you can show that populations that drink more A1 milk have more insulin dependent diabetes in them in children, and more heart disease in adults. You can also find that Samoan children, raised in Samoa don’t get insulin dependent diabetes, but raised in New Zealand, they do. If you take mice that are genetically sensitized to getting diabetes, and feed them either A1 or A2 milk, you can show that 47% of the mice fed A1 milk got insulin dependent diabetes, but non of the A2 fed mice did. And if you feed them A1 milk, but block BCM-7 with naloxone, they still don’t get the diabetes they otherwise would have developed.

Now, this is where this topic goes down a “rabbit hole” of controversy. Most of the big dairy money in the world that trades milk internationally, uses A1 milk. That means they are in deep trouble if this data is true. A1 milk might be dangerous for you. The dairy trade would collapse. That would mean it would be in “big milk’s” best interest to deny, degrade, denigrate, obfuscate and attack anything they can about this issue. And they have. It is possible to change over a dairy herd from A1 to A2, but it takes about 10 years of time to breed new cows and get the genes into them with proper breeding.   It can be done. It just takes 10 years.

And there continues to be data about the dangers of A1 milk. There was a patent application in New Zealand claiming that autism has a strong correlation to the consumption of A1 mild.   That application was made by the company denigrating the original research, and then withdrawn and never published in the medical literature. Oh, the intrigue!   So, more epidemiology: the Masai in Africa have A2 milk, and drink 7 liters a day. No heart disease. In Europe, the Finns drink only A1 milk and have lots of heart disease. The French have mostly A2 milk, and have half the heart disease. On and on…

What’s happening in Wisconsin?   There are some herds in Wisconsin that are being converted by using A2 bulls.   Some of the alternative media is beginning to run articles on it.   New Zealand seems to be leading the pack in developing an A2 herd. But there remains controversy. And some of that controversy appears to be research that proves the opposite, but was in fact, intentionally sabotaged with BCM7 protein, and should be actually takes as proof of the fact it was trying to unseat. Isn’t the intrigue a riot? Like a detective novel.

WWW.   What do I think of all this?   I believe there to be some truth to it all. Not certain how deep, but I trust passionate truth tellers more than corporate monied interests. Between Johne’s Disease in cows (paratuberculosis that I think may be the cause of Crohn’s Disease) and concerns about how proteins are altered with pasteurizing, I don’t drink much milk.   If I could find A2 milk from a single herd that was Johne’s free, I might reconsider.   I’m certainly going to think about it and pay attention to it. And likely to tell more clients to avoid milk, unless it’s A2.


Pop Quiz

  1. Our current milk supply in America is digested into a product that has morphine like qualities to it?   T or F


  1. American Milk is primarily A1 milk which is a genetic variation off the original aboriginal milk, now found in Asian and African cows, called A2 milk (even though it was the original).   T or F

True. You are now getting the gist of this article.

  1. There are epidemiological studies connecting A2 milk to heart disease and insulin dependent diabetes. T or F

False. That’s backwards, it’s A1 that is connected to those two.   And autism, and Crohns, and, and, and…

  1. You can convert a herd of cows to being A2 cows by using only an A2 bull for about 10 years.   T or F

True. And it’s happening right now in a bunch of Wisconsin herds.

  1. One little amino acid substitution at position 67 out of over 200 amino acids is all it takes to make this mystery mysterious?   T or F

True. Amazing, isn’t it. But the same can be said for Sickle Cell and many other conditions.


How Low Should You Go?

The Sprint Study: How Low Should Your Blood Pressure Be?

Sept 14, 2015

Reference: New York Times , NIH National Heart and Blood Institute Sept 2015

This is really a big deal.   I’m very relieved to hear at because it was just two years ago that a huge meta-analysis said it was no big deal to treat high blood pressure until it was 160/95.   Now we have exactly the opposite and to a remarkable degree.

This is the Sprint Study. In it, 9,300 adults from about 100 medical centers across America and Puerto Rico with high blood pressure were recruited to two arms. One group was treated to a systolic (the upper number) pressure of 140. The other was pushed down to 120 or lower.   The study was meant to be concluded in 2017 but was released this week because the preliminary findings were so robust that the authors felt it to be unethical to continue and not release their findings.   The extra effort of pushing blood pressure down to 120 or lower resulted in a 30% additional decrease in “bad things” like stroke and heart attack, and death about 25% less.   We have had about a 70% drop in stroke since the 1970s when we started to treat high blood pressure, so this should be in addition to that. This is a pretty simple study with a pretty dramatic finding, and just about every expert in the field agrees with the importance of it, and the need to implement this into clinical practice.

What’s my read on it.   Well, I can’t help but agree with it.   It makes sense. But I have a very different take on it. First of all, basic human physiology. As folks get older in indigenous societies around the world, their blood pressure drops. In America, it’s like a rite of passage that our blood pressure rises and by age 70 some 70% of us have high blood pressure.   That means it’s our environment that is askew here in America. And just what is it in America that is doing it to us? And what is high blood pressure?

Second answer first.   High blood pressure isn’t just your pressure gauge being higher. It is actually better called “Endothelial dysfunction” – which basically means the lining of your blood vessels is out of whack, and can’t relax. That results in high blood pressure. It can’t relax because of a shortage of nitric oxide, brought on by inflammation and toxins. The most notable toxin is sugar and fructose, that pushes you towards making more uric acid. Uric acid soaks of nitric oxide and with that, your blood pressure rises.   American’s eat 10% of their total calories in the form of fructose alone. (Not everyone agrees with this analysis.) Another toxin is lead.  Another is trans fats (though they are fading.).   But the biggest problem may be your waistline. Fat is inflammatory. Fat tissue is not just passive calorie storage, it is the source of potent inflammation. And that goes everywhere in your body, and annoys your blood vessels. And that contributes to high blood pressure.   Finally, carbohydrates are the final “toxin”.   They cause insulin to be secreted. Insulin tells your kidneys to hang on to salt. It’s that simple. You have shown it yourself when you go on a diet for three days and don’t eat any carbs. You lose 8 pounds.   Seven of those pounds were from the salt water you hung on to. High blood pressure is a disease of too much salt water stuffed into too small a space. The pressure has to go up. In the last 2000 years, and last 100 in particular, we have developed more and more foods that are more “glycemic” and hence, more insulin inducing.

WWW. What will work for me. This study is slightly insane. It’s advocating for treating high blood pressure more aggressively.   In the world of treatment, that is correct. But there is a better world. Prevention. And that starts with weight loss.   Prove it for yourself. Lose 10 pounds and watch your blood pressure drop. Lose 20, and watch it plummet.   The choice is ours.   Do we have the will to change our environment, and lose weight, eat less sugar, less carbohydrates, less trans fats, or would we rather take a pill. This is a huge study. It confirms that changing our environment is crucial. And if you can’t, well, then. Here are three pills.


Pop Quiz

  1. If we pay attention to this study, we should take pills until our blood pressure is below 120 instead of below 140.   (One extra pill a day on average) T or F


  1. This study was meant to be concluded in 2017 but was such a remarkable result, the authors felt compelled to release it earlier.   T or F

That’s exactly what happened.   Very significant

  1. Our environment has changed in the last 200 years by the addition of more fruits and vegetables. T or F

Well, actually probably true, because we can get vegetables year around now which we couldn’t before, but what has happened is that we really eating much less vegetables and fruits, and instead are eating a lot more sugar and refined flour products.

  1. We have not gained much weight recently in America.   T or F

Are you kidding, we are getting fatter by about 1 pound per person per year.

  1. Losing weight lowers our insulin, and helps our kidneys stop holding onto salt.   T or F

Bingo, making weight loss more important than an extra pill.

Food and Inflammasomes

Fire, Fire, Cells on Fire: Inflammasomes II

Reference:   Scientific American June 2015, Wen Nature Immunology

June 1, 2015

We learned last week that inflammasomes are activated when “stranger” and “danger” signals are present.   Bacteria and viruses can do it, but so can foreign chemicals like asbestos and amyloid in our brains.   The inflammasome is essentially a little factory that propels the inflammatory process forward and turns on the signaling in the cell and its surroundings that trouble is brewing.   When you have a cut finger and get redness around it, it is because your local macrophages have made inflammasomes inside themselves that are putting out the chemicals that make that factory become assembled, and then produce its inflammatory signaling messages.

But that’s not all. Food can do it. Eating too much food sets off inflammation.   Fatty acids can do it too.   A healthy liver has many immune cells within it, and is the first recipient of calories after a meal. The liver can become inflamed and swollen when it is overwhelmed with too many calories.   We have an epidemic of fatty liver in obese children right now. It appears that fructose plays a central role in that process.

What happens when you eat too much fructose (sugar)?   We know that it essentially exhausts your liver because it forces the liver to use up its ATP, resulting in a burst of uric acid and a burst of triglyceride release – as dramatic as with drinking alcohol.   Your liver gets swollen and doesn’t work very well.   You can see large globules of fat in it.   It can’t make an orderly progression of LDLs to transport the extra calories to your fat cells, where the fat can be stored. Instead, you have a wild, uncontrolled release of free fatty acids into the blood.   We call those triglycerides.

We know that triglycerides reflect a higher risk for heart disease than total cholesterol, particularly in women. And that would make perfect sense because triglycerides reflect the presence of inflammation in the liver, spewing out inflammatory messages to the whole body.

The interesting thing about food is that its inflammatory effect seems to be about 24 hours and then it cools off. Immune cells stop responding to the inflammatory messages after a while. The next door to be opened is just what on earth keeps the inflammatory process going and going.   Adenosine may be that signal. And when you eat fructose and overwhelm your liver, you break down ATP and make adenosine. That points a particular finger at fructose again!

How can we turn all this off? Fasting! Or eating a “ketogenic” diet that makes you put out beta-hydroxybutyrate.   Imagine, turning off inflammation by eating fat.

WWW. What will work for me. I know this is true. Eating fat reduces inflammation. My 70% fat diet for the last 4 months has reduced my CRP from 3.8 to 0.3, in just 4 months.   I’m getting better at saying no to sugar if I can just keep away from brownies and chocolate.   I believe that the alleged triglyceride activation of inflammasomes is actually a misplaced association – the triglycerides reflecting the excessive intake of fructose/sugar we Americans are obsessed with. It’s the sugar.

Pop Quiz

  1. Inflammation can be started by eating too much food? T or F


  1. Sugar seems to be able to turn on inflammation as well? T or F


  1. Fructose, from sugar, makes for fatty liver? T or F


  1. Inflammasomes in the liver are caused by eating too much food and too much sugar. T or F

I’m beating a dead horse here, but I want you to get the point.

  1. You can turn off inflammation by eating a keto-genic diet – aka, high fat? T or F


  1. Beta-hydroxybutyrate is the compound your body puts out when you are burning fat, either from your fat cells or from the food you eat – and it happens only when you eat less than 20 grams of carbs a day. T or F

Pretty close to accurate. Some quibbling on details.

Triglycerides/HDL Ratio – the Best Measure for Heart Disease Risk

The Best Cholesterol Predictor for Artery Disease

Reference: Gaziano Circulation 1997 Lemos de Luz Clinics Wan PLOS April 2015

You want to know how to predict your risk for heart disease, right? Half of us die from it, so having a bit of a warning is a useful thing.   You go to your doctor and get told that you should be on a statin. You don’t know what to say.   Should you, shouldn’t you.   That’s the conundrum.

Want some guidance?   Of course! You want to know the single best predictor for developing heart and vascular disease.   And you want to know how to change it and manage it.   Well, that’s a tall order, and now we know the answer.   And it’s NOT your LDLs and total cholesterol. We focus on LDLs because we have a 30 billion dollar industry of lowering it with statins.

The number you want is your TG(triglycerides)/HDL ratio.   The reference is above. The authors in the Clinics article took 347 high risk patients, most in their later 50s with total cholesterols over 200.   The examined the extent of their coronary artery disease by catheterization and correlated the findings with their lipids.   Because HDLs are known to be protective, and triglycerides known to be risky, the TG/HDL ratio is an attractive summarization to look it.   What the authors found was that this ratio is more accurate than the Total Cholesterol or LDL measures, which we usually use.   This study confirms the landmark first study by Gaziano that identified this ratio as being the best.

Now we have a follow up confirmation about mortality from Wan in PLOS published just last month.   They found the TG/HDL ratio to be the most predictive ratio for subsequent mortality.   After open heart surgery, they grouped their patients into three groups by tertile, (Top third, middle and bottom) and found a 5.32 fold increased mortality for those in the top third over the bottom third.

Now, here is the kicker.   You can get yourself from the top third to the bottom third in about a month with the right diet.   I’ve done it.   You have to stop eating carbohydrates that flood into your body too quickly.

This confirms the hypothesis that your blood fats are completely dominated by the carbohydrates you eat.   When you overwhelm the ability of the body to burn carbs, your insulin goes up, your liver starts to manufacture fats and your blood fats start going up.   Triglycerides reflect that you have so much fat being made that your LDLs can’t even pick it all up, so your blood starts being filled up with triglycerides. There is no drug for that. But you have choice. You can stop eating those carbs.

What food should you eat instead.   Ironically, exactly the foods that look like what is in your blood is what you should be eating to cure your bad blood fats: fat.   If you switch to a diet of 70% fat and less than 20 grams of carbs a day, you can cure your elevated triglycerides in the twinkling of an eye.

There have been some 20 articles published confirming this concept so it’s not new, but it should be considered the main method by which we confirm your risk.   When you get your cholesterol measured, make sure you know those numbers first, not your total cholesterol or your LDLs. Focus on your HDL and your triglyceride.   And then, aim to get your ratio to ONE.   One.   1.   Yes, ONE.   With that, you will be the safest and the healthiest.   Simple.   Just stop eating carbs and remeasure and you can be safe within a month.

WWW. What will work for me.   I’ve done it. I wanted to lose weight so I went on a 70% fat diet. My HDLs went from 29 to 59 in just three months. (I wasn’t measuring monthly).   My triglycerides went from 103 to 49. That makes my ratio 0.83. (Down from 3.55)   Yippeee!   I am now down 30 pounds and don’t need to lose any more weight so my new challenge is to figure out food that doesn’t make me regain weight.   Last night for supper, I started with 4 oz of cream cheese so I kept my fat up. Delicious.   No bread, no potato, no rice.   Short ribs, floating in fat, and avocado salad with olive oil dressing.   Sorry you couldn’t have it with me.


Pop Quiz

  1. Total cholesterol is the best measure for your risk for heart attack and vascular disease. T or F

If you said true, read this column over again. No, false.

  1. HDL is typically considered your “good” cholesterol. T or F


  1. The best risk measure for future cardiac mortality is your Triglyceride/HDL ratio. T or F

That’s it

  1. The means you want your triglycerides to be LESS than your HDLs. T or F

Perfect. With that, your risk of heart attack is less than 20% of the rest of us.

  1. The best way to have low triglycerides is to eat less carbs. T or F

Bingo. Eat fat instead.   And lower your risk for heart disease.

  1. That means the best way to improve your heart disease risk is to do exactly the opposite of what we have been telling your for 40 years. T or F


Diabetes Should Have It’s Guidelines Changed

Diabetes Turned Upside Down

Reference: Feinman Nutrition 2015

This is it! We have been doing it backwards for 50 years and now is the time to challenge the old treatment method for diabetes and turn to what works. If you or anyone you know has diabetes, send them this article. This review is a challenge to the status quo. It is time to turn our national guidelines on their head. Our health care systems should hear the clarion call and change their education, their dieticians teaching, their handouts, their clinical pathways.

Here is the evidence, as presented in this article. There are 12 points of evidence, as summarized here.

Point 1. Hyperglycemia is the most salient feature of diabetes. Dietary carbohydrate restriction has the greatest effect on decreasing blood glucose levels

Point 2. During the epidemics of obesity and type 2 diabetes, caloric increases have been due almost entirely to increased carbohydrates

Point 3. Benefits of dietary carbohydrate restriction do not require weight loss

Point 4. Although weight loss is not required for benefit, no dietary intervention is better than carbohydrate restriction for weight loss

Point 5. Adherence to low-carbohydrate diets in people with type 2 diabetes is at least as good as adherence to any other dietary interventions and is frequently significantly better.

Point 6. Replacement of carbohydrate with protein is generally beneficial

Point 7. Dietary total and saturated fat do not correlate with risk for cardiovascular disease

Point 8. Plasma saturated fatty acids are controlled by dietary carbohydrate more than by dietary lipids

Point 9. The best predictor of microvascular and, to a lesser extent, macrovascular complications in patients with type 2 diabetes, is glycemic control (HbA1c)

Point 10. Dietary carbohydrate restriction is the most effective method (other than starvation) of reducing serum TGs and increasing high-density lipoprotein

Point 11. Patients with type 2 diabetes on carbohydrate-restricted diets reduce and frequently eliminate medication. People with type 1 usually require lower insulin

Point 12. Intensive glucose lowering by dietary carbohydrate restriction has no side effects comparable to the effects of intensive pharmacologic treatment

“The need for a reappraisal of dietary recommendations stems from the following:

  • General failure to halt the epidemic of diabetes under current guidelines.
  • The specific failure of low-fat diets to improve obesity, cardiovascular risk, or general health (points 1 and 4).
  • Constant reports of side effects of commonly prescribed diabetic medications, some quite serious (points 12
  • Most importantly, the continued success of low-carbohydrate diets to meet the challenges of improvement in the features of diabetes and metabolic syndrome in the absence of side effects.”

WWW.   What will work for me. I’ve followed a high fat, low carb diet for four months and lowered my own borderline high sugar from 102 to 73. I lost 25 pounds.   I raised my HDLs to 61 from 28.   It was so simple. And I didn’t feel hungry. If your doctor tells you to follow a low fat diet, leave him/her and follow your own common sense.   Read this article, word for word and save your own life. It’s going to take 10 years for health care to get its act together and change.

Pop Quiz

  1. Current guidelines from the American Heart Association and American Diabetes Association advocate control of diabetes through the use of a low fat diet. T or F


  1. This has resulted in good control of Americans’ diabetes. T or F

Patently false

  1. We, as a nation, have made an enormous health care blunder. T or F


  1. It’s time to make a radical shift and change our approach. T or F

As fast as possible

  1. If you have a blood sugar above 90, you will serve yourself and your health better by eating eggs and bacon for breakfast instead of oatmeal? T or F



How to Raise Your HDLs and Lower your Heart Disease Risk

High HDLs and Risk of Heart Disease

Reference:   Wilkins JAHA 2014

We hear all this stuff about LDLs and statins, but no one ever talks about HDLs and how protective they are.   They are protective.   Ostensibly their duty is to scour around and pick up extra fatty acids that they can bring back to the liver for processing.   Small, dense HDLs are just as problematic is small, dense LDLs. You want to have big, fluffy HDLs just like you want to have big, fluffy LDLs.   Now, that’s the traditional medical interpretation of HDLs.   It markedly underestimates their role and their value. You want higher HDLs. It should be one of your health goals.

What this study shows is an elegant demonstration of the inverse relationship between heart disease risk and HDLs.   Following 11,515 men and 12,925 women for 307,245 people years of follow-up, the researchers were able to show that HDLs inversely correlated with heart disease risk. The higher your HDLs, the less heart disease risk you have. The lower your HDL, the deeper you are in doo-doo. Look at the graphs in the article (it’s open access) and you will see the decrease in heart disease risk in both men and women as you increase your HDLs. Men keep decreasing risk up to about 90 HDLs, and women up to about 75.   That’s great!

Eric Westman, of Duke University, and one of America’s leading weight loss experts uses HDLs in his weight loss clinic.   If someone’s HDLs are rising, they are losing weight and on track. We’ve known this phenomenon for years. But if you look over the studies in the literature, it has been masked and hard to see the pattern because most of the diets for weight loss are low fat. Eric Westman claims that when HDLs stop rising, he investigates precise dietary diaries and usually finds someone has started eating more carbohydrates, usually in the form of nuts.   The client thought nuts were basically all fat, but in fact have enough carbs to sabatoge both their weight loss and their HDLs rising.   After a year of dieting on a low carb diet, Westman claims that many will achieve HDLs of 100 – thereby reaching a peak of cardiovascular risk reduction.   Hmmm. That’s the opposite of what the American Heart says.

Ok, explain a simpler theory.   Here is mine. I believe that LDLs are simply transport tools in your body taking fats manufactured in your liver out to fat cells to be stored.   HDLs are their remnant and essentially reflect unused LDLs.   In the world of modern analogies, I call LDLs full 18 wheelers taking manufactured inventory from the factory (your liver) to the warehouse (your fat cell).   HDLs are empty 18 wheelers, sitting in the parking lot waiting for the dispatcher to give them something to do.   Throughout all of human history, we had carbs only seasonally at the end of the growing season, when we gorged on them, put on weight and had a seasonal rise in our LDLs. The rest of the year, we ate fat and protein, lost weight and had our HDLs climb.   HDLs will climb when you are on a high fat, low carb diet.   They will keep climbing as you lose weight and progressively decrease the biological demand for LDLs to transport fats.   You want more HDLs and a lower Total Cholesterol/HDL ratio. The Quebec Study proves that. The Lower your TC/HDL ratio, the lower your risk for heart disease.

WWW. What will work for me.   Ok, I was intruiged with this data. I’ve spent my entire career trying to raise my own miserable HDLs of 28. My father had heart disease and was diabetic. With running 2 miles a day and taking 1000 mg of Niacin (until my face flushed bright red) – the two recommendations to raise your HDL from American Heart), I got my own HDLs all the way up to 32.   Whoop dee doo! Now, since January 1 I have averaged a 70% fat, under 15% carb diet. I have lost 25 pounds and my HDLS just got in. I hit 61 in just 3 months. My LDLs didn’t fall but my ratio is now under 3, for the first time EVER.   If this was just me, I would keep private. But I’ve demonstrated this same phenomenon on dozens of folks willing to stick with it and get measured twice. In fact, it has worked on everyone so far.   Must be something to it.   Your enemy is not fat, it’s extra carbs. If you have high LDLs, it simply means you have overwhelmed the ability of your body to burn and process them, so your liver is turning them into fat and your body is transporting that fat to your fat cells. (No ifs, ands or butts!).


Pop Quiz

  1. High HDLs should be one of my health goals.   T or F


  1. The only way to reliably get high HDLs is to eat fat, stop eating carbs. T or F

Trick question.   It’s not the only way.   Getting yourself born into the right family helps. Good genes are useful. But diet can do it for those of us with lousy genes.

  1. I can change my lousy HDLS in three months more effectively than with a statin. T or F

Slam dunk true

  1. There is more money in statins than in effective weight loss and that has a huge effect on public policy. T or F

You guess

  1. Losing weight and eating differently is more effective than taking pills.

Four to one.



Eggs and Butter get a Pardon

Reference: Washington Post Feb 2015, 2015 Executive Summary, New York Times

The new Guidelines for 2015 are out!   And a subtle shift is happening of monumental proportions. Eggs are back! The long standing hostility to eggs and butter has been lifted with simply silence.   No one is saying, “We were dead wrong” but instead have come out with a much, much stronger recommendation that we eat less sugar.

The core diet they are recommending is less sugar, more vegetables, less red and processed meat (sausage, baloney, hotdogs) and more healthy fats from nuts and seeds and “vegetable oils.”   (Here is where I take difference with them.)

But eggs are back! You can eat eggs again. They admit that the very tiny percent of people whose dangerous blood fats go up with eggs are too small a minority to justify guidelines for the whole population.

They do recommend that a broadly shaped “Mediterranean Diet” be followed that has more vegetables, less sugar, more white meat. But I remain skeptical as to just what part of the Mediterranean they are talking about. There are some 14 – 16 countries that are around or in the Mediterranean, and each has a different cuisine.   I suspect there is an amalgam of ideas with more olive oil (really good for you) and fish (even better) and vegetables (best) but the recipes are different everywhere. Fresh, locally grown food with fish and vegetables are common in Thailand, the Philipines, Japan, Peru, Ecuador, South Africa….on and on. Aren’t they Mediterrean too?

What they don’t strictly address is how to lose weight. Maintaining is one thing, losing is another. I would maintain that this is the revolution that ultimately needs to happen. Teach us how to lose weight, effectively and forever!   The Guidelines Committee made the horrific blunder in the late 70s of telling us to eat more carbs and less fat, and we all got horribly obese. They were dead wrong.   Just plain wrong. They have yet to admit guilt and say sorry. I would like a sorry.

But the science is now there about how to lose weight.   And hints of it are in the guidelines. The best hint is the recognition front and center how dangerous sugar is. Sugar, even the flavor sweet, turns on insulin. Insulin is also turned on by the flavor sweet.   And even more devious, too much protein (More than 1-1.5 grms per ideal kg body weight per day) and your body turns the extra protein into glucose, and that turns on insulin. To lose weight, you must simply turn off insulin. With insulin gone, your fat cells open up and share their calories seamlessly and effortlessly with your body. That’s it. Simple. You have to turn off insulin. (Note, you also lose weight if you eat low enough glycemic carbs: alkali diet or vegan).

The “teleological explanation” is helpful. The time of year we naturally want insulin is August and September, when carbohydrate foods are plentiful, delicious and winter is just around the corner. To survive winter, we should gorge and fatten up. Insulin is the tool to do that. But come winter, to survive, we need access to that which we stored.   If you eat carbs, your body thinks it’s September. Plain and simple. If you eat fat, your metabolism thinks it’s winter, and your insulin is turned off. Anytime you eat any carbs, you put out insulin and for the next 12 hours, you won’t lose an ounce of fat weight. Insulin is intimately tied up with your appetite. (There are many more but I’m simplifying it).   If insulin is turned off, your fat cells open up and your appetite stays in control. Your brain learns to run on ketones (pieces of fat being chopped up).   You can get along on 1400 calories a day and feel fine. And that’s called weight loss.

Long term, what do you want?   Here, the Guidelines committee is finally getting it right (mostly). Much less sugar, less refined flour. More vegetables.   More omega fat containing meats. Less fake meats. Less feed lot meats. It’s clear that in the long term, more red meat makes for turning on cancer genes and acidifying you. In the short term, it’s far more important to lose weight than worry about the risk of red meat. Lose the weight, then lose the red meat. (Be like the eskimos, eat the fat of the caribou and save the meat for dogs.)

But central to all of this is the admonition to avoid fat is lifted. Eggs are two thirds fat, one third protein. They are ideal weight-loss foods. You can eat eggs. All the eggs you want. And your weight will go down and your waist will go down.

WWW. What will work for me. I embarked on a weight loss program on Dec 29th. I’m eating 4 eggs every day. Two for breakfast and two for lunch. No bread. I’m not hungry. I’m averaging about 1200 calories a day and feel fine. I do need an extra blanket and a sweater to stay warm. That could be the 5 degree temperature outside. (I’m down 16 pounds in 8 weeks.)   My body believes it’s winter.   It’s sharing its fat with me.


Pop Quiz


  1. Eating eggs will help you lose weight?   T or F


  1. Why

Because they are high fat, modest protein and make you feel full with only 90 calories each.

  1. Why do you feel full?

Because your insulin is turned off and your appetite doesn’t kick in

  1. What season does your body think it is if you are eating just fat?


  1. Our bodies were designed to eat what in winter?


  1. To lose weight, you have to eat fat. T or F


  1. That makes eggs?

“The perfect food for weight loss”. Back in style.   Eat up. (Buy the good ones naturally raised with more omega fats in them)

It’s Sugar, Not Salt that Causes Heart Attacks

The Wrong White Crystals for High Blood Pressure

Reference : OpenHeart Dec 2014

Ask anyone with heart disease what they have to avoid and they will answer, “Salt”. Right? Well, they are wrong.   It’s time to think carefully just what happens with our physiology and how heart disease develops. This article is an elegant discussion of the issue.   It’s not salt, it’s sugar.   We Americans eat about 15% of our calories from table sugar.   The American Heart Association has already come out with guidelines to reduce sugar intake to under half of our discretionary calories in a day. (6 teaspoons for women and 9 for men) That’s too complicated for me. Their earlier comment was simply less than an ounce a day. But is about a quarter of what we are eating today.

Why so stringent?   The evidence continues to accumulate that sugar causes trouble. DiNicolantonio, the author of this review, from Kansas City, has written a beautiful review article that details the problems with sugar. For example, “Compared to patients who consume less than 10% of their calories from added sugars, those who consumed 10.0-24.5% of their calories from added sugars have a 30% increased risk of mortality from heart disease and those who consume more than 25% have an almost threefold risk increase.” An intake of over 75 grams of fructose a day (table sugar is half fructose) is independently associated with 26%, 30% and 77% higher risk for blood pressures of 135/85, 140/90 and 160/100.   Consumption of 150 grams a day of table sugar will lead to a blood pressure rise of 3.8/4.1 mm Hg in just 10 weeks.

Ok, ok! I concede. The data is huge and convincing.   In fact, just one 24 ounce sugared soda will raise your blood pressure by 15/9 and your heart rate by 9 bpm.

What happens if you eat all your fructose in the form of fruit?   One study showed that 200 grams a day of fructose from 20 servings of whole fruit lowers blood pressure.   Way too many carbs, and you will gain weight, but at least your blood pressure doesn’t go up.

DiNicolantinio details several mechanisms by which fructose causes trouble. I like the NEJM review article on Uric Acid and fructose the best.   The steps of trouble go like this: 1. Fructose floods into your liver, that can’t resist taking it up.   2. Your liver must burn one ATP to phosphorylate the fructose.   3. You burn up all your available ATP. 4. Your liver tries to regenerate ATP desperately by turning two ADPs into one ATP and on AMP.   5. AMP degrades to uric acid.   6. Uric acid soaks up nitric oxide in your blood vessels. 7. Without NO, your vessels constrict – that’s called high blood pressure.

Most Americans are eating 2-8 times the generous American Heart Limits. We are in deep doodoo.

WWW. What will work for me? Wow. Sugar is just poison. The problem is, we are all sugar junkies. Our lizard brains were designed to go after sugar because for most of human history, it meant valuable fruit. But if your blood pressure is anything higher than 115/60, you will likely benefit by cutting the sugar.   And this is sugar season.   Hold on!


Pop Quiz

  1. Sugar is more dangerous for me than salt when discussing heart disease? T or F


  1. The Average American gets 15% of their calories from sugar? T or F


  1. Drinking one large 24 ounce of sugared soda will raise my blood pressure some 9 points.


  1. The way fructose causes trouble is via uric acid that soaks up nitric oxide.   T or F

Yup again. That’s a nice simple summary.

  1. And Nitric Oxide lowers my blood pressure, so I want it around. T or F

Now you’ve got it.


Tomatoes and High Blood Pressure

Tomatoes for High Blood Pressure

Reference: Fuhrman Antiox Redox Sigal, Armoza J Hypertension, Kim Atherosclerosis

Tomatoes contain lycopene. Lycopene is the bright red color in tomatoes (an watermelon and beans and other veges) that is part of the pathway to making Vitamin A, or β-carotene. It has 11 double bonds in it – which are it’s source of strong antioxidant activity. The color is pretty intense, so it doesn’t take all that much lycopene to make a tomato pretty red.   And eating a tomato raw doesn’t get as much lycopene as cooking it.

But now, along comes a constellation of research articles that really give us a better “flavor” for how useful lycopene can be. Hypertension is dangerous. The higher it is, the more mortality we have from cardiovascular disease.   The third hyperlink up above (KIM) is a powerpoint you can download that is a little lecture about hypertension and the benefits of lycopene.

The key to understanding of high blood pressure is changing our thinking about its cause. Most of us think that high blood pressure is caused by eating too much salt and that it happens to us naturally as we get older. Well, that’s just not true. In those shrinking parts of the world that don’t eat sugar and white flour, eat tons of vegetables and get abundant exercise, folks blood pressure drops with aging. In America, as many as 70% of us have high blood pressure by the time we are 70, making it one of the cardinal contributors to our epidemic of cardiovascular disease.

Ok. Explain what is the real cause of high blood pressure.   The real cause is the whole constellation of effects that cause “endothelial dysfunction”. That is a fancy term for the lining of your blood vessels getting all irritated.   And that is caused because we keep flooding our systems with oxidizing foods – most notably sugar and high glycemic foods (otherwise known as bread, cookies, donuts, bagels, milkshakes etc). Sugar, (15% of America’s calories) is 50% fructose. Fructose is a particularly wicked animal because it exhausts your liver, raises your uric acid, depletes your Nitric Oxide. Nitric oxide is the messenger in your arteries that tells them to relax.

There are other influences that make for inflammation in our bodies. Just being overweight raises the ante. Biopsies of your fat will show increasing white blood cells with increasing waist size, and increasing inflammatory markers flooding out of your fat.

Just what does the tomato extract lycopene do for me? It is a supercharged molecule of double bonds that eagerly suck up “oxidants”. Any chemical that is floating around in your blood, waiting to cause irritation by way of oxidation gets soaked up by lycopene. That stops the whole cascade at the beginning.

Can I get enough lycopene by eating tomatoes? Probably. But you need to eat a lot. Cooked is better. If I already have high blood pressure, will it help. Yup. 30 mg a day will lower your blood pressure as much as any blood pressure pill. And it’s just food.   Is it widely available? Well, that’s the kicker. Right now, not easily.

WWW. What will work foe me. This might be the most effective food extract that we have found to date to battle high blood pressure.   Step one has to be weight loss to reduce the inflammation coming from fat tissue. Step two needs to be cutting the sugar and white stuff – and then add a shake of exercise and pinch of stress reduction, and watch your blood pressure drop like a rock. Your arteries will thank you


Pop Quiz


  1. Lycopene is the red color it tomatoes and watermelon? T or F


  1. Lycopene is a champion antioxidant because it can soak up those chemicals that cause “oxidation” in my arteries. T or F

That’s it in a nutshell

  1. I can’t lower my blood pressure without getting a pill from my doctor. T or F

Wrong. Your doctor’s pill is likely only 25% as effective as your taking the matter into your own hands, losing weight, walking and then take some lycopene.

  1. I should eat more cooked tomato and tomato paste products.   Y or N

Sounds like a good plan

  1. And all the watermelon I want? T or F

Ouch. Watermelon has way too much sugar in it. Have a taste.