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Old 08-05-2008, 08:31 AM
Join Date: Jul 2008
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liverock is on a distinguished road
Default Triglycerides, Mistreated and Misunderstood

Most people are concerned about their LDL levels in their lipid profile, but Cardiologist Dr William Davis says if we concern ourseves more about lowering our triglycerides, we will get an improved level of the right kind of LDL that cuts down plaque formation.
Triglycerides, Mistreated and Misunderstood: Learn Why

by Dr. William Davis
Wednesday, July 23, 2008
What is a desirable level for triglycerides?

It depends on who you ask.

Ask those adhering to the Adult Treatment Panel (ATP-III), the �official� set of guidelines followed by most primary care physicians, and they will say �150 mg/dl.�

Ask those of us trying to achieve reversal of coronary heart disease, and we would say...�60 mg/dl or less.�

Why such a discrepancy? Which is closer to the �truth�?

The ATP-III guidelines are principally focused on cholesterol issues, particularly LDL. The guidelines provide the answer to what levels of LDL to achieve in different risk groups. If you read the full-text of the ATP-III guidelines, you will quickly recognize that triglycerides are treated almost as an afterthought, something to mention just in case LDL reduction proves insufficient (which it nearly always does, in my experience). 150 mg/dl is, therefore, a somewhat arbitrary level that is regarded as a �secondary goal� after LDL reduction is achieved.

But I believe that�s wrong.

I choose 60 mg/dl for triglycerides because that�s the level that minimizes the presence of triglyceride-containing undesirable lipoproteins like small LDL (the number one cause for heart disease in the U.S.!), VLDL, and the after-eating persistence of intermediate-density lipoprotein (IDL), a bad player in heart disease and stroke that underlie the causes of atherosclerotic plaque.

Obviously, this triglyceride target is far below that of the conventional guidelines. In my view, a level of 150 mg/dl is highly abnormal, permitting the persistence of multiple lipoprotein particles and virtually guarantees plaque growth in the coronary (heart), carotid (neck) and other arteries. In short, triglycerides of 150 are awful.

Conventional wisdom also dictates that a low-fat diet that reduced saturated fats, excess oils from olives, nuts, and meats, will reduce triglycerides. My response: absolute nonsense.

The reality is that while a low-fat diet may reduce triglycerides modestly, it often, in fact, increases triglycerides. That�s because a low-fat diet typically becomes a carbohydrate-rich diet. Any diet that increases the sugar load to your body increases triglycerides . . . enormously. But you won�t find that buried in the conventional advice, no matter how deep you dig.

Reduce carbohydratesand triglycerides drop. This simple fact was most recently observed in the DIRECT Trial comparing low-carb vs. Mediterranean diet vs. low-fat diet: triglycerides were most effectively reduced by a low-carb diet (the Atkins� diet, in this instance): triglyceride reduction of 23.7 mg/dl on low-carb vs. 3.7 mg/dl on low-fat. Larger triglyceride reductions of 40, 50, or more mg/dl are not unusual, in my experience.

Strategies for reducing triglycerides - for real

If genuinely powerful triglyceride-reducing effects are needed, then here are several ways to get started, strategies that pack far more power than the ineffective standard advice to �reduce fats�:

Reduction of high-glycemic index foods

Most notably snacks and . . . wheat.

Everybody knows that we shouldn't eat Snickers bars or bags of licorice.

But many people eat plenty of wheat-containing breads, pastas, pretzels, crackers, breakfast cereals, etc., all in the name of increasing whole grains and fiber. In reality, they cause triglycerides to skyrocket, dropping HDL, forming small LDL, increasing blood sugar and blood pressure, and increasing obesity. Backtrack on this advice, add back calories from healthy oils (olive, canola, flaxseed, walnut) and raw nuts, and triglycerides drop.

Fish oil

The omega-3 fatty acids from fish oil are a mainstay of triglyceride-reducing treatment. Omega-3 fatty acids are the number one most potent treatment for high triglycerides. Triglyceride-reducing effects begin at a combined EPA + DHA (omega-3 fatty acids) dose of 1200 mg per day.

Eliminate fructose and high-fructose corn syrup

This ubiquitous sweetener is now consumed in enormous quantities by the average American, nearly 80 lbs per year per person. (Imagine sixteen 5-lb bags of sugar.)

You'll find high-fructose corn syrup in a shocking number of processed foods, including soft drinks, fruit drinks, ketchup, beer, breads, breakfast cereals, and salad dressings. You'll find none in green peppers, cucumbers, and raw nuts. Fructose causes large increases in triglycerides, as well as diabetic patterns. Don't let "fat-free" claims fool you: It often means that the fat has been replaced by high-fructose corn syrup.

Here are the ingredients in a popular fat-free salad dressing, for example:

Ingredients: Water, Vinegar, High Fructose Corn Syrup, Corn Syrup, Salt, Parmesan Cheese, Part-Skim Milk, Cheese Culture, Salt, Enzymes, Contains less than 2% of Garlic, Whey, Onion Juice, Autolyzed Yeast Extract, Phosphoric Acid, Worcestershire Sauce, Vinegar, Molasses, Corn Syrup, Water, Salt, Caramel Color, Dried Garlic, Sugar ,Spices, Tamarind, Natural Flavors, Hydrolyzed Soy Protein, Xanthan Gum, Potassium Sorbate and Calcium Disodium EDTA as Preservatives, Dried Garlic, Buttermilk, Spice, Dried Parsley, Caramel Color, Sodium Phosphate, Oleoresin Paprika.

This low-fat or �lite� salad dressing is, in effect, water, vinegar, and corn syrup. It will skyrocket your triglycerides.

Limit alcohol

While a couple of drinks a day raises HDL, exerts anti-inflammatory effects, and reduces blood pressure, more than this begins to raise triglycerides. Increases of hundreds of milligrams/dl can occur with several drinks per day.

Beer, in particular, raises triglycerides more than wine or other alcoholic beverages. Could it be the wheat source of beer? Or the high-fructose corn syrup? Or both? I don't know, but beer is the least desirable form of alcohol of the choices we have.

Following these simple steps, it is unusual in my experience that you cannot achieve a triglyceride level <60 mg/dl, particularly if you also reduce weight through your carbohydrate reduction. Rarely do we need to add fibrate drugs or other prescription agents to reduce triglycerides.

Curious thing: Successful participants in our program of heart disease reversal, i.e., people who achieve desirable weight, reduce processed carbohydrate junk foods and saturated fat sources, and aim for the 60-60-60 targets for conventional lipids (cholesterol values), commonly end up with triglyceride levels of 25-50 mg/dl. We have witnessed many people reverse heart disease, in fact, just by achieving a triglyceride level of 60 mg/dl or less.
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Old 08-05-2008, 01:21 PM
Join Date: Apr 2008
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Boss is on a distinguished road

There were a few things I was not too enamoured with.

The link to small LDL, said American thinking states 6-8 servings of grains a day.

This is silly anyway, as British advice is 2-3, and that's classed as bowls of whole-grains, not just servings whatever that is meant to be.

Also it didn't say that some Grains, like Oats, Barley and to a lesser Wheat and Rye, contain Beta-glucan, a known player in possible Cholesterol management, yet that made it look like whole-grains are pretty darn bad, and are bad Cholesterol players, by stating Whole-grains cause small LDL, (I'm not disputing this possible fact), and as Small LDL supposedly contributes to Heart disease, it's as good as saying Whole-grains could cause Heart disease at least in part, or as a secondary factor.

I didn't understand this apparent Whole-grain bashing, but I don't trust it.
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Old 08-06-2008, 09:39 AM
Join Date: Jul 2008
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liverock is on a distinguished road

Dr Davis is not bashing whole grains as you put it, he is merely sharing his clinical experience on patients who have gone for the wheat free diet and found practically, that it does improve not only their lipid profiles, but also reduces weight and insulin levels,all of them connected with heart disease.

If you clicked on the WHEAT link in the article you can see that Dr Davis excuded oats and flaxseed from his condemnation of wheat.

Heart Disease Diet: Do You Have a "Wheat Belly"?
by Dr. William Davis
Tuesday, July 08, 2008
Low HDL cholesterol, high triglycerides, small LDL particles: the most common triad of abnormalities today behind heart disease.

Along with this pattern comes high blood pressure, high blood sugar, diabetes and pre-diabetes, increased inflammation, increasingly blood clot-prone blood. This common collection that now afflicts over 50 million Americans goes by a number of names, including metabolic syndrome, insulin resistance syndrome, and syndrome X.

But I call it “wheat belly.” Let me explain.

You've heard of "beer bellies," the protuberant, sagging abdomen of someone who drinks excessive quantities of beer.

Wheat belly is the same protuberant, sagging abdomen that develops when you overindulge in processed carbohydrates. It represents visceral fat that laces the intestines.

While nearly everyone knows that candy bars and soft drinks aren’t good for health, most Americans have allowed processed carbohydrates, but especially wheat products like pretzels, crackers, breads, waffles, pancakes, breakfast cereals and pasta, to dominate diet. I blame the extreme over-reliance on these foods for the obesity and related abnormalities: wheat belly.

How did this all come about?

Back in the 1960s, we had sandwiches on white bread, hamburgers on white flour buns, spaghetti made with bleached, enriched flour. Data from the 1970s and 1980s, however, demonstrated conclusively that using whole grains, with the bran and B-vitamins left in, was better: better for bowel health, blood pressure, cholesterol values.

Fast-forward to the 1990s and the new century, and the mantra has evolved to “eat more whole grains, eat more whole grains,” repeated by “official” organizations and propagated by countless media conversations. And Americans have complied.

But while video games, unhealthy snacks, and vending machines have been roundly blamed for the nationwide epidemic of obesity and diabetes, it’s curious that increased weight has befallen even active people who eat “healthy”: yes, plenty of whole grains.

In my view, it is the grains that are largely behind the obesity and diabetes epidemic, at least among the frustrated health-conscious.

But not all grains. Oats and flaxseed, for instance, seem to not contribute to weight and the associated patterns like small LDL.

The wife of a patient of mine who was in the hospital (one of my rare hospitalizations) balked in disbelief when I told her that her husband's 18 lb weight gain over the past 6 months was due to the whole wheat cereal for breakfast, turkey sandwiches for lunch, and whole wheat pasta for dinner.

"But that's what they told us to eat after Dan left the hospital after his last stent!"

Dan, at 260 lbs with a typical wheat belly, had small LDL, low HDL, high triglycerides, etc.

Many people, on hearing this peculiar perspective, are incredulous. “You’re nuts!” Whole grains are full of fiber and B vitamins. Everybody ‘knows’ they’re healthy!”

I thought so, too, 12 years ago when I followed a strict vegetarian, low-fat diet, rich with “healthy” whole grains. I gained 30 lbs, my HDL dropped to 27 mg/dl, triglycerides skyrocketed to 350 mg/dl, small LDL went crazy, my blood pressure was 150/90, and I developed diabetic blood sugars─while running 5 miles a day. It’s the wheat. I eliminated the wheat and promptly reversed the entire picture.

If you don't believe it, try this experiment: Eliminate all forms of wheat for a 4 week period--no breakfast cereals, no breads of any sort, no pasta, no crackers, no pretzels, etc. Instead, increase your vegetables; healthy oils; lean proteins (lean red meats, chicken, fish, turkey, eggs, Egg Beaters, yogurt and cottage cheese); raw nuts like almonds, walnuts, and pecans; and fruit. Of course, avoid fruit drinks, candy, and other garbage foods, even if they're wheat-free. (And don’t confuse this conversation with celiac disease or gluten enteropathy, an allergy to wheat gluten, an entirely different issue.)

Most people will report that a cloud has been lifted from their brain. Thinking is clearer, you have more energy, you don't lose in the afternoon, you sleep more deeply. You will notice that hunger ratchets down substantially. Most people lose the insatiable hunger pangs that occur 2-3 hours after a wheat-containing meal. Instead, hunger is a soft signal that gently prods you that it's time to consider eating again. You may even find that you miss meals, just because you forgot to eat. Very curious.

It’s unconventional, I know. The last 500 patients I’ve done this with also thought so─until they lost 15, 20 . . .70 lbs along with all the undesirable metabolic “baggage.”
Heres further thoughts on the subject with testimonies from people who have gone on his wheat free diet.
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