A tale of two "Wheat Bellies"

Before Dr. William Davis' name became synonymous with the elusive* Wheat Belly, he was well known for his subscription Track Your Plaque website.   This website currently charges $90 (all prices rounded) for the first year with yearly renewals at $72, for the basic membership ... more for shorter "contracts".  That's just the membership fee, that basically affords you discounts on various TYP products such as your Basic Membership Kit for $70 (reg. $110) or a Supplement Kit for $175 (reg. $215) or the testing kit for a cool $530 (reg. $570).   In the marketplace you can purchase all manner of testing supplies, etc.  

Now Davis is a huge backer of Jimmy Moore's Cholesterol Clarity book.  He contributed to it as an expert, provided an Editorial Review for Amazon.com and, as if that weren't enough, offered up a glowing 5 Star review on same, entitled Cholesterol bashing at its finest.  In it he writes:

Widely-held beliefs, many of them propagated by "official" agencies like the FDA, USDA, American Heart Association, Academy of Dietetics and Nutrition, American Diabetes Association, etc., are crumbling under the scrutiny of informed people uninfluenced by the pharmaceutical industry, agribusiness, or the excessive profiteering ways of modern "healthcare."

Uninfluenced by them, but influenced by profiteers and profiteers in their own right nonetheless.

In Cholesterol Clarity, Jimmy Moore, along with the help of a couple of dozen other vocal critics of the Lipid Hypothesis, systematically take apart the flawed logic often used to justify a $23 billion per year statin drug industry. He exposes the overly-simplistic thinking and the "research" used to prop up this example of how far wrong medical care can go when richly funded. Jimmy shows how the fiction that "cholesterol causes heart disease" belongs with other fairy tales like "Cut your fat and saturated fat for heart health" and "Fat makes you fat."

Actually, while there is  an undercurrent about diet and low fat diets, this book really does none of what he claims.  He did, however, get the anti-industry statin bashing correct. 

We live in a time when the messages in health have been distorted by bad science and biases introduced by corporate interests that stand to gain from a campaign of half-truths. In his characteristically genuine and straightforward style, Jimmy helps the reader understand how to navigate the real arguments behind heart disease risk unemcumbered by self-serving financial interests.

Oh the irony.  Nuff said.   The general take-aways from the book are that nobody should be on statins, lowering cholesterol levels is misguided and will harm you, and LDL-C and even LDL-P are totally irrelevant if you have good HDL-C, low small LDL-P, low trigs and/or your LDL particles are the fun-loving, life-giving "large and fluffy" kind.   

One would think that Davis promotes this approach on TYP, right?  That you shouldn't be at all concerned over elevated cholesterol?  Wrong.  Here is a 2006 publication from TYP:  TYP Special Report: Unique nutritional strategies to reduce cholesterol naturally (ht C.Grashow) .   But, but ... perhaps he has changed his tune? Nope: Health Diagnostics Lab Explained -- 8/15/2013.

Low-Density Lipoprotein (LDL) is composed of phospholipids, triglycerides, cholesterol, and a Apolipoprotein B (ApoB).

There is a 2-3x increased risk of cardiovascular disease when LDL-c, ApoB, and LDL-P are all 3 elevated.

Goal – < 100 mg/dL or < 70 mg/dL if there are other risk factors for heart disease or diabetes. Notice that this is a measurement of weight. It is measured in mg per dL. It does not tell us the size of the LDL particle or the number of LDL particles.

What to do to improve it – The first intervention is to improve overall health through the ‘Healthy Trinity’. We recommend RevChol if we cannot reach our goal.

I would note that RevChol is a pharmaceutical grade O3 supplement, so much for consistency on the pharmaceutical industry.  But note the recommendation to lower LDL-C.    He has not changed in his marketed-to-the-mainstream message, which means the sugary (excuse me, sucralosely) words for Jimmy Moore are knowingly targeted at the true believers.  And I'd dare say (click to enlarge) he'd take issue with the majority of the lipid profiles in the top "row" here that Jimmy Moore designated as "healthy" in his book -- especially that one in the top right from guess who.

Davis focuses on the small LDL particles in some of his MOC's (Moment of Clarity, what Jimmy designates his quotes).  So the question is, does he really have two standards?  Does he believe in the benign large fluffy LDL?  Because none of this comes of anywhere near as forthrightly as it does in the book.

“Of the thousands and thousands of patients I have personally seen over the years with coronary disease, I can count the number of people who lacked a prevalence of small LDL particles on one hand. It is possible for it to happen, but it’s highly unusual. The vast majority of people who have coronary disease or a risk of developing it have an excess of small LDL particles. There’s only one thing that causes small LDL particles and that’s carbohydrates, not dietary fat. We use a low-carb diet to eliminate the expression of small LDL, which also, by the way, reduces blood sugar levels and normalizes blood vitamin D levels.”     

Which wouldn't be quite so bad if he were more deferential to other physicians who try to treat their patients to achieve the same goals he claims to promote in his made-for-general-public consumption materials.  But no ...

“Sadly, we can’t always rely on our doctors for straight talk and intelligent, insightful answers. As a result, it’s becoming incumbent upon patients to educate themselves, engage with others online who are providing information about nutrition and health, and go into the doctor’s office as empowered patients. Doctors do help every once in a while, but they usually just hand patients some silly prescription.”   

I used to read links to TYP that were occasionally posted on Jimmy's forum.  They mostly seemed reasonable, though looking back there were signs.  However once he got the book deal for Wheat Belly, his writings noticeably changed.  He ratcheted up the LC dogma, and of course wheat caused all ills.  I put the "*" in my opening paragraph because for all the wheat and gluten bashing rhetoric in the book and blog and other writings and speeches, Davis has failed miserably in the prime objective of titling a book as he did:  He never provides any evidence that wheat in particular is responsible for obesity, and especially abdominal obesity.  Fail.

But here's an interesting thing from the 2006 link -- I feel the need to note that I'm not making this stuff up here!  

Beta-glucan is a soluble fiber that avidly absorbs water and transforms into a gooey gel.   This gel, as it traverses the twenty-some feet of intestine, is an efficient absorber of cholesterol.  Beta-glucan is responsible for the cholesterol-lowering properties of oatmeal.  You know what’s even better than oatmeal?  Oat bran.  You can buy oat bran in bags and boxes in most grocery stores.  Oat bran is also more versatile.  You can use it as a hot cereal microwaved in skim milk or soy milk (add raw sunflower or pumpkin seeds, fresh berries, or sliced fruit), or you can add it to yogurt, fruit smoothies, or protein drinks. One ounce of uncooked oat bran (1/4 cup) contains 4 grams of fiber, of which 3 grams are soluble. Including ¼ cup of oat bran a day in your diet can powerfully reduce cholesterol.

I don't think I need to remind my regular readers about Davis' newfound obsession with the evils of oatmeal.   A small bowl will send your blood sugar through the roof, and don't get any in your eye lest you burn your corneas with sulfuric acid.  In my post entitled Wheat Belly on Acid, I discussed this nonsense where oats topped a list of sulfuric acid containing foods.  When did he learn this?  Below are screenshots from nutritiondata.com for 100g (a little over a cup, uncooked) oats vs. oat bran (links are in images).  

You have the same amount of protein (that battery acid making stuff) in each, and an increase from 11g to 15g of fiber seems hardly significant.  Further, the "net carbs" are 55g for oat bran vs. 51g for oats.  Oh, but perhaps he didn't notice the blood sugar effects of all that glucose spiking??  Nope:

Create a smorgasbord of cholesterol-reducing foods and supplements 

Including just a little of one or two of these strategies will help reduce your cholesterol.  But if you’re looking for super-charged LDL cholesterol reduction, combine several of these functional foods and supplements. It is entirely possible to reduce LDL cholesterol 30% or more when you put several together each and every day. Here’s a sample approach: 

• Raw almonds—½ cup per day (total fiber 5.8 g; soluble 0.6 g) 

• Oat bran—¼ cup per day (total fiber 4 g, 3 g soluble) 

• Psyllium seed—2 tsp per day (6 g total fiber; 4.8 g soluble) 

• Citrus fruit—e.g., 1 orange (around 1 g soluble fiber) 

• Beans—1/2 cup per day, cooked (4 g total fiber; 1 g soluble) 

• Soy protein powder—3 tbsp in protein shake (25 grams protein) 

• Theaflavin—600–900 mg/day; or 6–7 cups green tea per day 

The fiber content of this regimen alone—over 20 grams added—packs a powerful effect on cholesterol. Most people lose a modest quantity of weight, as well, because of the feeling of fullness that fiber-rich foods provide and the weight loss effect of green tea.  If you are diabetic or have “borderline” or “pre-” diabetes, blood sugars are often LOWER {emphasis mine} on this regimen. (Discuss this with your doctor to avoid excessively low blood sugars if you take oral diabetic medications or insulin.)

Yes ... William Davis is a pretty common name, so reading such might make one wonder if we're talking about the same guy.  We are.  But now (Oct 2011 actually) 

Wheat Belly: Quick and Dirty

For everyone who asked for a simplified, essentials-only version of the diet I advocate in Wheat Belly, here it is.

This is the very same diet I advise for patients in my office that achieves spectacular reductions in small LDL particles (the #1 cause of heart disease in the U.S), as well as unraveling diabetic/pre-diabetic tendencies. The diet starts with the biggest step: elimination of wheat. But a healthy diet cannot end there, else you and I could eat no wheat but fill our calories with soft drinks and jelly beans. So the next step is to limit carbohydrates if your goal is to lose more weight and correct metabolic distortions like high blood sugar and small LDL particles.

Eliminate: 

All wheat-based products (all breads, all breakfast cereals, noodles, pasta, bagels, muffins, pancakes, waffles, donuts, pretzels, crackers), oat products (oatmeal, oat bran), cornstarch-based products (sauces or gravies thickened with cornstarch, prepared or processed foods containing cornstarch, cornmeal products like chips, tacos, tortillas), sugary soft drinks, candies

I don't need to quote the whole thing.  Nuts and seeds are still OK, but other items from the cholesterol lowering list -- legumes and fruit (citrus) -- are now also to be limited.

Lastly, Davis is very anti-statin.  OK.  But in the one clinical trial he participated in, guess what?  You got it.  Statins were used:  Effect of a Combined Therapeutic Approach of Intensive Lipid Management, Omega-3 Fatty Acid Supplementation, and Increased Serum 25 (OH) Vitamin D on Coronary Calcium Scores in Asymptomatic Adults  (ht CG again)

Abstract

The impact of intensive lipid management, omega-3 fatty acid, and vitamin D3 supplementation on atherosclerotic plaque was assessed through serial computed tomography coronary calcium scoring (CCS).

Low-density lipoprotein cholesterol reduction with statin therapy has not been shown to reduce or slow progression of serial CCS in several recent studies, casting doubt on the usefulness of this approach for tracking atherosclerotic progression. In an open-label study, 45 male and female subjects with CCS of ≥ 50 without symptoms of heart disease were treated with statin therapy, niacin, and omega-3 fatty acid supplementation to achieve low-density lipoprotein cholesterol and triglycerides ≤60 mg/dL; high-density lipoprotein ≥60 mg/dL; and vitamin D3 supplementation to achieve serum levels of ≥50 ng/mL 25(OH) vitamin D, in addition to diet advice.

Lipid profiles of subjects were significantly changed as follows: total cholesterol −24%, low-density lipoprotein −41%; triglycerides −42%, high-density lipoprotein +19%, and mean serum 25(OH) vitamin D levels +83%.

After a mean of 18 months, 20 subjects experienced decrease in CCS with mean change of −14.5% (range 0% to −64%); 22 subjects experienced no change or slow annual rate of CCS increase of +12% (range 1%-29%). Only 3 subjects experienced annual CCS progressionexceeding 29% (44%-71%). Despite wide variation in response, substantial reduction of CCS was achieved in 44% of subjects and slowed plaque growth in 49% of the subjects applying a broad treatment program.

So there you have it.  As they used to say at the end of the old game show:  Would the real William Davis MD please stand up!