Debbie posted this comment on the Wheat Belly Facebook page:
“I posted a few weeks back about our scare from our primary care doctor. My husband had a calcium score of 1200. We panicked! Messaged Dr. Davis and went the next day to a cardio doctor and had a stress test, ultrasound, and blood test (inflammatory markers). Got him on recommended supplements per Dr Davis.
“Latest update: Cardio doctor says, being as you started ‘Wheat Belly’ back in October, 2014, your score could have been higher and already started to improve, we don’t know. What we DO know is, because of this new way of eating, all other tests are NORMAL! Sugar A1C from 8.3 to 6.0, cholesterol way down, blood pressure down, etc, etc all down. Cardio doctor was AMAZED! Continue this diet, supplements and come visit again in 6 months or so!
“Without Wheat Belly, my husband was heading for a major heart attack. I have also found the cause of my own health problems. I started Wheat Belly 3/2014. I am down 78 lbs, no longer pre-diabetic and my symptoms are gone from muscle pain, headaches, chronic itching, bloating, digestive issues, etc., etc. THANK-YOU.”
What a terrific encapsulation of the entire Wheat Belly experience. I didn’t develop the concepts in Wheat Belly by one day just deciding to pick on wheat. These ideas were developed over years of working and researching ways to give people better control over health, but specifically heart health, as I became increasingly disenchanted with conventional notions of heart disease prevention. And it happened on the background of calcium scores of the sort that Debbie’s husband had. So let me tell you how it all happened.
I was practicing interventional cardiology in Cleveland, Ohio, at an academic medical center where I was director of the catheterization laboratory and the cardiology training fellowship. It was an age in which new devices, new procedures, and new techniques were being introduced at a rapid clip. A former trainee of mine asked me to join him in Milwaukee, Wisconsin. I told him: “No way! It’s too darned cold up there!” Nonetheless, I visited him and liked the town, the hospitals, the staff I met, the neighborhoods. Despite my initial misgivings, I moved to suburban Milwaukee to join him. I practiced out of several hospitals, doing much the same: day-to-night angioplasties, implanting stents, dealing with heart attacks and other cardiac emergencies, continuing to introduce new techniques.
Then my mother died of sudden cardiac death just two months after having undergone successful two vessel angioplasty at a New Jersey hospital near my hometown. This hit me like a ton of bricks: the disease I dealt with every day, 7 days a week, was the same disease that killed my mom.
But this event drove home to me that focusing on acute procedural care allows many people to die or experience other dangerous events before they can even get to the hospital. I began to look for methods to identify heart disease before such events took place. And I mean real methods, markers that, for instance, predicted the future in ways such as “heart attack within three years highly likely.” Symptoms? I was looking for markers in people without symptoms. Cholesterol? Don’t make me laugh. High blood pressure, family history, etc.–all were “soft” markers that didn’t have real power, didn’t tell you the “when” or “how much.” About that time a new device had come on the market, a type of CT scanner called an electron beam tomography device, or EBT, that was very fast, able to take an image of the heart in one tenth of one second, rather than the two seconds of conventional CT devices. The heart is a moving object and therefore very difficult to image in detail, but this device could do it. Then colleague and now friend Dr. John Rumberger at the Mayo Clinic did something extraordinary: he used this EBT device to image the coronary (heart) arteries of hearts from people who had died in car accidents and other means. He discovered that calcium–an easy component of atherosclerotic plaque to image–occupied 20% of the total volume of the atherosclerotic plaque that lined arteries. In other words, measuring calcium in the arteries provided a gauge, a dipstick, for the amount of total atherosclerotic plaque in the 3 coronary arteries. Early scientific publications validated the fact that the “calcium score”–zero for none, increasing values for greater quantities of calcium–was the most powerful predictor for future heart attack and death from heart disease ever developed.
I put together some investors in Milwaukee to bring an EBT device here. (I was never an investor, just the medical adviser.) No hospital showed interest, as they saw it as a tool for prevention, not for increasing procedural revenue. Thus Milwaukee Heart Scan was born and we began to image the hearts of hundreds, then thousands of people. But it created a dilemma: a businessman, say, would have his heart scan, obtain a score of 500 (quite high), then ask “What the heck do I do about it?” Because this was about 18 years ago, we’d tell them what I now understand is nonsense: cut your fat, take Lipitor, and exercise. The businessman would come back in a year for another scan: score of 670–much higher. Now he’s freaking out: “What now?! Do I need heart catheterization or bypass surgery?” (Recall that these people were without symptoms, often exercising, and usually proved to have normal stress tests. Regardless, an unintended problem also arose: unscrupulous cardiologists who put such people through unnecessary heart procedures. This was something I did battle with back then, but nonetheless witnessed hundreds of people go through heart procedures without real reason.) We’d tell them “cut your fat further, take a higher dose of Lipitor, etc.” The businessman would return in another year or so, another scan: score 880. It became clear by our experience, as well as the published experience that we contributed to, that the calcium score increased at a rate of 25-30% per year and that tools such as statin drugs had very little effect in stopping this terrifying progression. We were therefore left without any real tools to deal with this problem, while all around me nice people were freaking out as they watched their coronary atherosclerotic plaque grow.
So I set out to discover ways to put this to a stop. After all, we now had a tool, the EBT* device, that allowed us to track progression–or regression–of coronary disease. Little by little, step by step, we worked on new ways to slow or stop the process. I added advanced lipoprotein analysis, such as NMR lipoprotein testing, to better decipher the details in the fat-carrying particles in the bloodstream. I folded in new insights into such factors as vitamin D. Over many years, I learned several critical lessons:
- Having an omega-3 fatty acid RBC blood level of 10% or greater contributed to slowing. In other words, of all the fatty acids in red blood cells, RBCs, 10% or more had to be from the EPA and DHA of fish oil. This was achieved with EPA + DHA daily intakes of 3000-3600 mg per day from fish oil (only).
- Vitamin D–Vitamin D, when added to the mix of strategies I was using, yielded shocking effects. Before vitamin D, the majority of people only managed to slow the growth of their calcium scores. Adding vitamin D in oil-based gelcap form as cholecalciferol (not ergocalciferol, the prescription form) didn’t just slow it down; it actually reduced scores, often dramatically. I watched, for example, a score of 600 become a score of 300 a year later. This proved fairly consistent. Of course, vitamin D also proved to be so powerful in many other facets of health, as well.
- Small LDL particles that are oxidation-prone and persist in the bloodstream up to 7-times longer than large LDL particles were eliminated in the majority of people by eliminating wheat, grains, and sugars. This mean, for instance, that someone with a total LDL particle number (by NMR) of 2000 nmol/L, a virtual count of LDL particles in the bloodstream, of which 1400 nmol/L were small particles, would eliminate wheat, grains, and sugars and drop small LDL particles to zero, total LDL particle number to 600 nmol/L: 2000 -1400 = 600 nmol/L. An LDL particle number of 600 nmol/L is equivalent to an LDL cholesterol value of 60 mg/dl (drop the last digit from LDL particle number)–a spectacularly low value achieved without statin drugs. Over time, it became clearer and clearer: the majority of people did not need statin drugs and achieved values better than that on the drugs.
- Thyroid status needed to be perfect–Even a marginal degree of hypothyroidism (low thyroid function responsible for low energy, weight gain or failure to lose weight, inappropriately cold hands and feet) could trigger extravagant increases in calcium scores. And hypothyroidism was incredibly common, easily affecting 30% of the people I saw. It meant addressing iodine and aiming for a TSH no higher than 1.5 mIU/L and free T4 and free T3 in the upper half of the reference range, along with absence of any symptoms of hypothyroidism.
- Blood sugar needed to be in a truly normal range–This meant fasting blood sugars of no higher than 100 mg/dl, preferably 90 mg/dl or lower, and hemoglobin A1c, HbA1c, had to be 5.0% or less. In other words, you had to reverse pre-diabetes or diabetes to gain control over coronary plaque growth.
- Efforts to cultivate healthy bowel flora were necessary–This most recent lesson added even greater advantage to control over calcium scores, as well as overall health and metabolic markers.
There were some additional lessons learned along the way that applied to selected groups of people, such as the efforts targeting the genetic pattern, lipoprotein(a); the contribution of phytosterols/sitosterol to heart disease; dietary manipulations to accommodate specific genetic variants such as apoprotein E2 and abnormal postprandial (after-meal) processing of lipoproteins, etc. But, for the majority, the menu proved incredibly simple and straightforward, and most people following this program stopped the growth of their coronary atherosclerotic plaque/calcium scores altogether, many enjoying dramatic drops in scores, something my colleagues declare is impossible even today. And I stopped seeing heart attacks, heart symptoms, need for heart catheterizations, stents, and bypass surgery–coronary disease essentially came to a halt. Though my background was in heart procedures, I stopped doing them . . . because nobody needed them any longer. Five, six, seven, or eight procedures per day fell to zero. (You can also appreciate the indifference from my colleagues and hospitals, also, as their primary source of income is from heart procedures.)
Of course, as I introduced these strategies, I also watched people lose extraordinary amounts of weight, look and feel better, reverse diabetes, reverse autoimmune diseases like rheumatoid arthritis, reverse skin rashes like eczema and psoriasis, obtain freedom from acid reflux and irritable bowel symptoms, improve their emotional health, enjoy better sleep, reverse depression, obtain relief from migraine headaches, etc.–all the lessons I now talk about in Wheat Belly conversations. But, with the flood of wonderful experiences that continue to come into the Wheat Belly Facebook page, the Wheat Belly Blog, and elsewhere, it is sometimes easy to forget: this whole collection of life- and health-changing revelations began with efforts to stamp out heart attacks and coronary heart disease . . . and it works. It works big time. And it’s incredibly easy, while providing an astounding range of improvements in overall health.
*The EBT device has now been supplanted by a newer type of CT scanner, the multi-detector CT, MDCT, device. So for anyone looking for a heart scan to obtain a calcium score, the majority of imaging centers now have the newer devices. Also, anyone interested in how to apply advanced lipoprotein analysis, see the chapter on metabolic health in Wheat Belly Total Health.