A Chance to Help Change the Dietary Guidelines

A Chance to Help Change the Dietary Guidelines

The U.S Department of Agriculture is accepting public comments for the 2020-2025 U.S. Dietary Guidelines for Americans. They are accepting comments through March 30, 2018 so there is still time to send in your comments. 

To see the docket go to:


To see the full document:

Dietary Guidelines for Americans: Request for comments on Topics and Questions

To leave a comment go to:


Two of the issues of the many to be discussed are saturated fats and low-carbohyd

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Sugar and the American Diet by Karen Witter

Sugar and the American Diet by Karen Witter

Sugar and the American Diet

Karen A. Witter

February 24, 2018

Disclaimer:  This paper was written to share information with friends and colleagues about the harmful and addictive nature of sugar, which I learned more about through the Crossfit Instinct Longevity class in Springfield, IL. Books and web sites used as sources are listed at the end.  Some, but not all, are cited in the text. The paper was initially prepared for a verbal presentation to a small group of women and not intended for publication.

Early History of Sugar

Sugar has changed the world, and the history of sugar is not all sweet.  Its origins date back 10,000 years to New Guinea, which is located north of Australia, where sugar cane was first domesticated. Sugar cane reached the Asian mainland by 1000 BC. Indian alchemists discovered how to make a white powdered version of sugar by 500 BC. Sugar spread to the Middle East and then Europe, but it was initially only available to the wealthy.

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How does visceral fat lead to heart disease?

Type 2 Diabetes increases the risk of having arterial disease and heart attack.  You have probably seen ads for diabetes medication making that known.  The implication is that their medication lowers the risk of dying of heart attack.  But there is a deeper truth.

Before blood glucose rises, atherosclerosis is developing, and many have heart attacks before having high glucose.  The suspected mechanism is high insulin levels that compensate for insulin resistance.  Excessive visceral fat causes insulin resistance.  Insulin resistance inflames arteries leading to atherosclerosis.

If we rely on rising glucose or Hemoglobin A1c to diagnose insulin resistance, it will be identified later rather than sooner. 

The earliest indicator is abdominal obesity which we can measure as visceral fat using the InBody 570.  This measurement is noninvasive, quick and inexpensive.  It reveals details about your health that the scale can’t show.  http://www.thecenterforprevention.com/body-composition-analysis/

Once a baseline visceral fat level is measured, a plan to reduce fat is offered.  That plan is generally straightforward:  eliminate sugar, especially processed food.  Serial measurement shows progress away from becoming diabetic and atherosclerosis toward greater health and resilience. 

Of all the opportunities to reduce heart attack death and disability, reducing visceral fat is among the greatest.  Get yours measured.  Having high visceral fat is serious, but it isn’t as serious as a heart attack.

Heart Disease and Women

Women and men are different, including in the way we present with heart attacks.  Most of the classic symptoms of crushing chest discomfort, sweating, and shortness of breath with arm aching (which normally provoke an urgent response when present) may be completely absent in the woman having a heart attack.

Women are more likely to go undiagnosed and die with their heart attack because it goes unrecognized.

The more typical complaints have more in common with anxiety or panic attacks or just not feeling right.  They are all too easily dismissed as not life threatening.  If you have these symptoms and don’t know you are free of arterial disease, you should ask yourself or the doctor you are seeing:  “Could I be having a heart attack?”

That is why I believe it is even more important for asymptomatic women than men to be screened for arterial disease with carotid ultrasound looking for plaque.  These symptoms in a woman with known disease will be taken more seriously, while reassurance will be easier and more appropriate if screening reveals no disease. 

I have commonly had couples present to my office to have the male screened for arterial disease.  When we turn to the woman and convince them early detection and prevention are important for both, we often find more severe disease in the woman. 

It costs so little and is painless to be screened with carotid ultrasound with intima media thickness and plaque character focus.  It will detect disease far earlier than stress tests or even angiograms at a fraction of the cost and risk. 


Why do people resist testing for arterial disease?

After experiencing our care, many ask me “why would anyone not get this done?  It is easy, affordable and gave me information I did not have from my current care.”

Why, indeed.  Here are some reasons that come to mind and reasons to Choose Prevention:

·       Most of us are more reactive than proactive by nature.  Steve Covey’s First of 7 Habits is “Be Proactive.”  That suggests to me that this is a problem for many of us.

·       Denial.  This is the first reaction most people have to bad news.  “I don’t want to know.”  Women now routinely get their annual mammogram.  It is expected.  It took years to create this expectation.  The same needs to happen with early detection and management of arterial disease.  It will save more lives than mammograms.

·       Defensiveness.  When we are told “there might be a better way” we tend to hear “you aren’t doing the ‘right’ thing.”  Ego can keep us from learning about and implementing new approaches, even if they are more effective and cost less.  Those who provide the status quo feel threatened by change, especially if it threatens their livelihood or makes their current investment obsolete.

·       Fear of the consequences.  This is a legitimate concern.  “I had a positive coronary calcium score.  I was feeling fine.  That led to a stress test, then a cath and the next think I know I had bypass surgery!”  This is the story we want to avoid.  Identify the disease you have, but manage it to reverse it.  Avoid the trauma of intervention, disability or death.  Choose prevention.

·       Faith in Rescue.  “If I have a heart attack or stroke, technology is so good I will be saved.”  Like skydiving, we think the parachute will save us.  But what if it doesn’t open because we let someone else pack our chute?  We all must take responsibility for our own health.  Don’t count on a rescue.  You may not live long enough to get to the hospital and it may not work.  If it works, it will be a great story, but it will change your life and cost outrageous sums of money that will be somebody’s burden.  

·       Inadequate information.  Many don’t know that arterial disease can improve.  It can improve with personalized understanding of its root causes, effective lifestyle and medical treatment and measurements that show results.

Don’t let these or any other reasons prevent you from knowing all you can know to be healthier.  The Center for Prevention can help you, but first you have to Choose Prevention.

The Second Step of Process

The Healthy Business Prevention Program follows a 3 step process as we assess patients to determine their risk for heart disease or stroke.  The program is designed to:

For those patients who show onset of atherosclerosis, we move on to step 2, where we attempt to determine the causes of arterial disease.  We recognize that atherosclerosis can have many root causes, and by identifying the actual issues that might cause disease for each individual (rather than take a one size fits all approach), we are able to better treat the patient and prevent the onset of further disease. 


In this step, we perform several advanced lab tests, all based on blood draws, including reviewing the lipid panel, Apolipoprotein B, Lipoprotein(a), HbA1c (to detect diabetes and prediabetes), LpPLA2 ( to detect inflammation) and Vitamin D levels.  From these tests, we offer a consultation and make specific and individual recommendations.


We only administer follow up tests to those employees who have been identified as having a higher risk for heart attack or stroke.


Our goal is to save your human capital and preserve a healthy bottom line.

Learn More about our Healthy Business Prevention Program»The Process

Skip Your Next Heart Attack!

The month of February is national heart disease awareness month. At The Center for Prevention: Heart Attack and Stroke, we want you to know that you don't have to have a heart attack, or a stroke for that matter. No matter how high your risk, we implement the effective, evidence based strategies that go beyond the standard of care based on the Bale-Doneen method, outlined in the book Beat the Heart Attack Gene.

Beat The Heart Attack Gene, by Bradley Bale, MD and Amy Doneen, ARNP, allows a new understanding of prevention of heart disease. It gives readers materials to show their doctors and ensure personalized and unique care based on their needs and risk factors. The authors provide insight as to how their method could prevent a recurrence of heart attack or stroke by identification of what could be triggering the disease.

We encourage you to check out that book, as well as our website and come see us to have an assessment. Learn if you have arteriole disease, and then learn how to best avoid the consequences.

You don't have to have a heart attack, you can skip it! 

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The First Step of The Process

The Healthy Business Prevention Program follows a 3 step process as we assess patients to determine their risk for heart disease or stroke.  The program is designed to:

  • Detect arterial disease
  • Identify causes of disease
  • Manage and monitor patient's outcome

Our first step is to detect arterial disease, also known as atherosclerosis.  We use the Carotid IMT, a quick non-invasive test which can be performed in our office or in yours.  The CIMT detects thickening of the arterial wall, a sign of atherosclerosis, which can typically be seen through imaging well before symptoms present themselves.

For a low fixed cost, companies can have us screen their employees to prevent issues before they arise! Companies who take advantage of the Healthy Business Prevention Program benefit from improved productivity and cost-savings for health insurance plans.

To learn more, please visit our website or contact us 

Education: the first step of the Bale-Doneen Method

At the Center for Prevention Heart Attack and Stroke in Springfield, Illinois, we believe that education is very important. 

If we have the wrong information and keep acting upon it we are doomed to repeat the mistakes of the past. In late 2013, Dr. Backs learned of the Bale-Doneen Method and attended his first preceptorship in November 2013.  He had to unlearn much of what he thought I knew about treating arterial disease and incorporate new information into the treatment of my patients.  The results have been very good.

It’s important that we all be educated on what really causes arterial disease.  This is well outlined in Drs. Bale and Doneen’s book called, “Beat the Heart Attack Gene.”  Published in February 2014, it is intended for the general public, and we urge you to get a copy and read it. All the patients in the Heart Attack and Stroke Prevention program get a copy of this book so they understand their opportunities and can speak the same language.

So educate yourself about the truth about prevention of heart attack and stroke and arterial disease.  

Learn more about the first step of the Bale-Doneen Method

At the Center for Prevention, we believe that preventing heart attacks and stroke BEFORE tragedy strikes is not only possible, but a preferable way to address cardiovascular disease. 

The Bale-Doneen Method follows a 6 step process in assessing and treating patients to prevent heart attack and stroke.  The first step is Education, which is what this message will review in slightly more detail.

Dr Backs in CrossFit Instinct Longevity

As many of you are aware, Dr Backs doesn't just talk about making lifestyle changes for improved health and a healthy outcome, he has lived it.  Dr Backs is a member of the CrossFit Instinct's Longevity class; in his interview for this article, he talks about his personal story and how to has shaped his commitment to the patients in his practice.  

Check out this article that appeared in this month's issue of Crossfit Journal!

STROKE: Detect and Treat or Prevent?

May is Stroke Awareness month.  If you’ve had a stroke or known someone who has suffered a stroke, you know that the results can vary from mild change in function all the way up to severe paralysis, loss of speech or even death.  The recovery from a severe stroke can take months or years and costs huge sums of money, not to mention lost quality of life or earning potential.

Not all strokes can be prevented.  Some are due to congenital issues beyond our control. 

But most of the same conditions that increase the risk of heart attack also increase stroke risk.  These conditions include high cholesterol, high blood pressure, atrial fibrillation, diabetes, smoking and lack of exercise.  This list is not all inclusive, but controlling these conditions would save many lives. 

Given the cost of treatment once a stroke has occurred, prevention is key.  Don’t wait for symptoms to appear to act.  If you have one or more of the above listed conditions, take care of it.  If you really want to know if you have atherosclerosis, consider having a carotid ultrasound that identifies plaque and measures the thickness of the artery wall.  This is called a Carotid Intima Media Thickness Scan or CIMT.  The results can motivate you to act to save your own life.

We offer these scans in our office for under $200.  If you have more disease than you should, you will be motivated to make the changes necessary to improve your results. 

A word of caution:

Many of you have heard of or had the Lifeline Scan.  Though the same technology is used in both Lifeline and CIMT.  Lifeline is focused on blockage.  It is best to act long before there is blockage.  Any plaque should prompt more efforts to improve arterial health.  The CIMT costs a bit more, but you get what you pay for.  You can act much earlier and less invasively. 

So, if the signs and symptoms of a stroke appear, act FAST.  But don’t wait for the symptoms to understand your arterial health.  And don’t wait for arteries to be blocked before you act to make them healthier.

For more information on The Center for Prevention Heart Attack and Stroke, visit our website. Schedule your 15 minute CIMT screening right away by calling 217-321-1987.  15 minutes can save far more than money on car insurance; it could save your life.



How is the CIMT different from a Treadmill Stress Test?

Stress tests have been used for decades in the assessment of coronary artery obstruction or blockage. These tests are useful to sort out symptoms, especially when attempting to determine whether chest pain or shortness of breath is related to coronary artery atherosclerosis. 

Stress tests, however, are not good at detecting early atherosclerosis that isn’t blocking blood flow.  Plaque that is new and unstable may not block flow but could rupture and cause a clot to suddenly and completely block flow and result in a heart attack. 

It is not rare for a person to pass a stress test and have a heart attack a short time later. 

Despite these facts, stress tests continue to be used to reassure patients that they are “OK.”  A negative stress test means you aren’t going to be helped by a stent or surgery to address blockage.  It does not truly reassure that no atherosclerotic plaque is present.  A false sense of reassurance can be bad.

Carotid Intima Media Thickness (CIMT) identifies the earliest stages of atherosclerosis.  This is important because when you know you have a disease and are given the tools to prevent its progression, you can avoid the complications of late stage disease, including death and disability without warning.  You can also avoid the costs and complications of expensive and invasive treatments.

To sort out symptoms that could be related to your coronary arteries, a stress test is helpful. But to determine if you should take measures to improve your arterial health to avoid heart attack or stroke and their complications and treatments, Carotid IMT is far more useful. 

CIMT is also less expensive, less time consuming and does not require effort to be evaluated. 


I had a coronary calcium score. Should I have a Carotid Intima Media Thickness too?

In other words, does a coronary calcium score and a Carotid Intima Media Thickness (CIMT) scan give the same information? 

Although they both detect atherosclerosis, they do so at different stages of disease.  Costs for both tests in our community are comparable, and the CIMT scan is far more portable.

In addition, I have 2 concerns with coronary calcium score.  First, it is not useful for measuring the effects of treatment.  Without going into great detail, it does not improve when artery health improves because calcium deposition occurs late in the development of plaque and will not decrease with treatment.  It represents old scar. 

The second concern is that early, new, soft, non-calcified, dangerous unstable plaque is not detected because it has not yet become calcified.  A test that misses the most dangerous form of the disease is not as useful as one would hope.

The Carotid Intima Media Thickness Scan detects plaque at all stages, including the more dangerous non-calcified plaque mentioned above.

Granted, it is a surrogate sample measurement used to measure atherosclerosis generally.  It does not look directly at the arteries supplying the heart. 

But if you have plaque in your carotid arteries, you should assume you have plaque elsewhere, including the coronaries.  Treatment that improves the carotid artery health improves arterial health generally. 

And improvement (or progression) can be measured and documented.  The effects of treatment to reduce atherosclerotic burden can be seen.  If improvement isn’t seen as expected, treatment can be adjusted. 

Coronary calcium score is not useful for serial measurement of atherosclerosis development.

At the Center for Prevention of Heart Attack & Stroke, we do CIMT first.  If no disease is detected in an individual where it is expected due to a high risk profile, coronary calcium score is a consideration to be more sure the coronaries are not diseased before the carotids.  

I hope you found this answer helpful!