OT: Heart Disease-Do you have it

Jack, yes that is the book. I never finished it, I only read about the first 25%?of it, then got distracted by other things. But I do intend to finish the book.

As Billybob said, the government has been touting low fat for decades, and all the while, diabetes, obesity and heart disease, have soared in the u.s. So something is wrong with that picture.

I don't think we'll ever see large scale RCTs. They are too costly, no drug companies would benefit, and it's impossible to monitor thousands f people's diets.

Now, with all this said, there HAVE been smaller scale studies, or maybe I should say, more of "reported successes" by Dr Caldwell Esselstyn and Dr Dean Ornish showing a vegan diet, that is low fat, has REVERSED heart disease.
I think it can be a different solution fr different people. I know of people (Internet friends) who claim to have reversed atherosclerosis, or stopped progression (very hard to do) on a low carb high fat diet along with supplements (vet D, k-2, coq10, etc.)

So there is a dichotomy. I just look at my own situation, and as I've said in the past, I never had a cholesterol problem, other than moderately low HDL, total cholesterol was never above 170, and yet I have atherosclerosis. The only culprit can be Triglycerides. Which means I'd do very badly on a high carb low fat diet.

Pratoman said...
@Billybob - in all fairness to my Dr, he did advise me at the time to lower my carb intake, and restrict carbs to complex carbs. I was 50 at the time, I was immortal. I didn't listen to him. I was like, just give me the pills and let me get out of here. But you are right, many in the medical,profession don't bother to talk about diet.

I'm only on one med for TG now, and it's a low dose. It's Niacn, 1000 mg. I'm on a Statin as well, Crestor, but I do not believe statins lower TG. In the past I was on Lipitor, and it did not bring my TG down at all.

BTW, you commented about low fat raising HDL, was that a typo? My
My understandng is that HIGH fat raises LDL.

Well OK then, so he tried to warn you, and the culprit is you!

Well good on him then, but really, I wonder how many docs try to get folks to lower carbs and maybe even, gasp, raise or at least maintain fat? I'm pretty certain most, to this day, still knee jerk to recommendations of low fat probably with a few pills to help out. But hopefully, they are coming around.

I know what you mean about Ornish. As unlikely as it seems, and speaking only about CV disease and not necessarily also cancer, it appears that two opposite extremes are both effective. Except: Ornish has his very small scale clinical results for both PC and HD. All we have for studies and low carb, as far as I know, are numbers. Numbers of things they tell us are very important to both HD and all cause survival: weight, blood pressure, blood insulin, HD and TGLs, and maybe LDL particle size. In all those areas according to multiple small studies ( and personal experience) low carb rules. Also probably relatively high fat rules, possibly more so for the so called healthy fats. Low fat is a winner by small degree with LDL #s, everything else low carb kicks butt.

However, does improving all of those #s actually increase longevity and decrease Heart disease? That I do not know. Just like good cholesterol #s have not kept you from getting some calcium build up, and definitely worse #s than yours(except TGLs, but even that was over 200 before low carbing it) have given me a zero score. So, what the heck do we, or at least I, really know? I know how to hugely improve TGLs drug free by Golly! FWIW!

RCS, doesn't look to me like much has changed. They recommend grains, "at least half of which are whole,grains" . Which implies that the other half is OK of its processed grains, like enriched wheat flour.

And they recommend low fat or fat free dairy. Which pretty much always has more carbs, and plenty of chemicals that are unhealthy. Take a look at the ingredients in fat free cheese. It will horrify you.

RCS said...
Over the years my doctors (PCP, cardiologist) and nutritionists have always recommended a balanced diet. I have never had one recommend low fat (as in no meat) and high carbs. You might be surprised at the USDA recommendations for a balanced diet (now called a healthy eating pattern). I believe it is getting pretty close to what you are recommending,

health.gov/dietaryguidelines/2015/guidelines/chapter-1/key-recommendations/ ............................................

If you, or I, had followed these guidelines 30 years ago we would not have had the problems we have now ....

Well, I suppose most doctors would agree with you. Then again, untold millions have made a great effort to follow the dietary advice of their docs over the past 30-40 years, even with a perceived need( probably correct) for more exercise resulting in a huge number of gyms that did not exist 40 years ago. I drive by a couple on my way home to my recliner ( )every day and the parking lots are full of adults on treadmills. And yet what has happened with obesity and diabetes during those 40 years? I would say at the least it for sure has not decreased, but rather significantly increased.

When you say "my doctors (PCP, cardiologist) and nutritionists have always recommended a balanced diet. I have never had one recommend low fat (as in no meat) and high carbs", I suppose that means a diet as recommended in the government guideline link? Because those say: "The recommendation for the meats, poultry, and eggs subgroup in the Healthy U.S.-Style Eating Pattern at the 2,000-calorie level is 26 ounce-equivalents per week. " and "limit saturated fat to < 10% of calories..........total fat intake between 20 to 35 percent of calories" and "When selecting and preparing meat, poultry, dry beans, and milk or milk products, make choices that are lean, low-fat, or fat-free".

It is of course somewhat a matter of semantics. But 26 oz of meat group per week? < 4 oz per day? The linked recommendations will result in a diet with the by far largest % of calories coming from carbohydrates and to a lesser extent proteins which when consumed in excess to needs can be converted to carbs. So in my biased opinion, your docs/dieticians have indeed been recommending low fat/high carb to you all along, but they choose to call that balanced. Balanced being defined as mostly carb and little fat..

But, I do agree with you that things are slowly changing towards the better. Probably because of all the studies showing that- as far as almost all of the weight, BP and lab #s they tell us we should shoot for, there simply is no question that lowering the carbs/sugar load, even if replacing with various fats, is many times more effective than lowering fat and replacing with carbs. Plus, I have yet to see a good study showing the opposite, though there has to be one out there. There always is! But I don't look too hard for those other studies, since as we all know any study can be biased, and if they had a study showing that raising carbs greatly increased HDL and lowered TGL, BP, weight and blood insulin and sugar, it would conflict with my personal experience and that of several other folks I know, and I trust these personal anecdotes more than I do any 1 study. ( after all, such a study might come from folks- or good friends of folks- who want to sell me statins and BP meds and stents you never know! )

But once again, let me caution that improving all of those #s ALL the docs tell us we should improve, is not the same as actually lowering our rates of heart disease or living longer. On that I really don't know. All I know is, the docs tell us improving these #s is good for us. Are they correct? If so, I need to lower my carb input. And maybe even replace it with fat(got to eat something), which does not cause insulin production leading to insulin resistance then to heart disease and diabetes which leads to even more heart disease. Or so I am told. ( what about cancer? Don't know, but I do hear the lower insulin is better as it greatly helps cancer to grow. Or so some say.)

Post Edited (BillyBob@388) : 7/16/2016 10:13:56 AM (GMT-6)

RCS, congratulations on outliving your father 18 years so far. My goal too. Six years so far.


I'm struggling to grasp fully the type of diet you are endorsing--if that word can be appropriately used here, BillyBob. Is it essentially an Atkins diet?

RCS said...
If you, or I, had followed these guidelines 30 years ago we would not have had the problems we have now ....

I agree with you RCS, because the way I ate up till a couple of years before I was diagnosed with CAD, was serious abuse of my body. When I think back, I cringe. Perhaps a balanced diet throughout my life would have led to a better outcome. But now that I don't have much margin for error, it seems like extremes are necessary, almost like playing catchup.

Still, I think for most people, very limited carbs, with none coming from wheat, is better than a typical daily American carb intake even if it is limited to whole grains and complex carbs. UNLESS, your grains are primal grains, I forget what they are called but made from wheat that is similar to the wheat that our ancestors ate, no. GMO, ETC. Hard to find.

JackH said...
RCS, congratulations on outliving your father 18 years so far. My goal too. Six years so far.


I'm struggling to grasp fully the type of diet you are endorsing--if that word can be appropriately used here, BillyBob. Is it essentially an Atkins diet?

Are you asking me about the diet that most studies I have seen raise HDL significantly and drastically lower TGLs, plus a few other benefits but with the negative of slightly raising LDL? Yes, that is Atkins or one of several variations on it( South Beach or Protein Power or Paleo( a few extra tricks thrown in) and the milder versions like the Zone. The key shared by all of them lowering carbs to one degree or another, with Atkins limiting them pretty severely in the 1st 2 weeks. And most of them raise fat to replace the carbs. Atkins was the original famous one. They all work, but the more you drop the carbs the more and faster it works.

But, in the maintenance phase of atkins and most of the others, you end up with more carbs that you might think, quite a bit in fact. But it is mostly the high fiber low glycemic carbs. Think Broccoli. And many other vegetables of which you can eat all you can stand. It takes a ton of that stuff to get much net carb after subtracting the fiber from the carb. Carb load = carb(sugar) minus fiber. It is stuff like bread and pasta and pie/cake that causes the big problems. I know well, as I love all of that stuff!

Post Edited (BillyBob@388) : 7/16/2016 11:26:36 PM (GMT-6)

Prat:

Guilt is a horrible thing.

Mel

Pratoman,

Quitting bad eating is easy ..... I've done it thousands of times.

Glad you enjoyed a nice night out, you deserve it.

Atkins diet looks brutal. I think that's what you guy have been talking about for boosting HDL. From what I hear, nobody actually sticks to that diet...they just try it for a while, but they always revert. I'm talking with my wife about other ways to modify our diet for more HDL-boosting components. More avocado.

Prato, this is a great article for sure, Although, for all practical purposes, it is not telling me much that Atkins(a cardiologist BTW ) and the Protein Power folks didn't tell me 20 years ago. And more recently, the Paleo folks telling me the same though with slightly different approch. But what is different- and also great - about this article is a heart surgeon is saying "me and my fellow doctors" have been horribly wrong all these years, and we have caused a lot of damage, plus he is basing his claim on an additional 25 years of research. He is also more or less saying Atkins was right all along!

"Imagine spilling syrup on your keyboard and you have a visual of what occurs inside the cell. When we consume simple carbohydrates such as sugar, blood sugar rises rapidly. In response, your pancreas secretes insulin whose primary purpose is to drive sugar into each cell where it is stored for energy. If the cell is full and does not need glucose, it is rejected to avoid extra sugar gumming up the works.

When your full cells reject the extra glucose, blood sugar rises producing more insulin and the glucose converts to stored fat."

Notice his emphasis on insulin. This was always what both Atkins and many others said was the main culprit in all sorts of ills. And inflammation. But aren't both insulin and inflammation more and more frequently being implicated in cancer?

JackH said...
Atkins diet looks brutal. I think that's what you guy have been talking about for boosting HDL. From what I hear, nobody actually sticks to that diet...they just try it for a while, but they always revert. I'm talking with my wife about other ways to modify our diet for more HDL-boosting components. More avocado.

Jack:
I agree, it is brutal. Especially getting started and getting the ball rolling. ( My experience once the ball is rolling is zero hunger and few cravings if any. I often forgot to eat lunch) But then so is Ornish, IMO. I.E brutal. As for reverting, I have reverted many times. IOW, in 6 months( about 17 years ago) I took off 42 lbs(without hunger), dropped my BP from 145/90 to 105/60, dropped my TGLs from > 200 into the 40s, raised my HDL from less than 30 to about 50. All without hunger. Then I slowly went back to my ols ways. My BP and TGLs never got back up to the old levels. Over the years, eating whatever I wanted ( should not have done that ) my weight and waist would start creeping back up, at some point I would get nervous and go back on the system for a week or two and knock it right back down. Though my BP is still a good bit lower than it was, and TGLs still a lot better though more like 60s-80s, my weight recently hit my all time record. I have not low carbed in several years. But it took me 17 years to get there. On the other hand, I have known a lot of folks doing a low fat diet who lose some weight, do not improve most of their blood tests, and then 6 months later they have gained it all back +5lb.

Atkins may not be as brutal as it 1st appears. Keep in mind that it was developed for the grossly Obese who needed to see results quickly. And nothing works faster than some version of Atkins, both for weight loss and changing blood chemistry. It is psychologically very helpful for a person to see results quickly as an incentive to stay with the program.

No one is meant to stay on the 2 week induction phase forever, or at least very few. As soon as weight loss is happening and ketosis is reached, they start adding small amounts of carb back into the diet ( preferably healthy stuff like vegetables and a smaller amount of fruit) until weight loss stops, then back off to the previous step. Once desired weight loss is accomplished, you once again start adding carbs back to the point where weight loss stops and weight remains stable.

But again, this is usually only needed for the grossly obese whose weight is dangerously high. If that is not the problem, and you just want to raise HDL for ex, one can start at one of the maintenance levels. Which is probably the way some folks here have gone. IOW, just cut carbs(especially refined carbs) significantly, replace refined carbs with vegetables, and don't cut fat. Or maybe add some back if on a low fat diet. In my experience, cutting carbs AND fat is a set up for failure. The huge advantage to an Atkins style approach is no hunger. But if you cut the fat, hunger will probably show up quickly.

When comparing relative levels of brutality, if you are a meat eater like me, picture going Vegan and a life without a delicious rib eye steak at least occasionally. That concept is brutal for some of us. Might come down to individual preference.

As for those avocados, good idea IMO! Adding fat, yum! Trim some carbs at the same time and that HDL might start upward. As the TGLs fall as a bonus!

Post Edited (BillyBob@388) : 7/18/2016 8:06:32 PM (GMT-6)

Jack,

If you want to raise your HDL, you may also want to try lifting some weights. Heres's a link, there are others:
www.ncbi.nlm.nih.gov/pubmed/3824017

Researchers say that as long as fats are the good kind, and part of an otherwise healthy, vegetable-rich diet, there’s really no reason to curb their intake anymore.

www.forbes.com/sites/alicegwalton/2016/07/19/high-fat-is-healthy-if-its-part-of-a-mediterranean-diet-study-finds/#7f5e7f162197