People have to learn how to cook basic meals on their own and eat better. With a plant focused diet peoples lives could improve so easily.
But of course most are waiting for that magic pill.
Whole Foods Plant Based, period. I eat WFPB 95% of the time and vegan prepared foods 5% of the time. My cholesterol markers have greatly improved and I have lost 45 pounds. I’m far more active and feel so much better. It’s been 13 months and I am never going back to the SAD.
1
@Carla Cottrell
Finally, somebody who sees the truth!! Keep up the good work.
1
How could you not mention the importance of plant-based diets in reducing cardiovascular and stroke risk? Dr. Kim Williams, past president of the American College of Cardiology when asked why he chooses to eat a strictly plant-based diet said, “I don’t mind dying. I just don’t want it to be my fault.”
2
Unfortunately, for me, small town, hospital owned, primary care practice downplays, or is ignorant of, all possible signs of heart problems.
1
There are two types of LDL cholesterol: large, buoyant, and small, dense. The blood tests most commonly used cannot differentiate between the two. There is a way to measure the two separately but it is much more expensive to do so.
Fats cause large, buoyant LDL, which pass through without becoming stuck on the blood vessel walls.
Carbs cause small, dense LDL, which are the ones that can get caught up onto the epithelial cells and cause a buildup.
4
I don't get it.
I am recovering from open heart surgery, to correct a valve problem that created an aneurysm. I had a valve replaced and the aortic root replaced. That surgery is gruesome--i felt like I had been dragged under a bus.
My heart problem was not preventable. I am 70-years-old. My wife and I exercise 11 hours/week, much of it hard exercising (hiking carrying 25 pound backpacks, cycling 2500 hilly miles/year). She is a terrific cook, and makes foods from scratch. Consequently, my weight, blood pressure, and cholesterol levels were low.
In short I had a terrific heart--just had a piece that somehow got messed up.
I didn't avoid the heart surgery, despite following all of the guidelines, but importantly I am recovering at turbo speed. Within two weeks of the operation we were already walking 5 miles a day.
Listen folks: if your doctor prescribes a medicine, take it. If you are overweight, lose it. If you eat poorly, eat better. If you are a couch potato, buy a bike.
Avoid what I just went through. It is not fun. YOU DO NOT WANT OPEN HEART SURGERY!
We have a blog about our experience with the heart surgery:
http://livinginthebedofapickup.blogspot.com/
http://livinginthebedofapickup.blogspot.com/2018/10/my-first-night-in-ho...
4
Simply postponement of the inevitable.
Nobody leave this earth alive. If not heart disease, then cancer. Common sense and choosing parents with good genes is the trick.
2
There needs to be a huge public service campaign on billboards, radio, TV, social media that says “Fast Food Kills”. Unfortunately it will never happen.
1
An article on preventing heart disease with no mention of Dr. Kim Williams, past president of the American College of Cardiology, who recommends a whole food plant based dietary pattern, based on the Nobel-worthywork of Campbell, Ornish, Esselstyn and others? The recommendation to eat “less red meat” has led to people eating more chicken, which has saturated fat and cholesterol. Eat beans, whole grains, fruits and vegetables, nuts and seeds. Drink water. Address sleep and stress. Nurture relationships. Move more. The answer to the epidemic of heart disease is not more statins and blood pressure pills!
7
How do you prevent strokes? Signs of strokes? For me, strokes are mysterious. Also this article doesn't even list the signs of a heart attack.
2
Please add reducing meat and diary as essential.
I consider myself a moderate heart risk success story. A year ago my weight, cholesterol, A1c (diabetes measure), and vitamin D were all out of range. After a year of exercise, controlling my diet, and no medication, they’re normal.
Keys to my story, and ideas for others:
Eliminate salt and reduce sodium everywhere,
Substitute fruits for sugar,
Control fruit juice intake,
Eat Healthy protein and cooked veggies,
Walk at a brisk clip 20 to 40 min, 3 times/wk,
Do 1 min easy sprints every 5 min during walk,
Do circuit of weight machines 1 set of 10 ea,
Do balance exercise: dance, basketball, etc,
Get a little sun where possible.
I exercise 3 times a week and use a tread mill for the walk and sprints. Don’t overdo anything!
Your blood can’t perform its function if it’s loaded up with salt and sugar. Always eat a variety of foods. Stop eating before you’re full and drink a glass of water to finish each meal.
3
What if:
-- your arthritic (arthritis, an auto-immune disease) knees, back, neck, etc. make land exercise very difficult?
-- you live in a cold climate, so water exercise (indoor, warm pools; see above) are very limited and not easily accessed.
-- you have fibromyalgia, so any statin will most likely cause such severe muscle pain, even your internist says it's not gonna work out.
--And the new injectable statins are not a lot of fun (the injection part), cost about $10-15k a year, and insurance doesn't want to cover.
I'll answer the 'what ifs' myself: you do the best you can. With a deep and deadly history of heart disease in my family, yet all the 'what ifs' above applying to me ... I just do the best I can and hope and pray for a quick, definitive end. Death is preferable to a crippling event, for instance. One has to take this type of approach and mindset, or you get even more agitated. And that's not good either.
3
Though it has been popular to demonize salt consumption for many years, there has never been any conclusive scientific evidence that for the average person, salt has deleterious health effects. Unlike, for instance, SUGAR.
There is no such thing as 'uncured' olives.
2
@Comp--Of course there are uncured olives. They grow on trees, and you probably don't want to eat them.
2
@Comp.....One of the first lines of treatment for high blood pressure is treatment with diuretics. Diuretics work by reducing water retention. Salt intake increases water retention. Now that may not be proof, but if logic prevails, what do you think you should do if you want to keep your blood pressure down?
1
I am recovering from open heart surgery, to correct a valve problem that created an aneurysm. I had a valve replaced and the aortic root replaced.
That surgery is gruesome--i felt like I had been dragged under a bus.
My heart problem was not preventable. I am 70-years-old. My wife and I exercise 11 hours/week, much of it hard exercising (hiking carrying 25 pound backpacks, cycling 2500 hilly miles/year). She is a terrific cook, and makes foods from scratch. Consequently, my weight, blood pressure, and cholesterol levels were low.
In short I had a terrific heart--just had a piece that somehow got messed up that messed up another part. I didn't avoid the heart surgery, despite following all of the guidelines. (I am, however, recuperating at turbo speed because I did the right things in the years before my surgery, so it paid off in that way).
Listen folks: if your heart problem is preventable: PREVENT IT!
If your doctor prescribes a medicine, take it. If you are overweight, lose it. If you eat poorly, eat better. If you are a couch potato, buy a bike.
Avoid what I just went through. It is not fun. YOU DO NOT WANT OPEN HEART SURGERY!
7
@Dan
Agree with everything you say. I had open heart bypass surgery 14 years ago at age 55. My cholesterol was great, I was active, ate well, wasn’t overweight, etc etc. unfortunately, both my parents had heart disease which I’ve been unable to escape. You are right - open heart surgery is miserable. Do all you can to avoid it. I continue to eat healthy, exercise, and take all my meds in hopes that I won’t have a repeat.
3
Whole food plant based diet and exercise, there is nothing hard about this.
15
The path of health in the future is hardly well-established as a new generation will most surely lead the way combining a clarity of science and practice in clean nutrition, body exercise in strength, endurance and flexibility and mind flexibility with a more sustainable preventative stress defense through daily breath work.
An article profiling how to solve heart disease while barely mentioning a mediterranean or plant based diet and breath work shows how poorly educated and therefore unprepared our nutritionist and doctor professionals are in tackling one of our world's foremost killers.
11
Theylifestyle changes from the actual study are sound -- however, not all need necessarily to be medicated.
Ms.brody falls into the trap of promoting universal dietary salt reduction -- a discredited practice. The NY Times has covered the discrediting of this recommendation many times -- yet she continues to promote it. People who are Salt Sensitive needs to control salt intake. Your medical doctor can advise you if you have high blood pressure and are salt sensitive. Those whlo are not salt sensitive need not reduce salt intake -- salt reduction in non-salt sensitive people can have negative health effects.
ASK YOUR DOCTOR.
6
I had a heart attack a couple weeks ago (100% blockage in my LAD artery, aka "the widowmaker"). I'm alive (yay!) and since I have been given a second chance at life (literally), I am making better choices.
The things I should eat - fruits and vegetables - can be problematic. Why? Because most of the year, fruit does not taste very good. It is picked underripe, presumably because "hard fruit" ships well, but has no taste. Letting peaches sit on the counter does soften them, but I notice no increase in sweetness.
I love, love, love vegetables, especially in Indian and Thai food, but my homemade attempts fail, especially when compared to going out to those restaurants.
Fast food is ubiquitous and I must -- and do -- avoid it. But I wish, wish, wish, that we had a culture in which going out to get healthy, vegetable dishes were easy, if not the norm.
From experience, I realize that sometimes, yes, it takes a heart attack in order to "wake up"... er uh... assuming that we actually DO wake up.
4
It talks about, for instance, statins in the total absence of discussion about how to get the care and prescriptions required. Diet and exercise, OK; but everything else requires a fix to our broken healthcare system.
2
Another big problem is the studies themselves, that contradict each other, that are based on small studies, you name it. The problem is like gun violence, the one group that could pay for such studies, the government, is handcuffed by the food and farm interests, who don't want the truth out there. Put it this way, countries who didn't have obesity problems, whose diets we consider healthy (traditional Asian, Mediterranean diet), now have soaring obesity rates, and it can be tied directly to the rise of fast food and more importantly, packaged goods the food industry brings there, taking traditional dishes and 'packaging them', loaded with fats and sugar and chemicals to make them cheaply, and also with things designed to make you eat more (among other things, foods laced with sugar cause you to eat more). Companies like Nestles have teams of people doing this kind of work, supplanting 'real food'.
Doctors don't help, they promote 'treatements' that end up treating the symptom, not the cause. Statins lower LDL, but there is real evidence that lowering LDL like that may not help heart disease much. And their knowledge of nutrition is rudimentary, they say "eat less", when serious evidence out there is at least half of all diseases out there are based in lifestyle and especially food. The only way to clear this up is large, long term studies done under controlled circumstances, but the government won't do this, despite being the only one who can pay for it.
4
If it were not for my cardiologist, I would be dead. Instead, I am healthy. Doctors do help.
1
The biggest issue by far is what people are eating, and some of it is out of their control. Today 70% of the population is either overweight or obese (obesity is roughly 40%), and if you look at past figures you see it spiking up starting in the late 70's. Yes, sugar is part of this, there is no doubt, but soda consumption, for example, has plummeted, and people are not eating candy and the like at much higher rates.
The real devil is in fast food and more importantly, the packaged foods many people are eating, and that is the key. Take a look at the ingredients, and the real intake of sugar can be seen, sugar, especially HFC, is used all over the place, that roll you are eating is likely laced with sugar, that real ready to eat, same thing. Not to mention things like salt (most salt is ingested that way), and things like soybean oil being used (again, take a look at bread, it is supposed to be flour, salt and water with yeast, most bread these days comes with oil added, to make it 'taste better'. Packaged food and fast food are often cheaper than making it yourself...
And it comes down in many cases to government farm policy. We heavily subsidize grains, especially corn, making corn dirt cheap, so you have dirt cheap HFC being used in everything, cattle is stuffed with cheap corn to make it fat fast, and dirt cheap flour making cheap starches. 98% of farm subsidies go to wheat, corn and soybeans, while 2% goes to 'specialized' crops, ie fruits and vegetables.
5
@bill d
My bread is homemade with premium organic ingredients: whole wheat flour, olive oil, salt, eggs, and NO SUGAR, and it tastes great. High-quality fats and proteins are good for you and necessary in our diet. It's been established that salt and eggs are NOT drivers of cardiovascular disease; sugar IS.
1
I recently lost 50 lbs in 5 months by cutting out nearly all carbs other than those in vegetables while cutting out sugar and vegetable oils and increasing red meat (grassfed, locally sourced from a woman-owned butcher), eggs (pastured), sardines, ghee, etc -- and most importantly I've been able to afford that pricey local grassfed protein by integrating intermittent fasting into my life and saving so much on breakfast and lunch and snacks. Once you're used to living off your inner pantry of fat and not running on quickly depleted glucose from carbs and sugar it's easy to eat one or at most two meals a day without snacking, binging, or even CRAVING carbs or sugar or feeling all that hungry. (Oh, I've also increased my salt intake, adding pink Himalayan salt to my water!) Google Dr. Ted Naiman (champion of protein, high-intensity body-weight exercise, fat adaption) and Dr. Jason Fung (fasting champion). And if you're concerned about cholesterol, google Dave Feldman (cholesterol code). I also recommend the Peak Human/Food Lies podcast. I'm much lighter, stronger, and a quicker runner than I was in May thanks to this dietary change addled by education via podcasts and blogs. It was easy for me (much easier for me than a vegan diet which worked for me but not for my wife and child and required much more preparation and effort in the kitchen) and I'm very thankful for most likely avoiding diabetes, the metabolic syndrome, Alzheimer's, not to mention the medications!
11
I've always loved fruits, vegetables, whole grains, AND meat - at 61, my French doctor looks at me for two seconds and says 'see you next year.'
I'm interested in the new studies about calcium supplements. Recent studies show that women who have previously suffered strokes are at risk for dementia if they continue to take them. What about men? Other studies show increased risk for heart issues due to these supplements for both men and women.
I'm waiting for the article that states: avoid calcium supplements and rely ONLY on food based sources or you put yourself at risk for all cardiovascular disease.
There's an epidemic of dementia coming to the USA.
Might it be averted if doctors on automatic pilot stop prescribing calcium supplements?
3
This article is an inaccurate over simplification of heart disease the silent often symptomless
disease. It is a great disservice to put out such misleading information.
1
This is delusional. The fastest growing-- pun intended -- group in the USA are the morbidly obese. AND, 50% of the poulation is obese. So how does that figure indicate any reduction--pun intneded.
Eat plants.
15
In case this has not been mentioned yet, be certain to consult with your doctor before discontinuing your daily baby aspirin.
1
I think simplicity is key. As Michael Pollan said, "Eat food. Not too much. Mostly plants." There is much research about the plant-based diet that has stalled, even reversed, inflammatory disease, including cardiovascular disease.
As for exercise, we all just need to start moving more and be intentional about cardiac fitness.
The numbers will follow. But it is still very important to do this in tandem with your physician.
4
@Kate
Any "plant-based diet" which claims to prevent or reverse any disease always involves the removal of _sugar_, refined starches, refined seed oils, and other highly processed foods.
Yet somehow the benefits are always attributed to the veganism, while ignoring that sugary, processed elephant in the room.
6
@The Pooch I suggest you go to the site nutritionfacts.org about the tie behind a plant based diet and cardiovascular health and recovery.Yes, cutting out added sugar or fruit juices, limiting white flour and the like contribute to heart health, but a plant diet that is relatively low in fat (of any kind, healthy or not) has been shown to reverse heart disease, there are a lot of studies showing that. Yes, proponents of Keto diets claim that eating meat is more healthy than a plant based only diet, but what they leave out is the type of meat, too. A lot of keto proponents eat diets full of fatty, corn fed meat, claim it is healthy, and likely in the end they are going to be in trouble. The key if you eat meat (and I am not saying it is not healthy, saying it should be limited) is the portion and type, 4oz of lean protein is the serving size, and also it is wise to limit how many meals with meat.
The real problem is the type of meat, a 4oz burger is likely factory farmed meat fed on corn and using antibiotics and hormones, high in fat, that is not healthy. Like a vegetarian who eats things like french fries or a vegan product loaded with sugar and salt and fats to make it palatable, it is the type that matters.
1
@bill d
"Nutrition facts .org" is a vegan advocacy website. It's carefully cherry-picked nonsense with a vegan agenda.
Naturally fatty foods have never been demonstrated to cause any health problems. Decades of low fat advice were a gigantic mistake, and "low fat" as a population-wide guideline has been debunked as thoroughly as anything can be in nutrition science.
LDL cholesterol is not strongly correlated with heart disease, and statins are not nearly as effective at preventing heart attacks as is advertised. The NNT is extremely high, and they have never been proven effective in women. Saturated fats are not a nutrient of concern for CVD. Diabetes and hyperinsulinemia, on the other hand, most definitely are. A well-formulated low-carb diet combined with intermittent fasting can be very effective at reversing type II diabetes, which would go a long way to preventing heart disease, stroke, alzheimers, and a host of other diseases of modernity.
16
@Mimi
Diabetes has nothing to do with low carb diets, diabetes (type II, not 1) is associated with body fat, pure and simple. You could eat a ton of sugary food a day and not get diabetes, you could eat refined white flour and not get diabetes, with the caveat that the body weight stays the same, which is the kicker to all this, likely if you eat a log of sugary foods and the like you will gain weight, which is fat and that will cause diabetes. However, you can get fat on eating a low carb diet too, lot of people on Keto diets gorge on things like bacon and cheeseburgers and the like, the problem is that that can cause you to put on weight eventually..and that kind of diet is also high in inflammation which is a problem.
2
@Mimi
You should not get medical advice from secondary sources like magazines - The Daily Mail - and the like.
No major Heart Foundation around the world has changed their advice: "The evidence from large clinical trials demonstrates very clearly that lowering LDL cholesterol reduces our risk of death overall and from heart attacks and strokes, regardless of age."
And the regular use of statins is the most effective way to control cholesterol - absent a desire to fundamentally change individual behavior such as diet, exercise, etc.
This is the way it has been - and this is the way it is right now - chasing meta-studies with limited peer review and significant criticism is a fool's errand.
1
@SteveRR
Major heart foundations are still telling us to eat high carb/low fat, still telling us that eggs and butter are deadly, and still telling us to eat "heart healthy margarine." Their advice is worse than useless, it's actively harmful.
By focusing on LDL cholesterol because it's profitable to medicate, they ignore a dozen other more relevant factors and indicators of health.
How about telling people to quit eating sugar and refine starches for starters. A low fat- high carbohydrate diet does not work to fight heart disease or diabetes, " Good Calories Bad Calories", Gary Taubes. Read it. It could save your life.
12
What we seem to miss is the role family genes play in cholesterol. I've run high cholesterol for years and have tried weight loss, strict diets, no diets etc - no change at all in my cholesterol figures. I'm allergic to statins (muscle pain) but have begun to tolerate a combination of a newly improved (but weaker) statin with another drug. My cholesterol is going down. My mother's side of the family is to blame. She had two stents at age 82. She doesn't like/can't tolerate statins and so far has done very well (she's 96) by medicating with Kendall Jackson chardonnay!
9
Well, I *was* taking baby aspirin until I read a recent NYT article informing me that they did more harm than good!
4
@MLChadwick I was going to stop also until I read a 2017 study in Circulation, an American Heart Association publication. Consider a consult with your doctor.
@MLChadwick
I believe the article you mention focused on people 75 and older. If you have a family history of colon cancer, you might want to restart the aspirin regimen, as research shows a potential preventive benefit.
@MLChadwick--Never use the NYT, or other media, to make medical decisions. Use it to begin a conversation with your doctor about the reasons for and against taking baby aspirin, for instance.
2
Ms Brody like many folks in the health profession needs to get out of pitching last century's failed health policies, and base their guidance on today's health science. Bottom-line: we need the advice that gives us the insight to make the environmental and behavior changes to achieve metabolic health and if we do that, most of us will not have to worry about the chronic diseases like heart disease or diabetes or hypertension. I have a wonderful doctor that did this for me 9 years ago and I no longer need to see her, and the only prescription I'm still on is simply dietary.
13
why do you think so many people stop taking statins? The side effects are horrible, and most of the research recommending them is flawed. I’d rather have a good quality of life, followed by death, than a slow, lingering half-life on statins
25
It would be helpful if important health articles described consumption limits like salt in a user-friendly format instead of, for example, 1500 milligrams daily. I can't even visualize what that looks like since I use pinches, dashes and teaspoons when cooking or eating salt.
25
@Sean McCarthy
Salt reduction for the general population has been widely discredited. Ms. Brody is relying on widely-repeated medical factoid tropes from two decades ago.
1
https://www.ncbi.nlm.nih.gov/pubmed/30198808
LDL-C does not cause cardiovascular disease: a comprehensive review of the current literature
"The hypothesis that high TC or LDL-C causes atherosclerosis and CVD has been shown to be false by numerous observations and experiments."
"The fact that high LDL-C is beneficial in terms of overall lifespan has been ignored by researchers who support the lipid hypothesis."
"The assertion that statin treatment is beneficial has been kept alive by individuals who have ignored the results from trials with negative outcomes and by using deceptive statistics."
"That statin treatment has many serious side effects has been minimized by individuals who have used a misleading trial design and have ignored reports from independent researchers."
29
@Dan M
Exactly! Statins are the most widely distributed drugs in the world second only to aspirin which does not require a prescription. Many cardiac patients cannot tolerate statin drugs for prolonged periods of time due to side effects which can be serious
15
@Dan M
Is this an authoritative, peer-reviewed study? I see NIH in the URL but don't know if this study has its imprimatur.
Big deal you're talking about here.
@Dan M
Thanks for the link. I found it very surprising and am pleased to know that my doctor is on top of things. He refused to prescribe statins for my borderline high cholesterol. Here is the link to the actual article. https://www.tandfonline.com/doi/full/10.1080/17512433.2018.1519391
It is somewhat ironic that in today's Science Section of the Times there is also an article "Fast Food: Its What's for Dinner. And Lunch. And Breakfast." The article explains how more than one third of our population lives on fast food.
The sad reality is that too many smoke and eat poorly. How can we fix that?
12
On the other side of the spectrum you find this insignificant numerical minority grouped under the membership of the Road Runners Clubs, the U s Masters Swimmers, The Bikers Clubs, and alike. These people are given the general name of "regular exercisers". They do exercise on life time bases for pleasure. Most obviously they must have a genetic mutation somewhere, that the other 300 million inactive people don't have, and they are dying because of it
That is the research question to be solved. The "Diet", etc are palliative until somebody addresses the main problem: the disease is inactivity. The symptoms are obesity, DM, CVD. Treating the symptoms and not the disease is an exercise in futility.
7
@Mabarreiro Binghamton ny
The people who are active like that, the road runners, the biker clubs, the hikers, the people who do Spartan races and the like, also tend to be food conscious as well, they don't eat diets laden with sugar and fat and the like, they tend to eat diets with moderate eating, they don't run a Spartan race after eating McDonald's all week. The idea that all you need to do to be healthy is to exercise enough isn't true, any expert on fitness and health will tell you that 90% of the answer is in nutrition. Exercise and activity is important to health, but it is dangerous to promote the idea you can eat anything and not have to worry as long as you exercise a lot, lot of people die of heart attacks who go to the gym regularly and the like and still get heart attacks and so forth.
2
The Atkins diet brought all my numbers down.
I thought all the studies showed a daily aspirin worked only for those who had previously had a heart attack.
13
In the current issue of the New England Journal of Medicine, 3 studies are reported that each showed no net benefit of aspirin for patients who have never had symptomatic coronary disease, stroke, or peripheral vascular disease. Aspirin is still recommended for patients with a history of these vascular events.
12
"Every seed-bearing plant shall be yours for food." Genesis 1:29. This means that we should study the entire population of seed bearing plants for their nutritional and medicinal properties. But patent laws prohibit the patenting of any naturally occurring drugs, so science is steered towards man-made chemical meds.
And so, less than 2% of flowering plants have been studied for medicinal properties. But just 40 species provide 25% of the based chemicals in our current medical practices. It also means that we are supposed to be vegans or vegetarians.
Would war exist if mankind had never invented the weapons of the hunt? From what i've read, the most successful hominid species -- australeopithicus afarensis -- existed for 600,000 years as fruit and nut specialists. that's three times as long as homo sapiens sapiens, (us) Animal based food systems are killing us and the planet. and are the number on source of greenhouse gases. Eating animals is bad, any which way you look at it.
9
@Mark Jacobson
One that does seem to work is red rice yeast, it is a natural statin that doesn't have the side effects of lipitor et al. Integrative physicians like Dr. Weill have used it with patients for years and said it was effective in lowering serum cholesterol but without the muscle weakness. Another problem is statins lower the amount of CoQ10 in the body, which the heart needs, yet it is still not protocol to have people on statins take CoQ10 with it.
There is no mention of how difficult it is to get an appointment with a cardiologist. In Washington D.C. I made several calls yesterday and can't get in anywhere until January. They don't even ask for insurance information. It's also true of other fields, but heart issues are often urgent. Don't mock Doctor Google when it's all many will ever find.
15
@JP--Try getting a referral from a primary care doctor. They can often get you in much earlier, especially if you are experiencing a current problem.
@JP I recommend the book, “Prevent and Reverse Heart Disease” by Dr. Caldwell Esselstyn. Life-saving.
Preventing heart attacks and strokes isn't really rocket science. It requires some basic lifestyle changes; a diet that focuses on whole foods with considerably reduced amounts of animal fat and protein, a modicum of physical activity, and avoidance of tobacco.
Numerous studies, including the Harvard Nurse's Study, have pointed to the effectiveness of those simple changes for heart and cardiovascular health. However, the big problem is a lack of political will to promote those changes.
When the USDA a few years announced a "Meatless Monday," congressmen went nuclear at the USDA for having the "audacity" to tell people to cut back on meat. The initiative was actually meant for environmental rather than health reasons, but in either case it was scrapped in short order. And who can forget Oprah was sued for suggesting people should eat less beef.
The very industries that contribute to the problem are highly invested in keeping the status quo and have very powerful lobbies to make sure nothing threatens it. It's no secret that American school lunches are some of the least healthy compared to those in other countries.
When Barack Obama first came to the White House he was passionate about improving the diets of American school children. He was quickly warned to back off, and a more innocuous version fell to Michelle to implement.
And now, with a president who is a poster child for how not to eat for heart health, where is the political will for change?
33
I have osteoporosis. My doctors all tell me to increase my protein intake, at least 4 ounces of lean fish or chicken a day.
3
@Jane
For one, 4 ounces of fish or chicken provides about 25 grams of protein. The average American eats about 100 grams daily, four times that much. Harvard Medical says a 50 year-old woman who weighs 140 pound would need about 53 grams of protein a day. So if your doctors are telling you to increase to 4 ounces of fish or chicken, which translates into 25 grams of protein, you weren't getting enough protein previously.
You didn't mention your age, but an increase in protein for older adults, even up to say 70 or 80 grams per day, is recommended to help prevent muscle loss (sarcopenia), which is a major cause of frailty and disability in seniors. If you want to get the best of both worlds, sufficient protein without the drawbacks of animal protein and saturated fats, try including some plant-based sources such as beans or tofu.
As to osteoporosis, studies have shown protein helps in the absorption of calcium, with vitamin D (sunshine) also being a key player in the mix. Leafy greens and tofu are a good source of calcium, as are sesame seeds.
Research has also found a lot of evidence for moderate exercise as helpful for osteoporosis to the degree that you are able to do it, even if only walking. Good luck!
2
@JHM:
What "drawbacks" to animal protein and saturated fat? You mean like good nutrition, satiety, and blood sugar balance?
1
The only diet clinically proven to prevent and reverse Heart disease is a whole food plant based diet with no oil as shown by Dr Caldwell Esselstyn. Eliminating meat and dairy and oil should be the first recommended action before statins or aspirin. This article failed to inform people of the side effects of statins which can be severe..
19
@John Raffaele I've been on it for 7 years. My blood test numbers (cholesterol, lipids, etc) are excellent. Lost a lot of weight (w/o trying) within a few months. First 2-3 weeks were challenging; but after that it's easy. Main challenge now is restaurants - which I try to avoid - because so many restaurants soak vegetables and everything else in as much oil as they can (because that's what most customers demand.) But there are very good vegan restaurants around (unfortunately many of my acquaintances won't even try them - the name puts them off. Peoples' ignorance is boundless).
11
@John Raffaele That is absolutely not true. Do your own research, and avoid those selling books and DVDs on their miracle programs.
1
@John Raffaele
Any plant-based diet that claims to prevent or reverse any disease always involves the removal of _sugar_, other refined carbs, and usually also refined plant oils. Yet the benefits are attributed to the veganism, while ignoring the sugary elephant in the middle of the room.
4
Current healthcare is, in reality, 'sickcare', by which millions healthcare workers can live/ support families, and all their incomes are aggregated now to 18% of our National Income, exceptionally highest among the advanced countries. There is no incentive for these people including doctors to promote healthcare in real meaning.
In this sense, why doctors recommend or advise healthy nutrition and supplementation that eventually effect decreasing their jobs and income.
Based upon many scientific researches, in addition to macronutrients such as carbohydrates, fat and protein, it is apparent that we will become healthier if we take moderately micronutrients such as calcium, iron, magnesium, potassium, selenium, sodium, zinc, vitamins A, B6, B12, C, D, E, and K, as well as biotin, folic acid, niacin, pantothenic acid, riboflavin and thiamin from foods and supplements.
Please read following two researches to explain how vitamin C is helpful to prevent and treat diabetes and cardiovascular disease or osteoporosis.
"Effect of vitamin C on blood glucose, serum lipids & serum insulin in type 2 diabetes patients."
https://www.ncbi.nlm.nih.gov/pubmed/18160753
"The glucose/insulin system and vitamin C: implications in insulin-dependent diabetes mellitus.
https://www.ncbi.nlm.nih.gov/pubmed/9550452
Have any of your doctors mentioned or advised you?
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@Wind Surfer
The real problem is doctors are taught to treat disease, not prevent it, and a lot of that is the fault of medical schools. Doctors can get through 4 years of medical school having taken no or maybe 1 rudimentary course on health and nutrition, and most doctors are programmed rather than to try and understand it, to go along with the 'protocol' they are taught by other doctors and spout it as gospel..and a lot of that is with heart disease, start people on statins as soon as possible. Worse, they treat nutrition as a moral failing, rather than educating their patients or trying to, they tell them 'lose weight, stop eating so much, and exercise', which is the old puritan 'wages of sin' argument.
My take on nutrition is we should focus the diet around healthy foods, that most of it should be based around fruits and vegetables and healthy grains, with moderate intake of lean protein (you can get protein from things like soybeans and the like, not as easy) and cheese. The real problem is to get people off of fast food and packaged food, get most of their nutrition from the outer sides of the suspermarket and away from the packaged food aisles. The real enemy is the government and the agri-industry, the grain industry, the meat industry (agri business) that get huge subsidies and like the NRA with gun violence bloick serious studies of nutrition.
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@bill d
What you have described as a "healthy foods" diet was distinctly unhealthy for me. Stop pushing one-size-fits-all.
Nutrition + Exercise = Common Sense
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Incentive system works great. We get a discount on our premiums for meeting the criteria on the big 6. BMI, BP, blood sugar, cholesterol, waist, staying active (7,500 steps per day). Golf, tennis and Fitbit pretty much take care of it. Plus balanced diet. Eating junk pretty much negates everything. No liquid calories. Coffee black. Green tea. Occasional glass of wine.
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@SC
10,0000 steps a day is the recommended amount.
There should be a tax on all fast food both for the seller and consumer. To discourage consumption and help pay for consumer education and health care. The time has come to tax bad behavior and ingnorant food choices.
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It's crucial to underscore that the medical or "sickness" system simply refuses to pay for preventive and self-care education that really works. The latest major and painful example is the so-called Medicare reimbursement for the National Diabetes Prevention program---a multi-session year long group "lifestyle" course repeatedly proven to reduce the risk that pre-diabetics will get diabetes by 59%---and by close to 70% for "older" adults. People were thrilled when Medicare finally said it would start to reimburse for NDPP. The result? Providers get just $185! for providing pre-diabetics 13 sessions of proven group education over a year! And $160 more if the pre-diabetic loses 5% of their body weight. That's for having educators in place for a year to deliver a minimum of 13 hour long sessions. Community orgs. in the highest need areas cannot do this. They would go bankrupt. Yet having diabetes costs some $7,000 more a year in medical costs. While the "medical" and "public health" system won't pay $700 to save $7,000, we won't save many hearts.
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Emphasizing the need for weight loss is a standard response, yet incredibly difficult to do for large swaths of the population: https://www.washingtonpost.com/news/morning-mix/wp/2015/10/01/its-gotten... ("There are real, and difficult, biological reasons why it’s hard to lose weight," 6 Jan 2018) AND https://www.theatlantic.com/health/archive/2015/09/why-it-was-easier-to-... ("Why It Was Easier to Be Skinny in the 1980s," 30 Sept 2015).
This is not a simple matter of will-power.
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This initiative will mean that huge numbers of patients will be prescribed aspirin and a statin. Few if any of them will be informed that the only a tiny fraction of those who take them will benefit from them in terms of avoidance of heart attack or stroke. The physicians who compile the Number Needed to Treat (thennt.com) observe that only two percent of those with known coronary heart disease who take aspirin will benefit in this way, and only four percent who take statins. They go on to observe, however, that statins as a public health action can bring measurable benefits. Put a million patients on a statin and you will avoid 40,000 heart attacks. In my view, that's acceptable only if every one of the million patients is informed in advance that while he or she is unlikely to benefit from a statin, public health will improve.
I have been prescribed aspirin and statins by several different doctors. Not one has advised me of the very poor effectiveness of the drug. I should hope that a simple ethical posture would require doctors to do this -- that is, if they know how ineffective statins are.
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@Chauncey Wood
Your analysis is problematic: https://www.uspreventiveservicestaskforce.org/Page/Document/evidence-sum... .
The lack of benefit from statins you cite from thennt focuses on low risk groups--not those with major lipid abnormalities. Experts are in substantially more agreement when it comes to high risk groups and benefits are much greater than you imply: https://www.nejm.org/doi/full/10.1056/NEJMc082218 .
This is difficult stuff, even as experts parse the available trials. Most people will, wisely, follow expert physician advice--not comments thrown out on these boards.
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@JSK
As presented by Ms. Brody this generalized approach will recommend cholesterol lowering meds for a wide population. Your concern for extreme individuals is commendable, but is not relevant for this broad approach.
Here is my wish list for better national health: 1) Television, both cable and local, offer more health-related programs, and provide more information about prevention; 2) Print media report less about the latest medical breakthroughs and more about research related to prevention; 3) All levels of government pass laws restricting advertising unhealthy food and drink to young people, and eliminating soda machines from school properties, and promoting healthier options for school food; 4) Doctors provide more counseling about healthy lifestyles, even if it takes a change in reimbursement protocols to do so; 5) Fast Food eateries offer more healthy options, use healthier oils and cut down on salt; 6) Community resources such as places of worship start groups focused on healthier cooking and eating, weight loss and walking, and schools could make their buildings available in the evening for such groups. If a concerted national effort is not launched along these lines, the dire predictions will come true.
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@William
Even better, have farm policy and food policy around making health food cheaper and fast food and packaged food more expensive. As far as #4, that requires doctors are trained in nutrition science and really understand it, most doctors advice these days is 'exercise more, eat less, and avoid salt and sugar', which is a joke. I had a cardiologist tell me I should eat a 'low fat' diet, then proceeded to tell me if I didn't have time to cook, there were plenty of pre done 'low fat' meals I could eat, packaged foods...ever look what was in them? Salt, Sugar and the like, lots of chemicals.
As a family physician, I confront these issues on a daily basis. I'm always encouraging a healthier diet, more exercise, smoking cessation, and am prescribing the meds that the evidence calls for (statins, aspirin, ACE inhibitors, etc). I spend extra time strategizing with patients as to how they can fit these lifestyle changes into their busy day. I've worked with the local gyms to get discounts for my patients. I try to keep goals achievable and employ Kaizen techniques (baby steps) to help get folks on a sustainable path for change. I talk about how much money they'll save with these changes, how much better they'll feel, and how much longer they will live.
Aside from taking medication, rarely (less than 5% of the time) do my patients make the lifestyle changes necessary to get themselves healthier.
This is a tremendous source of frustration.
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We just reversed my (trim, athletic, vegetarian )husband's heart disease after near-fatal "widow maker" heart attack. After 4 weeks of completely "whole-food plant-based" his LDL went from dangerous 115 to near-heart-attack-proof 87, without statins. Scans show him clear of any issues.
There are no "heart healthy" fats, except actual whole nuts, seeds and avocados.
Chicken and fish have the same nutritional problems as "red meat." Dairy products and eggs are also bad news, period. it was by eliminating these and any processed oil (yes, even olive) that my husband's health was regained.
Jane's advice is a good start, but if you want to really make a difference and save your life, watch "Forks Over Knives" and follow the guidelines.
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Agreed! “Forks over knives” changed my life. And I am a cardiologist.
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@AKS Absolutely! I definitely recommend watching "Forks over Knives". I reversed osteoporosis by giving up meat and dairy, and have improved my cholesterol doing the same, minus medication.
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Yes! A plant based diet (PBD) is good for the arteries and the planet. See books on reversing cardiovascular disease by Ornish and Esselstyn. I went on Esselstyn’s PBD and within a few months my cholesterol level plummeted. The only trouble I’ve had with a PBD is eating on the road where it really is hard to find Whole Foods that are not meat, dairy, fish or
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Ms. Brody writes: "If your cholesterol level is too high and dietary changes like eating less red meat and more seafood, fruits and vegetables and choosing heart-healthy fats are not enough to bring it down, talk to your doctor about cholesterol-lowering medication like a statin."
Modest changes generally result in only modest improvements. To really see a change, try eating a plant based whole foods diet: veggies and fruit, beans and whole grains, and nuts and seeds in moderation. Avoid processed foods and animal products. Exercise. Don't smoke or drink alcohol. Consider drugs -- which always have adverse side effects -- as a last resort.
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Both _dietary_ cholesterol and dietary sodium have long been debunked as direct causes of heart disease. What is or isn't a "healthful fat" is a long-running and contentious debate, Brody has been wrong on this more often than she has been right, and there is little evidence that naturally fatty foods play a role in chronic disease.
Elevated blood serum cholesterol (carried by lipoproteins) is an indicator of future disease risk, although there is much debate over which fractions of which lipoproteins mean what in terms of risk. Statins lower cholesterol, but they are also anti-coagulant and anti-inflammatory. "Cholesterol-lowering" is probably an unfortunate side-effect, and not the main action of the drug.
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Sadly this won’t happen because our health care system isn’t a system but a national patchwork with too many hospitals and doctor offices all independent and not focused on common national goals like this.
As a practicing doctor, I’ve seen what possible inside Kaiser Permanente. But I’m skeptical it can or will be replicated nationally.
https://www.nytimes.com/2012/09/09/opinion/sunday/simple-treatments-igno...
I hope I’m wrong.
http://www.davisliumd.com/why-health-care-reform-wont-happen-without-phy...
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