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Eat to Live
When someone suffers a heart attack in midlife, as Dr. Dobson did, doctors often put the fear of God into them when it comes to their diet.
Lay off the Ruth's Chris steaks.
No more deep-dish, double-crust pizza.
Shake your salt habit.
Get rid of butter.
And no nuts.
The conventional wisdom among the medical establishment these days is that a high-cholesterol diet promotes coronary heart disease, and from my reading, this article of faith is one of the most deeply ingrained beliefs in modern medicine. Cardiologists point to the Framingham Heart Study, which began in 1948 when researchers recruited 5,209 men and women between the ages of thirty and sixty-two from the town of Framingham, Massachusetts, and began the first round of extensive physical examinations and lifestyle interviews that would be analyzed for common patterns related to cardiovascular disease development.
Over the last five decades, the detailed medical histories, physical examinations, and laboratory tests on the study volunteers have reputedly established high blood cholesterol as a major risk factor for coronary heart disease. The comprehensive study, conducted by the National Heart Institute (now known as the National Heart, Lung, and Blood Institute, or NHLBI) concluded that cholesterol hardens arteries carrying vital oxygen and nutrients to and from the heart.
The Framingham Heart Study spurred the drug industry to develop statin drugs that would interrupt the formation of cholesterol inside the body. Statins are a class of drugs used to lower blood cholesterol, and these pills prompt the liver to block a substance the body needs to produce cholesterol while helping the body reabsorb cholesterol that has accumulated in plaques clinging to the arterial walls. Commonly prescribed statins include:
Crestor (rosuvastatin calcium)
I would imagine that you recognize the first statin drug on this list: Lipitor. Racking up $11 billion in sales in 2005, Lipitor is the best-selling drug in the world and a cash cow for Pfizer, the makers of Viagra. If you happen to be forty years of age or older (and especially a male), submit to an annual physical, have blood drawn, and learn that you have a total cholesterol level higher than two hundred, your family physician will likely write you a prescription for Lipitor. It's practically automatic these days and one reason why 12 million Americans, or 4 percent of the U.S. population, are swallowing this cholesterol-lowering drug with their morning OJ despite its cost: most pay around seven to eight hundred dollars a year for their Lipitor.
Lipitor and its statin cousins are potent medicines that usually reduce cholesterol levels, but not without extracting a cost. So-called "minor" side effects are nausea, diarrhea, constipation, and muscle aches. Two potentially serious side effects are elevated liver enzymes (medicalese for liver damage) and statin myopathy (kidney failure), and the long-term side effects are not known at this time.
I'm convinced, though, that if you eat the foods that are part of The Great Physician's Rx for a Healthy Heart, you may make a visit to your physician, have him or her take a blood test, and find that your cholesterol is within the normal range. Then you can flush those expensive cholesterol-reducing drugs down the toilet (as long as you and your doctor are agreed on that course of action, of course).
Our bodies do need cholesterol, a soft, waxlike substance produced by the liver and found in the bloodstream and all the body's cells. Cholesterol digests fats, is the source material for cell membranes and various hormones, and serves other much-needed bodily functions. While the liver makes around 1,000 milligrams of cholesterol daily, the body receives an additional 200 to 500 milligrams of cholesterol from foods such as meats, poultry, fish, eggs, butter, cheese, and whole milk. Fruits, vegetables, and cereals do not have cholesterol.
Cholesterol is transported in the bloodstream by lipoproteins-actually, two different ones. A high-density lipoprotein (HDL) is known as the "good cholesterol" because it collects unused cholesterol and transports it back to the liver, where it is destroyed. A low-density lipoprotein (LDL) is public enemy number one, however, because this "bad cholesterol" builds up and clings to the inside of the arteries. Medical researchers have learned that large numbers of LDL particles are strongly associated with coronary heart disease. Thus, physicians pay close attention to LDL numbers, and there's a push in modern medicine to drive LDL levels below 100 milligrams per deciliter (mg/dl) for men and 110 mg/dl for women through the use of statin drugs like Lipitor or Pravachol.
Lately, however, I've encountered a push back in certain medical circles, and the charge is being led by a Swedish physician, Dr. Uffe Ravnskov, who earned his Ph.D. for his scientific studies at the Departments of Nephrology and Clinical Chemistry at the University Hospital in Lund, Sweden.
Dr. Ravnskov followed the scientific literature about cholesterol and cardiovascular disease for years, and throughout that time, he could never recall a study showing that high cholesterol was dangerous to the heart or the coronary arteries. Yet the medical grapevine around the world was heavily influenced by the Framingham Heart Study, which pointed the finger at cholesterol as the culprit for the leading cause of death in the United States.
From Dr. Ravnskov's viewpoint, however, the emperor-King Cholesterol-wore no clothes, because as best as he could tell, medical studies did not conclusively prove the connection between high cholesterol levels and cardiovascular disease. The Swedish doctor wrote nearly forty medical papers critical of the alleged association between cholesterol and cardiovascular disease.
For instance, he pointed out that in a thirty-year follow-up of the Framingham population, high cholesterol wasn't predictive for a heart attack after the age of forty-seven, and those whose cholesterol went down had the biggest risk of having a heart attack! His citation came straight from the Framingham study: "For each 1 mg/dl drop of cholesterol, there was an 11 percent increase in coronary and total mortality" (emphasis added).
Pointing out inconsistencies earned Dr. Ravnskov a reputation in the cardiology community as a gadfly at best and a bomb thrower at worst. His critical but scientific analysis was of little interest to the editors of the Journal of American Medicine (JAMA) or the New England Journal of Medicine (NEJM), nor to the mainstream medical community, which continued to advise patients to limit their intake of fats, including those rich in saturated fatty acids, to reduce their risk of dying from cardiovascular disease.
Stymied in his attempts to find an audience among his peers, Dr. Ravnskov put down his concerns in a book called The Cholesterol Myths, first published in Sweden in 1991-in Swedish. The book was largely ignored and produced little impact. Even worse, critics on a Finnish TV show burned his book on the air! Several years passed, and Dr. Ravnskov thought that having The Cholesterol Myths published in English would jump-start the discussion. Queries to literary agents and publishers in Great Britain and the United States were summarily rejected, however.
Then the Internet arrived on the scene in the latter half of the 1990s. Suddenly, Dr. Ravnskov didn't need a publisher; he posted a few chapters of The Cholesterol Myths on the Web, and presto, he was no longer a pariah tilting against windmills, fighting a lost cause like Don Quixote. As word of mouth built-and people typed in "cholesterol and heart disease" in their search engines-Dr. Ravnskov received e-mails from those impressed with his measured and clear-eyed analysis, including researchers skeptical about the "diet-heart" connection percolating through the medical community.
Dr. Ravnskov's work confirms my belief that the oft-recommended low-fat, low-cholesterol diet touted for preventing heart disease will never be the hoped-for panacea. Too many doctors are recommending that people not eat certain foods that can actually be quite beneficial to heart health.
I'm getting ahead of myself here, but certain "high fat" foods-steak, eggs, butter, and dairy products, when consumed from free-range and organic sources-contain fats that your body needs for optimal health. God, in His infinite wisdom, created certain fats to do the following functions: play a vital role in bone health, enhance the immune system, protect the liver from alcohol and other toxins, and guard against harmful microorganisms in the digestive tract.
The best examples of "good fats" are healthy saturated fats, omega-3 polyunsaturated fats, and monounsaturated (omega-9) fatty acids. You can find these fats in a wide range of foods, including salmon, lamb, and goat meat, goat's and sheep's milk and cheese, coconut, walnuts, olives, almonds, and avocados. These fats provide us with a concentrated source of energy and are the source material for cell membranes and various hormones.
Ah, you may ask, "Didn't the Creator know that fats and cholesterol are the main causes of coronary disease?"
Yes, He did, but it's the foods with trans fats that most likely are at the root of our national epidemic of cardiovascular disease. Trans fats are artery-clogging fats produced by heating liquid vegetable oils in the presence of hydrogen to make them solid at room temperature-a process known as hydrogenation. Food conglomerates routinely utilize hydrogenated oil in their manufacturing plants, which means that trans fats are found in nearly all our processed foods-foods that God definitely did not create.
I'm talking about vegetable shortening, frozen pizza, ice cream, processed cheese, potato chips, cookie dough, white bread, dinner rolls, snack foods, doughnuts, candy, salad dressing, margarine-the list is endless. Why do food producers employ so much chemistry? Because it allows them to produce a more competitively priced product with a longer shelf life. Commercially prepared fried foods, like French fries and onion rings fried in polyunsaturated vegetable oils, also contain gobs of trans fat.
One big problem with trans fat is the number it does on your cholesterol levels. Consumption of foods with trans fat raises your bad LDL and lowers the good HDL, which elevates the risk of heart disease as well as type 2 diabetes. Scientists have been warning us for years that eating trans fat can lead to heart problems, which is why in 2006 the U.S. Food and Drug Administration began requiring companies to state the amount of trans fat as part of the nutrition facts.
Laying the Groundwork
My first key-"Eat to Live"-happens to be the most important prescription in The Great Physician's Rx for a Healthy Heart, because what you choose to nourish yourself with will either positively or negatively affect the health of your heart-your most important muscle-as well as your entire body. The best way to "eat to live" can be summed up by these two foundational principles:
1. Eat what God created for food.
2. Eat food in a form that is healthy for the body.
Eating food that God created in a form that is healthy for the body means choosing foods as close to the natural source as possible, which will nourish your body, help your heart beat strong and continuous, and give you the healthiest life possible. As you have probably figured out by now, I'm a proponent of natural foods grown organically since these are foods that God created in a form healthy for the body.
Optimizing nutrition begins with an awareness of what you are sending to your digestive tract. To begin with, everything you put into your mouth is a protein, a fat, or a carbohydrate. Let's take a closer look at these macronutrients:
The First Word on Proteins
Proteins, one of the basic components of foods, are the essential building blocks of the body and involved in the function of every living cell. One of proteins' main tasks is to provide specific nutrient material to grow and repair cells-especially the heart muscle. Researchers at the University of Texas Southwestern Medical Center in Dallas are studying how a protein named thymosin beta-4 protects the heart muscle from damage and even triggers the repair of the heart following a coronary attack.
All proteins are combinations of twenty-two amino acids, which build and maintain the body's organs, including the heart, as well as the muscles and nerves, to name a few important duties. Your body, however, cannot produce all twenty-two amino acids that you need to live a robust life. Scientists have discovered that eight essential amino acids are missing, meaning that they must come from sources outside the body. I know the following fact drives vegetarians and vegans crazy, but animal protein-chicken, beef, lamb, dairy, eggs, etc.-is the only complete protein source providing the Big Eight amino acids in the right quantities and ratios.
The best approach for a healthy heart is eating the leanest, healthiest sources of animal protein available, which come from organically raised cattle, sheep, goats, buffalo, and deer-animals that graze on pastureland grasses. Lean grass-fed beef is lower in calories and doesn't contain as much fat as grain-fed beef.
I'm also a huge fan of free-range chicken and eating fish captured from lakes, streambeds, or ocean depths. Fish with scales and fins caught in the wild are excellent sources of protein, as well as healthy fats, vitamins, and minerals, and they provide all the essential amino acids. Wild fish, which is nutritionally far superior to farm raised, should be consumed liberally.
A Reprise on Fats
I've already mentioned how trans fat clogs arteries like sludge in a drainpipe. Yet eating healthy fats can have a protective effect against heart disease. I'm referring to foods loaded with the following:
polyunsaturated fats (high in omega-3 fatty acids)
monounsaturated (omega-9) fatty acids
conjugated linoleic acid (CLA)
key omega-6 fats such as GLA
healthy saturated fats containing short- and medium-chain fatty acids, such as butter and coconut oil
These good fats are found in a wide range of foods, including salmon, cod liver oil, lamb and goat meat, high omega-3 eggs, flaxseeds, walnuts, olives, macadamia nuts, avocados, butter from grass-fed animals, and dairy products derived from goat's milk, sheep's milk, and cow's milk.
The problem with the standard American diet is that people eat too many of the wrong foods containing the wrong fats and not enough of the right foods with the right fats. Two of the top fats and oils on my list are extra virgin coconut and olive oils, which are beneficial to the body and aid metabolism. I urge you to cook with extra virgin coconut oil, which is an extremely healthy food that few people have ever heard of.
Go for Those Carbs
By definition, carbohydrates are the starches and sugars produced by plant foods, and they are carried in the blood as glucose and regulated by insulin, a hormone that holds the key to each cell's nutritional door. Thanks to the low-carb diet popularized by two cardiologists-Dr. Robert Atkins and Dr. Arthur Agatston-creators of the Atkins diet and the South Beach diet, respectively, Americans have been on a carbohydrate witch hunt for the last decade or so. Low-carb diets are touted as a good regime for heart patients, especially those who need to lose weight.
Excerpted from The Great Physician's Rx for a Healthy Heart by Jordan Rubin Joseph Brasco Copyright © 2007 by Jordan Rubin with Joseph Brasco, MD. Excerpted by permission.
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