How do we stop heart disease (Atherosclerosis, Arteriolosclerosis, Arteriosclerosis, calcification)

[alicec]

While there is obviously going to be a range of diet types which suit different individuals, the blanket advocacy of low-fat diets as protection against heart disease is something I and many others question.

The low fat bandwagon incorporates misconceptions and assumptions that aren't borne out by serious analysis.

The advocates are still out there but there are plenty of serious scientists and cardiologists who challenge them.

We need to consider a broader picture in assessing the role of lipids in coronary heart disease. There are a plethora of articles and blogs out there but I am particularly impressed by the work of ChrisMasterjohn, a nutritional scientist who writes on many nutritional topics in depth, weighing and assessing evidence in a considered manner.

Here is an article which canvasses some of the issues that need to be understood.

Furthermore the role of fat soluble vitamins in protection against heart disease is usually ignored by the low-fat brigade. Here is some useful info about that topic.

 

[Timaca]

Oh Orla I hope your LDL doesn't increase on that medication!!!! Maybe read my blog post on what happened to me and also watch the GI of the foods you are eating somewhat!! I was shocked how much my LDL went up by eating such harmless foods like melons, dates and brown rice!

 

[prioris]

A post relating to saturated fats and liver disease I just created

http://forums.phoenixrising.me/inde...-type-2-diabetes-mitochondrial-disease.51786/

If fats not metabolized then it will cause problems. I think it needs to be approached from fat metabolism dysfunction and supplements approach to help process fats rather than cutting out the oils. Maybe as a temporary measure to bring about some therapeutic response but not permanently. Fats are critical for the health of ones body. You can moderate or balance the oils seems ok. Advice saying eliminating fat throws up a lot of red flags for me.

Timaca, You said your lipids came back high. Could you consider taking some of those supplements in link and see if that makes any difference

I will study the oil question as it relates to heart disease further. I know Heart association will want oils diminished but that is not addressing the root cause. They say keep saturated fats 10% of calories which seems ok but we need to understand what is causing problem rather than some blind advice.

 

[prioris]

I'm currently on a drug that can increase bad cholesterol (LDL) I hope it doesn't have that effect on me, but as I am desperate for getting some decent sleep unless my next set of blood tests are very bad I will probably stay on it for a while anyway.

Cholesterol does not cause heart disease. You need to find a natural medicine alternative to drug. What is drug? Why can't you sleep? what are your symptoms?

 

[pamojja]

I cut the dates down to one a day, switched to basmati or long grain rice and cut back on the fruits. My lipid levels improved.

I wonder if pamojja is like me....maybe having problems with the glycemic index of foods causing problems?

I'm much, much worse. If I ate anything with grains, even basmati rice, even only a handful, my blood glucose shoots up to 200 mg/dl. Have even to limit pulses.

I'm currently on a drug that can increase bad cholesterol (LDL)

LDL isn't necessarily bad. Small dense LDL or high LDL paricle number (of which Apo B is a approximation marker) is the one highly dangerous. Large fluffy LDL much less so.
The point with diet and LDL is, that high blood glucose spikes will drive triglycerides up. With triglycerides close to 150 mg/dl almost all your LDL is of the dangerous small dense kind. Close to 50 mg/dl the harmless fluffy kind. So two patients with a high LDL could have very different risks.

That's the reason low fat isn't for me. Carbs of any kind sharply increase my risks, proteins can't be raised or would contribute to gluconeogenesis and higher blood glucose too, leaves only fats to get the majority of calories from. And keep my number in shape.

 

[Orla]

I don't want to derail the thread onto sleep issues. I just mentioned the potential problem with this medication (mirap/Remeron) as there are other meds people are taking that might be causing changes in blood work so it is worth checking if someone has a change in the blood results.

Edit: Sorry I might have come across there as rude. I just didn't want to derail the thread into one on my sleep issues. I like the new drug I am on so will stick with it for now, but get my cholesterol levels checked in a few months. A lot of people put up a lot of weight on this drug so possibly the raise in cholesterol is linked to that, though I think it can also have a weird effect on metabolism. I haven't put up any weight on it yet so hopefully I will be ok.

 

[Orla]

I think it needs to be approached from fat metabolism dysfunction and supplements approach to help process fats rather than cutting out the oils. Maybe as a temporary measure to bring about some therapeutic response but not permanently. Fats are critical for the health of ones body. You can moderate or balance the oils seems ok. Advice saying eliminating fat throws up a lot of red flags for me.

A lot of foods contain fats. None of the "low-fatters" are talking about eliminating fats completely from the diet. That would be impossible anyway if a person was eating whole-foods, which is what they advocate.

They are talking about eliminating refined oils/fats (so basically a junk food, similar to sugar in that it has been stripped of nutrients).

So, for example, a small amount of Olives might be ok, but not Olive oil, nuts or seeds might be ok in small amounts (if a person is not overweight, and doesn't have advanced heart disease) but not oils made from nuts. Too many nuts can throw off ones Omega 3:6 ratio so can be a problem, and people can easily over-eat them which is an issue if they are overweight. Corn is fine for most people, but not corn oil.

A lot of low-fat foods contain some fats such as wholegrains, beans and peas, and vegetables. These should provide enough fats for most people, apparently. Some people eat ground flax or chia for extra Omega 3, or a plant Perslane. People with ME might have an issue with Omega 3 metabolism so some take oil capsules (which wouldn't be recommended as a general rule by low-fatters. But there is an argument for doing this in ME, and the oil would be a very small amount. Hard to know whether the risks outweigh the benefits at this stage).

Jeff Novick has some good information on his website about common questions people ask about low-fat diets http://www.jeffnovick.com/RD/Articles/Archive.html

I am fairly sure the very low-fat diet is the only one that has been shown to reverse advanced heart-disease. It is up to people what they do themselves, I'm just posting the information as it is not common knowledge.

 

[pamojja]

I am fairly sure the very low-fat diet is the only one that has been shown to reverse advanced heart-disease. It is up to people what they do themselves, I'm just posting the information as it is not common knowledge.

I really doubt that. When I was diagnosed with PAD I turned to TrackYourPlaque forum, because it was the only approach testing each and every supplement and dietary advise by measuring yearly CAC score until reversal is achieved. Usually, even with low fat and additional statin treatment it increases at approximately 30% per year nevertheless. Measuring CAC score even an 15% deceleration in the combined TrackYourPlaquers experience is the sign that the chosen approach is working. Don't trust anyone who claims 'have shown to reverse advanced heart-disease', if they didn't documented it with yearly CAC score! But mere substitution markers which might or might not track the actual plaque build-up in arteries. CAC score is the single most important marker for risks, because it measures the yearly increase in arterial plaque. You can have a zero score but all other Farmingham risk factors, and are 100 times unlikely to have a serious event the next 10 years.

TrackYourPlaque is run by cardiologist Dr. William Davis, and now runs under https://www.cureality.com/. 8 years ago when I joined there was still a 10% sat fat limit, short after Dr. Davis lifted every limit on sat fats, because it didn't correlated with decrease in CAC score at all. Choose wisely.

 

[Gondwanaland]

Biotinidase deficiency/blockage might underlie high blood lipids

Effects of Biotin Supplementation in the Diet on Adipose Tissue cGMP Concentrations, AMPK Activation, Lipolysis, and Serum-Free Fatty Acid Levels

 

[Orla]

I put up a link to a Dr Esselstyns talk earlier where he talks about his study where they had some reversal of blockages. He has a website with some links to papers here http://www.dresselstyn.com/site/articles-studies/ He has some pictures of coronary angiograms on the website that show improvements.

As I have reported earlier,28,29 a plant-based diet in conjunction with cholesterol-reducing medication eliminated progression of coronary artery disease over a 12-year period in patients with triple-vessel disease. Most of the 18 patients had experienced an earlier failed intervention of bypass surgery or angioplasty. All patients who maintained the diet achieved the cholesterol goal of less than 150 mg/dL and had no recurrent coronary events during the 12 years. At 5 years, angiography was repeated in most cases. By analysis of the stenosis percentage none had progression of disease, and 70% had selective regression.28 These data are compelling when one considers that the same group had experienced more than 49 coronary events during the 8 years before this study.28

http://www.dresselstyn.com/site/study03/

Study by Dean Ornish (his diet restrictions are a little different to Dr Esselstyn's, but both are low-fat. Ornish's study did include some lifestyle changes such as exercise so not all of the benefit can be put down to diet alone)

Intensive Lifestyle Changes for Reversal of Coronary Heart Disease
Dean Ornish, MD; Larry W. Scherwitz, PhD; James H. Billings, PhD, MPH; et al K. Lance Gould, MD; Terri A. Merritt, MS; Stephen Sparler, MA; William T. Armstrong, MD; Thomas A. Ports, MD; Richard L. Kirkeeide, PhD; Charissa Hogeboom, PhD; Richard J. Brand, PhD

JAMA. 1998;280(23):2001-2007. doi:10.1001/jama.280.23.2001
http://jamanetwork.com/journals/jama/fullarticle/188274

In the experimental group, fat intake decreased from approximately 30% to 8.5%, cholesterol from 211 to 18.6 mg/d, energy from 8159 to 7724 J (1950-1846 cal), protein from 17% to 15%, and carbohydrates increased from 53% to 76.5%. In the control group, fat intake decreased from 30% to 25%, cholesterol from 212.5 to 138.7 mg/d, energy from 5.49 to 3.59 J (1711-1573 cal), protein from 19% to 18%, and carbohydrates increased from 51% to 52%.

Results: Experimental group patients (20 [71%] of 28 patients completed 5-year follow-up) made and maintained comprehensive lifestyle changes for 5 years, whereas control group patients (15 [75%] of 20 patients completed 5-year follow-up) made more moderate changes. In the experimental group, the average percent diameter stenosis at baseline decreased 1.75 absolute percentage points after 1 year (a 4.5% relative improvement) and by 3.1 absolute percentage points after 5 years (a 7.9% relative improvement). In contrast, the average percent diameter stenosis in the control group increased by 2.3 percentage points after 1 year (a 5.4% relative worsening) and by 11.8 percentage points after 5 years (a 27.7% relative worsening) (P=.001 between groups. Twenty-five cardiac events occurred in 28 experimental group patients vs 45 events in 20 control group patients during the 5-year follow-up (risk ratio for any event for the control group, 2.47 [95% confidence interval, 1.48-4.20]).

A strategy to arrest and reverse coronary artery disease: a 5-year longitudinal study of a single physician's practice.
Esselstyn CB Jr1, Ellis SG, Medendorp SV, Crowe TD.

https://www.ncbi.nlm.nih.gov/pubmed/7500065

I'm not suggesting any of this will definitely work for anyone. I'm just putting it out there are most people won't have heard of these studies.

 

[pamojja]

I'm not suggesting any of this will definitely work for anyone. I'm just putting it out there are most people won't have heard of these studies.

Understood. I only recommend to rely on CAC scores to assess real decrease of plaque burden with whatever approach is taken. And not individual stenosis measurements. The reason being that highly occluded arteries plaque rarely burst. It's mostly the less occluded which rapture, causing heard attack, strokes. thrombosis or embolism. That's why a assessment of total coronary arterial calcium - in short CAC - is so essential to know if real risk is increasing, or not.

 

[prioris]

Any studies still hanging on to the cholesterol numbers myths with goals for study participants tends to lose it's credibility with me. It tells me they are either promoting the lie, still ignorant or too brainwashed with obsoleted ideas. When pamojja wrote about anything cholesterol, it at least zeroed in on the parts like dense particles etc of cholesterol that may be the real danger.

This doesn't mean I think cholesterol is totally harmless. I can see cholesterol being more relevant to other organs like the liver and gallbladder which is really about metabolizing the cholesterol so it doesn't cause liver disease or gallstones. The bile flow is an important in about processing that cholesterol I think. Problems from those organs may eventually reverberate back to the heart. when the liver goes, all sorts of things in body start breaking down causing inflammation and making heart disease worse. There is a feed back loop to other organs. One degenerating organ may set in motion a domino effect with other organs etc,

 

[pamojja]

Cholesterol has to go up with inflammation. It is one of the repair-mechanisms in damaged arteries. Shooting cholesterol numbers is like shooting firemen doing their job.

Instead it is essential to prevent the fires in the arteries in the first place.

 

[pamojja]

Biotinidase deficiency/blockage might underlie high blood lipids

Effects of Biotin Supplementation in the Diet on Adipose Tissue cGMP Concentrations, AMPK Activation, Lipolysis, and Serum-Free Fatty Acid Levels

Don't expect too much. This is a mice study, mice have a completely different diet than we.

 

[Gondwanaland]

Don't expect too much. This is a mice study, mice have a completely different diet than we.

I know Biotin supplementation can have adverse effects (I had them in the past when taking it on its own without a supporting B complex), but the mouse in me has been appreciative of a little Biotin boost for its ammonia-lowering properties

 

[prioris]

FYI biotin ... there were reports that alpha lipoic acid depleted biotin but my research concluded those weren't actually true. Some supplement manufacturers put biotin in there either because they think so or allay fears of biotin deficiency to help people feel more comfortable taking ALA... Some studies shown high dose biotin helps people with MS so popular in among MS people. High dose biotin used to help with hair and nails has caused thyroid tests etc to come back abnormal. So just stuff to be aware of.

That analogy of getting rid of cholesterol is like shooting the firemen was so funny.

 

[Gondwanaland]

I think when lysine is supplemented, there will be an increased need for Biotin. My daily Biotin intake as a supplement is 200-300 mcg tops.

 

[pamojja]

Mine has been about 4 mgs/d. But I do take gram doses of other Bs, like Inositol, B3 and B5. And since all Bs metabolism is intricately interwoven, better not to get too large off ratios.

 

[prioris]

Here some tidbit information from Liver thread that should be copied here

Choline & Inositol:
Choline and inositol are co-enzymes that are required for the proper metabolism of fats and have the ability to remove fat from the liver. Choline's function in fat metabolism is tied to its role in bile production because bile acts as emulsifier (allowing water and lipids to combine) to more readily transport fats.

Choline prevents fats from becoming trapped in the liver, where they can block normal metabolic functions. Choline, as well as inositol, acts as a fat emulsifier that prevents cholesterol from settling on arterial walls. Choline also works well with inositol to utilize fats and cholesterol.

Inositol is referred to as vitamin B8 and it helps to metabolize fats and cholesterol and aids in transporting fat in the blood system. Thus, inositol is an aid in the redistribution of body fat and can help to lower cholesterol levels.
-------------------------------

maybe it makes dense cholesterol more fluffier

 

[Orla]

Any studies still hanging on to the cholesterol numbers myths with goals for study participants tends to lose it's credibility with me. ,

Cholesterol reduction is mentioned as one of the few beneficial effects mentioned (I realise some may not view a reduction in cholesterol as beneficial, but I don't agree with this). The main interesting thing for me about the studies is the reduction in arterial blockages, improved blood-flow, and the reduction in cardiac events.

I got interested in this because of the improved blood-flow issue, rather than out of concern about heart-disease in the future. There is some evidence that patients with ME have reduced blood flow in some areas. It hasn't made much difference to my ME symptoms though, but I am happy with the diet so continue on with it and hope it will reduce heart-attack or stroke risk in the future. And the same diet can reduce type 2 diabetes risk.