Heart Disease

Diet and disease

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Standing in line at the convenience store for a newspaper on a warm summer afternoon, I couldn't help but notice some very heavy children with Big Gulps and large bags of penny candy in hand. It's one of the joys of a childhood summer, I suppose, but in light of what we now know about sugar, insulin resistance, type II diabetes, obesity and heart disease, it's heartbreaking too, because barring an intervention of some kind, a steely determination to shed the sugar addiction in exchange for real food and exercise, thousands of children will feel the serious effects of aging long before their time.

The president of the American Heart Association in 1984, Anthony Gotto, predicted that we'd conquer heart disease by the year 2000 by going low fat. But we've been low-fat crazy for decades and haven't even remotely conquered heart disease. Too many of us can identify with president Dwight D. Eisenhower as described by Gary Taubes in Good Calories, Bad Calories, and know well the frustration of shunning eggs and butter and cheese and all things cholesterol and fat in exchange for all things fat-free while watching our weight and cholesterol climb.

A new report in the Canadian Medical Association Journal confirms again that the risk factors for heart disease are on the rise among the young. Initiatives and regulation aimed at reducing advertising of junk food to children is of course a step in the right direction, as is encouraging more activity and less screen time. But it's time for the kind of stop-junk-addiction educational programs we applied to stop-smoking campaigns.

Also equally important is understanding that food calories must come from somewhere, and that low-fat usually means carbohydrate-intensive, and that carbohydrate-intensive usually means insulin-intensive and eventually metabolic syndrome, which, left unchecked, is directly linked to the development of diabetes and heart disease.

Getting insulin levels tested, not routinely done and often resisted as unnecessary when requested by patients, would be a good preventative first step. Because it is high insulin production that results in food energy being stored rather than burned, and it is high insulin that eventually results in insulin resistance, obesity, diabetes and heart disease.

We eat less and are naturally leaner and more active when insulin resistance is corrected—and we overeat and get heavier when we're insulin resistant and tired and unable to translate food energy into cellular energy. Food intake, energy and activity levels are largely endocrine-regulated—fix the need for the sugar or carb fix, fix the insulin resistance, and exercise becomes much more likely.

But though we know that our bodies store excess carbs as saturated fat, and that they are inextricably tied to excess weight, fluid retention, elevated triglycerides, arterial plaque and high blood pressure, high-carb low-fat diets likely to over-stimulate insulin production are still the recommended ones. Go figure.

If we don't change the way we eat and live, all the research dollars going into heart disease, all our knowledge that it now affects women more than men, all our trying to answer the billion dollar question of why 98 percent of arterial plaques cause no problem, all our stomach-surgery solutions, genetic analyses, avoidance of dietary cholesterol and saturated fats, all our new drugs and dissolvable stents and other heroic interventions—all will be mostly for naught.

A story published in the New York Times over a decade ago about Kilmer McCully is telling. McCully had long ago left appointments at Harvard Medical School and Massachusetts General Hospital because his research grants on heart disease had shriveled. His theory of heart disease linking it to inflammatory chemicals didn't fit with cholesterol theory and had been called "errant nonsense."

But McCully has been vindicated, now that we've run into a bit of a wall on the cholesterol front and know that the majority of heart attacks happen in those with normal cholesterol, and that cholesterol only becomes bad when it is oxidized and becomes inflamed. McCully bumped into one of those involved in his being terminated two decades later, who casually said, "It looks like you were right after all."

The National Institutes of Health declared scientific consensus two and a half decades ago: low-fat, low-cholesterol diets protect against heart disease. They don't. Low-sugar diets rich in veggies and fruits and organic proteins and essential fats do. V

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Heart Disease

Diet and disease

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