The "True" Facts about Coronary Heart Disease

Coronary heart disease (CHD) is a disease in which a fatty substance called “plaque” builds up inside the coronary arteries. This process is called “atherosclerosis” and is the pathology that leads to heart attacks and strokes.

CHD is predominantly a disease of the “middle aged” and older population. Men over 40 and women over 50 are candidates for CHD. Lately we have begun to see CHD in even younger individuals, due to an increase in obesity and diabetes caused by “bad” nutrition.
Coronary heart disease is the # 1 cause of death among men and women in the US, claiming more than 600,000 lives a year ! ( thats like 3 Jumbo jets crashing every day ! )

CDC statistics reveal that approximately 750,000 Americans have a heart attack every year at a cost of over $110 billion in healthcare, medication and lost productivity. The incidence of CHD has been rising paralel to the rise in obesity and diabetes and has reached “pandemic” proportions.

Causes and Risk Factors of Coronary Heart Disease

For the past three decades CHD was blamed solely on “dietery fats” and cholesterol. The plaques that cause CHD were found to be made up of  a form of “bad cholesterol” (LDL) so logically the culprit had to be the bad cholesterol that we consume in our diet. High blood levels of LDL were associated with CHD.

The problem is that; decades of the “low fat” diet craze and cholesterol lowering “statin” drugs did nothing to curb the incidence of CHD. In fact the incidence kept rising.

I must admit that, I too, was on the low fat and statin “bandwagon” until years later when I started to notice that it was not working. The moment of truth came when years ago I reviewed the lab data of the last 300 patients that I had operated on for CHD; More than half of these patients had normal levels of LDL !!! and that didn’t save them from getting CHD !? On the other hand we have seen thousands of people with high cholesterol levels and no evidence of CHD.

Why is LDL being deposited in the arteries of some people and not in others ?

The answer and truth began to surface in the last couple of years when we realized that there are actually two kinds of LDL and the  LDL we get from saturated animal fat is not the kind that is deposited in the arteries, these are large “fluffy” LDL molecules that are unable to settle in the artery walls. On the other hand the LDL molecules that can and will settle in the arteries to cause deposits and plaque are the “small dense LDL molecules”. Guess where these come from!; mostly the liver ! and they are made from sugars, not fat !!! ( Disclaimer : this does not mean we can eat all the animal protein and fat we like. We will get into that subject later ! ) In short; excess sugar is a more important risk factor than fats !

The second important factor in the development of CHD is “Inflammation”. Inflammation is the body's natural response to infection and allergens that cause iritation. Inflamation actualy fights these situations and aids in healing. When inflammation becomes chronic ( Chronic Whole Body Inflammation ) it sets the stage for a myriad of chronic diseases like CHD, Cancer and neurodegenerative diseases. In the case of CHD, inflammation damages the vascular tissues and make them susceptible to atherosclerotic changes.

Causes of Chronic Inflammation

• Trans fats
• High sugar consumption and diabetes
• Obesity
• Smoking
• Artificial sweeteners, flavours, colorings.
• Inactivity

In summary; quoting one of the pioneers in the field of preventative medicine; Dr. Caldwell Esselstyn of the Cleveland Clinic “CHD is a food-borne illness and need never to exist”. 

CHD is indeed a nutritional disease which can be avoided by proper nutrition; avoiding the “bad foods” and eating the foods that have the power to stop the disease process in it’s footsteps.

Midlife is a time in which many of the chronic diseases have already established a foundation and are just waiting for the right time to expolde. We have the means and power to reverse back into a healthy life.

In our future articles we will discuss the simple precautions to take in order to prevent and even reverse obesity, diabetes and coronary heart disease.

Take Care,

Middle Age Nutrition - It's not just about weight !

A healthy diet is a given, but does this "ideal" diet change over time. The short answer is yes.

The ideal diet of a child, adolescent, grown-up and that of a middle aged person actually differ drasticaly. So, one diet does not fit all !

İn childhood and adolescence a diet high in vitamins, minerals and protein from a variety of sources is essential for proper growth and development. The unlimited energy of this age group also requires a high calorie intake. Once development is complete these requirements begin to decrease. Unless the adult individual is an athlete or body builder the requiremnt for protein and fats is dramaticaly reduced. At this point excess protein, fat and calories will only contribute to obesity and a wide variety of associated chronic diseases and premature aging.

What happens to our metabolism as we get older ?

By the time we are in our mid-thirties we are pretty much done with growing and developing. It is not a coincidence that most of us ( previously of normal weight ) begin to gain weight in these years. (The Middle age spread). A Harvard study found that people tend to gain an average of 20 pounds between the ages of 35 and 50.

Here's why;

• We begin to ( physically ) slow down; less activity, less sports, less sex etc., thus burning less calories.
• Sensing that our growth and development is done, a certain group of hormones like "Human Growth Hormone" ( HGH ), Testosterone and Estrogen begin to decrease. The decrease of these hormones not only cause a slowing of our metabolism, it is also associated with gradual muscle tissue loss ( "Sarcopenia" ). Loss of muscle results in a further decrease in metabolism.

So, by eating the same amount of food that we ate in our thirties we will end up gaining weight in our forties and fifties !!!

So what do we do ? ; Eat less or try to walk it off !!!

Well, we do both, but we'll get to that subject later.

It's not just about weight

Nutrients like proteins and fat that are vital for our development in youth may become actually very hazardous to our health in later years. ( But not for the reasons you think they are ! )

It's common knowledge that excess calories from refined carbohydrates and sugars end up being converted to fat and stored in the liver and any other place that is available ! The same goes for fats and without going into detail this process leads to obesity and our #1 killer cardiovascular disease.

What about animal protein ( meat ) ? What happens when we consume too much meat ?

( Disclaimer : I am not a vegetarian and I actually enjoy a good juicy steak now and then ! ) 

But the following is not so pleasent for us middle aged  meat eaters; 

Meat proteins are digested and broken down into "amino acids". These amino acids are utilized to regenerate new cells, muscle tissue, blood and a variety of substances necessary for our metabolism. In middle age we still need protein to maintain these processes but our growth process is long over and we don't need so much for building muscle and bones etc. ( unless you are working out regularly and vigorously). So what happens when we have too much of amino acids circulating in our blood ?  The excess can't just be flushed out like in the case of salt or minerals and can not be pooped away like fiber. The answer is that just like in the case of excess sugar these amino acids are converted into sugar ( "gluconeogenesis" ) and then fat and stored, resulting in obesity, insulin rersistence and yes, diabetes and heart disease!

Meat consumption is percieved as a sign of "plenty" and "bounty" by our evolutianary metabolism. In times of bounty our metabolism gears up for growth and various mechanisms are set into action. One of these mechanisms is the production and release of a hormone called IGF 1 ( Insulin Like Growth Factor 1 ). Ordinarily this hormone promotes cell division and growth but if you are a full grown adult, cell growth may not be a good thing ! Unfortunately, at our age IGF 1 promotes and fuels Cancer growth.

A Harvard study that followed 120,000 people over 30 years was published in 2012 and reports that; Red meat consumption is associated with an increased risk of cardiovascular and cancer mortality.

Conclusion : At our age we need to reduce our intake of animal protein !

How much do we eat ? : The Dietary Guidlines for Americans recommends we eat about 50 grams (46 grams for women and 56 grams for men) of protein per day. This number may be too low for people in their twenties and thirties but too high for us middle aged. It is wise to divide this protein intake so that half comes from animal sources ( meats, eggs and dairy ) and half from plant sources (legumes, nuts and vegetables).

Just as a reference point :

• A 4-ounce piece of meat has about 28 grams of protein
• A cup of dry beans has about 16 grams
• An 8-ounce container of natural yogurt has about 11 grams
• A 3-ounce serving of broccoli has 3 grams

OK, we are told to limit our sugar and carbohydrate consumption, we now see that we need to limit our (animal) protein consumption. So what do we eat ?

In midlife it seems that we are aging more rapidly and we are now more vulnerable to chronic diseases like cardiovascular disease and cancer. At this point our nutrition should be focused on getting as much antioxidants and cancer fighting foods as possible; Fruits and vegetables.

The aging process, though not fully understood, is likened to the oxidation ( rusting ) of our tissues due to internal and external factors. This process called "oxidative stress" causes inflammation and damage to our tissues making them vulnerable to "aging" and chronic diseases.

The Solution : Antioxidants !

Food based natural antioxidants are the "antidote" to oxidative stress. All fruits and vegetables contain not only essential vitamins, minerals and fiber, but large quantities of different antioxidants.

Antioxidant Superstars

• Green Leafy Vegetables and Salad Greens : Especially Spinach, Kale, Arugula
• Apples
• Citrus Fruit
• Pomegranates
• Blueberries ( and other Berries )
• Red Cabbage
• Red Beet Root
• Tomatoes and Peppers
• Beans
• Nuts ( especially Walnuts )
• Spices ( Cinnamon, Cloves, Turmeric, Ginger )
• and last but not least ; Broccoli ; Broccoli is in a class of its own as it has very strong antioxidant and anti-cancer properties ( More on Broccoli in another article )

In Conclusion ; Middle age nutrition should be "fine tuned" as follows;

• Less sugar and refined carbohydrates
• Less animal protein 
• Less processed foods
• Much much more plant based whole foods.

Take Care,

Are You "Middle Aged" ?

For those of you who are not sure; Here are some hints !

• If you read the paper at arms length; You are “Middle Aged” (Buy a pair of reading glasses) 
• If loud music disturbs you; You are “Middle Aged"

• If you need help from your kids to download and run a computer program; You are “Middle Aged”
• If you see your mother/ father when you look into the mirror; You are “Middle Aged”
• If you wake up in the morning feeling tired; You are “Middle Aged”
• If your hairdresser and make-up bills are growing; You are “Middle Aged”
• If you have aches and pains on a regular basis; You are “Middle Aged”
• If you don’t miss the evening news; You are “Middle Aged”
• If you are doing a comb-over or growing a ponytail; You are in a “Mid Life Crisis” (shoot yourself)
• If sex begins to seem like a chore; You are “Middle Aged”
• If certain foods don’t “agree” with you; You are “Middle Aged”
• If smart phones and TV remotes confuse you; You are “Middle Aged”
• If you are considering “Botox”; You are “Middle Aged”
• If health shows on TV ( Dr. Oz ) grab your attention; You are “Middle Aged”
• If you begin stories with “in my days”; You are “Middle Aged”
• If you re-connect with old friends on facebook (the ones you didn’t bother to call for 20 years): You are “Middle Aged”
• If you make “grunting” noises when getting in or out of your car; You are “Middle Aged”
• If you have begun to dress “sensibly”; You are “Middle Aged”
• If you have more than 5 prescription drugs, vitamins or supplements in your medicine cabinet; You are “Middle Aged”
• And Finally
• If your logic overrides your feelings; You are “Middle Aged”

Welcome to Middle Age

The World Health Organization (WHO) describes “middle age” as the time period between 45 and 59. So are we young at 44 and middle aged at 46, are we middle aged at 58 and suddenly old at 60 !?

I prefer to describe middle age as 45 to 65 ( I also reserve the right to change these limits in 5 years )

The truth is there are no clear cut limits but this era is undoubtably a period of change and transition.

“Middle Age is a period of transition between youth and old age”

I will attempt to convince you that, despite all the changes that occur, middle age is the best time of your life. This is a time where you have matured as a person and become wiser. Your parenting responsibilities have eased and you now have more time to fulfill your passions. You are still young and healthy and there is nothing to stop you from being the person that you want to be. A friend of mine calls middle age the “second act”.Indeed these are the best and most exciting times of your epic story.

Middle age is unfortunately the times where we start to experience some of the illnesses that our parents once had. Chronic diseases like arthritis, diabetes, hypertension, heart disease and cancer are a threat to most of us.

In this series of articles we are going to adress some of the problems of middle age and the secrets to staying healthy and young.