A depressing read. We assume that scientific research is impartial and has integrity. Wishful thinking!
So who’s got it right? Dr Aseem Malhotra, a cardiologist at Croydon University Hospital published an article in the BMJ last October (20013)arguing that the evidence shows that reducing saturated fat intake “has paradoxically increased our cardiovascular risks”.
This, he says, has led to over-medication with statins. “Adopting a Mediterranean diet after a heart attack is almost three times as powerful in reducing mortality as taking a statin…”
http://www.bbc.co.uk/news/health-24625808 In this interview, we have a very confident dietician saying that he’s wrong – no dealing with the arguments, just a restatement of the received wisdom. The Medical Director of the BHF is less categorical…
studies on the link between diet and disease frequently produce conflicting results.
Unlike drug trials, it is difficult to carry out a controlled, randomised study, he says.
“However, people with highest cholesterol levels are at highest risk of a heart attack and it’s also clear that lowering cholesterol, by whatever means, lowers risk.”
But the evidence doesn’t seem to bear out the relationship between high cholesterol and a heart attack… That’s Dr Mahotra’s point, and no-one is giving a factual response to it.
By the way, do arteries really get full of white fatty sludge as another BBC article suggests? that doesn’t seem to me to be in the least what atheroscleroma is…
Atherosclerosis is the most common type of arteriosclerosis, or hardening of the arteries, and caused by plaque building up in the vessel. Over time the plaque causes thickening of the walls of the artery. Stiffness and a loss of elasticity also result. http://surgery.about.com/od/beforesurgery/f/ArteriosclerosisAtherosclerosis.htm
I didn’t post yesterday because I was too busy reading and researching. I found that another of the cardiologists on the ABC programme has published another pop science book Dr Ernest Curtis author of “The Cholesterol Delusion” (2010 Dog Ear Publishing) who describes the heart/diet, cholesterol lipid theory as “scientifically bankrupt.” At least he doesn’t seem to be trying to sell any supplements.
Science giant? – all the articles, books and interviews that purport to give us the information we need. Marketing mammoth – everything from major Pharmaceutical companies to doctors promoting their brand of supplements (perhaps even their books – who wouldn’t want a best seller to their name?) Confused little person – everyman/woman ….me!
What I don’t quite understand is that if there is such a body of respectable and respected medical people who find the cholesterol theory unproven, to say the least, how come they don’t get more air time? And I don’t mean on Australian TV – I mean in the Lancet, the BMJ, in serious scientific journals?
I’m now reading Dr Malcolm Kendrick’s book
At first the sarcastic jokey style irritated me (to be honest, it still does a bit), but I think perhaps this is how he deals with his rage and frustration.
Anyway, I’ve not take Atorvastatin for two nights. I haven’t died. Yet. In fact Helen at Cardiac Rehab said that my arterial disease is so mild that even if I had more heart attacks at that site they were unlikely to kill me. I hope to God she’s right.
I’ve cut bread out of my diet completely, and am eating much smaller amounts of starchy carbohydrate altogether – a Ryvita, a little pasta or potato – but still plenty of fruit and lots of fish and eggs. Some red meat, which I’d almost stopped eating. My weight is going down and so is my waist: I can see the difference in the mirror (and the tape measure already).
Plan: Keep reading, keep thinking and continue the rather terrifying task of taking responsibility for my own health.
Well, a poached egg on a bed of watercress and rocket may be healthy, but it’s not quite on a part with toast and marmalade for deliciousness! On the other hand, my weight has dropped further. I realise that what I’ve lost has been mainly water (how else would you lose 3 lb in 4 days?) But the fact that my body was retaining that much fluid shows something was not right.
Today’s research is to track down the doctors who were interviewed in the ABC programme I mentioned yesterday. First we have Dr Stephen Sinatra MD who is, in his own words, “a highly respected and sought-after cardiologist whose integrative approach to treating cardiovascular disease has revitalized patients with even the most advanced forms of illness.”
- Mind-Body Balance
This is not so much a blog as a record of my research and a personal diary. Having had a mild heart attack 6 months ago, I now take statins and have been following a diet low in saturated fats, high in wholemeal grains…and putting on weight despite an active lifestyle, and a relatively low calorie intake. I’ve noticed in the past that eating bread makes my (quite severe) arthritis worse. Pain can limit my walking, in particular.It sometimes feels as if life is going to be downhill all the way from here to the coffin.. I don’t want to feel like that – I want to be energetic and fit for my age.
So I’ve started reading up about diet, heart disease and aging. I’ve always believed that nutrition is profoundly important and have always mainly eaten well – within the parameters of what is known about nutrition at the time. I say mainly because I have two weaknesses – bread and sweet things – not puddings, but chocolates or fruit pastilles or jelly babies. I find them hard to resist – so most of the time, I don’t buy them, then I can’t eat them.
I’m not a scientist, so I sometimes struggle with scientific texts, but I’m reasonably intelligent and a good reader. I started off with Perlmutter’s Grain Brain, because I’d read a newspaper article based on it..
It’s populist money-spinning science and I can see that at times he’s extrapolating from one thing (coeliac disease, for example) to argue about something rather different and there’s too much anecdotal evidence for my taste.. However, he’s clearly studied his sources and uses a great deal of peer reviewed literature. His arguments have certainly raised questions. I’ve looked for a scientific response to his book and haven’t found one: there are certainly critiques, but they seem quite often to be based on misunderstandings or misrepresentations of what he actually says – for example, he’s fairly cautious when he talks about autism, whereas his critics say he claims to cure it. Anyway I’ve gone for 2 days with no bread (I have eaten a couple of Ryvita) and there’s a pound off on the scales. I can also feel that my stomach is less bloated – I can pull it in!
I’ve done a bit of searching and it appears the Perlmutter has had material published in peer-reviewed scientific journals – not a lot of it and all to do with neurology, rather than diet. It would appear that his hypothesis about cholesterol (ie that it’s only bad if it’s oxydised) is shared by a number of other medics. http://www.abc.net.au/catalyst/stories/3876219.htm interviews a few – including 2 experienced cardiologists. I’m interested in the passing reference they make to the relationship between stress and heart attacks. Mine followed a period of acute stress, and because my physical health is good it was hard to explain.
Meanwhile, it also seems as if there’s at least some evidence that high levels of carbohydrate can trigger coronary heart disease (CHD) in women: Dietary Glycemic Load and Index and Risk of Coronary Heart Disease in a Large Italian Cohort The EPICOR Study http://archinte.jamanetwork.com/article.aspx?articleid=225342
This study showed that out of a population of over 32,000 Italian women, those in the upper quartile for carbohydrate consumption had the highest risk of developing CHD
A diet with high levels of carbohydrates increases plasma triglyceride levels and reduces high-density lipoprotein (HDL) cholesterol levels,1– 3 in addition to increasing blood glucose and insulin levels,4 thereby creating a profile expected to increase the risk of cardiovascular disease (CVD). Moreover, postprandial glycemia is now emerging as an independent risk factor for CVD in diabetic and nondiabetic individuals.
It goes on to say
Short-term intervention studies on overweight and hyperlipidemic subjects show that low-GL diets reduce risk factors for CVD,7 whereas results from prospective studies suggest that low-GL diets can lower risk factors in healthy subjects.8,9 With regard to the association between dietary GI/GL and CVD, a recent systematic review on associations between dietary factors and coronary heart disease (CHD) concluded that there was strong evidence of a causal relation between high GI/GL foods and CHD.
(The reference for this last review is: Mente Ade Koning L Shannon HS Anand SS A systematic review of the evidence supporting a causal link between dietary factors and coronary heart disease. Arch Intern Med 2009;169 (7) 659- 669)
So at the very least, there seems to be a prima facie cause for approaching carbohydrates with caution. I shall try to stay off the grains and keep the intake of other carbohydrates low – lots of leafy vegetables, mono-saturate oils and proteins…In other words I’ll try Perlmutter’s diet and see how it goes.