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.Image