Cardiac diet?

[daylatedollarshort]

I did read the article, including the part you bolded for me. The issue is just about all cardio docs and nutritionists will say one size fits all on the no fat or red meat idea. Anybody who doesn't is considered an outlier or a dipwit and is made fun of.

Sorry, I didn't mean to diminish your comments. Truce?

We find the biomarker testing to be much more individualized and helpful than generic doctor's advice. We've had great results with the testing. For those that can afford it, which includes many of the posters here, it is really informative.

Both high and low levels of uric acid are linked to decreased mortality. It is a $13 test our doctors never ordered, but the Pubmed research on our different health conditions pointed us to test for it on our own, and it might just add years to our lives. One of us is normal (but would likely be high if not eating plant based) and one low, so for sure the same diet isn't going to be best for us both.

 

[Scuba]

After getting 3 coronary stents, I've been following sort of a combination of the Mediterranean and Dash diets. So far it's been 4 years now and I haven't had to go back for any further procedures and my numbers (ie cholesterol, blood pressure, etc) look great.

Get in the habit of reading nutrional labels and try to avoid things with excess saturated fat, sodium, and added sugars. Mainly, stick to whole, unprocessed foods as much as possible. Two servings of fatty fish such as salmon or tuna each week are important for heart health. Beans, nuts, tofu, chicken, non- or low-fat plain Greek yogurt, are other great sources of healthy protein. Whole grains like oats, brown rice, barley, whole grain bread are good, and most of all, lots, and lots of vegetables and a serving or two of fruit each day.

As much as possible, avoiding things like butter, soda, candy, ice cream, alcohol, excess salt and added sugars, and red meat really helps.

One of my favorite go-to breakfasts is non-fat Greek yogurt with frozen berries, oats, and a small handful of walnuts. Served with a glass of V8 it's a healthy nutritional powerhouse that is satisfying for many hours.

Dinner is usually something like a big green salad with beans in it and vinegar and olive oil dressing, a slice of unbuttered whole grain bread, and a glass of non-fat milk. Sometimes I'll have chicken with it instead of beans.

Talking with the cardiac rehab nutritionist is a great idea. Your husband is so fortunate to have such a supportive spouse as yourself. Your love and support as he navigates this lifestyle change will make a big difference and will be crucial to his healing and successfully making healthy changes.

Thank you for the practical and specific suggestions. Very helpful.

The good news is that I’m already used to reading nutrition labels and cooking healthy meals since I’m always trying to manage my weight. We already eat salmon and tuna at least twice a week, if not more often. And we don’t eat much processed food, baked goods, etc. I have been adding whole grains because before we either skipped carbs or ate white potatoes, which we are now avoiding.

I just got confused about cardiac diet needs because common sense tells me that too many carbs/sugar wouldn’t help him, yet the cardiac diet info I was given by the hospital said fats are the thing to avoid. Avoiding too much saturated fat makes sense to me, but giving him enough olive oil, nuts, etc, to make his food palatable and give him proper nutrition seems like it should be a good thing. That’s what I’m going with for now until I can learn more.

 

[Scuba]

You made me curious so I looked at a label you would need to eat an entire cup to get that protein and it's JMO but mixing a healthy like yogurt with artificial sweetener is a huge negative IMO. I noticed that the first 3 ingredients are non fat milk,WATER, and fructose . You also mentioned you were having trouble getting enough calories into your hubby. Those were my basic points about the non fat sugar free yogurt. I'm sorry if I offended you I didn't mean to. I've got a carton of GG yogurt in front of me right now.

No offense taken. He likes this as a small dessert or snack. I know a lot of people don't agree with consuming artificial sweeteners, but I think they're a lot better than sugar and sweetening some foods is necessary at least to me to make them palatable. YMMV

 

[Scuba]

You could see a functional medicine doctor or start by taking a look at ultalabs. They have a wide variety of heart health panels. I have a book by Dale Breseden for Alzheimer's prevention testing that includes his protocol of functional medicine tests and have been using that as a basic template in our family for good health in general. (Summary of tests here - https://wiki.apoe4.info/wiki/Bredesen_Protocol)

TMAO seems to be important for heart health - "According to a news article published June 11 in JAMA, three recent analyses have linked high blood levels of TMAO with a higher risk for both cardiovascular disease and early death from any cause. In one of those studies, researchers found that people with higher levels of TMAO in their blood may have more than twice the risk of heart attack, stroke, or other serious cardiovascular problems, compared with people who have lower levels. https://www.health.harvard.edu/staying-healthy/red-meat-tmao-and-your-heart.

And also magnesium: "Biochemical interactions of magnesium in cardiovascular diseases - In recent studies of hospitalised patients, 42% were shown to be hypomagnesaemic. However, physicians request magnesium testing in only 7% of these patients. In a study conducted among patients in the intensive cardiac care unit, 53% of patients had mononuclear cell magnesium content below the lowest normal control. https://openheart.bmj.com/content/5/2/e000775

Nutrition in general - "Dietary micronutrient deficiency is common in adults with heart failure (HF), with >20% having low intake of vitamin A, calcium, magnesium, selenium, and iodine and up to 75% having low intake of vitamin D. - https://www.ahajournals.org/doi/10.1161/JAHA.118.010447#:

Uric acid and CVD - Uric Acid and Cardiovascular Disease: An Update - PMC (nih.gov)

Patients can't order tests from the Rupa site directly, but they do have some good articles on functional medicine tests - https://www.rupahealth.com/post/the-5-most-commonly-ordered-functional-medicine-lab-tests#:


ETA: CRP - "CRP outperforms LDL cholesterol as a predictor of cardiovascular risk. In addition, the authors found that the two tests identify different high-risk groups, so using both is better than relying on either alone.- https://www.health.harvard.edu/heart-health/c-reactive-protein-test-to-screen-for-heart-disease

Wow, this is lots of great information! Thank you for taking the time to share. I have my homework assignment now!

 

[Scuba]

Scuba doesn't say and we don't need to know but if hubby had the bypass and came out with no damage from his heart attack, does he really have heart disease? That's the question isn't it. That's what happened to my brother15 years ago at age 52. He's fine. Now my DH ended up with AFib from his leaking heart valve and they found a genetic issue, so yes he has cardio issues or "disease" as they like to call it.



Could they Scuba's DH and my bro, have another stent or bypass type issue maybe but it won't be caused by eating a few hamburgers even though that's what they want you to think!

This is a great question. I'm sorry to say I don't really know. He is seeing his cardiac surgeon tomorrow so I will ask him about this. Thanks.

 

[athena53]

Dr. Lustig's books which have helped me a lot, pretty treat the fat that occurs naturally in real food as OK. Just don't grab a handful of coconut oil, mix it with factory made protein powder and think it's OK to eat this fat bomb. Ugh.

Oh, for those of you who are thinking of introducing plant based meats because they may be healthy ask yourself this question. Do any of these new fake meats actually contain anything you could identify as a plant? I'll take a black bean burger made with beans, onions, spices, egg, and a bit of flour to one of those factory made fake burgers any day. A bit of relish and mustard and they are delicious.

I second Dr. Lustig- very readable except when he gets into the weeds of biochemistry. Long story short: your body does very bad things with sugar and it's bad for your heart and your liver, among other things. And high-fructose corn syrup is just plain evil. Processed food is pretty much evil. It strips out all the good stuff, especially fiber.

I also follow Dr. Peter Attia's podcasts (thanks to the member who first mentioned them here). He's focused on longevity but he interviews many smart, eloquent, credible people. They also get into excruciating detail on biochemistry but their message is consistent with Dr. Lustig. In a recent one on diet they pretty much said they don't believe in a "one-size-fits-all" diet. Keto is good for some but not everyone. Same with the others.

You really do need to do research and make your own decisions- I figure that in the end you have to live with the consequences anyway! I've cut back a lot on refined sugar in all its forms, have gotten more relaxed about eggs and nuts, and rarely eat meat. I'm 69 and walked over 15 miles a couple of days ago (in Munich and the so-called smartphone apps kept giving me bad directions- finally bought a map ). I'm still standing. Must be doing something right!

And I share your suspicion of processed meat substitutes. Give me tzatziki, hummus, quinoa, portobello mushrooms, etc. and hold the chemicals.

 

[Scuba]

We met with the dietitian today as a part of the Cardiac Rehab program DH is in. She is more a fan of the Mediterranean diet than the Pritikin diet the program emphasizes. Key differences are:

- She believes a reasonable number of whole eggs are fine, as well as plant-based oils, nuts and seeds. The fats need to be measured to ensure appropriate calorie control.

- She said shellfish is fine as there is a weak link between dietary consumption of cholesterol and actual cholesterol levels. Most impactful are genetics and exercise levels.

- She suggested a macro mix of 45-50% carbs, focusing on fresh fruits, green vegetables, and whole grains; 25-30% fats, focusing on olive oil and other oils low in saturated fat, plus nuts and seeds; and 20-30% protein, focusing on lean proteins and fatty fish and limiting marbled red meat and processed meats. She also recommended keeping added sugar, caffeine, alcohol and sodium at low to moderate levels.

This all makes sense to me and is the way we’ve been eating since DH came home from the hospital. It’s not that different from how we ate pre heart attack, although DH did eat more high sodium/higher fat processed food in the past and we both ate bigger portions and more “white carbs.” We’ve had no problem sticking to this at home and haven’t eaten out together since mid April. I think it will be harder when we start going to other people’s homes and restaurants for meals. Portion control and staying as close as we can to calorie and macro goals will be our approach.

 

[daylatedollarshort]

Wow, this is lots of great information! Thank you for taking the time to share. I have my homework assignment now!

We started doing the Genova Labs' Metabolomix test in our family and the results have been really helpful so far in tailoring our diets and supplements. There is a sample report here if you are interested Metabolomix+ Sample report with add-on tests 0321 (gdx.net). I ordered ours through Directlabs.

I eat a lot of produce and was high in some common produce nutrients and yet low in others. I was surprised at the results and glad I took the test so I can make some diet tweaks.

 

[RAE]

- She believes a reasonable number of whole eggs are fine, as well as plant-based oils, nuts and seeds. The fats need to be measured to ensure appropriate calorie control.

I don't know if your dietitian talked about which "plant-based oils" are fine, but there is a lot of information out there about the dangers of consuming any of the industrial seed oils. These include: soybean oil, corn oil, canola oil, safflower oil, sunflower oil, etc.....any of the oils that are typically sold in big jugs. These are all man-made oils (using a chemical extraction process involving benzene, deodorizers, and other harmful compounds) that our bodies have not evolved to consume. I personally won't touch anything that includes or is prepared with those man-made oils. Olive oil and avocado oil are fine, as they are not made using such a process. I encourage you to do some of your own research on these oils, but here is one article (actually a series of articles) that discusses this in more detail:

https://chriskresser.com/how-industrial-seed-oils-are-making-us-sick/

 

[Aerides]

- She said shellfish is fine as there is a weak link between dietary consumption of cholesterol and actual cholesterol levels. Most impactful are genetics and exercise levels.

Keeper!

 

[ncbill]

I don't know if your dietitian talked about which "plant-based oils" are fine, but there is a lot of information out there about the dangers of consuming any of the industrial seed oils. These include: soybean oil, corn oil, canola oil, safflower oil, sunflower oil, etc.....any of the oils that are typically sold in big jugs. These are all man-made oils (using a chemical extraction process involving benzene, deodorizers, and other harmful compounds) that our bodies have not evolved to consume. I personally won't touch anything that includes or is prepared with those man-made oils. Olive oil and avocado oil are fine, as they are not made using such a process. I encourage you to do some of your own research on these oils, but here is one article (actually a series of articles) that discusses this in more detail:

https://chriskresser.com/how-industrial-seed-oils-are-making-us-sick/

So seed oils would be fine if extracted via a cold-press, no chemical method?

 

[Scuba]

Yes, we also use MyFitnessPal. It’s a great app! I’ve been using it ever since I left Weight Watchers. DH has been using it since he got discharged from the hospital. It’s very helpful.

 

[RAE]

So seed oils would be fine if extracted via a cold-press, no chemical method?

Cold-pressed is best, yes. Most good olive oil is cold-pressed. A few oils are made be using heat (but no harsh chemicals) during extraction, and that is better, but heat will cause oil to go rancid quicker than cold-pressed oils, so I tend to avoid those as well. Read the label on whatever you are buying to see if they say how the oil was made. If they don't say anything, you can reasonably assume it was made using both heat and chemicals such as benzene and deodorizers during extraction.

Here is what I consider to be good advice on oils from another Registered Dietitian. It is somewhat different advice than what Scuba got from the dietitian she talked to. Many of the oils she recommends are fairly high in saturated fat, but that's okay, because saturated fat does not cause heart disease (that is a whole separate topic that we could discuss).

https://www.katiethornernutrition.com/seedoils

 

[Scuba]

Cold-pressed is best, yes. Most good olive oil is cold-pressed. A few oils are made be using heat (but no harsh chemicals) during extraction, and that is better, but heat will cause oil to go rancid quicker than cold-pressed oils, so I tend to avoid those as well. Read the label on whatever you are buying to see if they say how the oil was made. If they don't say anything, you can reasonably assume it was made using both heat and chemicals such as benzene and deodorizers during extraction.

Here is what I consider to be good advice on oils from another Registered Dietitian. It is somewhat different advice than what Scuba got from the dietitian she talked to. Many of the oils she recommends are fairly high in saturated fat, but that's okay, because saturated fat does not cause heart disease (that is a whole separate topic that we could discuss).

https://www.katiethornernutrition.com/seedoils

Thanks for this. We’ve been using cold pressed EVOO along with avocado oil spray for cooking. I asked the dietitian we saw yesterday about canola oil and she said she believes it is fine despite the negative press about it, but we haven’t been using it. We don’t use a lot of oils anyway so can meet our needs with olive oil and avocado oil.

 

[Markola]

This string got me curious about grape seed oil, which works really well for nonstick cooking and has a high smoking point. Unfortunately, it sounds like its manufacturing process is chemical-ladened and it has high amounts of Omega 6 oil. https://www.healthline.com/nutrition/grape-seed-oil

Avocado oil works almost as well for nonstick cooking, so I’ll keep getting spray bottles of that. https://www.healthline.com/nutrition/9-avocado-oil-benefits#TOC_TITLE_HDR_8

 

[braumeister]

Another good choice is my personal favorite, clarified butter. It's easy to make yourself and has a very high smoke point.

 

[FloridaJim57]

The best advice that I have been given, and am passing on here, is avoid white sugar, white flour, and salt. The rest depends on your genetics, blood work, activity level, overall health, etc.

 

[audreyh1]

Another good choice is my personal favorite, clarified butter. It's easy to make yourself and has a very high smoke point.

Ghee is readily available in grocery stores these days.

 

[Katsmeow]

Do you have any sources on who "debunked" the Ornish diet? It is approved by Medicare because it has met their research based standards, and "U.S. News experts rank the diet highly in most categories – especially heart health – due in part to its solid evidence-base. The whole foods, plant-based diet is made up predominantly of fruits, vegetables, whole grains and legumes, minimally processed and low in fat, sugar and refined carbohydrates. But it’s not just a diet: It also emphasizes exercise, stress management and relationships."https://health.usnews.com/best-diet/ornish-diet

You know, time flies. That is, things change. I don't have any doubt that the Ornish diet has done a lot for people who are able to follow it. The question is really what parts of it are responsible for the results. Any time you don't eat one thing then you have to eat something else. What are you replacing with what? And sometimes what people think is essential really doesn't matter. Specifically, is it really that important to eat that low fat a diet. Or, could it be that, say, reducing saturated fat and reducing (or eliminating) trans fat was what created the difference particularly compared to the standard diet of the time.

We met with the dietitian today as a part of the Cardiac Rehab program DH is in. She is more a fan of the Mediterranean diet than the Pritikin diet the program emphasizes. Key differences are:

- She believes a reasonable number of whole eggs are fine, as well as plant-based oils, nuts and seeds. The fats need to be measured to ensure appropriate calorie control.

- She said shellfish is fine as there is a weak link between dietary consumption of cholesterol and actual cholesterol levels. Most impactful are genetics and exercise levels.

- She suggested a macro mix of 45-50% carbs, focusing on fresh fruits, green vegetables, and whole grains; 25-30% fats, focusing on olive oil and other oils low in saturated fat, plus nuts and seeds; and 20-30% protein, focusing on lean proteins and fatty fish and limiting marbled red meat and processed meats. She also recommended keeping added sugar, caffeine, alcohol and sodium at low to moderate levels.

Her approach is much more in accord with what I think. There is considerable evidence that nuts in particular are really, really good for you.

You had originally asked about calories. The key here is I think two fold. First, eat more calorically dense foods that fit within the parameters of the diet. Nuts are a perfect example of this. Nuts are very calorically dense which is why some people think of them as unhealthy. But, the kind of fat in most nuts is not unhealthy. So for people who need to eat more calories, nuts are a great and tasty choice.

For people trying to eat lower fat and lower carb the usual way to make up calories is through lean protein. The ubiquitous boneless, skinless chicken breast is a great choice. Also fish. Salmon is higher fat but not an unhealthy fat. Bodybuilders often have a lot of good suggestions on eating more calories but staying with healthier foods. Tom Venuto has an excelling meal planning guide that I've found helpful.

 

[The Cosmic Avenger]

You know, time flies. That is, things change. I don't have any doubt that the Ornish diet has done a lot for people who are able to follow it. The question is really what parts of it are responsible for the results. Any time you don't eat one thing then you have to eat something else. What are you replacing with what? And sometimes what people think is essential really doesn't matter. Specifically, is it really that important to eat that low fat a diet. Or, could it be that, say, reducing saturated fat and reducing (or eliminating) trans fat was what created the difference particularly compared to the standard diet of the time.

It's not just about what you're exchanging -- studies suggest that just logging foods causes more mindful eating, and less idle snacking because of boredom or depression. (https://www.sciencedaily.com/releases/2019/02/190228154839.htm) And after that, food availability/food deserts are another big factor, since you can't always exchange one food for another when your choices are strictly limited by geography, time, and cost. (https://www.nature.com/articles/s41467-021-27522-y)

 

[euro]

Another good choice is my personal favorite, clarified butter. It's easy to make yourself and has a very high smoke point.

I’m curious, what the advantage of clarified butter are over regular butter. Is it basically that it retains all the “good” properties of butter (taste, flavor, healthy fats, etc), while not suffering the drawbacks (tends to “burn” even at relatively low temperatures)? Or are there any nutritional upsides as well?

 

[braumeister]

Regular butter has a low smoke point, while clarified butter has a high smoke point. It's just regular butter with the milk solids removed.

 

[Chuckanut]

For those who are looking for a way of eating that is not as extreme as some of the very low-fat or very low-carb plans, I suggest you get Always Hungry by Dr. Ludwig (Not Dr. Lustig) from the library. My n=1 experience with it is that it works very well for me. YMMV.