Cardiac diet?

[Scuba]

The information we’ve received so far on the diet DH should be on following his quadruple bypass surgery ranges from low fat (25% or less of total calories) to very low fat (10% or less of total calories). Although the info we’ve received so far doesn’t mention any issues with whole grain carbs or fruits, I am trying to hold his sugar level down as well since his dad had Type 2 Diabetes and DH’s sugar level has always been somewhat borderline (90’s to slightly above 100). Also trying to keep sodium levels reasonable although DH has never had high blood pressure.

The issue I’m having is trying to get enough calories into DH with keeping carbs/sugar, fat, and sodium all low. He should be eating around 1,700-1,800 calories per day and many days he’s only at 1,300-1,500. I generally make everything from scratch except for breakfast. About half of his breakfasts are things I don’t make, such as Kodiak protein waffles, high fiber cereal, turkey sausage egg McMuffin type sandwich. The other half I do make from scratch, as I do for virtually all of his lunches and dinners now.

I’m going to ask the nutritionist at his cardiac rehab program for suggestions to boost calories a bit while still keeping his nutrients/macros in the appropriate range. If you’re on a cardiac diet and have ideas, please let me know. I’m not sure whether low sugar/carbs should take precedence or I should have him eat more carbs but keep the fat low. Or I really need to keep it all low and he just needs to eat more of everything so the ratios stay in balance.

 

[Qs Laptop]

The information we’ve received so far on the diet DH should be on following his quadruple bypass surgery ranges from low fat (25% or less of total calories) to very low fat (10% or less of total calories). Although the info we’ve received so far doesn’t mention any issues with whole grain carbs or fruits, I am trying to hold his sugar level down as well since his dad had Type 2 Diabetes and DH’s sugar level has always been somewhat borderline (90’s to slightly above 100). Also trying to keep sodium levels reasonable although DH has never had high blood pressure.

The issue I’m having is trying to get enough calories into DH with keeping carbs/sugar, fat, and sodium all low. He should be eating around 1,700-1,800 calories per day and many days he’s only at 1,300-1,500. I generally make everything from scratch except for breakfast. About half of his breakfasts are things I don’t make, such as Kodiak protein waffles, high fiber cereal, turkey sausage egg McMuffin type sandwich. The other half I do make from scratch, as I do for virtually all of his lunches and dinners now.

I’m going to ask the nutritionist at his cardiac rehab program for suggestions to boost calories a bit while still keeping his nutrients/macros in the appropriate range. If you’re on a cardiac diet and have ideas, please let me know. I’m not sure whether low sugar/carbs should take precedence or I should have him eat more carbs but keep the fat low. Or I really need to keep it all low and he just needs to eat more of everything so the ratios stay in balance.

I am not on a cardiac diet but I do use the My Fitness Pal app to maintain my weight. You can use the app on either your phone or your PC.

They have a very active forum there covering a wide range of topics regarding foods, recipes, weight loss, weight gain, heart health, etc. Also daily blog entries on a wide variety of subjects. I'm fairly certain you can read most content there without needing to set up an account.

 

[MRG]

I am not on a cardiac diet but I do use the My Fitness Pal app to maintain my weight. You can use the app on either your phone or your PC.

They have a very active forum there covering a wide range of topics regarding foods, recipes, weight loss, weight gain, heart health, etc. Also daily blog entries on a wide variety of subjects. I'm fairly certain you can read most content there without needing to set up an account.

+1
No specific diet but DW and I dropped 120 combined pounds with Myfitnesspal. We spent $15 on a food scale that's now the most used thing in the kitchen. You can see all your macros and adjust accordingly.

+2 on the multiple groups on their social network.

 

[Aerides]

Healthy calorie boosts include protein shakes and things like Ensure - check with the nutritionist if those fit with DH's plan? they are usually an easy way to get 200+ calories in a good way, and come in many flavors.

The carbs vs. fat thing...you'll get different answers depending who you ask. Some are going to be in the no fat camp, others, no sugar. I'd be doing a lot of reading in your shoes. I'm sure there is a balance where you can limit the obvious high fat, red meat stuff, while still eliminating bread and pasta.

 

[euro]

It is always shocking to me to see how far out of touch the medical establishment is in terms of dietary advice. The low fat craze that started somewhere in the 60-ies or so was thoroughly scientifically debunked by the end of the millennium, but even 20 years later many health professionals still teach and preach the nonsense. I’m a big believer in personalized diets. We all have our own genetics and out own metabolisms. Some of us can handle certain marconeutrients better/differently than others. Some can eat more carbs, some more fat, some more proteins. Accordingly, there is not ONE perfect diet for everyone. That said, certain truths are pretty clear. Excess carbohydrates cause/worsen cardiovascular issues. So, for someone with DEMONSTRATED heart disease, keeping carbohydrates low is essential. Otherwise, those precious flour grafts your DH just received will be clogged again in a short time.
Now, if you accept that, then how do you get enough calories to survive? Well, you can increase protein to some extent but you will HAVE to increase fat intake. Even most of the low-fat gurus can agree that certain fats can be and ARE healthy (olive oil, avocados, etc). If the physicians managed to (needlessly) scare you away from more common fats such as butter, meats, diary) then at least swamp your DHs food with as much olive oil and avocados as you can. He needs the fat in order to survive.

Again, for those who are not in specific carbohydrate sensitive health categories (diabetics, obesity, cardiovascular disease, etc), and are blessed with genetics that can handle tons of carbohydrates: have at it and enjoy! However, for the rest of us, it is: limit those carbs and don’t be scared of the (good) fats.

 

[braumeister]

Keep in mind that there are only three macronutrients: fat, protein, and carbohydrates.

If you're deliberately keeping fat and carbs low, the only other source of calories is protein, and nobody can eat huge proportions of that.

 

[Bamaman]

You might want to get hold of an American Heart Association cookbook and see the direction it goes. And it (with some modifications) is a good one to follow.

It's very easy to go a little overboard when someone first gets over heart surgery. Sure some changes are needed, but it's also very important to maintain a resemblance of a normal life.

Man don't consider a blood sugar of 90-100, to be borderline diabetic. 150-200 and it's inching up, yea. But many people that get under 100 may feel a little jumpy and weak. I'm like that.

But if you want to see a diet that's hard core, go to a Renal Diet. Following it really makes living unpleasant.

 

[daylatedollarshort]

In recent studies, a high carb, macrobiotic diet actually beat out the American Diabetes Association recommended diet for controlling blood sugar - Benefits of a Macrobiotic Diet for Diabetes | NutritionFacts.org.

This kind of diet would also fit in with the Ornish diet, which has been shown in studies to reverse heart disease.

 

[Chuckanut]

I am curious... Does the low-fat recommendation include so called good fats like olive oil and the fats from foods like nuts and avocados? Supposedly, these are neutral at worst and protective at best for most people.

But, I suppose by-pass patients are not most people. Recovery from bypass surgery may be a whole different ball game. So, while these may be good questions to ask, I would not do anything based upon advice from this site. Talk to the bypass recovery experts.

 

[The Cosmic Avenger]

+1
No specific diet but DW and I dropped 120 combined pounds with Myfitnesspal. We spent $15 on a food scale that's now the most used thing in the kitchen. You can see all your macros and adjust accordingly.

+2 on the multiple groups on their social network.

Same, I started on WW, but they kept tinkering with the plan after I'd make adjustments to their last "update", and it was awful, so I switched to MyFitnessPal 6.5 years ago and it's been MUCH easier. It does track all USRDA listed elements, but you will need to verify every item the first time you find it in their database, as it's largely crowdsourced, think like Wikipedia but a lot less rigorous.

 

[pacergal]

As mentioned previously, all foods fit three nutrients: Fats, Carbs, Protein. Your body needs all three.
Healthy fats are Ok.
Protein drinks can give extra calories if thats all he needs after eating three healthy meals. A drink can sub for a snack. Glucerna is one that is ok for diabetics.

Have you looked at "the Mediterranean Diet"? or google DASH diet for some ideas.

A few sessions with a local RD (Registered Dietician) may even be covered by insurance if a referral is made by PCP, and seems warranted given his surgery and diagnosis.
He/She will review his current dietary intake (usually a diary for a few days), will help create sample menu plans, answer questions. Well worth your time.

Best wishes for your DH continued recovery and good health.

 

[Montecfo]

My cardiologist does not believe in restrictive diets as they believe people make damaging substitutions.

But they do endorse the Mediterranean diet and I stick to low carb, high protein, healthy fats.

 

[Crewer]

Years ago Caldwell Esselstyn of the Cleveland Clinic got a group of "terminally ill" - clinic couldn't do anything else for them so he could have a go - cardiac patients and reversed their disease with a very low fat, plant-based diet. That's Ornish, too, if I remember right. I don't think the patients also had diabetes. Years ago I read an Ornish cookbook and though "how can you cook/eat this way? It's too weird." But now we pretty much do eat that way. We don't go as low fat as Esselstyn's diet but I don't seed oils that are high temp processed. We do have wild-caught fish sometimes. I use fake meat and fake cheese sparingly. We also don't eat much in the way of bread-like things, ie pasta, etc. If I want something sweet I eat dates or dried or frozen cherries and I sometimes have a diet coke. I go off plant-based in the winter because the CSA I belong to only has vegetarian then and not vegan. At least the eggs and cheese aren't from animals that were given steroids and antibiotics.

I have mostly lost my taste for sweets (Yes, I've said "Yuk! This ice cream is way too sweet." when plant-based ice cream was served for some occasion.)

I don't consider this diet to be onerous or restrictive. It does take my time for prep, though.

We both lost weight and got to "normal" BMIs and I don't track food or restrict myself, though I do try not to snack at night.

 

[razztazz]

When they said it reversed their heart disease, what does that mean? It unclogged their arteries? Or did they have enlarged hearts, carditis, congenital abnormalities, or other diseases of the heart. Simply unclogging arteries is easy to do. Ornish claims to have done it with diet but he's been debunked then rebuked, then conditionally semi-bunked.... like whom can ya trust?

As far as super low fat diets and weight, many have gotten the same results from Atkins and similar. (Keto? is that what they call it?)


Does anybody know how a super low fat diets can cure diseases that aren't caused by fat in the diet? Not trying to be a pain in the ass here but I will say that after 40+ years of this stuff, 22 of them as a vegetarian, and hearing all the data on every kind of diet change or or be mealy-mouthed into near oblivion, I am highly suspicious of any extreme type of diet that claims to be healthier than the others or any diet that claims to cure diseases.

 

[daylatedollarshort]

When they said it reversed their heart disease, what does that mean? It unclogged their arteries? Or did they have enlarged hearts, carditis, congenital abnormalities, or other diseases of the heart. Simply unclogging arteries is easy to do. Ornish claims to have done it with diet but he's been debunked then rebuked, then conditionally semi-bunked.... like whom can ya trust?

As far as super low fat diets and weight, many have gotten the same results from Atkins and similar. (Keto? is that what they call it?)


Does anybody know how a super low fat diets can cure diseases that aren't caused by fat in the diet? Not trying to be a pain in the ass here but I will say that after 40+ years of this stuff, 22 of them as a vegetarian, and hearing all the data on every kind of diet change or or be mealy-mouthed into near oblivion, I am highly suspicious of any extreme type of diet that claims to be healthier than the others or any diet that claims to cure diseases.

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

I don't think there is a one size fits all diet, but for heart disease there is pretty solid research behind the Ornish and similar diets. The studies are all out there on Pubmed. It is easy enough these days to try a diet like this if you have heart disease, then test your heart health biomarkers, adjust diet, retest, repeat as needed.


ETA - Elevated uric acid levels are linked to heart disease and that is a $13 test that can be self ordered from Ultalabs, and you can also buy test trips or a monitor on Amazon. Higher and lower uric acid levels are both linked to lower mortality.

 

[razztazz]

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

I don't think there is a one size fits all diet, but for heart disease there is pretty solid research behind the Ornish and similar diets. The studies are all out there on Pubmed.

Ref Ornish points: Who paid for the recommends? That's important. Always obscure (Of course!) but should always be assumed. Also, it fits the 50 yr old narrative ergo it must be good. I am still skeptical in light of the reproducibility crisis in all fields of science, especially life sciences. Simply having a body of research is hardly a ringing endorsement and is not to be confused with facts. Also, non-super low fat diets don't cause any of the diseases they are claimed to cure. Ah yes. It's the diet the diet and the diet. But they always feel compelled to throw in exercise, stress, yoga, music, positive thinking, or something else. IOW they don't really know what they're saying or what the causes and effects really are.

I have read Ornish many times. (He now recommends eating some fats in the form of nuts. Seed oils anyone? Unless he's revoked this...?) I see nothing believable in it. Lots of lack of controls. But lots of people swearing. And the AMA, AHA, Medicare connection is just more to be suspicious of, not something that makes me want to say "Hallelujah!" He does however exhibit some symptoms of obsessive compulsive disorder. But you can say the same about Louis Pasteur and all those doctors who recommended ice pick lobotomies and Chesterfield cigarettes. Again, whom can ya trust? At least Louis did his own research.

As far as quoting sources, sorry, I don't keep a box of 3x5's with everything I ever learned ready to zing out on demand. I doubt anybody does for anything other than recent events. This is ancient stuff.

I've see nothing in any extreme diets that are truly actionable. (Even though I've been on some of them myself for years.) It's like the proverbial cure for baldness. If there really was one everybody (affected) would know it and nobody would argue about it. (And medicare would probably pay for it.)

 

[lesjrp]

My cardiologist does not believe in restrictive diets as they believe people make damaging substitutions.

But they do endorse the Mediterranean diet and I stick to low carb, high protein, healthy fats.

True, applies to older people working out. I decided to stay away from heavy weights. Then I started doing chin ups.

 

[daylatedollarshort]

Ref Ornish points: Who paid for the recommends? That's important. Always obscure (Of course!) but should always be assumed. Also, it fits the 50 yr old narrative ergo it must be good. I am still skeptical in light of the reproducibility crisis in all fields of science, especially life sciences. Simply having a body of research is hardly a ringing endorsement and is not to be confused with facts. Also, non-super low fat diets don't cause any of the diseases they are claimed to cure. Ah yes. It's the diet the diet and the diet. But they always feel compelled to throw in exercise, stress, yoga, music, positive thinking, or something else. IOW they don't really know what they're saying or what the causes and effects really are.

I have read Ornish many times. (He now recommends eating some fats in the form of nuts. Seed oils anyone? Unless he's revoked this...?) I see nothing believable in it. Lots of lack of controls. But lots of people swearing. And the AMA, AHA, Medicare connection is just more to be suspicious of, not something that makes me want to say "Hallelujah!" He does however exhibit some symptoms of obsessive compulsive disorder. But you can say the same about Louis Pasteur and all those doctors who recommended ice pick lobotomies and Chesterfield cigarettes. Again, whom can ya trust? At least Louis did his own research.

As far as quoting sources, sorry, I don't keep a box of 3x5's with everything I ever learned ready to zing out on demand. I doubt anybody does for anything other than recent events. This is ancient stuff.

I've see nothing in any extreme diets that are truly actionable. (Even though I've been on some of them myself for years.) It's like the proverbial cure for baldness. If there really was one everybody (affected) would know it and nobody would argue about it. (And medicare would probably pay for it.)

This is the Medicare evaluation, which addresses your concerns about control groups and conflicts of interest: "The Lifestyle Heart Trial (5 year results reported by Ornish et al., JAMA 1998; 1 year results reported by Ornish et al., Lancet 1990) showed significant regression of coronary atherosclerosis measured by angiography in the experimental group randomly assigned to intensive lifestyle changes. Although the Lifestyle Heart Trial had a small sample size (n = 43), it used a random assignment and the readers of the arteriograms were blinded. The Multicenter Lifestyle Demonstration project (Ornish et al., 1998) showed that participation in the program with comprehensive lifestyle changes was associated with a reduction in revascularization at the 3 year follow-up. Although this study was not a randomized trial, it had a larger sample size, was conducted in more sites, and supported the results of the Lifestyle Heart Trial. These two published studies provided evidence that participation in the Ornish program positively affected the progression of coronary heart disease and reduced the need for bypass surgery and percutaneous angioplasty.

Dean Ornish, MD, the founder and director of the Ornish Program, was closely involved with many of the studies and reports evaluated in this analysis and as such, his direct financial interest in the program is important to consider. Despite this financial consideration that could possibly impact the objectivity of the science, CMS feels that these studies and reports offer scientifically valid information and are important for this evidence review. We also considered other peer-reviewed published research in which Dr. Ornish played a limited or no role."


Source -
https://www.cms.gov/medicare-covera...240&NcaName=Intensive+Cardiac+Rehabilitation+

 

[Scuba]

Thank you all for your insights and recommendations. I agree re MyFitnessPal being a great tool. I’ve been using it since I dropped out of WW, and DH has been using it since he came home from the hospital. We track his calories, macros, saturated fat, sugar, fiber and sodium with this app.

So far I’ve been severely limiting his saturated fats but giving him nuts and some olive oil so his fat is normally 25% or so of his calories. He’s eating lots of lean protein, minimal processed foods, and lots of green veggies. Some lower glycemic index carbs such as steel cut oatmeal, brown rice and whole wheat pasta, but not every day. Very few white carbs - no white bread, pasta, rice, or potatoes unless they’re sweet potatoes. And only fresh fruit, nonfat sugar free yogurt, or sugar free Jello pudding or gelatin for desserts. He does supplement with protein shakes or a Quest bar occasionally.

He is still losing weight but at a slower rate now. He can probably lose another 10 lbs or so without looking too gaunt.

The medical field does seem really divided. Most seem to agree that too much saturated fat, as well as partially hydrogenated oils and trans fats, are bad for pretty much everyone. Also most recommend limiting processed foods, especially meat. And most also agree that limiting refined sugar and sweet carbs such as donuts, cookies, cake, etc. is good.

The debate seems to be around the balance between “healthy” whole grain carbs and “healthy” fats. The traditional cardiac diets limit all fat, including healthy fats, to a very low 5-10% of calories, encourage lots of whole grains, and are ok with some savory white carbs such as white rice and potatoes. The newer thinking seems to encourage more healthy fats and limits starchy carbs to whole grains only/no “white carbs.”

DH and I will be meeting with a dietitian when he starts Cardiac Rehab in a couple of weeks. I’ll report back on what they recommend for him and why.

 

[ivinsfan]

Scuba gotta comment on the nonfat sugar free yogurt it's like eating air with no nutrition whatsoever.. try hunting around for a Greek type yogurt without added sugars. Real yogurt is full of good things. Even cardiac patients can eat it.as for fat,should you drink Wesson oil no but fat in not the evil they make it out to be.

 

[razztazz]

This is the Medicare evaluation, which addresses your concerns about control groups and conflicts of interest: "The Lifestyle Heart Trial (5 year results reported by Ornish et al., JAMA 1998; 1 year results reported by Ornish et al., Lancet 1990) showed significant regression of coronary atherosclerosis measured by angiography in the experimental group randomly assigned to intensive lifestyle changes. Although the Lifestyle Heart Trial had a small sample size (n = 43), it used a random assignment and the readers of the arteriograms were blinded. The Multicenter Lifestyle Demonstration project (Ornish et al., 1998) showed that participation in the program with comprehensive lifestyle changes was associated with a reduction in revascularization at the 3 year follow-up. Although this study was not a randomized trial, it had a larger sample size, was conducted in more sites, and supported the results of the Lifestyle Heart Trial. These two published studies provided evidence that participation in the Ornish program positively affected the progression of coronary heart disease and reduced the need for bypass surgery and percutaneous angioplasty.

Dean Ornish, MD, the founder and director of the Ornish Program, was closely involved with many of the studies and reports evaluated in this analysis and as such, his direct financial interest in the program is important to consider. Despite this financial consideration that could possibly impact the objectivity of the science, CMS feels that these studies and reports offer scientifically valid information and are important for this evidence review. We also considered other peer-reviewed published research in which Dr. Ornish played a limited or no role."


Source -
https://www.cms.gov/medicare-covera...240&NcaName=Intensive+Cardiac+Rehabilitation+

Two published studies. Whoopee. By people with an interest in the narrative. But thanks for the refs. At least it's something

 

[euro]

Two published studies. Whoopee. By people with an interest in the narrative. But thanks for the refs. At least it's something

Quite right, these are jaded studies. Also, they are 25 years old. The world has moved on - especially the nutritional science world. I have followed these issues for many years and in MY opinion, the Esselstyn/Ornish stuff has never held up to scrutiny. I am well aware that there ARE people who do ok on that diet, but God bless them for their exceptional metabolism! For the vast majority of the population that lifestyle is clearly unhealthy. Again: in MY opinion. As our mate from the islands would say: YMMV

 

[daylatedollarshort]

Quite right, these are jaded studies. Also, they are 25 years old. The world has moved on - especially the nutritional science world. I have followed these issues for many years and in MY opinion, the Esselstyn/Ornish stuff has never held up to scrutiny. I am well aware that there ARE people who do ok on that diet, but God bless them for their exceptional metabolism! For the vast majority of the population that lifestyle is clearly unhealthy. Again: in MY opinion. As our mate from the islands would say: YMMV

Do you have links to any other published studies from any other type of diets that have been shown to reverse heart disease? The plant based Ornish diet maybe more extreme but it has many similarities to the native diets of countries with very low incidence of heart disease - One in a Thousand: Ending the Heart Disease Epidemic (nutritionfacts.org). If I had heart disease I would start more or less with a diet known to reverse the condition and then test, adjust diet + lifestyle, repeat until my biomarkers, nutrition and gut tests all came out looking good. That is what we've been doing for different health issues. We search through Pubmed for best diet + lifestyle ideas, test, tweak, retest. Being able to order our own lab tests these days has been a game changer for my family.

 

[daylatedollarshort]

The medical field does seem really divided. Most seem to agree that too much saturated fat, as well as partially hydrogenated oils and trans fats, are bad for pretty much everyone. Also most recommend limiting processed foods, especially meat. And most also agree that limiting refined sugar and sweet carbs such as donuts, cookies, cake, etc. is good.

The debate seems to be around the balance between “healthy” whole grain carbs and “healthy” fats. The traditional cardiac diets limit all fat, including healthy fats, to a very low 5-10% of calories, encourage lots of whole grains, and are ok with some savory white carbs such as white rice and potatoes. The newer thinking seems to encourage more healthy fats and limits starchy carbs to whole grains only/no “white carbs.”

DH and I will be meeting with a dietitian when he starts Cardiac Rehab in a couple of weeks. I’ll report back on what they recommend for him and why.

Self order labs like walkinlabs and ultalabs have numerous heart panels for reasonable prices. Tracking his healthy heart biomarkers may take the guesswork out of which diet your husband would do best on. We've found we can order more comprehensive tests and order them when we want compared to what the doctors will order, because they have to follow the insurance company rules, and they often won't cover something as simple and important as a vitamin D test.

 

[Aerides]

Scuba gotta comment on the nonfat sugar free yogurt it's like eating air with no nutrition whatsoever.. try hunting around for a Greek type yogurt without added sugars. Real yogurt is full of good things. Even cardiac patients can eat it.as for fat,should you drink Wesson oil no but fat in not the evil they make it out to be.

Fage Total 2% is my favorite. A smidge of fat and sugar, and a ton of protein. It's also a great basis for making overnight oats, or for adding in extra protein powder, + bananas or nuts or berries. You can make an excellent healthy breakfast that way. And you can mix up a whole tub and have a few days of breakfast ready in advance.