Eat to Live: The Amazing Nutrient-Rich Program for Fast and Sustained Weight Loss (27 page)

Some studies published in the past have concluded that dietary changes alone are insufficient to alter plasma lipid levels.
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The
message reported in both the lay and medical media is that low-fat diets don’t work. This reinforces the concept that there is not much we can do to alter our genetics, except maybe take drugs. Sadly, the diets offered by nutritional authorities are not aggressive enough to offer true protection or to expect predictable recovery in patients with heart disease. These so-called heart-healthy diets are not anything like my dietary recommendations.

The concern that some medical authorities have regarding “low-fat” diets is that these diets may lower your HDL and raise your triglycerides.
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This is true. Lowering fat intake is not the principal step necessary to achieve a cardioprotective diet. It is not sufficient merely to lower your fat intake. If all you do is cut back on fat, you may see little benefit and possibly raise your triglycerides.

However, triglyceride levels increase on low-fat diets only when the diets
are high in refined foods, low in fiber, and unsuccessful in weight reduction
.
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My observations have been corroborated by other studies.
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Researchers have compared a high-vegetable-and-fruit diet (like the one recommended in this book) with a grain-based, low-fat diet. Study participants who ate the high-vegetable-and-fruit diet experienced a 33 percent drop in their bad cholesterol (LDL)—a reduction that is greater than that achieved with most cholesterol-lowering drugs.
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This reduction is dramatically greater than for subjects eating a grain-rich Mediterranean diet or the modern low-fat diet recommended by the American Heart Association.

I rarely ever see triglycerides rise when patients are placed on my nutrient-dense, high-fiber, low-fat diet. For 95 percent of patients, triglycerides drop dramatically. This is also because my patients do not overeat; they lose weight because they feel satisfied from all the fiber in the natural foods and because the diet has such a high nutrient-per-calorie density. We watch the triglyceride problem melt away as they lose the unwanted pounds; triglycerides drop precipitously with weight loss.

The conclusion of the nutrition committee of the American Heart Association is something we all agree on:

There is overwhelming evidence that reduction in saturated fat, dietary cholesterol, and weight offer the most effective dietary strategies for reducing total cholesterol, LDL-C levels, and cardiovascular risk. Decreases in saturated fat should come at the expense of total fat because there is no biological requirement for saturated fat.
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So the main difference between my recommendations and those of the American Heart Association is that I adhere more rigorously to these conclusions than they do. You must do what is necessary to achieve the results desired. If you water down the recommendations to make them more politically or socially acceptable, you sell out the people who want real help and are willing to do what is necessary to protect themselves. An example of the results possible with such aggressive dietary intervention is the patient above.

The results I see with my patients are consistently more spectacular than with other dietary interventions because my advice is generally more rigorous and takes into account the nutrient-per-calorie density of foods to devise a plant-based diet that is maximally effective.

Some studies from other parts of the world also show fairly impressive results utilizing what they call “anti-atherogenic” vegetarian diets, as illustrated by a Russian study where all types of lipid abnormalities were found to improve significantly.
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Two things are necessary to predictably reverse heart disease: one is to become thin and superbly nourished, and the other is to get your LDL below 100. Reversal of heart disease then occurs. If one expects to diminish atherosclerotic plaque over time and stabilize the plaque so the chance of having a heart attack significantly decreases, I insist that he or she must strive to achieve the following parameters of normalcy:

• The patient must achieve a normal weight or become thin (less than one inch of abdominal fat in women, and less than three-quarters of an inch in men), or be in the process of steadily losing weight toward this goal.
  

• The patient must achieve normal cholesterol. My definition of normal is an LDL cholesterol below 100 (most authorities are now using this benchmark). Drugs are rarely needed to attain this level when an aggressive nutritional approach is taken. An LDL below 100 earned as a result of nutritional excellence is much more protective than an LDL below 80 as a result of medication. When you achieve a favorable cholesterol level with proper nutrition, you promote
  a whole cascade of favorable effects, such as lower levels of inflammation; reduction of fat deposits all over the body, including inside the blood vessels; lower blood pressure; and reduced propensity of blood to clot.
  

• The patient’s diet must be nutrient-dense. Animal products and detrimental fats must be avoided to prevent the after-meal fat surge.
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  Refined carbohydrates should also be avoided to prevent the after-meal glucose surge and to control triglycerides.
  

• Blood pressure must return to within the normal range, below 130/85, or be slowly improving and moving toward this minimal goal. The normalization of blood pressure as medications are gradually discontinued represents the reversal of atherosclerosis and is an important criterion to predict cardiac safety. The person who has removed his or her cardiac risk no longer requires blood pressure medication to maintain normal blood pressure readings. The vessels have become more elastic through nutritional intervention.
  

My vigorous, nutritionally centered reversal treatment should be started in every patient diagnosed with coronary artery disease before elective revascularization procedures are considered. My experience has shown that most patients will pursue an aggressive regimen when it is supported by a knowledgeable and involved physician who provides sustained guidance and support. After spending adequate time with a doctor reviewing all the risks of the conventional approach and discussing how reversal is possible with aggressive nutritional management, how many patients do you think would choose to have their chests split open with bypass surgery?

Even if you are lucky enough to have no postoperative complications from bypass, some degree of brain injury occurs in almost every patient from the time spent hooked up to the heart-lung
machine. On neuropsychological testing six months later, about 20 percent still show deterioration.
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Brain injury can range from subtle degrees of intellectual impairment or memory loss to personality changes and permanent brain damage.
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Even if you do fine after angioplasty, stent placement, or bypass, atherosclerosis develops at a faster rate in those arteries that were subject to bypass or angioplasty—the plaque grows faster after surgery. Approximately 25 percent of arteries treated by angioplasty clog up again within four to six months.
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This is called restenosis.

Restenosis is an iatrogenic (physician-caused) disease. Because restenosis involves scarring, it does not behave like native atherosclerosis and does not respond as favorably or as predictably to lifestyle modifications later on. In other words, because of the changes made to the atherosclerotic plaque by the angioplasty treatment, the blockages are less responsive to nutritional intervention when they return. Many patients are worse off after treatment, not better. If they had followed my coronary artery disease reversal plan instead, they would be watching their heart get healthier each week.

Stenting attempts to reduce this high risk of restenosis but has not solved the problem.
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Stents are tiny wire-mesh tubes that are laced in the narrowed segment of arteries that were stretched by balloon angioplasty. A stent may also cause vascular instability or inflammation where the stent ends and the native plaque begins, thus increasing the risk for coronary thrombosis.
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It would be good to remind patients that revascularization procedures do not influence the underlying disease, because the rest of the coronary vasculature, with diffuse, nonangiographical noticeable atherosclerosis, is still there posing a risk for future cardiac events, whether the procedure is done or not.

Heart attacks most commonly occur when plaque of a lipid-rich segment ruptures. These vulnerable areas of plaque are not necessarily those that are seen as significantly narrowed on catheterization. Heart attacks still occur in the minimally narrowed
segments, areas that may appear normal on catheterization and stress testing.

Normal stress test results or cardiac catheterization results do not mean you do not have atherosclerosis. You can have a heart attack the day after you are told your vessels are clear. These tests show only advanced disease.

Massive atheromas (fatty deposits) lurking within the vascular wall—outside the view of angiography (cardiac catheterization)—account for two-thirds of myocardial infarctions.
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Most heart attacks occur at sites invisible to the tests done by cardiologists.
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This is why invasive cardiac procedures relieve pain but do not have an impressive record of reducing the risk of future heart attacks.

Only strong risk-factor control, with aggressive nutritional intervention, can reverse diffuse disease, avoiding the high probability of that heart attack occurring down the road. Your survival depends on risk-factor management—quitting smoking and lowering your weight, blood pressure, glucose, cholesterol, and insulin levels as a result of careful nutrition—not the procedures done by the interventional cardiologist or cardiac surgeon. Only then will beneficial changes occur in the plaque composition, promoting healing of the blood vessel’s lining that will stabilize the vessel wall and substantially reduce the risk of a heart attack.

You are deluding yourself if you think chelation or drugs alone will reverse your condition while you remain overweight and nutritionally malnourished. Chelation will not dissolve your atherosclerosis as claimed. The studies done on this therapy are not impressive.
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In spite of chelation, patients generally continued to deteriorate unless they changed their diet, lost weight, and lowered their cholesterol. In other words, changes not related to chelation.

The areas of vulnerable plaque that cause heart attacks have a large fatty core of cholesterol. Removing the lipid from the plaque can make it smaller and more resistant to rupture. Use common sense; chelation could no more suck fatty substance out of a coronary artery than it could suck the fat off your left hip. There is no way chelating agents can selectively remove the lipids in atheromas.

These atheromas that form on the inside of our blood vessels are fatty tumors with a fibrous cap. They shrink and become more resistant to rupture proportionally to, and as a result of, weight reduction, caloric restriction, nutritional excellence, and aggressive lipid lowering. The most impressive results of shrinking and removing atheromas occur after the person has lost all excess body fat. Body fat is designed for energy storage. Atheromas are more difficult to remove; they resolve after other fat storage sites have been depleted. Fortunately, the same body that created the atheromas has the ability to disintegrate them.