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Cardiometabolic Syndrome - When Does Heart Disease Begin?

My friend George keeled over at the water fountain at work and could not be resuscitated. He was 45 years old. He had "no history of heart disease". He was a smoker, somewhat overweight, living with an unhappy marriage, and working at a stressful job with little choice over his assignments. He was your typical "meat and potatoes" guy - toast and coffee for breakfast, hamburgers and French fries for lunch, steak and baked potatoes for dinner.

Was There Any Warning Signs?

Heart disease seems to be the body's final cry for help - or perhaps its final expression of the realization that there will be no help. Heart attacks usually do not come out of nowhere.

In allopathic medicine, we have come to learn that there are warning signs of heart disease, such as high blood pressure, high cholesterol, obesity, smoking... we call them risk factors. We know that certain laboratory markers are associated with increased risk of heart disease - small dense LDL particles, for instance, or homocysteine, or Lipoprotein(a) are well known to allopathic medicine as risk factors.

But what goes on in the human body before we develop high blood pressure or high cholesterol? What causes us to develop hypertension or dyslipidemia?

How about the driver who never changes the oil in his car until one day the engine has completely seized up and needs to be replaced? Is that how we treat our hearts? Would we not be well-advised to start in our youth with good food, free of chemicals and additives and preferably free of unnatural genes?

We live in an age where we anticipate that our children will live shorter lives than ourselves, not longer.[1]

This is a very sobering thought.

Timeline of heart disease:

  • Cow's milk intolerance in infancy or toddlerhood
  • Gluten intolerance as toddlers
  • Carbohydrate sensitivity as young children
  • Smoking tobacco (or chewing tobacco, or Nicorette® gum) as young adults
  • Weight gain
  • High cholesterol - recommended by the American Academy of Pediatrics for children as young as 8
  • High blood pressure
  • High blood sugar
  • Social isolation
  • Depression, anger, hostility (Type A behavior)
  • Chest pain, heart disease
  • Heart attack
  • Bypass surgery
  • Cardiac stents
  • Diabetes
  • Metformin
  • Artery bypass
  • abdominal aortic aneurysm
  • femoral/popliteal bypass
  • Non-healing sores on the feet
  • Gangrene
  • Amputation

Treating high blood pressure or high cholesterol is like turning off the fire alarm instead of using the fire extinguisher and thinking that somehow we have put out the fire. Does this sound even remotely sensible?

That is precisely what we do when we take a statin drug to lower an arbitrarily measured level of cholesterol, or a blood pressure pill to lower an equally arbitrarily measured level of blood pressure, or metformin to lower our blood sugar.

Do we really believe that our bodies are so poorly engineered that they cannot send us cries for help? What is the high blood pressure, or high cholesterol, or evidence of heart disease but our body's only way of communicating with us?

We all communicate through the tools we have available to us. Our heart communicates by hurting. Heart attacks happen with greater frequency on Monday mornings, and when a partner dies. [2] Our blood pressure is silent for a long time, but eventually starts screaming at us, by causing stroke or congestive heart failure or kidney disease.

Identifying the Causes of Heart Disease

We have the tools to measure high blood pressure and high cholesterol. We have the tools to measure the heart's electrical activity, the kidney's function, the workings of the pancreas, the sharpness of the mind.

If our cholesterol is high[3], maybe it's because our livers are not working correctly because we have fed ourselves too much sugar, too much wheat, too many desserts, too many chemicals, so that now our cell walls are stiff, our blood vessels are becoming inflexible and damaged, our blood sugar is out of control and we can't remember where we put the car keys.

Does that seem like a really far stretch? Actually, this relationship between high carbohydrate diet and both heart disease and high blood pressure has been published in the scientific literature since the early 1960s - over fifty years ago.[4] We - both allopathic physicians and patients - have simply chosen to ignore it. And now we are reaping the rewards of choosing the pharmaceutical over the functional routes to health.

Heart disease is the number one killer in the United States today,[5] slightly edging out cancer as the top dog. As of 2011, over twenty-six million of us were diagnosed with some form of heart disease - coronary artery disease, high blood pressure, stroke... Numbers are about equally divided between men and women, and a little more common in whites than in blacks, much more common in the affluent than in the poor.

This does not seem like much progress since we first started to associate cholesterol with heart disease in the 1950s.

Where did we go wrong? Let us go back to the 1950s.

The History of Heart Disease in the U.S.

First, for some reason we decided that because elevated cholesterol levels in the blood were associated with heart disease, therefore elevated cholesterol causes heart disease. This is a logical fallacy well known to debating teams. Post hoc, ergo propter hoc (after this, therefore because of this) has never been a valid argument.

Second, it just so happened that we had recently discovered a new class of drug which stopped the synthesis of cholesterol in the body, and therefore lowered blood cholesterol levels.

In 1984, the Lipid Research Clinics Coronary Primary Prevention Trial, funded in part by Proctor and Gamble (manufacturer of margarine and saturated vegetable oils) placed all subjects on a low cholesterol, low saturated fat diet (through the use of margarine, egg replacers, processed cheese and baked goods made with vegetable shortenings). One group took a cholesterol lowering drug, one group a placebo. Results of the study purportedly showed that the group taking the cholesterol lowering drugs had a lower incidence of death from heart disease.

Rarely mentioned was the conclusion that the group which took cholesterol lowering drugs also had an increase in deaths from:

  • Cancer
  • Stroke
  • Violence
  • Suicide

And when the data was re-analyzed by the lipid group from the University of Maryland, no difference was found between the two groups in the incidence of coronary heart disease.

In 1984 the Journal of the American Medical Association (JAMA) published results from the Lipid Research Clinic Coronary Primary Prevention Trial (LRCCPPT) which used cholestyramine and dietary changes. The study showed a decrease in deaths from coronary artery disease. Suddenly there was renewed interest in the media.

In 1984, the National Heart, Lung and Blood Institute (NHLBI) convened the Cholesterol Consensus Conference, ostensibly to bring together the proponents of the cholesterol theory with the dissidents. It appears that the report was written prior to the actual convening of the conference[1], simply leaving a few spaces to plug in the numbers to be considered as "elevated" cholesterol.

Is it a coincidence that Merck's re-application for new drug status was sent to the FDA in 1984?

In November 1986 the Journal of the American Medical Association (JAMA) published a series on the lipid clinical trials.[2]

In 1988, at a lecture given before the American Heart Association, DeWitt S. Goodman MD spoke about the many efforts which were being made to educate both patients and physicians in the benefits of treating high cholesterol levels (defined at that time as being over 240).

A physician's packet was prepared by the Physicians Cholesterol Education Program in 1987. Mary Enig writes that the American Pharmaceutical Association had representatives on the coordinating committee.[3]

Is it also a coincidence that Merck's lovastatin (Lipitor®) was approved by the FDA in 1987, one of the shortest times on record for approval of a new drug?

So... we have both a logical fallacy and an impelling financial reason to use that fallacy as though it were actually logical. The result? Billions of dollars in sales of cholesterol lowering drugs, and heart disease as the number one killer in the United States.

A recent issue of Consultant - Peer Reviewed Consultations In Primary Care has an article outlining steps to reduce the rick of cardiovascular disease and obesity.

How to Stop Heart Disease

The first recommendation is for dietary intervention - mainly caloric restriction. Well... we have seen how well that works in the past 30 years. The weight loss industry adds over $60 billion to the economy annually. But we are still grossly overweight as a population.

Weight reduction drugs are recommended. Amphetamines (or similar drugs in the same family) are recommended to curb the appetite, despite the fact that they increase the risk of cardiovascular disease in the long run. Intestinal fat absorption blockade has been attempted, with very little success and significant side effects.

Weight reduction surgery (bariatric surgery) has emerged as a "prominent and durable" alternative to weight loss therapy. The major complication rate is 4% - one in 25 people - with ongoing stomach pain, diarrhea, nutrient deficiencies and depression being some of the more commonly seen complications.

Contact our team of doctors and staff at our Scottsdale integrative medical center.

Food Addicts Anonymous

Is there such a thing as addiction to food?

Prevention magazine has a wonderful article available online and entitled: 6 Ways to Beat your Food Addiction.

It's an all-too-common scenario: You wake up in the morning swearing today's the day when you'll eat clean, nourish yourself with a healthy breakfast at home, and pass up the glistening bakery goodies that tempt you every day. You make it to work without incident and then stress hits-any kind of stress, from a new project deadline to a caustic remark from your boss. A little while later, you find yourself with pastries in hand, wolfing down sugary anesthetics and wanting more. When you finally pop out of your food trance, and the reality of what you've done begins to settle in, the ensuing feelings of shame and guilt stoke your stress levels more and you're already plotting your next food fix. You wonder: Why do I keep caving to these cravings? Where's my discipline and willpower?

This is your brain addicted to food.

Once we begin to understand that those of us who simply "cannot" lose weight are addicted to the foods that we eat, then the road to recovery becomes much clearer.

As with any addiction, the first step is to recognize that we are addicted, and that we have no control over our addiction. We turn ourselves over to a higher power - whether this be what we call God or a diet plan is immaterial. If we understand that we have no control over the addiction, then there is only one way out: DO NOT EAT THE FOOD IN QUESTION. It's relatively easy to say "no" to the first opportunity in any given day. But if we miss that option the first time, there really is no second opportunity - we are hooked.

Food addiction affects more people than one may think, and manufacturers actually design food products so that they are as addicting as possible. Yes, that perfect combination of salty, sweet, and savory was created to make sure you keep reaching for more.[4]

These so-called "hyperpalatable" foods are to be avoided at all costs. Like an alcoholic or a cocaine addict, we must say "no" to the first opportunity to ingest the substance, if we are to have any chance of moving past the addiction to unhealthy foods into a world of healthier choices.

Fortunately, we have a choice for a different path.[5] Our brains are indeed not only capable of making different choice, but also of changing their neurochemistry so that we actually enjoy those different choices. By paying attention to both taste and smell, we can enhance our liking of natural foods, increasing the perceived sweetness, for example, without actually increasing the amount of sugar.

It's a whole new world of choices. The key is the work "choices".

We have the choice. We can vote with our feet and our pocketbooks. The first step to metabolic health is good food. Feast the eyes, feast the nose, feast the palate. And let the addictions hang out where they belong, in the "Say no to the first one" category.

To learn more about stopping heart disease and beating food addiction, call our Scottsdale integrative medical center at (480) 418-0220.


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