Could the diets and food choices often advertised as ‘heart healthy” actually cause heart disease and other health problems?
Yes. And the science is actually quite straightforward, having been sorted out in detail over the past 30 years. All the tragic and misguided dietary advice surrounding heart health, early clinical studies from the 1950s and 1960s when the design of clinical studies was crude and unreliable, coupled with the ambitions of people who were absolutely convinced that fat intake caused heart disease, led us on a 50-year long goose chase. Fat is not the problem, never was. And the evidence never showed that it was. “Foods” added just a moment ago, speaking anthropologically, i.e., wheat and grains, and now sugars, are the cause. And there are concrete reasons to explain why this happens.
First of all, recall that heart disease is virtually unknown in indigenous human populations who have been studied, populations who survive by hunting, gathering, and generally living outdoors, exposed to the sun, drinking from streams and rivers, consuming animal organs and meats: no heart attacks, no coronary disease, little or no aortic disease, no type 2 diabetes, no obesity, as well as no constipation, no hemorrhoids, no irritable bowel syndrome, no colon cancer. In short, living the lifestyle that has been programmed into the genetic code of Homo sapiens over 100,000 generations is compatible with long life without heart disease and other modern health conditions. Then we made the mistake of adding foods from wild grains at a time of food desperation about 300 generations ago, the event that converted our species from hunter-gatherers to sedentary, agricultural populations, cultivating a limited number of crops, but especially wheat and grains. And then, of course, two generations ago geneticists and agricultural scientists got into the act and introduced major changes into the wheat plant and other grains that inadvertently amplified the toxic effects on humans consuming them.
So what effects do wheat and grains exert that could lead to heart disease? There are a number of ways:
- Provocation of VLDL particles—Very low-density lipoproteins, VLDL, are rich in fats (triglycerides), and are thereby low in density. VLDL particles interact directly with the walls of arteries, such as the coronary arteries of the heart, and trigger the cascade of inflammatory events that create atherosclerosis. The entire process begins with consumption of the amylopectin A of wheat and grains that sets in motion a liver process called “de novo lipogenesis,” the liver’s extraordinary capacity to convert carbs and sugars to triglycerides, the main ingredient in VLDL particles.
- Formation of small LDL particles-–Small LDL particles (not LDL cholesterol, the crude and indirect method that was meant to guesstimate total LDL particles but is virtually useless and outdated) are unusually persistent, lasting 5-7 days in the bloodstream, compared to the 24 hours of normal large LDL particles; are more prone to glycation (glucose-modification), and oxidation; are better able to infiltrate the walls of arteries; and are provoked by interacting with VLDL particles initiated by the amylopectin A carbohydrate of wheat and grains.
- Insulin resistance—Insulin resistance, i.e., the body’s inability to respond to insulin that prompts the pancreas to increase its output of insulin 10-fold, 50-fold, 100-fold, amplifies liver de novo lipogenesis to produce VLDL particles and thereby small LDL particles. The process is further amplified by inflammation caused by insulin resistance, and the wheat germ agglutinin and gliadin proteins of wheat. Insulin resistance leads to higher blood glucose that, in turn, glycates the exceptionally glycation-prone small LDL particles.
A helpful snapshot of your risk for heart disease can therefore be obtained by 1) lipoprotein analysis (e.g., NMR), 2) HbA1c, fasting glucose, fasting insulin, 3) 25-OH vitamin D blood levels, 4) RBC magnesium, 5) TSH, free T3, free T4, reverse T3, thyroid antibodies. The only useful measures on a standard cholesterol panel are triglycerides and HDL cholesterol; we aim for a triglyceride value of 60 mg/dl, achieved with diet, omega-3 fatty acids, and the other components of my program—drugs are NEVER needed to achieve this. HDL is passive and will increase just with these efforts. The value of total and LDL cholesterol? None. Take a big black magic marker and cross them out.
This constellation of abnormalities—increased VLDL, small LDL, higher blood sugar—does not occur in isolation. It occurs as part of a broader landscape of other metabolic abnormalities: low HDL, small HDL, increased triglycerides, increased HbA1c, increased insulin levels, increased C-reactive protein and other inflammatory markers, increased blood pressure, increased abdominal visceral fat, increased endotoxemia. I hope you appreciate that this notion that heart disease is caused by a fictitious lone marker, LDL cholesterol, is absurd and yields no insights into overall health nor heart health. “Treating” this lone fictitious marker with a drug like a statin drug is equally absurd. Instead, focus on the entire syndrome of metabolic abnormalities that lead you down the path of heart disease and do so by following an informed nutritional approach, addressing nutrients lacking in modern life that impact insulin resistance and inflammation, and addressing the widely prevalent disruption of the gastrointestinal microbiome, including the ascent of fecal microbes into the 24-feet of small intestine, i.e., small intestinal bacterial overgrowth, SIBO.
All of this is amplified, of course, by gliadin-derived opioid peptides triggering of appetite that makes you incessantly hungry, never satisfied. This is not normal nor natural. The normal situation is to consume the meat and organs or animals, supplemented by mushrooms, birds’s eggs, shellfish, berries, and other foods you find, then be satisfied for a day. It’s an experience completely different from the always-hungry, desperate feeling experienced by modern wheat/grain-consuming people.
So when your doctor tells you to cut your fat, eat more “healthy whole grains,” and take a statin cholesterol drug, recognize that he/she has done nothing to reduce your risk for heart disease and, in fact, has given you advice that increases your risk for heart attack, need for heart procedures, and sudden cardiac death. As I have often said, healthcare has nothing to do with health; healthcare is the system created to create abundant revenues and profits for healthcare insiders. Health is something you accomplish on your own without the interference of the doctor.