Schweiser, I was on the 20% diet for almost a year before my heart attack. In the hospital I kept asking myself what did I do wrong. Later when I read Dr. Esselstyn's book he address my specific problem. His patients could not lower their cholesterol enough (150) until they decreased fat intake to 10%. His patients that did this had no cardiac events the ones that did not had cardiac events like I did.
I can't recommend 20% fat in the diet when it failed me miserably. Apparently I'm not the only one.
"Almost all experts agree that reducing fat intake to less than 10% of calories consumed will help mightly in achieving low cholesterol levels." - Caldwell B. Esselstyn, Jr. Md - Prevent and Reversing Heart Disease p63.
I can't take a risk on making another mistake. I was mad at myself for not knowing this information before my heart attack. I could have prevented it. I hope this thread will encourage others here, or at least exposed them to the knowledge, that heart disease prevention and reversal exist. At the least, if they survive an episode, they know there is hope, there is more they can do.
The lifestyle change is sustainable, I have been doing it almost a year. Doctors need to challenge their patients and not be scared they will loose business.
txdon, I think you have an excellent plan. You can't go wrong on Esselstyn/Campbell/Ornish diets. I'm definitely not saying you should eat more than 10% fat.
I'm just stating traditional rec's from large groups such as American Heart Assoc. are less than 20-30% total fat in your diet, and no more than 10% of your diet from saturated fats, 7% if at high risk (like you). Average dietary total fat intake in America is 34%. I said less than 20% because it's at the low end of the rec's and few people are able to maintain the <10% for more than a few weeks before giving up. The 20% I said is about 1/2 of what current intake is, and people should decrease their sat fat intake to the least amount possible.
What would you tell a patient who says "I have had a heart attack and never want another"?
Almost the same as what you're doing, which can be accomplished by CHIP, Ornish, etc.
Like I said earlier, I'm not an expert in this, but I have studied it. I went to a medical school that has advocated whole body care for over a century -- physical, emotional, mental, spiritual. In fact the motto is "To Make Man Whole". The diet advocated in my med school nutrition courses was primarily plant-based, low fat, low sodium, low cholesterol. i.e. lacto-ovo-vegetarian w/ minimal diary and egg use, or vegan w/ care on the B12 issue. This is the same diet promoted by Esselstyn/Campbell/Ornish, but not proven by large prestigious universities yet or had the backing of bigger names like these guys. It was discounted and even scoffed at for 100 years until now, except for places like where I was trained that didn't have a lot of data to back it up. Heck, the national dietition on "Forks Over Knives" is saying meat is essential for enough protein. What a bunch of BS. (Great documentary, BTW. Haven't finished watching it yet. Heard a lot about the movie and finally started watching it 2 nights ago. Maybe finish tonight if I get home from the hosp early enough.)
No doctor is afraid they are going to "lose business" (in fact our gov't has made it extremely difficult to get rid of troublesome patients), but since you mentioned it: I said this many times other places: people want quick fixes and lots of tests, and a pill for this or that. People don't want to change eating habits. Doctors and nutritionists have a difficult time w/ changing their diets for that matter. And it's much easier to tell someone they have to have their gallbladder taken out than to tell someone their diet is killing them or they are morbidly obese. Of course, there is the gigantic problem of trying to see as many patients as possible as fast as possible to turn a profit. Much of this is driven by insurance companies and Medicare paying less and less through the years, while overhead goes up. Doctors (and nurse practicioners and physicians assistants) are more and more employed by a large group, which is trying to stay profitable. Medicare often doesn't pay the group enough to break even. The private ins. co's. base their reimbursement on what Medicare is paying. By law, you can't bill the patient more than what Medicare pays. You should be asking your (and my) gov't why the costs of medicine are going up, instead of just throwing more money into insurance co's, lawyers, malpractice, requiring people to buy approved insurance plans, etc. Those are topics for different threads and I'm not trying to hijack this one. "Why are the costs exponentially skyrocketing?" is the question everyone should be asking. I'll give you some examples from my field: old person falls down, bumps their head, no loss of consciousness but has headache (duh, they bumped their head). A decade ago, they would have been observed for any mental status changes before any expensive imaging. Now CT scanning is ubiquitous, but still not trivial or cheap. Still, in our litigious society the ER doc can't miss *anything*, so he sends the patient to the CT scanner for the obligatory head CT. Roll over MVA (motor vehicle accident) but no loss of consciousness or neuro deficits? Same thing. Ka-ching, ka-ching. $$$ It's all algorhythm based medicine, not thinking. Marginally better care but way higher costs. Sure, I'll get some of the money off those scans (usually a few percent of the cost for my interpretation) and I ask the ER doc why he had to do it. See where I'm going here. That example was valid a few years ago. Now the CT scan is not just of the head for that mechanism I described -- now the scan for MVA rollover is automatically CT head/C-spine/chest/abd/pelvis. $$$$$$$. Lawyer driven not exam driven. CT scan for old person fall down = CT head/C-spine.
Take home message: Don't go to ER unless true emergency! Use doctor to help you plan diet and lifestyle modification (like you're doing), preventive medicine/screening, and problems that can't be fixed by lifestyle (chronic or acute disease). Back to great discussion of healthy living....
Marcus
P.S. To those that like lobster/crustaceans/catfish -- just remember, those animals are the bottom feeders of the animal world, the scavengers. Take from that what you want. Just sayin'.
