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'Paleo' accepted generally as being appropriate as something that can help prevent heart problems, but what about people who've had a heart attack...

Answered on September 12, 2014
Created August 10, 2013 at 10:47 AM

As above; I'm curious about the dispositions of people in the commune here ;)

Cheers.

32f5749fa6cf7adbeb0b0b031ba82b46

(41757)

on August 13, 2013
at 01:04 PM

I'm not doubting the Jaminets both have PubMed PhDs, just saying that really anybody who knows how to read scientific literature can come up with something to support nearly any reasonable position. I'm completely convinced, for example, on total PUFAs in the diet (4% is artificially low), or macronutrient ratios. What little of theirs I have read on those topics leaves much to be desired. Of course, that's only my opinion as someone else with a PubMed PhD. ;)

32f5749fa6cf7adbeb0b0b031ba82b46

(41757)

on August 13, 2013
at 01:00 PM

Oh dear, you caught a typo. I'm forever shamed on the interwebz.

8d3cb0be5f31c75a05f853cb3b5c245a

(1601)

on August 13, 2013
at 12:38 PM

Hi Matt - I addressed your comments by editing my response above. The supplements section and also the last paragraph because I hate the limit on comments. I would appreciate any criticism or debate which would improve the quality of this answer. I'm generally interested in helping someone should they come across this answer and don't want to put out false or misleading information, so any edits you could provide I would appreciate.

32f5749fa6cf7adbeb0b0b031ba82b46

(41757)

on August 13, 2013
at 01:11 AM

I don't see how it's superior to "DYI Paleo".

32f5749fa6cf7adbeb0b0b031ba82b46

(41757)

on August 13, 2013
at 01:10 AM

PHD is based on a number of cherry-picked PubMed articles, you can come up with a vegan diet with enough PubMed support. Or Atkins. Or the twinkie diet probably.

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2 Answers

1
8d3cb0be5f31c75a05f853cb3b5c245a

(1601)

on August 12, 2013
at 08:32 PM

From my research, it seems like perfect health diet is great for people who have had heart attacks. I don't know if I would recommend DIY paleo - where people first gravitate towards chicken breasts and salad, bacon, pork chops, lots of muscle meats, and eggs and not a lot of variety in the way of bone broths, organ meats. But I would recommend the Perfect Health Diet, which is variety of paleo. It's more specific with respect to amounts of protein, carbs, how to plan a meal to include safe starches, and supplementation, which is likely very important for someone who has had a heart attack.

So a couple of different points:

I. Replacing carb intake with saturated fat improves health http://perfecthealthdiet.com/2012/11/more-evidence-for-low-carb-diets/ Talks about the nurses' study and "Those eating a 59% carb diet were 42% more likely to have heart attacks than those eating a 37% carb diet." (Reference provided in the link) Here's another post from them: http://perfecthealthdiet.com/2010/09/saturated-fat-reduces-risk-of-stroke-and-heart-disease/

"This study followed 58,453 Japanese adults, aged 40 to 79 at the start of the study, for 14.1 years [1]. The study found that higher saturated fat intake was associated with:

???A 31% reduction in mortality from stroke ???An 18% reduction in mortality from cardiovascular disease It was only earlier this year that a systematic review of the literature found that ???there is no significant evidence for concluding that dietary saturated fat is associated with an increased risk of CHD or CVD.??? [2] In a few decades the reviews will probably have to go further: there will be significant evidence that dietary saturated fat is protective against CHD and CVD.

[1] Yamagishi K et al. Dietary intake of saturated fatty acids and mortality from cardiovascular disease in Japanese: the Japan Collaborative Cohort Study for Evaluation of Cancer Risk Study. Am J Clin Nutr. 2010 Aug 4. [Epub ahead of print] http://pmid.us/20685950.

[2] Siri-Tarino PW et al. Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease. Am J Clin Nutr. 2010 Mar;91(3):535-46. http://pmid.us/20071648.

Also discussed here: http://www.drbriffa.com/2010/09/21/higher-saturated-fat-intakes-found-to-be-associated-with-a-reduced-risk-of-dying-from-cardiovascular-disease/

(A doctor's perspective, although I don't know if Dr. Briffa is an MD because I can't access the link for some reason, but I think he is)

II. Cholesterol is tricky and should be tracked well, but may take some time to settle...

Anyway, the takeaway for someone doing paleo is that cholesterol is important - it actually has important immune functions! http://perfecthealthdiet.com/2011/06/blood-lipids-and-infectious-disease-part-i/

However, cholesterol can also be totally normal in people who have heart attacks, per this paper:

Navab M et al. HDL and cardiovascular disease: atherogenic and atheroprotective mechanisms. Nat Rev Cardiol. 2011 Apr;8(4):222-32. http://pmid.us/21304474.

There is definite evidence that cholesterol can skyrocket based on nutritional deficiencies:

http://perfecthealthdiet.com/2011/03/low-carb-paleo-and-ldl-is-soaring-%e2%80%93-help/ http://perfecthealthdiet.com/2011/03/answer-day-what-causes-high-ldl-on-low-carb-paleo/

The ideal cholesterol can be obtained from this blog post:

http://perfecthealthdiet.com/2011/06/blood-lipids-and-infectious-disease-part-i/

Mortality goes up as cholesterol DECREASES below 200 mg/dL and INCREASES above 240 mg/dL I think is what that blog post says. Great chart, and discussion below.

III. Avoidance of wheat is great for the heart Sategna-Guidetti C et al. Binding by serum IgA antibodies from patients with coeliac disease to monkey heart tissue. Scand J Gastroenterol. 2004 Jun;39(6):540-3. http://pmid.us/15223677.

http://perfecthealthdiet.com/category/disease/autoimmune/

The Jaminets state: "In our book we note that heart transplants are generally precipitated by wheat-derived autoimmune attacks on the heart."

The paper provides some basis for that claim.

IV. Supplementing in the right way is important! Sometimes certain foods which are not grass-fed, for example, or pastured, may not have important nutrients. This is kind of a risky area of paleo. Ideally, you'd get all nutrients from food, but I read things like this: http://www.scientificamerican.com/article.cfm?id=soil-depletion-and-nutrition-loss and I think, "right, that's why one should supplement."

http://pmid.us/18198394. - This is a study showing that new zealand women who took calcium doubled their risk of heart attack. The Jaminets say: "Deficiencies in Vitamin K2 and Vitamin D will cause improper calcification."

(Paleo or perfect health diet call for sun!)

Based on this paper below-

Budoff MJ et al. Long-term prognosis associated with coronary calcification: observations from a registry of 25,253 patients. J Am Coll Cardiol 2007;49:1860-1870. http://pmid.us/17481445.

it's pretty clear, to the Jaminets, that "Calcification of coronary arteries may be the best single indicator of heart attack risk."

http://perfecthealthdiet.com/category/disease/cvd/page/3/

Magnesium can also be low on the paleo diet (unless you're swimming the ocean on a regular basis http://www.livestrong.com/article/400377-what-are-the-health-benefits-of-swimming-in-sea-water/ or taking lots of epsom salt baths OR have access to a good source of mineral water with high levels of magnesium)

and supplementation of Magnesium is very important for heart patients, per this: http://www.webmd.com/heart-disease/news/20001109/got-magnesium-those-with-heart-disease-should

Also, copper can be low if you're not careful about eating beef or lamb liver- below is a blog post discussing a potential link between heart disease and copper. http://wholehealthsource.blogspot.com/2010/04/copper-and-cardiovascular-disease.html

Again, perfect health diet recommends ~1/3 lb of beef or lamb liver per week OR supplementing copper and eating chicken liver. Eating liver in this amount OR supplementing copper, well it's something very specific which paleo or primal do not address, and which I think would be necessary for someone who had experienced a heart attack to address deficiencies in these nutrients right away.

The post here: http://perfecthealthdiet.com/2011/03/low-carb-paleo-and-ldl-is-soaring-%e2%80%93-help/

is a question from a paleo guy who was trying his best to do paleo but his LDL kept rising and rising. However, when he implemented Perfect Health Diet recommendations to supplement micronutrients, it finally started to come down. The answer is more discussed here: http://perfecthealthdiet.com/2011/03/answer-day-what-causes-high-ldl-on-low-carb-paleo/

In response to Matt: I think this is an example of how people honestly want good health, and paleo/primal will get them 80% of the way there, but Perfect Health Diet will get them to the remaining 20%.

I don't think that's an example of a cherry picked study but of an evolutionary type diet helping someone improve their health, and then perusing studies based on what are optimal nutrients of vitamins and minerals (based on studies from Japan to Europe to the United States) to set a good Recommended Daily Allowance for elements which have not been necessarily identified by doctors or nutritionists as affecting health.

V. Omega-3s in diet - in correct amounts

http://perfecthealthdiet.com/2010/06/omega-3-fats-and-cardiovascular-disease/

There is a graph on the link above that shows that as Omega-6 in tissue increases, so does Coronary Heart disease.

I'm basically paraphrasing a bunch of their different blog posts, and I hope you give them all the credit where it is due. They've done a lot of good in getting out good evidence for a "paleo-type" diet, and refining it further to optimize health. Their blog is a wealth of information. Convinced yet??

PS Paleo or Primal telling you to get a variety of foods is great. Telling you to go for high quality is also probably important. But paleo and primal didn't tell you what to do if you don't have access to foods with Vitamin K2, or live near the ocean and have access to seafood or hate liver and avoid it all costs. So paleo/primal are not idiot proof (unless, perhaps, you buy Mark Sisson's supplements or perhaps one of the Paleologix tool kits). Perfect health diet seems to be pretty idiot proof, in terms of what to eat, in what amounts, and how often. and that is the major contribution of the Jaminets.

I don't think you could find studies claiming the vegan or twinkie diets provide an abundance of B12, or that Atkins will get you into the optimal range for every nutrient. If you could, I'd love to see it.

What is DYI paleo Matt? (I'm being facetious and I couldn't help myself)

32f5749fa6cf7adbeb0b0b031ba82b46

(41757)

on August 13, 2013
at 01:00 PM

Oh dear, you caught a typo. I'm forever shamed on the interwebz.

32f5749fa6cf7adbeb0b0b031ba82b46

(41757)

on August 13, 2013
at 01:10 AM

PHD is based on a number of cherry-picked PubMed articles, you can come up with a vegan diet with enough PubMed support. Or Atkins. Or the twinkie diet probably.

32f5749fa6cf7adbeb0b0b031ba82b46

(41757)

on August 13, 2013
at 01:04 PM

I'm not doubting the Jaminets both have PubMed PhDs, just saying that really anybody who knows how to read scientific literature can come up with something to support nearly any reasonable position. I'm completely convinced, for example, on total PUFAs in the diet (4% is artificially low), or macronutrient ratios. What little of theirs I have read on those topics leaves much to be desired. Of course, that's only my opinion as someone else with a PubMed PhD. ;)

32f5749fa6cf7adbeb0b0b031ba82b46

(41757)

on August 13, 2013
at 01:11 AM

I don't see how it's superior to "DYI Paleo".

8d3cb0be5f31c75a05f853cb3b5c245a

(1601)

on August 13, 2013
at 12:38 PM

Hi Matt - I addressed your comments by editing my response above. The supplements section and also the last paragraph because I hate the limit on comments. I would appreciate any criticism or debate which would improve the quality of this answer. I'm generally interested in helping someone should they come across this answer and don't want to put out false or misleading information, so any edits you could provide I would appreciate.

1
46d2d71df39b4a6336df6d8307b25d87

(278)

on August 11, 2013
at 04:52 AM

I don't think that paleo would be bad... certainly better than anything processed (ie. any type of hospital food), and from what I've heard, organ meat (particularly heart) is high in CoQ10 (which is good for the heart). (I'm also not unconvinced that cholesterol is good for the heart, although I don't know why I think that.)

I would think that in recovering from any trauma, you'd want to pump your body full of as many vitamins/minerals/antioxidants/other good things as possible, and paleo seems to be a good way to do that. Probably, you'd want to focus less on the crazy high fat stuff so you're getting lots of the good stuff without totally overdoing calories, but can anyone seriously say that eating whole foods (in reasonable proportions) is ever a bad thing?

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