2

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Which Paleo version is the best for treatment and prevention of heart disease?

Answered on September 12, 2014
Created March 29, 2013 at 6:17 PM

What is the Paleo way to treat / prevent heart disease?

High carb or low carb? Fish or red meat? Egg yolks or nuts?

3ce6a0d24be025e2f2af534545bdd1d7

(26217)

on May 25, 2013
at 01:43 AM

Perfect Health Diet

A2c38be4c54c91a15071f82f14cac0b3

(12682)

on May 24, 2013
at 07:53 PM

What evidence is there that high carb/low fat prevents or reverses heart disease? If I recall, the WHI trial reported an increase in non-fatal and fatal heart disease among women with pre-existing CVD following the lower fat/higher carb diet.

Medium avatar

(10611)

on May 24, 2013
at 07:32 PM

My experience is N=1 and results may vary by person. It is my sincere attempt to eliminate the effect of Neolithic sedentism. Because it worked for me I don't have a lot of interest in managing macronutrients. I believe that this would be paleo, where diets were set by seasons and availability, and all transportation was by foot. I should also add that I went from diabetic to very high insulin sensitivity in the process.

Medium avatar

(10611)

on May 24, 2013
at 07:03 PM

5 miles a day would probably achieve the HDL and blood pressure improvements, but I would have to cut back how much I eat to not gain weight.

Medium avatar

(10611)

on May 24, 2013
at 06:59 PM

After 6 years I have it patterned pretty well. 5 miles before work, 3 miles at lunch and the rest on breaks. On weekends I'll trade walking for biking if the weather is nice, at a 50% discount since biking is more efficient. I'm walking as I type this.

Medium avatar

(2338)

on May 24, 2013
at 06:08 PM

how do you possibly have time to walk 10 miles a day??

8d386bf2c5ba20fcc1a2a0c805b217c9

(743)

on May 24, 2013
at 05:57 PM

I wish I could have the title of "Dr.", as it sounds so slick, but that would probably break a couple of laws. Hahahaha.

Medium avatar

(10611)

on May 24, 2013
at 03:45 PM

I consume at least 1000 cal/day of carbs and have TG's at 49. When I was sedentary my TG's were much higher.

Medium avatar

(10611)

on May 24, 2013
at 02:57 PM

@Travis conventional metrics were defined by the white bread and hot dogs diet. If you can win on conventional metrics you've won the game. You've beaten them on their home field.

F5a0ddffcf9ef5beca864050f090a790

(15515)

on May 24, 2013
at 02:02 PM

Thanks :)))))))

F5a0ddffcf9ef5beca864050f090a790

(15515)

on May 24, 2013
at 02:02 PM

Are you sure you are not a dr.? Dr. MPie sounds so sexy!

048dd52752c45129c1212bfffb37ca72

(3150)

on May 24, 2013
at 01:44 PM

I've also wondered many times how such an 'overall' inflammation could be possible, it seems weird. Like you, I'd understand an acute inflammation due to some trauma more than a generalized state of the body. But the fact I cannot understand it does not mean that it could not be possible, and there's some evidence that there can be inflammation even at a mitochondrial level which I guess it would be what we usually refer to. See for example this study http://www.ncbi.nlm.nih.gov/pubmed/22535248. Arterial plaque might be seen also as arterial inflammation, etc

Medium avatar

(10611)

on May 24, 2013
at 01:35 PM

I don't like the term inflammation much but I agree in general. We bandy the term around a lot here, but the measure of inflammation by CRP is only of much use in the case of trauma, such as burns, wounds and actual CV events. LPIR, triglycerides, fasting blood glucose and HDL are more useful measures of functional disorder in normal life.

Medium avatar

(10611)

on May 24, 2013
at 01:27 PM

I do enjoy eating natto, but IMO climbing K2 has more health benefits than eating K2.

32f5749fa6cf7adbeb0b0b031ba82b46

(41757)

on May 24, 2013
at 01:24 PM

In case somebody wants to play with that fancy calculator, here's a link: http://hp2010.nhlbihin.net/atpiii/calculator.asp

Medium avatar

(10611)

on May 24, 2013
at 01:08 PM

Drinking buttered coffee is not the way I raised my HDL from 30 to 80.

048dd52752c45129c1212bfffb37ca72

(3150)

on May 24, 2013
at 09:08 AM

My take is that anything that may be potentially harmful should be cut down as much as possible and what it's naturally fine should be used in the perfect balanced amounts. I also think that isolating fat as much as many people is doing here and having loads of it might not be a wise move, but IMHO between putting a tablespoon of organic grass-fed butter or the same amount of refined sugar into your coffee... I guess I'd stick to the former.

742ff8ba4ff55e84593ede14ac1c3cab

(3536)

on March 30, 2013
at 12:15 AM

@Travis, do you get most of your carbs from white rice? Do you spread them out evenly throughout the day? I have been eating pretty high carb but mostly in the form of tubers and lots of fat added (for calories). However, the other day I tried eating my starches without any added fat and I felt lighter and more energetic. So a 70/10 compared to a 40/40 split of carbs and fat actually made me feel better.

Medium avatar

(39831)

on March 29, 2013
at 08:40 PM

By conventional metrics, my likelihood of heart disease plummeted as I neared 300g of carbs per day.

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12 Answers

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1
048dd52752c45129c1212bfffb37ca72

on May 24, 2013
at 07:35 AM

The best would probably be the one that lowers your body inflammation status the most. I think lowering tryglicerides, bad cholesterol and cortisol levels at the lowest possible ranges and raising HDL, Vitamin D, DHEA, supporting good thyroid function and maximizing sexual hormene status.

Which diet is this? I guess it will make room for customization depending on each person but based on everything read here, in some articles, from many guru's and my personal N = 1 experience I think it would be loaded with seafood, high iodine/selenium intake, a good amount of meat muscle and flesh to deliver proper cholesterol, full Vitamin B family, and fat content without getting too past the dietary intake needs, a selection of veggies/greens that is known to not hurt the person (I think immune reactions to some families of greens like the nightshades and so) and maybe some occasional fruit when the season allows for it, in general a low carb diet.

I'd also focus on gut and liver health and personal food intolerances, if there's no problem I think eggs and some dairy could be of benefit to many (think good fats, great protein sources, Vitamin A and K2) but if some sensitivities are found then avoiding these as much as possible would be preferable, most nutrients can be found in alternative foods but the inflammatory response maybe hard to get rid of.

I don't know if this is the answer, at least is where I'm currently so I bet in this solution. We will see! I think doing some periodical blood work is critical for this because it's the only way to quantify our improvements and be able to tweak our diet to our own benefit, overall feelings and perceptions can be too subjective.

We must also be aware that many other lifestyle choices play also a huge role so it's difficult to base overall health on nutrition alone, I think this is why many people could be let down by their diets because they can't solve something that may have a different cause.

Medium avatar

(10611)

on May 24, 2013
at 01:35 PM

I don't like the term inflammation much but I agree in general. We bandy the term around a lot here, but the measure of inflammation by CRP is only of much use in the case of trauma, such as burns, wounds and actual CV events. LPIR, triglycerides, fasting blood glucose and HDL are more useful measures of functional disorder in normal life.

048dd52752c45129c1212bfffb37ca72

(3150)

on May 24, 2013
at 01:44 PM

I've also wondered many times how such an 'overall' inflammation could be possible, it seems weird. Like you, I'd understand an acute inflammation due to some trauma more than a generalized state of the body. But the fact I cannot understand it does not mean that it could not be possible, and there's some evidence that there can be inflammation even at a mitochondrial level which I guess it would be what we usually refer to. See for example this study http://www.ncbi.nlm.nih.gov/pubmed/22535248. Arterial plaque might be seen also as arterial inflammation, etc

3
Ac1e55cf06c2180f4008ff01953d10dd

on March 29, 2013
at 07:56 PM

While a good Paleo diet is great to prevent hearth disease it is not a medical treatment: for treatment you should consulted a trusted physician. In terms of Paleo version, I am sure that a diet that contains both fish and pasture fed meat, along with lots of vegetables is the best way to go. If you have all your required vegetables, it will not be low carb, perhaps more a medium carb diet.

2
8d386bf2c5ba20fcc1a2a0c805b217c9

(743)

on May 24, 2013
at 01:42 PM

I would like to start off by saying I am not a doctor and it's the individual's responsibility to do what's necessary to be healthy. Below is what I and I alone would do in order to prevent heart disease.

First, I would ensure to consumed only food that is organic/chemical-free. This would reduce the number of chemicals ingested, leading to reduced oxidative damage in the arteries.

Second, I would keep the amount of carbohydrates ingested at an appropriate level. If I were an athlete, more carbs would be necessary for the work performed. If I were sedentary, less carbs would be required. If I am not mistaken, it's excessive carbohydrate consumption that leads to increased levels of triglycerides in the blood. High triglycerides have been claimed to have a greater correlation with heart disease.

Third, I'd avoid any potential food allergens that an individual might have. This would be discovered through blood tests, or by doing a Whole30 or some kind of exclusion/inclusion type of diet to test for adverse reactions to food groups. My guess is that allergic reactions can be bad for the entire body, including the cardiovascular system.

Fourth, I'd include the widest variety of foods (that aren't allergenic) as possible to get the best and most balanced nutrient intake. This would make it easier for the body's physiological processes to be up to snuff and in balance. I'd follow this up by using some nutrition/calorie counter, like nutritiondata.self.com - looking at the intake over a period of two weeks or so and see how I can make up for deficiencies, either by eating different foods or adding supplements.

Fifth, I'd exercise. From what I've seen, most paleo-authors recommend both high-intensity and low-intensity exercise. Obviously, this would depend on my capabilities and current fitness-level, but starting out with walking can't hurt. Some authors recommend against long-duration mid-intensity exercise (ala Mark Sisson and "chronic cardio") as the benefits outweigh the negatives - systematic inflammation, injury, increased cortisol, etc.

F5a0ddffcf9ef5beca864050f090a790

(15515)

on May 24, 2013
at 02:02 PM

Are you sure you are not a dr.? Dr. MPie sounds so sexy!

F5a0ddffcf9ef5beca864050f090a790

(15515)

on May 24, 2013
at 02:02 PM

Thanks :)))))))

Medium avatar

(10611)

on May 24, 2013
at 03:45 PM

I consume at least 1000 cal/day of carbs and have TG's at 49. When I was sedentary my TG's were much higher.

8d386bf2c5ba20fcc1a2a0c805b217c9

(743)

on May 24, 2013
at 05:57 PM

I wish I could have the title of "Dr.", as it sounds so slick, but that would probably break a couple of laws. Hahahaha.

2
5dd50f78f47b8848d93724d6eb38d4c1

on May 24, 2013
at 08:59 AM

High carb/low fat. Until people start reversing heart disease drinking buttered coffee with an LDL of 240 this isn't even debatable. The research on HDL shows it isn't nearly as protective as once thought

048dd52752c45129c1212bfffb37ca72

(3150)

on May 24, 2013
at 09:08 AM

My take is that anything that may be potentially harmful should be cut down as much as possible and what it's naturally fine should be used in the perfect balanced amounts. I also think that isolating fat as much as many people is doing here and having loads of it might not be a wise move, but IMHO between putting a tablespoon of organic grass-fed butter or the same amount of refined sugar into your coffee... I guess I'd stick to the former.

A2c38be4c54c91a15071f82f14cac0b3

(12682)

on May 24, 2013
at 07:53 PM

What evidence is there that high carb/low fat prevents or reverses heart disease? If I recall, the WHI trial reported an increase in non-fatal and fatal heart disease among women with pre-existing CVD following the lower fat/higher carb diet.

Medium avatar

(10611)

on May 24, 2013
at 01:08 PM

Drinking buttered coffee is not the way I raised my HDL from 30 to 80.

2
Ee6932fe54ad68039a8d5f7a8caa0468

(2668)

on March 29, 2013
at 08:15 PM

i think the truth is that we don't have all the evidence in on what causes heart disease. or cancer. or alzheimers.

but people have lived healthy lives on a wide range of macros and foods. as long as they're not industrially produced junk!

1
91451db3488201f51e85e6a69a6e0f89

(198)

on May 25, 2013
at 12:14 AM

I think this is the question that baffles me most, and I don't think anyone is actually going to give an a satisfactory answer to this. We just don't know enough about how CVD actually happens, and what actually causes it. The mechanisms are so incredibly complex that we can't isolate it to something as simple as a macronutrient, and pointing a finger at something like inflammation is so huge that most laymen feel intimidated when asked to manage inflammation. We're at this weird point were CVD seems to be American destiny.

1
A2c38be4c54c91a15071f82f14cac0b3

(12682)

on May 25, 2013
at 12:06 AM

For prevention, a diet with dark chocolate:

http://www.ncbi.nlm.nih.gov/pubmed/21875885?dopt=AbstractPlus

"...seven studies met the inclusion criteria (including 114,009 participants). None of the studies was a randomised trial, six were cohort studies, and one a cross sectional study....The highest levels of chocolate consumption were associated with a 37% reduction in cardiovascular disease (relative risk 0.63 (95% confidence interval 0.44 to 0.90)) and a 29% reduction in stroke compared with the lowest levels".

And exposure to sunlight (for vitamin D):

http://www.ncbi.nlm.nih.gov/pubmed/20031348

"We aimed to evaluate the association between vitamin D levels, using 25-hydroxy vitamin D (25OHD) as an indicator of vitamin D status, and the presence of cardiometabolic disorders including cardiovascular disease, diabetes and metabolic syndrome...From 6130 references we identified 28 studies that met our inclusion criteria, including 99,745 participants...We found that the highest levels of serum 25OHD were associated with a 43% reduction in cardiometabolic disorders [OR 0.57, 95% (CI 0.48-0.68)]. Similar levels were observed, irrespective of the individual cardiometabolic outcome evaluated or study design".

Time to go eat some chocolate in the sun I am thinking. Interestingly enough both of these things totally improve my mood. I doubt this is the only reason they may help, but I personally think reducing one's stress is a good way of helping prevent heart disease.

1
2edfcc5c8044bbb4f22ba6ea4289f592

(1398)

on May 24, 2013
at 11:39 PM

I think this will vary from person to person. There is no magic macronutrient ratio which will ensure perfect health, as much as we would like that to be true. I believe food quality is far for important that food quantity. By quality I am including nutrient density, antinutrient composition, chemical content, etc.

I believe the most important factor in preventing heart disease is limiting inflammation from all sources. Concerning foods, this means restricting foods which damage the gut or contain compounds which cause inflammation, and maintaining a proper N-3/N-6 ratio. I believe polyunsaturated fats should generally be limited other than wild caught fish products, which should be consumed liberally. I believe saturated fat has a place in a (heart) healthy diet, provided it is from good sources: coconut and grass fed herbivores largely.

Taking away all other variables like weight, exercise, stress, sleep, etc, I think and ideal diet for long term health and to prevent heart disease would be rather moderate. Moderate amounts of protein, carbs, and fats, all from natural, high quality sources. I also believe that everyone should spent a certain amount of time periodically in ketosis or engage in some sort of fasting protocol regularly, as I believe constant glucose metabolism by itself is harmful over time.

One person may live to be 100 and die of old age eating like the Kitavans, another may do it eating like the Masai. There is a tremendous amount of variability in terms of macronutrient content, but I believe the common factor is always whole, natural, high quality foods.

1
Medium avatar

(2338)

on May 24, 2013
at 06:05 PM

the best version is one of moderation which is something alot of us have trouble with i think. We tend to take things to extremes but imo the best approach is to eat whole paleo approved foods and not think about it too much. i think mark sisson's primal approach is the best one out there for the majority of people.

1
83d2d5eaaa2704020286e98c470f6a44

(340)

on March 29, 2013
at 08:48 PM

One that is high in vit k2, and one that will keep your tri under 70.

Medium avatar

(10611)

on May 24, 2013
at 01:27 PM

I do enjoy eating natto, but IMO climbing K2 has more health benefits than eating K2.

0
F5a0ddffcf9ef5beca864050f090a790

(15515)

on May 25, 2013
at 06:14 AM

I want to thank everybody who answered. Again, I feel very very sorry I cannot evenly distribute the points and have to pick one "right" answer, even though there is more than one. Thanks to all and sorry one more time.

0
Medium avatar

(10611)

on May 24, 2013
at 01:06 PM

The most paleo thing I have done to improve my CV health is being active. Walking 10 miles a day for the last 6 years has reduced my weight, increased my HDL and reduced my systolic blood pressure. According to the Framingham model, the last two have reduced my likelihood of a CV event to 6% in the next 10 years. Before I started acting like a hunter-gatherer daily, my risk of a CV event was 3x higher.

http://hp2010.nhlbihin.net/atpiii/evalData.asp

Diet is important to the extent that it supports my activity. I favor a high carb diet for this reason. I prefer nuts and fish over eggs and red meat, but that moves away from the main CV benefits into matters of taste and availability.

It also leaves out the possibility of oysters.

32f5749fa6cf7adbeb0b0b031ba82b46

(41757)

on May 24, 2013
at 01:24 PM

In case somebody wants to play with that fancy calculator, here's a link: http://hp2010.nhlbihin.net/atpiii/calculator.asp

Medium avatar

(2338)

on May 24, 2013
at 06:08 PM

how do you possibly have time to walk 10 miles a day??

Medium avatar

(10611)

on May 24, 2013
at 07:32 PM

My experience is N=1 and results may vary by person. It is my sincere attempt to eliminate the effect of Neolithic sedentism. Because it worked for me I don't have a lot of interest in managing macronutrients. I believe that this would be paleo, where diets were set by seasons and availability, and all transportation was by foot. I should also add that I went from diabetic to very high insulin sensitivity in the process.

Medium avatar

(10611)

on May 24, 2013
at 06:59 PM

After 6 years I have it patterned pretty well. 5 miles before work, 3 miles at lunch and the rest on breaks. On weekends I'll trade walking for biking if the weather is nice, at a 50% discount since biking is more efficient. I'm walking as I type this.

Medium avatar

(10611)

on May 24, 2013
at 07:03 PM

5 miles a day would probably achieve the HDL and blood pressure improvements, but I would have to cut back how much I eat to not gain weight.

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