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Forum Name: Miscellaneous Cardiology Topics

Question: Heart Healthy Diet and Nutrition


 coolboot - Sat Nov 08, 2008 6:33 pm

I am confused about what diet regimen to follow for optimum heart health.
I had a mild heart attack last October, followed by an angioplasty. The left coronary was 40% blocked, and one stent was implaced; the right coronary artery was 90% to 100% blocked and because 5 or 6 stents would have been required to open it up, no stenting was attempted. A bypass was postponed because, I was told, I had established a collateral artery, sort of a "natural bypass," and I could focus on exercise and diet to strengthen and enlarge that collateral artery, and if successful after a period of time, I could forego further heart surgery.
I have been enrolled in the hospital's cardio rehab clinic exercise program ever since and have generally felt much better, even trying to do a little jogging from time to time, and walking 2 or 3 miles every day at a pretty good clip.
But diet continues to be a puzzle to me after reading so many conflicting things in the general literature available. I am genuinely confused.
I have been about 60% vegetarian for the past 10 years, and since the heart problem errupted I have migrated to an even more severe vegetarian focused diet. I eat no dairy, no refined starch, and no red meat, only chicken breast and ocean fish for dinner. For breakfast I eat only fresh fruit, for lunch only vegetables and nuts. Sometimes a little dark chocolate. Drink nothing but green tea, herbal tea, and purified water. I use olive oil for cooking and salads; no other oils except flax seed oil occasionally.
Dean Ornish tells me to cut out all meat and fish, and all oils, even olive oil. Other medical writers recommend that I eat lots of fish and use plenty of olive oil, flax oil, hemp oil, krill oil, for the benefit of the Omega 3. I am confused about whether I can use any oil or not! Some say the Omega 3 is essential. Ornish just says don't eat any oils.
I am considering moving to a raw food diet to cut out the meat. More of a vegan diet I suppose. But still the question of Omega 3 oil remains. Am I left merely with the supplements for Omega 3? Ornish bans even that.
Who should I believe? Ornish and MacDougal claim scientific proof of the efficacy of their regimen. But I am of the opinion that the oil is essential ("essential oils?") and am reluctant to stop using them. Am I doing my arteries harm when I use olive oil on a salad, or stir fry vegetables with it? Please advise me of your take on this issue.
 John Kenyon, CNA - Sat Nov 22, 2008 12:08 am

User avatar Hi there -

There's certainly no shortage of conflicting "authorities" on what works and what doesn't, and some of these approaches, while they may "work" for many people, often "work" no better than what the American Heart Association promotes, which is a prudent, heart-healthy diet. You've already surpassed that in terms of what you're doing, and omega-3 fatty acids do have proven benefits that go even beyond heart health. Your current diet should be more than adequate to prevent the addition of any baneful substances, and may well help reduce your serum cholesterol. What you haven't mentioned, and I would love to find out, is what your most recent lipid profile (total cholesteral and breakdown of LDL, HDL and VLDL) looked like. Also, has your cardiologist prescribed you any statin drug to lower cholesterol? These are now believed to be beneficial in ways other than just the lowering of blood fats, and appear to reduce inflammation, which is also true of omega-3 fatty acids, but can be administered as a known quantity (in addition to the healthy diet). Further, some statins would appear to have the potential to actually help reduce or remove plaque from arteries over time.

Since you're working on buiding colateral blood supply (a great do-it-yourself project for those able to do it), you want to keep the homemade bypass clean, and your diet will go a long way toward accomplishing that. A statin drug, unless there is a specific contraindication, would also add a good deal to the effort and is well worth the trouble (some are starting to regard statins as something like a vitamin or supplement, but that's still something of an avant-guard concept. Nonetheless, it's a great weapon in the arsenal against heart disease.

My personal opinion is that avoiding fad diets of all sorts, as well as complex guru-designed diets is wise. The diets which arise from consensus among the medical establishment are the most reliable, and you're more than in the ballpark as far as that goes. Your diet would fit very well within the "prudent" guidelines of the AHA, so I think you're definitely doing it right now, and wouldn't make life more complicated. Keep up the cardiac rehab program and listen to the nurses and techs who run that show. They'll provide you with AHA education that will be most useful and will avoid unecessary confusion.

Best of luck to you, and thanks for bringing this issue to the site, so that others with the same concern will see this discussion and hopefully benefit from it. Best of luck to you, and by all means follow up with us as necessary.

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