Tag Archives: Heart Health

Physician Profile: Kim Williams, M.D.

This physician profile is republished from the Winter 2015 edition of Good Medicine. Dr. Williams will be speaking at our upcoming conference on the topic of a plant-based diet for cardiovascular disease. To learn more or register for the International Conference on Nutrition in Medicine: Cardiovascular Disease, visit PCRM.org/Conference.

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Kim Williams, M.D., president of the American College of Cardiology, will be among the world’s leading physicians and researchers speaking at the Physicians Committee’s International Conference on Nutrition in Medicine: Cardiovascular Disease on July 31 to Aug. 1, 2015, in Washington, D.C.

In this Good Medicine exclusive, Dr. Williams, who began following a vegan diet in 2003, answers questions about the state of heart disease and tips for preventing it.

Describe nutrition or lifestyle recommendations that you discuss with your patients.

Everyone who is able should exercise for at least 45 minutes most days of the week. But food quality and content are also important. High fat and high sugar content increases mortality. Plant-based diets lead to better outcomes, reduce health risks, and have a much more favorable effect on obesity, compared with the standard American diet.

What is the one thing someone can do today to improve their heart health?

Everyone needs to know their critical numbers, such as blood pressure, fasting blood sugar, cholesterol levels, body mass index, and waist circumference. They say knowledge is power. In this case, being aware of risk factors helps motivate people to make a difference.

What do you think is the No. 1 cause of the heart disease epidemic?

I’m happy to say that there is not an escalating epidemic in the United States. We have reduced cardiovascular mortality about 50 percent over the last few decades. However, internationally the numbers are climbing as people and low and middle income countries adopt a more sedentary lifestyle with less healthy foods.

Cholesterol Confusion: Let’s Make Sense of It

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Dietary confusion just reached a whole new level. The Dietary Guidelines Advisory Committee has just announced it is backing off suggesting that traces of cholesterol in foods pose a health risk. The idea is that its effect on blood cholesterol is less dramatic, compared with saturated fat—so maybe an egg here or there is no worse than an occasional drag on a cigarette. Coupled with recent reports questioning how bad “bad fats” really are, many people are unsure what to believe.

Let’s clear up the confusion. Here are the facts, starting with cholesterol:

Cholesterol is not the same as fat. Fat is the white streak in a steak and the grease that dribbles out of a drumstick. But cholesterol is invisible. Cholesterol particles are found in the membranes that surround the cells that make up an animal’s body. Cholesterol is in all animal products and is especially abundant in the lean portions of meats. There are also loads of cholesterol in eggs, cheese, and shellfish, such as shrimp and lobster.

Cholesterol in these foods causes your blood cholesterol level to inch upward.1 The cholesterol-raising effect is not as strong as that of bacon grease and other saturated-fat-laden products, but it is still there. Especially for people whose diets are modest in cholesterol to start with, adding an egg or two a day can cause a noticeable worsening on a cholesterol test.

Some people make a point of saying that cholesterol in foods is not as bad as saturated fat in foods. Maybe, but the issue is academic, because the two travel together. Fat and cholesterol are the Bonnie and Clyde of the culinary world. An egg, for example, has a whopping 200 milligrams of cholesterol and gets nearly 20 percent of its calories from saturated fat. They conspire together to raise your cholesterol level. But most foods from plants—vegetables, fruits, beans, and grains—have virtually none of either one.

Okay, so what about fat? Is it really a health problem or not?

The short answer is yes, it’s a problem. “Bad” fat—that is, saturated fat—raises your blood cholesterol level and increases your risk of health problems, including heart disease and Alzheimer’s disease. Saturated fat is found in meats, dairy products, eggs, and coconut and palm oils. Trans fats—the partially hydrogenated oils used in some snack foods—are bad, too, and people who avoid these products do themselves a favor.

Some news reports have mistakenly suggested that saturated fat isn’t really so bad after all. The confusion came from statistics:

Studies that compare people who indulge in “bad” fats with those who generally avoid them clearly show fat’s tendency to boost heart risks. But studies where fat intake does not vary much from person to person do not show much effect. For example, a Finnish study in which most all the participants followed high-fat diets was unable to detect any benefit of avoiding “bad” fats—largely because there was no group in the study that actually avoided them.

A 2014 meta-analysis combined all the studies—the good ones and the not-so-good ones—and concluded that, if you jumble the data together, the dangers of “bad” fat are no longer clear.2 The study was widely quoted by food writers who saw it as an excuse to try to rehabilitate pork chops’ reputation.

The meta-analysis had another problem. It used adjusted statistics that downplayed the dangers of saturated fat. One of the studies it used was Harvard’s Nurses’ Health Study.3 In the original study, a high saturated fat intake boosted heart disease risk by 52%. But the numbers were then adjusted for protein intake, cholesterol intake, and other factors, and these adjustments made the dangers of “bad” fat hard to see. It’s a bit like studying whether alcohol causes car accidents. If you alter the statistics to compensate for whether people weave as they drive or have blurry vision, the relationship between alcohol and accidents can be made to disappear.

So the answer is not to tuck into a hunk of bacon. The answer is to look at good studies, and they clearly show the risks of fatty, meaty diets.

And what’s that about Alzheimer’s disease? In a 2003 study, the Chicago Health and Aging Project reported that people eating the most saturated fat had a higher risk of developing Alzheimer’s disease, compared with people who avoided “bad” fat.4

So the bottom line is that “bad” fat and cholesterol are as bad for you as ever. The products that harbor them—meat, dairy products, and eggs—are best left off your plate. People following plant-based diets have healthier body weight, better cholesterol levels, lower blood pressure, and much less risk of diabetes.5-7

So jump in. At the Physicians Committee, the 21-Day Vegan Kickstart Program starts fresh every single month, providing menus, recipes, and cooking videos free of charge. It is available in English, Spanish, and Mandarin, with a special program for people from the Indian subcontinent—plus our new Japanese program. As the confusion clears up, so will many health concerns.

1. Hopkins PN. Effects of dietary cholesterol on serum cholesterol: a meta-analysis and review. Am J Clin Nutr. 1992;55:1060-70.
2. Chowdhury R, Warnakula S, Kunutsor S, et al. Association of Dietary, Circulating, and Supplement Fatty Acids With Coronary Risk: A Systematic Review and Meta-analysis. Ann Intern Med. 2014;160:398-406.
3. Chiuve SE, Rimm EB, Sandhu RK, et al. Dietary fat quality and risk of sudden cardiac death in women. Am J Clin Nutr. 2012; 96:498-507.
4. Morris MC, Evans EA, Bienias JL, et al. Dietary fats and the risk of incident Alzheimer’s disease. Arch Neurol. 2003;60:194-200.
5. Tonstad S, Butler T, Yan R, Fraser GE. Type of vegetarian diet, body weight and prevalence of type 2 diabetes. Diabetes Care 2009;32:791-6.
6. Berkow S, Barnard ND. Vegetarian diets and weight status. Nutr Rev 2006;64:175-188. 7. Yokoyama Y, Nishimura K, Barnard ND, Takegami M, Watanabe M, Sekikawa A, Okamura T, Miyamoto Y. Vegetarian diets and blood pressure: a meta-analysis. JAMA Internal Medicine 2014;174(4):577-87.

Dick Cheney: Plant-Based Diets Can Prevent a Medical Odyssey

Former Vice President Dick Cheney’s new book, Heart: An American Medical Odyssey, describes his harrowing 30-year battle with heart disease, including five heart attacks and having to say goodbye to his family when he feared he would die from the disease. His excellent team of physicians and surgeons has provided him lifesaving medical care and he is on the mend. But I wrote to him today and asked that as he promotes his book he let people know that adopting a plant-based diet can prevent and reverse heart disease and the traumas he and his family endured.

Oct. 18, 2013

Dear Former Vice President Cheney,

I’m happy to hear your excellent team of physicians and surgeons has provided you lifesaving medical care and that you are finally on the mend from your five heart attacks and 30-year battle with heart disease. Surgery saved you, but others can avoid that fate. As you promote your new book, Heart: An American Medical Odyssey, please let people know that adopting a plant-based diet can prevent and reverse heart disease. It’s something millions of Americans need to do for themselves—and their loved ones.

Nearly 8 million people in the United States have had a heart attack, and 800,000 people die each year from heart disease. But a recent study in JAMA Internal Medicine found that people who improved their eating habits the most after a heart attack had a better chance of surviving. A diet lowest in red and processed meat products and highest in whole grains, fruits, and vegetables lowered the risk of death from heart disease by 40 percent, compared with no dietary changes.

I hope you’ll consider making some of these changes to maintain—and likely improve—your current heart health. But it’s not only your heart that will benefit.

A plant-based diet doesn’t only help people suffering from heart disease—countless studies show that it fights obesity, diabetes, cancer, and dementia, to name a few diseases. And vegetarian diets just help you live longer. A new study by Dean Ornish, M.D., found that men who adopted a low-fat, plant-based diet, may slow the aging process.

So do it for yourself. But also do it for your family and friends, who have suffered with you and would ultimately grieve your untimely loss from heart disease or any cause.

The American Heart Association says that caregivers who devote themselves to their loved ones to the exclusion of their own needs become ill, and that caregivers who experience mental or emotional strain have a 63 percent higher risk of death than noncaregivers. There’s also a financial toll. The Centers for Disease Control and Prevention says that families who experience heart disease deal with medical bills, lost wages, and decreased standard of living.

I’ve enclosed a copy of my book 21-Day Weight Loss Kickstart which explains the many health benefits of adopting a plant-based diet. It also includes a three-week meal plan and recipes. Please let me know if I can offer you any other guidance.

I hope you try a plant-based diet for your health. If not for yourself, do it for someone you love.

Sincerely,

Neal Barnard, M.D.
President
Physicians Committee for Responsible Medicine
5100 Wisconsin Ave, Ste. 400
Washington, DC 20016

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