food and medicine preventing heart disease john e whitcomb, md brookfield longevity and healthy...
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Food and MedicinePreventing Heart DiseaseJohn E Whitcomb, MDBrookfield Longevity and Healthy LivingBrookfield, WI
Sponsored by the Wisconsin Integrative Medicine SocietyFirst Annual Conf. in Wisconsin on Integrative Medicine
Country Springs Hotel, WaukeshaDec 1, 2012
Objective1. New understanding of how
heart disease develops2. How to measure the trouble
you are in3. Use food to fix it
Take Home Messages1. Heart diseases starts as
inflammation caused by bad food choices
2. It develops slowly over 30-40 years3. Insulin is the junction where
metabolism and inflammation intersect4. We learn in stages and adapt when
given successful options5. Viscosity, wheat, alkalinity may all
play heretofore unexplored roles6. Vascular disease can be reversed
Old Theory1. Heart disease is a plumbing
problem2. Blood vessel gets plugged up3. Solution?4. Rush to the hospital5. Rush to the cath lab6. Rush to surgery
Plumbing Problem
We try to fix it when it shows up
Our current model lets you jump off the cliff, then tries to pull you back
Dirty Little Secret…..Routine Angioplasty Does NOT
prolong lifeEmergency angioplasty stops a
heart attack“THE PROBLEM”…….?Insurance pays for it, richlyIn medicine we do what we are
paid for
As many as 85% aren’t visible
Like all good science…1. We always want to dig deeper2. Go to the real sourceWhat are the risks for Heart Disease?1. High blood pressure (>130/85)2. Diabetes (> 100 FBS)3. Disordered lipid metabolism (>150
triglycerides and or < 40 HDL, <50 HDL)4. Inflamed belly fat with big tummies
(WHO Waist to Hip > .9 or .85)5. Micro-albuminuriaAKA: Metabolic Syndrome
Pop Quiz1. 65 % of heart attacks occur where
there is no obvious visible plaque? T or F
Answer: False, 85%2. Dirty little secret of angioplasty is?It doesn’t prolong life (unless with an
acute MI) because that’s not where the next one will happen
3. Name the size your waist/hip ratio should be.
< .9 for men, < .85 for women
The Solution?
Data for Women and Lifestyle“Adherence to a Low-Risk, Healthy
Lifestyle and Risk of Sudden Cardiac Death Among Women” JAMA: July 6th, 2011 page 62-69
Nurses Study from 1984 to 2010: 81,722 women
Results: 92% less risk of sudden death for women lacking the four risk factors compared to women with all four risks
First reduction is 45% better for having one low risk feature
Risks are?1. Not currently smoking, 2. Exercise at moderate to
vigorous intensity ≥30 min/day, 3. Diet in the top 40% of the
Alternate Mediterranean Diet Score (aMed) distribution
4. And BMI <25 kg/m2
Mediterranean Diet Is?A diet in the Mediterranean?Abundant vegetables, legumes,
fruitSmall amounts of
fish/meat/cheeseCheese and yogurtOlive oil in moderationWine in moderationVariety of antioxidantsLittle sugar/refined white flour
Life Style Trumps Drugs 3:1
Pop Quiz1. Name two features of the
Mediterranean Diet?Lots of veges, olive oil, less fish and
meat, some wine, some sunshine2. Name two strategies to help you
survive a heart attack and sudden death.
BMI < 25, Exercise, No smoking, Diet3. Adding one less risk factor increases
your odds of survival by_____%?40
ConclusionLife Style beats taking pillsPills might not do that muchAngioplasty doesn’t do that muchOur four strategies are the current
state of the art. (Lunch today will be…)
Our first step, on our change journey, should be to adopt those four.
But what happens if you are ambitious and want to do better than 92%?
Good ScienceGoes to the rootIs high blood pressure the root or
is it a symptom?Is Diabetes the root, or a
symptom?Do you want to do better than
92%What’s the next generation of
improvement?
New ConsensusDiabetes and high blood pressure
are part of a confluence of forces“Endothelial dysfunction”Common Soil HypothesisInsulin, sugar metabolism and
diabetes are all comingled. With insulin and sugar, you get inflammation.
Bottom Line?The beginning of vascular
disease is likely an autoimmune reaction of disordered inflammatory messages in the vessel wall
Toll receptor proteins lining the vascular wall set of inflammatory messages that starts the cascade
When do you want to intervene?
Glycocalyx May be Key!
The simple view
Read it in Wikipedia
What may be setting this off?
Viscosity?Viscosity is so far the only diagnostic
marker that has been correlated with every presently proven cardiovascular risk factor,
Including cigarette smoking,Type 2 diabetes, Metabolic syndrome,High blood pressure, Elevated LDL cholesterol, Low HDL cholesterol, Age, and Simply being male
ConclusionTo fix vascular disease….We have to fix Diabetes and hypertension…..?ViscosityWhat makes viscosity?Inflammation (makes for thicker blood)Toll receptor proteinsAnd the data shows, it will work better
if we do it ourselves rather than depend on a pill
Post-Prandial Stress
Look what happens with a beverage containing 75 grams glucose with 700 cal cream
Within 2 hours, glucose and triglycerides double
Nitrotyrosine and C-reactive protein
Flow mediated dilation deteriorates
Makes you feel better about a milkshake?
How is food going to fix this?Turn off inflammationCool off Toll Receptor ProteinsCalm your blood thickeningAlkalize your bodyMellow out endothelial
dysfunctionWatch high blood pressure go
awayObserve diabetes melt
Big Boast?Can you turn off insulin?And lose weightControl your “endothelium”Answer: YES. It takes about 6
weeks to measure, control and heal your endothelium. Once controlled, your risk drops even further.
How to turn off insulinNO free CARBS – major shift to proteinWheat may be a topic all of its own with
its clear autoimmune triggersChoiceGreen vegetables – (vegetable protein)
◦Spinach is 50% protein◦Broccoli has more protein than steak (2:1)
Animal protein – what we eat during winter/dry season for 5 million years
What is insulin?Our STORAGE hormoneNOT, emphatically NOT, our glucose
hormoneReleased when we have too many carbs
released too quicklyIndicates foods rich in carbs which are
usually secreted at the end of summerSummer is followed by 6 months of….?Today: our bodies get the message that
we are always at the end of summer – store fat
Esselstyn has proven you can reverse CAD with LOW fat - plant
Nutrient Plant Based Food Animal BasedCholesterol (mg) 0 137
Fat (mg) 4 36
Protein (grams) 33 34
Beta-carotene (mcg) 29,919 17
Fiber (grams) 31 0
Vitamin C 291 4
Folate (mcg) 1168 19
Vitamin E (mg_ATE) 11 0.5
Iron (mg) 20 2
Magnesium (mg) 548 51
Calcium (mg) 545 252
500 calories from plants: equal part mix of spinach, potatoes, limas, peas, tomatoes500 calories from animals: equal part mix of beef, pork, chicken, whole milk
Pop Quiz: Plant vs Animal Source of Nutrients
WHICH has more Protein?
Pop Quiz1. Which food group has more
protein? Plants or animalsEqual – essentially2. Which food group, cal for cal,
has more iron?Plants3. Which food group has more
beta-carotene?Plants
Common Soil HypothesisInflammation and metabolism are oneCalm insulin And you calm inflammationConclusionThe trigger for insulin are foods rich in
freely available carbohydratesYou have to stop eating white carbs in
such abundanceWheat is a particular problem: leaky gut,
acid content, autoimmune stimulant, etc etc
Hence: Non Carb Diets -Atkins: If you choose the meat
approachOr pure vegetables, very low fat
if you choose the Esselstyn approach
But neither has carbsNeither gives the winter signalWith the loss of insulin, you open
up fat cells, lose weight, drop your LDLs, raise your HDLs
WWW: What will work for meYou have to turn off insulin < 5You have to lose weightYou have to exerciseYou can’t smokeYou need to replace missing
nutrients like Vitamin D, omega fats,
This gets you to 92% reduction in risk
Are you Ambitious?Reverse and prevent completely?Get off wheat and all high glycemic foods/sugarsChoose a diet high in natural protein, fiber,
antioxidants, omega fats, (Paleolithic)Optimize hormones, remove toxins (Lead etc)Alkalize? (High green vegetable)It takes about 6 weeks to control the
endothelium completely“As goes the endothelium, so goes the patient”Measure and supplement endothelial
dysfunction (arginine, folate, Vit C, taurine, Mg, NAC etc)
Supplement proper inflammatory inhibition
PreDx Test is FREE! So you can repeat it and see how you are doing
Questions?My practice is at 17585 W North AveSheila or Sharon: 262-784-5300We specialize in sustained and
permanent weight loss, hormone balancing for men and women, reversing high blood pressure and diabetes, sorting out fatigue, Lyme
Functional Medicine at its best….Teaching how your body functions at
optimal levels