A comment on the diet debate - British Heart Fou...

British Heart Foundation
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A comment on the diet debate

I thought it might be useful to look at the diet debate from a different perspective. 16 years ago my partner was diagnosed with prostate cancer. He had major surgery & has since been well although not entirely cancer free. He responded to this health crisis by going on a course at what was then the Bristol Cancer Centre , now the Penny Brohn Centre. At that time the centre was somewhat fanatical about diet & advocated what was essentially a vegan diet, especially for hormone related cancers like prostate and breast cancer. Since I have a family history of breast cancer, we both made radical changes our diet to one which was essentially plant-based. It is worth noting the diet recommendations were accompanied by large vitamin supplements, not only to boost the immune system but also because it is difficult to get all the nutrients needed in solely plant-based diet. We both now have osteoporosis which I sometimes wonder is related to having cut out dairy etc. Penny Brohn Centre have since relaxed their approach & now recommend a balanced diet on the same lines as BHF including a little meat, fish & chicken to get enough protein. What we have carried forward from this experience is avoiding processed foods, eating mainly organic and very little first class protein, mainly fish & occasional meat if I know the name of the cow! We still use 2 superb vegan-type recipe books Healing Foods & More Healing Foods by Jane Sen who was head chef at the Bristol Cancer Centre.

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I tend to agree! Over a decade ago a friend's wife decided to go vegan. She probably was only average at getting the right balance of nutrients and her health deteriorated. After a stern talking to from her GP she reintroduced eggs, dairy, fish and limited meat and over three months her health improved. The problem with many supplements is that your body does not make good use of them. It absorbs calcium better from dairy than tablets and likewise iron from liver. And getting enough Vitamin B12 from a vegan/vegetarian diet. Sorry to hear about the osteoporosis.

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I wonder if deficiency in vitamin K2 could have contributed to your osteoporosis. K2 is a fat-soluble vitamin available only from animal sources (except for an apparently disgusting Japanese fermented food called natto!). It might be worth your taking a K2 supplement or eating plenty of dietary sources.

Vitamin K does lots of things and is essential for proper calcium metabolism, including depositing calcium in bones rather than arteries. It has a water-soluble form K1 available from vegetables but we are poor at absorbing K1 and require also (from animal sources) fat-soluble K2 that we absorb well.

K2 is best found in grass-fed animal products. A K2 form called MK-4 is found in liver and the brown meat of duck and goose, also to a lesser extent of chicken. Grass-fed, e.g. organic, duck, chicken or goose liver are rich in MK-4. This form of K2 is also available in eggs. The vitamin's MK-7 form, which you should also eat, is found in aged cheese, especially hard cheeses. Grass-fed, e.g. organic, is good for all sources.

Statins inhibit our already limited synthesis of K2, and supplements might be worth considering for that reason if you take a station. The same applies to ubiquinol.

It's worth Googling to learn more.

I don't think a vegan diet is prudent, though eating a lot of vegetables is.

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Can you point us to the science that proves there's more K2 in dairy products/meat from grass fed animals? So far I've only read/heard opinons and no evidence.

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There is some further information here, with a degree of substantiation: westonaprice.org/health-top...

I haven't read it, but you may find additional information in a book by Dr Kate Rheaume-Bleue called "Vitamin K2 and the Calcium Paradox: How a Little Known Vitamin Could Save Your Life."

Kind regards

Jonathan

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I have BPH. I avoided drugs and surgery and resolved with plant based diet, some vitamins plus beta-sitosterol and the complete avoidance of sugar and refined carbohydrates. I also had triple bypass and 4 stents in 2015 and was able to get off all post-operative meds due to this diet.

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Some people need their meds to stay alive. Consider yourself lucky that your medical condition is well controlled that you don't have to take any meds at the moment, for a lot if people that is not an option.

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If you take statins make sure you take coQ10.

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Skating???

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Is that on thin ice or roller skating?

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Don't mention ice, Gunsmoke123 will want to put it in his gin!!

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Damn auto spell checker!!

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Yep, the other day I told someone to shave himself...instead of behave himself!! 😂 However, back to the statins, I don't take them my husband does. He's been on them for 15+ years and has never had a problem with them & he has regular blood tests. Also, he's very adequately looked after by a cardiologist, a very supportive GP & until recently a nurse partly funded by the BHF & partly funded by the NHS. None of these highly qualified medical personnel have ever suggested that coQ10 would be of benefit to him but thank you for your advice though

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Not hero to zero but hairy to baldy for some unfortunate member! 😁

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You may find this medical article of interest:

ahajournals.org/doi/full/10...

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Thank you but as I've already said my husband has no issues with statins. I've seen your comments about your own problems but like everything in life everyone is different. Also, I'm slightly confused by one of your earlier comments, you say you've avoided surgery but then say you've you had a triple bypass, is that not surgery?

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I avoided surgery for BPH (benign prostate hyperplasia).

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Oh sorry, I had thought it was a heart condition, I was a bit dim there. Did you start your plant base diet because of your prostrate issue? Is it OK to ask how long have you been on the diet? I was actually vegetarian myself for a number of years.

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I had my bypass surgery and stents in the March to May stretch of 2015. The pain from the statins peaked in late December of that year and so I changed my diet to a whole-foods, plant-based diet (legumes, vegetables, nuts, seeds, some goat dairy, and fruits) as well as increasing my exercise regimen from just walking to training with weights in the gym.

I still ate fish 3 times per week but I did not have whole eggs, just egg whites initially. I only consumed chicken or red meat twice per year at Christmas and Easter.

These changes resulted in a 40 lb weight loss from January 2016 to October 2016. This weight loss normalized my blood metrics and eliminated the need for all medications. I kept taking the baby aspirin though until a few months ago following the release of a new study on the efficacy and risks of baby aspirin.

npr.org/sections/health-sho...

I continued to educate myself on diet and nutrition and in the last 6 months or so I have relaxed a bit on the animal protein and whole eggs. I will now eat free-range chicken once or twice per week and red meat on occasion, maybe once per month.

Whatever animal protein I consume is in small portions - no more than 3 oz and no more than once in a day. I eat 2 boiled eggs, twice per week.

Today I basically alternate vegetarian days and non-vegetarian days. Most of the animal protein though continues to be fish such as wild-caught salmon and trout.

The BPH became an issue following the surgery - I continue to believe that the catheterization triggered a response that resulted in my prostate enlarging as my diet was as you can read above - optimal for BPH.

What I changed in the last 8 months is I added supplements - Beta Sitosterol (once per day); cranberry pills, and vitamin C after each meal. I also made a more conscientious effort to drink more water and have two cups of Nettle Leaf tea daily.

The other thing I did differently is I started eating pumpkin seeds daily and adding the whole eggs as I learned those two foods increase testosterone which helps shrink the prostate. Weight training also increases testosterone so I increased my frequency for those workouts as well.

I used to get a UTI every 2 months through 2017 and 2018, but I haven't had one yet in 2019 and my prostate also feels better when in use.

Best wishes.

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Catheters are known to irritate the prostate and also to cause UTIs if hygiene is not 110%. Convenient but maybe something less invasive needs developing?

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Thanks for the info.

The initial catheter was for my bypass surgery and I did not have a choice about its use. I have suspected the catheter caused the issue from the outset.

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With all the focus on oily fish you reminded me I haven't had skate in years. Probably make a sauce up with lemon juice, capers and mustard. With a few new potatoes and roasted tomatoes delicious!

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That's great you can manage without meds. I could do that, but choose to error on the side of caution and take low dose statin and BP med, although my cholesterol and BP are in healthy ranges without them. I like the statin for it's potential to reduce inflammation and,with heart disease I think the lower the BP is the better so long as not too low.

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You may wish to revisit statins and their risks. They were my motivation for why I changed my diet.

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I appreciate your insight. I've researched the pros and cons of statin medications and imo the pros outweigh the cons for myself. The fact that statins reduce the possibility of a plaque rupturing is what convinced me to take them, and I've had no negative side effects to date.

Did you have a bad experience taking statins?

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I did indeed. My left rotator cuff seized up and I couldn't move my left arm. The pain became so severe that I couldn't sleep at night.

FYI - there's a blood test - PLAC or Lp-Pla2 that measures the stability of plaques. Something to consider in the future for peace of mind.

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Interesting, I've not heard of that blood test before. I don't believe I'd have it done though, I can't see how it would change the course of my treatment .no matter the results.

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You would have to pay for the test privately. If you decided to come off of the statins for a month or two you could assess plaque stability without meds. For that matter you could assess plaque stability WITH statins to verify their efficacy along with that of your current diet and lifestyle.

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Here's an interesting study for you to read:

"Comprehensive lifestyle changes may be able to bring about regression of even severe coronary atherosclerosis after only 1 year, without use of lipid-lowering drugs."

ncbi.nlm.nih.gov/pubmed/?te...

Here's another:

"In conclusion, these results suggest that intensive lifestyle modifications are associated with a decrease in coronary and carotid atherosclerotic burden."

ncbi.nlm.nih.gov/pubmed/?te...

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I'm already on board with that. I wholeheartedly believe that intensive lifestyle changes can do just that. I like the low dose statin only for it's anti-inflammatory effect. The benefits outweigh the risks imo.

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Although I think there may be an increased risk for osteoporosis on a vegetarian/vegan diet, it is unlikely if you're eating sufficient calcium fortified foods, with vitamin D and K2 supplementation.

It's true that our body does not absorb supplements as well as we do from food, however with adequate supplementation osteoporosis can be avoided. Could the vegan diet have played a role in the development of osteoporosis? Perhaps, but the benefits of a well balanced proper vegan diet to fight disease and reduce risk factors for many diseases, far outweigh any potential, however unlikely, issues that may present themselves. I've been vegetarian, and now vegan for 15 plus years. With proper diet, supplementation, and regular weight bearing exercises I have no signs of osteoporosis or any other health issues, on the contrary a vegan diet has provided me with nothing but positive results and improved health.

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When did your heart condition occur?

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Just over 15 years ago

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Did you start your vegan diet when you were diagnosed?

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Yes, started vegan, then vegetarian, now vegan.

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Can I ask what your condition is & what if any medication you take?

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Diagnosed with early stage atheroscrelosis. Please see reply above to sos007 on meds. Also take low dose aspirin.

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If your BP is in a healthy range why would your Dr prescribe it? Which BP medication are you taking? Sorry, I'm just curious

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Low dose Lisinopril. Doctor was not keen on prescribing, but imo if you have heart disease 105/65 is better than 115/75. 105/65 may be to low for some, but I feel better and find stress much easier to deal with when BP is on the low end. Doctor agreed to prescribe when I explained that lower BP makes anxiety easier for me to deal with, and anxiety is an issue I've battled for years. I understand beta blockers such as propranolol help with anxiety, but since I have a resting heart rate of around 45 beta blockers are not a med I can take. Low resting heart rate is due to the fact I have been an avid runner for many years.

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Hi, I think we have exchanged views several times and I find myself in agreement with what you say regarding heart disease and treatment.

Also like you, I'm thinking of getting a non invasive heart scan to check for any progression. Although I wanted an mri I've been offered a cardiac profusion scan which I believe you have had.

In a previous post you mentioned that based on these scans you have decided that your atherosclerosis has not progressed.

I was just interested how much detail they provided because I thought that they can only detect a 50% stenosis so you could have had some small progression.

Was the one you had more accurate than this and what was it?

Thanks in advance.

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You are correct, with it being a non invasive test anything is possible, but all things point to no progression in disease, in fact I believe that the diet and lifestyle style changes I have strictly adhered to for 15 plus years have paid huge dividends and my heart health has actually improved. I've had 3 nuclear stress tests and have seen the results of them, and all facets of each test, both the perfusion imaging and exercise capacity with Bruce protocol treadmill stress were improved from previous tests. I realize a heart catheterization is the gold standard and that there is a margin for error with other tests, as well as the fact we have no guarantees in life. I could go tits up tomorrow, who really knows, but when it's my time to leave this world I'll bet it's not due to heart disease. I intend to stay the course and not lose sight of the fact that fighting this disease each and every day is necessary to keep it at bay, and it's a fight I do not intend to lose.

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Thanks for the prompt reply. 2.1/2 years ago I suffered an episode of breathlessness. I went to hospital and my ECG and cardiac enzymes were OK so no heart attack. I was told I was being discharged but because they were quiet the consultant decided to do an angiogram and I ended up with a mid lad stent.

I have been fine since until last week when I had another episode of breathlessness. Again no heart attack but this time I did an exercise stress test based on the Bruce Protocol. I completed the full 21 minutes with no chest pain and was subsequently discharged.

I realise that based on my exercise test there was no indication for another angiogram but the fact that this is exactly what happened last time and I ended up with a stent has my a bit worried.

Hence why I'm considering paying for a private non invasive test which will maybe detect a smaller stenosis than an exercise test which only does about 70% I believe.

Be interested in your opinion thanks

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Perhaps consider CTA test. It's more sensitive and therefore more likely to pick up on blockages. My understanding is that the only downside is that the test is so sensitive it may result in more false positives. I believe I have read that it has up to a 90% accuracy in detecting blockages. *21 minutes on a stress test is certainly not suggestive of perfusion issues, but based on circumstances you describe I may feel the same as you. Did you do treadmill stress test before .stents?.

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Yes I had a stress test 9 months before my stent and achieved 15 minutes before the test was stopped by the operator because I'd achieved 85% of my max heart rate.

9 months after my stent, so 20 months ago, I had another one and achieved 21 minutes and last week another one that was 21 minutes.

I realise that being able to exercise to this level, especially with no chest pain is not suggestive of any perfusion issues but I'm just concerned because of what happened last time and this seems very similar.

I live in New Zealand and I don't think that I will have any joy getting anything more in the public system, hence why I may have to go privately if I want any further tests done.

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I remember reading previously about your doing 21 minutes on Bruce protocol stress test, you must be incredibly fit. In spite of stress test youresult, I think your reasoning is sound. Additionally, the expense you incur going private will be a small price to pay for your peace of mind. I'm betting your test results would come back ok, but better safe than sorry especially if you have the means to pay for test. If I'm in your shoes I would very likely proceed as you have indicated.

Are you still exercising on a regular basis? Any issues to speak of? edit:. When you had the episode was it at rest?

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I have a small hiatus hernia which causes me sub sternal chest pain sometimes. When this happens I do some exercise to try to differentiate between hernia and heart issues.

Any difficulty breathing I will go to A and E because this is what happened when I had my stent.

I've had no problems, heart wise, for 30 months until last week when my chest pain happened at rest and when I tried to exercise I felt my breathing was restricted hence my trip to the hospital.

However in the morning I did the 21 minutes test and have exercised daily since leaving hospital with no problem.

I think I will take your advice and probably pay for a test privately for the peace of mind but also if there is a problem hopefully I can get it sorted.

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Tuhe reason I have had testing done over the years since my diagnosis has only been for peace of mind, not because symptoms presrwentwd and themselves. It was worth the expense for peace of mind, but I shall not have further tests so long as I remain asymptomatic. I empathise with you, and hope that you can put this behind you in short order.

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Thanks, I will let you know how I get on.

Your opinions are much appreciated.

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If you take Warfarin which I do and many people on this site will be you cannot take Vitamin K as it interferes with it

I do believe that you can get the vitamins and minerals you need from a good diet a good balance

with small amounts of good proteins and diary. The only vitamin we cannot get enough of is Vitamin D in the winter.

I have got osteopenia and will have to address this with my GP

The trouble we all face is that the scientists, doctors, nutritionists etc change the goalposts a lot and of course this affects what we are recommend to eat

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