Health & Nutrition by Michael R. Eades, M.D.

As I was going through all the comments that had stacked up while I was away, I came across one about the Ornish program that I thought might be of interest to the group. Here is the gist of it:

after my 3rd heart attack dec 04 I quit the veggie/ornish just plant food eating and now with type 2 this yr am still doing great with no carbs. also off BP drugs and since May have stopped all lipitor and crestor (7 days of crestor was enough) still getting stronger and no more brain fog feeling, wish I knew then what I know now

This comment reminded me of one I read in the long list of comments after Ornish’s response to John Tierney’s blog post about Taubes’ comments on the Israeli low-carb study. Said a commenter who states that he works in a clinic that uses the Ornish regimen:

I too, happen to work in a clinic that espouses the Ornish program. In practice, however, as long as patients do the stress relief, engage in exercise, and quit smoking, they seem to do fine. The diet doesn’t seem to do very much one way or the other, especially since most people give it up quickly. They seem to dislike it.
The diet does wreak havoc with our diabetic patients, however. They are put on the diet because diabetics are prone to heart disease, but the huge quantities of starch required by the Ornish program (whole grain or not) makes make blood sugar control almost impossible. There’s a lot of internal argument about this now.

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Olmsted County, MN

A recent paper in the Archives of Internal Medicine should give pause to those dispensing statins like candy. According to some fairly persuasive autopsy data, it appears that the rate of heart disease may be back on the rise after being in a slow decline over the past 40 years.

In Olmsted County, Minnesota, home of the Mayo Clinic, autopsies are much more common than in other parts of the country. So much so that the autopsy records of this county are often used in scientific inquiry as a surrogate for the country as a whole. Autopsies used to be more common nationwide but had fallen in 2003 to only 8.3 percent of deaths. Autopsies are conducted in Olmsted County at rates an order of magnitude greater than they are throughout the rest of the country.

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A few days ago the National Heart, Lung, and Blood Institute (NHLBI), the organization coordinating the ACCORD study (Action to Control Cardiovascular Risk in Diabetes), pulled the plug on the glucose lowering part of it. Why? Because in a stunning mid-trial finding, subjects in the arm of the study who were edging their glucose levels closer to normal were dying in significantly greater numbers than those whose glucose levels remained elevated.

What the heck is going on? Conventional wisdom has it that the lower (toward the normal range) the blood sugar the better. It has been the goal of diabetic management to reduce blood sugar levels as close as possible to the normal range; now comes this disastrous study presenting dramatic evidence to the contrary. Amazingly, those subjects who died in the lowered-blood-sugar group succumbed to some form of cardiovascular disease, the very condition the more aggressive blood-sugar lowering was crafted to prevent. Do these tragic deaths invalidate the sugar hypothesis of heart disease?

I don’t think so, but before we get into why, let’s summarize this experiment.

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Harvard strikes again.

The February 2008 issue of the Harvard Heart Letter (subscription only) contains an article titled Triglycerides: A Big Fat Problem. The article discusses the correlation of elevated triglyceride levels with the development of coronary artery disease, then lists eight methods for reducing elevated triglyceride levels. It’s this list I want to discuss, but first let’s consider what triglycerides are and what they do.

Triglycerides are storage fats composed of three fatty acid chains hooked onto a glycerol (a 3-carbon carbohydrate) molecule. Fats travel in the blood as triglycerides and are stored in the cells as triglycerides. Each time a triglyceride moves into or out of a cell, the three fatty acids must first be removed from the glycerol backbone. After the fatty acids move across the cell membrane into or out of the cell, the fatty acids are then reattached in a process called esterification. (The particular bond between the fatty acids and the glycerol molecule is called an ester bond.)

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