After my heart attack on Aug 20, 2017, the stent the docs put into my blocked artery seemed to fix everything. But then I got my lipoprotein panel test results back, and there were no risk factors. In fact all my ratios involving fatty acids and cholesterol were right at, or exceeded, target levels (even more after 6 months). I’d made daily exercise (walking or biking) part of my lifestyle my whole life, plus followed a “healthy” vegetarian diet (plus fish and dairy) for over 3 decades, limiting sugars. What had gone wrong? My cardiologist basically said “shit happens”. Eventually I decided to start doing my own research. What I found was shocking.

     But shouldn’t we just trust the experts at the American Heart Association who preached to us the miracles of their low fat diet and the USDA food pyramid, and how it would vanquish the evils of saturated fat and cholesterol? Not after it turned out to be a miracle of illness and death, the driving force behind the current global epidemic of debilitating and deadly chronic diseases (diabetes, heart disease, and obesity, for starters). Just read Nina Teicholz’s superb book “The Big Fat Surprise: Why Butter, Meat, and Cheese Belong in a Healthy Diet”.

     Teicholz ferrets out all the bad science (cherry picked data, PR hype, disregard of other explanations like sugar, implying that weak correlation = causation, etc.) in all the prestigious studies, while interviewing key players. Scientists who urged caution were sidelined, as a Big Pharma, Big Food, Big Medicine juggernaut was created. And, of course, the crusade against saturated fat was absurd from the beginning. Just the extraordinary health of the Inuit of old, who had the world’s diet highest in saturated fat was proof enough.

     Massive studies proved decades ago that the saturated fat dogma is false, yet this was so embarrassing to the medical establishment that much of the public is still unaware. Then attention shifted to blaming cholesterol, first all cholesterol despite its essential role in maintaining healthy cell membranes in the heart and brain. Then there was “good cholesterol” (HDL) and “bad cholesterol” (LDL). Now it turns out that only a fraction of the LDL cholesterol is actually bad, the “small, dense cholesterol”, and even this looks more like a symptom than a cause. Meanwhile some scientists had suspected from the beginning that inflammation of the arteries (= membrane damage) was the primary cause of heart disease, and recent studies have made their case far stronger, hence anti-inflammatory diets. And even cardiologists now admit that LDL cannot predict heart disease.

     But what I quickly discovered was even more astonishing. Consider this: “The research reviewed studies involving nearly 70,000 people to look for a link between LDL cholesterol and premature death in those over 60. Contrary to conventional wisdom, they found 92 percent of people with high LDL cholesterol levels actually lived longer than those who kept their levels at or below ‘normal’." (https://articles.mercola.com/sites/articles/archive/2017/02/18/insulin-resistance-causes-heart-disease.aspx ). Or this: “A recent study followed 724 hospitalized patients who suffered an acute heart attack. As compared to patients with high LDL-cholesterol levels and triglycerides, those with lowered LDL and triglyceride levels had a 990% increased risk for mortality. (https://healthimpactnews.com/2015/low-cholesterol-levels-associated-with-990-higher-mortality-after-heart-attack/ ). That’s right, the low LDL that cardiologists salivate over is actually a killer.

     So what in earth is going on?  Answer: Statins - one of the most prescribed and profitable drugs on the planet. Many studies show that statins reduce the risk of heart disease, and they are also very good at lowering LDL. So cardiologists reason that statins help because they reduce LDL. Yet it’s possible that the success of statins has other causes. Not only possible, but the two studies above and others, say that statins must be doing something else: That lowering LDL is actually a bad side effect of statins. Here’s a great write up on the true story of statins (https://spacedoc.com/articles/inflammation-and-heart-disease ). That’s right, statins are anti-inflammatory drugs (but so is aspirin) and that’s why they work.

     But for the majority of people, diet will work better, much better in fact. So what diet reduces inflammation of the arteries? For most people, the answer is very simple: Cut out almost all sugars and most other carbs too, except mixed veggies. An excess of these is what screws up insulin for so many. It is insulin which regulates the usage and storage of blood glucose and fatty acids (= the energy supplies of our cells). It is “insulin resistance” which is most implicated in inflammation, as well as diabetes, etc. (the diet overloads insulin, which becomes more resistant to doing its job, with erratic and possibly fatal consequences). Yet this is exactly where most cardiologists are still stuck in a rut, decades out of date.

     Scientists are still elucidating the details of how insulin resistance and inflammation work, but it certainly explains why low carb / high fat diets, sometimes called ketogenic, Atkins, or Banting diets, have proven so successful. The book “The Art and Science of Low Carbohydrate Living” by Jeff Volek and Stephen Phinney, two of the top researchers in the field, describes these studies. See Phinney’s videos (https://blog.virtahealth.com/dr-stephen-phinney-ketosis-ketogenic-diets ) for the latest research validating how a ketogenic diet combats inflammation, reducing heart disease. A more popular account is “Eat Rich, Live Long” by Ivor Cummins (www.thefatemperor.com/blog)  and Jeffrey Gerber. “The Case Against Sugar” by Gary Taubes is a very good narrative of how toxic sugar has become in our culture. That is, you’ll get the biggest benefit just from cutting out the sugars, which is how I started.

     However, starchy and processed carbs in general cause hunger and cravings in addition to stressing insulin, so the key to a sustainable diet is a very high fat content, which yields satiety as well as the necessary calories (a high protein diet would be deadly). Indigenous peoples like the Inuit have lived this way for eons. All fats are OK, except for too many omega 6s (mostly vegetable oils used in fried foods), with omega 3s being essential (as in fish). In my “ketogenic” diet about ¾ of the calories come from fats, so my old vegetarian diet is long gone, except for the actual mixed veggies. This is a real change in the energy metabolism of the body, so that it burns fat (via ketones) more than glucose. After 3 months on this diet I’ve lost 20 pounds, with no more hypoglycemia, and it feels great. The only hard part is finding the right drink mixes and combinations of foods, as little in the supermarket aisles or restaurant menus is acceptable. Just look hard, experiment, and start googling “keto-…”.