Why I’m Doubling Down on Low Carb, Intermittent Fasting in 2019

I’m not much of a New Years resolution guy, but it’s hard not to think about the year ahead as the new year approaches. When it comes to my diet plans for 2019, I feel the need to echo the late George Herbert Walker Bush during the 1988 presidential campaign — stay the course.

All of my reading and research last year led to my full adoption of a low carbohydrate lifestyle, and nothing has changed that would lead me to rethink this approach. I’m not a doctor, but I’m fully confident that my cardiovascular health improved over the course of 2018. A year-end visit to my cardiologist confirmed my own analysis. In December I had an echocardiogram, a nuclear stress test, and a blood workup and all of these diagnostics returned very positive results.

The biggest danger for a heart attack survivor like me is to have a second cardiovascular event. In the first few years following my near fatal event, my heart performance was stable and improved a bit. My blood work was better, if not perfect, and all the other tests showed incremental improvement. Most importantly, my ejection fraction (my heart’s ability to pump blood out to my body) went up each year.

At the time of my heart attack, my ejection fraction (EF) was measured at around 30-35 percent. An EF of less than 40 percent may be evidence of heart failure or cardiomyopathy. For me, this was the scariest aspect of my event. It was also what has been driving me to make changes to my lifestyle.

Improving my EF has provided positive reinforcement for the things I’ve been doing to improve my cardiovascular health. I know that lifestyle led to my heart attack, and therefore lifestyle could keep me from having another one. This is why I’ve spent the past seven years exercising more, taking my prescribed medications, seeing my cardiologist regularly, and eating right.

Honestly, the only aspect of the above lifestyle changes that have provided any complications for me over the years since my heart attack has been eating right. I truly believe the medical establishment either doesn’t know or doesn’t want to suggest how to eat appropriately for cardiovascular health (I think they don’t want to provide advice because it is not so clear cut and if they are wrong they may be worried about liability). All the proof you need that the medical establishment doesn’t know the best way to eat is to Google diet advice — you’ll go down a rabbit hole from which you may never surface.

After my heart attack, my first cardiologist told me to avoid sodium because high blood pressure can lead to heart failure and/or cardiomyopathy. In that first year I avoided sodium like it was poison. Do you have any idea how hard it is to limit sodium intake to less than 1,500 mg a day?

But sodium didn’t cause my heart attack, so I spent a lot of time researching the latest medical advice on diet. I was really frustrated with what I found. I read about the China Study and Dr. Caldwell Esselstyn and thought perhaps meat was the cause of heart disease. I became a pescatarian, eliminating all meat except for fish. Then research started to point to the Mediterranean Diet as the best overall diet and that seemed reasonable so I went down that path. My blood work was better, but still not where I needed it to be.

I watched every movie about diet from Forks Over Knives to Fed Up to Fat, Sick and Nearly Dead and all I got was more frustrated and confused. But as time went on, I started to notice a trend — there was more and more information out there about the dangers of carbs and sugar. I really honed in on this trend, reading everything I could get my hands on. At the same time, I started working with a new primary care doctor who also believed that carbs and sugar were the real culprits of diseases like diabetes, metabolic syndrome, and heart disease.

I jumped in to the low carb movement under doctor care and with regular blood work checkups to assess how I was doing. And for me, the results have been compelling. My blood work is enviable by any standard, and my weight is in a good range. Best of all, my EF has continued to rise and last month was measured at between 60-65 percent — the best it has been since before my heart attack and within the normal range.

As of today, I have above average blood work and a normal EF. That’s all I could have asked for seven years post heart attack. I may cheat here and there (I do enjoy a beer now and again), and my sugars are not as low as I’d like them (that’s where the intermittent fasting is hopefully going to help), but basically, I am in great cardiovascular health. And I’m enjoying how I eat, which is to say I get to eat a wide range of foods including meat, eggs, and a little whole grain bread.

So here I am in January 2019 with probably the best cardiovascular health I’ve had since I was a teen. I attribute this to exercising more, taking my prescribed medications, seeing my cardiologist regularly, and eating right — that is to say, a low carb, low added sugar diet. I definitely need to exercise a bit more, but for the first time in a long time, I am confident I am eating healthy.

It’s the Sugar, Stupid

A juicy steak on the left and a 6-inch Veggie Delight from Subway on the right

Which meal is more heart healthy, the steak or the sandwich? If you believe the American government, and the media, and the vast majority of medical professionals, then it’s no contest. The veggie sandwich is a better choice for heart health because it contains no cholesterol or fat. The steak, on the other hand, has been vilified for decades because we’ve been told that eating foods that contain fat (especially saturated fat) raises the level of cholesterol in your blood and high levels of LDL cholesterol in your blood increases your risk of heart disease.

Signed. Sealed. Delivered. Yes? Not so fast.

What if I told you there has been a vast conspiracy to condemn fat in order to bury the evidence that the real enemy of heart health is sugar? Would you tell me I am crazy and to lose the tin foil hat? Are you willing to risk your life on it?

Lately some of my friends and family have been telling me I sound like Oliver Stone barking about the Kennedy assassination when it comes to sugar. They’d like me to turn down the volume a bit and stop being such a fun suck. Sugar is a vice, but it’s not the root of all dietary evil they say. Shut up and eat a cookie for crying out loud!

Okay, I admit I’ve been ranting a bit too much lately. But if you’d read what I’ve been reading you’d be disturbed as well. And if you’d had a heart attack at a young age like me and have been in a life and death struggle to figure out how to keep it from happening again you might be more open to alternative theories.

The fact is, there is mounting evidence that sugar is the root cause of heart disease. Rather than treat you to a series of quotes from various authors, doctors, and scientific studies I’ll simply list some resources for you to explore on your own at the end of this post. But suffice it to say, I’ve seen enough evidence to convince me that fat has gotten a raw deal and sugar has been artificially and immorally propped up by the sugar industry itself as a simple vice that is fine in moderation. Hell, at first it was literally endorsed as a health food.

I’ve been on a personal journey to protect my heart for nearly a decade now, and at every turn I run into more evidence that sugar (and processed carbohydrates) is the cause of heart disease. Despite the fact that the government still points the finger at fat and cholesterol. It’s frustrating to see how slow this ship is turning. But I believe it is indeed turning and that in the very near future the health powers that be will be forced to issue a gigantic mea culpa and set us all on the path to healthier hearts.

Over the holidays I finally read The Case Against Sugar by Gary Taubes. You don’t have to read it to learn what he uncovered about the dastardly deeds of the sugar industry — you can Google it and read any number of reviews and interviews with Taubes like this one in the New York Times. Here’s a highlight:

Sugar is not only the root cause of today’s diabetes and obesity epidemics (had these been infectious diseases, the Centers for Disease Control and Prevention would have long ago declared an emergency), but also, according to Taubes, is probably related to heart disease, hypertension, many common cancers and Alzheimer’s.

Taubes is a journalist and a well educated one at that. He has degrees from Harvard, Stanford, and Columbia. He has won numerous awards for his work, including the Science in Society Journalism Award of the National Association of Science Writers. He is legit. But he’s not alone in this fight for dietary truth. My explorations have led me to some amazing journalists and health professionals who have all reached the same conclusions about sugar. Like Dr. Stephen Sinatra. Dr. Mark Hyman. Dr. Zoe Harcombe. And Nina Teicholz, science journalist and author of The Big Fat Surprise.

I have also been experimenting with my own body. The fewer carbs and added sugars I eat, the better my blood work turns out. I recently had a nuclear stress test and an echocardiogram as part of my cardiovascular follow-up care, and my cardiologist said my heart is pumping at full power and all the images indicate my heart is healthy. My most recent blood work reported total cholesterol at 118, triglycerides at 120 and LDL at 55. These numbers are enviable for anyone regardless of heart history.

I believe my heart attack was caused by a single blocked artery that became blocked from years of a high carb, high added sugar diet that caused my triglycerides to skyrocket. My trigs were so high at one point (north of 700) that it skewed by total cholesterol numbers to the point that they couldn’t be accurately measured. Ironically, I was not eating an unhealthy diet according to the U.S. government. In fact, I was eating the recommended diet of low fat, high carbs. Journalists like Taubes and Teicholz have uncovered how and why the U.S. dietary guidelines went so astray, but in a nutshell, the reason is sugar. Much like how the tobacco industry lied and manipulated the science and policy of cigarettes, the sugar industry did the same. The evidence is clear.

Sugar is toxic. It screws with your endocrine system, forcing your body to produce too much insulin, which in turn causes you to become insulin resistant. Insulin resistance causes increased production of fat in the bloodstream which causes both obesity and plaque in your arteries. That’s my nonscientific explanation, but if you want to understand it in more detail you can read more on your own.

So back to that question at the top of this post. Which is healthier for the heart, the steak or the sandwich? Well, the 6-inch Veggie Delight from Subway has 41 grams of carbs and the steak has none. Carbs are sugar. Sugar equals heart disease.

If you want to live a heart-healthy life, don’t listen to the government. Listen to science.

My Love/Hate Relationship With Breakfast

Today is National Cereal Day, and it comes at a time when I have been having a crisis of confidence regarding my breakfast choices. I’m not talking about whether to eat Lucky Charms or Cheerios (you might as well be pouring your milk over a bowl of cookies), rather my Sophie’s Choice involves grain in general. Because the more I look into it, even oatmeal or whole grain toast spikes your blood sugar which leads to diabetes and heart disease. Sorry Wilford Brimley, but oatmeal is actually NOT the right thing to do.

For years I’ve been eating plain steel cut oats with some berries or a banana and some sliced almonds for breakfast thinking this was a smart choice. It turns out this has been a better choice than cereal, pancakes or waffles but still inflammatory and a bad way to start the day.

“The major problem with oatmeal is the same problem with every other grain: It spikes your blood sugar and makes you hungrier.” — Dr. Mark Hyman, author of Food: What the Heck Should I Eat?

So if cereal is bad, and oatmeal is bad, what the heck should I eat for breakfast? That, my friends, is the question of the day.

In America, breakfast has really just become an excuse to pour sugar down your gullet. Breakfast has always been my favorite meal of the day. But as I’ve gotten older, and after having a heart attack, I’ve been obsessed with food and nutrition. I’ve talked to my doctors, read all the studies and looked into all the diets (Mediterranean, paleo, Engine 2, juicing, etc.) All the “expert advice” on the Interwebs is enough to drive you to drink. The web is a cacophony of conflicting advice. Who are we supposed to trust?

I’ve written about this before, but the best person to trust is yourself. My blood work has improved tremendously as I’ve eliminated grains and added sugar. My weight is down as well, though I’ve always been relatively thin by American standards. Late last year, six years post heart attack, I had another coronary catheterization and my arteries are clear. Whatever I’m doing seems to be working. So why change anything?

The biggest improvement in my blood work came after I started reading the advice of Dr. Mark Hyman. Yes, I’m skeptical of any “celebrity” doctor and I certainly don’t agree with everything he says — but he always links to research and that research is peer-reviewed and published in legitimate journals. When I started incorporating his paleo-vegan or “pegan” style of eating into my life, that’s when my blood work went from good to great.

After a year or so of eating a mostly pegan diet (I admit I didn’t always follow the rules, morning oatmeal being a perfect example. A little too much beer being another.) I was feeling pretty good about myself.

So recently when my wife picked up his new book Food: What the Heck Should I Eat?, I opened it first and started to read. And it reinforced what I’d been doing. And then starting on Sunday I doubled down on eating pegan. But then I woke up on Monday morning and with oatmeal off the table as it were I had no idea what to eat for breakfast! So I scrambled a couple of eggs with onions, avocado, and tomatoes using avocado oil in the pan and ate it with a serving of fresh blueberries. Then on Tuesday morning I fried a couple of eggs and ate them over a bed of sauteed spinach. And then this morning I woke up and couldn’t imagine eating eggs once again so I turned to the web to see what Dr. Hyman has for breakfast and basically it boils down to some kind of eggs with veggies or a smoothie.

So I poured some almond milk into the blender, added a half cup of frozen berries and a half cup of frozen mango, a tablespoon of ground flax seeds, two tablespoons of almond butter, half an avocado, and a tablespoon of coconut oil. And it was tasty. And it filled me up (in fact, as I write this it has been four hours since I drank my smoothie and I have not been hungry at all).

Still, there has to be more than eggs and smoothies, so I’ll continue to research. But it isn’t lost on me that what I’ve been eating for breakfast the past few days flies in the face of conventional wisdom about breakfast in America.

After all the controversy last year about saturated fat and in particular coconut oil, I’ve done more research. I think the medical establishment is wrong on fat and Dr. Hyman has helped to convince me. But I’m not just taking his word for it, I’m looking at the studies and ultimately my own body.

I’ll be getting some new blood work done soon so I’ll report out the results. In the meantime, just say no to National Cereal Day today and every day.