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Food and Medicine Preventing Heart Disease John E Whitcomb, MD Brookfield Longevity and Healthy Living Brookfield, WI Sponsored by the Wisconsin Integrative.

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Presentation on theme: "Food and Medicine Preventing Heart Disease John E Whitcomb, MD Brookfield Longevity and Healthy Living Brookfield, WI Sponsored by the Wisconsin Integrative."— Presentation transcript:

1 Food and Medicine Preventing Heart Disease John E Whitcomb, MD Brookfield Longevity and Healthy Living Brookfield, WI Sponsored by the Wisconsin Integrative Medicine Society First Annual Conf. in Wisconsin on Integrative Medicine Country Springs Hotel, Waukesha Dec 1, 2012

2 Objective 1. New understanding of how heart disease develops 2. How to measure the trouble you are in 3. Use food to fix it

3 Take Home Messages 1. Heart diseases starts as inflammation caused by bad food choices 2. It develops slowly over years 3. Insulin is the junction where metabolism and inflammation intersect 4. We learn in stages and adapt when given successful options 5. Viscosity, wheat, alkalinity may all play heretofore unexplored roles 6. Vascular disease can be reversed

4 Old Theory 1. Heart disease is a plumbing problem 2. Blood vessel gets plugged up 3. Solution? 4. Rush to the hospital 5. Rush to the cath lab 6. Rush to surgery

5 Plumbing Problem

6 We try to fix it when it shows up

7 Our current model lets you jump off the cliff, then tries to pull you back

8 Dirty Little Secret….. Routine Angioplasty Does NOT prolong life Emergency angioplasty stops a heart attack THE PROBLEM…….? Insurance pays for it, richly In medicine we do what we are paid for

9 As many as 85% arent visible

10 Like all good science… 1. We always want to dig deeper 2. Go to the real source What 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-albuminuria AKA: Metabolic Syndrome

11 Pop Quiz % 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 doesnt prolong life (unless with an acute MI) because thats not where the next one will happen 3. Name the size your waist/hip ratio should be. <.9 for men, <.85 for women

12 The Solution?

13 Data for Women and Lifestyle Adherence to a Low-Risk, Healthy Lifestyle and Risk of Sudden Cardiac Death Among Women JAMA: July 6 th, 2011 page 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

14 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/m 2

15 Mediterranean Diet Is? A diet in the Mediterranean? Abundant vegetables, legumes, fruit Small amounts of fish/meat/cheese Cheese and yogurt Olive oil in moderation Wine in moderation Variety of antioxidants Little sugar/refined white flour

16 Life Style Trumps Drugs 3:1

17 Pop Quiz 1. Name two features of the Mediterranean Diet? Lots of veges, olive oil, less fish and meat, some wine, some sunshine 2. Name two strategies to help you survive a heart attack and sudden death. BMI < 25, Exercise, No smoking, Diet 3. Adding one less risk factor increases your odds of survival by_____%? 40

18 Conclusion Life Style beats taking pills Pills might not do that much Angioplasty doesnt do that much Our 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%?

19 Good Science Goes to the root Is 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% Whats the next generation of improvement?

20 New Consensus Diabetes and high blood pressure are part of a confluence of forces Endothelial dysfunction Common Soil Hypothesis Insulin, sugar metabolism and diabetes are all comingled. With insulin and sugar, you get inflammation.

21 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

22 When do you want to intervene?

23 Glycocalyx May be Key!

24 The simple view

25 Read it in Wikipedia

26 What may be setting this off?

27 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

28 Conclusion To fix vascular disease…. We have to fix Diabetes and hypertension…..? Viscosity What makes viscosity? Inflammation (makes for thicker blood) Toll receptor proteins And the data shows, it will work better if we do it ourselves rather than depend on a pill

29 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?

30 How is food going to fix this? Turn off inflammation Cool off Toll Receptor Proteins Calm your blood thickening Alkalize your body Mellow out endothelial dysfunction Watch high blood pressure go away Observe diabetes melt

31 Big Boast? Can you turn off insulin? And lose weight Control your endothelium Answer: YES. It takes about 6 weeks to measure, control and heal your endothelium. Once controlled, your risk drops even further.

32 How to turn off insulin NO free CARBS – major shift to protein Wheat may be a topic all of its own with its clear autoimmune triggers Choice Green 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

33 What is insulin? Our STORAGE hormone NOT, emphatically NOT, our glucose hormone Released when we have too many carbs released too quickly Indicates foods rich in carbs which are usually secreted at the end of summer Summer is followed by 6 months of….? Today: our bodies get the message that we are always at the end of summer – store fat

34 Esselstyn has proven you can reverse CAD with LOW fat - plant

35 NutrientPlant Based FoodAnimal Based Cholesterol (mg)0137 Fat (mg)436 Protein (grams)3334 Beta-carotene (mcg)29,91917 Fiber (grams)310 Vitamin C2914 Folate (mcg) Vitamin E (mg_ATE)110.5 Iron (mg)202 Magnesium (mg)54851 Calcium (mg) calories from plants: equal part mix of spinach, potatoes, limas, peas, tomatoes 500 calories from animals: equal part mix of beef, pork, chicken, whole milk Pop Quiz: Plant vs Animal Source of Nutrients WHICH has more Protein?

36 Pop Quiz 1. Which food group has more protein? Plants or animals Equal – essentially 2. Which food group, cal for cal, has more iron? Plants 3. Which food group has more beta- carotene? Plants

37 Common Soil Hypothesis Inflammation and metabolism are one Calm insulin And you calm inflammation Conclusion The trigger for insulin are foods rich in freely available carbohydrates You have to stop eating white carbs in such abundance Wheat is a particular problem: leaky gut, acid content, autoimmune stimulant, etc etc

38 Hence: Non Carb Diets - Atkins: If you choose the meat approach Or pure vegetables, very low fat if you choose the Esselstyn approach But neither has carbs Neither gives the winter signal With the loss of insulin, you open up fat cells, lose weight, drop your LDLs, raise your HDLs

39 WWW: What will work for me You have to turn off insulin < 5 You have to lose weight You have to exercise You cant smoke You need to replace missing nutrients like Vitamin D, omega fats, This gets you to 92% reduction in risk

40 Are you Ambitious? Reverse and prevent completely? Get off wheat and all high glycemic foods/sugars Choose 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

41 PreDx Test is FREE! So you can repeat it and see how you are doing

42 Questions? My practice is at W North Ave Sheila or Sharon: We 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


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