Tag Archives: After a heart attack

Holiday Sale: Heart Health Guide

Tis the Season of Good Cheer

This year give a gift that will last all year and maybe save a life.

winter holidayIf you know anyone with health issues that might benefit from a paperback science-based health guide, consider giving them:

Your Heart – Prevent and Reverse Heart Disease in Women, Men and Children.

The book is available free as a Kindle e-book through December 15th Your Heart E-book but for those who are not e-readers, Your Heart is also for sale through Amazon at the reduced price of $9.99 through December 24thBuy Your Heart the paperback


Diabetes Health in your handsType 2 diabetes is preventable, treatable and partially reversible in many people. If you have prediabetes or borderline blood glucose without aggressive treatment including weight loss, you will likely progress to full blown diabetes within ten years. With proper medical care, exercise and healthful food choices, you can take control and improve your health.

 Until the epidemic of obesity around the world occurred, Type 2 diabetes was a disease of older people, not teenagers. We are now seeing overweight adolescents with Type 2 diabetes. Of grave concern is evidence of heart disease present in overweight 5-year-olds.obesity

Bad food choices and lack of exercise contribute to Type 2 diabetes & heart disease.

Even if heart disease runs in your family you have the ability to reduce hereditary risks and live longer. Interventions need to begin in childhood and continued throughout life, but it’s never too late to start. The American Heart Association recommends children should have a blood lipid panel before age twenty to help determine risks and begin treatment when appropriate. Do you know your lipid numbers?

You can offset “bad cholesterol genes” by making healthy choices.

 When vessels become narrowed with inflammatory cholesterol plaques, symptoms can be intense with crushing chest pain radiating into the neck and down the arms, weakness, sweating and collapse. However, that is not always the case. In fact, arteries may be more than 90% closed and generate no symptoms. Just because you have no chest pain, it doesn’t mean you don’t have cardiovascular disease.

 Major risk factors for coronary artery disease include: tobacco use, uncontrolled high blood pressure, cholesterol abnormalities, obesity, diabetes, low activity, alcohol and other drugs, high levels of calcium supplements (over 1200mg/day) and hereditary factors. In addition, microvascular dysfunction, a form of coronary artery disease in small vessels is common in women. This is because women more often develop autoimmune disorders such as rheumatoid arthritis, MS and lupus. In addition, anemia, polycystic ovary disease, hormone changes and Type 2 diabetes all contribute to the metabolic mix.

Even if you have been diagnosed with Type 2 diabetes, coronary artery disease, peripheralMed.Food vascular disease, or have had a heart attack, stents or a stroke, there is hope for improvement. Exercise and normalizing weight, blood pressure and blood glucose, in addition to a medication regimen to improve lipids — all contribute to lowering risks and reducing the closure of arteries and stents. Taking a statin to lower your cholesterol is not a ticket to eating fried foods, bacon cheeseburgers or eggs. Good dietary practices are essential to long term health.



One year ago Michael Mosley, MD, published his book The Fast Diet  with the 5/2 concept of intermittent fasting. Benefits of calorie restriction have been known for many years. There are many variations on this theme.

True fasting – eating nothing – can trigger a reduction in the body’s metabolic rate. This slowdown stimulates efficient calorie storage and weight gain when eating resumes. Known as a starvation response, it is part of our genetic makeup.

Ancestors who survived long droughts and periods of starvation carried the surviving genes of longer life.  With these favorable genes came the body’s natural ability to pack on weight easily during good times in preparation for periods when food was scarce. In the past, this was life-saving. Today, those same genes carry some of the responsibility for obesity, but not all.

 With food easily available and daily exercise reduced, one-third of our society has become obese. People are eating more calories than they need. The excess calories are stored in tissues as fat. Over time, the natural process of fat storage as energy reserve produced the obesity epidemic.

With the dramatic increase in obesity in the US and around the world in developed countries, we see an upsurge in related diseases. With excess weight, there is an associated increase in heart disease, Type 2 diabetes, sleep apnea, arthritic joints, high blood pressure and strokes. Many forms of cancer are also associated with obesity.

 Overweight people try many gimmick diets to lose weight and fail. If the dietary recommendations are non-sustainable over a lifetime, the excess weight returns. Learning and practicing healthy eating is the key to success.

 I am proposing  a variation on Dr. Mosleys concept. A 5/2 eating plan combined with the Mediterranean cuisine. Even if you are busy and eating in restaurants daily, this is effective, easy and can be followed over a lifetime.   I will explain more below.

First, a little background and recommended reading: The China Study, a book published in 2005, and the Mediterranean and plant-based food choices.

The China Study

A twenty year study began in 1983 with T. Colin Campbell, an American biochemist and nutritional expert at Cornell University and his physician son Thomas M. Campbell, in association with the Chinese Academy of Preventive Medicine, Cornell University and the University of Oxford. Using dietary surveys and blood work, these men examined the effect of diet on 48 forms of cancer and chronic disease on 6,500 people in 65 counties in China.

 Many complex analyses were made on the data, but in the final judgment, consuming animal-based protein increased blood cholesterol, heart disease, diabetes, autoimmune diseases and many forms of cancer. These diseases common in Western countries were extremely low in the Chinese population. This led to their recommendation of the vegan (animal product-free) plant-based diet.

Following President Bill Clinton’s diagnosis of coronary artery disease and bypass surgery, Clinton began eating vegan. His health improved. He lost weight and became a supporter. Sanjay Gupta, MD, CNNs chief medical correspondent is an advocate of plant based eating. Long time advocate of whole food eating and minimal animal product consumption, Dean Ornish, MD, combined this eating pattern with exercise and yoga. His patients with advanced heart disease showed evidence of reduction in arterial blockages.

 In 1970, a University of Minnesota physiologist, Dr. Ancel Keys published a report on cardiovascular disease related to diet. The initial research involved 12,000 men in Finland, Greece, Italy, Japan, Holland the United States and Yugoslavia. The highest incidence of heart disease was found in the US and Finland. These two countries also had the highest intake of saturated fat and cholesterol. Mediterranean and Japanese inhabitants with low saturated fat intake had very low incidence of heart disease and lived longer.

The Mediterranean diet, as it was later named, consists primarily of fresh fruits, vegetables, nuts, olive oil and olives, wine, whole grains, fish, limiting red and fatty meat.

 Mediterranean and Plant-based Cuisine Combined with a 5/2 Eating Plan

The Greek island of Crete had 57% fewer cardiac deaths than Finland. Their intake was also the highest in olives and olive oil, monounsaturated fats. Vegetarian or plant-based eating typically kabob vegavoids meat, but may include eggs, cheese and milk products. Omit meat and all animal products, and you are vegan.

This is the weekly menu for the 5/2 Mediterranean Plan for Weight Control and Lifelong Healthful Eating:

         5 days of a healthful eating following Mediterranean or plant-based food consumption and avoiding all fried foods

         2 non-consecutive days of eating 500-600 calories/day, such as Monday and Thursday

(Note: A low calorie intake like this done on consecutive days is more likely to induce the starvation response and reduce your metabolic rate. It is important to separate the days and add exercise to counteract this effect.)

         One hour of exercise each day, such as walking

 Utilizing the information above, you have the tools for eating healthy. If you are overweight, following the 5/2 calorie reduction plan is healthful. If you are taking medications for heart, blood pressure or Type 2 diabetes, discuss the 5/2 plan with your physician before using this. (This is not a plan for Type 1 diabetics or women who are pregnant.)

Weight Control Math

To review: One pound = 3500 calories. If your normal intake is 2500 calories/day and you eat 500 calories two days/week, your calorie reduction each week could be 4,000 calories or more than one pound in weight loss. This is approximately 4-5 pounds per month and 48-60 pounds in a year. In addition, if you choose lower calorie foods, (more vegetables, less fat and sugar), you may lose more. Most people find this plan easy to follow for long periods.

To be effective and long-lasting, the manner of eating must be sustainable. It must become a way of life something you can do for the rest of your life. If you have a lot of weight to lose, this would be a life-changing method of controlling your eating and reducing weight. Once you reach your ideal weight, omit the 2 light calorie days and continue eating a Mediterranean or plant-based cuisine daily.

 Animal and human studies examining the effects of fasting, show a heart benefit, along with reduced blood pressure and lower cholesterol levels. Intermittent fasting also decreases diabetes development in lab animals. Eating fewer calories two days a week is not true fasting but produces health benefits.

Because Dr. Mosleys unique concept of marked calorie reduction for two out of five days lacked scientific evidence to support the process in reduction of heart disease and diabetes in humans, I was hesitant to include it in my evidence-based book, Your Heart. However, as I was writing that portion of the book a very exciting scientific review in the British Journal of Diabetes and Vascular Disease was published!

 An Aston University team in the UK, led by Dr. James E.P. Brown evaluated various approaches to intermittent fasting, looking for any evidence of advantage for its use in treating Type 2 diabetes. In their review, they found intermittent fasting was just as effective, possibly even more effective, than daily calorie restriction and calorie counting. Other favorable findings: even markedly low calorie days (not true fasting) can reduce inflammation, reduce both glucose and lipids, and reduce blood pressure.

 In Your Heart Prevent and Reverse Heart Disease, there is a significant amount of information on the Mediterranean cuisine and plant-based eating and more information on the 5/2 eating plan with sample menus.

With the right knowledge and actions, the number one cause of death in women and men is preventable. If you already have heart disease, vascular disease or Type 2 diabetes you can take control and improve your health.

 Let me know how it works for you.

Betty Kuffel, MD


Living LongerA couple senior asian talking and exercising at a park

In health and disease, taking a positive approach is important, especially in heart disease. A recent medical article published in Circulation: Cardiovascular Quality and Outcomes, reported information gathered on mental outlook and mood in people following a heart attack. The people who lived longer and exercised more were those with positive attitudes.

 When the heart arteries narrow silently over years, the person may not realize they have a progressive disease. Suddenly a heart attack strikes and the disease makes itself known. At that point, when the shock and realization a life-changing event has occurred, it affects people differently. Disbelief and depression are part of the process.

 Most hospitals have cardiac rehabilitation programs and it is within these programs that many individuals develop the attitudes and confidence to take control of their health and do everything they can to live healthier and longer.

Four keys to improved health following a heart attack are:

  • Stop all tobacco use.
  • Eat a healthy diet such as plant-based or Mediterranean with minimal fat.
  • Control lipid abnormalities – the LDL goal is 70mg/dl in most. – This is the range that can show reversal of the size of cholesterol plaques within arteries and improve blood flow.
  • Exercise daily under the guidance of your physician.

In the Circulation study done in Denmark, the patients with the most positive outlook exercised more and had a 42% lower chance of dying during the five year follow-up period than those with a poor outlook and negative mood.  However, they found even those with less optimism lived longer if they exercised.