(Above) Dr. Nieca Goldberg, me, and Jane Chesnutt from Woman's Day Magazine
(Right) Me and Joy Behar
My overall message was that there are still troubling gender differences in the way that heart disease is researched, diagnosed, and treated; and that although more women today have a better awareness that they are candidates for heart disease and must be vigilant in recognizing the risk factors and symptoms, they are still not being taken seriously by doctors and practitioners in the same way that men are. My message was received well. I only hope it will resonate throughout the New York medical community and that fewer women will be sent home from emergency rooms like I was when I nearly died from a heart attack in 2006.
The general messaging from the AHA, however, still largely focuses on the individual.
For many reasons, I have a hard time with this, mainly because it places the sole responsibility of heart health care, and even blame, on the individual woman - a layperson. In fact, if you listen to Andie McDowell’s speech on the home page of the Go Red for Women website, you will hear her say that this campaign “helps women make smart choices,” as if to imply the reason they have heart disease and go undiagnosed is because they make foolish choices.
We rely on doctors - experts in the field - to guide us, give us medical advice, and be able to accurately diagnose and treat our diseases to their best capacity. What kind of message does it send to the public, to tell women that they cannot rely on doctors to do this, that they must do it for them? Where is the responsibility for medical professionals? And the problem is that even when patients arm themselves with information, doctors rarely take them seriously, in fact, they are usually annoyed by the “overly controlling” patient.
The other part of this campaign I have a hard time with its insistence that dietary fat and cholesterol are the major causes of heart disease.
I’ve been re-reading Gary Taubes’ Good Calories, Bad Calories, and revisiting the research-based evidence he provides to challenge the fat-cholesterol hypothesis of heart disease (which is still, by the way, nothing more than a hypothesis and has never been proven). The fact is that while high cholesterol may be associated with atherosclerosis, there is still no explanation as to why so many people have heart attacks despite having low cholesterol (including myself), and why a tremendous amount of people with high cholesterol never get heart disease.
Even though there is ample evidence (see studies below) which suggests that populations who follow a hunter/gatherer diet have longer life expectancies than those who follow a western, grain-based diet; and that high protein, yes- high fat, and low carbohydrate diets are much more effective for weight loss, reducing insulin levels, triglycerides, and raising good cholesterol; pop nutritionists and journalist are still trying to tout the low fat, high carb diet as being the healthy one, even though Americans are getting fatter on this diet every day.
Many researchers will readily admit that the evidence on the cholesterol/heart disease correlation is dubious at best. Taubes points out that one reason the medical community holds on to the cholesterol hypothesis is simply because cholesterol is measurable. Even though there are numerous other factors that are correlated with heart disease, such as diabetes, obesity, high blood pressure, and inflammation, there is no other measurable indicator that can be so easily remedied with a drug. And although statins have proven to lower cholesterol and lessen mortality in patients with heart disease, it has yet to be determined if it is statins’ cholesterol lowering properties that save lives. Statins also reduce inflammation. I am not suggesting that people with heart disease go off of their medication. I am on statins and plan on remaining on them for life. But do all people with high cholesterol (who are otherwise healthy) need to be put on statins (which have terrible side effects, by the way)? Couldn’t inflammation be controlled, let’s say, through a healthy diet? But what causes inflammation?
• Polyunsaturated vegetable oils like safflower, sunflower, corn, peanut and soy.
• Refined carbohydrates including flours made from wheat, corn, and soy.
• High glutinous foods like wheat, rice (even brown), and other grains.
It’s disturbing to see so many of my health conscious friends and associates follow this unsubstantiated advice that includes eating processed carbohydrates, high sugar, and soy-based vegetarian diets which have proven to raise insulin levels and cause inflammation. And people like Oprah keep wondering why they can’t take the weight off. Surely if someone like Oprah who can afford the most expensive nutrition and fitness gurus in the world can’t keep the weight off, something is wrong with the guidelines we are being told to follow.
Studies mentioned above:
A Palaeolithic diet improves glucose tolerance more than a Mediterranean-like diet in individuals with ischaemic heart disease.
Cardiovascular risk factors in a Melanesian population apparently free from stroke and ischaemic heart disease: the Kitava study.
Weight Loss with a Low-Carbohydrate, Mediterranean, or Low-Fat Diet
Dietary fats, carbohydrate, and progression of coronary atherosclerosis in postmenopausal women.
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