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Old 01-13-2013, 12:37 AM   #1
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My Father's Visit to the Cardiologist

My Father has serious heart problems (I won't go into detail here). He also LOVES to eat - it is probably one of his favorite things to do in life.

He finally broke down and went to see the cardiologist, who put him on tons of new medications and told him he needed to lose weight immediately (my father is probably 60lbs or more overweight). Yesterday, the cardiologist briefly told my father and my mother, who was also there, that he needed to go on a diet of:

-very low salt
-low carb
-no sugar
-no dairy
-only lean meats

Last week, I gifted my mom the New Atkins Book and supplementary cookbook.

However, after she returned from the doctor, she called me frantically and said "We can't go on Atkins anymore! We can't eat salt, dairy, or fat!" My mom was utterly confused. She had no idea what she could cook at all - and my father's life depends on this. The doctor didn't give them a book or a plan, or anything.

But really, what was the cardiologist thinking? Is he trying to put my father, the man who would rather eat than sleep, on a fat-free diet of chicken breasts and steamed vegetables? I agree with some of this suggestions - I was really happy he told them not to eat refined sugar at all anymore, and not to eat flour or too many carbs.

I don't necessarily want to go against the cardiologist, but doesn't my father need some sort of fat? I certainly don't think my father needs to follow my LCHF eating plan, but, from all of the studies I've read, fat is essential to health.

I think the diet plan the cardiologist prescribed sounds closest to "paleo". Even in paleo, fat is necessary.

Anyway, I helped my mom come up with a low salt, low carb diet plan with lean meats for the next two days. I did include fat in it, but sparingly - everyone knows that many nutrients are not even absorbed by the body without fat. I had to reassure my mom over and over that the small amounts of cream, butter, coconut oil, olive oil, or other fats was not going to stop my father from losing weight.

My father's general practitioner recently gave him a sheet of diets he could use to lose weight - the sheet included Atkins. They were very happy to start Atkins. Then, the cardiologist confuses my parents completely.

I guess this is a rant.... I would appreciate any input, though. What do you guys think?
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Old 01-13-2013, 01:15 AM   #2
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The zone diet is also a good one.
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Old 01-13-2013, 06:12 AM   #3
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My friend's cardiologist recently told him he had to cut out all meats, dairy, and fat and eat lots of fruits to treat atherosclerosis. I rolled my eyes and hoped for the best, but a little terrified for him I can't give medical advice because I am not a doctor, so I told my friend I thought he should seek a second opinion before committing to this diet.
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Old 01-13-2013, 07:23 AM   #4
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Maybe you could tell her that he meant unsaturated fats and that natural fats are good. He could then add natural fat in moderation...kinda like Atkins' induction. I would also ask the cardiologist about the good fats so that they would believe you if he backs it up.

I don't think that some know the difference between fats.

I believe South Beach is a lower fat but good fat diet.
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Old 01-13-2013, 07:55 AM   #5
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Protein Power by Eades is a good plan. My dr recommended that I follow that plan when I was diagnosed w/diabetes.
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Old 01-13-2013, 08:03 AM   #6
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I would just call and ask the Cardiologist (get your dad/mom on the phone with you, or get a health care power of attorney from your dad so you can directly discuss your dad's case with his doctors):
(1) about what kinds of fats and how much are okay.
(2) does he have a meal plan recommendation or someone who can show your dad what to eat,
(3) May be pull a couple of studies/articles (by MDs) about how cutting fats is a bad idea, and ask him to read the articles and get back to you once he has time to think about the studies/articles.
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Old 01-13-2013, 09:10 AM   #7
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Maybe they can set up another appointment with the cardiologist and you can go with them and ask questions.

South Beach Diet maybe a really good plan for him.
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Old 01-13-2013, 02:19 PM   #8
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I have NEVER seen a reputable scientific study showing a correclation between eating dairy and heart disease.

I dont know his heart issues, but salt may actually be a legitimate concern.

Most cardiologists are comfortable with a mediterranean style or South beach style diet. They may balk at Paleo since it includes sat fat, but would be ok with it if you are sticking wtih avocados and olive oil instead of coconut oil. Their main concern on low carb diets is going to be the saturated fat.

I have a feeling if your dad starts losing weight and improving his cholesterol numbers, etc that your cardiologist will be happy with whatever plan you are using.

Remember Doctor does not equal all-knowing diet expert!
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Old 01-13-2013, 02:50 PM   #9
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no advice here but I understand the confusion.

I'm trying to figure out what to eat/not eat with cancer, diabetes and kidney stones and it IS confusing.

I agree that perhaps cardiologist would be ok with olive oil.
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Old 01-13-2013, 04:01 PM   #10
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Did the doctor state that your father needs to be on a low fat diet? And why no dairy?

Other than the low salt that is how I eat. I eat lean meats & veggies. No sugar, no grains, no dairy.

I do cook with virgin coconut oil & use some butter & mayonnaise. My nutrition is not low fat. It is high fat.
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Old 01-13-2013, 04:05 PM   #11
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To me, it sounds like your mother & father misunderstood what the cardiologist said. Saying he needs to eat lean meats is not the same thing as saying he needs to be on a low fat diet.

If he did really mean a low fat diet I would be looking for a new cardiologist.
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Old 01-13-2013, 07:21 PM   #12
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If it were my parents, I would first, get a second opinion, but secondly, have the conversation about saturated v unsaturated fats (butter = good, margarine = bad).
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Old 01-14-2013, 12:20 AM   #13
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Thanks for the suggestions. I don't know why the doctor said no dairy. He left my mom with the impression that it should be low-fat, low-salt, very low-carb, and no sugar.

My father was severely dehydrated yesterday. He lost 10 lbs of water weight overnight. My mother called me, she was a nervous wreck. He was feeling deathly ill and they didn't know why. Keep in mind, the doctor has him on cumadin, diuretics, plus the low salt - it is almost a deadly combination.

My mother called late last night and told me my father was very weak, not acting like himself, and had unusual cramps in his side. I had her instantly mix a glass of water and orange juice.

He called me back 2 hours later and said he felt like the drink saved his life - he finally started to feel like himself again. He has a doctor appointment this morning.

The doctor's diet is simply too drastic all at once. That is all there is to it. You can't change absolutely everything you eat and begin 10 new medications at the same time!

I would gladly go with my father to the doctor, but I am currently in Germany. I have a feeling I'm going to have to take an emergency trip to America this week or next. My poor parents - they simply don't understand many basic, biological processes. Its not their fault. If my father had kept drinking just water, his dehydration could have led to many worse consequences.

I'm certainly not a doctor or nurse.... which is also a problem.
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Old 01-14-2013, 12:58 AM   #14
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I sorry your father is having health problems , and hope he and your mom finds the right diet for him. Glad to here you were able to help him start feel better.

What gave you clue to have him drink orange juice with water ? You rock

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Old 01-14-2013, 01:10 AM   #15
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I used to work as a cocktail waitress in the US as a part-time job to pay for school. We always had girls in the bathroom with adverse reactions to ecstasy, which usually was severe dehydration.

We had a first aid course, and the nurse told us not to give them pure water even though they were thirsty - she said that would throw their electrolyte balance off even more. She said to mix juice and water.

I'm glad it worked for my Father yesterday, but it was merely a lucky guess. It could have been worse. I think the new diet and new medication are simply too drastic.
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Old 01-14-2013, 02:31 AM   #16
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This sounds so stressful for you and for your family. My sympathies! Perhaps you can figure out a way to have a conference call with the cardiologist and your parents, but that might be challenging since you're in Germany.

Because the health consequences are so great, I hope you can talk with the cardiologist as soon as possible to figure out what he meant and why. Your parents are so stressed that it must be difficult for them to recall exactly what he said. In my experience, doctors and nurses have been very helpful when I call to get more information about my elderly mother's health and diet recommendations. (I explain that my mother wasn't certain she remembered exactly what the recommendations were, so I'm calling to make sure we understand properly.)

It sounds to me as if the cardiologist was describing a dairy-free version first phase of the South Beach Diet (ie, lean protein, lots of vegetables, certain fruits, reasonable daily servings of legumes, beans, nuts, avocado, olives, and olive oil). So not a low-fat diet, but a low-saturated fat diet, with no added sugars or simple carbohydrates. I hope the cardiologist's office can clarify this for you.

You might have the best results talking to the cardiologist if you start with a list of very specific questions, such as:
1. which sources of omega 3 fatty acids should my father eat each day? Are walnuts fine? How large a serving each day? Is extra virgin olive oil fine? How much each day?
2. which vegetables should my father have each day? How many servings? Which ones should he avoid?
3. which fish and meats should he have each day? Is salmon fine? Is chicken fine? Is lean pork fine? Etc..and also ask how much at each meal?
4. which fruits can he have each day? etc...
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Old 01-14-2013, 06:47 AM   #17
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There is nothing more confusing these days than trying to find a healthy diet/woe.
There is just too much conflict among the "experts"
Those of who are not dealing with serious illness have the luxury of experimenting but in your dad's case he needs to eat properly RIGHT NOW!
I only know that certain things just don't make sense to me. For example the carb recommendation by the diabetes association is, IMHO just plain crazy.
My personal experimeint with lc has been very successful. In four months I lost about 15 pounds, and my lipid profile improved in every category. I eliminated one medication (tricor) and cut the dosage of my other (lipitor) in half.
I hope your dad finds his healthy woe very soon.
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Old 01-14-2013, 07:41 AM   #18
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Remember that cardiologists are not nutritionists. The cardiologist is just parroting the CW that fat and salt are bad. If you press him, your dad will be referred to a dietician who will parrot CW too and suggest your dad switch butter and healthy fats for margarine and canola oil, plus six or more servings of carbs a day.

It might help to keep in mind that Dr. Atkins was a cardiologist and so is dr William Davis (see his wheat belly and heart scan blogs). They come from a place of preventing heart disease with diet, not drugs.
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Old 01-14-2013, 07:56 AM   #19
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Well the low fat does work for some: See Bill Clinton – he's transformed into a lean guy who is visibly much healthier than before. He's done vegan, cooks with no added fat I think. Not easy and I'm sure his army of nutritionist and cooks make it easier.

I think we need to realize that our way isn't the only way. However, we can all agree that sugar and refined crabs should be completely cut out.
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Old 01-14-2013, 04:31 PM   #20
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Quote:
Originally Posted by unna View Post
The doctor's diet is simply too drastic all at once.
This ^^

Quote:
Originally Posted by Janknitz View Post
Remember that cardiologists are not nutritionists. The cardiologist is just parroting the CW that fat and salt are bad. If you press him, your dad will be referred to a dietician who will parrot CW too and suggest your dad switch butter and healthy fats for margarine and canola oil, plus six or more servings of carbs a day.

It might help to keep in mind that Dr. Atkins was a cardiologist and so is dr William Davis (see his wheat belly and heart scan blogs). They come from a place of preventing heart disease with diet, not drugs.
And This ^^
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Old 01-14-2013, 07:34 PM   #21
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Well the low fat does work for some: See Bill Clinton – he's transformed into a lean guy who is visibly much healthier than before. He's done vegan, cooks with no added fat I think. Not easy and I'm sure his army of nutritionist and cooks make it easier.
Personally I don't think he looks that great at all and he has continued to have progression of his cardiac disease while following this diet.
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Old 01-14-2013, 07:51 PM   #22
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Personally I don't think he looks that great at all and he has continued to have progression of his cardiac disease while following this diet.
I have not heard anything about him having progression of his cardiac disease in the last two years since he changed to a vegan diet. But in any case, diets like the Dr Ornish diet can demonstrate in clinical studies that patients can reverse heart disease (coronary artery plaque buildup) with very strict low fat diets that involve very little meat and a lot of veggies and legumes. The most important factor seems to be ANY diet that gets someone to lose weight and start eating whole unprocessed foods.
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Old 01-14-2013, 07:56 PM   #23
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I may be wrong.....but I think there are dietary restrictions that go along with cumadin. Green leafy veggies are out. You might want to do a search and see if I'm remembering correctly.
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Old 01-14-2013, 08:23 PM   #24
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I may be wrong.....but I think there are dietary restrictions that go along with cumadin. Green leafy veggies are out. You might want to do a search and see if I'm remembering correctly.
That is incorrect unless one has a lazy doctor.
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Old 01-14-2013, 08:33 PM   #25
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For coumadin, the most important thing is to keep the levels of vitamin K intake from foods CONSISTENT. The dose of coumadin can be adjusted down if you want to regularly eat leafy greens. What cant happen is to eat very little veggies one week, and then buy 3 bunches of kale the next week.
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Old 01-14-2013, 11:56 PM   #26
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This sounds like Loren Cordain's version of the paleo diet. If this is what the doc meant, she is missing the nuts/seeds. Lean meats, fruits, vegetables, nuts, and seeds.

Ornish is proven to reverse heart disease, but it is high carb. Grains are allowed, so I don't think the cardiologist was refering to Ornish.

If they can afford it, a Vitamix makes it easy to get down the fruit and vegetables and retains the fiber in the juice, which is really necessary and makes the large volumes of these foods easier (and tastier) to get down and digest. A simple drink is carrot and apple blended into a juice. Frozen blueberries and spinach blended into a juice (I swear, this is good). Unsweetened almond milk may be added to these. A frozen blueberry/strawberry with splenda smoothie is a godsend for someone that can't have dessert.

Potassium is essential for someone on diuretics. It is hard to absorb from even the horse-sized potassium tablets (but it does work, so he has to take them).

He needs to beware of any time he has diarrea or meds that cause this as it will wash potassium out of the body and the diuretics will create an emergency similar to the one he just experienced.

Salad dressing = balsamic vinegar plus olive oil. It is one way to make salad dressing that is not full of sodium but still tastes good. Nuts on the salad gives crunch.

If he has heart failure, then a 10 pound change in weight = trip to emergency room. If kidney function is a question mark, then this can happen in a blink. I learned the hard way that the liver and kidneys eventually decline from heart failure, so my feeling is Atkins may not be the right diet. My husband had heart failure.

Sodium is the devil for heart failure and high blood pressure, of course.

Coumadin, if he is on it, requires a consistent diet. Sudden changes create a difficult moving target for the INR nurse to manage dosing.

heartvalvepatients.org is a small group of nice people that will help with heart failure questions, especially Nancy.
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Old 01-15-2013, 02:11 PM   #27
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You might try google searching for suggestions on how to make low salt food more tasty. There are a lot of strategies like using vinegar or lemon juice, making dishes with curry powder, various spice mixes to take the place of salt. A "salt alternative" such as potassium chloride may be ok - but I would check with the doc.

And encourage your father that "low sodium" does not mean ZERO sodium. it just means adding up the sodium in foods and not getting too much. Just like most of us dont do ZERO carb, we just track carbs and make sure we are under a certian amount, while still allowing many things.

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Old 01-15-2013, 02:33 PM   #28
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I'm a member of the healthcare community and I also work in research. Two things I can tell you: the medical community, for the most part are far behind the times in terms of diet and what has caused epidemic obesity in America and many studies are not worth the time it took to do them. Low salt and no sugar are very good ideas. Walking every day is great idea and will help immensely ( at least 30 min a day at speed that pushes you a bit). The medical community still blames fat in our diet for everything when it is usually the starchy carbs, sugared up fruits that are doing it, coupled with no exercise. It's like everything else, find a good eating plan that he can live with or he will be miserable and won't stick to it. Good luck and God bless
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Old 01-15-2013, 02:55 PM   #29
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Do not use salt substitutes with heart failure if the kidneys are starting to have issues. This causes hyperkalemia and can be fatal because it causes arryhmias.

I don't know why cardiologists don't mention this when they put patients on low salt diets.

Heart failure is common problem after heart attack or with obesity
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Old 01-15-2013, 10:41 PM   #30
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Keep in mind, the doctor has him on cumadin, diuretics, plus the low salt - it is almost a deadly combination.

Oh, good grief!!!!!


OK... when you're taking Coumadin -- which has potentially deadly interactions with all kinds of every-day foods -- you're not supposed to make drastic dietary changes!!

The dosing on Coumadin is so hard, because the amount that's in your bloodstream today is based on the amount you swallowed two days ago (plus how it's interacted with everything -- food, drink, and supplement -- you've swallowed since). Changing the amount of vegetables, or of coffee, or of anything else can take you from "just fine" to spontaneously bleeding.
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