A Cardiologist's Guide to Real Food, Real Living, and Real Happiness
Is there a Low Carb Diet Mortality Risk? New Study Results
Is there a Low Carb Diet Mortality Risk?
Everyone seemed to think carbs were bad until this new study was published last week. Is there a way to follow a low carb diet and still live a long life? In this article, I'll teach you how to optimize your carbs so that you can avoid the low carb diet mortality risk.
The Dietary Carbohydrate Intake and Mortality Study
In what has to be one of the biggest carbohydrate studies ever done, Harvard University researchers included a total of 447,607 people. Of these 447,607 people, a total of 46,464 people passed away during the 25-year follow-up of this study. These Harvard researchers then analyzed their mortality risk based on food questionnaires filled out over the years prior to their deaths. Here are the results:
1. If you ate a moderate amount of carbs (40-70% of your total calories) you lived the longest.
2. If you followed a low carb diet (less than 40% of your calories are carbs), you lost about 4 years of life.
3. If you followed a high carb diet (more than 70% of your calories are carbs), you lost around 1 year of life.
How do you explain these results?
As carbs have been blamed for the obesity crisis, diabetes, and just about every other health problem, how can these study results be explained? The answer is really quite simple. Just as there are good and bad carbs there are also good and bad proteins and fat.
In the case of this study, people eating the most carbs ate a lot of flour and other processed carbohydrates. As a result, their lives were cut short. This fits nicely from what we know from countless other studies.
For the low carb eaters in this study, the problem is that they replaced their carbs with animal proteins and fat. Indeed, these lost years of life could have been avoided had plant-based proteins and fat replaced their carbs. Once again, this finding is something that comes up in study after study.
While nutrition studies are hard to do and sometimes reach the wrong conclusion, the results of this study seem believable based on what we already know. Personally, I really don't think what percentage of carbs you eat matters provided you are eating a mostly real food plant-based diet. In other words, if you choose to eat meat it is a very small portion of wild meat. The bulk of what is on your plate is vegetables and you also have a healthy fat like nuts, seeds, avocado, etc.
How do you find out your carb percentage?
It is really easy to find out what percentage of your calories come from carbs. Simply download the free version of either Lose It or Cronometer from iTunes or Google play to your smartphone. If you still use a flip-phone, there is also a free desktop version to both of these apps.
Next, enter in everything you ate today. Both of these apps will then automatically calculate what percentage of your calories came from carbs.
How to Eat Low Carb and Live a Long Life
Many of my patients swear by the ketogenic diet. Some of the biggest celebrities in the world are also following the ketogenic diet. Even my own carbohydrate intake this past week was 40%. This 40% number was just 1% away from falling into the danger zone according to this new study.
Yes, you can eat low carb and still live a long life according to this study. The way to do this is to replace your carbs with plant-based fat and protein.
For example, nuts, seeds, avocados, olives, and coconuts are all mostly fat. Likewise, there is a lot of protein in beans, lentils, and other legumes.
The big take away for me from this study is that unless you want to eat more plant-based you should probably moderate your carbohydrate intake. If you are trying to lose weight or reverse diabetes with the ketogenic diet, start embracing a much more plant-based way of eating...
Dr. Day’s Riced Cauliflower Fast Food
Dr. Day's Riced Cauliflower Fast Food
It often seems like there is no time to prepare healthy food. Wouldn't it be great if you could have great tasting healthy food in 5 minutes? In this article, I'll share my riced cauliflower fast food meal. This dish is guaranteed to fill you up for hours!
My "No Cooking Skills" Disclaimer
I am not a chef. In fact, I am horrible in the kitchen. While my wife is a fabulous cook, I'm not. If your time and cooking skills are limited, like me, you may want to consider giving this recipe a try.
4 Ingredients from Trader Joe's
We love Trader Joe's. For those of you outside of the US, Trader Joe's is a popular and affordably priced health food store. We have one between our home and my hospital. While these four ingredients all came from Trader Joe's, you could easily improvise with your local health food store.
1. Frozen Organic Riced Cauliflower
While you could buy fresh riced cauliflower, I like the frozen variety better. It is always fresh and I never have to worry about it going bad. Given that it was frozen immediately, you don't get the loss of nutrients that often comes from long farm to plate transport times. I use the whole bag for this riced cauliflower fast food meal.
2. Frozen Melodious Blend
I love the frozen melodious blend from Trader Joe's. There are only six ingredients with no chemicals, preservatives, or any added sugars. The six ingredients are cooked green lentils, cooked red lentils, cooked green garbanzo beans, tomatoes, extra virgin olive oil, and sea salt. This little-frozen concoction is a meal unto itself. I just use half the bag for this riced cauliflower fast food dish. If you don't have a Trader Joe's near you, I would suggest substituting in one cup of cooked lentils in light olive oil.
3. Can of Organic Diced Tomatoes
I like the 14.5 oz (411 g) can of organic tomatoes (diced and no salt added) from Trader Joes. I use the whole can which works out to be 1.5 cups of diced tomatoes.
4. Salt or Garlic Salt to Taste
I can't give you an amount because everyone's tastes and health needs are different. You can make this rice cauliflower fast food dish with or without added salt.
If you choose to skip the salt, it will be a little bland. Personally, I like to use garlic salt. I like the added flavor that comes from the garlic.
I would suggest adding in a little salt or garlic salt and see how it tastes. If you want a stronger flavor, add more.
Combining the 4 Ingredients
Preparation is simple. Use the whole bag of organic riced cauliflower (12 oz or 340 g). Add in half the bag of the melodious blend (or 1 cup of cooked lentils in olive oil if you don't live near a Trader Joe's). Mix in the entire small can of diced organic tomatoes (1.5 cups, 14.5 oz or 411 g). Then add salt or garlic salt to taste.
Given that most of the dish comes frozen, you can heat it on the stove or in the microwave. I often throw the frozen bags and can of tomatoes in my computer bag when I leave in the morning as it is so easy to prepare everything at my hospital. The total preparation time for me, including warming it up, is 5 minutes.
The Nutrition Stats
I eat the entire dish and it fills me up for half the day. You could easily share this meal with a couple of other people. Assuming you eat the entire dish by yourself, here are the nutritional stats.
Cauliflower 80, melodious blend 200, and tomatoes 90 for a grand total of 370 calories. No other 370 calorie meal fills me up as much as this one does. When you see how much food is in this 370 calorie meal you will be amazed. Be prepared to use a huge container for this meal as it probably won't all fit on your plate.
Cauliflower 8 g, melodious blend 11 g, and tomatoes 3 g for a combined total of 22 grams.
4 Reasons Why Vacations Make You Live Longer
4 Reasons Why Vacations Make You Live Longer
Wouldn't it be great if the more vacations you took, the longer you lived? Having just returned from a family trip I'd like to think that this week away added years to my life. In a landmark study, researchers found that the more holidays you take, the longer you live. In this article, I discuss four reasons why vacations make you live longer.
Vacation Longevity Study
In this study, researchers recruited 12,338 people who were at high risk for a heart attack. Over the next nine years, they found something exciting. If you want to live a long life, you need to take a lot of vacations.
Interestingly, the reason why these people lived longer was that vacations somehow protected them from heart problems. Indeed, those taking the most vacations lived 17% longer and were 29% less likely to have serious heart troubles.
4 Reasons Why Vacations Make You Live Longer
To explain the life-extending benefits of vacations, these researchers came up with four possibilities.
1. Vacations Allow You to De-Stress
Really? Perhaps this is because I have four strong-willed children. In my experience, time away can be more stressful. Everything from sleep deprivation to the various delays can make travel hard.
Perhaps the magic lies in the fact that it is a different kind of stress. In my case, rather than the pressure of the operating room or being on call for hospital emergencies, it is now the stress of moving a large family from point A to point B and making sure my two-year-old doesn't get lost or injured in the process.
When it comes to stress and the heart, I have learned that you can't ever eliminate stress. The only people without any stress have all passed away. Whether or not stress causes you an arrhythmia or an early cardiac death all comes down to how you perceive your stressors. Perhaps this helps to explain why any vacation related stress might be a good thing.
2. Vacations Increase Time with Family and Friends
Spending more time with friends and family may be one of the healthiest things we can do for our heart. Indeed, studies show that your social life may be a better predictor of longevity than either smoking or obesity. Sometimes it takes a vacation to wake us up to what is most important in this life.
3. Vacations Increase Physical Activity
Most people live their lives going from one chair to the next. We sit for breakfast, sit in our cars, sit at work, sit in our cars again, and then sit to watch TV at night. Sometimes we need an enjoyable vacation to shake things up and get us a bit more active.
In my case, vacations offer the chance of a long workout. And, as you know, long workouts can be challenging to come by during a typical workday. Physical activity from time away could be yet another reason why vacations make you live longer.
4. You're Working Fewer Hours
If nothing else, getting away means you aren't usually working. And if taking a vacation makes it so that you avoid overtime then it may be good for your heart. For example, many studies have shown that putting in more hours than the typical workweek significantly increases your risk of atrial fibrillation. As a recovering workaholic, vacations help me remember the importance of creating memories that my children will remember for the rest of their lives.
How to Vacation Regularly on a Budget
Everyone's idea of the perfect vacation is different. Rather than just settle for one big annual family getaway, we try to spread out many budget-friendly mini-vacations over the course of a year. Our goal is to try and do something, even if it is just a one-night getaway, on at least a monthly basis.
Staying a couple of nights with old friends or family members can be another budget-friendly vacation.
4 Reasons Why Eating Nuts Prevent Atrial Fibrillation
4 Reasons Why Eating Nuts Prevent Atrial Fibrillation
Wouldn’t it be great if a handful of nuts could prevent atrial fibrillation? In this article, I'll review the atrial fibrillation nut studies and share what I have learned from treating tens of thousands of atrial fibrillation patients over the last 23 years.
The Swedish Atrial Fibrillation Nut Study
If you are a nut lover, like me, then you’ll love this most recent study. In this Swedish atrial fibrillation nut study, researchers followed 61,364 people for 17 years. After reviewing all of the data, they concluded that eating nuts decrease the risk of atrial fibrillation by 18%.
In order to get this 18% reduction in atrial fibrillation, the Swedes in this study had to eat nuts at least three times weekly for 17 years. Sadly, they didn’t ask what kind of nuts they ate. Thus, we have no idea if one nut is better than another for treating atrial fibrillation.
The most interesting part of this study was that the more nuts people ate, the less atrial fibrillation they had. Unfortunately, the researchers only analyzed the data out to eating nuts three times weekly. Based on the direction the graph was going, I suspect that daily nut eaters probably enjoyed even more atrial fibrillation protection.
While researchers did their best to make sense of the data, we can’t know for sure whether it was the nuts or the healthy habits of nut eaters that provided this protection. To better understand whether nuts prevent atrial fibrillation, we need to look to other studies.
Two Other Atrial Fibrillation Nut Studies
In addition to the Swedish atrial fibrillation nut study, there have been two other significant studies looking at nut eaters and atrial fibrillation. One of these studies showed that in male U.S. physicians, nuts offered no protection against atrial fibrillation. The other study showed that while nuts, as part of an ancestral Mediterranean diet were helpful, they didn’t specifically prevent atrial fibrillation when compared to olive oil.
4 Reasons Why Nuts Could Prevent Atrial Fibrillation
I want to believe the Swedish atrial fibrillation nut study. It only makes sense that nuts prevent atrial fibrillation. Below are four reasons why it is possible that nuts prevent atrial fibrillation.
1. Nuts Are High in Magnesium and Potassium
Having optimal magnesium and potassium levels may be protective against atrial fibrillation. As nuts are high in electrolytes, they could offer some protection. Also, all of the other vitamins and micronutrients of nuts make a compelling argument as to why they might help.
2. Nuts Help You to Lose Weight
Despite all of the fat in nuts, studies show that these healthy fats help you to lose weight. And as weight is so tightly linked to the risk of atrial fibrillation, it only makes sense that anything you can do to keep your weight in check would also help keep atrial fibrillation away.
3. Nuts Are Anti-Inflammatory
Our studies, as well as those from many other people, have shown that the higher your levels of inflammation, the greater your risk of atrial fibrillation. As nuts help to reduce inflammation, you would expect that this would help your heart to stay in rhythm.
4. Nuts May Prevent Almost All Forms of Heart Disease
Depending on which study you look at, nuts have been shown to be protective against almost every form of cardiovascular disease. Thus, given the incredible track record of nuts, you would expect that the same would be true for atrial fibrillation.
Nuts in My Atrial Fibrillation Practice
I wish I could tell you that all I have to do is prescribe a handful of almonds and atrial fibrillation goes away. If the most potent antiarrhythmic drugs only have a fifty-fifty chance of keeping people in rhythm for even just a year,
Is Left or Right Side Sleeping Best for Your Heart?
Is Left or Right Side Sleeping Best for Your Heart?
Most of my cardiac patients sleep better on their right side. Is right side sleeping best for your heart? In this article, I discuss the science of behind right versus left side sleeping.
Gravity and Left vs. Right Side Sleeping?
Gravity plays a role in where the heart goes during sleep. For example, if you sleep on your left side, then gravity will pull your heart toward your chest wall. In contrast, gravity pulls the heart toward the center of the chest with right side sleepers. This subtle change in where gravity pulls your heart may affect symptoms, cardiac output, or even your heart rate.
Why Back Sleeping is Probably Bad for the Heart
If you are carrying any extra weight, back sleeping is definitely bad for your heart. This is because when you sleep on your back, the extra weight collapses your airway (sleep apnea). And studies show that sleep apnea dramatically increases your risk of heart failure and atrial fibrillation.
Stomach sleeping is another possibility. However, as I have learned personally, stomach sleeping is a perfect recipe for neck and back issues.
4 Reasons to Sleep on Your Right Side
If you suffer from heart issues, talk with your doctor about whether you should sleep on your right or left side. Based on the science, here are four reasons why you may want to consider sleeping on the right.
1. Less Shortness of Breath
As far back as 1937 doctors have noted that heart patients breath better sleeping on their right side. Indeed, the worse the cardiac function, the more likely people are to sleep right side down. While the reason for this isn't entirely clear, it may have to do with a better venous return and lower pressures within the heart and lungs.
2. Better Cardiac Output
For the same reasons as number one above, cardiac output may be better with right side sleeping. Once again, gravity pulling the heart toward the center of the chest may optimize cardiac performance.
3. Fewer Palpitations
No one likes the sensation that their heart isn't beating correctly. As the heart is in the center of your chest with right-sided sleeping, studies show that palpitations become much less noticeable. In contrast, when you are on your left side, the heart is pulled to the chest wall, and you may feel every irregular beat of your heart.
While many atrial fibrillation patients have noted that they have fewer arrhythmias when sleeping on the right side, I could find no studies supporting this finding. Thus, when it comes to sleeping and arrhythmias, I suggest sleeping in whatever position that seems to help.
4. Lower Heart Rate and Less Sympathetic Nervous Activity
The sympathetic nervous system is the fight or flight response. This fight or flight response makes the heart rate and blood pressure go up.
For most of my patients, sympathetic nervous system stimulation makes their heart failure, chest pain, or arrhythmias worse. And when it comes to sleeping and sympathetic stimulation, studies show that right-sided sleeping may be better.
3 Reasons to Sleep on Your Left Side
Not everyone does best with right side sleeping. In fact, there are three distinct groups of people that may do worse.
1. Acid Reflux Sufferers
People suffering from acid reflux may sleep better on their left side. This is because studies show that acid reflux may be worse with right side sleeping. Thus, if your acid reflux is causing you more symptoms than your heart, you may want to consider sleeping on your left side.
2. Vagus Nerve Arrhythmias
The vagus nerve connects the heart, brain, and gut. Because of this connection, vagus nerve activation may be an important cause of arrhythmias.
With vagus nerve stimulation, you get increased parasympathetic activity which is the e...
Is Weekend Catch Up Sleep Healthy?
Is Weekend Catch Up Sleep Healthy?
Getting enough sleep during the workweek is hard. Wouldn't it be great if weekend catch up sleep could undo any damage from sleep deprivation? In this study, I review a new study that goes against decades of sleep research.
The Longevity Plan
Ma Xue, one of the centenarians we came to love and know during our time in China's Longevity Village, taught a timeless principle.
"My life is simple. Because of this, it is easy to know when something is out of balance."
Sadly, our modern lives are usually a rhythmic mess. Indeed, when I see new patients whose hearts are out of rhythm, it is usually because their lives are also out of rhythm. We’re generally not just out of rhythm in one way, but rather in multiple ways. And while we might be able to withstand a bit of disequilibrium in one part of our life, it’s hard to keep our balance when so many parts of our lives are so out of sync.
But starting quite simply, we can rebuild this balance piece by piece. And perhaps the best place is where almost all of us start each day, and where we end up each night.
Modern Life = Lack of Sleep?
Most of us wake up based on when we need to be somewhere, and from day to day that often changes. An early morning meeting can prompt a wake-up that is an hour or two earlier than usual. A late plane flight out of town can mean an extra few hours of slumber in the morning. And even if we keep a typical 9:00-to-5:00 workday, our five-days-on-two-days-off schedules promote sleeping timetables that are anything but routine.
Of course, very few of us are in a position to perfectly align our schedules to a sunrise-to-sunset existence. There are, however, things that almost all of us can do to bring a more consistent rhythm to our lives. And while we work to bring our lives and our sleep into balance, fortunately, a new study just came out that offers hope.
Weekend Catch Up Sleep Study
I was amazed to read about a recent study looking at sleep duration and longevity. After sifting through 13 years of records on 43,880 Swedes, they stumbled upon something that was rather interesting.
It should come as no surprise that these researchers found that those sleeping five or fewer hours each night increased their chances of dying early by 65%. However, if these same sleep-deprived people could catch up by sleeping longer on the weekend, then their survival was as if they slept seven hours each night. If this is true, it tells us that even if you have an incredibly demanding job, there is no longevity hit provided you can get some weekend catch up sleep.
I can't even begin to tell you how this study contradicts decades of previous research. And, quite frankly, I need to see some additional research to convince me that these findings are actually correct.
The Dangers of Acute Sleep Deprivation
To understand how bad sleep deprivation is for us, we have merely to look at the time of the year in which almost everyone is simultaneously thrown off kilter: when most folks across the United States “spring forward” an hour to accommodate for daylight saving time, effectively losing an hour of sleep. On the Monday following the spring daylight saving change, the incidence of heart attacks rises 24 percent, and the impact continues on Tuesday, when rates drop only slightly to 21 percent above the usual rate.
A lack of sleep impacts us right down to the genetic level, affecting the expression of more than 700 genes, which in turn dictate everything from our rates of metabolism, to the way our bodies deal with inflammation, to the antibodies created inside our cells to deal with infections or toxins. Pulling just one late-night work session or just staying up to watch a single TV show leads to the release of some of the same biomarkers that are increased with a co
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