There’s a consistent tragedy among heart surgery patients: they believed disease was inevitable.
Where lung cancer victims may express regret for smoking, and an alcoholic may wish they’d made different choices when they develop cirrhosis, patients with heart disease are often oblivious that their diet affects their heart health.
Some do make the connection and tell me they wish they’d eaten healthier and not let their weight get out of control, but these people are the exception. Overall, heart disease, obesity, diabetes and other chronic diseases are simply considered unavoidable and inevitable.
As a heart surgeon, it’s my job to keep people alive and give them another chance. And while it’s possible to live a long time after surgery, and to become healthier than before, it is always true that prevention is better than cure.
It hurts me to think that millions of people are walking around with the sincerely-held belief that they have no control over their health, resigned to spending time on my operating table. They not only hold this belief for themselves, they pass it on to their spouse, children, and friends.
And what really hurts me is to think that I was very close to having the same mindset.
Doctors don’t know nutrition
Doctors and medical practitioners are held in such high regard that people typically believe everything they say with regards to health. There’s good reason for this: we spend a long time studying to earn our qualifications, and it’s sensible to take the advice of an expert on their specialist topic.
But being an expert in one area doesn’t make someone an expert in all areas. There’s a misunderstanding between what people think doctors are taught, and what doctors are actually taught. One subject we learn almost nothing about is nutrition. A few hours of top-level information perhaps, where we hear the same things that the general public hears.
This creates a negative loop where everyone thinks they’re doing the right thing because everyone in your circle has the same opinion on eating, and your doctor validates it.
I struggled with obesity for most of my life, from childhood into adulthood. I was obese and pre-diabetic even as a practicing heart surgeon, operating on people to save them from obesity-related disease. I didn’t want to be obese, the simple truth is I didn’t know how not to be obese except for short periods after dieting.
I told my patients the same thing I told myself: eat low-fat foods and follow the food pyramid. Looking back, it’s no wonder I was obese!
Medical school had not taught me about metabolic health. My training as a heart surgeon informed me, repeatedly, that heart disease is about cholesterol – even though people on medications for cholesterol still develop heart disease.
My perspective changed at a Society of Thoracic Surgeons meeting, where there was a guest lecturer by the name of Gary Taubes. His talk on sugar shifted my worldview significantly, leading me on a path that led me to where I am today.
Without it, I may still be obese, caught in the endless cycle of losing weight and gaining it back again, and sharing the belief of my patients that heart disease is just inevitable.
The unspoken truth about heart disease
As I implemented Gary Taubes’ advice and eliminated sugar from my diet, I lost my excess weight – and kept it off.
Heart disease, like other areas of medicine, has minimal focus on prevention. In the 1980s and 1990s surgery, statins and stents became mainstream, so prevention was overlooked. Why prevent something that can be treated?
I have a different goal. I want to help people avoid the need for surgery and heart disease treatment entirely.
To do this, we need to acknowledge that what we eat influences our health. Seven of the top 10 causes of deaths in America are directly linked to poor metabolic health. Despite this, every day when I do my hospital rounds I see patients being served a breakfast of pancakes and orange juice – while also attached to insulin drips to manage high blood sugar.
The journey to better metabolic health is straightforward. Best of all, once a person focuses on improving it, weight loss happens all by itself. Getting started is as simple as a blood panel, with insulin levels, triglycerides and HDL levels checked.
If you don’t have any symptoms of heart disease yet, great! That’s an excellent time to check your metabolic health. Insulin resistance starts to appear probably a decade before atherosclerotic disease.
By taking these small steps, you put your health in your own hands and drastically reduce your risk of experiencing heart disease.