Getting Out of Hot Water: Preventing Heart Attacks

Certain genes have been associated with an increased risk of strokes and heart attacks. Researchers have studied whether people with some of these genes can lower their risk of cardiovascular disease (CVD) with dietary changes. They can.

A study from McGill University, published in 2011 in PLoS (Public Library of Science) — Medicine, examined heart attack rates in 8000 people who carried a gene called 9p21. Four thousand of the research participants were fed large amounts of fresh produce, while the other half ate the standard Western diet.

Researchers found that those individuals who ate a diet high in raw fruits and vegetables decreased their risk of cardiovascular disease by 50 percent. They reported hopefully that “…the deleterious effect of 9p21…might be mitigated by consuming a diet rich in fresh fruits and vegetables.”

A diet rich in fresh produce probably has not one, but two benefits: Firstly, you obviously eat more fruits and vegetables, but secondly, and equally important, is that replacing manufactured items with produce also likely reduces the volume of ultraprocessed items consumed.

I would have written a slightly different conclusion: I would say that whereas the Western diet is deleterious, its effect happens to be greater in certain individuals with particular genetic makeups. A diet rich in fresh fruits, vegetables, and legumes likely reduces the risk of heart attack across the population, but the benefit may be more dramatic in individuals who carry certain particular genes.

Let us consider the well known metaphor of frogs in hot water. High temperatures will be deadly, but not all frogs will succumb immediately. Those that are most sensitive will be the first to go. Let’s run that experiment here:

Begin with a large pot of cool water, and frogs from all over the world. Then move the pot to a fire. As the water temperature begins to rise, a few frogs will begin to struggle immediately. As the temperature rises further, more and more will die until, finally, none remain alive. What can we learn from this?

  • You could run the experiment a few times and learn to predict the effects at each temperature. 
  • You could do a chromosomal analysis of frog DNA to look for commonalities among the frogs with greater sensitivity to rising temperatures. 
  • You could conclude that frogs with the identified chromosomes could be protected by avoiding high heat. Or, 
  • You might recognize that high temperatures constitute an abnormal, unusual, and externally administered environmental stress, and that while some frogs appear more tolerant than others, high temperatures are ultimately lethal to them all.

If I were to generate a diagnosis for this phenomenon, I might call it dyscalorimetry. But dyscalorimetry doesn’t mean that heat intolerance is genetic. It means that hot water is deadly. 

In the same way, we can continue to improve our ability to identify those individuals at highest risk of intolerance to the Western diet, put them on cholesterol-lowering medication, order nutrition consults, and schedule more stress tests. Or we could markedly increase government stipends for produce. 

 


The Neighborhood, Its Trees, and a Recent Potluck (with Recipe)

I live on a cul-de-sac with a special group of neighbors. I’ve heard it said that ours was the first residential street in the village; attempts to maintain its character have continued for 70 years. Many homes—though not ours—are identifiable by the local stone used to build their original facades. The Neighborhood Lane Association that was formed shortly after people began moving in continues to this day. We have seen members of the last generation grow up, and then return to raise a generation of their own.  Continue reading


Stripped Carbohydrates: A Primer

Generally speaking, and with the exception of milk and honey, the carbohydrate in nature virtually always comes with fiber attached. Whether from orchards, meadows, gardens, or forests, and whether as roots, leaves, stems, or fruits, intact—or whole—carbohydrates belong to four major categories (fruits, vegetables, beans, and grains), all of which are rich in fiber as well as phytonutrients, the source of their often vibrant colors. Continue reading



Nourishing Fats for Healthy People

Today I’m talking about the word “fat,” and the term “healthy fats.” Fats are one of the three macronutrients: protein, fat, and carbohydrate.

A brief aside about carbs: The term carbohydrates included in the list of macronutrients refers to carbohydrate that comes from a plant that grows in the soil. Whether leaf or fruit or root or stem, this kind of carbohydrate is always, always rich in fiber and phytonutrients. Except for milk and honey, carbohydrate doesn’t really exist in nature without the fiber. Continue reading


Scoop at the Coop Returns!

About 15 years ago we built a small chicken coop in the backyard, and our first three hens, Hamburgs, were delivered to Cleveland soon after, all the way from my parents’ New Jersey farm. They were followed by a couple of Golden Buffs from a nearby farm in Middlefield, Ohio. 

We enjoyed our hens, their antics, and their eggs, and I told many stories in this blog about them in posts identified with the title “Scoop at the Coop.” After a few years, we expanded the coop to include an area with an overhang plus two long pens. With room for a few more hens, we (and friends) enjoyed an endless supply of gorgeous eggs. Continue reading


Nourishing Yourself With Joy

Joy has been in the news lately, and that’s what I want to talk about today. 

Eating is meant to be a source of joy, as satisfying as the sunrise. Like listening to music. Talking with friends, or sitting together on a bench at the park. The wind at your back. Trading backrubs. Dancing. Stretching. A hot shower. A book that transports you to the other side of the universe. Walking along the shore. 

Eating is deeply satisfying. It speaks to your soul. Eating is sour, sweet, bitter, spicy, umami. Crunchy, soft, toothy, smooth, sticky. Beautiful, colorful, warm, cool, icy, bubbly. Expressive, imaginative. Fun, chaotic, quiet, or peaceful. Continue reading


There Is So Much You Can Do To Make It Better

Sometimes I think this blog should have a category called “It’s worse than you think” or “I’m really not exaggerating,” or maybe just “More scary news.” Sometimes I even get the feeling that people think I may be overstating the urgency of the diabetes epidemic. So I gathered together a few statistics for you. Continue reading


Giving Your Body the Help it Needs

Some years ago, when my patient, Mrs. Price, heard me say that her blood sugar measurement had come back from the lab at 204, a single tear ran down her cheek as she said,  “My eldest granddaughter is getting married next year.” A blood sugar measurement over 200 is one way to confirm a diagnosis of diabetes. Both of Mrs. Price’s parents had died in their 60’s from complications of uncontrolled diabetes, or chronically elevated high blood sugars. This is what I told her. Continue reading


Learning to Keep Your Blood Sugars Normal

As a doctor, it’s easy enough for me to think I understand a disease state, and then to know how to manage it with medication to be taken two or three times daily. I spent hours and hours studying that problem. I talked with patients who were diagnosed with that illness, and learned how it changed their lives. But it’s still not the same as having someone close to you diagnosed with it. Continue reading