As many followers of 3DMJ know, I was diagnosed with a moderate / mild case of coronary arteriosclerosis (plaque) in one of the main branches of my heart. To be specific, the branch called the left anterior descending artery. The coronary artery disease, CAD, was diagnosed on a Cat Scan in December 2018. I had many questions that arose from my diagnosis. How did I get it? How long has it been there? What do I do about it? How do I treat it? This blog is my explanation of all that I have learned and adopted to treat it and hopefully fight off any looming heart attack and early death.
Before I get into the actual diagnosis of the CAD it is important context to divulge that I had a complete cardiac workup only a year earlier. I was experiencing arrhythmias that was cause for concern. Full blood panel, chest X-ray, EKG, Stress EKG, 48-hour halter monitor, and an echocardiogram. Luckily, I was still employed as a CT Technologist at the time because I’m sure the bill was 10’s of thousands of dollars. In any case, while I had arrhythmias, they went away when my heart was above 100 bpm during both the 48-hour Holter monitor and Stress EKG. Essentially the entire workup showed that I had “superior cardiac function” with occasional junctional beats at rest.
One year later the radiologist that diagnosed the CAD on my Cat Scan had this to say: “You have a fair amount of plaque in your left anterior descending artery. It is not in the bifurcation (where it splits), so you are lucky there. You don’t have to go rushing into the Emergency Room, but you had better keep an eye on that.” At the time, it did not concern me. I figured I probably had better get some more cardiovascular exercise and maybe start watching my cholesterol intake. But I didn’t think much of it, considering I had “superior cardiac function.” I also realized that the amount of plaque I had took years to accumulate. So, it had to be present at the time of that workup, and I was not going to overhaul my entire life, or so I thought.
It was January 16th, 2019, my son’s 16th birthday. We went out to eat at our local Mexican Food restaurant. I had not eaten all day so I could let loose a little and really enjoy as much of the authentic Mexican food this place had to offer. Chips and salsa, horchata, a large California Burrito (this thing has French fries in it, so maybe not completely authentic) with Carne Asada. All topped off with Birthday cake and ice-cream. My fullness was a level 10 of 10. An hour or so later, I experienced what I thought was a mild case of indigestion. I say that because I have never really had indigestion and would still say I do not really know what it feels like. I can only describe what I felt as pressure on the right side of my chest just above my rib cage anteriorly. If you place a couple of fingers or your thumb and press against your chest hard, this is similar to what I felt. Like I said, at the time I was thinking it was indigestion, but later that night my health care provider brain started to kick in and made me think this might be angina (chest pain caused by reduced blood flow to the heart). Considering this experience, and my previous diagnosis of arterial plaque, I decided I needed to be more proactive.
Being the good evidence-based practitioner that I am, I started researching how to treat CAD with diet. My early findings pointed to a predominantly plant based diet. I dove in. I eliminated all meat, dairy and eggs from my diet and followed that for a good month. Eric provided me with some good information and more research to dive into and I soon tweaked my plan. I learned the 3 most important micronutrients that I had to pay attention to was saturated fat, fiber, and to a certain extent cholesterol. I started, and continue, to eat oatmeal pretty much every day. I get my 5 to 9 servings of raw fruits and vegetables every day, with a large portion from leafy greens rich in nitrogen. Legumes of some sort became a staple nearly every day. Over time I began being more inclusive of fish, small amounts of low-fat dairy and more recently, nuts. On the exceedingly rare occasion, I will have eggs, meat, or a small amount of high fat dessert. I was fairly exclusive when I started nearly a year ago, but the plan has slowly evolved since then to what I just described.
I am a hardline in the sand commitment type of person, so once I make my mind up to do something, I am on it. Now a year later, I am still executing. I track my saturated fat in my head every day keeping it to 25 +/- 5g. My only dairy is fat free coffee creamer and the occasional tablespoon of fat free Greek yogurt on my Vegetarian and Seafood Burritos. To me it tastes like sour cream. I limit eggs or meat or a treat to once every 2 or 3 months. About a month ago I bit the bullet and reassessed where I was at and had an official consultation with an old friend of mine who is a Cardiologist. We did a full panel of blood work (again) which showed that even with my high quality, cardiac friendly diet, my LDL (Low Density Lipo-protein) was still mildly elevated at 135mg/dl when the upper limit should be 100mg/dl. Considering my already significant dietary changes, there was no realistic way I could get my LDL (the primary contributor to CAD) any lower with dietary changes alone. This elevated level was something genetic in my family, so a cholesterol lowering medication was the option I took to get my LDL down to no higher than 70mg/dl. I will have to report back later once I re-check my LDL in March, but I have been on this medication now for about 2 months. Hopefully my LDL is lower, but I’ll also do a Stress Echocardiogram which is essentially an Ultrasound of my heart while I am running on a treadmill to assess the blood flow and function of the actual heart muscle. Stay tuned.
Now that I have been following this largely Pescatarian diet, I want to take the time to pass along my observations. This will reveal whether I belong on the sequel of the vegetarian documentary “The Game Changers.” Am I busting PRs left and right or back to running 6-minute miles? Unfortunately, nothing so exciting; however, I have had just a couple of other notable changes. I am never hungry. I honestly must make myself eat. I typically skip breakfast, and usually eat 1 big meal mid-day to a fullness level of 8 (what I describe as a slight food baby), using some sort of a combination of the foods I described above. Honestly, that one meal could probably suite me fine. However, I can usually only get 45 to 85g of protein with that meal which is obviously not enough for a 200lb man who trains with weights. Therefore, I often have a dinner that consists of a protein shake mixed with juiced fruits and vegetables so I can get at least another 45 to 80g of protein. However, on the rare occasion I’m hungry come nighttime, a small bowl of oatmeal with powdered peanut butter, whey, and a handful of nuts suits me fine. Either way, I am not hungry again until mid-day the following day.
Remember that feeling of pressure on the right side of my chest I experienced the day of my son’s 16thbirthday? I have never had the severity of that feeling since. However, there were times when I would get just a hint of that feeling before I made the big change to my diet. Now, that feeling has all but gone away. I usually only feel it when I haven’t been tracking my saturated fat and eat foods a I don’t normally eat for several days. To be honest, I don’t even know what that feeling is, or if it’s relevant. But I told my cardiologist about it and he was not concerned, especially since I never get that feeling while training (which occasionally gets my heart rate close to 200 bpm).
Another interesting benefit of my dietary change is how it affected my headaches. I have always suffered from frequent migraine headaches. Nitrates and artificial meats like salami, pepperoni and bologna always brought them on. I avoided those like the plague, but still for years, once a month, I would be out of commission for a day due to a migraine headache. Milder versions usually hit once per week. I had a “magic remedy” for treating them: 800mg of ibuprofen, 500mg of Tylenol, and a hot shower with the hottest water I could stand beating right on top of my head until I ran out of hot water. It did the trick 90% of the time. However, I have only had to do this process 2 or 3 times over the last year. The severe headaches that would put me down for a day have all but been eliminated. I have no explanation for this, but it is the most notable positive effect I can relay, even though I wish it was breaking PRs left and right.
Importantly, I’m not a doctor, and this isn’t medical advice. While I think what I’m doing as a dietary treatment is working, I’m sure it’s not the end all and be all. In fact, it may change again once I get my next blood panel and stress echocardiogram. However, I feel like I have done my due diligence when it comes to choosing my approach. Most importantly, I am executing it every day. This gives me confidence that I will be around for a good number of decades throwing around the iron and helping others doing the same.