Why Didn’t My Husband’s Cardiologist Mention a Change in Diet?

Dr. Oz and I embrace diet as important in preventing and even reversing coronary artery disease. So, this question from the wife of a 48-year-old guy from Chicago didn’t surprise us.  It’s a long question, so bear with me:

“Dear Docs, I read your column in the Chicago Sun Times regularly and you speak to the importance of diet in preventing and reversing heart disease. And Dr. Oz speaks of those good dietary choices, enjoying whole grains, nuts, fruits and veggies, and avoiding simple sugars and saturated and trans fats, as in red and processed meats, frequently on his show.

“So when my 48-year-old hubby … had a heart attack and cardiac surgery at one of Chicago’s leading institutions … I was surprised he did not suggest my husband change his processed meat- and simple carb-laden diet. I’ve had no success, and we have two kids about to get into high school, so they need their dad – so do I). I was even more surprised when the cardiologist, after I asked, said, ‘Sure he can have red meat – he’s on optimal medical therapy. He’ll get and keep optimal cholesterol levels with that statin and aspirin, and had a bypass. Diet’s overrated. Don’t believe what you see on TV or read in the Sun Times.’

“So my question to you docs: Is the data really good that diet matters even in the face of statins, or does diet not matter if he’s on a statin and gets optimal cholesterol levels, and if not, why would he say that?”

The data are very solid that diet (and other lifestyle choices like physical activity, as in cardiac rehab), stress management, even flu shots (they decrease inflammation), and avoiding tobacco (even secondhand smoke) add to optimal drug management to decrease heart attack and cardiac death rates after a first heart attack.

A recent international study indicated that individuals (more than 31,000 men and women of an average age of 66 in this study) who chose whole grains, fruits, veggies, nuts, and fish over meat, eggs and simple carbs had a 35% reduction in cardiac death rates over 5 years.

That’s a 35% reduction in addition to the decrease from surgery and optimal medical management. And these men and women were older, where you’d expect diet to be able to reverse less.

So, I agree with you – that cardiologist seems out of touch with the science (refer him to the December 42012 issue of Circulation if you see him again).

As to why he would say that, well as a cardiologist friend, Dr. Stephen Devries in Chicago (not the same cardiologist I am sure), tells us while every cardiologist must be trained in many things to get certified by the subspecialty cardiology board, they have no requirement for nutrition or diet education. NONE! Dr. Devries adds that probably most cardiologists do not know what a “healthy diet for the heart is,” and can’t or feel uncomfortable giving advice on diet or nutrition.

Shame. “They learn what is reimbursed,” he says, “and insurance companies and Medicare reimburse them putting in stents and even managing statins, but do not require a cardiologist to know anything about diet or nutrition.”

By the way, you can also write the American College of Cardiology, too, and suggest they ought to require at least one hour of nutrition education before a cardiologist can be “Board Certified” – we’d be glad to provide it, free. So would cardiologist Dr. Devries.

-Young Dr. Mike, The Enforcer