You Are What You Eat

Long before I suffered a heart attack I had been thinking a lot about food and its relationship to health. I had good reason to learn more about food as my cholesterol, triglycerides and blood sugar were elevated due to a combination of genetics, inconsistent activity levels and an undying love of pizza. So I started doing research on how to naturally lower these signs of impending crisis and each time the path led back to the same place — food.

Flash forward to last night and here I am again watching a documentary about food and health, this time at a special screening of Fat, Sick and Nearly Dead at a local restaurant called Pomegranate Cafe. And just like all the others, the premise involves eating fruits and veggies. Hmm. Maybe it’s true that 50 million Elvis fans can’t be wrong.

Here are just some of the films I’ve seen and books I’ve read over the past few years that preach the gospel of healthy eating:

I’m sure you can find tons more, but these are some of the popular ones. The thing is, so much research (both scientific and anecdotal) points to the plain fact that food can make us sick and conversely food can heal. You don’t have to believe it, or even care, but that doesn’t make it not true. What would it take for you to change the way you eat?

What of you had a heart attack? Would you change the way you eat, or would you continue the unhealthy lifestyle that made you susceptible to heart disease in the first place? It’s not an easy answer. In the months since my heart attack I have run into all types of survivors — those who don’t change because they either don’t care about living or they think it’s too hard to those, like me, who are willing to make a radical change in hopes of not only living longer but being healthy enough to enjoy that longevity. For me it’s a no brainer, but I understand the other side.

Changing my diet was really hard at first, and not just because I missed regularly having a couple of slices at NYPD Pizza. The hardest part has been eating at restaurants. I’ll tell you what’s not hard — eliminating most animal products. I have been mostly vegetarian for years (I continue to enjoy seafood) and truthfully I don’t miss the meat. Yes, every once in a while I dream about a Double Double, but it passes and those cravings happen less and less. I’m even thinking being vegan or raw wouldn’t be too hard since I’m almost there already. Limiting fat and cholesterol is simple, especially if you eat mostly vegetarian anyway.

Unfortunately for me, my heart was damaged by my heart attack and if I want to take care of it — permanently — I need to severely limit sodium. This has been the hardest thing for me, and not because I crave the taste. It’s hard because sodium is everywhere and often in places you least expect it. I won’t go into detail on why sodium is so bad for heart patients, but suffice it to say sodium makes you retain water and retaining water makes your heart pump harder. When your heart pumps harder, it will naturally enlarge and that would exacerbate my damage and inevitably lead to heart failure. How much sodium are we supposed to eat? The recommended daily allowance for a healthy person is 2500 mg. For someone like me, I need to stay under 1500 mg. I am currently eating between 1000-1500 mg per day. To give you an idea of what that means, a single teaspoon of table salt? There is around 2500 mg in a teaspoon of salt. A typical slice of pizza? 700 mg. How about a “healthy” meal at a “healthy” restaurant? A small Greek salad at Pita Jungle has 940 mg of sodium.

So you can see eating at restaurants is a challenge for me. But it’s worth the hassle given my condition. If you don’t have a heart condition, changing your diet is a breeze. But even keeping to the RDA is tough for a healthy person. A single portion of lasagna classico at Olive Garden contains 2830 mg of sodium. Holy salt lick Batman!

Why wouldn’t you change your diet? It’s so easy and the evidence is so clear. I know, you love a good steak. Enjoy, but why not consider making small steps in the right direction? Michael Pollen says it best. When asked how to dig through all the hype and misinformation he says, simply:

Eat food. Not too much. Mostly plants. 

In case you’re confused, by suggesting we “eat food” he’s basically saying to eliminate anything processed, chemical, manufactured, toxic, etc. Broccoli is food.  Methylchloroisothiazolinone is not.

Heart Attack? That Was So Six Months Ago

Today is the six-month anniversary of my heart attack. Milestones seem like a good time to reflect a little, so here are some random thoughts:

  • Thinking back to the early days of my recovery, it feels like I have traveled a “life marathon” since then. So much has happened, both physically and emotionally. Truth is the emotional has been more difficult.
  • Health wise I have made tremendous progress. Without getting too technical, my ejection fraction has gone from “about 30-35” in the days following my heart attack to “about 45” six months later. This measurement means my heart is working much more efficiently than it was at the time of my M.I. and is now pretty close to the normal range of “50-75.” My cholesterol is way down (much lower than yours I bet!) thanks to diet and medication. I have had no medical issues since my heart attack and in fact I’m probably stronger now than I was prior to the attack thanks to stronger blood flow through the three stents in my left anterior descending (LAD) artery. In other words, I feel great physically.
  • I am exercising without any issues 5-6 times per week.
  • The mental rehabilitation has been more complicated. Most days I feel great. Happy to be alive and feeling like I have the whole world in front of me. Some days I freak out that I had a heart attack and worry that I’m going to drop dead at any moment even though that is extremely unlikely. My cardiologist said he had a higher chance of having a heart than I do now. Still, it’s hard not to think about how close I came to death and how scary it would be to leave my family behind.
  • Some days I wake up feeling anxious even though there may be no apparent reason for the anxiety. It’s a nasty thing anxiety. If you’ve ever struggled with it you know it can manifest itself in physical ways including chest tightness, the inability to concentrate and even heart racing or palpitations. The anxiety comes less often now but it can strike at any time. If I seem short with you one day maybe I’m having one of those days. 😉
  • Some of my friends and co-workers seem to be worried that I have to avoid stress or I’m going to have another heart attack. To them I say thank you for your concern, but stress didn’t cause my heart attack and stress is not a big issue for me these days. Like everyone I have some days that are more stressful than others, but don’t baby me — I’m not going to drop dead from stress.
  • The biggest (and in some ways only significant) change in my life has been food. If you believe as I do that food can kill you and food can heal you then it seems like an obvious thing — eat well and you’ll be well. But it’s not that easy. There are three things I have to look out for — saturated fat, cholesterol and the biggest one, sodium. Lowering fat and cholesterol is really quite simple. I stay away from red meat and fatty foods. Simple. Sodium on the other hand is a bitch. Why is sodium so important? Well, sodium makes you retain water and that forces your heart to work harder and your blood pressure increases. You don’t want that, as a heart patient or as a normal person. It’s one of the biggest reasons why heart disease is the number one killer of men and women in America. The average American gets as much as 10 times the daily recommended allowance of 2,500 mg per day. As a heart patient, I’m supposed to keep my intake to around 1,200-1,500 mg per day. It’s not so much the added salt that troubles me (I don’t use any), but it’s the sodium in foods that you may not know about. Cooking at home makes things easier, but eating out is no fun. Do yourself a favor (and I won’t preach anymore) and check out the nutritional charts online for some of your favorite restaurants. It will scare the shit out of you. Before my heart attack one of my favorite places to eat was Rubios, where I’d typically have a shrimp burrito. The burrito has 2,200 mg of sodium, nearly double my daily allowance. Nowadays I still go to Rubios but I have the salmon or mahi mahi tacos on corn tortillas (190 mg of sodium per taco).
  • Eating out has become a social occasion for me rather than an eating event. For instance, tonight I am going to a concert with friends and we’re meeting beforehand for a meal. I checked out the online menu of the place we’re going and there’s really nothing I can eat, mostly because they don’t list their nutritional values on their site. I’m going to eat something at home beforehand and enjoy my time with my friends over a beer. This is, as my lovely wife likes to say, my new normal. I nearly lost my life because of food and I’m not about to give it a second chance to kill me. Most people who have heart attacks have more than one — I am never going to have another one because I am willing to sacrifice being a foodie for being alive. Yes, it’s a tough sacrifice, but I feel like I don’t have a choice. Not everyone who has suffered a heart attack makes this choice (some don’t even stop smoking), but I have too much to live for to let a little thing like food stop me from enjoying my life. I will miss you NYPD pizza and Rubios shrimp burritos…have fun killing someone else!
  • Lately I have thought about becoming a vegan. It is clear to me that a vegan diet is healthier for humans, and the research I’ve seen (including the film Forks Over Knives) makes a pretty compelling case. I was a pescaterian prior to my heart attack, meaning the only meat I ate was fish, but I ate a crap load of dairy and dairy is loaded with bad fat. From the way I’m eating now it’s not a stretch to get to veganism. Maybe if I make the decision it will take some of the stress away from worrying about meal preparation and eating out. It would certainly simplify it. I’m willing to listen to my vegan friends out there. Sell me.
  • I need a hobby. I love to read and watch films, but I need something more active. Any suggestions? Golf is fun but it’s expensive and it’s about to get hot in Phoenix. I’d love to go fishing if anyone out there enjoys it and wants to bring me along. I have a rod. Bowling maybe? At least it’s indoors which is a bonus here in Phoenix. I don’t really have an active hobby and frankly I’m a little bored in the evenings and on weekends. I certainly don’t want to work more!
  • I have been trying to be more active with my volunteering. I’ve always volunteered and done pro bono work, but these days it’s calling me. I’ve started to do some work with the Heart Association, helping them with PR and social media. I’m also looking into ways to be more involved with what my company has to offer in terms of corporate social responsibility. Apollo Group does a nice job in the community and I’ve already reached out to some folks in our external affairs department for ideas. I’m looking for something more in-depth than just doling out food or cleaning up trails — I’m thinking board level or committee chair. Send me your ideas. When I have been an active volunteer in the past it has come with many rewards.
  • I’m going to do more travelling with Leslie and Connor. I lost all of my vacation and sick time when I was on disability, so we haven’t done much travelling in the past six months. We did spend a wonderful weekend in Coronado at New Years and we’re planning something small for Memorial Day weekend. In July we’re going to go to Chicago to meet family and see some sites, and then after my vacation gets refreshed in August I think we’re going to plan something special for fall break. We’d also like to do something spectacular next summer — perhaps Europe. Having future things to look forward to makes life worth living.

Well, that’s about it for now. Consider this my therapy blog post! Six months post heart attack and frankly I think I’m doing great. People tell me I look great, which makes me wonder how I looked before October 15, 2011. I have lost about 20 pounds as a result of my healthy diet and I am exercising a ton so maybe I do look good! Oh, and methinks the goatee has outlived its usefulness so I think it’s coming off today to mark the anniversary. Hearing Josh Brolin make fun of goatees as “so 90s” last night on SNL was the clincher.

Thanks for reading.