Welcome to Dr. Warrick's podcast channel. Warrick is a practicing cardiologist and author with a passion for improving care by helping patients understand their heart health through education. Warrick believes educated patients get the best health care. Discover and understand the latest approaches and technology in heart care and how this might apply to you or someone you love. Hi, my name is Dr. Warrick Bishop and I'd like to welcome you to my podcast and videocast station and of course to the Healthy Heart Network. What I'd really like to touch on today is some of the confusion that seems to fall around what is healthy eating and what should I eat. I get this all the time, there are mixed messages. in the media all the time. Sometimes eggs are good, sometimes eggs are bad. If you were listening to the radio just recently, you will have heard that the Heart Foundation have moved their position a little bit on eggs and dairy. They're recommending we reduce meat and they're recommending fruit, vegetables and grains. So what is the best diet? Well what I would like to do is encourage you to think of it in a slightly different way. One of the things that frustrates me as we listen to information coming through the media is that that information is often directed at trying to find what the best diet is. And what I'd like to put to you is that perhaps we should be thinking about that slightly differently. Perhaps we should be thinking, instead of what's the best diet and trying to find something that suits absolutely everyone, maybe we should be trying to think what's the specific sort of diet that an individual requires given their particular situation. So let me elaborate on that a bit more. If we were to try... and figure out what is the very best diet then I would say well would that be the very best diet for a child who's three or four years of age or a baby who's three or four months of age or a man who's 30 or 40 years of age and has a physical job or a man who's 30 or 40 years of age and has a sedentary job or a man who's 80 or 90 years of age and is frail. Or a man who's 50 or 60 and pre-diabetic. Or a man who's 70 and has coronary artery disease and diabetes. Or a man who's 25 and runs marathons. Do you get what I'm getting at? What I think distresses me the most about the conversation around eating guidelines is that we miss... the importance of trying to understand the eating objectives an individual has, and we try and figure out what must be the very best diet for everyone to take. And really, I think, when you think about it, that just doesn't make sense. There is no question that we can apply some principles to the way we eat, and those principles may be generalised. But I think... It's really important to start to understand that when we're talking about eating guidelines, I believe we need to try and make that personal for the individual patient based on what their dietary objectives are. So, for example, a couple of years ago, I was wanting to put on some muscle bulk. I was deliberately wanting to put on muscle bulk so I could be stronger surfing. and stronger paddling. To do that, I was eating like a horse, and I was eating an awful lot of protein to do that. The upshot was that in combination with appropriate exercise that I'd planned out, I was able to bulk up a bit. It wasn't quite as attractive as I might have thought it might have been, but nonetheless, I bulked up a bit, I was stronger, and I did in fact achieve a dietary objective. These days, my dietary objective, as someone who's in their early to mid-50s, is to maintain my weight in context of the degree of exercise I do. I also want to maintain health, and I want to make sure I'm consuming a broad range of foods with good nutrients. So I eat nuts, I use olive oil, I enjoy a lot of leafy greens. I don't tend to eat starchy vegetables, and I don't tend to eat a lot of fruit, mainly because of the sugar in fruit. So for me, I've been able to find an eating habit that works, but I do at times have patients who have specific needs, people who may have coronary artery disease, and we want to bring their cholesterol levels down. Well, selecting the fats they eat and being judicious about that in combination with their medication works. We know that. But we also know from some of our studies, like the PredMed study, that a Mediterranean diet, which is rich in leafy greens, rich in olive oil, and rich in an assortment of nuts, together with fish proteins, can lower coronary events without necessarily seeing any lowering in the cholesterol levels. So we can see improvement in outcome in that sort of Mediterranean-style diet, in secondary prevention studies, in situations where the cholesterol is not really changing. So the diet of its own is doing something that seems to be beneficial. So I think that's worth knowing. We know that the Heart Foundation recently came out and mentioned that full fat milk, full fat yogurt and cheese could now be added back onto the list. And I have to say that's good for me because that's what I tend to use myself. My feeling is if you're taking fat out of something, then you're either going to put protein or sugar back into it because there's only three macronutrients that we tend to think about. If we're going to take our fat out... then what's cheaper for the manufacturer to put in either protein or sugar? You guessed it, sugar's cheaper and often it sells more. So if you pick up the low-fat alternatives on many food products compared to the standard product, you'll actually see that the sugar content is much higher. And I don't actually think that that's a good thing or that extra sugar is going to be beneficial. really in the longer term for that individual. I don't think it necessarily makes it a healthy food, to be honest. There was in the Heart Foundation statement fairly recently a suggestion that we should cut down a little bit on red meat. But how confusing is this? Because just in the last couple of days, there's also been media coverage of an increased rate of depression. in women who don't eat enough red meat. Go figure. I'm afraid I really don't know the answer for that at the moment. My own personal habit is to try and keep the sugars down, including too much complex carbohydrate, because I think complex things like pasta, rice... Even grainy breads break down fairly quickly if you eat too much of them, or at least break down into large amounts of sugar if you eat too much of them. If that's the case, then you're still getting a load of sugar, which could well be detrimental. My own practice is to reduce carbohydrate where I can, particularly simple sugars to a degree complex carbs. I tend to eat healthy oils, particularly olive oil. I tend to enjoy nuts at least once a day. I'm very careful about plenty of greens. We cook up beans. We cook up salad most nights, often onions. Fermented food, if I can, we have sauerkraut from time to time. I think that adds extra variance. We try to get a broad range of different vegetables so that we're getting different nutrients from different sources. And personally, I tend to eat a fair bit of meat. That's what I tend to do, and I've been able to maintain weight, maintain blood, lipid profiles, etc. I think what I want to get to you is that the principles of keeping the sugars down, plenty of greens, healthy fats, including olive oil, an array of nuts as snacks makes a lot of sense, lots of good healthy meat, grass-fed beef we talk about because of the... fat composition, which comes about from grass-fed beef as opposed to grain-fed beef, and looking at really making sure that these sensible eating guides fit in with your dietary objective. Great reason for you to lock in with someone who can give you some advice, a dietician who may be able to guide you to your personal objectives. So eating, often complicated. There is often small tidbits that come out in the press, things like sort of headlines like blueberries are good or eggs are bad or bacon will kill you or I think you know what I mean, these snapshots, these sound bites that get amplified in the media and we try to then modify our world about it, but it doesn't make sense. Because you can't imagine that if, for example, and I'll take a silly example, if we take, for example, blueberries are good. I have no issue with people eating blueberries, but it's very hard to imagine that you could eat a punnet of blueberries. Those blueberries would be macerated through the process of chewing, swallowed, and then dissolved or broken down in the acid of your stomach. Sure, they've got... acithidins and various other colours and phenols and so forth within them. But then that all needs to be broken down, absorbed through the intestine too, the smallest possible particles to allow that absorption, then passes through the liver. Assuming some of it gets through the liver because the liver does extract a fair bit of nutrient, then those nutrients then have to pass through the venous system back to the heart. through the lungs, into the arterial system, and then whatever blueberry is left in the arterial tree then has to go to whatever part of the body you're thinking it's going to be helpful for. And we're hoping in some of the stuff that we read that that punnet of blueberries that we've just eaten half a handful of or a whole handful of will miraculously lead to decreased inflammation within a plaque that's one centimetre long in one or two of our arteries that we may or may not have scanned or we may or may not know about. It's more complicated than a single nutrient or food group. It's got to be. So let's focus on the principles. Let's be sensible about our eating. Let's be clear about our eating objectives. Let's remember that things like exercise are really important to support that. And if people do want to do what they can, I'm really happy that people try and embrace sensible eating guidelines. make sure you do some exercise, but also remember things like yoga. It's clearly been demonstrated in trials to improve outcomes. Depression increases your risk of coronary disease. So eat well, exercise, do yoga, be happy, and go and see your doctor for a checkup. Make sure your blood pressure's good. Think about getting a scan on your heart and see how you go. I'm going to wrap up on eating there, but I really, want to get those messages across that we've got to be really careful about getting too precious, about specifics which are being applied generally, but we do need to understand we need to think about our own situation and what our dietary objectives are. Well, I'm going to wrap up the food discussion there. I hope you found that interesting, actually. If you have any queries or questions, let me know. As always, I wish you the very best and until next time, please don't die from a heart attack. Goodbye. You have been listening to another podcast from Dr. Warrick. Visit his website at drWarrickbishop.com for the latest news on heart disease. If you love this podcast, feel free to leave us a review.
