Wednesday, January 15, 2014

Your Favorite Restaurant Could Be Killing You

I'm one of the last people on Earth you'd be concerned about when it comes to eating right. Since my early twenties, I've made a point of maintaining a well-rounded diet, reminiscent of the food pyramid chart on the wall of my classroom in third grade. Meat, dairy, vegetables, fruit—everything in moderation, nothing to excess. As an adult, I've become a fan of culinary prowess, seeking out restaurants that push the creativity envelope as a matter of pride. I love the way today's young chefs connect with local farmers, bringing a new level of freshness to the dinner table. So, you can imagine my surprise when I discovered a few years ago that my love affair with fine food could be killing me.

I've always thought of myself as having good genes. I come from good stock. Neither of my parents smoked, and neither of them were notably overweight. While most of my friends spend their adult lives trying to lose weight, I've spent most of mine trying to gain it. Sounds perfect, doesn't it?

Some years ago, when I turned forty-five, I had a gym installed. The goal was to sharpen my mind, as well as my body. I hadn't had regular aerobic exercise in years. It took a while to regain my stamina, but once I did, it felt great. I settled into a three-times-a-week routine.

I received some good advice on working out properly, always starting with some stretching and a half-hour of treadmill time, the goal being to get my heart rate up to 80% of its theoretical maximum and keep it there for at least twenty minutes. Only then would I start lifting weights.

I kept this routine going without interruption for ten years. My appetite increased, and I continued to enjoy fine restaurant food whenever I could. When my knees began complaining about the treadmill, I switched to a Concept II rowing machine. The rowing machine made it possible to push my heart rate up more efficiently. I looked younger and felt great. My annual checkups at the doctor's office became a running joke. My blood pressure was off-the-charts low. My resting heart rate was fifty beats-per-minute. I was far from the train wrecks they were used to seeing at the doctor's office.

Then something changed. I began feeling a slight pressure in my chest while on the rowing machine. I did what most people do in this situation and ignored it, although I did make a point of keeping the phone within reach. What I experienced wasn't really chest pain per se; it simply felt as if something was pushing against my sternum from the inside, and only at high heart rates. Eventually, I decided to visit a cardiologist.

The cardiologist recommended a stress test. For that, I was wired up to an EKG monitor and put on a treadmill. Gradually, they raised the speed and incline of the treadmill until my heart rate was in the same territory I'd been achieving on the rowing machine. Sure enough, I began feeling the same chest pressure. Afterward, they did some chest scans to see if they could identify any blockages. The results were inconclusive. The next logical step, though a more serious one, was to get a heart catheterization at the hospital. That procedure would show, for sure, what was going on.

Two weeks later, as I lay there in catheter lab, feeling smug that this whole thing was probably about nothing, the cardiologist remarked, "Well, look at that. You have two forty-percent blockages in your L.A.D. artery. I suggest we put two stents in there right now." An he did.

For the next few weeks, I struggled to get my head around this development. How could this possibly have happened to me, I wondered, a guy who's been working out like an astronaut for ten-plus years, a guy who's been eating the healthiest diet imaginable? The answer to this question came to me in the form of some education at the cardio rehab center. As much as I thought I knew about healthy food, there was a lot I didn't know and I dare say the chefs at my favorite eateries didn't either.

Restaurant chefs will tell you: the three easiest ways to make customers happy are: butter, cream and salt. The industry code word for recipes featuring these items is comfort food. When times are tough or the winter wind is howling, the public is unconsciously drawn to comfort food. It's a perfect fit. But, as I have learned, these are the three worst things someone could consume as part of their daily diet. Butter and cream are high in saturated fat—one of the primary components in heart disease.

Saturated fat can be found in lots of things we eat regularly: crackers, chips, peanut butter, chocolate, energy bars, "low fat" yogurt, cheese and ice cream, just to name a few. Saturated fat is processed by the liver, resulting in cholesterol being released into the bloodstream. The small arteries that surround the heart muscle are particularly prone to getting clogged with this stuff. In many cases, the result is a sudden heart attack. If I hadn't been getting regular aerobic exercise, I wouldn't have known I had a problem until it was much more serious. I was very lucky to have an early warning.

There are factors that increase your risk for getting heart disease, including diabetes, smoking, high blood pressure, and obesity. If you also have a family history of heart disease, these risk factors become much more critical. My father had heart disease later in life. I should have taken that as a clear signal that I, too, might have the gene for it. With that knowledge, I could have taken proactive measures fifteen years ago to reduce my cholesterol. I just assumed, incorrectly, that people who exercise and are not overweight can't get heart disease.

There are three pieces to the heart health puzzle, all of which are equally important:

• Diet—A healthy diet should include no more than 20 grams of saturated fat per day. Read the health labels when you shop. When you eat out, request "dairy free" versions of your entrees. Most restaurants will accommodate your request or suggest a different item. Use olive oil instead of butter.

• Exercise—Get into a regular exercise regimen that includes 30 minutes of aerobic activity at least three times per week. Use a heart rate monitor.

• Cholesterol lowering drugs—If you have a history of heart disease in your family, you should start getting your blood tested at age 40 and every year thereafter. At the direction of your doctor, take a low dose statin if your LDL and cholesterol values begin to rise. Note: Not everyone can tolerate statins. There are different varieties, and some people will tolerate one type and not another.

An excellent resource, the one I use, is a cookbook written by Philip A. Ades, a cardiologist in Burlington, Vermont. The first section of the book will give you a fast education on the subject of heart disease and how to prevent it...

The EatingWell for a Healthy Heart Cookbook

So here I am five years later, feeling great, and happy to be writing about it. I still have my workout routine, and I still have my favorite eateries. I'm just a bit smarter about reading the menu and asking the right questions.