Today’s New York Times carried the obituary of Dr. Lynn Smaha, former president of the American Heart Association, who died suddenly of a heart attack at age 63. I’m not in any way using this post to make light of Dr. Smaha’s death and I wish his family my heartfelt sympathies and deepest condolences. I can only imagine what a blow it must be to suddenly lose a spouse and father totally unexpectedly. (Click here for another obituary.)
My point in mentioning Dr. Smaha’s passing is to mention that he was a disciple of the lipid hypothesis of heart disease, a staunch advocate of the low-fat diet (although he started to modify his views and at least consider a Mediterranean type diet after the data came in from the Lyon Diet Heart Study) and an even stronger proponent of aerobic exercise. He was also a strong believer in physician’s practicing what they preach.
Excerpts from Heart doctors flunk own advice
By Maggie Fox, Reuters [11/07/99]
The advice is clear — do not smoke, eat plenty of fruits and vegetables, and keep fat intake low to avoid heart disease.
But even heart specialists who are supposed to preach this advice to every patient, every day, are failing to take their own medicine, Dr. Lynn Smaha, president of the American Heart Association, says.
He took his fellow heart specialists to task on Sunday for their bad habits and for their failure to stress to patients that heart disease, in many instances, is self-inflicted.
“There are those among us who do not follow proper diets, who do not engage in physical activity,” he told the opening session of the group’s annual meeting. “And if we do not do it ourselves, how then can we translate effective techniques to our patients?”
Another statement by Dr. Smaha:
“Cardiovascular disease accounts for more than 40% of U.S. deaths and affects both men and women,” says Lynn Smaha, MD, PhD, president of the American Heart Association. “Heart disease strikes men earlier, but the risk for women rises at menopause and continues to increase. Additionally, women are more likely to die from heart attacks.” Smaha says women often underestimate their risk of stroke as well.
“Many women don’t realize that stroke is just as serious for them as it is for men,” says Smaha. “Stroke claims the lives of over 90,000 women a year. In comparison, approximately 40,000 die of breast cancer.” Smaha says many of these deaths can be prevented.
“Strokes and heart attacks are often preventable, but American adults have a long way to go in changing their behavior,” says Smaha. “On average, 60% of us don’t get enough exercise, 55% are overweight, 45% have [LDL] cholesterol levels over 130, and 25% have high blood pressure.”
Dr. Smaha, I’m sure, followed his own advice, kept his weight down, ate a low-fat diet, did aerobic exercise, and made sure his cholesterol remained in check–in short he did everything he recommended to others to avoid heart disease, yet he succumbed to a heart attack. If cholesterol were the cause of heart disease, if a low-fat diet was truly ‘heart healthy,’ if aerobic exercise kept coronary arteries supple and plaque-free, then Dr. Smaha would surely still be with us today.
But he isn’t. And I don’t think that all the beliefs he had on the proper prevention of heart disease were valid. I do believe, though, that we should all reflect on this tragically early death and ask ourselves if we’re doing everything we can do for our own hearts. Although cancer is the disease we all seem to dread, statistically we’re much more likely to die of heart disease. And in one third of the cases of heart disease, the first symptom is sudden death, which, I suspect is what happened to Dr. Smaha.
I can tell you that of the many thousands of patients MD and I have taken care of first hand with low-carbohydrate diets not a single one has had a heart problem while under our care. We have treated, say, 10-15,000 patients over the years, most of whom were under our care for an average of two months. Multiplying two months times 10,000 patients gives 20,000 patient-months, which, statistically should have produced a number of heart attacks, especially considering that virtually all of these patients were middle aged and overweight and most had high blood pressure, elevated cholesterol, blood sugar problems, and all the rest of the disorders making up the Metabolic Syndrome. I’m not saying that the low-carb diet we treated these patients with kept them from having heart attacks, I’m simply remarking on the statistics.
I wonder if Dr. Smaha’s outcome would have been different had he followed a low-carb diet?