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"Frank Fry" was an upper class executive living the good life. He enjoyed good food, good wine, and good friends. He ate relatively well and was in good shape. His diet consisted of meals at fancy restaurants: bread, salad, wine, a main course including steak, fish, or chicken, and dessert (fatty and plumpy).
At the age of 66, Mr. Fry suffered a heart attack because of advanced, genetically accelerated heart disease, CABG, and advancing atherosclerosis.
Mr. Fry's world-famous doctor placed him on a strict reversal program: a very low fat, mostly vegetarian diet (little meat or fish), cholesterol lowering drugs, one aspirin, beta carotene, and 800 mg vitamin E every day. Although Mr. Fry's weight was OK at 162 lbs., he was asked to lose 5 lbs. slowly (better to be thinner).
After 3 months, Mr. Fry's triglycerides (TG) increased from 107 to 152, his HDL ("good cholesterol") decreased from 56 to 35, and his TC/HDLC ratio increased from 2.9 to 4.1. He felt much worse than he had before starting the very low fat diet. He lacked energy, was tired most of the day, was sleepy after lunch, and could no longer work or exercise as he used to.
Mr. Fry consulted Dr. Siguel after reading about his new blood test in a national magazine. Mr. Fry provided Dr. Siguel with a brief description of his problem and the name of his personal family physician (rather than the more famous consultants he had been seeing). He then instructed his personal doctor to talk with Dr. Siguel.
Dr. Siguel discussed with Fry's doctor about Fry's current status and various treatment alternatives. Because of various restrictions (and lack of adequate information), it is often not practical for Dr. Siguel to become the patient's doctor. Instead, Dr. Siguel merely provides scientific discussion with your doctor.
Mr. Fry could afford the best treatment. The issue was not cost, but optimal diagnosis. Nobody has enough blood for all possible blood tests, and many other invasive tests have high risks. The plan was to minimize risk, select the best diagnostic tests, and avoid potentially harmful diagnostic or treatment approaches.
Fry's doctor quickly understood Dr. Siguel's concepts. Both Mr. Fry and his doctor liked the idea of prolonging Fry's life by optimizing nutritional intake and using blood tests to achieve optimal nutritional status. Moreover, they understood that the approach suggested by Dr. Siguel involved minimal risks and had the potential for huge payoffs. Although no assurances could be made that the treatment would succeed, optimizing dietary fat intake made sense to everyone. Fry and his doctor decided to follow some of Dr. Siguel's suggestions.
Fry's doctor ordered a comprehensive set of blood tests and a fatty acid profile. The fatty acid profile EFA-SRÔ found low levels of w3 and w6 fatty acids. Mr. Fry's previous low fat diet had depleted his body of EFs and aggravated his heart disease. If Mr. Fry did not quickly build his body reserves of EFs, he might suffer irreversible complications or death.
Dr. Siguel spent many hours comparing the test results of Mr. Fry with those of hundreds of similar patients and healthy subjects. The results revealed a fairly unusual blood pattern that was not obvious before and had evaded other experts. Dr. Siguel discussed the test results with Mr. Fry and his doctor and several nutritionists. On the basis of these findings, a new plan was developed that was radically different from the strategy followed before. Instead of following usual recommendations (the American Heart Association, NIH (Step 1 or 2 diet) and the USDA Food Pyramid), Mr. Fry and his doctor decided to follow the radical suggestions proposed by Dr. Siguel.
These radical suggestions involved eating more PUFAs, more protein, and less carbohydrates. It was as if the USDA food pyramid had been inverted.
Treatment. Instead of a low fat diet with practically no oils and no PUFAs, Mr. Fry was placed on 2-3 tablespoons/day of oils rich in w3 and w6. He was told to avoid processed carbohydrates (bread, pasta, cereals), SFAs, and MUFAs (i.e., olive oil). He was told not to eat foods with TFAs (hydrogenated or cooked oils). He was allowed to eat chicken, lean beef, fish, eggs, and foods he liked in the context of a low-calorie diet. He would also exercise as much as possible. On this diet, Mr. Fry planned to maintain his weight or lose a few pounds.
Although Mr. Fry's primary drugs were not changed, various abnormalities were identified and treated. The dose of multivitamins and minerals was changed to reflect the RDA and ~ 200 IU of vitamin E/day.
Results. Mr. Fry was a model patient and followed instructions to the letter. Within 12 months, his TGs declined to 53, his HDL increased to 50, and his TC/HDLC decreased to 2.5. His "energy" level improved considerably. Mr. Fry now works many more hours, exercises more frequently and for longer periods of time, and feels much better. A heart PET scan revealed regression of stenosis (his heart disease actually regressed!). This was the first time in years that a PET scan showed regression.
Moral: Before a patient starts on a very low fat diet, he/she should be evaluated for EF abnormalities. EFs should be provided to correct deficiencies or imbalances to achieve ideal levels.
All cases presented describe composites of people and have been created for illustration and educational purposes. Any similarities to actual individuals or institutions are circumstantial and fictitious. No criticism is intended of any particular person or institution. We have to use composites to maintain confidentiality of patient information.
If you are a health provider who would like us to post your case, and you can obtain adequate approval and liability release, please contact us.
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All information on this website is copyrighted; see use and permission to reproduce. The information in this website is not medical advice, merely a general scientific discussion. See warnings & disclaimers. |
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© 1998 Edward Siguel. All rights reserved |
modified 9/15/98 |