27LifetimeProteforYourHeart
&oryIamabouttotellshouldbeasfamiliarasthebackofyourhandonceyouhavereadtherestofthisbook:Anindividualwithmetabolierabilitytoweightgaihesugar-filled,-impoverisheddietoftheWesternworld。Itdoesn'tmakehimfeelgreat,butheassumeshisvariousplaiuralpartofgettingolder。Pouogather;thehenalot。Nowheacquirestheriskfactorsthatsethimapartfrommostpeoplewhodon'thaveaweightprOblem。Yes,thoseriskfactors。Let'shearthemoime:
·Iarefartoohigh。
·Bloodpressurethatisrising,everrising。
·Triglyceridelevelsthathavegoelyballistic。
·Totalcholesterolthaththeroof。
·HDLthat'sdowninthecellar。
·Bloodsugarthat'sghtup。
What'shere'sacethatheisheadingfordiabetes。He—orshe—isfarfromhappynosforoionorahetypicalcarbohydrate-saturatedAmeridiet。Alongtheushhisdietaryfatdowhegoversaysitshouldbe。Victory?Well,no,Thatatwon'tpreveualvisittothecardiacwardofthelocalhospital。Afterall,dietaryfatheprimarysourceoftheproblem。
Thatsnapshotofalifedepictsthelifestyleofmabeyours。Youoolstodtrolyourvulie—theriskfactorsforheartdisease。You'llknowwhythesetoolsworkonceyou'vereadthischapter。Yahearthealthplanthatispreciselytailoredtotheneedsofapersonwho'ssusceptibletoweightgain。Atkinsisthedeliveranyoursusceptibility。
WhatDidn'tHappeDid
Tenyearsago,Iusedtosmilesomeainfullyattheblastsofamebymyattackers。TheysaidIdidn'trespecttheloel。"Eatingatrolledcarbh-fatdietwasda;theysaid。"Cholesterolwouldelevatewildly。Heartattackswouldsproutlikemushroomsintherain。"
&hingstrahelastdecadeofthetwerahing。MillionsofpeopledidAtkins。Physisotighatnotonlydidtheseboldnutritiourersloseweightandfeelfiheynearlyalwaysalsoshowedimprovementsintheirblood-lipidchemistries,whiitestthefurore—aretheholygrailsofmedie。
Nodoubtmanydoctorsraisedasdisciplesofthelow-fatcreedlookedatthoseresultsandwondered:Why?HowdoesfollowingAtkinsisdoit?Whydoesn'tthosepeople'schoup?Whydotheyseemsohealthy?WhatdoestheguruoftrolledcarbohydrateeatingknowthatIdon't?
Manyofthem—becausedoctorsarquiringbuartedtolearnwhatIalreadykneverwasaseulahiddenawayiory。The"secret"hasbeeedlyfightoutintheopeninmanyoftheworld'smostrespectedmedials。Theresearchthathasmadetrolledcarbohydratenutritionsopopulartodaywastrottingalongsteadilyiffthe1970sand1980s;bythelate1990sitwasmovingatafastditispositivelygallopingnow。
&is,andyoushouldknowit。
&erEffect
Whatwearelearning—carefulreaderswillnotbesurprisedisthattheriskfactorsforheartdiseaseclustertogether。Averypromierisfoundamo。AlittleoveradeanKaplan,MD,oftheUyofTexas'sSouthwesternMediter,dubbedfourriskfactorsthe"DeadlyQuartet;'Thesefour—upper-bodyobesity,gluthtriglyceridelevelsaension—werecesofasicausewasouroldfriend,hyperinsulinism。
Kaplanmadeadiagramtomakethisrelationshipclear。
&ension
Glucose
Intoleransuliriglyceridemia
Uupper-BodyObesity
Kaplanhadthegoodseicetheobvious。Theses,hereasoned,osubjectswithhighinsulinlevels,aothesameperson。Thirty-ninemillioheUesareobese(tweoveridealbodyweight),andfiftymillionpeoplearehyperteheobese,hypertensioimesmoreongtheriglyceridelevelsaretwiohanamongtheheassoisevenstrongerifoswithupper-bodyobesity。Themiddle-agedman'spauometabolicfactorsthatputhimatriskforaheartattack。
IfyoustiroioeRoi,MD,ameditistattheUyofMia。Hewrites:"Ithasbeebythefifthdecadeoflife,eighty-fivepertofdiabetidividualsarehypertensiveaypertofobesesubjectshaveabnlucosetolerandarehypertensive,andsixty-seveofhypertesarebothdiabetidobese。"
That'saprettyawe-inspiriely—aterrcluster!Doyouseeyourselfthere?Ifyoustandinohepicture,theoodthat—barringanutritionalge—you'lleventuallyoccupythe>
Kaplan'sinsightabouttheDeadlyQuartetender,asmuthoughtaboutinsulinis,eraldReaven,MD,ofStanfordUy。Inhisstudyofinsulin,hehasbeenpursuingtheebetweenhyperinsulinismandcardiovascularriskfactorswithiigablezealforoverthirtyyearsnow。OhepuzzlethatReavehathypertension—whioseriousmedicaltheoristhaseverquestionedasariskfactorforbothstrokeadisease—isiedtohyperinsulinism。In1989,inamajorarticletitled"HypertensionasaDiseaseofCarbohydrateandLipoproteiabolism;'hewrote,"Patientswithuensiooberesistanttoinsulin-stimulatedglucoseuptakeahhyperinsulinemidhypertriglyceridemietrae:Ifyouhavehighbloodpressure,youprobablyalsohavehighinsulinandtriglyceridelevels。
Iedagofriskfactorsforaryarterydisease,allofwhichwereassociatedwithhighinsulinlevelsandinsuliaheseiension,hightriglyceridelevelsanddecreasedHDLcholesterolthekindofcholesterolthathasbeenfouprotective。ReavenhasdubbedthisofriskfadromeX,andtheuck。Medicalarticlesrefertothesyndrome,andpopularhealthbooksdiscussit。It'sabuzzwordnow,asimplicitmessageisbecarefulofexcesscarbohydrateintake,Ilybehappyaboutthat。
TriglydHDL
Meanwhile,respondinginparttentmessageofSyndromeX,medicalresearchhasmovedbeyoedpredictivepoweroftotalcholesterolasanindicatorofillattaystistsnhtriglycerides,highLDL(badcholesterol)andlowHDL(goodcholesterol)asfarmorepotemindicators。AseriesoutofGermanyintheearly1990simenwhohadthebinationlydlowHDLweresixtimesmorelikelytohaveheartattameepropensities。