KC Craichy talks with Dr. Leonard Smith about heart health and food.
Audio Transcription
KC: Welcome to Living Fuel TV. I’m KC Craichy with special guest, Dr. Leonard Smith. Welcome back, Leonard. It is always a joy to have you.
Dr. Smith: Thank you, KC. It’s a pleasure to be here.
KC: Thanksgiving is coming up. You’re looking forward to the apple pie and the pecan pie and the stuffing and the turkey.
Dr. Smith: Tell me about the pumpkin pie.
KC: And the pumpkin pie. So this is fun, fun, fun. But, Leonard, there’s some dangers associated with that, aren’t there?
Dr. Smith: Oh, absolutely. We know of a cardiac stress test, but most people don’t think of a food stress test, but both Thanksgiving and Christmas are definitely food stress test times. And so what we’re talking about there, and as a surgeon for many years, if you happen to be on call either Thanksgiving, Christmas, or even the day after, you know you’re going to get ER calls, and it’s people coming in with pain right in there. So the question is, is it the gallbladder or is it the heart, or is it both?
KC: Or is it just indigestion?
Dr. Smith: Or is it just indigestion? Exactly.
KC: So the differential diagnosis is the number one cost, or the liability associated with the differential diagnosis of heart disease versus dis-ease in the emergency room, correct?
Dr. Smith: Right.
KC: So people think they’re having indigestion, but what could be going on here?
Dr. Smith: Well, yes, you come into the emergency room. Now, we have sophisticated enough equipment to tell just by measuring blood enzymes if your heart is losing oxygen and the pain is coming from there. But there have been people operated on to have their gallbladder removed and had trouble during surgery because, in fact, they’d had a heart attack. So they really do need to differentiate between these. But the connection to food is there for both the heart and the indigestion obviously, and the gallbladder because when you eat a high saturated fat diet, there may be too much protein in the meal, and top it off with a bunch of sugar, you’re actually creating inflammation that will start in the intestinal tract and immediately go to the blood and then go throughout the body. It’s been very well documented. People that are on more of a basic meat diet most of the time have a higher population of gram-negative anaerobic bacteria in their intestinal tract. Now, these bacteria at all times are doing what? They’re living, they’re being born, and they’re dying, so as they die, a part of their cell walls have a trigger in them called LPS. It stands for lipopolysaccharide. It’s sort of a lipid and a sugar together that’s part of the cell wall. So we always have a little in our blood, and we pretty well deal with that, but when you have, what we said, that kind of a dinner that we talked about, a wonderful Thanksgiving dinner, or even – this broke my heart when I heard this one – just a little bowl of Haagen-Dazs ice cream could do it because you’ve got, again, the fat, then the sugar.
KC: A single blast of sugar can triple the inflammatory response.
Dr. Smith: With the fat and the sugar. And this is how it does it. Those bacteria that are more likely to be involved in that, when that gets there, the door of the intestinal tract opens up to allow the fat and the sugar to get through. But if you’ve got a lot of the dead anaerobic gram-negative bacteria, their cell walls get through quicker, too. So, they’ve actually shown, that kind of a meal will increase the blood lipopolysaccharide level. So it’s like bacterial products are waiting to get through, but you open the door by what you fed it, then your body got tricked in opening it up. Those lipopolysaccharides then go in the bloodstream, and your monocytes and macrophages and even your white blood cells get up-regulated. They start producing, again, the IL-6, the IL-1, the TNF-alpha, all the inflammatory markers that cause endothelial dysfunction. It means your blood vessels stop working well, and there’s a test for that. It’s where they put a cuff on your arm and blow up the cuff longer than you would for blood pressure, and it squeezes on the artery hard enough that the artery senses danger. It releases more nitric oxide, if it can, and then when the cuff comes down, they actually ultrasound the artery, and normally it’ll do like this. It has nice pulsatile flow. After eating a fatty, sugar meal, within 30 minutes later, it’s this. So if you happen to already have some arterial disease in your heart and you lose that natural distensibility due to the diet…
KC: Plus you have inflammation closing it down.
Dr. Smith: That’s what I’m saying. The inflammation has been there. Everybody has got some element of atherosclerosis, most everybody I’ll say, but if you’ve got significant amounts – you may not even have enough to have ever had heart symptoms – but too much fat and sugar at one time could actually cause enough endothelial dysfunction, artery dysfunction, it’s not delivering blood as well as it should, it’s hitting blockages, and now you get chest pain. Now, chest pain from the heart is the same thing as chest pain from doing too many curls. It’s lack of oxygen.
KC: Right.
Dr. Smith: Now, it could be just that. Hopefully, that’s all it is.
KC: Ischemia.
Dr. Smith: But it could be the start of a heart attack.
KC: Wow.
Dr. Smith: In the gallbladder, that same fatty diet hitting the duodenum releases a hormone called cholecystokinin, and it causes the gallbladder to really squeeze out harder than ever. It says, “Boy, he’s really loaded me up with fat. We’ve really got to get the bile down there.” If you’ve already got gallbladder disease before, whether it’s silent stones that you don’t know about or, let’s say, you’ve had an attack or two, when you put it under the stress test of a high-fat diet, the high cholecystokinin will squeeze that gallbladder down, push the stone in the cystic duct, now the gallbladder gets swollen, can’t come down, and you’re looking at an operation.
KC: Overeating is a big problem. To your body it’s a major, major stress, particularly if you’re not already in good health, and you don’t have to be obviously obese to have a problem. There are many people who look skinny who have the same issue as a result. So we just want to have you be careful, take your time, plan what you’re going to eat, and don’t overdo it this holiday season. God bless you and have a great day.
