Why bagels, pretzels, and sandwiches cause heart attacks

We have sadly wasted the last 60 years (!!) agonizing over dietary cholesterol, saturated fat, and total fat intake, being urged to center diet around “healthy whole grains.”

Has this advice resulted in a nation of slender, non-diabetic people with less heart disease? Absolutely not. We now have the fattest, most diabetic population ever, with no reduction in coronary events like heart attack, need for stents and bypass surgery, and sudden death.

It began with the misguided ambitions of several people who believed that excessive saturated fat intake was the cause for the surge in heart disease in the mid-20th century. This hypothesis became dietary dogma due to several poorly designed clinical studies, misinterpretations, misrepresentations, despite more recent clinical studies such as the Women’s Health Initiative that showed that a low-fat diet did not reduce the incidence of heart disease. The low-fat notion has unfortunately become so deeply-entrenched, so many people have devoted careers to promoting it, so many doctors have repeated the advice to limit fat and saturated fat, so many dietitians have echoed this awful advice that no one seems wiling to go against  conventional “wisdom” and retract it. Instead, they choose to advocate a lifestyle that not only does not prevent heart attack, but promote foods, especially wheat and grains, that cause heart attack and other coronary events.

People are often taken aback by this claim. After all, how could a turkey sandwich with tomatoes and mayonnaise on two slices of whole grain bread cause heart disease? Conventional thinkers would blame the mayonnaise due to its fat content. But it’s the bread because:

• The amylopectin A content of wheat and grains are flagrant triggers of small LDL particle formation–Let’s be clear here: Despite the widely held fiction that LDL cholesterol causes heart disease, it does not. A major cause of heart attack and heart disease is an excess of small LDL particles that persist in the bloodstream for 5-7 days after eating the sandwich, not the 24 hours that large LDL particles persist after fat consumption. Small LDL particles are more prone to oxidation, 8-fold more prone to glycation, more adherent to the components of the artery wall, more likely to provoke inflammatory responses, more likely to be taken up by inflammatory macrophage cells. One wheat/grain food per week is sufficient to yield increased cardiovascular risk 52 weeks per year.
• The amylopectin A content of wheat and grains triggers high blood sugar and insulin–This is the process that cultivates growth of visceral fat, i.e., fat that encircles abdominal organs like liver and intestines, showing on the surface as “love handles” or “muffin top.” Visceral fat is inflammatory fat and makes further contribution to insulin resistance, the process that leads to type 2 diabetes, heart disease, dementia, and cancer. Virtually every person who has a heart attack has insulin resistance. Insulin resistance also worsens the expression of small LDL particles.
• The amylopectin A content of wheat and grains fuels liver de novo lipogenesis–This is the liver’s conversion of carbs (amylopectin A) to triglycerides, released into the bloodstream as VLDL particles. VLDL particles are a direct cause for coronary atherosclerosis. VLDL particles, rich in triglycerides, also interact with LDL particles, enriching them in triglycerides, the process that leads to small LDL particle formation. (Some triglycerides are retained in the liver; this is the process that causes fatty liver, a condition that now affects over half the U.S. population.)
• The gliadin protein of wheat increases intestinal permeability–The normal barrier between intestinal cells is disrupted by the gliadin protein of wheat, increasing serum zonulin levels and increasing the penetrability of the intestinal barrier. In addition to increased entry of the gliadin protein into the bloodstream caused by this process, there is also increased entry of bacterial breakdown products from bowel flora, especially lipopolysaccharide, LPS, that fuels inflammation throughout the body, as well as worsening insulin resistance. This is the process of bacterial endotoxemia.
• The phytates of wheat bind magnesium–The phytate content of wheat, increased in recent years since farmers and agribusiness scientists select wheat strains with greater phytate content for their pest-resistance properties, binds most dietary magnesium in the gut, causing it to be passed out into the toilet. Lack of magnesium contributes to a process called “endothelial dysfunction,” the abnormal constrictive behavior of arteries, a dangerous effect when any quantity of coronary atherosclerosis is present.
• α-amylase/trypsin inhibitors in wheat amplify inflammation–The α-amylase/trypsin inhibitors in wheat mimic the effect of bacterial LPS and activates inflammation in both the intestinal wall and elsewhere. As with phytates and wheat germ agglutinin, modern strains of wheat have been bred for greater α-amylase/trypsin inhibitor content, as they also provide pest resistance to wheat crops.

This is not a complete list–there are other ways that a turkey sandwich or handful of pretzels takes you closer to a future of stent implantation, bypass surgery, or sudden cardiac death. But I think that you get the idea: Consuming products made with wheat and related grains leads to heart attack and other cardiovascular events. It’s not red meat, it’s not bacon fat, it’s not butter–it’s the multigrain bread, pancakes, and dinner rolls that trigger a multitude of reactions that lead to small LDL and VLDL particle formation, insulin resistance, intestinal permeability, inflammation, and endotoxemia. Does a baby aspirin or Lipitor Band-Aid these phenomena and reduce or eliminate their effects? Of course not.

Then how do you address this scary list of phenomena that cause heart disease? Easy: Don’t eat the foods that initiate these effects.