…to prevent cardiovascular disease and stroke. Those mineral trends are natural with the paleo diet, although not mentioned by Dr. Pande.
For detail: http://www.health.harvard.edu/blog/getting-more-potassium-and-less-salt-may-cut-heart-attack-stroke-risk-201304126067
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This treadmill stress test is looking for hidden heart disease
To protect you from injury, I recommend that you obtain “medical clearance” from a personal physician before starting an exercise program. A physician is in the best position to determine if your plans are safe for you, thereby avoiding complications such as injury and death. Nevertheless, most adults can start a moderate-intensity exercise program with little risk. An example of moderate intensity would be walking briskly (3–4 mph or 4.8–6.4 km/h) for 30 minutes daily.
Men over 40 and women over 50 who anticipate a more vigorous program should consult a physician to ensure safety. The physician may well recommend diagnostic blood work, an electrocardiogram (heart electrical tracing), and an exercise stress test (often on a treadmill). The goal is not to generate fees for the doctor, but to find the occasional person for whom exercise will be dangerous, if not fatal. Those who drop dead at the start of a vigorous exercise program often have an undiagnosed heart condition, such as blockages in the arteries that supply the heart muscle. The doctor will also look for other dangerous undiagnosed “silent” conditions, such as leaky heart valves, hereditary heart conditions, aneurysms, extremely high blood pressure, and severe diabetes.
She looks healthy enough, but how can you be sure?
The American Diabetes Association’s Standards of Care—2011 states that routine testing of all diabetics for heart artery blockages before an exercise program is not recommended; the doctor should use judgment case-by-case. Many diabetics (and their doctors) are unaware that they already have “silent” coronary artery disease (CAD). CAD is defined by blocked or clogged heart arteries, which reduced the blood flow to the hard-working heart muscle. Your heart pumps 100,000 times a day, every day, for years without rest. CAD raises the odds of fainting, heart attack, or sudden death during strenuous exercise. I recommend a cardiac stress test (or the equivalent) to all diabetics prior to moderate or vigorous exercise programs, particularly if over 40 years old. CAD can thus be diagnosed and treated before complications arise. Ask your personal physician for her opinion.
Regardless of age and diabetes, other folks who may benefit from a medical consultation before starting an exercise program include those with known high blood pressure, high cholesterol, joint problems (e.g., arthritis, degenerated discs), neurologic problems, poor circulation, lung disease, or any other significant chronic medical condition. Also be sure to check with a doctor first if you’ve been experiencing chest pains, palpitations, dizziness, fainting spells, headaches, frequent urination, or any unusual symptoms (particularly during exertion).
Physicians, physiatrists, physical therapists, and exercise physiologists can also be helpful in design of a safe, effective exercise program for those with established chronic medical conditions.
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Tagged diabetes, exercise, heart disease, medical clearance, physical activity, treadmill stress test
Swedish researchers reported in 2010 that a Paleolithic diet was more satiating than a Mediterranean-style diet, when compared on a calorie-for-calorie basis in heart patients. Both groups of study subjects reported equal degrees of satiety, but the paleo dieters ended up eating 24% fewer calories over the 12-week study.
The main differences in the diets were that the paleo dieters had much lower consumption of cereals (grains) and dairy products, and more fruit and nuts. The paleos derived 40% of total calories from carbohydrate compared to 52% among the Mediterraneans.
Even though it wasn’t a weight-loss study, both groups lost weight. The paleo dieters lost a bit more than the Mediterraneans: 5 kg vs 3.8 kg (11 lb vs 8.4 lb). That’s fantastic weight loss for people not even trying. Average starting weight of these 29 ischemic heart patients was 93 kg (205 lb). Each intervention group had only 13 or 14 patients (I’ll let you figure out what happened to to the other two patients).
I blogged about this study population before. Participants supposedly had diabetes or prediabetes, although certainly very mild cases (average hemoglobin A1c of 4.7% and none were taking diabetic drugs)
As I slogged through the research report, I had to keep reminding myself that this is a very small, pilot study. So I’ll not bore you with all the details.
Bottom Line
This study suggests that the paleo diet may be particularly helpful for weight loss in heart patients. No one knows how results would compare a year or two after starting the diet. The typical weight-loss pattern is to start gaining the weight back at six months, with return to baseline at one or two years out.
Greek investigators found a link between the Mediterranean diet and better clinical outcomes in known ischemic heart disease patients. On the other hand, researchers at the Heart Institute of Spokane found the Mediterranean diet equivalent to a low-fat diet in heart patients, again in terms of clinical outcomes. U.S. investigators in 2007 found a positive link between the Mediterranean diet and lower rates of death from cardiovascular disease and cancer.
We don’t yet have these kinds of studies looking at the potential benefits of the paleo diet. I’m talking about hard clinical endpoints such as heart attacks, heart failure, cardiac deaths, and overall deaths. The paleo diet definitely shows some promise.
I also note the Swedish investigators didn’t point out that weight loss in overweight heart patients may be detrimental. This is the “obesity paradox,” called “reverse epidemiology” at Wikipedia. That’s a whole ‘nother can o’ worms.
Keep your eye on the paleo diet.
Reference: Jonsson, Tommy, et al. A paleolithic diet is more satiating per calorie than a mediterranean-like diet in individuals with ischemic heart disease. Nutrition and Metabolism, 2010, 7:85.
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