The Culinary Cardiologist

May 25, 2009 | By | COMMENTS

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Rob Siegel is a cardiologist who joined a big group of us last week, before seeing “Star Trek,” for dinner at The Brooklyn Diner (not the best place for a meal, but a decent option near the Ziegfield Theater). There were so many of us, we were split into two groups, and, unfortunately, I wasn’t at Rob’s table; Craig was, however, and he reports that Rob–again, a cardiologist–ordered a bacon cheeseburger. Rob, a thoughtful, funny guy, shrugged his shoulders and began explaining his theories about nutrition, health, and eating, theories that led to a discussion later that night which concluded: “Why don’t we do a Q&A on my blog?” So here’s that Q&A. And if you enjoy Rob’s sensibility, and want to read more, you can read his blog–Let Them Eat Cake–on the Psychology Today website.

I have a theory I like to call Food Negation Theory. The idea behind this theory is that if you have a burger for lunch and a salad for dinner, the salad negates the burger. Is there any truth to this? And if not, can you pretend that there is so I can say this method is “doctor approved”?

Not sure I understand what you’re saying. In my best guess, you’re saying that:

-burgers are bad for you

-salads are good for you

so if you eat a burger for one meal (bad), then a salad for another meal (good), then you end up with:

good+bad=neutral

is that right?

If that’s what you’re trying to say, then it’s a cute idea. If there’s any scientific evidence to support (or refute) it, I’m not aware of it.

What’s worse, from a cardiological perspective, bad diet or lack of exercise?

The magnitude of the offense is important here.

For comparison, what if you asked a lawyer: Which is worse, stealing or fighting? What if you answer “fighting,” but it turns out that someone stole a billion dollars from orphans but once punched someone in the arm? The lawyer will gladly explain that one is a felony-grade offense and another a misdemeanor.

We don’t have great terminology for degrees of “badness” in diet and exercise in medicine. However, it’s clear that you can you can have a diet so bad that it’s worse for your health than your laziness, and vice versa.

Recently I saw you when we all went to see “Star Trek” and you shared a theory of yours that might shock my readers–a theory that says switching from a bad diet to a good diet only increases your life span by 2 months. Did I get that right? Can you tell us about your theory?

First, it’s not a theory. It’s a summary of available evidence.

Available evidence says that, comparing the healthiest possible diet we can imagine to the a standard American diet, the median weighted survival advantage to making the change is two months.

This assumes several things:

1) You don’t have diabetes or any other health conditions that are affected by diet (such as heart failure or cirrhosis), and you are not at elevated risk to develop diabetes

2) You ignore the proven good things (fish oil) and the proven bad things (trans fats, sodium, poison) from the analysis

3) You don’t change the caloric intake of your diet–this is to say, this is a comparison of what you eat, not how many calories you’re eating

What, from your perspective, is the worst thing you can eat? The best? Or is there no such thing?

Worst thing to eat: Paste.

No, really, paste is not the worst thing to eat. Plutonium is.

Okay, among things that we call “food” and not “paste” or “poison,” what’s the worst thing to eat that lots of Americans regularly eat? Probably trans-fats. (A shout out is warranted for Dr. Thomas Frieden, NYC’s health commissioner, who got trans fats out of our city’s restaurant food. Today he got appointed to run the CDC–thank you, Dr. Frieden, and congratulations on the promotion!) Lots of evidence suggests that trans-fats cause atherosclerosis, which can cause heart attacks.

Best thing to eat: Fish oil.

This is probably only beneficial for people who are at risk for heart attack–healthy people don’t seem to get much benefit. Seeing how a large number of Americans are at risk for heart attack, fish oil applies fairly broadly for American adults.

-The answer to this question is much different for children, pregnant mothers, and for people with vitamin deficiency syndromes or other clinical conditions where certain foods are known to help.

Have you ever eaten a heart? If not, will you do so and report back?

Next time you eat a whole chicken breast, use your silverware to hack into the thick bony part in the middle of the breast. The heart and lungs are in there, and you can eat them. You know which part is the heart because it looks like a heart. I have eaten a chicken heart, and, well, it tastes sort of like liver, but worse.

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Thank you, again, Rob for your answers. To my readers: if you have any food-related questions for Dr. Rob (I realize he’s Dr. Siegel, but I want to be like Oprah here and commodify and exploit him!) please type them up in the comments and Dr. Rob will either answer them there or will answer them in a future post.

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