Holy Partially-Hydrogenated Vegetable Oil, Batman!

Tradition is an explanation for acting without thinking.

–Grace McGarvie

He’s at it again! SOMEONE STOP HIM.

I’m talking about Dr. Oz trying to scare you about eating high fat foods. This time he was on with Piers Morgan talking about the untimely demise of an actor: James Gandolfini. Mr. Gandolfini died recently of a massive heart attack.

First I would just like to say that I find it highly reprehensible to use the tragic death of a relatively young man–who left behind a widow and two children, one of them an infant–in this way. Mr. Gandolfini’s death also apparently occurred while he was on the toilet, something which hardly anyone would even know had not Mehmet Oz (which is an awesome name for a comic book villain, by the way) told the entire world about it on Piers Morgan’s show.

I’m sure that Mr. Gandolfini’s grieving 13-year-old son is just thrilled by that. Probably no kids will ever tease him about it, either.

But what I really want to talk about is Dr. Oz blaming Mr. Gandolfini’s last meal–specifically the fat–for his heart attack:

…[O}ften your last meal is truly the last meal. It turns out that fatty foods spasm, they literally close down the arteries of the heart, ahh, and that’s a problem…

Well boil that killjoy in his own low-fat pudding and bury him with a celery stick through his heart because that’s a lie.

Eating fat at a given meal does not cause your heart’s arteries to just suddenly start spasming. If they did, we would all be in danger of death every night. Every night, your body goes into ketosis. This is the natural and healthy state of burning your own fat as fuel for your cells. Your fat, which is saturated and almost identical to Evil Lard in its composition, is shuttled through your bloodstream for fuel. It doesn’t cause you to spasm out, and your cells can’t tell the difference between the flab around your waist and a slice of bacon.

Back to artery spasms.

So, know what MedlinePlus says?

Spasm often occurs in coronary arteries that have not become hardened due to plaque buildup (atherosclerosis).

That’s kind of funny, isn’t it? Seeing as how fat is supposed to be the thing that creates those plaques in your arteries? Granted it can happen in arteries with plaques, but that’s not as common.

That’s the deviousness of fat, you see. The Dr. Doom of Dr. Oz’s fantasy world. It both causes plaques, and also causes spasms which don’t happen as often when there’s plaques. And why does Dr. Oz say the spasm killed this man?

So he goes to the bathroom; his blood pressure drops. There’s his heart. Let’s go to that major vessel inside of the heart…. That little plaque. You see that yellowish thing?… And it ruptured!

Fat caused the plaque, that sat in the heart, that lived in the body, that ate more fat, that caused a spasm, in a likely plaque-less artery, that caused the plaque, to rupture anyway, that stopped the heart, that lived in the house that Jack built.

Here’s some stuff that MedlinePlus says does trigger spasms

Alcohol withdrawal

Emotional stress

Exposure to cold

Medications that cause narrowing of the blood vessels (vasoconstriction)

Stimulant drugs such as amphetamines and cocaine

Interestingly, “eating a piece of fat” isn’t on that list. It also says:

Unlike angina that is caused by hardening of the coronary arteries, chest pain and shortness of breath due to coronary artery spasm are often not present when you walk or exercise.

Start laughing or crying now, because Dr. Oz also took the opportunity of this man’s death by heart attack–supposedly brought on by a spasm that came because he ate some fat–to say:

Shortness of breath, the inability to walk up two flights of stairs or a sudden change on how breathless you get during normal activities. That’s an issue that really worries me. It’s subtle but it’s there and it’s a big warning sign to everybody out there…If you look like [a giant fatso like] Mr. Gandolfini, that’s a warning sign as well.

I took the opportunity to elaborate a bit on Oz’s words in the brackets there, but I think I’ve captured the spirit quite nicely.

Let’s look at two more tiny thoughts about these supposed artery spasms that killed Mr. Gandolfini:

If you have this condition, you should avoid coronary artery spasm triggers, including exposure to cold, cocaine use, cigarette smoking, and high-stress situations.

I just can’t understand why MedlinePlus keeps forgetting to put “and eating a piece of fat” into their list of spasm triggers…

So what else could have caused this heart attack if not “fatty foods spasm?”

First I looked into Mr. Gandolfini’s last meal. 4 shots of rum, 2 pina coladas, 2 beers, 2 orders of giant fried prawns with mayo/chili sauce and foie gras. Yeah, it was high in calories. Had a lot of fat, too. About 133 grams. But you know what it had more of than fat?

Carbs. About 178 grams.

And what do carbohydrates–particularly nicely refined ones like sugar in the pina coladas, flour in the fried shrimp ,and grain in the beer–do to the heart? You can read all about here, but I’ll summarize some interesting things:

“Looking inside” the arteries of students eating a variety of foods, Dr. Michael Shechter of Tel Aviv University’s Sackler School of Medicine and the Heart Institute of Sheba Medical Center — with collaboration of the Endocrinology Institute — visualized exactly what happens inside the body when the wrong foods for a healthy heart are eaten. He found that foods with a high glycemic index distended brachial arteries for several hours.

Elasticity of arteries anywhere in the body can be a measure of heart health. But when aggravated over time, a sudden expansion of the artery wall can cause a number of negative health effects, including reduced elasticity, which can cause heart disease or sudden death.

Using a clinical and research technique pioneered by his laboratory in Israel, Dr. Shechter was able to visualize what happens inside our arteries before, during and after eating high carb foods. It is a first in medical history. The results were published in the Journal of the American College of Cardiology.

“It’s very hard to predict heart disease,” says Dr. Shechter, a fellow of the American College of Cardiology and the American Heart Association. “But doctors know that high glycemic foods rapidly increase blood sugar. Those who binge on these foods have a greater chance of sudden death from heart attack.

So, we have no proof that fat causes an instantaneous effect like Dr. Oz’ “spasms.” But we do have good reason to suspect that eating a lot of carbohydrates can cause sudden death from heart attack.

And what about all that fat he did eat? All I can say is that if fat played any part, it wasn’t the coconut fat in the pina colada. It certainly wasn’t the foie gras, or Frenchmen from the southwest of France would be dropping like plague victims instead of doing better than everyone else in a country already low in heart disease.

Yep, if fat played any part at all, it was the vegetable oil that his prawns were most likely fried in. You know, the stuff you can buy in the oil section of the supermarket, with giant hearts on the bottles. The stuff you’re supposed to swap out all your butter and lard and coconut oil and foie gras for. Notice that the Medline article particularly implicates vegetable oil for causing inflammation. What does inflammation do?

It causes plaques to form in your arteries.

Yep, that’s correct. Fat is never going to cause plaques to form in your arteries until such time as we can figure out:

A. How to pour it directly into your arteries without killing you.


B. How to then cool you down enough that your own body heat doesn’t keep the fat liquid, again without killing you.

Now that all the Nazi prison camp doctors are gone, I just don’t see how we’re going to manage to test those things.

Oh, and speaking of things that hurt your heart, guess what else does? That would be drinking too much. Mr. Gandolfini had been battling alcoholism, unsuccessfully, for some time. Those close to him report that he wasn’t looking too good–and often had a drink in his hand–in the days leading up to his death. He had eight drinks with his last meal, which Dr. Oz apparently thinks isn’t even worth mentioning.

No, it was all that fat causing spasms.

Here’s what long-term heavy drinking can do to your heart:

  • Increase the risk of high blood pressure. Alcohol is thought to do this through its effects on the kidneys and the blood vessels.

  • Weaken the heart muscle. It’s known as cardiomyopathy and can cause premature death, usually through heart failure.

  • Lead to an enlarged heart.

And binge drinking can lead to “Holiday Heart Syndrome:”

Holiday Heart Syndrome tends to come on after episodes of heavy drinking – usually at least 15 units… Your blood pressure changes, increasing your risk of a heart attack and sudden death.

Now granted Mr. Gandolfini doesn’t appear to have had quite that much, though since we don’t know the size of the beers or the cocktails he drank we can’t say for sure. If they were the standard “1 drink,” he had about 8 drinks or units. If each drink was larger than standard–which is very common in the United States–he could easily have had 12-16. But even if he only had 8, this is still a better explanation than Dr. Oz’s “fatty foods spasm.”

Know what else are better explanations? The MedlinePlus article quoted above, about heart spasms, mentions both emotional stress and cocaine as possible triggers. Interestingly, the New York Post article mentions that Mr. Gandolfini was apparently never comfortable with his sudden rocket to fame through his acting career, and was highly stressed all the time–to the point of sometimes acting irrationally. He also was accused of doing cocaine with several other cast members. Again, two more possible reasonable explanations; yet Dr. Oz resorts to Fatty Foods Spasm as not just likely, but definitely the cause.

I think I’m going to stop now before I have a spasm.


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