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“Interventional Cardiology Delivered with a Fork???”

Posted by Hari Nair, PhD on Nov 24, 2017 9:05:00 AM

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Recently, I attended the Cardiometabolic Health Congress in Boston and had the opportunity to sit in on a talk given by an interventional cardiologist, Stephen Devries MD, FACC from Gaples Institute of Integrative Cardiology in Deerfield, IL. His presentation was titled “Interventional Cardiology Delivered with a Fork.” I went into the presentation expecting to learn about the new developments in interventional cardiology and how diagnostic testing may be beneficial to an interventional cardiologist. Instead, I was subjected to the idea that the most effective tool in the hands of an interventional cardiologist is, in fact, non-FDA regulated therapeutic agents such as blueberries, spinach, salmon and olive oil. Sure, growing up we are all told to eat our veggies and limit our candy consumption, but an interventional cardiologist rolling out these time tested clichés as interventional therapy? This was surprising.

In my opinion, Dr. Devries answered the debate convincingly with the data that he presented from studies with sufficient statistical power.

As evidence to his assertion, he pointed to the final result of the famous Lyon Diet Heart Study. In this study (N=7447), two groups of patients above the age of 70 who have all had a myocardial infarction (MI) were advised to follow a traditional prudent western diet (low in calories) vs. a Mediterranean diet (a diet rich in plant based foods, nuts, olive oil and low sodium). It is to be noted that this was not enforced upon the subjects but just dispensed as advice.

He presented the audience with five year survival plots for the following measured outcomes:

  1. Cardiac death and non-fatal MI
  2. Secondary end points like stroke
  3. Events requiring hospital admission

In all three categories, the patients following the Mediterranean diet showed significant risk reduction (70%) for secondary prevention of and about 30% reduction in vascular events.

Another interesting aspect of the Lyon Diet Heart Study was that the risk reduction was evident in the first weeks of the study (Kaplan Mayer curves separated within weeks of the study between the two patient groups).

Dr. Devries also referenced the results of another study which showed the outcome (diagnosis of full blown diabetes) from 3234 borderline diabetic patients across three years. The subjects were separated into three groups:

  1. Placebo (no intervention)
  2. Metformin
  3. Diet and exercise

At the end of the study, the patients were tested for the diagnosis of full blown diabetes. Compared to the placebo group, the data showed that the metformin group had a 31% reduction in a diabetes diagnosis, while the lifestyle group had a 58% reduction. Diet and exercise was almost twice as beneficial in preventing diabetes compared to metformin therapy.

The supporting data from the studies Dr. Devries referenced formed the basis of his assertion—that nutrition is in fact interventional cardiology. Based on the data he presented, I could not find a reason to disagree with him.

In good health,
Hari

 

Topics: About Stroke, Diabetes and CVD, Clinical and Science