Hi, I had a heart attack at the beginning of 2020 and started a Keto diet along with exercise about 4 months later. I feel pretty good now but I get a little nervous eating 80% fat. Given my heart disease if this diet turns out to be bad I’m looking at a fatal outcome. My heart surgeon gets annoyed when I mention keto and says I should be on a Mediterranean diet. He says keto is a fad.
Any thoughts?
@Gruntbuggly Welcome to the forum!
You’re in good company here with many others who have traveled similar, if not the same paths. I’ll let others with more specific health experiences weigh in, but my belief is that you are headed in a wise direction.
One caveat I’d offer is that - as you transition to a sharply carb-reduced eating lifestyle - many metabolic changes will occur. Be VERY mindful of adjustments in Rx and other lifestyle habits that might be warranted along the way.
E.g., my wife was taken off of statins and blood pressure meds shortly after going keto as her body didn’t need them anymore. Taking them would have been more harmful than helpful.
Many others find similar adjustments are required. You need to work closely with your physician to accomplish these transitions prudently.
If your current doc isn’t on board, you might need to find one who is. They are out there in increasing numbers … especially the younger (more open-minded) ones.
I appreciate that making such a change might not be easy (hopefully, not even necessary), but keep open to the possibility if your current physician becomes an obstacle to your health success.
Welcome to the fad 
… and best wishes!! 
(stay hydrated and keep your electrolytes up)
p.s. - yeah, eating all that delicious fat IS scary to those of us raised on the message that it wasn’t good for us. “Fat=bad” was pummeled into me. If I could get over it (I have), then I’d bet most anyone can.
The doc has me on a statin and beta blocker, both of which I want to kick having read about statins being a bad deal, and the beta blocker absolutely killing my workouts and making me feel lousy.
The doc just doubled my beta blocker dosage.
Having been ok a Keto diet since April I’m pretty much used to it now - after a brief keto flu it’s been smooth sailing.
Well then, this might be of some interest. Since I’m having trouble uploading a highlighted pdf file for you, you might follow this link to a study regarding how many patients stop using statins after they are prescribed and taken…
Spoiler alert: "… a more recent study demonstrating that almost 90% of
statin-treated patients discontinued treatment."
And the conclusion: "Our perspective of the literature is that non-adherence to
statin treatment for primary prevention of CVD is justified because the meager benefits are more than offset by the extensive harms."
HOWEVER, the one situation in which statins appear to have some benefit that might outweigh the risks/side effects is (a) adult male with (b) a previous heart attack. Preventing a secondary attack is different than preventing an initial (primary) attack.
This sounds like it describes you, so be aware that the statins might make statistical sense in your case. Whether your particular side effects are acceptable is something you and your physician should discuss in detail.
Sorry, I just don’t trust this sort of statement:
Roberts urged physicians to “ convince patients that these miracle drugs … are the best anti-atherosclerotic insurance they can purchase .”
Dr. Stephen Phinney (who first coined the term “nutritional ketosis”) says that heart muscle has been shown to thrive on the ketone body, β-hydroxybutyrate. If the heart is having trouble getting oxygen because of blocked arteries, ketone bodies are a good fuel, because they require less oxygen to metabolise.
The evidence that has been used to show that cholesterol causes heart disease is actually not as robust as people believe. There is actually evidence, in fact, to show that, whatever the actual cause might be, it cannot be cholesterol. In fact, cholesterol is needed to build cell walls, is the precursor to many important hormones and other chemicals in the body, forms part of the mechanism that repairs damage to arterial walls, and it even plays a role in the immune system. Trying to lower it runs the risk of doing more harm than good. While it is true that cholesterol is present in arterial plaque, it appears to be as part of the repair, not the cause of the original damage. As Dr. Phinney says, blaming cholesterol for atherosclerosis is a lot like blaming fire trucks for fires.
The British cardiologist, Dr. Aseem Malhotra, uses statins only in certain fairly rare cases. For most patients, he finds that a statin should not be prescribed, and he has seen many patients improve only after their statin was stopped.
Wow thanks EqiPro. I could have written the first part of that article myself it matches up so closely with my circumstances. Except the vegetarian part.
Thanks PaulL.
On my last visit to my surgeon I said (among other things he didn’t like) that with LDL I’d be a pile of mush on the floor.
There are actually a number of large, government-funded studies that show a negative correlation between LDL and cardivascular risk. This is not to say that low LDL actually causes cardiovascular disease (it could easily be some other factor that is associated with low LDL), but it is certainly enough to show that high cholesterol cannot possibly be the cause of CVD.
People are very aware of Mediterranean and it has more mainstream knowledge than keto, not surprising. People like to cry about it, but keto is absolutely a fad, so he’s right there. another year or two and nobody will be talking about it anymore, people will be sick of the word and the only people that will be doing it will be all us originals that were doing it before it’s fad status happened.
My thought when he called it a fad was "Yes, 2 million years of keto diet interrupted by 10,000 years of agriculture (and 50 years of Ancel Keys).
Everybody does that, but being around for ever doesn’t mean it’s not a fad right now. But having a quick popularity burst that doesn’t last long term does.
I’m stealing this one!
All the best on maintaining your health going forwards.
The funny thing is that the so-called Mediterranean diet overlaps significantly with healthy keto:
Avoid These Unhealthy Foods
You should avoid these unhealthy foods and ingredients:
- Added sugar: Soda, candies, ice cream, table sugar and many others.
- Refined grains: White bread, pasta made with refined wheat, etc.
- Trans fats: Found in margarine and various processed foods.
- Refined oils: Soybean oil, canola oil, cottonseed oil and others.
- Processed meat: Processed sausages, hot dogs, etc.
- Highly processed foods: Anything labeled “low-fat” or “diet” or which looks like it was made in a factory.
Source: https://www.healthline.com/nutrition/mediterranean-diet-meal-plan#foods-to-avoid
The main difference seems to be that keto encourages more healthy saturated fats and meats.
I think you made a good bet. 
Hi KetoType2, I guess I was eating the SAD, lots of processed food, high carbs etc. Also alcohol. Not overweight though. I’ve zeroed in on inflammation causing the plaque causing the heart attack, so my focus is keto diet, exercise and no alcohol (at least I try).