Friday, January 25, 2008


In the 14th Jan issue of the American College of Cardiology, Dr James O'Keefe, a senior cardiologist from the mid-America Heart Institute, was given the honor of writing the Journal's first "state of art "article for 2008. He chose to write on, "Dietary strategies for improving post-prandial glucose, lipids, inflammation, and cardiovascular health." Obviously he was very keen to highlight that young America is getting too fat and burdening the healthcare budget by getting heart disease. Although this is not a clinical study, he writes from his considerable experience and review of the literature. He has also coined a new term for us called post-prandial dysmetabolism.

What he is saying is that eating a high carbohydrate and high fat meal like burgers from Burger King and pizzas from Domino Pizza, the acute glucose and lipid load into the blood stream can cause a surge in lips and glucose (dysmetabolism) and this is acutely toxic to the arterial wall by its oxidative stress insult and so promotes arterial wall inflammation and atherosclerosis. Obviously, if there is enough fiber in the same meal, the absorption of glucose and fats will be slowed down and the acute arterial toxicity of the diet will be avoided. This is indeed an interesting theory. That very nicely explain the association of the fast food culture with the increasing trend of obesity and diabetes that we see in the 21st century. We should soon have to develop a MacDonald index for obesity and diabetes.

What O'Keefe did not mention was the role of the carbonated drinks, be it the "diet" variety or not. I am sure putting the burger down with a generous gulp of coca-cola can only make things worse. I have often wondered whether or not our nasi lemak, roti canai, roti bomb and the likes, will have the same arterial toxicity. I have often wish that our own home grown cardio-researchers will do some research on this. If only we can ban or limit the sales of these offending fast foods, we could save quite alot of healthcare budget, but then can the government withstand what is obviously bad cardiac food.

No comments: