Training Didn’t Help

My name is Dr. Peter Megdal, and this is my story of curing heart disease. In 2010 I noticed a steep drop in my power output during races. Racing cyclists have power metersA power meter is a device fitted to a bicycle that measures the mechanical power output of the rider in watts, providing an objective and reproducible marker of athletic performance. In this article, a subtle but sustained drop in power output was the first clue that something was physiologically wrong before any clinical symptoms appeared. that are attached to our bikes so we can accurately measure how strong we are in training and competitions. I was 50 years old, and my coach and my friends all told me that this was because I was getting older, but I knew a 15% drop was pretty steep and not normal especially in just one or two years.

For the next four years, I trained harder and differently, but saw no improvement in my performance and got concerned and curious, so I sought medical advice. I looked for the best doctor in the area which happened to be a cardiologist at Mass General Hospital who specialized in athletes. He suggested that I try a maximum oxygen uptake stress testA stress test watches your heart while you exercise on a treadmill or bike, sometimes with imaging added. which is not done generally for people that have suspected heart disease, but he thought it would be good since I was a high-level athlete.

Here Come The Tests

In 2013, the year before, I got third at the regional cycling time trial championships in my age group. After getting tested, my oxygen consumption was so high my doctor thought that everything was okay even though I had a signal on my EKG that showed an ST segment depressionAn abnormal finding on an electrocardiogram (EKG) in which the ST segment—the portion of the tracing between the end of one heartbeat and the start of the next—drops below the baseline; a horizontal ST depression during exercise is a classic sign of cardiac ischemia, meaning the heart muscle is not receiving enough blood. that had a horizontal characteristic to it. This indicates cardiac ischemiaIschemia is when a tissue is not getting enough blood and oxygen for what it is being asked to do. or reduced blood flow to the heart. My doctor believed that this was an artifact and  that the only way to ensure that I had no disease was to undergo an angiogramAn angiogram is a test where doctors thread a thin tube into your arteries and inject dye, so the inside of the arteries shows up on an X-ray. (where they stick a wire in your arteryAn artery is a blood vessel that carries blood away from the heart to the rest of the body. with a dye to inject and view with an x-ray to take an image of the heart arteries) which is the golden standard to see if there are actually blockages in the arteries restricting blood flow.

I underwent the test which showed that I had five significant blocks in several of the arteries including the left anterior descending (LAD), the right coronary artery (RCA)One of the two main coronary arteries that supply oxygenated blood to the heart muscle; it runs along the right side of the heart and feeds the right ventricle and, in most people, the lower wall of the left ventricle. and two branches off of the LAD or left anterior descending artery, the largest being 70% in my right coronary artery. Consenting to a stent, I believed that this would fix my problem. I felt fine after and began riding my bike only about three days after the procedure. It was the fall of 2014 and the offseason for racing, but I continued to train hard. One of the reasons I worked so hard was I knew I was undergoing another exercise test in December and wanted to have a good outcome.

Research Brought Me To The Facts

However, it turned out that my oxygen uptake dropped another 5 or so percent and of course this is very disappointing to me. About the same time, I started reading significant literature on how to reverse heart diseasePlaque regression means existing plaque actually gets smaller, rather than just growing more slowly. including the book from Caldwell Esselstyn, “Reversing Heart Disease.” I also began reading “The China StudyA 2005 book by T. Colin Campbell summarizing decades of epidemiological research, including the China-Cornell-Oxford Project, that links diets high in animal protein and fat to higher rates of chronic disease including cardiovascular disease; it is widely cited in plant-based nutrition literature.” by Colin Campbell. Because of my doctoral training, I understood that you couldn’t believe everything you read particularly in the popular literature.

I began researching the original studies to see if there is a factual basis to the books -in other words, were the books accurate. What I found shocked me … it seemed that a low-fat, whole food plant-based dietA whole food plant-based diet is built from vegetables, fruit, beans, whole grains, nuts, and seeds, with animal products and processed foods largely removed. eliminating all added fats and eating no animal products seem to be the way to go. It took me about five months of adjusting my attitude to actually take this all in simply because I love eating meat, drinking milk, and so forth. After all, I grew up in Texas, and everyone pretty much had a cow in their backyards.

A New Diet Led To A New Life

So in March of 2015, I made the personal decision and so did my wife to not eat any meat. Since I knew this was the right thing to do but without really preparing for it, I was really hungry for about 2 weeks. I then started figuring out that it wasn’t so bad to eat only plants and my taste buds started to change, and I started feeling like I had more energy.

In the fall of 2015, I was retested in the lab, and I had a 15% increase in my vo2max. And then my power began to improve. This was still no guarantee that I was out of the woods and I continued to read and study to modify my diet and exercise program. The rest, as they say, is history- last year in 2018 I was on the podium at the national championships and missed the podium by one spot at the world championships, and I set an hour recordA competitive cycling discipline in which an athlete attempts to cover the greatest possible distance in exactly one hour on a velodrome track; it is governed by the UCI and is widely regarded as one of the most physically demanding feats in endurance sport. for cycling on a track for an hour at just under 29 miles.

How Does This Apply To You?

So how does this apply to you or somebody you may know that has heart disease? Being an athlete is not unique to having heart disease and having heart disease is not unique to being a non-athlete. So I believe that everything that I experienced applies to the general public.

The caveat of the story is I didn’t just rely on the diet to help me. The link between blood cholesterolCholesterol is a waxy substance your body needs. It goes into cell walls, hormones, vitamin D, and the bile that digests your food. You would die without it. and cardiovascular diseaseCardiovascular disease is the umbrella term for problems with the heart and blood vessels, including heart attacks, strokes, and blocked leg arteries. is well established in the medical literature. As a matter of fact, it is as closely linked as bacteria is to infection or smokingSmoking damages the lining of your blood vessels, raises blood pressure, makes blood clot more easily, and speeds up plaque growth. is to cancer. I’ll get into this a little bit later in some of my lectures, but there is no doubt that even though I had what was considered normal range cholesterol, this had led to the problem because I lived a healthy lifestyle and I thought I had eaten well.

Astounding Results

So, soon after changing my diet, my total cholesterolTotal cholesterol adds together the cholesterol in all your particles, harmful and helpful alike. went from about 200 to 150 and my LDLLDL cholesterol, or LDL-C, is the amount of cholesterol sitting inside your LDL particles. It is the number on almost every standard lab report. went from about 140 to 100. That was a significant drop, but I also decided to get on medications. I started with statinsA statin slows the enzyme your liver uses to make cholesterol. Your liver responds by pulling more cholesterol out of your blood, which is where the real benefit comes from., but they made my muscles hurt and decreased my performance on the bike, so I petitioned to get on Repatha, also known as Evolocumab, which is a pcsk9 inhibitor. This particular drug is called a biologic and disables a proteinProtein is the nutrient your body uses to build and repair muscle and tissue. that causes your cholesterol to go up, so when you disable this protein your liver can remove more cholesterol from your blood. It operates in a completely different way than statins. The side effect profile according to the literature is near zero. I, in fact, have no side effects from the drug.

At about the same time I decided to start up a support group in my home for other athletes or pretty much anybody who is interested in changing their diet and improving their cardiovascular health. I’ve been running the group now for about 3 years. In the group, we discuss our diet and we have a potluck dinner with low-fat whole foods, and I give a short lecture on scientific topics that the group has asked me to address.

Helping Others Live Rewarding Lives

So it is with this that I will begin an educational series on what I did to improve my health. This informational series is not intended to replace your physician’s guidance or treatment. I am not a physician. I’m going to present the scientific literature and discuss things that I have done to benefit me. Any suggestions that you might get from any of my presentations need to be addressed with your personal health care provider. In other words, talk to your physician first before you do anything that might affect your health.

Some Key Takeaways

A physician is a medical doctor who is trained to treat disease, whereas a Ph.D. is a person who goes through a higher degree to learn a specific topic, do research and write a dissertation which may or not be medically or scientifically oriented.

When I speak of cardiovascular disease, I’m specifically talking about atherosclerosisAtherosclerosis is the disease behind most heart attacks and many strokes. Cholesterol particles get stuck in the wall of an artery, the body sends immune cells to clean up, and over years that mess hardens into plaque.. Atherosclerosis is also known as hardening of the arteries. It is where the plaquePlaque is the buildup of cholesterol, immune cells, scar tissue, and calcium inside an artery wall. is deposited in the wall of an artery. This plaque can break off and cause a heart attackA heart attack happens when blood flow to part of the heart muscle is cut off and that muscle starts to die. which can either kill a person or damage part of the heart.

Ultimately my goal is to educate by presenting unbiased scientific information through the lens of my personal experience as a heart disease survivorA person who has been diagnosed with significant cardiac disease—such as severe atherosclerotic heart disease—and has not died from it, often implying they have managed or reversed their condition through medical treatment, lifestyle change, or both.. Both of my parents and my younger brother, who was only 42 years old, died from heart attacks. My two surviving siblings both have diabetesDiabetes is a condition where blood sugar stays too high, either because the body makes too little insulin or because it stops responding to the insulin it makes., and my older brother has cardiovascular disease that we know to be severe. Everything I’ve done has been to save my own life. I didn’t go through medical school to become a cardiologist and treat people with cardiovascular disease, but I also feel that you shouldn’t have to get a Ph.D. and go through what I went through to learn what I did.