If a vegan has a heart attack, NOW what do they eat?

As a vegan, you don’t consider heart disease as something that will affect you, especially not in your 40s. So I didn’t believe that as a possibility when I felt tightness in my chest, and my arms felt weak.

I thought by being vegan for 15+ years and vegetarian for 22+ years I would avoid the heart disease and type 2 diabetes in my family. Apparently not.

And while I was not a health food super fit vegan, I also wasn’t a junk food slothy vegan slamming Oreo’s and potato chips. I think like many vegans I was somewhere in between. Sure, we occasionally made Daiya Mac & Cheese from the box ate decadent fatty veggie burgers like the Beyond Burger, and ate vegan doughnuts when we found them (thankfully, that’s a rare occurrence.)

On the other side of that, we destroyed tons of kale, I defaulted to whole grains, and almost never chose the deep-fried option. Also, I rarely drink and never smoked. And yet, I still had a heart attack at 49 years old.

Why? I have no fucking clue.

The cardiologist answered that it must have been the family history. And he said that I would probably be on drugs the rest of my life.

Fabulous.

Okay, well, I’m not going to rely on drugs to help me get healthy. Don’t worry; I’m taking them all as directed. But I’m also cleaning up my diet.

Gathering Information

To get my diet in order, I’m reading everything I can find.

In the past, I’ve read The China Study and Eat to Live. I’ve also read some of Dr. McDougall’s books.

More recently I’ve read How Not To Die by Dr. Greger, Prevent and Reverse Heart Disease by Dr. Esselstyn and Plant-Based Nutrition 2E. I just virtually cracked open The End of Heart Disease by Dr. Joel Fuhrman on my Kindle. I’m only partway through, but so far Dr. Fuhrman’s book has had the best explanation of the kind of heart attack I had.

Frustrations

So, here’s the thing. I wasn’t eating the Standard American Diet (SAD). I was eating a moderately healthy vegan diet for over 15 years. And it still happened to me.

Dr. Esselstyn says over and over in Prevent and Reverse Heart Disease that if you have a cholesterol level less than 150, you will not have heart disease.*cough* Mine was 134 when I had my heart attack.

No, I’m not misreading that or exaggerating. Check it out.

That’s a bold statement. I’d understand something like “in my study” or “for most people” Maybe he’ll temper that statement with some caveats later. Nope, he doubles down.

Triples down.

Quadruples down.

And then he brings in a reinforcement.

I get it. A bold statement can get people to make bold changes. But it just makes me call into question all other claims he makes. Because I already had a cholesterol level under 150 and an LDL under 80. This example is why it’s important to take in many sources, not only when it comes to your health but in all things.

What I’m Eating Now

I’m not a doctor or a registered dietician. I’m just someone taking in as much information as I can to formulate a plan that’s right for me. Nothing here should constitute medical advice. Everyone has a unique set of circumstances and should work with their doctors and dieticians to make their plan. And arm yourself with knowledge! Read everything you can about your condition and ask questions.

All that said, I based my decisions on a few factors. First, I never had high blood pressure. Second, while my cholesterol was 134 and my LDL was 69, my HDL was 26 (low compared to LDL), and my triglycerides were 196 (high.)

My heart is in great shape except for the part that gave me a heart attack. There I have plaque causing a 30% obstruction. It ruptured throwing out a blood clot which is what prompted my heart attack.

So, my goals are:

• Lower my cholesterol/HDL ratio, which was at 5.2 where under 4.5 is recommended, by raising my HDL levels while holding my LDL steady or lowering it slightly
• Lower my triglycerides
• Dissolve that plaque
• Lose weight
• Exercise regularly
• Reduce doses or come off of as many drugs as possible as soon as possible

A few changes to my diet

I’ve been vegan for 15+ years which means I’ve consumed no dietary cholesterol in all that time. But that doesn’t matter because your body makes cholesterol by design. The American Heart Association has a simple description of the process here.

My low HDL level may have made it hard for my body to dispose of excess cholesterol my body was making. And, consuming saturated fats (coconut oil, palm oil) could have caused my body to produce more cholesterol.

High triglycerides also contribute to the equation.

So, taking into account Dr. Greger’s information about getting the most nutrient dense foods possible and Dr. Esselystyn’s advice for reversing heart disease, here’s what I’m doing:

• No added oils, only whole food fat sources in moderation (nuts, seeds, avocado)
• No refined sugars
• Limited sodium intake (I’m currently averaging about 1200-1500mg/daily)
• Only eat whole grains
• Eat about three servings of fruit daily
• Eat more fiber – this is hard not to do when eating whole food plant based

Examples of meals I’ve been eating

My typical breakfast

I eat oats for breakfast every day either old fashioned or steel cut. I have two different formulas I follow. When we’re on shore power, I make microwaved old fashioned oats. I add 1/2 cup of berries, usually blueberries, a tablespoon of ground flax, a pinch of green tea, two tablespoons of walnuts, and 1/4 teaspoon of turmeric.

When we’re boondocking, overnight oats are easier. I’ve been using this recipe from the How Not to Die cookbook. I also add walnuts, green tea, and turmeric to this.

Protip: you can use steel cut oats to make overnight oats also. Just use a smaller amount. I use 1/3 cup steel cut oats to 3/4 cup liquid.

Oats for breakfast gets the day started with fiber and omega 3s from the nuts and seeds. And blueberries are nutrient-dense anti-oxidant powerhouses.

I also have a cup of coffee, sometimes two, with unsweetened vanilla almond milk.

Lunch and Dinner

I’ve put lunch and dinner together because they’re pretty much interchangeable. We do usually have fruits for lunch as well.

While I avoid most processed foods, I still rely on veggie burgers quite a bit. Thankfully, I’ve now found a recipe that’s healthy and easy to make in the RV. I’m looking forward to playing with this basic formula to create different tasty versions.

Here are a few examples of meals we’ve been eating post-heart-attack. Recipes linked when available.

Beyond Meat’s chicken strips, black beans, salad greens, red cabbage, avocado, tomatoes, carrots and red bell pepper over brown rice with cashew nacho sauce.

The healthiest commercial veggie burgers I’ve found are the Engine 2 Plant-Strong line. I’ve seen them at Whole Foods.

When roasting vegetables, make extra, so plates like this come together easier. Here I have roasted cauliflower and sweet potato, edamame, sauteed kale and Beyond Meat chicken strips over quinoa with a balsamic dressing. 

Veggie burger, half a sweet potato with nutritional yeast (do you see a pattern yet?), and Sesame Purple Cabbage & Carrot Slaw from the How Not To Die Cookbook. For some reason, I take pictures of veggie burger plates more than anything else.

Spicy Asian Vegetable Soup from the How Not To Die Cookbook.

Veggie burger, sauteed kale, and Bean and Artichoke Salad from Prevent and Reverse Heart Disease.

Eating Out

I’ve decided to cover eating out at restaurants in a separate post. Click through to find some examples of what I’ve been eating in restaurants and how I felt about those choices.

Tracking Tools

MyFitnessPal

I track everything I eat in My Fitness Pal. It’s a pain in the butt when you cook mostly from scratch or eat out, but I’ve been keeping up with it since the heart attack. If you’re on My Fitness Pal want to see what I’m up to, you can follow along here.

One thing tracking has taught me is that it’s hard to eat a whole food plant-based diet without higher fat plant foods and meet your calorie goals. Even with the minimal nuts and fats that I eat, I still come well below my recommended calories. I think it’s okay now, but there may be a point where I need somehow to get more calories to maintain weight.

Apple Healthkit

I have an Apple Watch, so this is what I’m using to track steps and exercise. It’s not super accurate, but it’s okay for what I’m doing right now. I also have Polar Watch with a heart rate monitor I can switch to if I ramp up exercise.

Headspace

I started a meditation practice back in December using Headspace. It hasn’t been easy concentrating since the heart attack, but I’m mostly sticking with it.

So, this is what I’ve been doing. I won’t know if I’m on track until I have follow-up bloodwork mid-May. As I read more, I may make more changes along the way. My journey to heart health is an evolving process.

Questions, comments, observations? I’d love to hear from you! Just pop a comment below.

Update: lab test results after 6 months on a whole foods plant-based diet