Break your heart?

In 1996, Matthew Bayan was the poster boy for mid-40's good health.

Lean and fit, he exercised daily, avoided stress, never smoked and faithfully adhered to a stringent low-fat diet. Imagine his surprise when a massive heart attack ripped through his chest on a cool night in May that same year.

Good intentions, Bayan insists, nearly cost him his life.

What went wrong four years ago? As Bayan explains in his controversial new book, "Eat Fat, Be Healthy: Understanding the HeartStopper Gene and When a Low-Fat Diet Can Kill You," the traditional, cardiac-friendly, low-fat diet pushed his heart over the brink.

"I suffered from small-particle LDL syndrome or atherogenic lipid profile" a little known disorder that changes all the rules, Bayan says. "Welcome to the world of what I now call the HeartStopper genes, where your blood chemistry is turned topsy-turvy and most of what you've been taught about fat in your diet is wrong."

According Bayan's research, this genetic "HeartStopper" glitch causes one man in three (one woman in six) to produce the worst kind of LDL or "bad cholesterol" when the person eats only low- or no-fat foods. This small-particle LDL then accumulates on the walls of arteries that feed a steady flow of blood to your heart. Even small amounts of this unstable cholesterol plaque can spur a deadly heart attack.

"It doesn't need to completely block a coronary artery to be dangerous," he says. "Its unstable nature causes it to crack or tear. Blood senses this break as being a tear in the wall of the artery, which it's not, and begins to clot. That causes the heart attack."

"The disorder described by Bayan is generally known as the metabolic syndrome," says Dr. Katherine R. Tuttle, director of research at the Heart Institute of Spokane. "And there is an increasing awareness of this syndrome among physicians. But the problem is actually multifactorial."

Tuttle suggests a combination of many contributing factors - including an increased circulation of small, dense LDL particles, hyperinsulinemia and insulin resistance, hypertension, low HDL cholesterol levels, elevated triglyceride levels and obesity - causes this condition, which she says is only one clinical step away from full-blown diabetes.

Bayan stands by his conclusions. What makes him qualified to write such a controversial book?

"This condition nearly killed me," he says.

On May 9, 1996, Bayan's heart stopped six dozen times. And six dozen times, doctors at Mercy Hospital in Des Moines, Iowa, brought Bayan back from the dead.

Even after he survived the initial attack and moved from Iowa to Reno, Nev., Bayan still had to find a way to keep it from happening again - no easy task, considering traditional dietary treatments would do more harm than good.

Bayan managed nutrition and health programs for more than 25 years before his heart attack. Since then, he has turned to writing and research.

"The low-fat diets prescribed to heart patients are dangerous for people with my condition," he says. "They emphasize the reduction of fat intake and an increase in carbohydrate intake.

"But the genes responsible for the HeartStopper effect use increased carbohydrates to raise triglycerides (simple fat molecules) in the blood. Triglycerides trigger the HeartStopper effect by providing the raw material necessary for greater production of small- particle LDL."

Through trial and error, Bayan and Nevada cardiologist Dr. Frank Carrea created a customized lifesaving regimen - an aggressive diet and exercise program to combat small-particle LDL syndrome. Their diet eliminates "bad fats," such as butter, whole milk, cheese and meats, but includes "good fats," such as olive oil, canola oil and fish.

Their experimental journey is dramatically profiled in Bayan's insightful and highly personal book.

Carrea admits some heart patients could use Bayan's book as an excuse not to revise their unhealthy diet.

"These resistive patients clutch at any straw to justify their bad eating habits," he says. "But I think `Eat Fat, Be Healthy' does an admirable job of illuminating the differences between these two groups of patients" - those with small-particle LDL syndrome or atherogenic lipid profile, and those with more traditional forms of heart disease.

How can heart patients determine, for certain, which category is a match?

"They must have their blood tested for presence of small LDL particles," Bayan says. "The lipid panel is considered by most doctors as the gold standard for diagnosis of coronary artery disease."

But he insists the lipid panel can be as much as 50 percent inaccurate when it comes to detecting smallparticle LDL syndrome.

According to Bayan, the $250 Gradient Gel Electrophoresis is the only conclusive screening for small-particle LDL syndrome.

"But I know of only one commercial lab that does the test," he says. "A spinoff from the research facilities of the University of California at Berkeley, Berkeley Heart Labs, www.berkleyheartlabs.com."

Tuttle agrees the test Bayan describes is not readily available here in Spokane.

"Small, dense LDL particles can be measured at the Lipid Research Clinic at the University of Washington," she says. But she questions the necessity.

"Most experts believe that the LDL cholesterol level, along with the other determinants of metabolic syndrome, is sufficient to identify the high-risk subgroup," she says. "Measurement of the small, dense particles may be valuable when there are doubts about the diagnosis or for research purposes," she continues, "but this measurement is not necessary in the usual clinical situation."

While Bayan acknowledges Tuttle's concerns, he is no stranger to medical doubt in general.

"In my face-to-face encounters with physicians, it usually runs like this: First, there is skepticism; I have no M.D. after my name. Then they either dismiss the whole topic as needing more research or they ask me for copies or citations of some of the medical papers that I use to prove my points.

"I think it sometimes depends on ego," he continues. "But my book isn't about ego. It's about saving lives.

"I am passing knowledge on to others like a baton in a relay race," he says. "It is a race with a finish line that nobody wants to reach, an endless marathon for survival."

With proper diagnostics, Bayan hopes it's a race that will at least take its natural course.

Copyright 2000 Cowles Publishing Company
Provided by ProQuest Information and Learning Company. All rights Reserved.