Summary: recent research shows that preventing heart disease begins with an anti-inflammatory diet. Sugar and polyunsaturated vegetable oils are both highly inflammatory, and the latest research shows that it is sustained high blood sugar levels and the presence of too many omega 6 fatty acids (found in vegetable seed oils) that begin the process of heart disease.
There is no such thing as a "sudden" heart attack. What happens to the arteries in cardiovascular disease is a cascade of events which unfold slowly over years or decades. Preventing heart disease requires attention to diet years before it manifests (and... it's not about reducing fat and cholesterol).
Heart disease begins with inflammation in the arteries1. Inflammation occurs as a response to damage caused by elevated blood glucose, which comes from eating high-carbohydrate foods, especially sugar.
Glucose is the energetic end product of eating carbs - any carbs, not just sugar. Glucose is a particularly dirty-burning fuel, leaving as "exhaust" molecules known as reactive oxygen species, more widely known as free radicals2. Free radicals act like little fires that can damage or kill cells, including the cells lining the arteries. Preventing heart disease requires keeping blood glucose (and resulting insulin) levels low.
Inflammation is the body’s attempt to heal these damaged cells or tissues. It increases circulation to the affected area in order to deliver white blood cells (to fight infection) and cholesterol (to form scar tissue).
Cholesterol is a major component of all scar tissue, as well as a vital component of all cell membranes in the body. Scar tissue is laid down over a wound to seal it shut, and as healing progresses, the scar tissue eventually recedes as it is replaced by normal tissue.
But when cellular inflammation is continuous and chronic because of repeated or continual assault by high blood glucose and other inflammatory substances, the inflammatory response is also continuous and chronic.
The attempted healing of the damaged arterial walls occurs from the backside of the "pipe", not the side that the blood is coursing through. Nevertheless, the arterial wall thickens as cholesterol and white blood cells called macrophages cluster and build up in an attempt to heal the oxidative damage.
As the body continues its attempts to heal the injured arterial walls by continuing to lay down scar tissue, eventually the scar tissue itself - the arterial plaque - impedes or occludes the blood flow through the arteries to the heart, resulting in a heart attack.3
So the old image of "fat clogging the arteries" like grease poured down a drain is not only inaccurate, it diverts us from the actual root cause of heart disease. It also diverts us from the best course for preventing heart disease.
While it is true that cholesterol is one component of the plaque that forms in the arterial walls, blaming cholesterol for a heart attack is like blaming a bandage for a skinned knee.
The modern diet is now largely based around pasta, bread, rice, corn, potatoes, and sugar-laden processed foods, which means that we eat far higher levels of inflammatory carbohydrates than ever before in human history. This is what initiates heart disease, so preventing heart disease means not eating these inflammatory foods.
Our modern diets also include other highly inflammatory foods, all of them very recent introductions to the human diet. These include vegetable seed oils [like sunflower, safflower, and canola oils], trans fats, low-fat hormone-laden dairy products and meats, genetically modified foods, pesticides and herbicides.
(Note: Olive, avocado and coconut oils are not inflammatory, coming from the flesh of the plant rather than the seed. Unlike vegetable seed oils, they are not extracted using extreme heat and pressure along with chemical solvents).
We did not evolve to eat these industrially-produced, unnatural substances. Our ancestral diet, the one our miraculous metabolisms evolved to handle, had very few carbohydrates and none of these industrially-produced "foods".
Preventing heart disease is only one benefit of a low carb diet. Most of us experience systemic inflammation without recognizing it for what it is. It is reflected in low energy, headaches, joint pain, GI problems, acid reflux, weight gain, insomnia, slowed healing of injuries, lowered resistance to colds and flu and many other complaints.
But much more serious than these symptoms, however, is the fact that systemic Inflammation precedes virtually all the “diseases of modern civilization” 4 including heart disease, Type 2 diabetes, cancer and Alzheimer’s.
Preventing heart disease means cutting its root cause: eating primarily high carbohydrate and inflammatory foods. To learn how to change your diet and eliminate your true risk factors, explore the other articles on this site (and other sites) that can teach you how to cook and eat low carb and keto.
1) Clean Gut, pg 65
3) Clean Gut, pg 65-66
4) The Case Against Sugar, pg. 227