The whole person

I notice going through the various posts they very rarely mention a list of other important factors[maybe an odd one].

The age of the person.

The weight / BMI of the person or more details related to weight. Getting close to 70% of Americans are overweight or obese.

Their diet in sufficient detail to get a good understanding of it.

The exercise status of the people in sufficient detail to understand it.

I can think of more points but as a starter I don't think many people will list the above points and to me neglect of them is part of the problems people face. We can't change our age but we can change our weight, diet and exercise parameters.

Alex

Here you go Alex <[www.afibbers.org] age: 60, height 6'0", weight 167# (BMI 22.6). Waist = 33', Using US military correlations, body fat = 12%. Water fast 22 hours/day. Animal protein (20g/day or 4 oz serving) is limited to white fish, shellfish or omega 3/pastured eggs. Diet is approximately 80% fat calories and from non-animal sources, mostly monos. Fiber is >50g/day. Carbs are 80-90g/day, including fiber. Protein is about 60g/day. No grains, legumes or nightshades. Do include non-starchy carbs, some whole food resistant starches and a small serving of berries. All food is from whole sources. I skied 7 hours/day on the steeps for 3 days this week, rock climbed on another and hiked on yet another. I train HIIT Tabatas (8 sets 20:10) & jump rope a few times/week. When not otherwise occupied, I do body weight exercises as programmed for the military. {edit} Also do 15-20 minutes of yoga/day, meditate 30+ minutes/day and all exercise is done with nose breathing.

Enough for you?

George



Edited 2 time(s). Last edit at 03/20/2016 11:52AM by GeorgeN.

Very interesting George. Would you mind elaborating on that 80% fat? Exactly what foods and what amounts?

Thanks

Sam

Sam,

There is more detail in my first link above <[www.afibbers.org], but I eat off this list: <[drive.google.com] (this version does not have the ApoE4 animal fat restrictions noted). As noted in my link, I have a copy of the single ApoE4 gene. Dr. Steve Gundry, from Palm Springs (& I consult remotely), has noted that people with my gene tend to spike sdLDL (small dense LDL, most likely to oxidize as has longer life - 5 days in body) when they consume animal fats. Other genotypes (ApoE 3's & 2's) don't have this issue. Other things that can spike sdLDL are excess carbs.

My wife & I consume about a liter a week of unfiltered extra virgin olive oil. I also tend to eat a 4 oz serving of guacamole/day and 1/2 avocado. The rest of the fat comes from the nuts on the list: macadamia, hazelnuts, walnuts, pecans, pistachios. I consume about a cup total of these nuts/day.

The bulk of my meal is raw veggies off the list. I do steam the white & shell fish and make something from the eggs that is cooked. When we eat eggs, we usually split a dish with 4 eggs in it. As for veggie selection, I pay attention to Dr. Terry Walhs' adaptation of Dr. Bruce Ames "triage theory of aging & micronutrients." <[www.google.com] In this I aim for 1/3 of greens, 1/3 sulfur containing veggies and 1/3 colored all the way through with 3 different colors, applied to Gundry's Matrix food list as linked above. <[terrywahls.com]

Gundry has us limit animal protein because methionine (an amino acid) will spike insulin like growth factor-1 (IGF-1) and leucine will activate the mTOR (mechanistic target of rapamycin) pathway [www.google.com] <[www.google.com]. Both are overexpressed in animal protein compared to vegetable protein. Centenarians are correlated with low levels and the life extension of caloric restriction studies can be duplicated with restriction of methionine & leucine. (Shannon will have a different take on keeping IGF-1 low. IGF-1 does stimulate muscle growth and there can be a tradeoff depending on your desired outcome).

{edit} I should note that I am in "nutritional ketosis" <[www.google.com] most of the time eating this way. <[eatingacademy.com] If I sample, my serum beta-hydroxybutyrate levels range between about 0.5 and 2.0 mM (nutritional ketosis is usually between 0.5 & 3.0 mM). My breath acetone levels range between 45 & 60 ppm (nutritional ketosis range 40-70 ppm). Constant ketosis can deplete selenium & I do supplement. Also caloric restriction and low carb, low meat can increase sex binding hormone globulin which means my free testosterone can be low. Dr. Gundry has me supplement with DHEA to increase testosterone and offset this.

George



Edited 1 time(s). Last edit at 03/19/2016 01:32PM by GeorgeN.

Age 56, female, 133lbs, 5'3" bmi = 23.52. Diet is pretty good, relatively gluten free, lots of greens and proteins, no white sugar, flour or rice etc limited dairy just recently cut out potatoes completely. I supplement with Vit D3, multi vit, sublingual B12/6, magnesium and potassium when I feel PACs. Reasonably active (dog walk everyday, Pilates and Melt Pilates). My heart rate post ablation (in 2013) is back to around 60 resting but can go as low as 55 in the night (small but strong heart). Suffer from BPPV on occasion, stressful job !

George and Heather,

I know there are other trim people with afib !

At the gym I go to there are quite a few trimmies.But the fact remains getting to 70 % of Australians and Americans are overweight or obese and the proportion is increasing.

So exercise and really good diets are rare.

It would be interesting though very difficult to impossible to do a good survey

Alex

Alex,

It so happens that, except for one, all the afibbers I know personally are fit and trim. The one not highly fit got his afib during surgery to repair an aortic aneurysm and was in his 80's. From Hans' data (from 10 years ago), chronically fit afibbers represented about 15% of the total afibber population. Most others get it a) from heart or lung surgery or b) have comorbidities such as hypertension, CVD & etc. This latter group can benefit from lifestyle changes as have been noted here.

George

George,

We tend to associate with people of common interests and attitudes.

When I asked my cardiologist some ago about fit people with afib he said It was very rare in his experience .

15 % sounds high and it would be interesting to see the detailed methodology.In any case that leaves 85 % not so fit so still very normal.

If is an interesting subject.

Alex

Alex - When my AF onset hit almost 21 years ago, I was fit and active. Once I began the prescribed drug treatment protocols, I became lethargic and eventually, insulin resistant which also resulted in gaining weight even though I was still exercising the same … more, actually, because the Afib forced me to retire early since the events made me unreliable to work my patient load, so I had even more time to devote to workouts. With time, my events became more frequent and of longer duration.

Related to the onset, I had no recent surgery, heart disease, hypertension or any other dysfunction other than hypothyroidism which was managed with Armour thyroid hormone replacement and I was also using BHRT for post-menopausal symptoms. As close as I could come to determining the underlying cause (the doctors weren’t interested) was the Exatest results indicated low IC magnesium and the potassium/sodium ratio indicating too low on potassium. An ah-ha! moment.

My history then was after 8 years of struggling and finally signing up for an ablation, I found this website, learned about magnesium deficiency as a potential cause and after about 3 months of intense Mg dosing along with potassium and treating for vagus nerve impingement (diaphragm), I went from daily and very prolonged AF to zero events… tried to wean off the flecainide, but couldn’t get off the last 50 mg… so proceeded with the ablation because of the potential that I might lose my insurance.

I have always felt there is a genetic mutation or defect that affects some individuals unless they are able to determine how to prevent the expression of that mutation. One study indicates there is a mutation that prevents or interferes with magnesium assimilation for individuals. There are probably other gene factors involved as well that haven’t yet surfaced.

Over many years, I’ve worked out and taken classes at various fitness centers and during discussions on health with various members and staff, I’ve only met one other person with arrhythmia. In his case, he was a permanent afibber and never even knew it.

Jackie

Alex,

If you look at this paper <[www.hindawi.com] you'll see that the average age of onset for "Lone Afib" is ~51. From this paper, <[www.ncbi.nlm.nih.gov], the median age for all afibbers in the US is 75. I'd venture to guess that a very high percentage of those whose Lone Afib came on in their 30's, 40's or 50's come from a fit, active background. From other data I've seen, afib in people these ages is very rare, except in the fit. This is not true where age of onset is >65.

Also, if you read Hans' first book and go look at his surveys, from the days that this site focused on "Lone Afibbers," you'll note that there is a high percentage of very active (and tall) people.

I've participated here since 2004. I can say with certainty that most who showed up here back then were chronically fit. I specifically remember many showing up and being incredulous that exercise could be the root of their problem. I would suggest that while exercise was good for the heart's plumbing, it is not good for the electrical system. I had many of these posts.

George

George and others,

I think we should consider the process of statistical analysis and coming to conclusions on causation.

It is a long time since I got honours in statistics at university level. I haven't practised in that area but have retained an interest.

I suggest a very good book to read is [www.amazon.com].

I read recently that 75% of supposedly researched conclusions on causative factors don't have adequate substantiation. This doesn't mean they are wrong but it does mean they are just opinions.

Doctors and scientists can get things wrong too. Remember when fats were very bad. Now good fats are good. Eggs were bad now eggs are good. It is easy to find examples.

An headline example that came up today. High intensity training is nine times as effective for weight loss as aerobics. I don't know how many people are involved but some non headline info was the weight lost over 15 weeks of hard HIT training was an average of 1 pound with the high-intensity protocol. Another analysis would be that the effect of either would be negligible. I don't know the numbers or full details so won't come to more conclusions.

In the Hidawi example you mentioned afib in the younger age group it said AF in the young had eight causes in which endurance sports was one.

I have seen cases where profound conclusions seemingly important to the researchers came from a test group in the 15 to 24 number category. From a statistical point of view close to impossible to justify though it may point into a more research is required area

Good research like the Framingham study is very welcome.

I can't say your guess is wrong but my guess would be different and there is no point trying to have an authoritative conclusion based on guesses.

Did all the people that Hans asked on the forum reply and give full answers to the questions asked? I suspect not but again I can't be sure.

Another regular problem is assuming correlation indicates causation as mentioned. It may do so sometimes or often but that needs analysis.

I can supply many examples of newspaper headline health revelations being completely misleading and/or not having adequate information so the study group can be delineated.

Jackie has sometimes mentioned we are examples of one. Having a small number like 20 or so is better but not by so much.

Alex

alexe Wrote:
-------------------------------------------------------

> When I asked my cardiologist some ago about fit
> people with afib he said It was very rare in his
> experience .

I had to switch cardiologists after my initial diagnosis of AF. I was 41 yrs, 6'0", 185 lb, 4-5 mile/day jogger. He told me I should lose weight! He did not want to refer me to an electrophysiologist and, after a normal stress echo, told me that AF could only be caused by alcohol use in young people. When I asked about exercise as a possibility, he said only if I were running marathons. I was flabbergasted, to say the least!

In my opinion, I think most cardiologists treat folks in advanced age with congestive heart failure (CHF). They also put stents in people with demonstrated blockages. Those two things have got to be an overwhelming majority of what they do. They're plumbers, not electricians - to put in bluntly.

That's not to knock cardios, mind you. I felt far more comfortable with my second doctor. He said rhythm isn't his specialty, that's electrophysiology (EP). He put me on rhythm control and discontinued rate control (because my normal resting HR was already upper 40's, low 50's). It "held the line" OK until the ablation, which he recommended as first line treatment. He put me in touch with an EP and we got it done.

AF is a condition that is going to require a team effort between your cardiologist and an experienced electrophysiologist. Just one or the other isn't going to be as good as the two. Your cardio will be your "first-line" doctor who can medicate any arrythmia if it shows up but then refer you on to the EP for further study if it is required.

Hello Wolfpack,

I am sure if we ask a variety of cardiologists will get a variety of opinions based on their experiences with their particular clients.

We should always do our best to increase our knowledge and improve our understanding of the subject.

A broader knowledge base has helped me a lot and I'm sure it would help others.

This is not scientific research with statistically valid conclusions.

Nearly all of our decisions in life are not based on valid control group research but on our personalities and life experiences.

The best of luck with your choices!

Alex

"told me that AF could only be caused by alcohol use in young people. "

Yep, when talking about afib with my MD friend and neighbor, he commented that "holiday heart" (i.e. excessive alcohol use) was what he typically saw in young people.

During a treadmill test about a month after my first episode, I described my afib presentation to the cardio doing the exam (comes on at 3AM, could be converted with exercise - a typical vagal presentation), he said he'd never seen anyone presenting like that. It was this comment that drove me to research afib and led me to this site and Hans' book. A month later, I described my presentation to cardio #2. He told me he didn't believe in vagal triggers and digioxin was his favorite med. I would not take it and he passed me off to his EP partner. When I described my presentation to him, he said, "you are obviously vagal and there are certain meds we won't prescribe for you."

All this being said, afib is very uncommon in the young and in the young typically has chronic fitness at its root.

Alex, arguing over the stats will not help an individual. In my case I went down the list of possibilities: coronary heart disease, heart attack, heart surgery, valvular heart disease, hypoglycemia, electrolyte imbalances, hyperthyroidism, pheochromocytoma, strenuous exercise, binge drinking, consumption of tyramine-containing foods, and exposure to emotional or physical stress are all triggers for afib. I excluded everything except strenuous exercise and electrolytes.

There also was a longitudinal afib study from Olmsted County, MN (where the Mayo Clinic is located). Hans posted it here some years ago. I recall it was something like 30 years. The paroxysmal afibbers had better mortality than the normals. The afibbers started out with better CVD, hypertension & other chronic illness metrics. However these did tend to degrade over time. Possibly because of the afib, they weren't able to exercise as much.

When I looked at my case, I tried to extinguish any potential chronic illness indicators. I addressed these issues. I detrained, I added magnesium, potassium & taurine for electrolytes. When I started, I was fit but in retrospect had signs of insulin resistance. I dropped my A1C to 4.7% (correlates with average glucose of 89 mg/dL or 4.9 mmol/L) and fasting insulin to 4 or 3 (depending on the day). My BP is 108/65. In summary, I addressed as many possible causes as possible and plan to keep it this way.

It is working for you George so be happy !

Alex

Hi George,

When you get back form spring skiing can you relay how much DHEA you take and what brand you are using?

Thanks in advance,

Daniel