"Heart Surgeon Declares On [sic] What Really Causes Heart Illness,"
这篇病毒性文章接着说，推荐降胆固醇药物和低脂饮食“在道德上已经不再合理”。他解释说，这是因为低脂、高碳水化合物（Low Fat & Refined Carbonhydrates)饮食正通过引起慢性炎症，积极破坏我们血管壁。这种炎症使胆固醇粘附在墙壁上，形成斑块，最终阻塞它们，导致心脏病发作或中风。
他有一双曾经剥离过成千上万动脉壁的外科医生的冰冷的手， “凝视着成千上万条动脉。” 他在书中写道:“花点时间想象一下，在柔软的皮肤上反复揉搓，直到它变得非常红，几乎要流血。”“这是一种很好的方法，可以让你的身体看到炎症过程。”
A Heart Surgeon's Viral Confession
Behind the beloved idea that processed food is "slowly poisoning everyone"
Around 237,000 people now have Dr. Dwight Lundell's confession on their Facebook walls. His essay, headlined "Heart Surgeon Declares On [sic] What Really Causes Heart Illness," was published on a website called Tuned Body in December. Over the past week it has taken off across social media with phenomenal force.
In the essay, Lundell describes his purportedly newfound understanding that a diet of natural, unprocessed food can prevent and reverse heart disease, high blood pressure, diabetes, and Alzheimer’s disease. He recalls two and a half misguided decades as a cardiac surgeon prescribing cholesterol-lowering medications and recommending a low-fat diet. He says that he recently realized the error of his ways, stopped practicing, and dedicated his career to heart disease prevention.
"We physicians with all our experience and authority" he writes, "often acquire a rather large selfishness that tends to make it hard to accept we are wrong. So, here it is. I openly admit to being mistaken. As a heart surgeon with 25 years experience, having done more than 5,000 open-heart surgeries, today is my day to right the wrong with medical and scientific proof."
The viral essay goes on to say that recommending cholesterol-lowering medications and low-fat diets is "no longer morally defensible." That's because the low-fat, high-simple-carb diet is actively destroying the walls of our blood vessels by causing chronic inflammation, he explains. That inflammation makes cholesterol stick to said walls, forming the plaques that eventually block them, resulting in a heart attack or stroke.
"When you spike your blood sugar level several times a day, every day, it is exactly like taking sandpaper to the inside of your delicate blood vessels," he writes, with the cool hand of a surgeon who has "peered inside thousands upon thousands of arteries." His eye for imagery is also hardened. "Take a moment to visualize rubbing a stiff brush repeatedly over soft skin until it becomes quite red and nearly bleeding," he writes. "This is a good way to visualize the inflammatory process that could be going on in your body right now."
Lundell blames not only the refined carbohydrates, but the proportion of omega-6 to omega-3 fatty acids in Western diets. Excessive omega-6 acids create inflammation, and American diets that are high in corn and soybean oils often involve omega-6:omega-3 ratios around 15:1. Lundell is not alone in saying that the ratio should ideally be around 3:1. He gets into the popular hunter-gatherer reasoning there, that "the human body cannot process, nor was it designed to consume, foods packed with sugars and soaked in omega-6 oils."
"There is but one answer to quieting inflammation," Lundell writes, "and that is returning to foods closer to their natural state." Don't eat anything your grandmother wouldn't recognize as food. He recommends eating protein and complex carbohydrates like colorful fruits and vegetables. He recommends abandoning concern about saturated fat, choosing olive oil or grass-fed meat or dairy as a better source of fat than high-omega-6 processed foods.
"Since we now know that cholesterol is not the cause of heart disease, the concern about saturated fat is even more absurd today," he writes. "Mainstream medicine made a terrible mistake when it advised people to avoid saturated fat in favor of foods high in omega-6 fats."
The thing is, like so many viral posts, this is a rerun. It's an old one. That's fine, except that learning it makes the "Today is the day" framing feel disingenuous. Lundell's same confession was also very popular when it was published on the website Prevent Disease in 2012. At that time it openly included a plug for his book, The Cure for Heart Disease, which made the same argument. That was published in 2007.
Lundell since came under fire from consumer advocate Dr. Stephen Barrett who runs the blog Quackwatch. In "A Skeptical Look at Dwight Lundell, MD," Barrett offers a profoundly skeptical look at Dwight Lundell, MD. Barrett digs into Lundell's past, which is fraught with legal issues including having his medical license revoked in 2008 on several counts of professional misconduct and negligence, issues with bankruptcy, and pleading guilty to three counts of willful failure to file income tax returns. Barrett concluded, "Dr. Lundell would like you to believe that he has special knowledge of heart disease prevention. I do not trust his advice."
Beyond questions of credibility, Lundell's essay does make some overreaching claims. There is not "but one answer to quieting inflammation." I'd add exercise and reducing stress. Also, his invocation of moral defensibility loses gravitas in light of his criminal history. Still, the basic tenets of what he says in the essay are sound. Since his original writing in 2007, this way of thinking about nutrition and heart disease has become more mainstream. Statin medication guidelines are being reevaluated, as is understanding of the relationship between dietary fat and heart disease.
That said, this type of eating isn't a panacea. His book's website, The Great Cholesterol Lie, sells oversimplifications that range from potentially defensible on grounds of empowerment ("Heart disease has a cure. ... You can beat it without harmful medications and painful, risky surgery") to all-out overreaching medical advice not to be taken from a commercial website ("Before You Start Taking, Or If You Are Taking Lipitor, Crestor, Zocor, Mevacor, Provachol, Altocor, Lesacol, or any other statin medication—STOP!!").
More interesting to me is just how popular this essay has become this week despite its lack of new insight. Medical advice is everywhere. Diet advice, in particular, is in even more places than everywhere. It comes from all kinds of credible experts who cite evidence. What made this essay take off? The voice of a physician "with all [his] authority and experience" in the context of a candid confession? The always-engaging "we've been lied to" tonality? That visceral image of sandpaper on skin? My thought is that this diet is something many of us have already internalized. Since its introduction years ago, these ideas have seeped into us. We actively want to support and believe this narrative, even enough to incorporate this man into our Facebook aesthetic.
A Heart Surgeon's Viral Confession - The Atlantic https://www.theatlantic.com/health/archive/2014/01/a-heart-surgeons-viral-confession/283413/