He should follow that which his doctors have advised him to be on.  I
would guess that he has been advised by his doctor(s) to stick with a
diabetic low fat/low cholesterol diet.

Since his being overweight is an issue, he may benefit from the addition
of the diabetic 2PD approach as described at:

http://www.heartmdphd.com/wtloss.asp

Would suggest you have your dad ask his doctor(s) about this combination.

Is this self prophesy?

Hyperketonemia would be a concern for folks with known atherosclerosis.

My guess is that he had blockages 5 years ago that weren't bad enough for
angioplasty or bypass surgery.  And, they worsened because your dad still
had metabolic syndrome (MetS) that was not adequately treated (i.e.
cured).

Servant to the humblest person in the universe,

Andrew

--
Dr. Andrew B. Chung, MD/PhD
Board-Certified Cardiologist
http://www.heartmdphd.com/

**
Who is the humblest person in the universe?
http://makeashorterlink.com/?W1F522557

What is all this about?
http://makeashorterlink.com/?J2DB148A7

Is this spam?
http://makeashorterlink.com/?N69721867

I've read a lot of recommendations lately that say that people with
existing cardiac problems should try to get their serum cholesterol
under 100 with a favorable HDL/LDL ratio.

He needs a reasonably balanced diet relatively high in protein to help
his body repair the trauma of the surgery. Here's the body of a note I
posted on a mailing list in 1999, after my bypass.

<<< begin quote >>>

Speaking of food...

After my recent surgery, I felt lethargic.  A friend
(medical writer) went out on the net and found some
very interesting stuff about post-traumatic (open-heart
surgery is VERY traumatic) nutrition and found info for
the amount of protein desirable and caloric
requirements in the circumstances.  Cells are being
repaired and for that reason, the major nutritive
requirement is protein.  Beyond that, to my surprise,
even though activity is reduced, MORE calories than
usual are necessary, for the same reason.  The
suggested protein level is 1.5 grams of protein per
kilo of body weight per day.  Not meat, protein.  I
weigh 83 kilos with all this inactivity.  That
translates into lots of meat, eggs and cheese.

Very interesting stuff and, for me, smack on.  I was
trying to do a more broadly balanced diet and was
feeling weak.  Switched to this approach and
immediately - the same day - felt better.  Mood
improved, energy came up and general sense of
well-being improved.  Hardly statistically important -
one man's experience - but confirmatory.

According to the formula for caloric needs, I should be
taking in almost 3,000 calories per day, tapering off
as I get closer to pre-surgical condition.  It's been
almost 5 weeks now and I'm very close to baseline now
so I've cut back on the food.

I've also had the unfortunate task of disposing of the
candies I bought for Halloween.  I'm doing very well
with that project, thank you.  Whew.

Pastorio
-----------------------------------------------------------------

[source: "Surgical Nutrition," a lecture by Michael L.
Cheatham, Assistant Director, Surgical/Trauma ICU, Orlando Regional
Healthcare System, Orlando, Florida; can be found at
<http://www.mdacco.com/meded/surg-med/Lectures/surgnutr.html>]

The Harris-Benedict equation is perhaps the most
commonly used method of estimating a patient’s metabolic energy
requirements. It calculates the estimated basal energy expenditure
(BEE) in kcal/day for a patient using the following equations:

Male: BEE = 66 + (13.7)(weight in kg) + (5)(height in
cm) - (6.8)(age)
Female: BEE = 665 + (9.6)(weight in kg) + (1.8)(height
in cm) -  (4.7)(age)

The resting energy expenditure (REE) is considered to
estimate a patient’s true metabolic energy requirements after
accounting for activity and the stress of injury and can be calculated
using the BEE as:

REE = BEE * activity factor * injury factor

Activity factor:
      bedrest 1.2
      ambulatory 1.3

Injury factor:
      minor surgery 1.2
      trauma 1.35
      sepsis 1.6
      burns 2.1

The Harris-Benedict equation was derived from the
energy requirements of healthy volunteers and is therefore not
directly applicable to critically ill patients. While the BEE tends to
underestimate the true metabolic requirements of the surgical patient,
the REE commonly overestimates energy requirements. Nutritional
therapy based on these measurements alone will therefore likely lead
to overfeeding. The Harris-Benedict equation is, however, frequently
used as an initial estimate of a patient’s energy requirements in
order to begin nutritional support.

Surgical patients are inherently catabolic due to the
stress imposed by their disease process, operative intervention, and
metabolic recovery. Thus, they require increased protein
administration to prevent further protein breakdown. These patients
also have increased energy and protein requirements to provide for
wound healing as well as the need to replace protein which is lost
from wounds and fistulae. Estimation of protein requirements must
therefore take these increased losses into account.

Because of the inaccuracy associated with determination
of protein requirements, the current recommendations are that an
estimate of 1.5 grams of protein/kg/day should be used in calculating
protein administration for surgical patients. For comparison, a
healthy person requires approximately 0.8 grams of protein/kg/day.
Administration of more than 1.5 grams/kg/day exceeds the body’s
ability to incorporate protein and does little to restore nitrogen
balance.

It likely won't be dangerous, but check with his doctor.

Pastorio

This leads me to my second question:

Hi Don,

I'm suggesting that you might ask about a Cardio Rehab program for your dad,
as soon as he gets stable and up and about. They have these programs at many
hospitals. They monitor you and check your indicators, weight, BP, etc. Meet
2 or 3 days a week. Also, your dad will be exposed to lots of good info to
help him live a long life, not to mention the chance to talk to others in
the program. Initially, he has to get lots of rest when home, TLC, and take
his meds. Rest is important. Low stress around him, is best. Good Luck!

130 is too high for a diabetic.

The kind he should've been following his entire life...a balanced,
healthy diet. Depending on his comorbid medical problems, low sodium
may also be in order. Ask his doctors. Fad diets (e.g., Atkins) need
not apply.

I wouldn't recommend it. "Low carb"="high something else" (usually
*fat*), which is a *bad* idea in known coronary disease.

The passage of time.