Fit does not mean healthy

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My personal trainer had a heart attack. He was fit and muscular, everyone was shocked. I was not surprised. He promoted the “paleo” diet and argued that we needed to “eat meat to build muscle.” He survived the heart attack and I resisted the urge to say “I told you so” because I actually felt very sad. He truly believed that he had a healthy diet, but his diet could have killed him. He was also unintentionally giving people advice that could kill them.

fixxMy trainer’s heart attack reminded me of Jim Fixx. In the 1980s I became interested in fitness and running after reading his book The Complete Book of Running. I was shocked when he died of a heart attack at age 52 during his daily run. His autopsy showed that he had atherosclerosis with three clogged coronary arteries. By all accounts he had a poor diet and believed that it did not matter. He believed that if he exercised regularly to stay fit and did not smoke he could prevent a heart attack.

This is the same advice that most people get from health care professionals, with a little twist of genetics. If you don’t smoke and you’re physically fit, but still have a heart attack, then it’s your genes. The common belief is that some people are predisposed to heart attacks and what they eat does not matter. This is changing, but is it standard medical practice to take a detailed family history and never ask patients about their eating habits.

Even when a nutritional history is taken, advice to unclog arteries with diet is rarely ever given. We now know that the ONLY requirement for atherosclerosis to develop is cholesterol in the diet. When we stop eating cholesterol-containing foods, arteries heal and become unclogged. That is the science, it is not complicated. What is complicated is how to get health professionals, personal trainers and the general public to accept the science and overcome deeply held cultural beliefs about food, fitness and health.


Fitness is the ability to do a specific task such as walk a mile or lift a specified amount of weight. You can be overweight with clogged arteries and be fit to perform your chosen activities. Health is a different story. The World Health Organization defines health as a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity. Most of us may never achieve that lofty ideal but we can start by being physically active AND unclogging our arteries with a cholesterol-free plant-based diet.