Book Review: Don’t Die Early

      28 Comments on Book Review: Don’t Die Early

Lying on the gurney in the emergency room, I shielded my eyes from the glaring overhead lights and tried to remember exactly when my heart went wacko. I remember being anxious and out of sorts all evening. Looking back, I realized that during dinner my chest felt fluttery and strange inside, and I recall snapping at my wife, Laura, over nothing as I left the kitchen to go upstairs.

By the time I reached the top of the stairs, I knew something was very wrong— I could barely breathe and when I placed my fingers to the side of my neck, my pulse felt very unusual. Not the rhythmic beating I would have expected, but more like an indistinct, squishy fluttering. Walking into our spare bedroom, I retrieved the pulse meter from the shelf next to the treadmill. I slipped the meter on my finger and looked at the readout. The effort seemed exhausting. Sitting on the edge of the bed, I called for Laura. When she arrived a moment later, I handed her the pulse meter.

The display read 195 beats per minute and I knew my life had just changed forever. The old carefree way of taking care of my body that had worked fine in my youth and young adulthood wasn’t working anymore. I now had to become a conscious advocate of my own health.

That’s the opening from Don’t Die Early, an educational and very well-written book by Rocky Angelucci – who did nearly die early.  Finding yourself lying on a gurney should certainly put a scare into you, but unfortunately many people respond to that scare by following their well-meaning doctor’s orders … you know, cut back on the eggs and saturated fats, eat your hearthealthywholegrains, etc.

Rocky didn’t go that route, partly (and I’m delighted to say this) because of Fat Head.  As he explained in an email some months ago:

I have been a fan of yours since discovering a snippet of Fat Head on YouTube the evening I returned home from the hospital following a life-changing episode of atrial fibrillation. I was only 45 years old at the time, but had just been rudely awakened by the realization that the carefree lifestyle of my youth had become increasingly harmful. Fat Head’s discussion of insulin resistance and fat storage resonated very well with my pre-med college days studying life sciences and my experiences with the Zone diet and the hormonal implications of foods. Fat Head also catalyzed my growing displeasure at a procedure-driven medical system and gave substance to my vague feeling that politics, not science, has infiltrated medical care.

Because my underlying cardiac problem ultimately turned out to be an alarming plaque burden, my research quickly lead me to Dr. William Davis’ Track Your Plaque forum, where I have been a very active member for the past two years. I became so impressed with Dr. Davis that he has been my cardiologist for the past year.  His warmth and prevention-minded attitude makes the journey from Dallas to Wisconsin entirely worthwhile. Thanks to my radical lifestyle changes, most of them flying in the face of conventional wisdom, I’m fortunate to be one of the TYP members who has shown dramatic plaque reversal, recently showing a 24% six-month decrease immediately following a horrific 83% increase the year before.

If I had heart disease, there’s no one in the world I’d rather have treating me than Dr. Davis.  Rocky’s in good hands.

His email continued:

Emboldened by a background as a technical writer in the fields of software, nanotechnology, and medical devices, I’ve spent the past year writing a book on preventive health that captures what I’ve learned and applied to my own condition.

I read the book before it was published and again last week, and it’s excellent.  When I consider recommending a book (publishers send me books I don’t recommend, by the way), I ask myself two questions:  1) Is the information useful to people who want to lose weight or become healthier?  2) Does it pass my “Aunt Martha” test … that is, could your Aunt Martha read it and understand it?

The answer to both questions in this case is an enthusiastic yes.  Rocky has a gift for taking the science of nutrition and health and explaining it clearly, and it’s obvious from the many topics he covers and how well he covers them that he jumped into that science head-first.  I learned more from this book than I thought I would, which is always a pleasure.

As the title indicates, Don’t Die Early isn’t about weight loss.  It’s about how to live to a ripe old age and remain healthy along the way.  Weight loss is covered in a section about dietary fallacies, but Rocky’s goals for the reader are the same goals he set for himself:  1) understand the true causes of heart disease, diabetes and inflammation; 2) learn how to reliably measure and track the instigators or markers of those diseases, such as LDL particle size and A1C; and 3) take specific actions to reverse disease or prevent it from developing in the first place.

That’s what Rocky did, and was rewarded with excellent results:

In the first six months after embracing a preventive lifestyle, I accomplished the following:

  • Lowered my body fat percentage from 20% to 11%
  • Lowered my inflammatory markers by as much as 75% (you’ll learn about inflammation later)
  • Reduced my triglycerides by more than 90% (this happened in the first 30 days)
  • Improved every measurable aspect of my cholesterol
  • Improved my fasting glucose by 25%
  • Improved my muscle tone and stamina
  • Lowered my blood pressure from an average of 145/90 to an average of 115/70
  • Reduced my resting heart rate by more than 13 points

As impressive as these results might appear, I’m not revealing them so that you’ll invite me to your next party. They are to show you what is very attainable for anyone who makes the proper lifestyle changes.

The book is divided into two parts.  Part One, titled The Major Players, provides in-depth explanations of heart disease, diabetes and inflammation.  The message Rocky pounds home in these chapters is that it’s important not only to understand what these diseases actually are and what causes them, but to know specifically what to measure so you can tell if you’re developing them.  Sadly (but not surprisingly), the tests your doctor orders often add up to too little, too late:

Imagine having the following conversation with your child’s teacher:

You: How is my daughter doing in school this semester? Is she learning the required material?

Teacher: Based upon her age, and what we infer her socioeconomic status to be, as well as her assertions that she does homework on a regular basis, we believe she has a very high likelihood of having mastered this semester’s materials acceptably.

You: Excuse me? What does this mean? Have you tested her on the material?

Teacher: No, we compared her socioeconomic status, apparent nutritional health, and her testimony that she does her homework regularly to a statistical model we have and there’s a strong correlation between your daughter’s parameters and students who mastered the coursework. Oh, and we measured the callouses on her writing fingers and they indicate that she’s likely doing quite a bit of writing, which our statistical model shows increases by 22% her chances of having mastered the material. Overall, we feel very confident that she has mastered this semester’s material.

You: I don’t understand why you’re comparing her to a statistical model instead of testing her. Do you ever plan on testing her?

Teacher: Only if she shows clear signs of having failed to master the material would we test her. As long as her parameters correlate acceptably to the statistical models of a successful population, we will assume that she is mastering the material.

Does this sound like a school you would like your child to attend? Does estimating your child’s performance by comparing indirect parameters to a statistical model sound like an ideal way to gauge her mastery of the subject matter? It certainly doesn’t to me.

Yet this is how our medical culture typically measures the risk of coronary artery disease during routine preventive exams.

That’s why Rocky didn’t know he was developing plaque in his arteries.  He quotes Dr. William Davis, who says that the traditional methods of identifying people at risk for heart disease miss 90 percent of the people who eventually have a heart attack.  If you want to know if you’re developing plaque, you should (surprise!) measure plaque.

The standard test for measuring diabetes often misses those who are developing it as well:

Many of the clinical guidelines in use today encourage a physician to use fasting glucose as the sole indicator of one’s diabetic health. Seeing a fasting glucose level within the laboratory “normal” range, both patient and physician are satisfied that the patient is at low risk of Type 2 diabetes.

Now that you know more about how diabetes progresses, you can see that gauging the risk of Type 2 diabetes solely on fasting glucose is terribly ineffective. An abnormal fasting glucose is typically the last commonly used indicator to show the presence of diabetes. In fact, by the time your fasting glucose is no longer in the normal range, you are already diabetic.

Throughout these chapters, Rocky explains which health markers you should be actually measuring and which specific tests you can request from your doctor or order online and perform at home.

Fat Head fans will be familiar with much of material on heart disease and diabetes, including how much of the standard advice from so-called experts is wrong.  But even though I’ve read quite a bit on those topics, I kept coming across information in Don’t Die Early that was either new to me or struck me as particularly well-explained.  Here are a couple of sample bits:

Perhaps the biggest problem with insulin being a growth hormone is that not all of the tissues in the body become desensitized to increasing levels of insulin at the same rate. As a person becomes more and more insulin-resistant, cells that are much less affected continue to respond to the ever-increasing levels of insulin, growing and multiplying more rapidly as insulin levels increase. What cells exhibit this behavior? The endothelial cells that form the lining of your arteries, for one. As these arterial cells multiply more rapidly, the lining of an insulin-resistant person’s arteries thicken and grow inward, hastening coronary artery disease. This is one of the reasons why so many diabetics die from heart disease.

A typical cell membrane is composed of a lipid bilayer, which is just what it sounds like: two layers of fatty acid molecules, sandwiched together to give cell membranes their much-needed strength. This bilayer also forms an effective barrier to foreign substances, through the use of embedded receptors that are designed to transfer only specific things into and out of the cell. The impermeable lipid layers and their receptors serve as gatekeepers to help ensure the health of a cell by transferring only what the cell needs, in the right amounts, into the cell and removing unwanted substances from within the cell. Virtually anything that the cell consumes or produces is transported this way, ensuring that only the proper substances ever reach the interior of the cell.

As with most structures of the body, the cell’s lipid bilayer needs to be constantly maintained, which the body does by constantly replenishing the crucial fatty acids that comprise the cell membranes. What happens if a person eats a trivial amount of healthy omega-3 fatty acids and an abundance of unhealthy omega-6 fatty acid? Simple, the body does its best with what you give it and will use the omega-6 fatty acids instead.

What this means is that in addition to their role in promoting inflammatory chemical messengers, omega-6 fatty acids become incorporated into virtually every cell in your body.

Part two of the book, Lifestyle Changes, includes chapters on dietary truths and fallacies, setting goals, and taking action.  Again, the chapter on diet covers ground that’s largely familiar for Fat Heads (Gary Taubes and Dr. William Davis are quoted several times), but it’s well written and worth the read.

In the final two chapters, Rocky urges the reader to do enough testing to establish several baseline measurements (blood sugar, fasting insulin, vitamin D concentration, LDL particle size, etc.), set specific and attainable goals for improving those markers, then work  to meet them.  If you’ve ever wondered what your fasting insulin level or vitamin D concentration should be (ideally, anyway) this chapter will tell you.   Rocky also gives advice on how to improve your odds of meeting each goal.  For example, to achieve optimum triglyceride levels:

In summary, the best approach to reducing one’s triglycerides is

  • Eliminate grains, replacing them with vegetables, nuts, and berries.
  • Minimize carbohydrates (especially fructose), eating them in sufficient moderation so as to never cause unfavorable glucose levels.
  • Consider supplementing your diet with omega-3 fatty acids from fish oil.
  • Speak to your physician about supplementing with niacin to help optimize your triglycerides.
  • All of the above steps will very effectively control your fasting triglycerides. To really take it to the next level, buy a Cardio-Chek triglyceride meter to measure your body’s response to different types of meals to identify exactly how sensitive your body is to specific types and quantities of fats. If you perform a small series of these carefully controlled tests, you’ll have infinitely more clarity on how to optimize your diet for the best possible postprandial triglyceride production (this will be especially valuable in determining whether saturated fat is good for you and at what level).

Near the very end of the book, there’s a section I’m sure many of you will relate to … the sub-chapter heading is Prepare To Be An Outcast. Here’s chunk of that section:

You may find yourself biting your tongue every time you see a friend, colleague, or loved one wolf down a low-fat, grain-based meal, laden with vegetable oil, as they complain about having acid reflux or autoimmune disorders.

You may see friends and loved ones struggle with weight problems while they eat low-fat foods that constantly elevate their blood glucose level, ensuring that they live life as the “walking starving,” trying unsuccessfully to lose weight.

Even your more health-conscious friends may not appreciate your one-upping them on matters of health and nutrition. Responding to their enthusiasm for fish oil with “Yes, but do you track your daily intake of omega-3 and omega-6 fatty acids and have you ever checked your Omega-3 Index?” will make you sound like a know-it-all.

It’s painful to realize that some people just don’t want to hear that there’s a better future available to them if they just abandon the current thinking on what’s healthy and what’s not. Many refuse to believe that they could ever get bad advice from a physician or from a “trusted” source like the USDA, the American Dietetic Association, or the American Diabetes Association. In such cases, you may just need to silently watch them continue on their path.

Sadly, that’s true.  But for people who are open to trying a new path to health, Don’t Die Early is an excellent guidebook.


28 thoughts on “Book Review: Don’t Die Early

  1. Rocky Angelucci


    I’m honored and humbled by your review, Tom.

    Thank you again for inspiring so many as only you can do.

    I was just getting ready to email you that I’d posted it. I guess I can skip that one.

    Great book, Rocky. You should be proud.

  2. TonyNZ

    In a lot of cases, but particularly the teacher-parent exchange it gave the impression that FatHead has started to spawn some little book-babies. Good to see that there is some baton-passing going on.

    Sounds like a good read.

  3. Bill Fabrey

    Sheer genius, both of you. I’m a fan of the Fat Head DVD, and now I need to run out and buy Rocky’s book. I can tell from the sections quoted that I’ll love it. I am no fan of conventional medical science, but find my own PCP to be pretty moderate, and she lets me go at my own pace with nutrition and exercise, having given up nearly all prescription medication, especially including statins. I am glad that health, not weight loss, per se, is the main goal here–I have a very stable BMI of 31 (not that BMI is any kind of health indicator).

    Weight loss is great, but health should always be the primary goal. Weight loss is a nice side benefit.

  4. Melissa

    I went to Amazon and read the samples there–I know what my dad is getting for his birthday in a month. Thanks for pointing me to it. Love that there’s a Kindle edition. That’s the only way my parents read books anymore. It’s me who is a dinosaur who prefers books.

    Hey, even my 76-year-old mom owns a Kindle now. I don’t, but she does.

  5. Rae

    I plan on buying this book for my mother. She is suffering from arthritis, acid reflux, depression, and a blood pressure problem (which they have her on statins for – the quacks) and I truly believe that if she gave eating better a try most if not all off these ailments would be lessened or eradicated. She’s a retired nurse and I’m hoping that if I show her another person’s testimonial with some science thrown in she will see the light. I look forward to reading it myself also.

    I hope she reads it. I know some people will dismiss the book because Rocky isn’t a doctor, but he’s done a ton of research and quotes doctors throughout. The foreword was also written by a doctor. I hope that convinces the white-coat-awe crowed.

  6. Ellen

    I wasn’t as sick as Rocky, but was having issues, like having my heart pounding out of my chest waking me up in the night, scaring me badly (probably due in part to the cookie dough or other sweets I used to eat during my 9pm cravings). I’m close in age to him and thought I’m too young to have problems! I’ve also had similar improvements in blood work and weight loss in the past year since going LCHF. Despite having many people ask how I’ve lost weight, I don’t always tell them the whole story after the looks I’ve gotten, they think I’m clogging my arteries. Biting my tongue has been the hardest part! I can’t wait to read his book.

    I do a lot of tongue-biting as well (and I don’t mean beef tongue).

  7. LCNana

    Thanks for this review, Tom. It looks like a valuable book. Only quote I question is this one:

    “If you perform a small series of these carefully controlled tests, you’ll have infinitely more clarity on how to optimize your diet for the best possible postprandial triglyceride production (this will be especially valuable in determining whether saturated fat is good for you and at what level).”

    I thought it was a given, especially here on Fat Head, and in the science that we know to be true, that saturated fat WAS good????? Is Rocky just being cautious because most of his readers need to be lead gently to “sat fat good” thinking?

    I did kind of leave that out there hanging, didn’t I? Rocky explains elsewhere in the book that people with dyslipidemia can have a difficult time metabolizing saturated fats.

  8. Rocky Angelucci

    Hi, LCNana, great question.

    As Tom observes, the discussion of the postprandial triglyceride monitoring is in the context of those rare individuals who are dyslipidemic.

    In such atypical individuals, excessive saturated fat intake in a single massive surge (for example, a huge glass of eggnog made with many cups of heavy whipping cream and half a dozen eggs) can cause a dramatic postprandial triglyceride elevation for a number of hours. For someone who already has an abundance of cardiac plaque AND who happens to be dyslipidemic, frequent surges such as that would very likely be counterproductive to their plaque-reduction goal.

    Even though such dyslipidemia is atypical, I discuss it in the book for three reasons: 1) In light of my LC lifestyle, I was puzzled why my fasting triglycerides weren’t lower than I thought they should be and self-testing revealed that I’m dyslipidemic in this way, 2) Simply looking at fasting triglycerides, which is what virtually all physicians do (even cardiologists treating plaque-laden, high-risk cardiac patients), would never reveal this level of insight, and 3) While I’m loathe to play into the “fat is bad” hysteria, the two-inch lawyer sitting on my shoulder didn’t want me to advise readers that unlimited saturated fat intake is absolutely beneficial to 100% of the people out there, thereby shortchanging those dyslipidemic people who are like me.

    As soon as I can get some friends to agree to be guinea pigs, I would like to blog about this one day and show some real-world postprandial triglyceride curves from the non-dyslipidemic. I think those unfamiliar with the benefits of a low-carb lifestyle (especially those interested in cardiac health) would be stunned to see that their “healthy” grain and fructose-laden meal spikes their postprandial triglycerides infinitely more than the forbidden grass-fed steak with sour cream and butter. In the meantime, I have persuaded a few friends to let me share their glucose curves and cardiac plaque measurements and blogged about them, and other topics, at

    Thanks for the clarification, Rocky.

  9. Bret

    The tongue-biting phenomenon really hits home with me.

    The only hard part about reshaping my diet and lifestyle has been the inability to share all this great information with people I care about who are suffering. It’s like knowing a juicy secret that you want more than anything to tell your friends about. But instead of being bound by someone’s confidence or privacy, you are kept effectively silent by deaf ears and closed minds.

    I have family members on the brink of organ/tissue removal surgery due to deteriorating chronic conditions. They are perfect candidates for carb reduction, wheat removal, etc, but they won’t take advice from me, an uncredentialed lay person. If I ever do proffer any information, they dutifully tolerate me, but I can tell they are not really listening–certainly not receiving the information. They seem springloaded to resist any advice “from the street.” I can relate, having been guilty of the same attitude in the past. It’s a much simpler world when you just trust the established authorities and conveniently ignore their decidedly human flaws, as The Older Brother so poignantly articulated in his guest posts on economics back in May.

    At the same time, I realize my friends and family have the right to both listen to and tune out anyone they please. I’ve had to step back and get a grip on myself, reckoning that the likes of Meme Roth and CSPI probably became what they did after feeling similarly empowered and frustrated, but then succumbing to the arrogance that lets people think their own good intentions are a suitable replacement for others’ personal freedom.

    Finally, I have to remind myself that I came upon Fat Head and subsequently read 1500+ pages of text out of my own curiosity and initiative. When I look in the mirror and give it some thought, I realize that if, before discovering the low carb revolution for myself, a friend or family member had discovered it first and tried to preach the message to me (other religious words like “convert” and “save” come to mind), I probably would have resisted it too. I think that kind of resistance is hardwired into our psyche.

    Still, I hate to see my loved ones suffer. 🙁

    I go through the same thing seeing people I care about suffering from ailments I believe they could avoid if they just gave up grains. It’s not an easy sell, considering how the “experts” have been grains as health food for decades.

  10. jake3_14

    Sounds like a good read. But I question the recommendation of substituting nuts for grains. All nuts are high in omega-6 fatty acids. Since it’s such a bad thing to have the lipid bilayer uses O-6 fats instead of O-3 fats, why recommend nuts at all? This is especially true since there’s no general agreement about what amount of O-6 fats we can tolerate without damage, or a good general ratio of O-6:O-3 intake? If seen recommendations for O-6 fats from 2% of calories up to 7%, and recommend ratios of O-6:O-3 from 1:1 (ideal) to 4:1 (tolerable).

    As for LDL particle size, I recently heard the reputable Chris Kresser say in a 09/05/12 podcast that when experiments controlled for LDL particle number, the association between LDL particle size and cardiovascular disease “disappered.” diminished below the point of statistical significance. I’ve also hear Chris Masterjohn (who’s forgotten more about cholesterol than most of us will learn) say he’s skeptical of LDL particle size as a diagnostic tool. I think it’s at least premature to assert that LDL particle size is an acceptable marker for CVD. Moreover, even LDL particle size is just a proxy for LDL receptor sensitivity, which medicine can’t measure directly. Relying on such a marker seems to commit the same fallacy as the parent-teacher conversation that Angelucci presents.

    Lastly, I would also question the recommendation for fish oil capsules. Omega-3 fats are usually quite fragile and go rancid easily. Unless one bites into every single capsule, one cannot be assured that one’s getting fresh oil, especially if that oil has been stored at room temp, even when it’s mixed with stabilizing agents. It’s far better, according to a number of sources, to either take your omega-3 fat in the form of certain oily fish (most of which is either expensive or strong-tasting (salmon excepted), fermented cod liver oil, or krill oil capsules (which are stable at room temp. for up to 3 years due to krill oil’s double-phospholipid structure).

    For nuts it would be matter of balance. Cut all the vegetable oils out of your diet but eat a few nuts (as I do), you’ve probably moved toward a better balance.

    Rocky actually does recommend checking for total LDL particle count in addition to particle size.

  11. Sol y Sombra

    Another great book tip, Tom, thanks! And thank you, Rocky, for taking the time to write the book and share your valuable experience!

  12. jake3_14


    Please replace para. 2 of my comment with the following correction (or at least allow this post):

    As for LDL particle size, I recently heard the reputable Chris Kresser say in a 09/05/12 podcast that when experiments controlled for LDL particle number, the association between LDL particle size and cardiovascular disease “disappeared,” (I assume meaning diminished below the point of statistical significance). I’ve also hear Chris Masterjohn (who’s forgotten more about cholesterol than most of us will learn) say he’s skeptical of LDL particle size as a diagnostic tool. I think it’s at least premature to assert that LDL particle size is an acceptable marker for CVD. Moreover, even LDL particle size is just a proxy for LDL receptor sensitivity, which medicine can’t measure directly. Relying on such a marker seems to commit the same fallacy as the parent-teacher conversation that Angelucci presents.

  13. Marilyn

    Tom wrote: “I go through the same thing seeing people I care about suffering from ailments I believe they could avoid if they just gave up grains”

    I’m probably not alone in this, but I distinctly remember when I was in my “low fat phase” thinking the same thing about fats — quietly wishing that a person I cared about could just get rid of the fat in her diet.

    Same here. I’d see people eating sausage and wonder why they’d do that to themselves.

  14. LCNana

    Now if we could only get “Wills and Kate” to go low carb/high fat, we’d be fine….how’s about we get Rocky to courier over a copy of his book?

  15. Rocky Angelucci

    Hi, Jake!

    As you observe, too much omega-6, no matter the source, is suboptimal and the reason that generic statements like “just replace all grains with nuts and you’ll be great!” is too superficial and is what I refer to as “soundbite nutritional advice.”

    The book’s discussion of omega-6 and omega-3 intake is very detailed and addresses very carefully the need for ensuring that one’s daily intake be within an optimal range. Also addressed is the usefulness of measuring one’s Omega-6 Index, an inexpensive blood test that determines the ratio of Omega-3 to Omega-6 within one’s cell membranes.

    A significant motivation for my writing Don’t Die Early was the ill-fitting nature of the generic advice flying around today. Rest assured, Don’t Die Early goes way beyond generic advice in every feasible regard.

    I would also point out that we shouldn’t label all nuts as problematic when it comes to Omega 6 PUFAs. According to a chart in “The Art and Science of Low-Carbohydrate Performance,” the fat in an egg is 22% PUFA, 42% MUFA, 36% SFA. Compare that ratio of 22/42/36 to some nuts:

    Macadamias: 2/82/16
    Cashews: 18/62/21
    Almonds: 26/66/8

    By contrast, soybean oil is 60% PUFA.

  16. Sally Myles

    So I got a letter yesterday saying I’m getting a tax rebate for the equivalent of four weeks’ fulltime wages.. I’ve got a copy of Fathead I bought from Amazon that you got no money for, so as soon as the cheque clears I’m making you a Paypal donation. Don’t need another Fat Head… I know you weren’t begging for funds in your blog post, but the benefits my son and I have got from having watched same can’t be put in monetary terms. You should see him. He was a chunky baby, and got labelled obese at age five despite looking totally normal and eating a good diet. Since Fathead, he eats a lot more fat (we fight over the fat on a brisket) and he’s growing so fast (in two months, as I measure him and date the measurement on the door jamb) he grew 2 centimetres. His behaviour is fantastic from him being a problem child (he had total emotional meltdowns warranting daily restraint) in a Nurture Class with children who had ADHD and other such nonsense. He’s so polite now he stuns me with how old fashioned he sounds. He’s like a Knight of the Round Table the stuff he comes out with. And he’s lean. You can see his ab muscles. And the energy he’s got, Oy!! Like he’s powered by Duracell. I knew you’d done me proud, I’m fitter than I’ve been for years, but only tonight, writing down the changes in my little boy, can I truly appreciate how far reaching Fat head has been. He’s seven, as tall as a nine year old, and having to have the waist on his trousers cinched in as he’s too lean for a nine year old… Breakfast now is not coco pops, it’s eggs scrambled in coconut oil with crumbled bacon. School recommend a mid morning snack. He tells me ‘why do I need a snack, Mummy, I’m not hungry even at lunchtime’ thankyou. thankyou. thankyou.
    Every comment I make makes me sound like an arse kisser.. but I’m not. It’s all true. You save lives.

    You made my day, Sally. Tell your son I said hi.

  17. Julie

    Thanks for the recommendation! I bought and read the book in one day! I’m sure I will go back and re-read it several times as it was chock full of excellent information. Of all the baseline tests suggested the only two I haven’t had are the calcium score and the post prandial triglycerides. I thought I was doing pretty great after bringing my tri’s down from 401 to 106 but maybe not so much. I follow a HFLC lifestyle and my LDL-P’s are only slowly improving but still way too high. Maybe this suggests that a high saturated fat diet is not for me. Would that possibly indicate that? I have an Apo-E of 3/3 so normal. Insulin of 14 at this point but down from 19. Hm. I have some considering to do. Thanks for putting this book out there. It was very informative for someone living in constant fear of having a heart attack at age 39!

    Rocky will probably want to chime in here, but I don’t see the harm in adjusting your diet and testing again. If you don’t metabolize saturated fat well, you should find out.

  18. Rocky Angelucci

    Hi, Julie!

    As you undoubtedly learned from reading the book, deciding how concerned we should be about our various indicators can be a bit of a juggling act. A 50 year old person with a zero calcium score, very little family history of heart disease, and no other cardiac symptoms can probably be minimally concerned about optimizing LDL particle count and LDL small particle count. For such a person, a fasting triglyceride in the low 100’s would be fantastic. On the other hand, the same 50 year old with a very high calcium score and strong family history of heart disease may need to be more concerned about optimizing LDL particles and triglycerides. You don’t say over what timeframe your fasting insulin dropped from 19 to 14 but that points to a drop in insulin resistance, which is always a good thing. I’m sure you know by now that being a homozygous E3 can still mean that you respond as an E2 or an E4, depending on what your body has endured.

    Rather than continue to this in Tom’s comment section, if you want to talk more about it, feel free to comment at and I’ll get back to you.

  19. Ray Kelley

    Oh, the tongue-biting. The horrible, horrible tongue-biting. I’m going through this right now. Despite the dramatic transformation a paleo-style diet has brought about in me, most people just aren’t ready to hear the pro-fat argument. “You’re still clogging your arteries,” they’ll tell me. And I can’t get to mad at them; it was only a few years ago that I believed the same thing was simply objectively true. Looking back, it’s kind of silly. Like any food goes down your throat and directly into your bloodstream the way a kitchen sink works. Like there’s not a whole metabolic process separating those two systems.

    Sometimes when people ask me advice (and they’re starting to) I might try and meet them halfway and tell them to stick with vegetables and lean meats. Of course, that is to deny oneself the wondrous benefits of animal fat, but this is where I started like three years ago, and it helped a lot. But learning not to fear the fat is what really put me over the top.

    This one close friend of mine in particular frustrates me to no end. He saw my results and decided to start trying to lose weight himself. But instead of listening to me, he went the low-fat route. And he has lost some weight, in his chest and shoulders. But his upper body looks withered and he looks like he’s smuggling a basketball under his shirt. He once told me that he hated me for being able to eat the way I do and lose weight, (and gain muscle mass), but he can’t bring himself to do it.

    Once we were at breakfast at IHOP, and I said that I’d skip the pancakes and just get bacon and eggs. He then looked at me dead serious and said, “Actually, pancakes are low fat.”

    I had to stop myself from strangling him. He also recently told me that he switched to Fruity Pebbles for breakfast because they’re fat-free.

    How can you begin to reason with someone who actually thinks pancakes and Fruity Pebbles are a healthy breakfast simply because they’re low-fat?

    It’s really frightening how powerful conditioned beliefs can be when drummed into the heads of a populace over and over again. My incredible journey of discovery regarding the paleo lifestyle has caused me to being questioning everything I was ever told to simply accept as true throughout my life. It makes you wonder how many of our opinions are actually our own.
    All I can do is share my experiences with those who ask, mention what I’m making for dinner on my Facebook page, and order like I normally would when I’m out to dinner with friends. I hope that if they see how I eat and then the results, a circuit will close in my mind. And I know the results will continue, because I’m not on a “diet”. This is a way of life for me now.

    I feel ya. Fear of fat is so pervasive, most people think it’s based on something like science. We went out for dinner on Saturday and the waitress proudly told Chareva that most of the fat was trimmed off the beef brisket. Imagine her surprise when Chareva asked if she could order it without any of the fat trimmed away.

  20. Jose Marti

    Very interesting.However I still see too much emphasis put on constant medical tests(which I never do).If we follow the proper diet and feels ok I just don’t see the need for this obsessive testing.On the other hand, the bylayer of fats in the cells membranes are mostly saturated fats as well as in the linings of the heart(which feeds on palmitic and stearic acids,both saturated),so I don’t see the recommendation on Omega 3 pertinent since this comes mostly from polysunsaturated fats which are proven to be highly unstable as Jake pointed out and easily degraded in the body unless they are protected by a healthy dose of saturated fats.I offer myself willingly to a diet of saturated fats and then,what else?, being tetsted.

  21. Rocky Angelucci

    Hello, Jose!

    Your comments illustrate very well some of the reasons I wrote the book. How closely one chooses to test various things will depend heavily upon the individual condition. For example, I don’t know a single 20-year old man whom I would encourage to have a coronary calcium scan to detect cardiac plaque. That same person at age 40, however, may be an entirely different matter. A 40-year old man whose cardiac health has only been assessed using indirect indicators like standard cholesterol tests or a stress test, can have a very false sense of security regarding his cardiac health. In such a case, a calcium scan can provide inexpensive, highly valuable insight. Then what? It depends. If the scan showed no plaque there would probably be no reason to test again in a year. Maybe scan again five or 10 years, depending on a bunch of other individual factors, as discussed in the book.

    Similarly, testing one’s lipids using advanced subfraction analysis is far more critical for a person who already has heart disease and who is attempting to reduce the cardiac plaque that their calcium scan revealed. Such a person, in the face of a rapidly increasing plaque level, may need to test his lipid subfractions “obsessively” for six months or a year while he’s making careful adjustments in his diet and lifestyle to zero in on the perfect combination that results in plaque regression. On the other hand, a 25-year old low-carber would probably have little concern for such careful monitoring, possibly just doing so once a year at an annual physical, just for the bragging rights.

    For some things, however, anyone could benefit. Virtually everyone in modern society is severely magnesium deficient, for example. A simple blood test to identify RBC magnesium levels would reveal the need for adding a very inexpensive magnesium supplement to one’s diet (and/or increase foods containing magnesium). Vitamin D? Most are deficient in vitamin D and the metabolism of vitamin D is so highly variable that it’s virtually impossible to make a generic recommendation for supplementing with vitamin D. A vitamin D blood test once a year would avoid speculation. Having ideal vitamin D and magnesium levels would pay great long-term dividends, especially to people in their 20’s. Even if I were in my 20s and eating very well and feeling great, I wouldn’t want to wait until I was 40 years old to find out that some quirk in my metabolism caused my vitamin D level to be needlessly low for the past 20 years.

    We don’t want to test or worry needlessly but nor do we want to overlook a silent killer like heart disease, which is predicted so poorly by traditional medical testing.

    Don’t Die Early replaces today’s generic advice with specifics, so that every individual, no matter their age or condition, will have the understanding necessary to chart their own individual path towards optimal preventive health.


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