Heart Disease, Not Diet, Killed Bos, Report Says

Otto Bos, Gov. Pete Wilson’s longtime aide, had unknowingly suffered a heart attack before the one that killed him earlier this month, the San Diego County medical examiner’s office concluded in a report released Tuesday.

Medical Examiner Dr. Brian Blackbourn said the previous heart attack and not Bos’ liquid diet, Optifast, had contributed to Bos’ heart failure. Bos died as a result of a heart attack caused by narrowed arteries, Blackbourn said.

At his death, Bos’ heart was 25% larger than it should have been, posing a further strain on an already weakened coronary system, Blackbourn said. The three main arteries leading to his heart had become so clogged with fatty deposits that their blood-carrying capacity was reduced by 95%, Blackbourn said.

“The fact that he suffered a previous heart attack without knowing it is not that uncommon,” Blackbourn said. “Frequently, people don’t know they’ve had one.”

Bos, 47, conducted warm-up exercises and was playing soccer with friends at a University City Elementary School on June 2. At halftime, he complained of a cramp in his side, which did not seem unusual to him or the other players after the strenuous exercise, according to the report.

But, at 4:30 p.m., 25 minutes into the second half of the game, Bos kicked the ball and suddenly collapsed, lying ashen on the playing field. Efforts to resuscitate him were unsuccessful.

Bos knew he had an elevated cholesterol level. Apparently, he had occasionally complained to his wife, Florence, of pain in his left arm and neck. But Bos had “no known prior cardiovascular disease, hypertension or any known malignancies,” according to the report.

In fact, Bos saw a doctor May 31, only two days before his death, but no warning signals were detected during that checkup, according to the report.

Because Bos’ death was so sudden and came at a relatively early age, the coroner investigated whether his liquid diet had contributed to his death. During the 1970s, liquid diets were responsible for at least 58 deaths. And, according to the Journal of American Medicine, low-calorie diets are inappropriate for people such as Bos with fewer than 40 pounds to lose.

About four years ago, Bos went on an Optifast diet and lost about 25 pounds. Remembering that success, he had recently decided to put himself back on the diet in an effort to trim down. This time, however, his diet was unsupervised by a doctor.

Two weeks before his death, Bos resumed the Optifast diet and had lost about 11 pounds. Experts, however, warn against an individual going unsupervised on such a liquid diet.

“You don’t do something like this without being supervised,” said Dr. Wayne Callaway, an associate clinical professor of medicine at George Washington University’s School of Medicine.

Federal dietary guidelines recommend that dieters keep their weight loss to no more than one pound a week, said Callaway, a member of the Dietary Guideline Advisory committee that issued the new guidelines this past fall.