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Preventing and Reversing Heart Disease

(and preventing, reducing, and/or reversing many other diseases too!)

I was born in 1960, and grew up believing that a lot of major diseases were just natural by-products of aging or some combination of natural aging and bad luck/bad genes. In my childhood, medicine treated what was already broken, and I don’t remember much talk about preventing major chronic diseases, and I certainly didn’t hear anybody talking about the role of diet in preventing or reversing major diseases.

Fast forward a half century, and the largest study ever of the state of health in America concluded that the major chronic diseases are primarily caused by what we put in our mouths (diet and smoking), with exercise playing an important but smaller role. The diseases primarily caused or profoundly influenced by diet include obesity, diabetes, cancer, heart disease, and all the diseases that are by-products of cardiovascular disease—strokes, erectile dysfunction, some eye problems, some forms of dementia. Mortality is powerfully influenced by diet, with the healthiest diets leading to people living 10 years longer than the US average, and even longer than those with much unhealthier diets. Even arthritis, back problems, constipation, migraines, colitis, diverticulitis, neuropathy, gallbladder attacks, kidney stones, kidney disease, and even mood and depression are influenced by diet.

We know that diet profoundly affects these diseases because these diseases are rare to non-existent in cultures eating traditional plant-based diets, but when people from these cultures start eating the rich western diet, these diseases ramp up dramatically. For example, Asia is now experiencing rapid increases in these major diseases—following increased consumption of the western diet. For some of these diseases—including obesity, diabetes, heart disease, strokes, erectile dysfunction, and others, we have clear evidence form experimental studies that switching to a healthier diet can dramatically improve symptoms or even reverse the diseases.

But let’s focus here on heart disease, the #1 killer of U.S. men and women. Virtually all heart disease can be prevented or halted and reversed, given that people are willing to follow a very healthy diet. Populations that consume a low-fat, whole food, plant-based diet show virtually no cardiovascular disease, yet 80-90% of American over the age of 30 have atherosclerosis, which is the underlying cause of most cases of heart attack and stroke, as well as vascular dementia, erectile dysfunction, and other diseases affected by the health of our arteries. Significantly, the only diets that have been proven to stop the build-up of arterial plaque and selectively reverse the build-up of plaque in arteries are very low-fat plant-based diets.

An earlier study by Caldwell Esselstyn followed 18 individuals with advanced heart disease who ate a low-fat, whole-food, plant-based diet over two decades, and none who followed the diet had any major cardiac incidents or died from the disease. This research is described in the best-selling book Prevent and Reverse Heart Disease.

Research by both Esselstyn and Dean Ornish clearly established that diet can dramatically improve individuals cholesterol levels, dramatically improve cardiac symptoms (e.g., angina/chest pain), and actually leads to many documented cases of reversal of the build-up of plaque in the arteries.

A 2014 study by Esselstyn and colleagues then reported only a 1% recurrence rate for coronary events among the 177 patients in their study—patients who had serious heart problems at the beginning of the study but were compliant with a low-fat, whole-food, plant-based diet. In contrast, there was a 62% recurrence rate for similar patients who were not compliant with the diet. That is, the diet worked roughly 60 times better for preventing future coronary events than it worked to not follow the diet and continue with standard medical care. Coronary heart disease (CHD) gets progressively worse in most individuals eating a typical diet, and even in those individuals who achieve very low levels of LDL cholesterol (so-called “bad cholesterol”) by taking statin drugs.

A 2013 study of parent-child pairs with obesity and high cholesterol levels had 15 parent child pairs eat a plant-based diet with no added fats and 15 parent child pairs eat the American Heart Association Diet (which has animal foods, less plant foods, and higher levels of fat). Despite only lasting four weeks, parents and children on both diets had statistically significant and beneficial changes in health outcomes related to cardiovascular health. However, adults on the plant-based diet had seven beneficial and statistically significant health improvements, compared to two such improvements for those on the AHA diet. Children on the plant-based diet had nine beneficial and statistically significant health improvements, compared to four for those on the AHA diet. In short, the kind of plant-based diet recommended by Dr. Esselstyn yielded significantly better cardiovascular outcomes than did the diet promoted by the American Heart Association.

Heart health & preventing the majority of heart disease through nutrition

http://nutritionfacts.org/video/eliminating-90-of-heart-disease-risk/

http://nutritionfacts.org/video/protein-and-heart-disease/

http://nutritionfacts.org/video/dietary-guidelines-from-dairies-to-berries/

Finland was #1 in world in CVD deaths in 70s, undertook massive campaign to reduce saturated fat intake, decreased CVD death rates 80%! Also decreased all-cause mortality 45%

Many of our most common diseases found to be rare or even nonexistent among populations eating plant-based diets. (Gives evidence of super low rates of top western diseases in places eating whole food, plant based diet (Uganda). Rates of coronary infarcts were 100x higher among westerners, and many diseases (including kidney stones) were very rare to non-existent among peoples eating whole fat, plant-based diet.

How far is the average American diet from being healthy?

http://nutritionfacts.org/video/nations-diet-in-crisis/

http://nutritionfacts.org/video/how-many-meet-the-simple-seven/

The American Heart Association came up with seven simple lifestyle goals to combat the leading killer of men and women, heart disease. Interestingly, most Americans think they eat a healthy diet, but the NHANES study in 2012 found that only 1% of Americans follow truly healthy eating habits, meaning 5+ daily fruits/veggies, eating beans, whole grains, drinking less than 3 cans of soda a week, etc.

Furthermore, only 1 out of every 2000 Americans consistently do/manifest the “simple seven” lifestyle habits [not smoking, not being overweight, being very active [e.g., walking at least 22 min./day], eating 3+ fruits/vegetables daily, below average cholesterol [below 200 total, untreated], normal blood pressure [< 120/80], normal blood sugars [glucose <100 untreated].)

Kaiser HMO weighs in on what they consider to be a healthy diet

http://nutritionfacts.org/video/what-diet-should-physicians-recommend/

http://nutritionfacts.org/video/low-carb-diets-and-coronary-blood-flow/

Compared to low-fat diets, low-carb diets impaired flow-mediated dilation in arteries, meaning they caused blood to flow less well (in this meta-analysis). Another study found the same thing in patients’ extremities. In a 3rd study, those following a low fat, plant-based diets led to reversal in coronary artery disease, with 20% less plaque at the end of the year, while those going to a low-carb diet had 40-50% more plaque at the end of the year. Low carb diets are also associated with significantly higher rates of all-cause mortality.

Helpful Websites

***** NutritionFacts.org

I think this is the best comprehensive nutrition-health website.

Dr. Michael Gregor, who notes that, “Death in America is largely a foodborne illness,” provides tons of information and an amazing array of hundreds of short, research-based videos on health, medical research, and especially the role of nutrition in health. You can just search the vast database of videos based on the topic you’re interested in.

Healthy Longevity

healthylongevity.blogspot.com

For people who want or need really heavyweight statistical analysis of nutrition studies and explanations of how we’ve been fooled (such as recent meta-analyses suggesting saturated fat isn’t harmful), this blog is terrific. It’s also very readable, and you can skip some of the statistical analyses. Some of the blog posts also have links to helpful videos that help de-bunk some of the smaller myths (no the Inuit were not that healthy and disease-free eating all that animal fat and protein) that fuel the bigger nutrition myths.

Caldwell Esselstyn

http://www.heartattackproof.com/

Former Cleveland Clinic surgeon, Esselstyn’s book Prevent and Reverse Heart Disease describes the dramatic success he accomplished with roughly 18 patients who had such advanced heart disease, in some cases, even their Cleveland Clinic heart surgeons said there was nothing they could do for them. With a low-fat plant based diet plus statins, the patients who stuck with a diet, and had no progression of heart disease, and some reversals of existing build-up of plaque in their arteries. It’s important to note that even on statins, heart disease generally continue to progress (plaque continues to build up inside arteries). Also, on the standard American diet, individuals’ arteries stay inflamed and they have hundreds or thousands of tiny plaques, and it is these small juvenile plaques that cause the overwhelming majority of heart attacks. With a low-fat, whole-food, plant-based diet, the inflammation dies down and the arteries steadily heal.

Related book(s): Prevent and Reverse Heart Disease / The Engine 2 Diet

Final Thoughts

It may sound crazy to most people to try eating a plant-based diet, but I tried one 2-1/2 years ago when I’d gotten up to 240 pounds and felt lousy, and months after changing my diet, I had dropped 75 pounds and felt 20 years younger, much healthier, and had tons more energy. In experimental studies, patients’ acceptance of this diet was found to be quite high—even though it’s quite different from what they used to eat—perhaps because they feel so much better after changing their diet. I grew up eating burgers, pizza, and ice cream, but now I only eat plant-based foods, with lots of whole foods (salad, baked potatoes, fruit, etc.) It sounds hard to adapt, but one thing to understand is that after several weeks, your taste buds adapt to and will even start craving the new foods, and researchers have found that when people eat 15% of calories from fat (or less), they stop having cravings for fat, which makes staying on this kind of eating pattern much, much easier.