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Kathy Freston

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Heart Disease: A Toothless Paper Tiger That Need Never Exist

Posted: 10/27/09 10:43 AM ET

"If the truth be known coronary artery disease is a toothless paper tiger that need never, ever exist and if it does exist it need never, ever progress."

So says Dr. Caldwell Esselstyn, who was a researcher and clinician at the Cleveland Clinic for over 35 years. In 1991, Dr. Esselstyn served as the president of the American Association of Endocrine Surgeons, and organized the 1st National Conference on the Elimination and Prevention of Heart Disease. In 2005, he became the 1st recipient of the Benjamin Spock Award for Compassion in Medicine. Dr. Esselstyn is also an Olympic gold medalist in rowing, and he was awarded the Bronze Star as an army surgeon in Vietnam.

In this series of interviews I've conducted with extraordinary nutritional researchers and medical doctors, I've sought to understand the link between diet and the most common and dreaded diseases that are prevalent in our culture. What I'm hearing over and over is that a plant based diet is both preventative and healing, whereas a diet high in animal protein is destructive to our health - this is the case with cancer, type 2 diabetes, and heart disease.

The great news is that there is very real hope in shifting the course of our health. What is becoming very apparent through various peer reviewed studies is that by changing our diet - eliminating that which causes havoc in the body (animal protein) and adding in plant based proteins and eating lots of vegetables, legumes, beans, and whole grains, we can not only prevent disease, but also heal from it once it is already in motion. Following is a fascinating conversation I had on diet and heart health.

KF: What exactly is coronary heart disease?

CE: Coronary heart disease is the leading killer of women and men in western civilization. It is predicted to become the #1 global disease burden by 2020.

It consists of an inflammatory buildup of blockages in arteries to the heart muscle. These blockages are made of fat, cholesterol, calcium, and inflammatory cells. Blockages can become severe enough to cause symptoms such as shortness of breath or chest pain (angina). When blockages suddenly become complete, the portion of heart muscle fed by that blocked artery is now deprived of oxygen and nutrients, thus it is injured or now dies. This is a heart attack. The patient may survive or succumb if the event is accompanied by a fatal heart rhythm.

KF: Who develops heart disease?

CE: Everyone eating the typical western diet. In autopsy studies of our GI's who died in the Vietnam and Korean wars almost 80% at an average age of 20 years, had disease that could be seen without a microscope. Forty years later in 1999, a study of young persons between the ages of 16-34 years who have died of accidents, homicides and suicides, finds the disease is now ubiquitous.

KF: What is the cause of the disease?

CE: It is the typical western diet of processed oils, dairy, and meat which destroys the lifejacket of our blood vessels known as our endothelial cells. This cell layer is a one cell thick lining of all of our blood vessels. Endothelial cells manufacture a magical protective molecule of gas called nitric oxide, which protects our blood vessels. It keeps our blood flowing smoothly, it is the strongest dilator (widener), of our blood vessels, it inhibits the formation of blockages (plaques), and it inhibits inflammation.

KF: With such natural protection, why do we ever develop heart disease?

CE: Every western meal of processed vegetable oils, dairy products, and meat (including chicken and fish) injures these endothelial cells. As individuals consume theses damaging products throughout their lives, they have fewer functioning endothelial cells remaining and thus less of the protective nitric oxide. Without enough nitric oxide the plaque blockages build up and grow creating eventually heart disease and strokes.

KF: Can it be stopped or even reversed?

CE: Yes. First we must look at the lessons learned from cultures where there is a virtual absence of coronary artery heart disease such as rural China, the Papua Highlands of New Guinea, Central Africa, and the Tarahumara Indians of Northern Mexico. Their nutrition is plant based without oil.

Beginning in 1985 I initiated a study of seriously ill coronary artery disease patients. Their nutrition became plant based without oil. Their cholesterol levels plummeted. Their angina disappeared. Their weight dropped. I have reported this study at 5 years, 12 years, and 16 years, in the peer reviewed scientific literature and again beyond 20 years in my book Prevent and Reverse Heart Disease. In some of the patients we had follow up angiograms (x-rays) of previously blocked arteries demonstrating striking disease reversal, which is a testament to my often quoted statement "The truth be known coronary artery disease is a toothless paper tiger that need never exist and if it does exist it need never progress." The greatest gift to these patients is the increasing recognition that they are the locus of control for their disease - not some pill or procedure. They have made themselves heart attack proof and lose the greatest fear of all heart patients and their families - when will the next heart attack occur?

KF: What about drugs, stents, and heart bypass surgery?

CE: Admittedly in the midst of a heart attack a stent or bypass may be live saving, however, for the remaining 90% studies confirm that they do not prevent future heart attacks or prolong life. They are associated with significant complications such as hemorrhage, heart attack, stroke, cognitive decline, depression, and death. The benefits erode with the passage of time as the stents and bypasses may themselves develop blockage.

Some drugs may decrease blood pressure and the heart workload. Others interfere with clotting which helps a stent remain open. Statin drugs lower cholesterol. None of these drugs or interventions addresses the basic causation of disease and not surprisingly the disease progresses with the need for more drugs, stents, and repeat bypasses.

KF: Why aren't physicians using nutrition therapy?

CE: Most physicians have no training or understanding of the power of nutrition. In a busy practice they would not have the time for it. It is my belief that physicians must accord the plant based lifestyle transition its due. Every patient with cardiovascular disease should be referred to a physician or nurse practitioner with the knowledge and expertise in these counseling skills.

KF: But I understand physicians don't believe patients will make this transition. How come?

CE: Nutrition counseling is a skill which physicians don't possess. Of all the encounters a patient with cardiovascular disease experiences, perhaps the least time and lowest priority is nutritional counseling. I see many patients with heart disease who recount that nutrition was never even mentioned. It is therefore unlikely that the patient feels that nutrition is important.

KF: What is that you do differently?

CE: In an intensive 5 hour counseling session for a group of heart patients, my first priority is to eliminate the mystery of what causes their disease. It has not been stress, or genes. It is their western diet of processed oil, dairy, and meat. Hypertension, diabetes, and smoking must be controlled but food trumps all. I spend at least an hour defining the protective role of endothelial cells and nitric oxide functioning as the ultimate guardians of our blood vessels. They quickly understand that their lifetime of ingesting these harmful products has totally overwhelmed and destroyed their endothelium to an extent where it is unable to protect them. They fully grasp that they must forever eliminate ingesting foods that will further destroy their already compromised endothelium. They understand heart disease is a food borne illness.

KF: Where is the good news?

CE: The patients understand that they can halt their disease. They are presented with my scientific articles demonstrating reversal of disease. They learn that anginal chest pain may diminish or disappear within 10-14 days in some patients while others may take longer. We share our data confirming reversal of carotid artery disease to the brain, coronary artery disease of the heart, peripheral vascular disease in the extremities, and the reversal of erectile dysfunction. They are made to appreciate how rapidly and powerfully the endothelial function may be restored. The most significant message in our counseling is patient awareness that they are empowered to be the locus of control of their disease.

KF: What is your take on the present management of heart disease through drug stents and bypass surgery?

CE: It is expensive, dangerous, and ineffective. None of these approaches addresses the factors that cause the disease. A doctor would never treat poison ivy without advising the patient to avoid exposure to poison ivy plants. Sadly the usual treatment of cardiovascular disease almost never includes hours of patient counseling so they may completely eliminate the foods which are injuring their endothelium. Stents may block, bypass veins shut down, drug doses increase, and blood vessel disease worsens. The present cost of this non-treatment of heart disease is unsustainable even in our wealthy nation.

KF: Dr. Esselstyn, are you a threat to the stenting and bypass industry?

CE: Not really. Stents and bypass surgery in an emergency setting are absolutely lifesaving. However, for non-emergency situations an intensive lifestyle trial of 3-6 months would eliminate the need for most interventions. It is of interest that when physicians and some interventional cardiologists themselves develop the disease they come knocking at my door.

KF: Why do you think this information on diet and heart disease is not more widely known? Is someone or something blocking your message?

CE: The government, drug industry, and some of my own profession. The USDA every five years produces a food triangle which promotes the very foods which guarantee that millions of Americans will perish.

The drug industry has a $21 billion dollar income from statin drugs alone. The stent manufacturers make billions more. Neither of these industries would want this epidemic resolved.

Physicians who perform stents and bypass surgery earn millions and are hardly clamoring for fewer patients.

KF: Any final thoughts?

CE: When people learn to eat plant based to eliminate heart disease it could inaugurate a seismic revolution in health. Other diseases that resolve include obesity, hypertension, stroke, heart attacks, gall stones, diverticulitis, asthma, osteoporosis, allergies, rheumatoid arthritis, multiple sclerosis, lupus, and a marked decrease in the common western cancers of breast, prostate, colon, endometrial, ovarian, and pancreatic.


For more information, go to www.HeartAttackProof.com.

 
 
 
"If the truth be known coronary artery disease is a toothless paper tiger that need never, ever exist and if it does exist it need never, ever progress." So says Dr. Caldwell Esselstyn, who was a r...
"If the truth be known coronary artery disease is a toothless paper tiger that need never, ever exist and if it does exist it need never, ever progress." So says Dr. Caldwell Esselstyn, who was a r...
 
 
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01:50 PM on 10/30/2009
This is a message that needs to be said over and over again. For nearly 20 years, Dean Ornish has been using plant based low fat diets to reverse heart disease. I know after my father started eating that way, he never had another heart attack.

Before we start a national health care plan, we need a national food care plan--don't we?

Amy Cross
women make news
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Roryfreedman
05:59 PM on 10/29/2009
Another heroic effort from Ms. Freston to educate the masses. Thank you, Kathy, and you, Dr. Esselstyn, for your incredibly important work. The science is indisputable.
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Goliadkin
Irony: it's not just for smart people anymore.
01:30 AM on 03/13/2010
Indisputable? Very little in science is indisputable. Dispute, debate, and doubt are essential elements of the scientific method. Besides, Esselstyn is a doctor, not a scientist. All the "studies" listed on his web site are written by him alone. Science is a social endeavor. This isn't science, it's one man's opinion, regurgitated here by a Greek chorus.

There may be some veracity to the claims made in this article. But comments of this type lend an air of blind zealotry to the discourse, and tend to undercut whatever credibility it would otherwise have.
03:12 PM on 10/28/2009
Dr. Esselstyn's message is so important and life-saving for both humans and animals. Eating meat, dairy, and eggs is downright dangerous. Not only does an animal-based diet lead to heart disease, cancer, diabetes, and many other illnesses, but a startlingly high percentage of meat is contaminated with dangerous pathogens such as E. coli and Salmonella. Not to mention that the meat industry is responsible for outbreaks of diseases such as Swine Flu, Mad Cow, and Avian Flu. Animals on factory farms are crammed by the thousands into filthy sheds where they are often confined to cages so small they can't even turn around or stretch a limb, and they are routinely mutilated without painkillers. For your own sake, and for the sake of the animals, go vegan!
02:06 PM on 10/28/2009
For more info on how to greatly improve your health and environmental health simultaneously, please visit Eco-Eating at www.brook.com/veg
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01:09 PM on 10/28/2009
While he is certainly correct, all I could think was "duh."
This has been known for decades.
01:06 PM on 10/28/2009
This entire article, while comforting to vegans and vegetarians, is not very useful for omnivores. How can such a broad statement such as this be taken seriously: "eliminate the mystery of what causes their disease. It has not been stress, or genes. It is their western diet of processed oil, dairy, and meat. Hypertension, diabetes, and smoking must be controlled but food trumps all"?
I think a few equally credentialed MD's might have issues with that statement, to put it very lightly. The doctor lumps "processed oil" into his indictment of animal-based diet, but of course most processed oil we encounter in food today is from plant sources. That's just one of many examples of confusing or unsupported statements in the article.

And you claim that "What is becoming very apparent through various peer reviewed studies is that by changing our diet - eliminating .... (animal protein) and adding in plant based proteins ... we can not only prevent disease, but also heal from it once it is already in motion." OK, can you point us to some of these "peer reviewed studies"? I have no doubt that there are some, but I also know that much can be learned from the "peer review" process, including an understanding of how feeble a study's conclusions might be.

If your interest is truly to enlighten your readership, then you must provide them a view to the entire debate, not just claims which support a certain ideology, in this case exclusively "plant-based" diets.
02:58 PM on 10/28/2009
"The doctor lumps "processed oil" into his indictment of animal-based diet, but of course most processed oil we encounter in food today is from plant sources. "

He does this because he feels so strongly about the dangers of oil that he devotes an entire chapter to it in his book. Plant based is part, but not the entirety of his heart disease reversal program.
12:53 PM on 10/28/2009
Thank you for posting this article, and thanks to Kathy Freston for fighting the good fight. She is right that in just a couple of generations, all people will be vegans and will be horrified at how foolish and stubborn so many people were. I'm continually amazed at the lengths the anti-vegan people will go to to intimidate and aggressively deny the health, environmental, and spiritual benefits a plant based diet provides. My guess is that their anger is an attempt to justify in their minds what they know is wrong. Very few people can honestly say that it wouldn't bother them at all to kill an animal - and how troubling is it that there are people in the world that wouldn't be bothered?
10:00 AM on 10/28/2009
Bravo Kathy for sharing this fascinating and well-researched information. Now, if only we all would "listen."
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rjhuntington
left is right and right is wrong
08:43 AM on 10/28/2009
Results are what counts. I gave up meat almost a year ago and am down to my original adult size! Back in my early 30s (I'm in my mid 60s now) I weighed about 165 and wore size 32 pants. By age 62 I was pushing size 38 (36s were tight) and weighed at least 200. My cholesterol was high. I had some peripheral arterial blockage in my left leg that made walking painful after about a block.

Now I weigh 165 again and wear size 32. I feel great. I just had a blood test but don't have the results yet, though I imagine my cholesterol must be way down. I sleep less, have more energy, take fewer and shorter naps, stay up later but get up as early as I used to. I can walk again at full pace for any distance! There is still some slight discomfort but that decreases with each passing month. ED is a thing of the past!

And here's a benefit I haven't seen anyone else mention yet, minimized bathroom odors. Farts are virtually odorless! Seriously, meat consumption produces smelly wind. Veggie consumption does not! Whodathunkit?

Do I miss the taste of meat? A perfectly grilled steak? Rack of lamb? Pork loin? These are things I relished before. Do I miss them now? Not one bit!
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Mirabai305
Are you Jeff Vader?
06:50 AM on 10/28/2009
I just found an interesting blog, well researched by a very reasonable young man who is discovering very interesting things about the fiction surrounding heart disease and modern diet myths.

thehealthyskeptic.org

If you're interested in learning how the pharmaceutical industry is behind these dietary recommendations with a direct intent to cause disease and/or make people believe they have diseases, this blog is an interesting read.
04:22 PM on 10/28/2009
I'm skeptical of your skeptic.

It's actually the opposite. Pharmaceutical companies like the status quo because the status quo diet produces the most amount of sick people who will demand their drugs to "manage" their disease.
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Mirabai305
Are you Jeff Vader?
12:05 AM on 10/29/2009
Not quite. All drug sales level off after a few years. That's why they are constantly developing new drugs and repeatedly increasing the market-size for illnesses. Making up new 'diseases' and basically marketing them to the general public. PMDD and ODD are perfect examples. Do teenagers really need to be medicated for not listening to their parents? Suddenly acting like a teenager is a disease and you need to give your kid pills for it..

It's the same reason that the pharmaceutical industry repeatedly encourages the AMA to reduce the recommended level of cholesterol in spite of the fact that heart disease is increasing in the face of steadily reducing numbers. It's so they can prescribe statins to an ever larger audience of people, regardless of whether or not these medications actually have an effect on heart disease.

The thing about the blogger in that link is that he actually does the research. he reads the real studies. He doesn't make wildly speculative claims based on reading nothing more than the abstracts. When he finds something that makes him question, he goes looking for information rather than making assumptions. We may not like the results of his research but I belive he's the real deal.
02:41 AM on 10/28/2009
Kathy Freston is the best blogger on Huffpo!! Hands down!! Kathy FTW
02:40 AM on 10/28/2009
Want to see some clogged arteries, this video will change your life.
http://www.youtube.com/watch?v=Mm7ROf5ZylQ
02:21 AM on 10/28/2009
There are many things that can make an individual prone to heart disease.

Smoking
Diabetes (usually caused by eating too much sugar)
Lack of exercise
Obesity.
History of infections (they damage arterial walls and create places for plaques to build up)
Many other things, including diet.

Eating nothing but plants will not necessarily eliminate the risk for heart disease. People can certainly eat meat and live a healthy lifestyle. In fact, we're kind of wired to eat meat. Our forebears were meat eaters going back a few million years.
06:15 AM on 10/28/2009
Actually, the human digestive system from the shape of the teeth to the structure of the bowel is designed for a plant based diet.

Early man tended to eat what grew naturally. That is why we have a so-called sweet tooth, to insure early man would eat fruits that provided energy and vitamins.

To eat meat man first had to invent weapons to kill the animal. Besides, early man expended so many calories trying to stay alive that many of today's problems, like obesity and sedintary lifestyle, were not an issue.

Plus early man died young so the accumulated effects of the meat diet on the circulatory system would not yet develop.
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03:25 PM on 10/28/2009
"the human digestive system from the shape of the teeth to the structure of the bowel is designed for a plant based diet"

"Designed?" Hmm.

Even if true,that doesn't mean that's it's optimal--only that we've evolved to handle the worst as well as the best. And then there are those pesky incisors, canines, and eyes in the front of our heads.

I wouldn't read too much into that, either way.
02:08 AM on 10/28/2009
The bigger point here is that the Western medical model will not incorporate lifestyle as part of their treatment model. There is way more money to be made with the disease model. Cancer, diabetes and heart disease result in the highest profits for insurance and pharmaceutical companies and hospitals, so there is no incentive on their part to promote preventative treatments such as diet and exercise that would actually improve outcomes.

Only when the profit motive has been removed from the health care system will people in this country receive real and effective treatments for their problems.
01:54 AM on 10/28/2009
Another physician who has done some excellent work on this is Dr Dean Ornish, who I believe was the first MD to prove to insurance companies that they could save money by paying for patients to learn new habits instead of having bypass surgery.

Speaking of which -- I find it downright obscene that one of the questions above was about this strategy being "a threat to the stenting and bypass industry." My own dad had bypass, but that is one industry I'd LOVE to see put out of business because people didn't need it. An industry should serve a need, not the other way around.