Twenty years ago, 23 men and women came to Dr Esselstyn out of desperation. They had all suffered heart attacks and were given morbid prognoses. It was then that Dr.Esselstyn, a cardiac surgeon at the Cleveland Clinic, began a 20-year experiment that would change modern medicine, not to mention the lives of all his patients. This landmark study is the topic of his book ‘Prevent and Reverse Heart Disease’.
I attended a talk by Dr. Caldwell Esselstyn at the Healthy Lifestyle Expo in Los Angeles, California. This tall, slim, smiling man had a kindly manner and a modest air. Not only was this former internationally-known surgeon, researcher and clinician (at the world famous Cleveland Clinic) the author of this amazing book, but he was also an Olympic Gold Medalist. Yet, there he was, delivering his message to the people with obvious feeling and care.
Dr.Esselstyn’s 20-year nutritional study is the longest study of its kind ever conducted. And so, he is in a position to say with irrefutable scientific evidence, how we can end the heart disease epidemic forever by changing what we eat. Dr.Esselstyn convincingly argues that a plant-based, oil-free diet can not only prevent and stop the progression of heart disease, but also reverse its effects. This breakthrough has the potential to change the health of millions for the better.
The idea is simple – make someone "heart-attack proof" by keeping their cholesterol below 150. Dr.Esselstyn does this through a strict vegetarian diet with no dairy, no nuts and no oils. The diet may sound extreme, but his recipes show that it can taste good and actually reverse heart disease in severely ill patients.
The Medical Science
Heart disease persists as the leading cause of death for men and women in the ‘civilized’ world. Dr.Esselstyn argues that conventional cardiology has failed patients by developing treatments that focus only on the symptoms of heart disease, not the cause. But, he explains, by removing the cause it can be prevented, reversed, and even abolished.
The patients in Dr.Esselstyn’s initial study came to him with advanced coronary artery disease. Despite the aggressive treatment they had previously received, among them bypasses and angioplasties, 5 of the original group were told by their cardiologists that they had less than a year to live. Within months of being on Dr.Esselstyn’s program, their cholesterol levels, angina symptoms and blood flow improved dramatically. Twelve years later, 17 compliant patients had no further cardiac events. Adherent patients survived more than twenty years, free of symptoms.
Here are some details about the changes that took place -
Drop in cholesterol levels: After 5 years on Dr.Esselstyn’s plant-based diet, the average total cholesterol levels of his research group dropped from 246 milligrams per deciliter to 137 mg/dL (above 240 mg/dL is considered “high risk,” below 150 mg/dL is the cholesterol level seen in cultures where heart disease is essentially nonexistent.) This is the most profound drop in cholesterol ever documented in medical literature in a study of this type.
Cardiac events: The 17 patients in the study had had a total of 49 cardiac events in the years leading up to the study, and had undergone aggressive treatment procedures. Several had had multiple bypass operations. After beginning Dr.Esselstyn’s eating plan, there were no more cardiac events in the group within a 12-year period.
Angiogram evidence: Angiograms taken of the participants in the study show a widening of the coronary arteries, and thus a reversal of the disease. This is the most impressive aspect of the study. There are photographs of such angiograms in the book.
Although all this work may seem overwhelming for the layperson, Dr. Caldwell Esselstyn’s book is written in a remarkably simple style that makes it easy to read. By adding case studies that have a human face, Dr.Esselstyn manages to make this book interesting even for the novice.
His first chapter begins with the story of a fellow doctor at the Cleveland clinic, who experienced a heart attack while at work. He was only forty-four years old. He had no family history of heart disease, was not overweight or diabetic, and did not have high blood pressure or a bad cholesterol count. All this goes to show that a heart attack can affect anyone - an important reason to make ourselves heart attack proof. This colleague did just that, and to his surprise, his angiograms showed disease reversal.
Getting at the Underlying Cause
Dr.Esselstyn’s message is clear and absolute: coronary artery disease need not exist, and if it does, it need not progress. The costs of this epidemic are tremendous, both in terms of lives and in terms of money spent to try to save them.
But Dr.Esselstyn believes that the truly shocking statistic is that nearly all of that money is devoted to treating symptoms. This can provide only temporary relief. It does nothing at all to cure the underlying disease or to prevent its development in other victims.
Over the past one hundred years, the mechanical treatment of disease has increasingly dominated the medical profession in the United States. Surgery is the prototype, and its dramatic progress is nothing short of breathtaking. But surgery has serious flaws. It is expensive, painful and frightening, often disabling and disfiguring, and too often merely a temporary stopgap against the disease it is intended to treat. It is a mechanical approach to a biological problem.
Until now, there has been little incentive for physicians to study alternate ways to manage disease. Modern hospitals offer almost nothing to enhance public health. They are cathedrals of sickness. But there are some signs of change. Physicians and researchers increasingly agree that lifestyle changes —controlling blood pressure, stopping smoking, reducing cholesterol, exercising, and modifying diets —are essential to overall health.
The Diet Plan
The bottom line of the nutritional program is that it contains not a single item of any food known to cause or promote the development of vascular disease.
According to Dr.Esselstyn, it is clear that continuing with the slightest bit of the foods that cause the disease in the first place is like adding fuel to a fire. The fuel in this case is fat. Here are the rules of his program in their simplest form:
- You may not eat anything with a mother or a face (no meat, poultry, or fish).
- All animal products necessarily contain fat.
- You cannot eat dairy products.
- You must not consume oil of any kind — not a drop. This is the fuel, which would keep the fire going.
- Generally, you cannot eat nuts or avocados
- What you can eat are a wonderful variety of delicious, nutrient-dense foods:
- All vegetables except avocado. Leafy green vegetables, root vegetables, veggies that are red, green, purple, orange and yellow and everything in-between
- All legumes - beans, peas, and lentils of all varieties
- All whole grains and products, such as bread and pasta, that are made from them—as long as they do not contain added fats.
- All fruits.
Dr Esselstyn is a leader in that wave, and he is working to improve medicine through dietary prevention, and nutritional cures.
The diet works. According to Esselstyn, in fully compliant patients, angina disappears in a few weeks and abnormal stress test results return to normal.
This book describes the simple nutritional plan that can make anyone “heart-attack proof”. It includes more than 150 delicious recipes that Dr.Esselstyn and his wife, Ann Crile Esselstyn, have developed over the years. Many of these may seem difficult to adopt in the Indian context. What we need to understand are the principles of eating, and translate them into our Indian menus, which is easily enough done with the help of this book. India should embrace a plant-based diet with ease. In fact, it may be even simpler for us to adopt because traditional Indian food has been largely plant-based. Today, because of the Westernization of our diet, urban Indians, like our American counterparts, are facing increasing rates of the diseases of affluence, such as cardiovascular disease.
By eating this way, you do more than prevent or cure heart disease. If you eat to save your heart, you eat to save yourself from other diseases of nutritional extravagance: from strokes, hypertension, obesity, osteoporosis, adult-onset diabetes, and possibly senile mental impairment, as well. You gain protection from a host of other ailments that have been linked to dietary factors, including impotence and cancers of the breast, prostate, colon, rectum, uterus, and ovaries. And if you are eating for good health in this way, here’s a side benefit you might not have expected: for the rest of your life, you will never again have to count calories or worry about your weight.
Dr Esselstyn says he has an ambitious goal: to annihilate heart disease – to abolish it once and for all. “Your arteries at the age of ninety ought to work as efficiently as they did when you were nine. My nutritional program is strict, and allows no shortcuts. I am uncompromising. I am authoritative. But as I always tell my patients, I am a caring presence. I want to see people succeed, and if they share my vision, they will.”
This report has been written in conjunction with Madeline Neal Bakewell, an intern from USA.
All Pictures from Wikimedia Commons.