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Authors: Kathy Freston

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BOOK: Veganist: Lose Weight, Get Healthy, Change the World
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Dr. Caldwell Esselstyn, a researcher and clinician at the Cleveland Clinic for over thirty-five years, says emphatically, “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.” In 1991, Dr. Esselstyn served as the president of the American Association of Endocrine Surgeons and organized the first National Conference on the Elimination and Prevention of Heart Disease. In 2005, he became the first 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. Here is what I learned from him.

Straight from the Source: Caldwell Esselstyn, MD, on Heart Disease

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 number one 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 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:
Just about anyone eating the typical Western diet. In autopsy studies of our GIs who died in the Vietnam and Korean wars, almost 80 percent, at an average age of just twenty years old had disease that could be seen without a microscope. Forty years later, in 1999, a study of young persons between the ages of sixteen and thirty-four who had died in accidents, homicides, and suicides found that 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 life jacket of our blood vessels—our endothelial cells. This cell layer is the one-cell-thick lining of all 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 these 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, eventually creating heart disease and strokes.

 

KF:
Can it be stopped or even reversed?

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

Beginning in 1985 I initiated a study of seriously ill coronary artery disease patients. I put them on a plant-based diet, without any oil. Their cholesterol levels plummeted. Their angina disappeared. Their weight dropped. I have reported this study at five years, twelve years, and sixteen years, in the peer-reviewed scientific literature and again beyond twenty years in my book
Prevent and Reverse Heart Disease
. In some of the patients we had follow-up angiograms (Xrays) of previously blocked arteries demonstrating striking disease reversal.

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 one occur?

 

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

CE:
In the midst of a heart attack a stent or bypass may be lifesaving, however, for the remaining 90 percent of patients, 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.

“Stents may be lifesaving
during
a heart attack, but they do not prevent future heart attacks or prolong life.”

—Dr. Caldwell Esselstyn

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:
Any final thoughts?

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

“Plant-based eating could inaugurate a seismic revolution in health.”—Dr. Caldwell Esselstyn

Now you know how heart disease happens from a medical viewpoint. Here is one man’s personal story. Actually, it’s three stories woven into one.

Robert Dew’s Story:
Reversing the Family Heart-Attack Pattern

For the record, this is a portion of my family’s health history:

Great-uncle: deceased at 45. Cause: heart attack.

Grandfather: deceased. Cause: heart attack.

Grandmother: deceased. Cause: stroke.

Great-grandfather: deceased. Cause: heart attack.

Mother: deceased. Cause: congestive heart failure.

Father: living with two triple bypasses, two pacemakers, and congestive heart failure.

That’s how my family stories end. We all die of heart attacks and strokes. But every story has a beginning, too…

I recall a set of stemware from my childhood—a nice set of sturdy, faceted goblets. They were obtained courtesy of a well-known peanut butter manufacturer. The peanut butter came off the shelf in special glasses, sealed with a pry-off lid. Our set was a result of my eating countless spoons of it in front of the TV. We had an even dozen. I would have been pleased to supply a dozen more, but the promotion ended.

I had another food treat, this one invented by my dad. He would sit down to watch a football game with a stick of butter, a packet of saltines, and a bottle of ginger ale. He scraped out a furrow of butter onto the cracker and downed the thing in one bite. Every two or three of these were washed down with ginger ale. I loved it too. By halftime, the butter, crackers, half a jar of peanut butter, and a quart of ginger ale were gone. We were eagerly consuming the three main food groups in the American Food Pyramid: sugar, grease, and salt.

I did eat other things. I loved breakfast; listening to bacon and eggs talk to me as they cooked in the same pan. Grits had to be consumed with a ton of butter, salt, and pepper. Hamburgers were my favorite food. I always took off the lettuce and tomato and gave the pickle to my wife. I could not pass a hamburger stand without wanting to stop for double fries and triple burgers. When I cooked burgers on the grill (which was often) I always made an extra rare and greasy one to eat while I was cooking the rest. I did like broccoli, as long as it was rendered unrecognizable, swimming in butter and cheese. Then there were doughnuts; fried in oil, dripping hot from the basket, coated in sugar. And more than once, at midnight, I found myself eating Oreo cookies while staring at the clock. So there you have it: breakfast, lunch, supper, dessert, and snacks—a diet of kings.

I ate a lot of fast food, and dined at other restaurants. When we ate at home there was plenty of meat and potatoes. Of course we added a tiny feel-good garnish of fruits and vegetables that were either loaded with sugar or cooked in some sort of fat. I went to the gym and took vitamins. But while I was eating all this, I was doing something else; I was constructing, piece by piece, the links of a chain. The resulting concatenation: heart disease.

Awakening

My awakening was gradual. I had been watching my father take a seemingly inexorable journey. During each of his bypass surgeries I witnessed drops in his cognitive skills. This once sharp and inventive man was moving backward. Holding the thread of a simple conversation became difficult. In parallel with this was an increasingly diminished physical capacity. The strong man of my youth was growing feeble. In many ways our roles were reversing; the child became parent and caregiver. But it made me think…

A few years ago I started to consider my position. In thinking about my dad, I remembered reading an article in the late ’70s about a treatment that reversed heart disease through diet—the Nathan Pritikin diet. While researching his methods I found other books that detailed the relationship between the typical Western diet and degenerative diseases—books by Ross Horne, Dean Ornish, Caldwell Esselstyn, and Lance Gould. I tried to practice the lifestyle, but could not maintain it.

Then it happened to me. I became aware of symptoms consistent with heart disease. Once they began, they progressed at an alarming rate. I contacted Dr. Esselstyn and described my symptoms. I had already read his book and asked if he could recommend a doctor who supported his method of treatment. In July 2009, I went to a clinic and had a stress echo test. I failed miserably.

The attending nurses and doctor wanted to send me to the hospital immediately to have a catheterization and most likely a stent or bypass. I told the attending doctor that I respected his opinion but that I had to put on the brakes. I had already concluded that I wanted to try a plant-based solution to my problem. Needless to say, that announcement caused some hysteria.

Treatment

Dr. Esselstyn supported the decision. I was immediately armed with nitroglycerin tablets and instructed to go to the hospital if I had to use them. Beta blockers and statin medications became part of my daily regimen and I renewed my dedication to a plant-based diet. As it turned out, there was a cancellation and subsequent opening in what was Dr. Esselstyn’s first small-group program at the Cleveland Clinic’s newly opened wellness center.

This was my condition just prior to stress echo testing:

  • Blood pressure: resting, 130/95.
  • Cholesterol: 250.
  • I had to stop three times on my way to the test from the hospital parking lot. No hills or steps; I was on level ground.
  • During walks with my grandchildren, I could make two driveways before angina onset.
  • I could no longer maintain my former fast walking pace.
  • I couldn’t wrestle on the living room floor with the grandkids.
  • I had excessive weight gain. Waist size 38 inches, pushing 200 pounds at 5
    7
    .
  • Emotional and work stress could trigger angina attacks.
  • I had to take an acid reducer every day or suffer severe indigestion.
  • My joints ached; I was stiff every morning.
  • I’d had acne rosacea since puberty, and my skin was worsening every year. (I like to joke that I had four of the new seven dwarves: Flaky, Oily, Blotchy, and Red.)
  • I had developed tinnitus (ringing in the ears) during the previous year. It was worsening.

I attended Dr. Esselstyn’s program in early August 2009. Since then, I have had no surgical intervention. The approach has been through diet and regular moderate cardio exercise. The diet is totally plant-based with no added fats or oils. Beginning gradually, after about a week into my new lifestyle, and over the course of six months, my physical conditions changed to:

  • Blood Pressure: resting, 115/65.
  • Cholesterol: 127.
  • I was no longer stopping halfway through parking lots.
  • I walked around the block with my grandkids without discomfort, and I wasn’t counting driveways.
  • I walked at my old fast pace again.
  • I could wrestle with the grandkids again.
  • Emotional and work stress did not trigger angina.
  • I lost about 35 pounds, back into a 32-inch waist.
  • I stopped taking acid reducers. No indigestion.
  • My morning stiffness and joint aches almost completely stopped.
  • My acne has cleared up beyond what I could ever have imagined.
  • I’ve experienced a perceptible reduction in the volume of the tinnitus.

As far as I am concerned, the results are nothing short of miraculous. That’s my story, but my story is really three stories.

BOOK: Veganist: Lose Weight, Get Healthy, Change the World
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