Advisor Spotlight: Caldwell B. Esselstyn, Jr., MD
Making Yourself
Heart Attack Proof
I
caught up with Dr. Esselstyn while he was in Missoula, Montana to give
a talk to oral surgeons, dentists and their families about "making
yourself heart attack proof," which has been his passion and expertise
for more than twenty years.
Caldwell
B. Esselstyn, Jr., received his B.A. from Yale University and his M.D.
from Western Reserve University. In 1956, pulling the No. 6 oar as a
member of the victorious United States rowing team, he was awarded a
gold medal at the Olympic Games. He was later trained as a surgeon at
the Cleveland Clinic and at St. George's Hospital in London. Dr.
Esselstyn has been associated with the Cleveland Clinic since 1968.
During that time, he has served as President of the Staff and as a
member of the Board of Governors. He chaired the Clinic's Breast Cancer
Task Force and headed its Section of Thyroid and Parathyroid Surgery.
It
was during his years on the breast cancer task force that he became
increasing disenchanted with the fact that no matter how many breast
operations he was doing, he was not doing anything to protect the next
unsuspecting victim. This was particularly frustrating given that
research studies had already suggested an obvious culprit. The fatty
American diet was, in all likelihood, responsible for heart disease as
well as many Western cancers-- illnesses which are infrequently seen in
parts of the world where much less fat is consumed. This quandry
compelled him into a global research project and his ground-breaking
work addressing the leading cause of death in the United States for men
and women: heart disease.
Dr.
Esselstyn notes: "The world's advanced countries have easy access to
plentiful high fat food; ironically, it is this rich diet that produces
atherosclerosis. In the world's poorer nations, many people subsist on
a primarily plant-based diet, which is far healthier, especially in
terms of heart disease. To treat coronary heart disease, a century of
scientific investigation has produced a device-driven, risk
factor-oriented strategy. Nevertheless, many patients treated with this
approach experience progressive disability and death. This strategy is
a rear-guard defensive approach.
In
contrast, compelling data from nutritional studies, population surveys,
and interventional studies supports the effectiveness of a plant-based
diet and aggressive lipid-lowering to arrest, prevent, and selectively
reverse heart disease. In essence, this is an offensive strategy. The
single biggest step toward adopting this strategy would be to have
United States dietary guidelines support a plant-based diet. An expert
committee purged of industrial and political influence is required to
assure that science is the basis for dietary recommendations."
(Preventive Cardiology, 2001)
Theory into Practice
"It
was ridiculously simplistic, really," he recalls, "to see if we could
get people to eat the same plant-based diet as other countries in order
to slow, stop or even reverse heart disease; to change patients'
metabolism/bio-chemistry." So Dr. Esselstyn and his wife Ann
determinedly started it themselves in April 1984. Within the first
several months Dr. Esselstyn's cholesterol dropped to 119, from 190.
He
then went to cardiology at Cleveland Clinic to seek patients who would
agree to the diet. The patients in Dr. Esselstyn's initial study came
to him with advanced coronary artery disease. Despite the aggressive
treatment they received, among them bypasses and angioplasties, many
were told by their cardiologists that they had less than a year to
live. Within months on Dr. Esselstyn's program, their cholesterol
levels, angina symptoms, and blood flow improved dramatically. Twenty
years later, compliant patients remain free of symptoms. Here are the
documented results:
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 total cholesterol level seen in cultures where
heart disease is essentially nonexistent.) This is the most profound
drop in cholesterol ever documented in the medical literature in a
study of this type.
Cardiac events: The 17
patients in the study had 49 cardiac events in the years leading up to
the study, and had undergone aggressive treatment procedures. Several
had multiple bypass operations. After beginning the 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.
Within
3-4 weeks of starting this nutrition plan, the cap over the plaque is
strengthened so it cannot rupture. High fat foods such as oils,
avocados, dairy, meat, fish...all destroy the endothelial cells.
Endothelial cells produce nitric oxide which insures smooth blood flow
and strengthens the cap over the plaque. As Dr. Essestyn so creatively
put it: "Anything with a face, that flaps its wings, wiggles a fin, is
not allowed because it injures the endothelial cells."
In
1991, Dr. Esselstyn served as President of the American Association of
Endocrine Surgeons, That same year he organized the first National
Conference on the Elimination of Coronary Artery Disease, which was
held in Tucson, Arizona. In 1997, he chaired a follow-up conference,
the Summit on Cholesterol and Coronary Disease, which brought together
more than 500 physicians and health-care workers in Lake Buena Vista,
Florida.
His
scientific publications number over 150. In 1995 he published his bench
mark long-term nutritional research arresting and reversing coronary
artery disease in severely ill patients. That same study was updated
at 12 years making it one of the longest longitudinal studies of its
type. It is most compelling, as no compliant patients have sustained
disease progression. Today, 20 years later compliant patients continue
to thrive.
Proundly Simple:
The
following is an exerpt from Dr. Esselstyn's article:Resolving the
Coronary Artery Disease Epidemic through Plant-Based Nutrition,
published in Preventive Cardiology, 2001; 4: 171-177:
Replace the "Food Pyramid"
"An integral part of this offensive must be to eliminate the toxic food environment. Look at
the so-called Food Guide Pyramid, the familiar geometric symbol used to
promote the recommendations by the U.S. Department of Agriculture
and the Department of Health and Human Services. It is laden with dairy
products, animal products, and oils, which are the essential building
blocks for coronary artery disease. In addition, from a design
standpoint, the choice of a pyramid is potentially confusing and
misleading. Some viewers may be led to believe that the foods at the
top (meats, sweets, and fatty foods) are the most helpful, when in fact
they are the most harmful. To avoid such sources of confusion, we
should eliminate geometric figures and promote 3 simple food
categories: safe, condiments, and unsafe.
Safe: whole grains, legumes, lentils, vegetables, and fruits
Unsafe:
oils, dairy foods, meat, poultry, and fish (not regulated by
inspection, and frequently contain unacceptable levels of PCB's,
dioxin, and mercury.)
In
addition, we should recommend dietary supplementation with a daily
multivitamin, and, for those over 50 years old, an additional
1,000-1,200 mg calcium and 600 to 800 IU of Vitamin D. These
recommendations are in concert with those of the expert faculty from
the First National Conference on the Elimination of Coronary Artery
Disease."
Dr.
Esselstyn's enthusiasm for educating and inspiring his patients is
evident. "It is so powerful when patients recognize that they are the
locus of control to protect themselves from having another heart
attack. When properly counseled, patients comply not only one year, but
for the rest of their lives." Dr. Esselstyn and his wife have now been
following a plant-based diet for 25 years. They work together to
counsel patients both in Cleveland, where they live, and in summer at
the farm in upstate New York where Dr. Esselstyn grew up. Dr. Esselstyn
concentrates on the medical details, and Ann focuses on healthy foods
and how to prepare them.
His book, Prevent and Reverse Heart Disease
offers readers the same simple, nutrition-based plan that dramatically
changed the lives of his patients forever. With this eating plan,
sufferers of heart disease will maintain cholesterol levels low enough
to ensure that they will never have a heart attack. Best of all, the
book offers more than 150 delicious recipes that Dr. Esselstyn and his
wife have developed over the years-showing readers how easy it is to
enjoy their new way of eating.
For more information, articles and studies, please see Dr. Esselstyn's website:
