Happy Healthy Long Life

Cholesterol: Fact or Fiction? What Effect Does Diet Have on Cholesterol? But the More Important Question is: "What Effect Does Diet Have on Your Cardiovascular Health?"

 

 

 

 

About a week ago I received an email from a reader in New York.

She asked a really good question.  But, I wanted an expert to answer it.

 

The Back Story

 

She had just received a copy of the January 2012  "Beating Edge", the newsletter of the Cleveland Clinic's Heart & Vascular Program. 

 

Here's what this New York reader wanted to know:

 

"I just received the Cleveland Clinics Heart and Vascular Newsletter this morning and its leading article was a short Q&A piece on cholesterol.

I know that Dr. Caldwell B. Esselstyn, Jr. has a long association with the Cleveland Clinic.

Below lies an excerpt from the newsletter:

"Have your cholesterol checked.  And, understand how cholesterol works, recommends Cleveland Clinic heart surgeon Marc Gillinov, MD, and cardiologist Steven Nissen, MD.

Can you tell fact from fiction?

1. Diet is the most important factor in determining your cholesterol level.

False. Eighty percent of the body’s cholesterol is made by the liver. That means, only 20 percent comes from your diet. That’s why it is so hard to lower cholesterol through diet alone. By banning nearly all cholesterol from your diet, you might be able to reduce your total cholesterol level by about 20 percent. Understanding this can often make the choice to take cholesterol-lowering drugs easier. If you need to reduce your cholesterol by 50 percent, you cannot accomplish this through diet alone. You’ll need a good diet and the right medication."

She went on to say:  I have no intention - or at least I don't think so - of veering from my Esselstyn fare but I am wondering what sense you make of the above... I feel like this flies in the face of claims made by others who have followed the Esselstyn diet and seen significant decreases in their LDL.

Her question:  Do you have any thoughts on the above? 

 

The Response from a Plant-Based Cardiologist

 

What would a cardiologist, who personally follows the Esselstyn diet, say about the answer given to the Diet & Cholesterol question in this newsletter?

I certainly wanted to know, so I asked a professional who has the knowledge & expertise to best answer this reader's question.  He prefers to remain anonymous.  I feel so privileged that he took the time to respond to this question.  Thank you!

 

Diet's Effect on Cholesterol - A Plant-Based Cardiologist's Point of View

 

"I don't find fault with anything said, except that I think it is fallacious to say that because 20% of your intake is dietary, you cannot reduce [your cholesterol] by more than 20% by changing your diet. 

This part is just plain wrong.   As you can see from the discussion that follows the article, there is more hype than fact.  Unfortunately, funding for nutritional research is miniscule.

The statement that 80% of your cholesterol is made by the body and only 20% comes from diet is based on the average (as measured in the population eating the Western diet) cholesterol production of 1 gm per day and the recommended dietary intake of cholesterol of 200-300 mg. 

For many Americans, the daily intake of cholesterol is much higher.  For those eating a plant-based diet, the intake is near zero.  So the 20% is not representive of a population, but rather an average of very different nutritional choices.  Several other logistical fallacies occur to me:

 

1)  Population studies on humans who eat a plant-based diet with very low dietary cholesterol intake show some of the lowest intrinsic cholesterol levels.  We have many studies on dietary modification showing that decreasing cholesterol intake can result in dramatic lowering of serum cholesterol level. So the implication that dietary modification is not effective beyond 20% is just wrong.  I personally cut my total cholesterol from 209 to 136 and my LDL from 144 to 72 with just nutritional changes.

 

2)  Relatively few (if any) studies of cholesterol regulation have been performed in vegans, so we don't have much information on the effect of this nutritional strategy on cholesterol synthesis. You can't extrapolate findings from studies of patients on a Western diet.  This is one of my biggest pet peeves.  The majority of the research we are doing is on a population that is (hopefully) irrelevant.  Drugs and devices may lead to much different results in a study of vegans with heart disease (if you could find enough to study!).

 

3)  The assertion that drug therapy of elevated cholesterol is more effective than nutritional changes focuses on a surrogate endpoint, that is, the cholesterol level, rather than clinically important endpoints like death, MI and stroke.  Dependence on surrogate endpoints is one of Dr. Steven Nissen's biggest criticisms of drug and device studies.  Statins have been shown to result in improvement in early MI and death rates, but they are not above suspicion for longer term adverse outcomes and there is a growing concern about the downside of life long administration.  Several drugs have been removed from the market because they lead to higher death rates despite their beneficial effect on surrogate endpoints.  We need to look at the the MI, death and stroke rates of nutritional changes, not whether they can decrease cholesterol by 20%.

  

That said, there is no question that statins have a role in the early treatment of unstable coronary disease, but it is likely not due to their cholesterol lowering effect, but rather on their anti-inflammatory and pro-endothelial effect.  There may be much less powerful effects long term on mortality and MI rates (as well as other longterm adverse effects).  There is much less data on that." 

 

I'm so grateful for the balanced response this cardiologist provided to the important question of how diet can affect cholesterol--or more importantly, its effect on heart disease.

I certainly hope we can call on him again to share his expertise in questions of heart disease and  its prevention--and the beneficial effects of a plant-based diet.

 

As always, I'd love to get your feedback on this excellent guest post!

If you have a personal success story to share--now is the time.

 

 

 

Final Note:  If you haven't yet paid a visit to my new Facebook page: Happy Healthy Long Life - The Healthy Librarian  you are missing out on a lot of "hot off the press" health & nutritional news.  In the past 7 days I've posted over 30 new items.  (Is that too much?)  You can always google:  happy healthy long life - the healthy librarian facebook to find me, too.

Just a sample of the topics posts:

• From Fred Hutchinson's Cancer Center:  the effect of low-glycemic carbs on inflammation levels and its potential effect on cancer
• The effect of statins on diabetes in post-menopausal women
• An hysterical Italian video on "Fresh Made Pork Sausage"
• Bruce W. Hollis, PhD's & Dr. John Cannell's response to the latest research on vitamin D levels & CRP
• The effect of exercise on the genetic risk of Alzheimer's
• The best slow-cooker
• Dr. Esselstyn's 14 minute recent TED talk in Cambridge, MA
• A video about the pros & cons of nuts from Dr. John McDougall
• And whole lot more

Police Chief Patrick Berarducci's Gone Plant-Strong and is Cracking Down on Heart Disease in Medina, Ohio

 

Thursday Morning's Weight Work-Out

 

Strange, isn't it? Each man's life touches so many other lives. When he isn't around he leaves an awful hole, doesn't he? 

-Clarence, the Angel, in the 1946 Film, "It's a Wonderful Life"-

 

 

If you received this post via email, click here to get to the web version.

 

Have I got an inspiring story to share.

It's crazy how interconnected we all are to each other.  You never know how much influence we can have on each other.

Here's the story Ann Esselstyn shared with me this morning--after a morning weight-workout class.

I just happened to have the day off--otherwise I wouldn't have attended this class--and I wouldn't have heard Chief Berarducci's story.

 

This summer a police chief's grown-up son learned about the benefits of a plant-based no-added-oil-diet at one of Rip Esselstyn's Engine 2 Immersions in Texas.  

The newly-plant-strong son convinced his not-so-healthy Medina, Ohio Police Chief dad to just give the diet a try.  It worked for Bill Clinton--it'll work for him.

When the Police Chief started losing weight & gaining energy, he convinced his officers to give the diet a try.

Then the Police Chief decided to take it a step further & get his whole community turned-on to all the health benefits of eating plant-based--so he invited Dr. Caldwell B. Esselstyn, Jr & his wife Ann to explain all about the diet at the Medina Performing Arts Center.

The plan: to make Medina into a "Heart-Healthy City"

That was last night.

The community came out in full force to hear Dr. Caldwell B. & Ann Esselstyn explain how they can become a "Heart Healthy City--packing the Medina auditorium.

The front row was filled with police officers--and I'm pretty sure the mayor was there, too.

 

How lucky that Chief Patrick Berarducci listened to his son's pleas to do something about his health.

How lucky for Partick Berarducci, Jr., that his dad took his advice to heart--and turned his health around.  Not many parents are willing to do that.  What a gift this father & son gave to each other!

 

"The greatest gift that you could possibly give to your family--you can make them aware of this incredible power to avoid life's most painful events.  You just don't have to have those kinds of events." 

-Dr. Caldwell B. Esselstyn-

 

 

How lucky for the city of Medina, Ohio that they have a Police Chief who wants the entire community to "crack down" on heart disease.

And the delicious part for everyone in the Northeast Ohio area---Chief Berarducci wields a lot of influence in the local restaurant community.

Rumor has it that at least two Medina restaurants, Sully's & Thyme, are more than willing to turn out plant-based oil-free dinners for the Police Chief--so, I'm guessing that they'll know exactly how to prepare healthy meals for everyone else who's looking for plant-based fare in the Medina area .

Ann Esselstyn told me that the dinner she & Dr. Esselstyn had in Medina last night was absolutely outstanding--and prepared by a local restaurant, exactly to Chief Berarducci's oil-free specifications!

 

 Trimmed-Down Medina Police Chief is Sharing Secret of Success with Community 

 

Medina Town Square--The New Heart Healthy City

 

Police Chief Patrick Berarducci

I learned all the details about Chief Berarducci's heart-health turn-around from Jake Poole's Sun Newspaper story, "Trimmed-Down Medina Police Chief is Sharing Secret of Success with Community."

 

Here's the full text of Poole's 12/2/11 story.

 

I started to just include the highlights--but, frankly, the article is just so good, I'm reprinting it all right here.   Please, please go ahead & click on Jake's story so he'll get credit for lots of internet traffic!

 

Trimmed-Down Medina Police Chief is Sharing Secret of Success with Community

 

 "The 61-year-old Medina resident and 37-year law enforcement official is cracking down on heart disease.

Over the last three months, Berarducci has lost nearly 40 pounds while following a ground-breaking diet that was designed by Cleveland Clinic doctor Caldwell Esselstyn Jr., who will speak at the Medina Performing Arts Center next Wednesday. Dr. Esselstyn claims that the diet makes a person heart attack-proof.

“I’m going to do whatever I can to protect my health and be here as long as I can, and I haven’t been disappointed,” Berarducci said of the diet.

'Dad, you need to do something.'  How & why Berarducci went plant-strong

His wife, Judy, and two grown children had become increasingly worried about Berarducci’s rising weight and climbing blood sugar, which required Berarducci to take 20 mg each day of Crestor, a medication to regulate cholesterol.

On the weekend of Sept. 4, Berarducci’s son, Patrick Jr., made a plea.  (according to HL's sources, Patrick, Jr. learned about the Esselstyn diet when he attended an Engine 2 Immersion weekend in the summer)

“He said, ‘Dad, you need to do something,’” the elder Berarducci recounts. “To me, I’m a cop, I’m used to somebody showing me the evidence. I’ve got to understand it.”

Show Me the Evidence

So Patrick Jr. did. He showed his father a recorded CNN special, “The Last Heart Attack,” that features Dr. Esselstyn’s research and a story about U.S. President Bill Clinton, who, despite having world-class health care, needed bypass surgery only a couple years after leaving office.  

It was a wake-up call to Berarducci, who formerly worked as a federal agent and knew the protective measures exerted for the President, including strict health care. If it could happen to someone on such a formulated and planned diet, it could happen to a local police chief.

“What do we do?” Berarducci asked his son. His next meal was on Dr. Esselstyn’s diet, and he has not looked back.

The Challenge of an Ever-Shrinking Waistline

Since September, Berarducci has lost 38 pounds and has had to invest in a tailor.

“The big problem now is I have to continue to have my clothes taken in,” he said. “That’ll be a price I’m willing to pay.”

Berarducci's Cardiovascular Fitness Has 'Skyrocketed' with Exercise

He has lost 11 percent of his body weight, and Berarducci, who works out at least five hours per week, says his cardiovascular fitness has “skyrocketed.”

“I’m doing miles instead of blocks,” he said.

Prior to starting the diet, 30 minutes of walking was a strenuous workout, but now, Berarducci rips off a one-hour walk with ease, even after 12-hour days. “You just don’t get tired,” he said.

The Heart Attack-Proof Lifestyle

The heart attack-proof diet, which is based on a 20-year study by Dr. Esselstyn, is plant-heavy and rejects the use of oils in cooking.

In his book, “Prevent and Reverse Heart Disease,” Esselstyn details his study and 150 heart-healthy recipes.  Read more here.

According to the book’s website (www.heartattackproof.com), heart disease can be “prevented, reversed, and even abolished.”

'I've Not Enjoyed My Meals in the Past Like I Do Now'

By following the diet, food has come alive to Berarducci. Lentil soup over spinach, whole-wheat tortillas, whole wheat pasta: It’s like eating for the first time.

“The food you taste is so good, and I don’t remember feeling that way about normal food,” said Berarducci, whose wife is cooking through each one of Dr. Esselstyn’s recipes. “I’ve not enjoyed my meals in the past like I do now.”

Medina, Ohio--Where the Restaurants Now Make Plant-Strong Fare

And he’s taken his new diet out — to Sully’s, Thyme, and other local spots.

Berarducci will tell the chefs what he can and cannot eat, and the chefs’ creativity will flow out, producing new and unique dishes.

“To me, it almost looks like chefs are getting to be chefs. They are getting to prepare foods that they normally don’t get to,” Berarducci said.

As Berarducci’s weight plummeted and he continued to evangelize the diet, other police department employees began using the diet. But he could not stop there.

Like any good safety official, Berarducci wanted to protect the whole Medina community. He invited Dr. Esselstyn to present the diet to those in Medina City.

“I’m so thankful that my son didn’t give up on me and he got the message to me,” Berarducci said, “and I’ve kind of taken that on for the community.”  

 

I want to give a shout-out to my blog-buddy, plant-strong grandmother extraordinaire, Bonnie, who I finally had a chance to meet in person on Sunday.  She has her own inspiring story!  Bonnie's the one who told me about the upcoming event in Medina. I know you were there, Bonnie.  Care to fill us in on the evening's events?

And I thank Ann Esselstyn & Jake Poole for filling me in on all the details of Berarducci's story!

Go, Chief Berarducci!!!  We'll all be looking to Medina, Ohio for inspiration.

Every single week I hear motivating stories from readers who have switched to a plant-strong no-oil diet & are blown-away by the results.  They can't believe how easy it was to make the switch.

• Effortless weight-loss
• Greatly improved blood pressure, reduced blood sugar levels, & lowered cholesterol levels
• New found energy & cardiovascular health

 

I never tire of hearing these inspiring stories.

If you've got one--please share it with all of us.  Just click on over to the comments section at the bottom of the post--or drop me a line.

We really do motivate each other to get--and stay healthy!

 

 

 

 

CNN's Dr. Sanjay Gupta's Convinced! A Plant-Based Diet Can Prevent & Reverse Heart Disease & Give You Energy to Spare

 

CNN's Ali Velshi:  Can you really cure heart disease with food?

Dr. Sanjay Gupta:  The answer is yes!  We found living proof of this.

Sharon Kintz is the woman we profiled.  A 66 year old woman--had a heart attack--she needed to have heart surgery & she said, "No!"

She's adopted a plant-based diet.  She's very strict about it.  She's been doing it for over a year & it's quite remarkable.  Not only in how much she hasn't had any symptoms of heart disease, but in terms of her energy levels.

She could barely walk before all of this & literally now--a year later--on a plant-based diet, she's able to jump rope & has high energy levels.

CNN's Ali Velshi:  OK, so the plant-based diet is good for your heart, but can you really get enough protein on this diet?

Dr. Sanjay Gupta:  The answer is yes! The protein argument is a fallacy.

It's simply not true that you can't get enough protein on a plant-based diet.  If you do even a little research you find out that broccoli has more protein per gram than most meat.  Spinach has the same amount.  And of course there's tofu.

People who do this diet feel good & have a lot more energy.

 

 

If you received this post via email--you'll need to click here to get to the web version with the videos & links. 

Even though I watched the entire CNN "Last Heart Attack" special on Sunday--this promo really "Takes the Kale" for bringing home Dr. Sanjay Gupta's main point:  Heart disease--the No. 1 killer in the U.S. is a food-borne illness.  It need never exist.  Food can cure it--and make you heart-attack proof! 

Please take the four minutes to watch this promo--yes, even if you watched the special!  I promise you--it's worth it.  

Gupta comes clean with exactly what he learned after a year's worth of research on heart disease.   Talking to the experts.  Talking with patients.  Studying the research.  And Gupta's not just a TV doc--he's a practicing neurosurgeon at Emory University in Atlanta who graduated from the University of Michigan--undergrad & med school.

If you missed my post that summarized the special--& included the entire video, click here  for "Dr. Sanjay Gupta's "The Last Heart Attack" Finally Airs on CNN - Looks Like Diet & Non-Invasive Diagnostic Testing Win Over Bypasses & Stents - The Cliff Notes, the Collected Transcripts, & the Entire Documentary"

And if you missed "The Last Heart Attack" you can catch it again on Saturday, September 3 at 8:00 PM EST--or watch it now, without the commercials--right here!

 

Can Food Cure Heart Disease?

 

If you don't see this video on your screen, click here to go directly to it.

 

 

If you don't see the 2nd video on your screen, click here to go right to it.

Eating Your Way to Health--What About Protein on a Plant-Based Diet?

 

 

 

So, What About Those Energy Levels?  And What Exactly Do You Eat on This Diet?

 

Yesterday, I was up at 6:00 am--and I ended up working much later than I expected.  Like over 11 hours.  Got home about 9:15 pm--and my day included about 2 1/2 hours of moving heavy medical journals from one floor to the next--on & off shelves & pushing a heavy journal-laden trolley between floors.

Good thing I had packed my "lunch box" with breakfast, lunch, & snacks.  It easily got me through the day--until I could finally get home & eat dinner--at 9:30 pm.

 

Here's what got me through the day.

Check back for the Taco Salad, the No-Fat Creamy Chipotle Dressing, & the Chickpea & Spinach Burger recipes tomorrow--no time to post it right now--I'm off to exercise, and then I'm working late, again, tonight!

 

My Breakfast & Snack: "Cheezy Savory Oatmeal" with Spinach, Chia Seed, & a Peach

 

 

Cheezy Savory Oatmeal with Shiitake Mushrooms, Sun-Dried Tomatoes & Spinach--Ready to Eat

 

 

 

OMG Amazing Taco Salad with Black Beans & My No-Fat Version of NYC's Famous Candle Cafe Chipotle Dressing.  YUM!  Next Time I'll Add Roasted Corn.

 

Packed & Portable Taco Salad for Lunch

 

My Green Smoothie Mid-Day Sipping Snack-27 Ounces of Spinach, Carrots, Kiwi, Berries, & an Orange

 

My Late Night Dinner--Chickpea & Spinach Burgers with Light Tahini Lemon Sauce, Sprouts & Oven-Baked Spicy Sweet Potato Fries

And sometime this weekend--I promise--Part II of my 15+ months on a plant-based no-oil diet.  The tips, my favorite pantry staples, the supplements, & what's for lunch & dinner.

Tip:  Word has it that "Forks Over Knives" is now streaming on Netflix.  If you haven't seen it--it's a not-to-be missed documentary.  Read more about it here & here.

 

Readers Keep Asking for Updated Photos of Me & My Husband - This Week's 2 Hour Bike Ride on the Tow Path

 

Dr. Sanjay Gupta's "The Last Heart Attack" Finally Airs on CNN - Looks Like Diet & Non-Invasive Diagnostic Testing Win Over Bypasses & Stents - The Cliff Notes, the Collected Transcripts, & the Entire Documentary

 

Half of all heart attacks come with no warning at all, making diet changes & diagnostic tests all the more important

Last night Dr. Sanjay Gupta told us, "I'm on a mission to never have a heart attack."

He has a strong family history of heart disease and like most of us, he wants to avoid medications, stents, and bypasses.  None of these are without risk.

For over a year Gupta's been investigating "how to prevent a heart attack,"  speaking with the top cardiologists--as well as patients who have taken different approaches to treating their heart disease--from bypasses to stents to making radical dietary changes.

Gupta's documentary,  "The Last Heart Attack", aired last night, and frankly, its tenor and its key points took me by surprise.  It wasn't about cutting-edge drugs or snazzy procedures.  It was all about utilizing the newer more accurate non-invasive diagnostic tools--and making a radical change to a plant-based diet.

Dr. Arthur Agatston with his not-often-used non-invasive diagnostic tests, and Dr. Caldwell B. Esselstyn, Jr. with his plant-based diet--were far and away the stars of the show.

Gupta tells us at the start, "I'm going to tell you about things your doctor won't."

 

"And the truth is, it doesn't involve spending any more money, investing in any more research or creating any more tests.  Rather, it will take a strict implementation of what we already know about diet and nutrition. 

It will also take brave champions to navigate through confusing counsel, special interests and shoddy science,"  says Gupta.

 

"Dr. Caldwell B. Esselstyn, Jr.  tells Gupta, 'Sanjay, we want to make you heart attack proof.'

Pretty audacious, I thought, but I couldn’t help but be engaged by this Cleveland Clinic surgeon, who was now devoting his life to preventing the diseases he made a living treating.

'We are never going to end the epidemic of heart disease with stents, bypasses and medications,' he told me.

That was music to my ears, because I didn’t want any of those things. Of course, it would involve essentially eliminating meat, dairy, eggs and oil – even olive oil.

'Nothing with a mother, and nothing with a face,' the good doctor added.

Virtually eliminating heart disease – it can be done, and truth is, we have known for a very long time how to do it.

People have said to me as I was preparing this documentary – 'Sanjay, you are advocating a radical change to the way we eat.'

Perhaps, but if you really think about it, the way we eat now is in fact more radical. And when we look back on this time, a couple of hundred years from now, I guarantee you that our diet of today will be considered one of the most radical in history.

If we collectively ever want to get to the point where we have “The Last Heart Attack,” a good start would be to stop ignoring what we already know to be true."

-Dr. Sanjay Gupta, CNN, "The Last Heart Attack,"  August 28, 2010-

 

If you received this post via email, click here to get to the web version with all the links & videos.

I thought Dr. Sanjay Gupta's show would never air. 

First it was pre-empted by Libya.  Then by Hurricane Irene.

But, last night, Sunday August 28th at 9:00 pm I finally got a chance to see Gupta's long-awaited documentary, "The Last Heart Attack".

I settled into my favorite chair--with notebook in hand to take notes--I figured that many of you would have missed its last minute airing--and I was happy to fill you in on some of the key points.

But, when I checked my email early this morning, bingo--we were all in luck.   CNN has finally posted the full video on line.

If you missed the special, it will re-air on Saturday, September 3, 2011 at 7p and 10p Central.

If you do not see the video on this page, click here to go directly to the CNN Link.

 

The Last Heart Attack

 

 

 

The Transcripts & Extras from Dr. Sanjay Gupta's "Last Heart Attack" - All on One Page

 

I've created a transcript page that includes the text of all the key sections from "The Last Heart Attack"--you'll find it right here.

 

So Here You Go! 

 

If you're like me, you can't absorb everything when you watch a video. 

• What were the names of those diagnostic tests Dr. Arthur Agatston recommended?

• Why aren't cholesterol numbers the best indicators of heart disease risk?

• What kind of success can I expect on the Esselstyn diet?

• Oh--and what exactly is that diet anyway?  What foods do I need to avoid?  What foods do I need to eat?

It's all here in these transcripts--and there are links to most of the CNN videos related to the show.

Enjoy!

 

• Will you have a heart attack?  These Tests Will Tell.
• What Your Cholesterol Number Really Says
• Gupta:  Becoming Heart Attack Proof.
• Esselstyn: The Heart Attack Proof Diet.
• Tom Bare: The "Heart Attack Waiting to Happen Isn't Always Obvious"
• From Omnivore to Vegan:  The Dietary Education of Bill Clinton"
• The Heart Attack Diet Worked for Me  Don't miss this fascinating personal story from one of Dr. Esselstyn's patients--it wasn't part of the documentary.
• Ornish: Asking the Right Questions About Health Care

 

The "Last Heart Attack" Highlights

 

 Bill Clinton's Story.  From Couch Potato & Junk Food Aficionado to Plant-Based Booster

• In spite of having the best health care from the country's top physicians,  Clinton still ended up with quadruple bypasses, two stents, & medication.  And even Clinton knew he was heading into trouble if he didn't do something serious about changing his diet.  
• Clinton had the trifecta of heart disease risk:  he had a family history of heart disease, he was overweight & out-of-shape, and he was eating all the wrong foods.
• When Clinton's stents failed in February of 2010, his doctor said,  "This isn't a result of diet or exercise--it's a mechanical failure of stents."  But statins, stents, & the Mediterranean Diet aren't always enough to stop heart disease.  And moderation & pharmaceuticals aren't enough to stop the onslaught of atherosclerosis.
• Last year Clinton decided to hit the books & read what the medical literature had to say about preventing and reversing heart disease through diet.  He discovered that there is only one way to do this--a strict plant-based diet loaded with green leafy vegetables, and without meat, chicken, fish, dairy, or added oils.  The two physicians who pioneered this type of treatment are Dr. Caldwell B. Esselstyn, Jr. and Dr. Dean Ornish.  With nothing to lose, Clinton decided to conduct his own personal clinical trial.
• For over a year he's been eating 100% plant-based, if you don't count the one single bite of turkey he ate at Thanksgiving.   No dairy, no meat, no fish, and almost no oil. 
• First of all, Clinton unabashedly says, "I like the stuff I eat.  And if anything, I'm getting stricter about my diet as time goes on."  He's lost 27 pounds, all his blood tests are good, he has more energy, needs less sleep, and feels great.  He's almost down to his lowest weight since high school--185 pounds.

 

The Three Tests That Can Predict a Heart Attack

Dr. Arthur Agatston, the cardiologist who created the best-selling South Beach Diet, recommends three relatively new tests if you want to get a far more accurate picture of your heart attack risk than you can get from cholesterol numbers.

• Coronary calcium scan.  This looks at plaque in the arteries leading to the heart and can provide a good indicator of one's risk of a heart attack over the next 4-5 years.  This is a better indicator than you'll get from the Framingham Risk Score--and Agatston believes it should be done routinely at age 50--and earlier for people with a family history of heart disease.  Full disclosure, though--Agatston invented the coronary calcium scan--but makes no money on it.
  
• Ultrasound of the carotid artery.  This looks at plaque in the main blood vessel leading to the brain.  Plaque in the carotid artery is a sign of increased risk for a heart attack & a stroke.
• An NMR lipid particle test (The NMR-LipoProfile) This is a $65 test that looks at the size of one's LDL--the bad cholesterol.  Patients with a lot of small-particle LDL are more likely to build up plaque in their arteries.  The larger, light & fluffy LDL particles are less likely to enter into the blood vessel walls & cause damage.  It's not just about the LDL level--it's about the size of the particles.
  

 

The Heart Attack Proof Diet

Dr. Caldwell B. Esselstyn, Jr. has been teaching patients to prevent & reverse heart disease through a plant-based no-oil diet since 1985.

According to Esselstyn, heart disease is a food-borne illness, and one's risk of having a heart attack is not sealed in stone by one's family history or genetics.  If you change what you eat--and you can make yourself heart-attack proof.  Click here to learn more.

Esselstyn looked at the diets of indigenous people around the world.  In the communities where no heart disease existed, it turned out that the people were eating a mostly plant-based low-fat diet:  The Papua New Guinea highlanders, the Tarahumara Indians of Mexico, and some rural Chinese.

What do you eat on this diet?

• Vegetables-lots of green leafy ones to restore & heal the endothelial lining of your blood vessels.  Kale, Swiss Chard, Cilantro, Collards, Bok Choy, Parsley, Spinach, Broccoli, Brussel Sprouts, Cauliflower
• Whole fruit
• Whole grains
• Beans/Legumes; "light" tofu--cautious use of low-fat soy meat substitutes. Many are highly processed, high-fat junk food.

Gupta followed up with his own research, checking the medical literature for sound studies on the use of  plant-based diets to prevent & reverse heart disease.   He was impressed with Dr. Esselstyn's research at the Cleveland Clinic.

• 5 years later no patients who followed the diet had another cardiovascular event
• Three-quarters of Esselstyn's patients saw their blockages reduced.
• There are detractors: Dr. Allan Schwartz, the New York-Presbyterian Hospital's Columbia cardiologist who put in Bill Clinton's stents in February 2010 says the idea that diet can prevent or reverse heart disease is an overstatment.
• Dr. Erin Michos, a cardiologist at the Ciccarone Center for the Prevention of Heart Disease at Johns Hopkins University, says diet can reverse heart disease, but some people just aren't willing to make the necessary changes. 
• Gupta points out that Dr. Esselstyn's diet prescription runs counter to the powerful lobbies of the meat, dairy, & egg industries--not to mention our fast-food culture.  Could that be another reason that it hasn't gone mainstream?
• Most doctors & their families eat meat themselves, making them less likely to offer a plant-based diet as a prescription to prevent heart disease.

 

Two Patients Who Chose Diet Over Surgery to Prevent Another Heart Attack

 

The  41 year-old Male

He didn't smoke, was in good shape, and ate well.  His was a case of bad genes.

At age 31 he already had eight stents placed in his arteries.  At age 41 he had four more.

Clearly, stents weren't working for him.  He decided to contact Dr. Esselstyn after learning about his successes last September through Wolf Blitzer's CNN interview.  

No surprise that his doctors thought Esselstyn's diet was too extreme.  "Unnecessary," they told him.  But after having multiple stents he was losing confidence in their advice.  

Next Step.  The Esselstyn Diet.

He attended Dr. Esselstyn's one day session at the Cleveland Clinic in December 2010 and has religiously followed the diet since then.  (Learn more here: "What I Learned From Dr. Caldwell and Ann Esselstyn's Prevent and Reverse Heart Disease "School")

Since December Dr. Esselstyn's patient has lost 48 pounds. 

Last June, before changing his diet, his cholesterol was total of 208, LDL of 93, HDL of 41, and triglycerides of 368. 

His most recent test results are:  total cholesterol of 89, LDL of 19, HDL of 53, and triglycerides of 83.

The transformation is nothing short of amazing.

This CNN article wasn't part of Gupta's documentary, but part of series of articles leading up to show. Don't miss reading the entire inspirational story here.

 

Sharon Kintz--The 66-year old woman who had a heart attack, but decided to treat it with diet--not surgery.

 

Video: Woman Trades Heart Surgery for a New Diet

If you do not see the video, click here to go directly to it.

 

 

 

Sharon Kintz' story:

She's a 66 year old private investigator, who said, "NO" to open-heart surgery after experiencing a heart attack a year ago.  Brave woman.

Her symptoms before the heart attack?  Only fatigue & a pain in her jaw.  All fairly typical for women.

According Dr. Esselstyn, there's no down-side to Kintz' diet approach.  Once you start eating this way you will not have a heart attack.   Kintz continues to be seen by her cardiologist, as well as receiving dietary guidance from Dr. Esselstyn.   Her cardiologist is impressed with the results.

Kintz is a true believer in the diet approach & she's got plenty of company with some high-power business moguls like:  Steve Wynn, Mort Zuckerman, Russell Simmons, Bill Ford, Biz Stone, and Whole Foods' John Mackey.

She also has the "how to eat plant-based no-oil" thing down pat when she's on the road, or traveling.

 

Tom Bare--The Science Teacher Who Opted for the Bypass--Not Interested in Making Diet Changes

 

Then there's Tom Bare.  He's 54 years old high school science teacher, with none of the usual heart disease risk factors.

• He was thin.
• Ate what he thought was a healthy diet--oatmeal for breakfast, fruit, chicken or Mexican food for dinner
• He was on a statin--& his total cholesterol had gone from 300, down to 125.
• Exercised now & then
• He took care of himself & his body
• He didn't smoke
• He wasn't diabetic
• He did have a strong family history of heart disease

Bare did have one big risk factor hanging over his head.  He had a coronary calcium score that continued to increase.  Four years ago it was 111.  Anything over 100 means an elevated risk.  This year he had another scan--and this time it had gone up to 243!

One day this year, while out for a jog he experienced the classic chest pain, pain down his left arm, & shortness of breath.

His risk was all about coronary plaque--atherosclerosis--that narrowed all the major blood vessels of his heart.

Bare ended up with quadruple bypass.  But that wasn't the end of his problems.

He had a slow painful recovery.  Eight days after surgery he was heading for a life-threatening complication. 

Seventeen days after surgery he had no idea how uncomfortable he would be.

Three weeks after surgery he was finally able to take his first walk outside--and that's when he started to experience chest pain & shortness of breath. 

As it turned out--all his bypasses failed and he needed to have them all redone.  His doctors had never seen anything like this before.

• 12% of bypasses experience serious complications

• 1 in 300 need a 2nd operation in 3 years

• 1 in 20 end up needing follow-up stents.

Bare  was told that he'd feel like a million dollars.  He doesn't.

He is now back to teaching part-time--until he regains his strength--and he's hoping that bypass surgery has given him a new lease on life.  He's looking forward to being able to travel in the future.

"I'm told that I'm good for another 40 years or so, and I'm hoping that's the case, but with my history, I'm going to have to watch it."

Even so, he says he has no plans to give up the food he loves!

Read Bare's story here.

 

Did you get the same impression as I did about Gupta's "The Last Heart Attack"?

Did the documentary have a decided diet over drugs & procedures slant?

 

 

 

 

 

 

 

 

 

Fifteen Months Into the Esselstyn-Style Plant-Based No-Oil Way of Eating - The Healthy Librarian Spills the Beans - And It's All Good! Can't Wait to Compare Notes with Bill Clinton on Saturday.

 

My Work-Late Lunch Box: Yogurt Spelt Tomato Dill Cucumber Soup, African Sweet Potato Stew, Heavy on the Veggies Green Smoothie, Cilantro, Cherries, & Chia

 

"Making breakfast and lunch simple and nearly the same as possible everyday is helpful.  For breakfast, include some form of oats with their good cholesterol- lowering properties.

Try to keep lunch to soup and bread, salads, or sandwiches. Start as many meals as possible with salads.  Add all the vegetables you can!  Find a salad dressing you love.

Greens!!  Put them everywhere!  Focus on them."

-Ann Esselstyn, heart disease prevention & reversal diet teacher, coach, & recipe developer, extraordinaire-

 

"When I look at the two of you--and compare you to all the over-50 & 60 year olds I know--well, that's what convinced me that there's really something to the way you're eating.

You're both active, slim, exercise, have plenty of energy, no health problems,---and can really get down on the floor, pick up, & play with "your favorite gorgeous grandson".

"The best thing I learned from you is that it's really possible to cook without oil!"

-Paraphrased from My Daughter-in-Law-

 

 

If you've received this via email, click here to get to the web version with all the links.

 

 I'm now into my 15th month of sticking with Dr. Caldwell B. Esselstyn, Jr.'s Prevent & Reverse Heart Disease Diet.  Bill Clinton started in May 2010.  I started in June 2010.  Can't wait to compare notes.

Still going strong, with only a few modifications.  Got it down pat--and I've been able to stick with it, in spite of a year filled with travel that's taken me all over the U.S. & the Mediterranean.

I've been wanting to write this update for awhile--but frankly, there's just too much to say. 

But, I'm just going to dive right in & share some of the postive health changes I've experienced over the past 15 months--some tips that have worked for me--and some of my favorite products & cookbooks that have made cooking this way such a delicious & nutritious experience.

What I Love About This Way of Eating

• At 5' 3" I now weigh 117 lbs--sometimes 116, sometimes 118.  I've lost 15 pounds since starting this diet, and at age 61+, that's a weight I'm comfortable with.  In my twenties--before babies--I weighed 114, but, back then I didn't have a muscle to speak of.  Now I do.
• Just so you know.  I'm a foodie and I'm picky.  I won't settle for just anything.   But, for the past 15 months I've eaten as much scrumptious creative interesting food as I've wanted.   If I'm hungry, I eat, and I don't think twice about calories.
• If I had the nerve to wear a bikini--I really could!  
  
• Clothes now fit so well--no belly, a "just-right" butt, no underpant bulges.  No need for Spanx.  Ever!  I've dropped between 2 & 3 sizes, even though I've only lost 15 pounds.  Based on my experience--and everyone I've heard from who is on this diet--this is about the only way to really lose your belly fat.  And there are plenty of good reasons to do just that.  Click here to find out why!
• I'm not taking any medication, except for a low-dose of transdermal estrogen & natural progesterone--but that's for bone health, not health problems.  Read more about that, here.
• Can't remember the last time I was ill (knock on wood) or had a cold. 
• The digestive system couldn't be running any better.  Even when I'm traveling--as long as I'm eating according to "the plan", as Rip says, "I'm as regular as a Swiss train."
• I can really trust my appetite to tell me when I'm hungry--and that's when I eat.  I've lost that urge to eat just because I'm surrounded by tempting food or snacks.  You can't "make yourself" eat air-popped popcorn or apples--if you aren't hungry!
• My blood pressure is now in the low-normal range. 
• My cholesterol levels earned me a price break from my health plan for 2010 & 2011--but given the rules of my workplace's healthcare plan--they won't recheck my cholesterol levels until 2015.  Sorry, I can't entice you with how much my lipids have continued to drop on this diet--you'll have to wait 4 more years.
• I feel wonderful.  No aches.  No pains.  No joint stiffness.  No problem sitting in a car for 10 hours.  Is it because I've ditched all the oils and meat--the major sources for inflammatory omega-6 overload?   No way to know--but, here's what Bill Lands, has to say about it.  To read all you'd ever want to know about the benefits of lowering your intake of omega-6s, click here.

"..if you understand that food energy causes transient inflammatory insults and omega-6s amplify that into chronic injury and omega-3s moderate it, then you can tell people that the take home message is:

• Eat more omega-3s
• Eat less omega-6s
• Eat fewer calories per meal and stop smoking.  That's it.

-William Lands, PhD., a pioneer in the study of lipids, omega-3 fatty acids, and the effects of diet on disease, University of Michigan & NIH-

• Vanity!  This was the last thing I thought about when I started this diet.  I did it strictly for health--the weight loss & healthy skin glow was unexpected--but I've embraced it.  I love the compliments I continue to get from my husband, my friends, my nieces, my brother-in-law, my sister, my co-workers, and even strangers.  It's like returning to the body of my twenties.
• My example has helped others to change what they eat, or at least consider making some changes.  I'm beyond surprised to see how many relatives, friends, co-workers, neighbors, & perfect strangers are wading into the waters of a plant-based no-oil lifestyle.
• The healthy plant-based no-oil recipe options & food products continue to multiply.  I can't even keep up with all the creative recipes I have to choose from--and there's always a new healthy product out there in the marketplace to try out.
• I absolutely have enough energy for 5-8 hours of exercise a week.  I'm not an athlete--but I'm not a wimp, either.  I'm talking about 3-4 hours of serious spinning, 3 hours of challenging weight-training, and 2 hours of yoga a week.  At least when I'm not traveling.  Am I getting enough protein?  I'm guessing, yes!
  

The Esselstyn Rules:

• No meat, no poultry, no fish--not even salmon
• No dairy of any kind--not even skim milk or non-fat yogurt. 
• No eggs--not even egg whites or Egg Beaters. 
• No oil--not even virgin olive oil or canola oil
• Aim for 100% Whole Grain products. Ingredients must say, Whole Wheat, or Whole Buckwheat, Whole Rye,etc. 100% stone-ground wheat is not Whole Wheat unless the word Whole appears.  Forget about semolina flour in pasta.  Forget about white rice.  I thought my Barilla Plus multigrain pasta was fantastic--turns out, semolina is the number one ingredient.
• Do not drink juice. Fruit is fine.  A little juice used to saute, or season recipes or for salad dressings is fine
• Do not eat nuts, even walnuts, unless you do not have heart disease.
• Do not eat avocados, if you have heart disease.
• Do not eat coconut, if you have heart disease.
• Eat soy products cautiously.  They are high in fat (40% +) and many are highly processed.  Only use Lite Tofu (like Mori-Nu or NaSoya Lite Firm Tofu).  I also use Soy Boy Organic 5 Grain Low Fat Tempeh.
• Reduce sugar as much as possible.  When you do use it for recipes, stick to the more unprocessed varieties.  But don't fool yourself, maple syrup, agave, and honey are still sugar. I use stevia.
• Read all labels, especially THE INGREDIENTS!!!
• The Rest of the World of Vegetables, Fruit, Legumes, and Whole Grains is Yours.
• To read more about Ann Esselstyn's cooking & shopping tips, click here.

 

Why Am I Following This Diet If I Don't Have Heart Disease?

Because  my parents were very sick for many years & I'd prefer to not be. 

I don't want to end up in a wheelchair, unable to walk, unable to talk, incontinent, unable to feed myself, or recognize my loved ones.

Heart disease, strokes, vascular dementia, diabetes, Alzheimer's, and even some cancers can take years to develop.  Why wait until it's too late to do something about them?  

After seeing the debilitating effects that strokes had on both of my parents--my dad at age 69--and my mom in her late 70's--I decided to be pro-active.  No corned beef sandwiches or chocolate chip cookies are worth that price!   Want the science behind these statements? Click Here.

  To learn about how my parents' health influenced me, click here.

 

Did I Ease Into This Diet--Or Jump Right In?  Which Is the Best Way to Do It?

Jump right into it 100%!  Just do it--but do it right!

Half measures bring wimpy results, and you'll lose interest.

Here's my story:  After eating mostly plant-based for 2 years I had my cholesterol checked--and was surprised to see that it hadn't dropped as much as I thought it would.   And, I hadn't lost a single pound--but that didn't bother me--since I figured my weight was just fine--with a BMI of 24.  Wrong!

Here's the thing.  Plant-based isn't necessarily heart healthy.  I was still loading up on olive oil, canola oil, Larabars, hummus & baba ghanoush loaded with tahini, avocados on all my sandwiches, coconut milk in recipes, lots of dark chocolate, lots of nuts, Earth Balance margarine, a favorite chipotle spread with 6 grams of fat in 1 tablespoon, too many desserts, and vegan cheese. 

When I asked Dr. Esselstyn why I wasn't seeing major changes in my lipids after eating plant-based for two years, he generously invited me to attend his day-long session at the Cleveland Clinic Wellness Center on June 18th, 2010.  He challenged me to do it right--100%.

So, I jumped in 100%.  No exceptions.  No slip-ups.  I really wanted to see how my diet could affect my cholesterol--and the only way to do that was to be true blue.  To read the results of my first four weeks on the diet, click here.

 

The Best Advice I Ever Got--Too Bad It Took Me Nine Years to Follow It

About 9 years ago I attended a Grand Rounds at my hospital on the benefits on a plant-based diet. 

Dr. G advised, "You can ease into this--or jump into it 100%.  But, let me warn you.  If you ease into it--it will take you a long time to see the benefits.  And you'll probably lose interest and quit before you get to that point.

If you do it 100% you'll quickly see changes in your body & how you feel--and that will motivate you to keep it up.  And you'll be able to more quickly lose the cravings for fatty, salty, & sugary foods.  Read more here.

According to the Monell Chemical Senses Study  you will actually down regulate your fat receptors when you eliminate fat from your diet.  You will stop craving it & wanting foods made with fat.  The "fat craving"  takes 90 days to go away.

 

It's Not About Willpower.  Make It Easy On Yourself.  It's About Removing Temptations.  Changing Your Tastes.  And Staying Full.

 

The work counter that sits smack dab in the middle of the medical library's back offices is often filled with sugary treats. 

Yesterday J. brought in a gorgeous homemade strawberry cake frosted with strawberry buttercream.  M. brought in blueberry scones.  Last week it was donuts.  Other times it's chocolates or pound cakes or chocolate chip cookies.

I can easily ignore them all.  Really.  They've lost their power over me.  No, I don't have extraordinary willpower.  I know that if I had one piece of J.'s cake I'd want more.  So, I just ignore it. 

The office refrigerator is loaded with delicious food that I bring from home everyday.  It keeps me full--and if I'm full, those goodies have no power over me.

How can you have room for cake if you've already eaten a huge bowl of steel-cut oats with fresh peaches & chia, a giant portion of African Sweet Potato Stew that's made with red lentils, garbanzo beans, & loaded with spice?  Plus I have a 27 ounce green smoothie, cherries or plums waiting for me in the fridge--and in a real emergency there's always a Hammer Bar tucked away in my desk.

Why would I want to waste 500 calories on a giant piece of strawberry cake?

Source: Dr. Joel Fuhrman, Eat for Health. Book One, 2008.  pg. 68.

 

If you haven't already read it--be sure to read NYT science writer, John Tierney's latest piece, "Do You Suffer From Decision Fatigue?" in the August 17, 2011 New York Times Magazine.  Then you'll understand why I've been able to stick to this diet.  

The Esselstyn Diet works because if you follow the simple rules, you can't make a bad decision.  Esselstyn has already removed the "bad guys" from the decision-making process.  You don't have to waste time deciding what not to eat.  Plus, you stay full--your blood sugar stays steady--and if you're smart, you've eliminated all the "bad guys" from your pantry & fridge.

 

“Good decision making is not a trait of the person, in the sense that it’s always there,” says Roy F. Baumeister, a social psychologist with an expertise in decision-making research.

“It’s a state that fluctuates.”

His studies show that people with the best self-control are the ones who structure their lives so as to conserve willpower. They don’t schedule endless back-to-back meetings.

 They avoid temptations like all-you-can-eat buffets, and they establish habits that eliminate the mental effort of making choices.

Instead of deciding every morning whether or not to force themselves to exercise, they set up regular appointments to work out with a friend.  

Instead of counting on willpower to remain robust all day, they conserve it so that it’s available for emergencies and important decisions.

“Even the wisest people won’t make good choices when they’re not rested and their glucose is low,” Baumeister points out.

That’s why the truly wise don’t restructure the company at 4 p.m. They don’t make major commitments during the cocktail hour. And if a decision must be made late in the day, they know not to do it on an empty stomach.  

“The best decision makers,” Baumeister says, “are the ones who know when not to trust themselves.”

 

Start with a Good Breakfast.  Same Old Same Old Times Five

 

I've got about 5 breakfasts that I revisit over & over again.  I never tire of them.  They're delicious, hearty, and they're time-savers.

I make my steel-cut oats ahead of time--in a batch that's enough for 4 days.  I switch between pumpkin-spice, fruited, & Cheezy Savory with Greens.

When I'm pressed for time I reach for a cup of Wildwood Probiotic Plain Soy Yogurt, mixed with thawed frozen berries, a couple crumbled walnuts, & a tablespoon of chia seed.  It's loaded with protein, fiber, & antioxidants.  Quick, filling, and delicious.

When there's no oatmeal made, or I haven't had a chance to restock the yogurt in the fridge, there's always PB2 (a defatted peanut powder) & an all-fruit jam, spread on a sprouted Ezekiel Cinnamon Raisin English Muffin.

Savory "Cheezy" Oatmeal with Spinach

 

 

Pumpkin-Spiced Oatmeal with Berries & Chia

Fruited Steel Cut Oats with Dried Apples, Cherries, Fresh Peaches, & Chia

 

Wildwood Probiotic Plain Soy Yogurt with Berries & Chia

PB2 with Fruit-Only Jam on Ezekiel English Muffins

 

FInd the recipes or product info here:

• Savory Cheezy Oatmeal with Greens
• PB2 on Ezekiel Muffins
• Wildwood Probiotic Plain Soy Yogurt & Berries
• Pumpkin-Spiced Steel Cut Oats
• Fruited Steel Cut Oats with Berries - I now make this with low-sugar dried fruit--like dried apples & cherries.  I make it on the stove, rather than in the crockpot, but I make enough to last for four days.  1 cup of steel-cut oats, 2 cups of water, 1 cup of non-dairy milk, & 1 tsp pumpkin pie spice.  Mix it all up in a pot the night before, stick it into the fridge over night, and cook it in the morning.  It cooks faster, is creamier, & sweeter when you soak it overnight.

 

Do I Ever Cheat?  Have I Loosened the Rules?  Have I Modified the Plan?

 

Honestly?  Just a very little.  I'm quite happy to stick pretty close to the program.  I guess you'd put me half-way between Rip's Plant-Strong & Dr. Esselstyn's Plant Perfect!  Explanation?  Click here.

 1.No oils of any kind are in my house.  I'm hard-lined about that!  But, I sometimes use a little expeller-pressed canola spray on my air-popped popcorn, & on my outside grill, when necessary.  It would be a mess without it.

2. No interest in meat, chicken, dairy, cheese, or eggs.   No temptation there at all.

3. I don't have heart disease, so I definitely eat walnuts--but I don't overdo it.  I notice that I want them more when I exercise a lot.  Dried fruit & walnuts fill the bill when I've burned a lot of calories.

4. I very rarely buy avocados, but I will eat them, & have used them occasionally for company recipes.  I wouldn't turn away from guac.  Avocados are on on the OK Esselstyn list for those without heart disease.

5. I've deviated from "the program" by recently adding small amounts of cashews, peanuts, or tahini for salad dressings, or in recipes.  Cashews really do add a delicious creaminess to dressings & sauces.  Tahini is a unique taste & just a small amount can turn a so-so dressing into something extraordinary.  But, I use them sparingly, & not regularly.  Click here for those dressing recipes from Isa Chandra Moskowitz's, Appetite for Reduction.

6.  I'm a fan of soy & seitan.  I love Field Roast (seitan) sausage (but I use it very sparingly), Match (soy meats), Soy Boy Low-Fat Tempeh, Tree of Life Hot 'n Spicy Smoked Tofu, NaSoya Low-fat Tofu, & Wildwood Probiotic Plain Soy Yogurt.  None of these would likely be on Dr. Esselstyn's  OK-to-Eat List.  Maybe not even on Rip's Engine 2 list.  They're by no means "everyday" foods--but I do eat them--and enjoy them.   To read about soy click here.  To read about my favorite fauxs click here.

7. There are times when I've eaten wild salmon, or another fish--but, again, it's very rare.  I will definitely eat fish this upcoming wedding weekend, because the fish option is healthier than the vegetarian option.

8. If I'm at a celebration I'll eat a dessert if it looks extra-special.  I'll eat an extraordinary wedding cake.  But, mostly I stay away from making or eating desserts.

9. And yes, I've indulged in a few serving of the most amazing ice cream that I know of--Jeni's.  Salty Caramel, Buckeye State, and Poached Pear & Riesling Sorbert.  I know my limits--I'm staying far away from Jeni's in the future.

But, none of these have sent me down that slippery slope.  They are once-in-a-long-while treats.  I choose carefully--and they're usually worth it!

 

Oops!  I've Run Out of Time

OK, once again I've run out of time, and haven't even gotten to the cooking tips, my favorite night-time snacks, my favorite food finds, my favorite kitchen tools & pantry staples.

Check back later--probably next week for the rest of this post!  It's a wedding weekend.

And until then--please share some of your own Esselstyn-friendly tips & favorite foods--how you're doing--and how you're "working the plan"!

I'm sure Bill Clinton would appreciate your advice!

 

Is Bill Clinton Still Sticking with a Plant-Based No-Oil Heart Disease Reversal Diet? The CNN Story - From omnivore to vegan: The dietary education of Bill Clinton

 
Former president Bill Clinton's current goal is to avoid food that could damage his blood vessels

 

If you received this post via email, click here to get to the web version with all the links & video.

Ever since I learned that Bill Clinton had adopted a plant-based no-oil diet back in May 2010, I've been waiting for an update.

Was he still sticking to the Esselstyn-style plant-based no-oil diet?

Up until a week ago there was complete radio silence on the subject.  I was going to have to wait until Dr. Sanjay Gupta's CNN special on Sunday August 21, 2011 at 8:00 PM EDT to find out what Bill was up to these days. 

I was hoping he hadn't backed off & switched to Dr. Arthur Agatston's South Beach Diet.

Well, thanks to Son #2, I just got the update.

Yay, Bill!   He's still staying the course, and feels better than ever.

Click below to read the full story.   Hot-off-the-press:  CNN August 18, 2011 7:15 EDT.

From omnivore to vegan: The dietary education of Bill Clinton

 

Why Clinton Decided to Make the Switch to A Plant-Based No-Oil Diet

 

September 25, 2010  (my post from a year ago)

Wolf Blitzer's Interview with Bill Clinton's Diet Gurus, Dr. Caldwell Esselstyn and Dr. Dean Ornish - What the Interview Didn't Have Time to Explain about How to Prevent and Reverse Heart Disease with a Plant-Based Diet

 

 

Wolf Blitzer Interviews Esselstyn & Ornish - the Doctors Who Influenced Bill Clinton's Heart Disease Reversal Diet- September 24, 2010

If you received this post via email, click here to get to the web version with the video and links.  You'll find the video of the interview at the end of this post.

Yesterday my husband and I had the pleasure of watching Drs. Esselstyn & Ornish explain on national television just how a plant-based diet can prevent or reverse heart disease.  Unfortunately, nine minutes can't do it justice.  So here's the rest of the story. 

As we watched, we enjoyed an amazing homemade whole wheat cheese-less pizza topped with kalamata olives, fresh basil, roasted red peppers, sun-dried tomatoes, and artichoke hearts--that took just minutes to put together!

September 2004:  Bill Clinton has quadruple bypass surgery to repair blocked arteries after he experienced chest pain.

February 10, 2010:  Clinton has two stents placed in one of his previously-treated arteries, after one of his bypass grafts completely closed up.  According to his physician, Clinton had "toed the line" about adhering to diet, exercise & medical therapy.  Click here for the Medtronic (the stent company) press release.

Spring, 2010:  The stents fail to prevent further cardiovascular blockages. This is not an unusual occurrence. Clinton decides to read the medical literature about preventing and reversing heart disease.  He discovers that there is only one way to do this--a strict plant-based diet loaded with green leafy vegetables, and without meat, chicken, fish, dairy, or added oils.  The two physicians who are pioneers in this treatment approach are Dr. Caldwell Esselstyn and Dr. Dean Ornish.  Clinton decides to conduct his own personal clinical trial.

Zero cardiovascular events have occurred in Dr. Esselstyn's original group of 17 compliant patients that he has followed for over the past 25 years.  Esselstyn continues to work with hundreds of other patients who have similar success stories.  There is no mortality, no morbidity, no expense from following a plant-based diet--if you eat in a way that makes the cap over your plaque super strong!

Like most Americans, Wolf Blitzer didn't seem to understand why bypass surgery or stents cannot cure cardiovascular disease. These procedures only treat emergency blockages.  And statins are no guarantee that it won't happen again.  Too bad Dr. Esselstyn didn't have a chance to tell Blitzer this:

"Some people think the "diet" is extreme.  Half a million people a year will have their chests opened up and a vein taken from their leg and sewn onto their coronary artery.  Some people would call that extreme."

"The elephant in the room when we talk about stents and bypass surgery--those procedures don't protect from new heart attacks.   Stents & bypasses are used to treat large arterial blockages.  Yet according to many research studies only a small percentage of heart attacks are caused by the largest build-up of plaque.  The rest are caused by the more numerous newer blockages that are far more inflamed and much more likely to rupture than the larger older, more stable plaques.  So this is why those procedures don't treat the disease.  They are treating the symptoms."

 Just published: Am J Cardiol 2010 Sep 15;106(6):902-4.  Esselstyn, CB Jr.  "Is the present therapy for coronary artery disease the radical mastectomy of the twenty-first century?"

--Dr. Caldwell Esselstyn--

And take it from two of the country's top cardiologists:

"Multiple studies show that if you have one ruptured plaque you have many."  -Dr. Steven Nissen, chairman of Cardiovascular Medicine at the Cleveland Clinic-

"We can't cure this disease until we address the fundamentals of lifestyle."  -Dr. Eric Topol-

Wolf seemed surprised at Dr. Esselstyn's suggestion that the only way we will ever stop this disease is by changing the eating habits of our children.

"What?  Are you suggesting that our kids shouldn't drink milk, or enjoy French fries, and chocolate cake-all the pleasures of life?"  Blitzer asked.

Unfortunately, there wasn't sufficient time for Dr. Esselstyn to answer that question.  But, if he had had time, here's what he might have said.

It All Starts in Adolescence according to the PDAY Study:  Atherosclerosis begins in youth. Fatty streaks and clinically significant raised lesions increase from age 15 to age 34. 100% of the autopsies done on 15-34 year old accident victims showed fatty streaks in the aorta and 50-75% showed streaks in the coronary artery--all precursors to later coronary artery disease.    Click here for study.

By 65-70 we all have it.  All males 65 years & older, and all females 70 years & older who have been exposed to the typical Western diet have cardiovascular disease & should be treated as such.  Without making any changes, you can expect to have a catastrophic event (a heart attack or stroke) in your 70's or 80's.  -Dr. Lewis H. Kuller, The University of Pittsburgh-

Dr. Ornish waffled when he answered Blitzer's question about whether or not it was necessary for everyone to be on such a strict plant-based diet--even people without heart disease.   Ornish suggests there can be a spectrum (the title of his latest book) of dietary strictness--based upon whether one has heart disease or not.

There's a bit of a problem here.  Heart disease is often invisible, and it's years in the making.  We often don't know what's going on inside of our blood vessels until it's too late.

Cholesterol levels, and other risk factors don't always predict future coronary events accurately.  Cardiovascular disease lurks in the unseen damage we do to the endothelial linings of our blood vessels, from the foods we eat.  This inflammatory process starts a cascade of bad-news biological events that lay down atherosclerotic plaque, damages vessel linings, and if we're unlucky, puts us at risk for vessel-blocking plaque ruptures--that set us up for heart attacks, invisible strokes, major strokes, dementia, and more.

Fit, lean, athletic people who are eating a Mediterrean Diet are not immune.  Just ask Dr. Esselstyn.  Just read my email--from people who exercised, ate right, & thought they were disease-proof.  Just read, "I'm healthy, I exercise, I eat right, I'm heart-attack proof - "Not a moment too soon I thought of Tim Russert"

"Now I finally understand how we can have a heart attack or a silent stroke even if we think we don't have heart disease or atherosclerosis.  Your coronary artery has to be 70% occluded to have symptoms, like angina. If your arteries are even 10-69% blocked, and you're inflaming them with what you eat, you're at risk.  It's all about inflammation - Calm down the inflammation & you'll keep those atherosclerotic plaques safely stuck to your artery walls."   From my post Yes, you can prevent and reverse heart disease, but are you up for the challenge - Let Dr. Caldwell Esselstyn Convince You.

Here are Some of the Questions the Interview Did Not Allow Enough Time to Answer

Why not just follow the Mediterranean Diet, which includes olive oil & fish?  Yes, the Mediterranean Diet is better than the American Heart Association Diet & the Western diet, but it only slows the progression of heart disease--it doesn't prevent & reverse heart disease.  And, sure who doesn't want to believe that it's healthy to eat fish & olive oil?  I know I did.  But followers of the Mediterranean Diet show reductions of only 19-25% in cardiovascular mortality compared to followers of more standard diets.  Not a huge reduction in my book.  Click here for a recent JAMA study.

Why can't I use olive oil?  I've covered this at length in I'm Going to Miss My Olive Oil - Who Knew It Wasn't So Healthy After All? Drs. Esselstyn, Ornish, Vogel & Rudel Did  but here's the short story:  Dr. Lawrence Rudel fed African Green monkeys (who are close substitutes to humans for study purposes) olive oil for 5 years, and then compared their arteries to those of Green monkeys who were given saturated fat to eat.   Rudel was shocked by the results--he expected the olive oil monkeys would be disease-free.  Turns out even though the olive oil monkeys had high HDLs, they also had just as much coronary heart disease as the monkeys who ate saturated fat.  Oops!  Olive, soybean, palm, coconut, oils all contribute to heart disease--just avoid them.

Why can't I eat nuts?  Recent studies say they increase HDL's, and lower LDLs?  Esselstyn is skeptical about this reearch, based on the surprising results of Rudel's study.  Just because the HDL's go up, & the LDLs go down, it's no guarantee that nuts are preventing or slowing down coronary heart disease.  Little known fact:  the nut industry has sponsored these cholesterol/nut studies & participants had to consume 2.3 ounces of nuts to accrue the lipid changes--that's 350-400 calories worth of nuts.  

Then there's the omega-6 to omega-3 ratio thing--ideally we want to aim for a 2:1 or a 1:1 ratio of omega-3s to omega-6s, because a diet high in omega-6s is inflammatory.  Most of us typically eat a diet that has a 17:1 ratio of omega-6s to omega-3s.  Except for walnuts (and Esselstyn gives the OK for a few walnuts for folks without heart disease), most nuts are very high in omega-6s, and low in omega-3s.  Cashews have a 117:1 omega-6 to omega-3 ratio.  And all nuts are high in calories and saturated fat.  Almonds, the nut super-star is 6% saturated fat.

Isn't This Diet Extreme? Isn't it Too Hard to Follow?  Doesn't It Take All the Fun Out of Eating?

Not at all.  I'm someone who LOVED Kentucky Fried Chicken, corned beef sandwiches, Big Macs, barbecued ribs, and eating chocolate chip cookies for breakfast.  Don't miss them at all.   And I'm following this diet just for prevention.  I have no diagnosed heart disease.  But I saw two wonderful parents go through lengthy stroke-related declines, and if there is anything I can do to avoid that future, I'm going for it! Honestly, if I can do it, anyone can.  Really.  By now I can't imagine eating any other way--and I'm eating delicious food with lots of spice and zest--and it's far more interesting than broiled chicken.

 

Yoda:  So certain are you.  Always with you it cannot be done.  Do you hear nothing that I say?

Luke Sky Walker:  Master, moving stones around is one thing.  This is totally different.

Yoda:  No.  No different.  Only different in your mind.  You must UNLEARN what you have learned.

Luke Sky Walker:  All right.  I'll give it a try.

Yoda:  No. Try Not.  Do.  Or Do Not.  There is no Try.

If You Have More Questions About How a Plant-Based Diet Can Prevent Heart Disease--You're Welcome to My "Cliff Notes"

If the Esselstyn/Ornish Interview doesn't answer all of your questions, read Dr. Esselstyn's & Dr. Ornish's books.

If you want answers right now, read my summary of the day-long session I attended with Dr. & Ann Esselstyn--"What I learned from Dr. Caldwell and Ann Esselstyn's Prevent & Reverse Heart Disease "School".

Or go through my whole series of posts about Dr. Esselstyn's diet, how I adapted my cooking and recipes, and my successful experiment with the diet, click here, Dr. Caldwell Esselstyn's Prevent and Reverse Heart Disease Diet.

And Now For Wolf Blitzer's Interview with Drs. Esselstyn & Ornish

If you do not see the video, click here.

 

 

 

Dr. Dean Ornish Pays a Visit to Talk About Making Lifestyle Changes to Reverse Chronic Diseases - Is the Plant-Based/Mostly Vegan Diet Going Mainstream? Exercise, Meditation & Yoga, Too!

Smith, Steven R. MD.  "Clinical Implications of Basic Research.  A Look at the Low-Carbohydrate Diet."  N Engl J Med  361(23):2286-88, December 23, 2009

 

Why Eat Plant-Based & Low Fat?  Just Look at the Picture!

 

All that matters is what's happening inside of the the arteries. 

The traditional intermediate risk-factors of cholesterol, weight-loss, blood pressure, HDL & LDL don't always tell the whole story--which is why promoters of the high-protein high-fat low-carbohydrate diets, like Atkins & Gary Taubes, think their (HPLC) diet works--while all along, unbeknownst to them, it promotes plaque & atherosclerosis. 

If you're eating a diet that's high in animal protein, high in fat, and low in healthy carbs--your weight & lipid numbers might even be looking good--but your arteries are not!

The high-fat high-protein low-carbohydrate diets cannot produce the circulating endothelial progenitor cells (EPCs) that are needed to repair damaged blood vessel walls & improve endothelial function. 

And the HPLC diet doubles the nonesterified fatty acids (NEFAs) which promote inflammation & atherosclerosis.  If you think high-protein-low-carb is good--think again!

And it's all about what's going on inside of the arteries--not just the lipid numbers!  A low-fat high-unrefined-carbohydrate diet increases those endothelial progenitator cells--and keeps the artery walls healthy, flexible, and atherosclerosis-resistant.   Read more in the PNAS "Vascular effects of  a low-carbohydrate high-protein diet"

Full disclosure: the graphic is from an animal model study.

--My paraphrasing of both Dr. Dean Ornish's comments on the graphic & Smith's N Engl J Med article--

 

If you received this post via email, click here to get to the web version with all the links.

What a week this has been!  I've had a chance to hear Dr. Dean Ornish (twice), Dr. David Katz of Yale, Dr. Ezekiel Emanuel of NIH, and Dr. Joshual Sharfstein.  All national healthcare experts--all saying the same thing--in four different ways:   

Change Your Lifestyle & Change Your Health.

Our Western diet is killing us and our children. 

This younger generation will likely be the first generation to not live as long as their parents.

 

93%  of diabetes, 81% of heart disease, and 60% of cancer could vanish with diet, exercise, weight loss, smoking cessation. 

 

When the Cleveland Clinic, the top hospital for cardiac care in the U.S., invites Dr. Dean Ornish to speak about reversing heart disease, diabetes, hypertension, and prostate cancer with low-tech lifestyle changes--you know that the no-oil plant-based Esselstyn-style diet is getting closer to going mainstream!

And on May 11, Dr. Caldwell Esselstyn, Jr. is also scheduled to speak at the Cleveland Clinic Wellness Grand Rounds!  That comes right after his April 27th (this Wednesday)  appearance on Dr. Oz's Show along with Dr. T. Colin Campbell and Dr. Neal Barnard.  Click here for more info.

Looks like plant-based & low-fat is starting to seem commonplace these days.  Dr. Neal Barnard--another plant-based disease-reversal pioneer--is currently speaking around the country, promoting his latest science-based book, too.  Definitely one that I recommend.  Wendy, at Healthy Girl's Kitchen heard him speak on Tuesday night and she does a terrific job of summarizing his lecture.  Part l and Part II.  Thank you, Wendy!

And don't forget that Forks Over Knives premiers in theaters on May 6, 2011.  Click here for the schedule, and here for my review.

Sorry for the "non-commercial" interruption--now back to the post:  Since most of you didn't have the chance to attend Dr. Ornish's lecture--here's what you would have heard....

 

Dr. Dean Ornish on the Power of Personalized Lifestyle Changes

 

For 34 years Ornish has been directing clinical trials proving that major lifestyle changes--without medications or procedures--can prevent or reverse heart disease, type 2 diabetes, hypertension, and early prostate cancer. 

He's got the data and the high-tech measurements to back up his claims that a very low-fat vegetarian diet, along with exercise, stress reduction (meditation/yoga), & social support really work--and their effects are synergistic & additive.

The lecture hall was filled with health professionals & support staff.

Ornish Goes Mainstream with Medicare.  Could this be a game-changer? 

In August 2010, Medicare approved both the Ornish & Pritikin comprehensive lifestyle disease-reversal programs for reimbursement.   As Ornish says, "If we can change reimbursement--we'll change the practice of medicine!"  Reimbursement to prevent chronic diseases?  Money well-spent.

So What Is the Ornish Approach?

Participants in Ornish's clinical trials always followed a very low-fat, vegetarian diet, closely bordering on vegan.  That's what reversed their heart disease, type 2 diabetes, hypertension, and early prostate cancer.  But he carefully side-stepped discussing the diet specifics in this lecture.

Maybe he was mum about the details of his diet because these days he doesn't want to scare people away by demanding that they follow a super strict low-fat vegetarian diet.  And, he hates the word DIET!

Lately, he's offering more of a Spectrum of food choices--you choose how strict you want your diet to be--based on your health and your risk factors.  To get the details, I had to go to his website.  Click here

Here's the deal.  When it comes to reversing heart disease--even Ornish says, you need to go mostly plant-based & very low fat.  If you're healthy--and without risk factors or excess weight, you can be a little more indulgent. 

But wait a second.  I've read the research studies.  I've heard Dr. Esselstyn speak.  I've heard Dr. Steven Nissen speak--the head of Cardiovascular Medicine at the Cleveland Clinic.  If you're eating a typical Western diet--you either have heart disease or you're on the way to getting it!  Who's left?

Ornish Food Plan to Reverse Heart Disease

• Fat--No more than 10% of calories are from fat. This is achieved by not adding any fats, oils, seeds, nuts, avocados, coconut and olives to a mostly plant-based diet. The 10% of calories from fat comes from fat that occurs naturally in grains, vegetables, fruit, beans, legumes and soy foods.
• Cholesterol-- No more than 10 milligrams of cholesterol per day. To meet this goal, non-fat dairy products are limited to 2 servings per day. Non-fat dairy products are optional. Soy products can be used instead of dairy products because they are cholesterol free.
• Primarily Plant-Based--no meat, poultry, fish, or products made from these foods.  Non-fat dairy foods (no more than 2 servings/day) and egg whites are included.
• Calories--Unrestricted unless weight loss is desired. Small frequent meals spread throughout the day help avoid hunger and keep energy levels constant. Portion control will assist in reaching and maintaining a healthy body weight and controlling blood sugar levels.
• Sugar--Permitted in moderation. No more than 2 servings/day including non-fat sweets. A serving is equivalent to 1 tablespoon or 12 grams of sugar.

 

Ornish's Spectrum of Food Choices

Heart Disease Reversal Sticks to the Bottom 2 Levels

Ornish's Spectrum Diet is based on one's health, genetics, and risk factors.  If you've got risk factors or health problems--you're on the strictest plan.  Young & healthy--he's a little more lenient.

 

"The Spectrum has no rules, no forbidden foods, no guilt -- just a blueprint for determining where you fall on the continuum, and encouragement to make healthful changes.

What matters most is your overall way of eating. I am not saying that you should never consume foods from Group 5-the top of the pyramid (unless you have a serious health condition). If you indulge yourself one day by eating foods from Group 4 or 5, spend a little more time in Groups 1 and 2 the next day.

If you get on a diet, chances are you’ll get off a diet. Sooner or later. For most people, being on a diet—any diet—is not sustainable."

But the further you move toward the healthier end, the more likely you are to look and feel better.

 

Bottom-line:  It's a DOSE RESPONSE RELATIONSHIP!  The better your program/diet adherence--the better your health!

Look,  I understand Ornish's soft-pedal approach--but, I prefer the Esselstyn's "Just Stick to the Program 100%" approach.  Why fool around with half measures?  Give me too much leeway--and I'm sliding down that slippery slope!

If you commit yourself to just follow the program (Esselstyn or Ornish) 100% for one month--you'll lose weight, you'll feel great, your energy will improve, and you'll be motivated to continue.  With half-measures you just aren't going to see the same results!

Program Basics--click here for the details:

• Diet: mostly vegetarian, no added oil, no nuts, no-fat dairy & egg whites are allowed, whole grains, fruit, vegetables, beans & legumes.  But, Ornish, also offers a Spectrum (as his book is called) of choices for people who are healthy, or aren't quite ready to follow a super strict diet--including small amounts of "safe" fish, like wild salmon.
• Exercise:  at least thirty minutes a day--but Ornish will forgive you if you skip a day or do less.  Click here for details.
• Meditation/Stress reduction  Click here for program details.  Don't have 20 minutes to meditate?  Try it for 5 minutes.
  
• The Importance of Social networks/close relationships:  depression & loneliness impair health.  Group support is needed to sustain lifestyle changes.  Click here for details.

In Ornish's experience, all these elements are key to preventing & reversing disease.   The body has a remarkable power to heal itself with diet and exercise, but stress, depression, and loneliness all have powerful negative effects on health.  Depression increases mortality by 3 to 10 times.

 

The Fear Factor Fails - What Motivates Us to Change?

 

Ornish's viewpoint:  No one makes long-lasting lifestyle changes based on the fear of a future disease.  That's why he says only 30-40% of people stay on statins.  But, what about me?  Fear worked for me. I made major lifestyle changes after seeing my parents suffering after ischemic strokes. 

According to Ornish, no one is thrilled to stay on statins, diabetes or blood pressure meds for the rest of their lives--in the hopes that they'll avoid a future heart attack or stroke.  And let's face it, these drugs usually don't do a thing to make us feel better, look better, feel happier, or lose weight.  And all drugs come with side effects.

Ornish's favorite cartoon is of men madly mopping up a wet floor without bothering to turn off the running faucet that's making the sink overflow.   Change your diet, start to exercise, find a way to reduce stress--and it's like turning off the faucet--actually treating the causes of disease. 

After 34 years in the diet-exercise-meditation-disease-reversal business, Ornish has figured out what motivates people to make serious lifestyle changes.  He knows that information alone isn't sufficient to get people to change.

Joy (from feeling healthy), freedom (to choose the changes), & pleasure (from real food & good health) are the real hooks that get people to make changes--and to continue on with them. 

No one wants to give up something they like (cheeseburgers & ice-cream)--if there's no pay back--and if it doesn't come quickly!

It's only when you start to see positive changes in your body, like weight loss, energy, reduced pain, less stress, and you're able to cut your meds--that you realize your health is in your own hands.   Just ask these folks who are following Dr. Esselstyn's diet, or my friend Neal.

Creating guilt, fear, threats of non-compliance, or being told, "Do this--or else!"--usually backfire.

The Joy & Pleasure Pay-Offs:

• Benefits of Exercise.  Walking 3 hours a week helps to grow brain cells--it's called neurogenesis, baby!  Within 3 months of exercise the brain's size actually increases.  Read more here.
• Benefits of Meditation.  Within 8 weeks of starting to meditate, stress is reduced, cortisol levels drop (the stress hormone), pain lessens, nitric oxide increases (you heard right), the genes responsible for stress & aging are down-regulated, and oxidative stress is also reduced.  Stay tuned for an upcoming post on the benefits of meditation.
  
• How You Look. Your skin improves because a plant-based diet along with exercise increases blood flow & slows aging.
• Sex Life.  As your sexual organs get more blood flow--sexual function improves--and erectile function improves.
• Heart Health. As the heart gets more blood--heart disease is reduced--perfusion improves.
• It's All Good. You feel better, you look better, you think better, your energy improves---and because you see change quickly--you're motivated to continue.  Convinced?

 

So how hard is it to make these lifestyle big changes?

 

Here's how Ornish explains it.  He asked the lecture hall audience a couple of questions.

"How many of you have one child?"   Lots of hands go up.

"Did your life change?"  Lots of nods & chuckles.

"And how many of you had a second one?"  Lots of hands go up.

"Did you forget how much your life changed?"   Lots of laughter.

You can change your lifestyle, and it will bring joy & pleasure.  You do get used to it!  I did.

Our palates are malleable.  Notice how people easily change from drinking whole milk to skim milk to almond/soy/rice milk?  And if you grow up eating healthy foods, you prefer them. 

 

Just Show Me the Evidence

 

I'm all about the research data.  Did I hear anything new from Dr. Ornish?  Not really--and if you're a long-time blog reader you've already heard most of this.  But, it still motivates & inspires me to to hear it again.  It helps me to stay the course!

 

One Patient's Experience--one year after starting the Ornish program

Dr. Ornish assured us that this man's experience wasn't anything exceptional--but the norm.

• After 7 weeks his angina disappeared
• Lost 50 pounds in one year
• His ejection fraction went from 46% to 61%, into the normal range.
• Triglycerides went from 819 (?? not sure if I got this one right) to 93
• Total cholesterol went from 243 to 110
• HDLs went from 27 to 38
• PSA went down
• No longer using a cane or the (humiliating) wheelchair he needed to use at Walmart
• Off the diabetes medications
• His total medication use was reduced by 75%
• No longer gets chest pains just walking to the mail box
• He now rides his stationary bike 8-10 miles a day & walks 2 miles a day
• The best part of the program?  Improvements in his quality-of-life.  His fear of dying has been replaced with the joy of living.

Ornish's Pearl:  The most adherent patients see the most improvements

 

 

 Ornish's Prostate Cancer Study - Turning Your Bad Genes Off.  Turning Your Good Genes On.

 

The red squares on the left represent the prostate cancer genes.  After 3 months of lifestyle interventons, they were down-regulated, showing up as green.

 

 This prostate cancer study demonstrated how our lifestyle choices can literally change our genes.

Ornish recruited 30 men with low-risk prostate cancer tumors, and for 3 months put them on a low-fat (10%) plant-based diet, had them exercise for 30 minutes a day--6 days a week, and participate in stress management sessions with yoga, stretching, and meditation for 60 minutes a day.  

Before the intervention, their cancer genes are red--three months later, the cancer genes are turned off, and show green.   The men literally "turned off" the RAS family of genes--these are the ones that promote the growth of breast, colon and prostate cancer. 

Yes, they turned off cancer genes with lifestyle changes. 

And it gets even better--the also "turned on" the GSTM-1 genes--the protein-producing genes that cause breast, colon, and prostate cancer cells to commit suicide. 

They turned off the genes that promote cancer--and turned on the genes that promote its death. 

Additional changes seen in Ornish's prostate cancer study participants:

• 70% of cancer tumor progression was stopped or reversed in the group who followed a plant-based diet, exercised, & meditated or practiced yoga for stress relief.   
• PSAs were reduced 
• Dose-response relationship--the men who were the most compliant achieved the most beneficial effects.
• 30% increase in telomere length--a measure of longevity.  After only 3 months, 24 out of 30 men showed significant increases in their telomerase levels.  Click here to read about the study. No drug is able to achieve this effect.  (my note:  omega-3s however, do!  click here) 

 

 

Emerging Consensus of What to Eat--According to Ornish

 

1. Mostly plant-based--but Ornish does includes no-fat dairy & egg whites
2. Calories do count  (nuts, seeds, avocados are all high in calories!)
3. Ornish now recommends fish oil--4 grams/a day or the equivalent--a new addition to his plan.  He thinks fish oil is better than eating fish, because right now there are no "safe" fish, and when the oil is removed, it can be molecularly distilled to remove any mercury or PCBs. If you do eat fish--choose wild salmon.
4. Organic produce is better
5. Reduce fat.  Total fat does matter.  It promotes inflammation and atherosclerosis.  For heart disease reversal, limit fat to 10% or less of calories.
6. Reduce sugar & refined carbohydrates
7. Increase fiber--it will fill you up.  Move from bad carbohydrates to the good carbohydrates to  prevent chronic insulin surges.  Refined carbs accelerate the conversion of calories into fat & promote chronic inflammation.
8. Forget about olive oil!  And by the way--the Lyon Study used canola oil--not olive oil--and that's the study everyone cites to promote the benefits of olive oil.  They used canola because they couldn't disguise the taste of olive oil.  Read more about the negatives of olive oil here.
9. Reduce sodium.
10. According to Ornish, although there have been multiple studies on the health benefits of nuts--whether or not they are beneficial for heart patients will require more study!
11. When it comes to calcium, there's a balance between intake & excretion.  Too much animal protein causes calcium excretion.

 

Why Lifestyle Improvements Save Money & Trump Procedures & Pharmaceuticals

 

• Participants in Ornish's programs reduce their LDL by 40% without the use of statins--with none of the side effects of statins.
• The EPIC Healthy Living Study showed that 93% of type 2 diabetes & 81% of myocardial infarctions can be prevented through lifestyle changes.  Click here.
• 75% of our $2.5 trillion "sick care" costs are due to chronic diseases that are preventable.  Read more here:  Dr. Michael Roizen's Straight Talk About Chronic Disease - Lifestyle Changes Can Control Them and Bring Health Care Costs Down. Roizen's Thirteen Pearls of Wellness.
• Angioplasties & bypasses don't prolong life--diet does.  They will get you out of a crisis or stop angina.  Read the COURAGE Trial results here.

 

The Ornish Program Approved for Medicare in August 2010

 

Getting Medicare approval for any new program, procedure, or diagnostic tool is tough.  It took  Ornish 7 years to finally get approval for his program.

Bottom Line:  Ornish's program saves money!   On average, his patients lose 20 pounds, improve their quality of life, get their blood pressure back to normal without drugs, lower their cholesterol, and get off of diabetes medications--while helping to prevent future coronary events. 

According to Ornish, getting Medicare on board with prevention & reimbursing for lifestyle changes is a major step in changing the practice of medicine.

 

 

 

 

 

 

 

 

 

Wolf Blitzer's Interview with Bill Clinton's Diet Gurus, Dr. Caldwell Esselstyn and Dr. Dean Ornish - What the Interview Didn't Have Time to Explain about How to Prevent and Reverse Heart Disease with a Plant-Based Diet

 

Wolf Blitzer Interviews Esselstyn & Ornish - the Doctors Who Influenced Bill Clinton's Heart Disease Reversal Diet- September 24, 2010

If you received this post via email, click here to get to the web version with the video and links.  You'll find the video of the interview at the end of this post.

Yesterday my husband and I had the pleasure of watching Drs. Esselstyn & Ornish explain on national television just how a plant-based diet can prevent or reverse heart disease.  Unfortunately, nine minutes can't do it justice.  So here's the rest of the story. 

As we watched, we enjoyed an amazing homemade whole wheat cheese-less pizza topped with kalamata olives, fresh basil, roasted red peppers, sun-dried tomatoes, and artichoke hearts--that took just minutes to put together!

September 2004:  Bill Clinton has quadruple bypass surgery to repair blocked arteries after he experienced chest pain.

February 10, 2010:  Clinton has two stents placed in one of his previously-treated arteries, after one of his bypass grafts completely closed up.  According to his physician, Clinton had "toed the line" about adhering to diet, exercise & medical therapy.  Click here for the Medtronic (the stent company) press release.

Spring, 2010:  The stents fail to prevent further cardiovascular blockages. This is not an unusual occurrence. Clinton decides to read the medical literature about preventing and reversing heart disease.  He discovers that there is only one way to do this--a strict plant-based diet loaded with green leafy vegetables, and without meat, chicken, fish, dairy, or added oils.  The two physicians who are pioneers in this treatment approach are Dr. Caldwell Esselstyn and Dr. Dean Ornish.  Clinton decides to conduct his own personal clinical trial.

Zero cardiovascular events have occurred in Dr. Esselstyn's original group of 17 compliant patients that he has followed for over the past 25 years.  Esselstyn continues to work with hundreds of other patients who have similar success stories.  There is no mortality, no morbidity, no expense from following a plant-based diet--if you eat in a way that makes the cap over your plaque super strong!

Like most Americans, Wolf Blitzer didn't seem to understand why bypass surgery or stents cannot cure cardiovascular disease. These procedures only treat emergency blockages.  And statins are no guarantee that it won't happen again.  Too bad Dr. Esselstyn didn't have a chance to tell Blitzer this:

"Some people think the "diet" is extreme.  Half a million people a year will have their chests opened up and a vein taken from their leg and sewn onto their coronary artery.  Some people would call that extreme."

"The elephant in the room when we talk about stents and bypass surgery--those procedures don't protect from new heart attacks.   Stents & bypasses are used to treat large arterial blockages.  Yet according to many research studies only a small percentage of heart attacks are caused by the largest build-up of plaque.  The rest are caused by the more numerous newer blockages that are far more inflamed and much more likely to rupture than the larger older, more stable plaques.  So this is why those procedures don't treat the disease.  They are treating the symptoms."

Just published: Am J Cardiol 2010 Sep 15;106(6):902-4.  Esselstyn, CB Jr.  "Is the present therapy for coronary artery disease the radical mastectomy of the twenty-first century?"

--Dr. Caldwell Esselstyn--

And take it from two of the country's top cardiologists:

"Multiple studies show that if you have one ruptured plaque you have many."  -Dr. Steven Nissen, chairman of Cardiovascular Medicine at the Cleveland Clinic-

"We can't cure this disease until we address the fundamentals of lifestyle."  -Dr. Eric Topol-

Wolf seemed surprised at Dr. Esselstyn's suggestion that the only way we will ever stop this disease is by changing the eating habits of our children.

"What?  Are you suggesting that our kids shouldn't drink milk, or enjoy French fries, and chocolate cake-all the pleasures of life?"  Blitzer asked.

Unfortunately, there wasn't sufficient time for Dr. Esselstyn to answer that question.  But, if he had had time, here's what he might have said.

It All Starts in Adolescence according to the PDAY Study:  Atherosclerosis begins in youth. Fatty streaks and clinically significant raised lesions increase from age 15 to age 34. 100% of the autopsies done on 15-34 year old accident victims showed fatty streaks in the aorta and 50-75% showed streaks in the coronary artery--all precursors to later coronary artery disease.    Click here for study.

By 65-70 we all have it.  All males 65 years & older, and all females 70 years & older who have been exposed to the typical Western diet have cardiovascular disease & should be treated as such.  Without making any changes, you can expect to have a catastrophic event (a heart attack or stroke) in your 70's or 80's.  -Dr. Lewis H. Kuller, The University of Pittsburgh-

Dr. Ornish waffled when he answered Blitzer's question about whether or not it was necessary for everyone to be on such a strict plant-based diet--even people without heart disease.   Ornish suggests there can be a spectrum (the title of his latest book) of dietary strictness--based upon whether one has heart disease or not.

There's a bit of a problem here.  Heart disease is often invisible, and it's years in the making.  We often don't know what's going on inside of our blood vessels until it's too late.

Cholesterol levels, and other risk factors don't always predict future coronary events accurately.  Cardiovascular disease lurks in the unseen damage we do to the endothelial linings of our blood vessels, from the foods we eat.  This inflammatory process starts a cascade of bad-news biological events that lay down atherosclerotic plaque, damages vessel linings, and if we're unlucky, puts us at risk for vessel-blocking plaque ruptures--that set us up for heart attacks, invisible strokes, major strokes, dementia, and more.

Fit, lean, athletic people who are eating a Mediterrean Diet are not immune.  Just ask Dr. Esselstyn.  Just read my email--from people who exercised, ate right, & thought they were disease-proof.  Just read, "I'm healthy, I exercise, I eat right, I'm heart-attack proof - "Not a moment too soon I thought of Tim Russert"

"Now I finally understand how we can have a heart attack or a silent stroke even if we think we don't have heart disease or atherosclerosis.  Your coronary artery has to be 70% occluded to have symptoms, like angina. If your arteries are even 10-69% blocked, and you're inflaming them with what you eat, you're at risk.  It's all about inflammation - Calm down the inflammation & you'll keep those atherosclerotic plaques safely stuck to your artery walls."   From my post Yes, you can prevent and reverse heart disease, but are you up for the challenge - Let Dr. Caldwell Esselstyn Convince You.

Here are Some of the Questions the Interview Did Not Allow Enough Time to Answer

Why not just follow the Mediterranean Diet, which includes olive oil & fish?  Yes, the Mediterranean Diet is better than the American Heart Association Diet & the Western diet, but it only slows the progression of heart disease--it doesn't prevent & reverse heart disease.  And, sure who doesn't want to believe that it's healthy to eat fish & olive oil?  I know I did.  But followers of the Mediterranean Diet show reductions of only 19-25% in cardiovascular mortality compared to followers of more standard diets.  Not a huge reduction in my book.  Click here for a recent JAMA study.

Why can't I use olive oil?  I've covered this at length in I'm Going to Miss My Olive Oil - Who Knew It Wasn't So Healthy After All? Drs. Esselstyn, Ornish, Vogel & Rudel Did  but here's the short story:  Dr. Lawrence Rudel fed African Green monkeys (who are close substitutes to humans for study purposes) olive oil for 5 years, and then compared their arteries to those of Green monkeys who were given saturated fat to eat.   Rudel was shocked by the results--he expected the olive oil monkeys would be disease-free.  Turns out even though the olive oil monkeys had high HDLs, they also had just as much coronary heart disease as the monkeys who ate saturated fat.  Oops!  Olive, soybean, palm, coconut, oils all contribute to heart disease--just avoid them.

Why can't I eat nuts?  Recent studies say they increase HDL's, and lower LDLs?  Esselstyn is skeptical about this reearch, based on the surprising results of Rudel's study.  Just because the HDL's go up, & the LDLs go down, it's no guarantee that nuts are preventing or slowing down coronary heart disease.  Little known fact:  the nut industry has sponsored these cholesterol/nut studies & participants had to consume 2.3 ounces of nuts to accrue the lipid changes--that's 350-400 calories worth of nuts.  

Then there's the omega-6 to omega-3 ratio thing--ideally we want to aim for a 2:1 or a 1:1 ratio of omega-3s to omega-6s, because a diet high in omega-6s is inflammatory.  Most of us typically eat a diet that has a 17:1 ratio of omega-6s to omega-3s.  Except for walnuts (and Esselstyn gives the OK for a few walnuts for folks without heart disease), most nuts are very high in omega-6s, and low in omega-3s.  Cashews have a 117:1 omega-6 to omega-3 ratio.  And all nuts are high in calories and saturated fat.  Almonds, the nut super-star is 6% saturated fat.

Isn't This Diet Extreme? Isn't it Too Hard to Follow?  Doesn't It Take All the Fun Out of Eating?

Not at all.  I'm someone who LOVED Kentucky Fried Chicken, corned beef sandwiches, Big Macs, barbecued ribs, and eating chocolate chip cookies for breakfast.  Don't miss them at all.   And I'm following this diet just for prevention.  I have no diagnosed heart disease.  But I saw two wonderful parents go through lengthy stroke-related declines, and if there is anything I can do to avoid that future, I'm going for it! Honestly, if I can do it, anyone can.  Really.  By now I can't imagine eating any other way--and I'm eating delicious food with lots of spice and zest--and it's far more interesting than broiled chicken.

Yoda:  So certain are you.  Always with you it cannot be done.  Do you hear nothing that I say?

Luke Sky Walker:  Master, moving stones around is one thing.  This is totally different.

Yoda:  No.  No different.  Only different in your mind.  You must UNLEARN what you have learned.

Luke Sky Walker:  All right.  I'll give it a try.

Yoda:  No. Try Not.  Do.  Or Do Not.  There is no Try.

If You Have More Questions About How a Plant-Based Diet Can Prevent Heart Disease--You're Welcome to My "Cliff Notes"

If the Esselstyn/Ornish Interview doesn't answer all of your questions, read Dr. Esselstyn's & Dr. Ornish's books.

If you want answers right now, read my summary of the day-long session I attended with Dr. & Ann Esselstyn--"What I learned from Dr. Caldwell and Ann Esselstyn's Prevent & Reverse Heart Disease "School".

Or go through my whole series of posts about Dr. Esselstyn's diet, how I adapted my cooking and recipes, and my successful experiment with the diet, click here, Dr. Caldwell Esselstyn's Prevent and Reverse Heart Disease Diet.

And Now For Wolf Blitzer's Interview with Drs. Esselstyn & Ornish

If you do not see the video, click here.

Stay tuned this weekend for some of my favorite plant-based pantry staples, and some of my long-promised recipes--that is if I can stand to sit at this computer any longer!

Painless Calorie Restriction for People Who Love to Eat - Lessons for Health, Longevity, and Disease Prevention from the NIH CALERIE Study

Calorie Restriction Without Counting Calories - A 6 Cup Salad, Eggplant Lasagna, a 27 ounce Green Smoothie, & Fruit for Lunch & Dinner

"I didn't think calorie restriction worked in humans until I started working with people who'd been doing it for years.

They are among the healthiest people I've ever known.  Their heart function is similar to people 15 years younger, they have very low levels of inflammation and very few get cancer."

-Dr. John Holloszy, M.D., lead CALERIE investigator, Washington University, St. Louis, Missouri-

"In terms of cardiovascular diseases - the No. 1 cause of death: 4 out of 10 people die of it in the U.S. and Europe - we know that they (Calorie Restriction Society members) will not die of cardiovascular death."

"..every day doctors are publishing hundred of papers on circulation research and medications that are lowering blood pressure or cholesterol by a small bit. And here we have such a powerful intervention that is basically cleaning out the arteries."

"I don't know why anyone would take drugs when they could do something like this."

-Dr. Luigi Fontana & Dr. Susan Roberts, Washington University & Tufts University, investigators for the NIH-funded CALERIE Study-

9/21/10 update: Bill Clinton's CNN interview.  Why he's eating plant-based.  His stent wasn't going to cure his cardiovascular problems.  He wanted a long-term solution.  Click here.

Update 9/25/10:  Click here for my latest post about Bill Clinton's Diet and Wolf Blitzer's Interview with Drs. Esselstyn & Ornish.

Back to October 11, 2009 - Revisiting the CALERIE Study

One of my all-time favorite posts was almost a year ago--about the CALERIE Study that's been ongoing at Washington University in St. Louis (a shout-out to Wash U!), Tufts University in Boston, and the Pennington Biomedical Research Center in Baton Rouge.

I was totally intrigued by these 132+ people who were cutting their calories by 25%, eating a nutrient-dense diet, and getting super healthy all at the same time.  But, honestly, it sounded like a whole lot of measuring, weighing, calorie counting, and constant hunger.  Back then I didn't seriously think it was something I could ever do it.

Fast forward to June 18, 2010 when I decided to up the ante on my plant-based diet, and take Dr. Caldwell Esselstyn's challenge to cut out oils, nuts, and avocados from my already healthy diet.  That was 3 months ago--my 4 week "experiment" is over, but I'm still going strong with this eating lifestyle.

Weight-loss is always a huge motivator.  I got on the scale today and I was 121 pounds--unbelievable for me--and that's with plenty of muscles, I'll have you know!  Down 10 pounds in 13 1/2 weeks, and I'm not counting calories or depriving myself one bit. 

I love how my clothes fit--I love that my blood pressure is consistently low normal--that my resting pulse is around 56--my cholesterol is just fine, I've got plenty of energy, the toxic belly fat is almost gone, as well as my extra tush cushioning--and guess what?  I didn't set out on this diet to lose weight.  I figured I was fine just the way I was--at 131 pounds--OK for a sixty-year old. 

I set out on this path for the same reason that Lisa Walford did.  She's the 55 year-old daughter of the late Dr. Ray Walford, one of the first researchers to look at the benefits of caloric-restriction.  Lisa has followed a 25% calorie restricted diet for over 20 years and at 4 foot 8 inches, she weighs in at a diminutive 80 pounds, and eats around 1500 calories a day.  If Lisa wasn't trying to lose or gain weight--her "set point" would be 95 pounds and she'd be consuming 2000 calories a day.

"Personally, I don't do it in hopes that I live longer.  I do it so that I can liver better now!  If I do live longer, it'll be a nice bonus."   Lisa Walford

My Unintentional Calorie-Restriction Experiment

Without intending to, it turns out that I'm following many of the precepts of calorie restriction, as well as the guidelines of the CALERIE Study (the Comprehensive Assessment of the Long Term Effects of Reducing Intake of Energy). 

• Sticking to the most nutrient-dense foods like fruits, vegetables, whole grains, and legumes--although the CALERIE study is not vegan or vegetarian.
• Eating foods that are filling, appealing, low in calories, and nutrient-rich.
• Eating lots of fiber--like close to 50 grams a day (for me) without counting grams or even trying.  Fiber is key to keeping satisfied and full--and it likely activates the satiety receptors in the lower intestine.  My husband is a huge fan of eating a big bowl of high-fiber cereal (Uncle Sam's & Ezekiel's) with oat milk as a dessert, or when he craves a snack.
• I've easily cut my calories by 25% just by eliminating the high calories of oil, avocados, chocolate, sugar, and nuts.
• Why I wasn't losing weight on a plant-based diet. To maintain my previous weight of around 131 pounds I was eating around 2000-2200 calories a day, and exercising around 5 days a week.  Sure, I had been eating mostly plant-based since March 2008--but I still used olive & canola oils, salad dressings, ate avocados, nuts, nut butters, chocolate, and didn't scrutinize labels for added fat.  I never lost a pound.
• Eliminating high-calorie-low-nutrient foods. By just cutting out the added oils in my food and in my cooking, eliminating nuts (except for small amounts of walnuts in recipes), avocados, vegan mayo, my beloved Terrapin Ridge Chipotle sauce, my favorite Whole Foods prepared deli vegan fare, hummus with tahini, and chocolate--I've naturally cut my calories to about 1400 a day without counting a calorie, or missing a thing!  Believe me, I never thought I could cook without oil, or live without nuts.
• I eat whenever I'm hungry and as much as I want.

If you had the chance to stay healthy and lean as you aged--free from the diseases of aging, like diabetes, cancer, and cardiovascular diseases--and all you had to do was cut out 25% of your daily calorie intake--would you do it?

Oh--and if you could also fit into cool clothes, drop to your high school weight,  & enjoy super energy?  Would you be willing to do it?

Why Is Calorie Restriction on My Mind Right Now?

A few weeks ago I picked up the Sept/Oct issue Natural Health and zeroed right in on their cover story "Eat Less, Live Longer" by  Catherine Guthrie.   And then I watched the 2010 Milken Institute panel, "The Science of Longevity", that featured my favorite calorie restriction expert from Washington University, Dr. Luigi Fontana.  I highly recommend viewing this video if you ever have 70 minutes to spare.  Right!

Here's what I learned:

1.  Your body has a natural set point weight.  That's the weight your body would naturally gravitate to if you weren't trying to lose or gain weight.   If you want to lower your calories by 25%--you first need to know how many calories you typically eat to maintain your "natural set point" weight.

2.  Short-term pleasure vs long-term benefits.  To make this work, you have to be willing to sacrifice the short-term pleasure of chocolate cakes for the long-term benefit of good health.  Easier said than done.  It's also not just a calorie-cutting game--it's eating the most nutrient-dense foods possible.  Otherwise you end up malnourished.

3.  Why does calorie restriction confer good health?   Most researchers in the field believe it's because low-calorie nutrient-dense foods stave off oxidative stress, which is the damage caused by free radicals--a natural byproduct of the body's metabolism.  Catherine Guthrie offers an elegantly simple explanation of the process.

"Think of free radicals like the carbon dioxide produced when you burn gas driving a car.

By restricting the amount of calories entering the body, cellular engines are forced to be more efficient (hybrid vs SUV), and the entire body hums like a well-oiled machine.  More efficient cellular engines mean less metabolic waste and fewer free radicals spewed into the body.

Since free radicals (and inflammation) play a role in nearly all age-related diseases, especially cancer, heart disease, and diabetes, the result is healthier aging."

4. Caloric restriction slows aging. According to Dr. Luigi Fontana, caloric restriction is the most powerful tool we have to slow aging, and reduce disease.  All the cardiac risk factors are reduced significantly, type 2 diabetes is reduced to zero, arteries are clean, and cancer causing hormones are down-regulated.  Right now the average life span in the U.S. is 80 years.  The average health span is 50 years--after that it's doctor visits, prescriptions & treating disease.  We need to bridge that gap.  Fontana's latest article on "Extending Healthy Life Span--From Yeast to Humans"  is published in Science 2010 Apr 16;328(5976):321-6. Click here.

5.  Animal protein & cancer.  Reducing the amount of animal protein we eat to 10% of calories eaten reduces risk factors for prostate, breast, and colon cancers, and neurodegenerative diseases.  Animal protein increases IGF-1, a growth factor associated with these diseases. (Fontana)  Click here to read more.

6.  A Flat Belly Means a Healthy Body.  BMI is a crude way to measure health.  Waist circumference is better.  A flat belly means you are eating just the right amount of calories you need. Yikes!  A round belly means you are eating too much. (Fontana)

7.  If you have a family history of cancer, eating a high animal protein diet is not a good idea. (Fontana)

And now for the original post from Oct. 11, 2009.  It will explain a lot.

CALERIE: The NIH Calorie-Restriction Experiment. Lessons for Health, Slowing Down the Aging Process, Longevity, and Disease Prevention

Photo credit: Reinhard Hunger NYT 10/11/09

"In terms of cardiovascular diseases - the No. 1 cause of death; 4 out of 10 people die of it in the U.S. and Europe - we know that they (Calorie Restriction Society members) will not die of cardiovascular death."

"... subjects have cholesterol around 160, blood pressure around 100 over 60, high HDL, low triglycerides and very low levels of inflammation."

"...every day doctors are publishing  hundreds of papers on circulation research  and medications that are lowering blood pressure or cholesterol by a small bit.  And here we have such a powerful intervention that is basically cleaning out the arteries."

"I don't know why anyone would take drugs when they could do something like this." 

Dr. Luigi Fontana & Dr. Susan Roberts, Washington University & Tufts University investigators for the NIH- funded CALERIE Study,   NYT 10/11/09

If you had the chance to stay healthy and lean as you aged--free from the diseases of aging, like diabetes, cancer, and cardiovascular diseases--and all you had to do was cut out 25% of your daily calorie intake--would you do it?  Oh--and if you could also fit into cool clothes, drop to your high school weight,  & enjoy super energy?  Would you be willing to do it?

We know that careful calorie restriction--eating a nutrient-dense-low-calorie diet--works in rodents and those University of Wisconsin rhesus monkeys--but will it work for humans who are constantly tempted by cheeseburgers, pizzas, office parties, and dinners out with friends?  (Read about the Rhesus Monkey 20 year follow-up here)

According Dr. Susan Roberts, one of the principal CALERIE investigators, when it comes to animals,  "They don't just live longer, they are healthier.  They actually aged biologically slower.  Their hair has gone gray less quickly.  Their hormones have stayed at their youthful profile and their immune function has stayed good."

I'd heard for years about too-skinny "calorie-restriction groupies" who were out to beat death with a miserably low-cal boring diet.  It held no appeal for me.  I love food too much!

But, I've got to tell you, after reading about the National Institute of Aging's ongoing calorie-restriction  experiment known as CALERIE  (Comprehensive Assessment of Long-Term Effects of Reducing Intake of Energy)--I'm rethinking this whole calorie-restriction scene!  This is not excruciating or boring at all!  And since I started on my "veganish" adventure in March of 2008--I'm not that far away from the CALERIE model already!

Take a look at Jon Gertner's fascinating story, "The Calorie-Restriction Experiment" in the October 11, 2009 New York Times Magazine, here. 

Honestly, I'd describe it as Weight Watcher's on steroids--with help from physicians, dietitians and counselors.  There's even room for an occasional Uno's pizza, Haagen Dazs ice cream bar, bratwurst, or beer.

The first participants are finishing up their 2-year trial and the results are promising.

What is the CALERIE Study?

• Since it's virtually impossible to follow people over a lifetime to find out if restricting calories by 25% would slow aging, drastically reduce diabetes, cardiovascular diseases, and cancer--CALERIE aims to follow a select group (right now there are 132 enrolled) for two years to find out if the biomarkers for aging can be modified when calories are restricted.
• The study will measure if inflammation, insulin levels, blood pressure, core body temperature, and body weight can be lowered simply by reducing calories by 25%.
• Where are the sites?  Tufts University in Boston; Washington University in St. Louis; Pennington Biomedical Research Center in Baton Rouge.
• Who is eligible?  20-50 year olds who are healthy and not too fat or too thin--having a BMI of 22-27.9.  Participants also have to be motivated, organized (they have to measure & record every morsel they eat for 24 months), have stable jobs with little travel, and a supportive family.

What's the Diet Like?

• So, do you think you know how many calories you eat every day?  Think again.  Most participants guessed wrong.  Using a high-tech lab technique that involves swallowing water with rare isotopes, the researchers are able to figure out precisely how many calories each participant is typically consuming.  Then they cut it down by 25%.  
• Liz Ewen, a molecular biologist, was eating 2,226 before CALERIE--now she's at 1,670.  Dr. Jeff Peipert, an OB-Gyn, was consuming a whopping 3,300 a day pre-CALERIE--now he's at just under 2,500. 
• For the first 28 days participants get all their meals & snacks cooked for them and at no cost--based on their individual calorie counts.  This gets them accustomed to portion sizes and adjusted to eating the kind of foods that will keep them filled and satisfied.  And this food isn't spartan:  Mediterranean-style fish with Greek-style potatoes, or Farfalle with Pesto & Diced Chicken, for example.  After 28 days--they buy and prepare their own food--with regular help and guidance from dietitians and a support group.
• The Key to eating 25% less:  eat foods that are nutrient rich and high in fiber, like vegetables, fruit, high fiber cereals, and soups.  Aim for foods that weigh as much as what you were eating before the diet--but lower in calories--to keep you full and satisfied.  Favorite food for keeping hunger at bay:  apples.   Everyone in CALERIE has become a big fan of apples. 
• The 4 Rules for Eating Less:  Eat Foods That Are Filling, Appealing, Low in Calories, Nutrient Rich!
• Dr. Susan Roberts of Tufts says, "If you don't change your diet to a high-satiety diet you will be hungry, and you will fail."  Fiber One, the breakfast cereal, or Nature's Path Organic Smart Bran--both with soluble & insoluble fiber, "have a unique  effect in helping calorie-restriction subjects feel fuller, probably because they activate certain receptors in the lower intestine."

To see some of Dr. Roberts' satiating snack recipes in my previous post click here: "The Instinct Diet Helps Us Combat Our Hard-Wired Food Cravings - And Satisfy Our Cravings for Something Spicy, Salty, Crunchy, & Chocolate"

• CALERIE tip: Save up calories if you have a special occasion or celebration coming up.  Want a bratwurst or Haagen-Dazs?  Save up those calories.  Decide what's more satisfying--170 calories for a gin & tonic, or a  190 calories for a  Haagen Dasz ice cream bar.

What Is the Hardest Part of the CALERIE Diet?

• Surprisingly, no one complains of raging hunger.  But most everyone felt hungry for the first few weeks.  When I joined Weight Watchers years ago to lose pregnancy weight I felt exactly the same way.  But then you just get used to less calories and learn to eat more filling foods.
• The hardest (& most annoying) part is getting used to measuring the food, preparing the food, and keeping track of the calories.

Why is CALERIE Working For Most of Its Participants?

• There's accountability. 
• You have to submit a weekly food diary.
• Attend weekly weigh-ins
• Once or twice a week you must attend individual counseling sessions
• Group counseling sessions give participants an opportunity to swap strategies and get support from fellow dieters.
• There's a battery of medical tests every 6 months.  Cognitive tests.  Blood tests.  Bone-mineral density tests.  Measurements of resting metabolism, respiratory output, and internal core temperature.

What About Weight Loss?  What About Health Improvements?  What About Energy? 

• Most participants met their weight loss goals.  They were told to expect to lose about 15% of their weight during the first year.  After that initial drop they would plateau to "weight stability".
• Doug Hansen started out at 198 pounds and dropped to 168--near his plateau--after 6 months.  Jeff Peipert began at 174 pounds--dropped to 151 after 52 weeks--and was projected to plateau at 147 pounds.
• Benefits.  For example: Peipert's blood pressure started out at 130 over 80.  Now almost a year into CALERIE, he's at 110 or 115 over 54. At age 49 his weight is what he weighed in high school.  Same for Brad Beggs. He is down to wearing a size medium shirt--a size he hasn't worn since high school.  And Beggs adds, "I've never gotten so much pleasure in my life."

Dr. Jeff Peipert, a Washington University CALERIE participant

Wondering about energy?  Check out how Dr. Jeff Peipert spent a recent day off:

1.   18 holes of golf

2.   Biking 8 miles back & forth to his office just to pick something up

3.   Cutting his 1 acre lawn

4.   Pulling out tree roots with his son for over an hour

5.   40 minute after-dinner walk with his wife.

6.   This "calorie-incinerating machine"  was wondering why he felt particularly hungry the next day,  resulting in his eating a bowl of cereal in the middle-of-the-night.  Both my husband & I have definitely noticed the huge uptick in our appetites the day after long work-outs.  It makes sense to us.

Is Calorie-Restriction Possible for the Average American?

• The Naysayers:  Dr. John Holloszy, a Washington University lead investigator thinks 99% of Americans can't stick with it.  Other doctors think calorie-restriction requires too much individual effort--too much in medical resources--too much in counseling.   Dr. Robert Krikorian, a neuropsychologist who happens to be a long-time follower of a calorie-restriction diet himself-- thinks that most people won't pay attention to how much they eat--and they would refuse to keep up the organizational requirements necessary for such a diet.
• The Boosters:  Many doctors involved in CALERIE are surprised & encouraged at the high level of compliance with the diet.
• The Participants:  All of the subjects that Times writer Jon Gertner spoke with intended to continue with calorie-restriction when the trial ended.  Liz Ewen likened it to Weight Watchers (& I agree).  Given the right online tools, some sort of infrastructure, group meetings, and dietitians available for support, Ewen thinks it's suitable for many people.  "It's really not much more than embarking on a diet that teaches you how to eat normal foods but make better choices!"
• Some of the  first of the group to finish:  Most of "first finishers" plan to keep up the diet--but switch to estimating the calories, rather than counting them precisely.  Josh McMichael finished up with CALERIE in September.  In the few weeks since ending the program he gained eight pounds--but it's now mostly gone.  "I tried the new massive burgers at Burger King,"  he said.  "Twice.  Wasn't worth the side effects.  I think I've gotten over things like that.  For the most part."

Words of Encouragement from the Lead Investigators

• Dr. Luigi Fontana of Washington University in St. Louis.  "My perception right now is the effects of calorie restriction are multiple, so I think it is highly difficult to find one, or two, or three drugs that will mimic such a complex effect."  And although he isn't optimistic that calorie restriction will gain traction in the general public, he does believe an important common sense lesson will be learned from the experiment:

"Eating less is better than eating more, especially if it's a nutritious mix of whole grains, fruits, vegetables and the like.  The evidence is overwhelming now that it will improve your health and will improve your chances of living healthier and probably longer."

• Dr. Susan Roberts of Tufts University in Boston:  Roberts thinks the study will have greater effects than the average clinical trial.  "I don't know why anyone would take drugs when they could do something like this--calorie-restriction,"  said Roberts.

The Healthy Librarian Weighs in on Calorie Restriction

For my money, the folks in the CALERIE study are following a plan that seems very similar to:

• Dr. Joel Fuhrman's Eat for Health: Lose Weight, Keep It Off, Look Younger, and Liver Longer
  
• Dr. Susan Roberts'  (a CALERIE lead investigator) Instinct Diet
• Dr. Caldwell Essestyn's Prevent and Reverse Heart Disease
• The Weight Watcher's diet plan

Easiest way to cut calories:  ditch added fats, like butter, margarine, mayo, cooking oils, salad dressings, desserts, high-fat dairy like cheese & ice cream, and the after-dinner snacking.

Foods highest in nutrient density:

*Dr.Fuhrman’s  Aggregate Nutrient Density Index
Top 30 Super Foods Score

1. Collard, mustard, & turnip greens 1000
2. Kale 1000
3. Watercress 1000
4. Bok choy 824
5. Spinach 739
6. Brussels sprouts 672
7. Swiss chard 670
8. Arugula 559
9. Radish 554
10. Cabbage 481
11. Bean sprouts 444
12. Red peppers 420
13. Romaine lettuce 389
14. Broccoli 376
15. Carrot juice 344
16. Tomatoes & tomato products 190-300
17. Cauliflower 295
18. Strawberries 212
19. Pomegranate juice 193
20. Blackberries 178
21. Plums 157
22. Raspberries 145
23. Blueberries 130
24. Papaya 118
25. Brazil nuts 116
26. Oranges 109
27. Tofu 86
28. Beans (all varieties) 55-70
29. Seeds: flaxseed, sunflower, sesame 45
30. Walnuts 29

Drugs or Diet?  I find it interesting that the only cure for celiac disease (the inability to digest gluten) is to follow a gluten-free diet.  There are no pharmaceutical or surgical cures.  People with celiac who want to get better just follow a gluten-free diet.

Yet, when it comes to the diseases of aging, like Type 2 diabetes, some cancers, and cardiovascular diseases--most physicians find that the majority of people are unwilling to follow a diet even if it promises to free them from these diseases.  Oh well!

Do you think such a diet is ready for Prime Time?  Would you be willing to give it a try?

Bill Clinton is Doing His Own Plant-Based Diet Experiment to Reverse His Heart Disease! Credits Esselstyn, Ornish & Campbell

Clinton Has Lost 24 Pounds So Far Following a Plant-Based Oil-Free Diet

Update 9/25/10:  Click here for my latest post about Bill Clinton's Diet and Wolf Blitzer's Interview with Drs. Esselstyn & Ornish. It's far more informative than this post.

Looks like Bill Clinton is following Dr. Esselstyn's plant-based heart disease reversal diet. 

Who would have ever guessed?  A reader from New Hampshire--who has been successfully following Dr. Esselstyn's diet after experiencing his own quadruple bypass three years ago--just sent me this recent post that appeared today on VegSource.   Good bye pulled pork--hello oil-free lentil salad!

Bill Clinton talks about going plant-based to reverse heart disease, so he can be healthy in the years ahead to see his potential grandchildren.

"I'm trying to be one of those experimenters," said Clinton. "Since 1986, several hundred people who have tried essentially a plant-based diet, not ingesting any cholesterol from any source, has seen their bodies start to heal themselves -- break up the arterial blockage, break up the calcium deposits around the heart. 82 percent of the people who have done this have had this result, so I want to see if I can be one of them."

Just hours ago, Ecorazzi received exclusive information from a friend of Clinton (who wishes to remain anonymous) regarding first-hand conversations with the former president about his vegan diet.

According to our source, Clinton decided to adopt the diet in the early part of May. While he does occasionally eat fish, the former president otherwise follows a strict vegan diet.

What made him go vegan? According to our source, Clinton has read many books on the topic, including books by T. Colin Campbell, Caldwell Esselstyn and Dr. Dean Ornish. Although losing weight was a benefit of the dietary change, the choice to go vegan was about more than just losing weight.

"I've never known him not to say what's on his mind," says our source. "And he knows quite a bit and likely has a lot to say about the benefits of a vegan diet. He has read The China Study, and he knows the issues. With time, I think it's likely he could become the most outspoken proponent of a complete vegan diet."

I certainly hope he can stick with it.  What better spokesperson for a heart healthy diet that can cut heart disease, cholesterol, and health care costs all at the same time?  Go Clinton!!

For a link to Clinton's latest CNN interview (9/21/10) explaining why he switched to a plant-based diet, click here.  He realized that his stent was no guarantee against future cardiac events--only a change in diet would provide that, and Dr. Caldwell Esselstyn of the Cleveland Clinic had 25 years of research to back that up.

If you aren't seeing the video below--click here for the link.

Looking for a "refresher" on what this diet is all about, read: 
What I Learned From Dr. Caldwell and Ann Esselstyn's Prevent and Reverse Heart Disease "School"