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« 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 | Main | 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 »

August 23, 2011


Chris O'Keefe

I'm also 61, started the diet 6 months ago, and my cholesterol plummeted! I've also lost about 15 lbs. - from 140 to 125. I'm hoping to drop a few more pounds.

Here's the downside: I have terrible neuropathy in both legs and it hasn't helped that - but I didn't expect it to. From what I've learned from years of neurologist visits at Mayo and Cornell Weil, it's an unstoppable situation (way too long a story to go into here). It limits exercise so I can't really tell if I'm better able to perform.
Also - big problem for me is travel and dining out. We're not party types so most of our social life consists of dinner out with friends, as well as travel where we eat a great many of our meals in restaurants. I just don't find ANY restaurants who happen to cook without any oil or fat, and I just get tired of ordering a salad with no dressing for lunch and dinner (breakfast is easy: oatmeal). So I tend to go off the reservation - quite a bit - when we travel or when we go out. I just don't see an easy solution to this problem until the rest of the world has seen the light and converted and all restaurants offer China Study meals!

The upside: I feel as if I actually have a future! My father died at 64 of his 5th or 6th heart attack, and my mother had a massive, crippling stroke in her 80's and spent her last years in a wheelchair requiring 24/7 assistance (and HATED IT). I've had a black cloud over my life as I approached my 60's thinking life would only get worse. Now - I expect to live a long life - yeah, with a lot of neuropathic pain, but it could be a LOT worse! I can study painting, hang out with friends, be with my husband, read, laugh, and love life without dreading that heart attack or stroke. It's changed my entire outlook on life!

And thanks in a very large part to this website, which I followed for quite some time before I took the leap. So THANK YOU!!!
Chris O'Keefe

Donna Cash

Hi Happy Healthy,

Please think about putting a bikini shot, or at least a workout wear photo of yourself and your husband on here. Nobody would think ill of it, and a picture is worth a thousand words ! You convinced me a year ago to eat this way - my only transgression is a bit of daily peanut butter. I forward your postings about the benefits of eating this way to friends and several have signed up for your blog emails themselves, but so far only one friend has bought into it. Maybe the photos would give other 50 and 60 year olds that seeing is believing factor ! OK,they see me, but think that is all due to exercise, which its not.


Who knew Bill Clinton - of all people - would become a poster boy for the health benefits of a plant-based / vegan diet?!

Thank you for this down-to-earth run down of the practicalities and outcomes of a whole foods, plant-based diet. Most inspiring! And helpfully broken down into readable sections.

It's very timely as I'm currently doing the Plant-Based Nutrition course with e-Cornell (recommended - as much for student interaction online, as for the lectures) and so have just been introduced to Dr Ess and the science behind heart disease reversal.

I already eat a very green and clean diet, but have been reducing oil as an experiment based on what I've learned (bit of a sucker for coconut oil on everything). Helpful to hear about the 90-days needed to lose the taste for it. It certainly adds a certain 'mouth feel' otherwise.

A few other thoughts as I read through:
* I heartily concur with the concept of 'decision fatigue' (or 'the tyranny of choice'). It's so much easier to breeze through your shopping when you're ignoring the meat, dairy, processed foods etc.
* You really do a LOT of exercise by normal standards. You put me to shame and I'm quite a bit younger! Particularly impressed at how you manage to fit it all in. (ps. I've tried spinning and it KILLS).
* I was slightly disappointed / surprised that you're opting for hormonal creams in what is presumably the postmenopausal stage of your life. Do you not think food can be your medicine in this stage too? (I have an interest here as I advocate a plant-based diet to manage PMS and perimenopause:
* There are both pros and cons to some foods, including plant-based ones. I agree with you about tahini being tasty, and I usually indulge on the basis that the sesame seeds it's made of contain a lot of iron.

Thanks again for the marvellous blog. Here's to your continued good health and 'zip'!


I started doing the Esselstyn food plan almost one month after you did, and I was fortunate to stumble onto your blog which convinced me to jump in. I immediately lowered my cholesterol, my blood pressure and my weight. I lost about 15 pounds and would have lost more except that I have had a really difficult summer staying on the plan due to our long trip to Africa and our son's return home from college. HOWEVER, I am going to go back to being strict about it since I feel so much better and I noticed I got acid reflux when I went off the plan! YUCK. That is a nasty problem. I like that you are sharing your favorite recipes. I too try to stick to some basics that I like. For me it is raw whole oats mixed with Ezekial grain cereal, ground flax seed, stewed prunes and fresh fruit with almond milk (40 cal). I also like a whole grain muffin with a teaspoon of PB. For lunch one of my favorites is to mix organic black beans with fresh salsa on a n Ezekial whole grain tortilla. Dinner is usually a mixed green salad - kale, spinach, arugula with chopped fresh apples, walnuts, dried cranberries and shallots. I sometimes add lentils or beans too. I also find that when I go out I order Salmon and that helps with socializing because I do agree with the other poster that it is hard to be social around food when going out with others or attending their celebrations like weddings etc...Skipping oil is easier than I thought it would be, but I still add about 1/4 teaspoon of olive oil and basalmic vinegar to my salads. I do not have heart disease. I started doing this for my overall health and in order to live long and stay away from taking medications. It is working great! Most people are shocked to find that I am 52. I went to my high school reunion (35th)this summer and definitely felt that I looked great. I really appreciate your blog. I think it is excellent and I love all the science you have behind your postings. Personally I believe you should write a book. It could be targeted to older women who wish to look their best, feel their best and eat well without being hungry. That is the best thing about this food plan. YOU ARE NOT hungry.


I was bummed that Bill Clinton got pre-empted Sunday night but am looking forward to watching this weekend. I really appreciate all of the recipes, tips and products that you share. Looking for powdered peanut butter next.

You've been a great inspiration to me. I've lost 10 pounds since January. It's slow coming off but I am thrilled to have reached this weight and will continue on to lose 15-20 more. The blogs and recipe/diet books are a godsend to me as I do better with a daily boost. So fortunate that my husband and daughter are mostly with me plus 2 friends.

I met Isa C. M. at a vegan meetup in Lincoln NE a few weeks ago! What a thrill and I hope to see her at future meetups.


Your website introduced me to Dr. Esselstyn. And I like your many links and great recipes.

I also have followed Esselstyn for a little over a year now, with the exception of using fish oil (morning and evening). This appears to be the only point of difference between Dr. Ornish and Dr. E, when one is on the reversal diet. I have a 30-40% blocked right coronary artery, no symptoms, no risk factors, no family history, but wanted to nip any further clogging or damage in the bud. After 13 months, my lab numbers are the best I've ever had in my life, and they weren't very bad before. Everything, including blood pressure, is just perfect, including lipid readouts. I take no meds other than vitamins and one 81mg aspirin daily. I also lost 17 pounds, though was not a big fatso prior. Never went above 15% bodyfat. For the previous seven years before encountering Dr. E on your website, I had thought I was doing everything right with diet (e.g., using canola and olive oil), no non-skim dairy, lots of beans, other veggies, meats once a week max, and heavy
gym workouts for 2-3 hours several times a week. I'm 66.

There are three things I feel compelled to mention. First, Esselstyn says to use flaxseed instead of fish oil for n-3 fatty acid intake. Ornish says to use fish oil, for which there is more than ample evidence. There is also evidence in Am Jl Clin Nutr 2006;83(suppl):1526S-35S that fish oil does indeed provide plenty of DHA and EPA. However it does not provide adequate ALA. Flaxseed oil does indeed provide an ideal source for this third n-3 fatty acid. What it does not appear to do, yet Dr. E says it does -- without published evidence but only his say-so as far as I can make out, including his personal conversation with my niece -- is provide adequate DHA and EPA. Dr. E says that the flaxseed oil is converted to these two in adequate amounts, CONTRARY to published evidence cited in the above paper and elsewhere. It has also been said that he does not have an animal rights agenda, which might skew his judgment, so I find his strong belief puzzling, and
possibly harmful, if it is not evidence-based. I use both freshly ground flaxseed (electric coffee mill) on my oats each morning, and the fish oil as mentioned. From my reading of the *evidence* this appears to be the rational choice if I want to be certain, certain, of all 3 adequate omega-3 daily intakes. While Dr. E is never mistaken, I am not a faith-based person when it comes to avoiding strokes or cardiovascular "events" so prefer to maximize benefits there according to published peer-reviewed evidence in reputable journals.

Second, I was really hoping to read what your lipid numbers before and after (now) year were, and I'm *astonished* that you could wait several years to find out. Or perhaps I read wrongly. Even with no insurance, unless I were broke (hence had to have a yard sale or ebay sale), I would pay for a lab test out of pocket (they are not that expensive), especially if I had your expressed familial concerns for being proactive and evidence-based about your health. My cousins here get blood work done once a year, sent to them and to their family physician, by companies that come through town and charge 60 dollars. But even the in-town labs aren't that expensive. so I don't get it. I hope I did misunderstand what you wrote and apologize if I did.

Third, because I exercise so much and keep my body fat below 10% max, I find what appears to be a glaring omission from much healty eating advice, including Drs. E and O. Namely, adequate daily protein intake. I am not a bodybuilder or power lifter but do my best to maintain the muscular physique I had in my twenties, and do a pretty fair job of it. Even at my geezer age and short height, I get satisfaction is being one of the strongest people of any age at my gym, and for certain movements am the strongest regardless of age. Real athletes, which I am not, have a need for a certain amount of daily protein intake. But so do the rest of us, and that is the problem. What I find when reading suggested vegan-vegetarian diet recommendations for a person of X years of age, or for athletic folks of any age, is a deficient amount of daily protein supplied. When I actually add up the numbers of grams of protein provided in a daily meal summary, it is way too
low, even for a normally lazy layabout, such as most of my neighbors. I do eat loads of beans daily, whole grains, lots of fruts and veggies, drink light soymilk on oat breakfast. But based upon published requirements also drink combo shakes of pea protein, soy isolate protein, and whey protein isolate (2 scoops of whey protein max daily, it contains 8 mg of cholesterol total daily), all of which are quite healthy with benefits according to published evidence, and which give me adequate protein which otherwise would be lacking. Would I die or fall ill without it? Of course not. But that doesn't mean I would be maximally healthy or not lose strength due to normal protein-based bodily tissue turnover. After all, some poor people live and work by eating out of the public dumps in poor countries and appear fine and often to old age.

Most vegans and vegetarians may be (are?)shortchanging themselves, as pointed out in this definitive paper by a vegan, surprisingly. Especially for those of us over 60.

Thanks for a great website, one that changed my life for the better.

Wendy (Healthy Girl)

This was a fantastic post. You are an inspiration! Great reminder to make those cheesy oats. Got the ingredients out on my counter for later.

Steven Rice Fitness

I hope many more become inspired by you. You are quite an example and spokesperson for a healthful plant based diet(and exercise ;-) )

The Healthy Librarian

Hi BC,

Thanks for your thoughtful & detailed reply. Lots to discuss--but I'm limited by time. Sorry about the delay in getting back to you--very busy week & a half.

First, congratulations on all your successes! Our experiences seem very similar--thinking we were eating very healthy, exercising, no weight problems, etc---but then learning otherwise.

Re the fish oil---that's a big long complicated story because it's almost impossible to do the research on how plant ALA behaves when a person only ingests omega-6s at a ratio of 1:1 or 4:1, instead of the typical Western diet of 17:1. There are hardly any research subjects who eat that way to test it out!! n-3 & n-6 compete for the same receptors in the body--which is why all the fish oil research finds it necessary to use 1 to 6 grams of fish oil to show benefits.

Since that Am J Cln Nutr article was published in 2006---there have been 2 or 3 recent articles showing decreased carotid intima, & other postive end-point cardiovascular markers in vegetarians/vegans who are eating a lot of plant-based ALA--much better than compared to fish eaters. So the jury's still out. I've spoken to 2 omega-3 researchers & they both agree that if omega-6s are lowered you need far far less omega-3---and that omega-3 from algal sources will be the way to go--not through fish.

Dr. E's concerns about fish oil are because it's in oil form, which can get rancid, & oxidized, release damaging free radicals, plus the issue of mercury & pcbs in fish.

Like you, I hedge my bets. I've taken a pharmaceutical grade fish oil (about a gram--but not daily) for years, so I don't worry about the mercury & the pcbs & they're individually wrapped to prevent oxidization---and I also take a DHA capsule made from algae.

I will definitely make sure that I get my blood work done before 5 years go by---but unlike those who have heart disease, I don't have the luxury of getting every 3-6 month lipid numbers to post. I'm sure I'll have them taken on my own dime when I have opportunity---but, frankly, I'm more interested in my HS-CRP than anything else. From what I've learned---numbers definitely don't tell the whole story--and can be deceiving. High HDLs are no guarantee---see research on efflux capacity, & hdls that behave like ldls. And not-so-low ldls aren't necessarily atherogenic---light fluffy ldls aren't atherogenic.

Re protein---I've posted on it in the past--and cited the same Jack Norris article as you have in your email. Like you--I make it a point to eat enough beans, soy, etc & don't take the protein issue lightly. But--beware of too protein from animal sources--which includes whey. Whey has casein, and that's the cancer driver in Dr. Colin Campbell's original research--turning on & off cancer cells. It's also what was fed to the rats in the NEJM study on high protein diets--and it caused atherosclerosis. You can't overdo it with plant protein--but you can with animal protein.
The body can't store protein, so too much can cause kidney stones, put stress on the kidneys, or get stored as fat.

You tracked your protein from your diet--which was very wise. I agree with you, that people can get into trouble with ingesting too little protein--especially if they exercise a lot--particularly weight-training.

I tracked my yesterday, motivated by your email--and it was right where Jack Norris' studies recommend for over 60 athletes at my weight--but that was with the help of some brown rice protein powder & soy yogurt. We've ditched soy protein isolates & whey in our household. My husband, who runs ultras will use brown rice or hemp protein in his smoothies if he feels he needs more. Would love to get the pea protein--it's good to combine them--but I thought it was no longer available--not that I've looked, though.

Thanks again for writing--for sharing your personal experiences and adaptations to plant-based no-oil eating. Like you, I don't blindly follow one path--I read the scientific evidence myself--and then make decisions.



Is the PB2 ok under the esseltyn diet ?

The Healthy Librarian


PB2 is not a product the Esselstyns recommend. I've given them a jar to try out--but I have yet to ask them about it. They really do not want their heart patients to eat nuts--so perhaps they prefer to not encourage that taste preference. I don't know.

There are small amounts of sugar & salt in it for taste--and it does have 1.5 grams of fat in it--per a 2 TBS serving. Obviously, most of the fat's been removed.

We don't use it often--but it's a great take-along for traveling, and for a quick breakfast spread on an Ezekiel English muffin. It also works well in an Asian peanut sauce, and in recipes that use peanut butter. It tastes delicious--but, it's in no way a food you would want to overeat---probably because the fat has been removed.

If you are not a heart patient--give it a try!

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