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?

 

 

 

 

 

 

 

 

 

Comments

[Kiki Ohio]

I was particularly disappointed to read that Mr. Bare stated that he "had no plans to give up the food he loves". That means he can expect to see his heart disease needlessly continue to progress. So frustrating to read!

[Victoria]

Thank you for this summary. I have been reading your blog for a while now and really appreciate all the information you condense and summarize so well. I decided to watch the whole video and I agree with you - definitely prized diet over surgery. A question I am left with though is that Dr. Agatston's diet is not the same as Esseltyn's yet also reports positive health outcomes and also Ornish who was the person who actually worked with Clinton also does not propose something as strict as Esselstyn. I'm moved significantly towards a plant-based, whole grains, whole food approach after the last few months of reading but the varying diet advice is confusing. What's your perspective on South Beach?

[Ginger]

Thank you for another wonderful post. "The Last Heart Attack" was the most informative health program I have seen in a long time and I was so pleased to see such strong emphasis on diet.

[Anna]

Thank you again for your summary. I've fallen off the Esselstyne diet often and it's always because of milk chocolate, milk in my tea or a piece of cake. It's so frustrating because the conclusion I have to come to is that I'm incredibly weak-willed or just addicted to these things. Sometimes I just despair! I keep going though as I do want to do this and agree that it's got to be all or nothing as I won't get the results I want.

An example - I have an upcoming trip abroad where my hosts (who have never met me before) are eager to do their special BBQ for me. I told them I don't eat meat but after pressure, gave in and agreed to some fish! It's so annoying. Now I am stressed about an upcoming trip.

[Anna]

OK - just watched the documentary. Thrown out the milk. The documentary was excellent (what a joy to watch American television with no advertisements) and as far as I'm concerned, it wasn't just *slanted* towards the diet over drugs and procedures - its core message was that it is only diet that will save you from plaque build-up in your coronary arteries.

[The Healthy Librarian]

Kiki---I was more than disappointed that Mr. Bare wasn't going to give up any foods--I was shocked. What was he thinking? Hopefully, he has since watched the show & changed his mind.

Anna, Ginger, & Victoria--glad to hear that you also got the same impression as I did from the documentary---diet rules!

Anna--just keep at it. Remember, I'm dabbled with this diet for 2 years before going 100%. And yes, I will have fish, ice cream, & unhealthy desserts once in awhile--and all in the context of social occasions. But I keep all that stuff out of the house--and keep a lid on it when I'm socializing or eating out.

[Alexandra]

Well, just to be radical, and take it a step further: The way to drastically cut health care costs, is to implement(prescribe) diet and exercise as the treatment, and drug and surgical intervention as the exception to the rule, only to be used in extraordinary circumstances.
Of course the drug, medical and food industries would be up in arms. If Americans want their fat added carnivorous diet, let them pay for their own health care costs, or join an insurance pool with like-minded individuals.

[The Healthy Librarian]

Alexandra,

Your idea doesn't seem radical to me--I think it's brilliant. Thanks for telling it like it is!

[Barbara Zimmermann]

Its a matter of Forks over Knives. Changing where your fork goes as opposed to going under the knife. Simple. And I think it has implications for for all metabolic syndrome diseases. I look forward to that research being as self-evident.

[PGYx]

Thanks for posting your notes as well as links to transcripts and the entire documentary! I'm definitely the healthiest eater I know, which makes it easy to fall of the wagon more often than I'd like. Your post is a good reminder for me. I'm really happy to see former President Clinton so excited about his healthy diet.

I'd like to clarify that stents do not treat or cure heart disease. They can open a short stretch of blockage but have never been shown to decrease mortality from heart disease. One reason for this is that cardiovascular disease is a systemic process affecting every vascular bed, including the heart, carotid arteries, kidneys, and brain. Another reason may be that the least stable vascular plaques are thinner ones that do not sufficiently occlude coronary vessels to warrant elective stenting. However, they can cause an acute blockage upon rupture.

It's better to treat the underlying cause of systemic disease rather than apply band-aids to the most striking areas of disease.

[The Healthy Librarian]

Hey PGYx,

Good to hear from you--it's been awhile.

So well said! Thanks for the most excellent explanation about why it's imperative to really "cure" the systemic disease--all the rest are just band-aids!

Your patients are very lucky to have you as an example to follow!

[S&S]

Just wanted to say thanks, I stumbled upon your blog from a link you posted in the comments on a nytimes article. My Fiance and I have been searching for the best dietary practice and have slowly but surely arrived here, we are happy to be taking the vegan approach to eating and have been enjoying every second of it.

[The Healthy Librarian]

S&S,

Happy you found the blog--and wishing you good health & excellent eating on the plant-based plan. I sure wish I started back in 1971 when I got married. Happy wedding!

[PGYx]

HL,

I've had a busy summer but read your blog religiously! If I had to pick one blog to inspire people to live happily and healthfully I would (and often do) choose yours!

Oddly enough, the two people who emphasized the "no mortality benefit from stents" have been interventional cardiologists (a.k.a. the folks who place stents).

One of them also told me he sees "much more more coronary disease [on coronary angiograms]" on the east coast than he did during a 12-year stint in Indiana. I asked him why there would be such a difference as I estimated the midwestern diet is no healthier than that of east coasters.

He responded emphatically with zero hesitation: "Stress! They don't have the amount of stress we do here. Stress is a major cause of coronary disease. It's as bad as smoking!"

I don't know if there are any good studies to support his experience, but we do know stress increases blood pressure, which in turn directly contributes to endothelial damage and coronary plaque formation.

I'll take it as one more reason to make happiness a priority!

[Shelly]

I have learned so much from your blog and am thankful you keep writing. My husband who is a meat & potato man watched the special with me and is going to try a couple of meatless days. Hey that's a start. I have been dabbling the last year with going plant based and am more determined than ever now. By the way my local library has on order the video "Forks Over Knifes" and I can't wait to see it when it comes in.

[Willow]

I want to include my thanks for this post and for the links to CNN. I watched it today. And Victoria--I agre with you, too!

[Chris G.]

"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." - Sanjay Gutpa

This statement is extremely profound. Now that we know that the same diet that promotes heart health also promotes brain health and fights cancer, I believe human diets will be progressively transformed from the lethal concoctions consumed today to plant-based diets void of dangerous foods in the (hopefully near) future.