I had a very pleasant surprise this afternoon: a call from Caldwell B. Esselstyn, MD. You may not have heard of Dr. Esselstyn, but if you or someone in your family has heart disease or diabetes you should find out more about him.
Dr. Esselstyn is a surgeon at the Cleveland Clinic, and the author of a 2007 book, Prevent and Reverse Heart Disease, in which he presented in layman’s terms the results of his research on dietary approaches to prevent, stop further progression of and even reverse cardiovascular disease, the number 1 cause of death in the United States. Another physician, Dean Ornish, MD, had published similar findings about 20 years ago, and both published the results of their research in peer-reviewed cardiology journals.
Both Dr. Ornish and Dr. Esselstyn found that severely-ill patients, most of whom had had heart attacks or chest pain, improved dramatically after changing to a plant-based diet. Even though the evidence is clear that plant-based diets work as well or better than medications like statins, most cardiologists won’t even mention these studies to their patients because they assume most patients won’t tolerate such “strict” diets.
I have a family history of heart disease, and even though I’ve never experienced chest pain of any kind, six months ago I decided to follow Dr. Esselstyn’s recommendations to see what would happen, if anything. Think of the Esselstyn diet as a low-fat vegan diet, because to me that describes it very well: no meat, fish, dairy or oils of any kind (not even olive oil). In a show of support, my wife also went on the same diet. After 3 months on the Esselstyn regimen I had lost some weight, gone from a 35 inch waist to a 33 inch waist, and reduced my serum cholesterol and LDL-cholesterol (the bad kind) so much that my cardiologist cut my statin dose in half. I felt healthier than I have in a long time. I made even further progress in the following 3 months, but that’s a story for another article.
My wife and I had already reduced our consumption of meat and fish over the past few years, eliminating them completely didn’t present the problems for us that most Americans might have in giving up meat. Giving up cheese (think pizza) and ice cream were the hardest things for me.
As a scientist, I like objective evidence to confirm that any changes I make in my lifestyle are having an effect. Here are the results: after 3 months my cholesterol dropped from 181 mg/dL to 134 mg/dL, and my LDL cholesterol dropped from 90 mg/dL to 65 mg/dL. I don’t know my LDL particle count (LDL-P) before we started the diet, but after 3 months it was 1,163 (“optimal” is less than 1,000). I did a literature search hoping to find dietary methods to reduce LDL-P, but the only food items I found that had been shown to do so were pistachios and avocados, both high-fat foods that Dr. Esselstyn recommends avoiding. Still, I started eating small amounts of avocado and moderate amounts of pistachios about a month ago. See my August 20th blog about LDL-P.
I wrote to Dr. Esselstyn recently, asking what he thought about the pistachio/avocado evidence, and whether limited amounts of pistachios and/or avocados might be permitted on his diet. I expected the reply to be a form letter from one of his secretaries, so when he called me personally I was pleasantly surprised. We spent a little over 15 minutes discussing the newer lipid tests for particle count and particle size. In the end he told me what I already knew: one lab result isn’t enough evidence to prove or disprove that dietary change is the cause of the test result change. Further, even if the pistachios and/or avocados did decrease my LDL-P, we don’t know whether such a change would present an improved outcome for my health.
Personally, I’m convinced that following the Esselstyn diet will reduce my chances of having a myocardial infarction (heart attack). If you or someone in your family has a history of heart disease, I strongly urge you to look into Dr. Esselstyn’s research and the improvement in outcomes his plan has made for many patients (many had no further chest pain; others were able to reduce or elininate their medications). While medications treat the symptoms of the disease, the Esselstyn diet addresses the cause of the disease. A lot of information is available free on his web site: http://www.dresselstyn.com/site/articles-studies/.