Prevent and Reverse Heart Disease by Caldwell B. Esselstyn Jr. M.D.

Read about my personal experience with the Esselstyn diet.

Seldom, if ever, have I read a more compelling argument. Dr. Esselstyn’s presentation of the rational for a plant based diet is clear, concise and demands action.

I have heart disease. Specifically, I have coronary artery disease — the clogging of the arteries that supply blood to my heart.  I have stents in my heart. I have cholesterol levels, once thought ‘normal’, now considered in the dangerously high range — around 210 mg/dL. I have tried the statin drugs to reduce my cholesterol; but I do not tolerate them at all well. I have tried to moderate my diet and increase my activity levels. But my cholesterol remains in that range.

If you believe you do not have heart disease here are a few comments from the book that you might want to reflect on:

  1. For one quarter of the people who are diagnosed with heart disease, the first symptom is sudden death!
  2. Each year in the United States, more than half a million people die from coronary disease.
  3. Autopsies of Vietnam war dead revealed that over 80% of casualties showed signs of coronary artery disease. These were generally young men in their late teens or early twenties who were in the prime of life and physically fit.

I read this book (it is an easy read) on 1 February 2012 during a 3 hour flight. By 3 February I had adopted his diet. What was so compelling in this presentation? Essentially what struck me so emphatically were the following four major points:

  1. Dr. Esselstyn formulated a plan of action to take 24 persons to whom cardiologists had indicated they could do no more for them and that they essentially should go home and would die in a fairly short time. These persons were placed on a strict plant based diet. Subsequently 6 of these patients withdrew from the study and reverted to their usual diet. Of the 18 persons who stayed on the program, and had had 49 cardiac incidents prior to the study, there was only one incident of a cardiac event in the next 12 years, and this was for a patient who had gone off the diet for 18 months. Of those who withdrew there were 11 cardiac incidents and two deaths.
  2. Dr. Esselstyn notes that persons with a cholesterol level below 150 mg/dL generally do not have the symptoms of heart disease. This level of cholesterol is common in parts of the world where people live on a plant based diet — generally in the undeveloped nations. But he also notes that as these populations become more affluent and adopt western eating styles they evolve to western levels of morbidity from heart disease. This information, in part, is from “The China Study” and substantiates the basis for Dr. Esselstyn’s  plant based diet.
  3. Moderation kills. In a well reasoned chapter Dr. Esselstyn discusses the issue of how strictly his diet needs to be followed. The moderation diet (low fats, fish, olive oil, etc.) — the kind I have followed for years — just puts far too much fat and cholesterol into the body — and it causes continued (if perhaps slowed) progression of heart disease. An interesting part of this argument is the effect that even one fatty meal can have on your arteries; he describes a test that has been performed that shows that it can take up to 6 hours to recover from such a dietary event.
  4. The program reverses the damage of heart disease. This, of course, is the most compelling part of his argument. If you have heart disease (and you probably do if you live on a western diet) there is hope of reversing this damage. This is illustrated by angiogram photographs showing how blocked coronary arteries have recovered fully after three years on the diet. Similar examples exist for the unclogging of blocked arteries in the legs.

This is just an outline of the information in the book. There is much more. The book has about 300 pages. The first 118 deal with the medical argument which I have partially summarized above. The remainder of the book is a cookbook — recipes for the diet itself, which, simply, is:

  • plant based foods only and that means:
    • no meat
    • no fish
    • no dairy
  • no oils, meaning
    • no animal based products such as butter or cheese, but also
    • no olive oils or canola oils or other vegetable oils
    • no avocados
    • no nuts

This book needs to be read. And you need to act on its recommendations! (You can buy this book at Dr. Esselstyn’s website or at Amazon.)

I have just been on this journey for a month. Surprisingly, I have not had any particular difficulty with the diet. I do not crave meat or fish or dairy products or oils. If anything, this diet has given me a much easier time with my digestion and it seems to me that my skin is healthier and that I have a bit more energy. I will have my next cholesterol test in another month or so and will see how quickly and to what extent I am progressing at that time.


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