2.90 Reversing Heart Disease with Diet

In this HeartStrong.com video/article, we are going to talk about reversing…yes reversing heart disease with diet. Atherosclerosis, the cholesterol build-up in the arteries of the body including the heart, can be reversed with diet. This is achieved with a specific pattern of plant based nutrition. It is very important to note that no other dietary pattern has ever been shown to angiographically reverse heart disease in humans and animal studies support this as well.

While there are many fad diets, popular books and theories about what we should be eating to prevent diseases including heart disease, again, only a whole food plant based diet low in fat (10% or less) has been shown to actually reverse atherosclerosis and it has been shown to do so in more than 1 publication1-3. Whenever you are presented with a question from family or friends about any other dietary pattern, simply ask them the question “Has this diet been shown to reverse heart disease in peer reviewed publications” and the answer will be no.

Initially developed by Nathan Pritikin who was diagnosed with severe angina, then meticulously studied nutrition discovering that a whole food plant based diet low in fat is the optimal dietary pattern. He eventually died in 1985 at the age of 69 after a long battle with leukemia (diagnosed prior to his diet changes) and his autopsy report was published in the New England Journal of Medicine4. He was found to have no significant heart disease or atherosclerosis in any artery proving that he was indeed able to reverse his heart disease with diet.

The “Esselstyn Diet” developed by Dr. Caldwell Esselstyn at Cleveland Clinic as discussed in detail in his groundbreaking book “Prevent and Reverse Heart Disease” and the Ornish Diet developed by lifestyle medicine pioneer Dean Orinish M.D. are the two published programs shown to reverse heart disease. These will be discussed in detail below after a brief review of animal research on the same topic.

Reversing Heart Disease

While HeartStrong.com does not advocate the use of animals in medical research presently and in the future, much can be learned from animal studies of diet and atherosclerosis in the past. Here is what we have learned.

Animals out in nature such as monkeys and rabbits eat a predominately whole food plant based diet (i.e. bananas and carrots) and are physically active. They do not get ANY atherosclerotic cholesterol plaque in their arteries in their natural environment. Humans, on the other hand, as young as the age of 35-7 have been seen to already have cholesterol fatty streaks building up in their aorta and by the age of 10 nearly all children already have fatty streaks. Now…if you feed a monkey/rabbit a diet high in cholesterol and saturated fat (meat and egg yolks), researchers can quite easily cause the arteries to clog with cholesterol.

The theory of evolution states that humans evolved from monkeys. The standard American diet is very high in cholesterol and saturated fat frequently consisting of eggs/bacon/sausage for breakfast, lunch meats or burgers for lunch and beef/pork/chicken/fish for dinner. Chicken ends up being the #1 source of cholesterol in the American diet due to the large volume Americans eat (eggs are the #2 source). Americans put cheese on our breakfast, cheese on our lunch and cheese on our dinner. Cheese is the #1 source of the bad saturated fat in the American diet. This is why we get heart disease.

The research gets better though. We know that if you take these animals that were just clogged up with cholesterol and stick them back into their natural environment (their natural whole food plant based diet), they have the ability to actually starting breaking down and reversing the cholesterol plaque8-11! Researches said…why don’t we try this in humans. So they did.

The Esselstyn Diet

Caldwell Esselstyn M.D. is a leader in heart disease reversal with only changes in nutrition. If your goal is to reverse atherosclerosis, then his book Prevent and Reverse Heart Disease is a must read.

The Esselstyn Diet consists of 100% of calories from plant based sources with no added oil or sugar, however the goal is to achieve 10% or less of calories from fat. This requires eliminating higher fat plant foods as well such as nuts, seeds, avocado and certain soy such as tofu. Having said this, his book gives a myriad if recipes that fit this pattern, are easy to make and are quite enjoyable.

Those following the Esselstyn Diet had a 0.6% incidence of heart attack, stroke and death from cardiovascular disease versus a control group were the rate was 63%, more than 100 times higher. This low incidence has led to the phrase “heart attack proof” for those following this dietary pattern. Bill Clinton follows a similar plan with minimal deviation. An interesting CNN investigation by Dr. Sanjay Gupta is worth watching.

This publication titled, “A Way to Reverse CAD?” where CAD stands for “Coronary Artery Disease” is a good read for those who are interested.

It is important to note that the Esselstyn Diet did not include any exercise or other lifestyle changes, just changes in nutrition. Despite this fact, powerful results were seen.

The Ornish Diet

Dean Ornish M.D. showed in the Lifestyle Heart Trial that a low fat whole food plant based diet with other lifestyle changes can “angiographically” reverse the atherosclerosis that occurs in the heart causing heart disease. This means that patients were tested before and after undergoing the lifestyle changes in the Ornish program via coronary angiography, an invasive procedure to check how much cholesterol plaque they had built up in their arteries.

This trial was randomized, thus some patient’s were in the Ornish program and there was also a “control group” where standard recommendations were given. Then the subject’s coronary angiograms were sent to an independent lab, blinded as to “before” or “after” AND also blinded as to which group the patient was in, Orinsh program or the control group.

Those in the Ornish group had significant “regression” or reversal of heart disease compared to the control group at 1 year and it was even more pronounced at 5 years. More importantly though, heart attack risk was dramatically reduced on the Ornish Plan group.

The Lifestyle Heart Trial was published in the Journal of the American Medical Association in 1998 and and is a good read if interested by patients looking to reverse their heart disease.

1. Ornish et al. Can Lifestyle Changes Reverse Coronary Heart Disease? LANCET. 1990;336:129-133.
2. Ornish et al. Intensive Lifestyle Changes for Reversal of Coronary Heart Disease. JAMA. 1998;280:2001-2007.
3. Esselstyn et al. A Way to Reverse CAD? J Fam Pract. 2014;63:356-364,364a,364b
4. Nathan Pritikin’s Heart N Engl J Med. 1985 Jul 4;313(1):52
5. Holman RL, McGill HC Jr, Strong JP, Geer JC: The natural history of atherosclerosis: the early aortic lesions as seen in New Orleans in the middle of the 20th century. Am J Pathol 34: 209, 1958
6. Strong JP, McGill HC Jr: The natural history of aortic atherosclerosis. Relationship to race, sex, and coronary lesions in New Orleans. Exp Mol Path 2(suppl 1): 15, 1963
7. J. P. Strong, H. C. McGill. The pediatric aspects of atherosclerosis. J Atheroscler Res 1969 9(3):251 – 265.
8. Armstrong ML. Evidence of regression of atherosclerosis in primates and man. Postgrad Med J. 1976;52:456–61.
9. Armstrong ML, et al. Regression of coronary atheromatosis in rhesus monkeys. Circ Res. 1970;27:59–67
10. Malinow MR. Experimental models of atherosclerosis regression. Atherosclerosis. 1983;48:105–18
11. Armstrong ML. Evidence of regression of atherosclerosis in primates and man. Postgrad Med J. 1976;52:456–61

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