By Caldwell B. Esselstyn, Jr., M.D.
January 17, 20007 — Recent weeks have witnessed a collapse of the drugs and technology which form the present back bone of cardiology’s assault on the coronary artery disease epidemic. Is this a dark shadow over our cardiac health or could it be a time to rejoice?
Pfizer, in late December 2006 announced its long hoped for block- buster new drug Torcetrapib was killing more people in its test run than were dying in the control group. Pfizer had spent 800 million in developing this drug to raise HDL, “good” cholesterol and had openly forecast it would reap billions for the company once it came into production. But the research trial was clear and unequivocal with its results. Among 15,000 patients, 82 died taking Torcetrapib and 51 died taking a standard drug to lower cholesterol Additionally the Torcetrapib group experienced a greater number of cardiac events such as angina, heart failure, and a need for angioplasty. The independent monitoring group advised Pfizer to halt the trial and they complied. The unfathomable mysteries of human metabolism could not tolerate the assault of this drug. It was making vascular disease worse not better.
The double whammy for cardiology also developed in the second half of 2006. Reports from Europe in September 2006 indicated that patients utilizing the new drug eluting stents were suddenly having heart attacks and some were dying. While the number was small (0.5%), it was disturbing to cardiologists and remains frightening for patients.
When an artery to the heart is severely narrowed and causing symptoms cardiologists insert a balloon tipped catheter to the area of blockage and expand the balloon to widen the constriction. The benefit of this angioplasty is lost in 50% of patients because of recurrent constriction in 6 months. Placing a metal scaffold or stent improves the results to only 10% to 20% recurrent narrowing. Starting in 2003, stents were coated with a drug which diminished the rate of recurrent blockage after angioplasty. However, it is essential to maintain patients on an anti clotting drug for 6-12 months to prevent the stent from developing a clot or thrombosis. It now appears that after stopping the anti-clotting drug 1 in 200 or 0.5%or 5,000 nationwide and 10,000 persons worldwide will have a heart attack and 50% of these will die when the stent fails. These results have so upset cardiologists and the Federal Drug Administration that a national conference was called in December 2006 to review this disturbing news. Watching intently and participating were the stent manufacturers Johnson and Johnson and Boston Scientific. Billions of dollars are at stake.
Following testimony, experts contend that for patients with uncomplicated disease the benefits of the drug-coated stents outweighs the risks. For patients with more advanced or complicated disease patterns the outlook is less clear and more research data is required. What is clear is that everyone feels it may be necessary to prolong the period requiring the anti-clotting drug: Plavix from months to years or indefinitely. However Plavix is not without complications. It promotes bleeding, which may mean a gastrointestinal hemorrhage as well as easy bruising. The most desperate situations occur when a patient taking Plavix must stop it for dental work, hip or other major surgery and colonoscopy. Will they have a heart attack or die from a stent clot when Plavix is stopped? This scenario has occurred and is continuously encountered. It is as if a therapy for one disease now is painting patients into a corner from which they can not escape when other illnesses require surgical therapy.
This Gordian knot has lead leading cardiologists to question stent therapy.
Dr. Eric Topol, a member of the conference panel stated, “There’s a much more liberal use of angioplasty and stenting than there needs to be.”
The head cardiologist at Kaiser Permanente, Dr. Calvin L. Weisberger added, “A large pool of angioplasties and by pass surgery are being done with out scientific evidence.”
The hard science, which seems not to be prominent in all these discussions is that it is not the major blockages which are treated by angioplasty and stents which account for heart attacks. The small unstable juvenile arterial plaques are prone to rupture and cause over 85% of heart attacks, and they are not treated by angioplasty or by-pass surgery. Then why do cardiologists treat the blockages unlikely to cause the heart attacks? There is a lingering belief that somehow the patient will be improved by widening the opening, and there is the unspoken force of money – huge guaranteed money from doing these procedures.
Then there is the harshest critic of all- scientific research. Study after study indicates for most patients undergoing angioplasties and stents, there is no increase in survival and no decrease in heart attacks.
Why might this be a time to rejoice? The morbidity, mortality, expense and transient benefits of a high technology approach toward the coronary disease epidemic, has failed. It is time to realize that the answer to a faulty lifestyle epidemic is not drugs and technology – it is lifestyle. The epidemiologic evidence that coronary artery disease does not exist in cultures consuming plant-based nutrition is robust and overwhelming. There is clear evidence that cultures which switch from a plant based culture to a western diet develop an epidemic of coronary heart disease. Lewis Kuller, Professor of Medicine at the University of Pittsburg School of Public Health, based on his 10 year cardiovascular health study states “all males 65 years of age or older who have been exposed to the traditional western diet have cardiovascular disease and should be treated as such.
This toxic diet with its burden of animal protein, dairy, processed oils, white flour, sugar, and excess saturated and trans fats and free radicals marinates in our bodies injuring our delicate cellular matrix with every bite at every meal. Science shows us how this occurs. We depend mightily on the capacity of our endothelial cells, which comprise the single cell layer lining our arteries, to manufacture nitric oxide. Nitric oxide is the strongest vasodilator in the body. It causes blood vessels to enlarge, prevents blood flow from being sticky or sluggish, and inhibits arterial plaque formation.
The brachial artery tourniquet test quantifies the endothelial responses. The test requires an ultrasound measure of the diameter of the brachial artery below the elbow before and after an upper arm tourniquet stops blood flow to the forearm for 5 minutes. Normally when the cuff is released and the brachial artery ultrasound measurement is repeated the artery dilates or widens. This occurs from a healthy out pouring of nitric oxide from the endothelium. When volunteers consume cornflakes their brachial artery tourniquet test is normal. If they consume sausage, olive oil, or saturated fat they fail the test. The ingested fat so injures the endothelium that it cannot produce nitric oxide. Regular consumption of the toxic western menu is a cardiovascular disaster. The time is long overdue to challenge the failure of drugs and technology to stop the coronary disease epidemic.
The natural next question is can patients who have severe coronary artery disease arrest and reverse this disease by consuming a totally plant based diet?
Dr. Dean Ornish and this author have investigated this question through scientific peer reviewed study. Dr. Ornish reported his results at one year and again at 5 years. This author reported results at 5 years, 12 years and most recently at 21 years in a book for the public, Prevent and Reverse Heart Disease, Avery /Penguin, February 2007. These studies indicate that fully compliant patients decrease the episodes of angina or eliminate them, decrease their cholesterol, decrease their weight, increase their exercise capacity, and arrest and selectively reverse their disease on follow up x-rays of the coronary arteries. Seeing these patients thrive beyond 20 years of initiating their plant-base therapy is the most powerful reason for wanting the cardiology community to embrace and utilize plant- based nutrition. There is no morbidity, mortality or added expense with plant-based nutrition and benefits endure and improve with the passage of time. Cardiologists say they doubt that patients will follow such a nutritional change. My experience in counseling hundreds of these patients indicates this concern is flatly not true. As a matter of fact, patients rejoice in the knowledge that they have become the locus of control over the disease that was destroying them and are distraught they were never told of this option by their cardiologist.
In summary, the dark shadow cast over cardiology, through failure of its miracle drug and the melt down of drug eluting stents with unforeseen clotting resulting in heart attacks and death should motivate us to look more closely at a proven therapy which is effective and endures and has the potential to eliminate the coronary heart disease epidemic, as well as other chronic western illness such as strokes, hypertension, adult onset diabetes, obesity, impotence and dementia.
Caldwell Esseltyn MD is a preventive cardiology consultant in the Department of General Surgery Cleveland Clinic Foundation, Cleveland, Ohio, and the author of the forthcoming, “Prevent and Reverse Heart Disease” due out February 1, 2007.
What Are Phytosterols?
Phytosterols can help keep your heart and brain young. Find out which foods contain them and how much you need.
The word “phytosterol” may be unfamiliar but you’ve probably been eating them your whole life.
At least I hope you have!
Read on to learn more.
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What Are Sterols?
The word “phyto” means plant, of course. But what does “sterol” mean? Sterols are a family of molecules with a specific shape and structure. Phytosterols are sterols found in plants. The sterols you find in animals are called zoosterols and the best-known of these is cholesterol. And here’s where the link between phytosterols and heart disease comes into play.
How Do Phytosterols Protect Your Heart and Brain?
Stimagsterol appears to inhibit the formation of the beta-amyloid protein that builds up in the brain of people with Alzheimer’s.
Phytosterols and cholesterol are similar enough in structure that they are absorbed through the same mechanisms—and only so many molecules are going to get through the gate. When your diet is high in phytosterols, you absorb less cholesterol. This can lead to lower LDL (or, “bad”) cholesterol levels and and a reduced risk of heart disease.
Even better, new research suggests that phytosterols may also help reduce your risk of Alzheimer’s. One phytosterol in particular, called stimagsterol, appears to inhibit the formation of the beta-amyloid protein that builds up in the brain of people with Alzheimer’s. The research is still preliminary; we have to see if it works as well in people as it does in animals. But if stigmasterol can help protect our brains as well as our hearts, that will be a welcome bonus!
Where Do You Get Phytosterols?
Pistachios, peanuts, sunflower and sesame seeds, split peas, wheat germ, and canola oil are all particularly good sources, but virtually all nuts, seeds, and legumes contain decent amounts of phytosterols. Some fruits and vegetables, including berries, broccoli, Brusells sprouts, and avocado are also good sources. You can also buy foods, such as butter spreads, peanut butter, mayonnaise, and even orange juice, that have been fortified with extra phytosterols.
Vegetarians tend to have higher intake of phytosterols than meat-eaters, probably because they tend to eat more vegetables, nuts, seeds, and legumes. That could be part of the reason that heart disease rates are lower in vegetarians.
See also: Should You Be a Vegetarian?
Of course, you could just go to the vitamin store and pick up a bottle of phytosterol supplements but I would much prefer that you get these nutrients from foods rather than pills. Why? Because foods that are high in phytosterols tend to be high in other nutrients that also protect your health, such as fiber and antioxidants. Eating nuts and legumes is also linked with a healthy body weight, which further protects you from disease. Finally, when you get your phytosterols from whole foods, it’s pretty hard to overdo it. Not so with supplements.
The Case Against Supplements
Extracting individual nutrients from foods and putting them into pills makes it easy to ensure consistently high intakes, no matter what you eat. But isolated nutrients don’t always have the same benefits as they do in a whole food context. Often, some critical co-nutrient is inadvertently left behind. Sometimes taking concentrated amounts of single nutrients leads to imbalances or overloads. Most importantly, when we rely on supplements to supply our nutrients, we rob ourselves of all the collateral benefits of a whole foods diet.
See also: Can You Get Too Many Vitamins?
A high intake of phytosterols can lower your cholesterol, for example, but it can also lower your beta-carotene levels. In the context of a diet that includes lots of fruits and vegetables, this is unlikely to cause a problem. But adding a phytosterol supplement to a diet that’s deficient in fruits and vegetables might. Very high levels of phytosterols have even been linked to an increased risk of heart disease. So let’s not assume that if a little is good, a whole lot more will be a whole lot better!
How Much Phytosterol Do You Need?
The cholesterol-lowering benefits of phytosterols appear to peak about about 2,000 mg per day. That’s probably more than you’ll be able to get from diet alone. (Typical intakes max out around 500mg per day.) I still recommend eating phytosterol-rich foods on a regular basis, but if you’re trying to maximize the cholesterol-lowering effect, you might want to add a phytosterol-fortified food to the mix. Check with your doctor to see what target range she recommends. And don’t forget to load up on the fruits and vegetables for extra beta-carotene.
For those who aren’t worried about their cholesterol, enjoying nuts, seeds, legumes, wheat germ, and avocado is a great (and delicious) way to get the protective benefits of phytosterols, along with the many other benefits of these nutritious, whole foods.
The epidemic of cardiovascular disease is nonexistent in cultures which thrive
predominantly on whole foods, plant-based nutrition. Is it logical to assume that patients
with this disease would be willing to transition to plant-based nutrition and might this
transition halt or reverse the disease? The authors have experience beyond 25 years
demonstrating the success of plant-based nutrition in arresting and reversing
cardiovascular disease. Nevertheless, the medical community is still skeptical of
patients’ adherence and efficacy of this method. We, therefore, report three case
histories of carotid, coronary, and peripheral vascular disease. Each case demonstrates
disease progression and the failure of the standard cardiovascular approaches in
contrast to the prompt, powerful and enduring resolution of disease with whole foods,
plant-based nutrition. These outcomes constitute an additional mandate that patients
with cardiovascular disease be offered a plant-based option which is safe, inexpensive,
empowering, and has the potential to end the cardiovascular disease epidemic.
“[We observed in monkeys] that the amount of coronary artery atherosclerosis was similar in the monounsaturated and saturated fat groups, in spite of the significantly improved LDL cholesterol concentration and LDL/HDL cholesterol ratio in the former.”
2. Dietary Monounsaturated Fatty Acids Promote Aortic Atherosclerosis In LDL Receptor–Null, Human ApoB100–Overexpressing Transgenic Mice, Arteriosclerosis, Thrombosis, and Vascular Biology, 1998
Mice were fed one of 6 diets with different fatty acid content: saturated, monounsaturated (cis and trans), polyunsaturated (n-3 and n-6), and a control diet.
“The reduction in aortic atherosclerosis was not found when either cis or trans monounsaturated fatty acids were fed. Rather, just as much atherosclerosis was seen when cis monounsaturated fat diets were fed as when saturated fat was fed, and significantly more atherosclerosis was seen when the trans monounsaturated fatty acids were fed.”
This is an important outcome when one considers that monounsaturated fats, often in the form of olive oil, are widely promoted as being healthful and effective for protection against heart disease.
3. Effect Of Fat And Carbohydrate Consumption On Endothelial Function, Lancet, December, 1999
“Consumption of a meal high in monounsaturated fat was associated with acute impairment of endothelial function when compared with a [low-fat] carbohydrate-rich meal.”
4. The Postprandial Effect Of Components Of The Mediterranean Diet On Endothelial Function, Journal of the American College of Cardiology, November 2000
“Contrary to part of our hypothesis, our study found that omega-9 (oleic acid)-rich olive oil impairs endothelial function postprandially.
The mechanism appears to be oxidative stress because the decrease in FMD was reduced (71%) by the concomitant administration of vitamins C and E. Balsamic vinegar (red wine product) and salad reduced the postprandial impairment in endothelial function to a similar extent (65%).
In a clinical study, olive oil was shown to activate coagulation factor VII to the same extent as does butter (44). Thus, olive oil does not have a clearly beneficial effect on vascular function.”
The major unsaturated fatty acids in olive oil are oleic acid (18:1n-9) and linoleic acid (18:2n-6) (42). A high-oleic and linoleic acid meal has recently been shown to impair FMD in comparison with a low-fat meal(28). (That’s the study above by Ong et al.)
In terms of their effects on postprandial endothelial function, the beneficial components of the Mediterranean and Lyon Diet Heart Study diets appear to be the antioxidant-rich foods—vegetables, fruits … not olive oil. Dietary fruits, vegetables, and their products appear to provide some protection against the direct impairment in endothelial function produced by high-fat foods, including olive oil.”
Clearly, olive oil is not the heart-healthy food it’s made out to be. It truly is a feat of marketing that a food which has been shown over and over to impair artery function exists in peoples’ minds as an elixir. The Mediterranean diet, with its generous portions of fruits, vegetables, and whole grains, improves health not because of olive oil, but in spite of it.
In this guest blog, Kim A. Williams, MD, a cardiologist at Rush University in Chicago and the next president of the American College of Cardiology, explains why he went vegan and now recommends it to patients.
Physicians want to influence their patients to make lifestyle changes that will improve their health, but sometimes the roles are reversed and we are inspired by patients. It was a patient’s success reversing an alarming condition that motivated me to investigate a vegan diet.
Just before the American College of Cardiology’s (ACC) annual meeting in 2003 I learned that my LDL cholesterol level was 170. It was clear that I needed to change something. Six months earlier, I had read a nuclear scan on a patient with very-high-risk findings — a severe three-vessel disease pattern of reversible ischemia.
The patient came back to the nuclear lab just before that 2003 ACC meeting. She had been following Dean Ornish, MD’s program for “Reversing Heart Disease,” which includes a plant-based diet, exercise, and meditation. She said that her chest pain had resolved in about 6 weeks, and her scan had become essentially normalized on this program.
When I got that LDL result, I looked up the details of the plant-based diet in Ornish’s publications — 1- and 5-year angiographic outcomes and marked improvement on PET perfusion scanning — small numbers of patients, but outcomes that reached statistical significance.
I thought I had a healthy diet — no red meat, no fried foods, little dairy, just chicken breast and fish. But a simple Web search informed me that my chicken-breast meals had more cholesterol content (84 mg/100 g) than pork (62 mg/100 g). So I changed that day to a cholesterol-free diet, using “meat substitutes” commonly available in stores and restaurants for protein. Within 6 weeks my LDL cholesterol level was down to 90.
I often discuss the benefits of adopting a plant-based diet with patients who have high cholesterol, diabetes, hypertension, or coronary artery disease. I encourage these patients to go to the grocery store and sample different plant-based versions of many of the basic foods they eat. For me, some of the items, such as chicken and egg substitutes, were actually better-tasting.
There are dozens of products to sample and there will obviously be some that you like and some that you don’t. One of my favorite sampling venues was the new Tiger Stadium (Comerica Park) in Detroit, where there are five vegan items, including an Italian sausage that is hard to distinguish from real meat until you check your blood pressure — vegan protein makes blood pressures fall.
In some parts of country and some parts of world, finding vegan restaurants can be a challenge. But in most places, it is pretty easy to find vegan-friendly options with a little local Web searching. Web searching can also help with the patients who are concerned about taste or missing their favorite foods. I typically search with the patient and quickly email suggestions.
Interestingly, our ACC/American Heart Association (AHA) prevention guidelines do not specifically recommend a vegan diet, as the studies are very large and observational or small and randomized, such as those on Ornish’s whole food, plant-based diet intervention reversing coronary artery stenosis. The data are very compelling, but larger randomized trials are needed to pass muster with our rigorous guideline methodology.
Wouldn’t it be a laudable goal of the American College of Cardiology to put ourselves out of business within a generation or two? We have come a long way in prevention of cardiovascular disease, but we still have a long way to go. Improving our lifestyles with improved diet and exercise will help us get there.
Blood pressure rises naturally in response to a clogging of your blood vessels in order to deliver oxygen and nutrients to your body. The pharmaceutical industry’s answer is to inhibit the natural mechanisms of the body, causing the pressure to fall. The problem with this artificial reduction of pressure is that nothing helpful has been accomplished by the medication to improve the health of the blood vessels themselves. The arteries remain fragile and ready to burst into a stroke or heart attack. Attacking the cause of the problem – the rich Western diet – cleans up and strengthens the blood vessels and reduces the resistance to blood flow. Your blood pressure will then fall naturally. In less than 2 weeks of following the McDougall Program, people with high blood pressure (150/90 mmHg or greater) experience an average reduction of 23/14 mmHg and in most cases significantly reduce or stop all blood pressure medications.
Related Newsletter Articles
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- November 2009: How I Treat Patients with Elevated Blood Pressure
- August 2008: Salt, The Scapegoat for the Western Diet
- May 2008: Monitor Blood Pressure at Home Says the AHA
- August 2006: Over treating Blood Pressure Kills
- February 2008: Intensive Therapy Means You Will Die Sooner with Good Looking Numbers
- March 2011: BP Pills (ARBs) Increase the Risk of Dying
- July 2013: Salt Sugar Fat: How the Food Giants Hooked Us
- August 2002: Take Blood Pressure at Home – Get Off Your Medications
- July 2004: Over-treat Your Blood Pressure and You Could Die Sooner
- December 2004: Blood Pressure Pills (Calcium Channel Blockers*) Kill
- March 2004: Hypertension Caused by Blood Flow Restriction
- February 2007: Disease Mongering: New Women’s Guidelines for Heart Disease
- January 2004: Hot Tubs Are Safe for People with High Blood Pressure
- May 2004: Soon Children Will Be on Blood Pressure Pills
- June 2007: Save Your Kidneys—Part 1 The Hard Way, with Medications2009 John McDougall All Rights Reserved
Consuming too much sugar can increase the risk of premature death from heart disease, a finding that is fuelling calls for the Canadian and U.S. governments to offer dietary limits on sugar.
For an adult consuming 2,000 calories a day, drinking the equivalent of a bottle of pop sold in vending machines would exceed the level that a new U.S. study suggests raises the risk of death from cardiovascular disease (CVD).
“A higher percentage of calories from added sugar is associated with significantly increased risk of CVD mortality,” lead author Quanhe Yang of the U.S. Centers of Disease Control and Prevention in Atlanta and co-authors conclude in this week’s issue of the journal JAMA Internal Medicine.
The researchers analyzed national health and diet surveys between 1988 and 2010 of more than 30,000 Americans with an average age of 44. They found the fatal heart risk became elevated once added sugar intake surpassed 15 per cent of total calories.
“Too much sugar does not just make us fat; it can also make us sick,” said Laura Schmidt, a health policy specialist at the University of California, San Francisco, who wrote a commentary accompanying the study.
Previously, sugar used in processed or prepared foods, such as sugar-sweetened beverages, dairy desserts, candy, ready-to-eat cereals and yeast breads, has been linked to increased risks for non-fatal heart problems and with obesity. Naturally occurring sugars in fruit aren’t included.
Sugar is hugely important to the trillion-dollar processed food industry, said Michael Moss, a journalist in New York and author of the book, Salt Sugar Fat.
“They’re a very powerful lobby,” Moss said in an interview Tuesday.
“It’s very frustrating for consumers, especially when you go in and buy a product, look at the label and there’s a blank spot next to sugar. There is no government recommendation on how much sugar you should be capping yourself on and consuming in a day.”
The Canadian and U.S. governments don’t provide dietary limits for added sugar and there isn’t a consensus on how much is too much.
“What we really need as Canadians is more information,” said Dr. Yoni Freedhoff, an obesity doctor in Ottawa. “We need food labels that don’t allow for sugar synonyms and actually list the amount of added sugar there.”
To get a sense of sugar amounts, Freedhoff suggests that consumers take the number of grams of sugar on a package and divide by four to get the number of teaspoons.
Yang’s findings add to a growing body of rigorous studies that demonstrate added sugar “is not as benign as once presumed,” Schmidt said.
“Proponents of sugar taxes and sugar controls have a new arrow in their quiver and it’s this linkage to deadly heart disease,” Moss said. “That’s a very powerful tool in the hands of policymakers.”
Schmidt notes that the American Heart Association recommends no more than 25 grams a day or six teaspoons of sugar for women (five per cent of a 2,000-calorie a day diet) and 38 grams or nine teaspoons a day for men (7.5 per cent of daily calories).
In 2005, a panel at the Institute of Medicine, which advises the Canadian and U.S. governments, recommended added sugar make up less than 25 per cent of total calories. The World Health Organization (WHO) recommends less than 10 per cent.
Expert committees from the Institute of Medicine have concluded there’s no evidence of harm attributed to current sugar consumption levels, the Canadian Sugar Institute said in a statement to CBC News.
A spokeswoman for the trade group said Canadian sugar intakes are about 11 per cent of total calories. “There is no magic number because our age, gender and activity levels are all different.”
In the study, 831 people died from heart disease during the 15-year followup. The researchers took
other factors that contribute to heart problems, including smoking, inactivity and excess weight into account.
Many doctors treating heart disease tend to prescribe drugs known as statins like Lipitor, but some physicians in Canada are trying a new method: a vegan diet.
Heart disease is the second leading cause of death in Canada. It kills 47,627 Canadians every year.
Dr. Shane Williams is a community cardiologist in Bracebridge, Ont. He’s been a vegan since 2010. Vegans don’t eat meat, fish, poultry, eggs, dairy products, or honey. They do however, eat fruits, vegetables, whole grains, nuts, seeds and legumes.
“People do not know the power of food,” Williams told CBC News
For the past four years, the cardiologist has been slowly refocusing his patients on lifestyle changes.
“The challenge is that this takes time,” said Williams.
Starting in 2011, he started using a plant-based diet for patients who were interested and added group counselling sessions circling on veganism.
Williams says this is making a big difference in patients who are willing to keep an open mind about their diet.
“I see it here first hand, and it is simply amazing,” he said.
Liam Cragg, 59, ofBracebridge, Ont. is one case.
In 2012, he went to the hospital because he exhibited signs of a heart attack. Cragg followed up with his family doctor a week later who referred him to Williams. After four months on a mostly plant-based regime, Cragg noted a big difference.
“I was at least 30 pounds lighter, my waistline had shrunk by four inches and my knees didn’t ache anymore,” said Cragg.
Williams says he commonly spends 60 minutes or more with patients at their initial assessments.
“My experience is that most cardiologists tend to spend 15 to 25 minutes on a first assessment,” explains Williams, who says he’s trying to get “into the mechanics of a particular patient’s motivation for their eating habits.”
The cardiologist would like to see more doctors take an alternative approach in treating patients and specifically, honing in on their behaviour.
“What concerns me is that most doctors do not realize the power of food as an alternative to medication,” said Williams.
He is not alone about his theories about veganism and heart disease.
Herbivore vs Carnivore
Dr. William Roberts, a prominent cardiovascular pathologist and the editor of the American Journal of Cardiology, also believes that a vegan diet is the solution to heart disease in the Western world.
Roberts contends that the cause of heart disease is elevated cholesterol from not eating vegan.
“Human beings are far more like herbivores than carnivores,” he said.
Some experts argue that the structure of our teeth, and the length of our intestinal tract, are indications that humans are more herbivore oriented. While carnivores have sharp teeth, the majority of ours are flat, which is ideal for grinding fruits and vegetables. Carnivores have short intestinal tracts, but ours are very long.
Meat consumption has been linked to higher risks of developing heart disease, cancer and diabetes and there’s a lot of evidence connecting diet and disease.
For example, in plant-based cultures like rural China, central Africa, the Papua highlanders in New Guinea and the Tarahumara Indians of northern Mexico, coronary artery disease is almost nonexistent.
When these people adopt Western, animal-based diets however, they quickly develop heart disease.
Roberts argues that the plant-based diet is both cost effective and safe.
“If we put everyone on drugs then thousands of people would suffer side effects, so of course a vegan diet is the least expensive and safest means of achieving the plaque preventing goal,” he said.
Statins can be effective
But, statins, which are cholesterol-lowering drugs, are one of the most commonly used medications in North America and there’s some argument that they’re effective, if used properly.
- Statin benefit questioned for heart disease prevention
- Cholesterol-lowering statins more widely recommended in the U.S.
A study, published in Annals of Family Medicine last week, analyzed 16,712 responses from people aged 30 to 79 years-old. Americans who filled at least two prescriptions for statins were classified as statin users.
According to the authors, many people at high risk for heart disease were not getting the statins they should be.
“A lot of people who [might have] benefited aren’t on statins, and we don’t know why that is,” said Dr. Michael Johansen, the study’s lead author.
‘Statins should be reserved for very sick people, and a healthy diet is for everyone.’– Dr. John McDougall, leading expert on diet and heart disease
He said this could be for a number of reasons, including doctors who aren’t prescribing them, patients who don’t have health insurance, or people who aren’t taking medications they’re given.
“As doctors we need to make sure patients understand the benefits, and are being compliant. We need to make sure everyone has access to these drugs from an insurance, and access to care perspective,” said Johansen.
Dr. John McDougall, an American physician and a leading authority on diet and heart disease, says statins should be the last solution.
McDougall thinks that heart disease can be prevented and treated with a diet consisting of starches, vegetables and fruits, but no animal products or added oils.
“Statins should be reserved for very sick people, and a healthy diet is for everyone,” said McDougall.
Back in Bracebridge, Williams and McDougall will be holding what they call an “immersion weekend” sometime in late summer or early fall at the clinic with McDougall participating in a Skype discussion with patients.
Food before drugs
For Williams the focus should be on prevention.
“What we’re told by pharmaceutical companies is that only 10 per cent of the cholesterol in our bloodstream is what we consume, and the rest is made by our liver. What they don’t tell us is that the Western diet causes the liver to over produce cholesterol — a pretty significant ‘oops we forgot to tell you’ on the part of pharmaceutical companies,” said Williams.
The plaque that builds up in our arteries is made of cholesterol, but when our cholesterol is low enough there’s nothing for our body to build plaque with.
“The best way to prevent heart disease is to be a vegetarian-fruit eater, a non-flesh eater and a non-saturated fat eater,” said Roberts.
Want a flatter, leaner tummy? Remove from your diet white, processed grains like white bread and white rice, and eat more whole grains such as oatmeal, barley, bulgar, 100% whole-wheat bread, whole-wheat pasta, and brown rice, research has found.
Studying 50 obese men and women, scientists at Pennsylvania State University put all 50 subjects on a calorie-reducing diet for 12 weeks, but divided them into two groups. Half were instructed to eat whole grains; the other half were told to choose refined, processed grains, like white-flour foods.
After 12 weeks, average weight loss for both groups was about the same: 8 to 11 pounds. But the whole-grain group showed significantly greater reductions in the percentage of fat around the middle, the researchers reported in the American Journal of Clinical Nutrition.
That’s great news not only for a svelte tummy but also for health. Numerous studies published over the past two decades have found that belly fat is particularly harmful to our hearts and health. Abdominal fat is one of the characteristics of a now-epidemic condition in the U.S. called the metabolic syndrome, which is a collection of several risk factors for diabetes, heart disease, and stroke.
Belly fat is also linked with chronic low-level inflammation in the blood vessels, which in turn is a harbinger of heart attacks and strokes. Another risk factor that tumbled among the whole-grain eaters (and not the refined grain eaters) in the Pennylvania State University study was a key marker of chronic inflammation – C-reactive protein, or CRP.
Similarly, research on people who adopted the Pritikin Program found that CRP levels plummeted. Within two to three weeks, C-reactive protein decreased 45% among women, 39% among men, and 41% among children.Metabolism, 53: 377, 2004; Journal of Applied Physiology, 100: 1657, 2006; Atherosclerosis, 191: 98, 2007.
At the Pritikin Center, guests learn their fat-to-muscle ratio via DEXA Body Composition Scanning. After two to three weeks, follow-up scanning reveals how powerful Pritikin living is in shedding fat and increasing muscle.Studies have also found that among both adults and children, the Pritikin Program reversed the clinical diagnosis of metabolic syndrome.
“But please don’t feel complacent if you don’t have a pot belly,” urges Dr. Danine Fruge, Associate Medical Director at the Pritikin Longevity Center.
“There’s a tragic – and growing – problem in our country, and we doctors call this problem TOFI, which means thin on the outside and fat on the inside.”
You are a TOFI if your weight is normal, but your body mass shows a high ratio of fat to muscle. You may not see the fat, but it’s there, under the skin, and deposited around and inside the internal organs, including the heart, muscle, and liver. It’s largely the result of our sedentary lifestyles — our lack of muscle use — and our fatty, sugary, white-flour-focused calorie-dense diets.
At the Pritikin Longevity Center, guests learn their fat-to-muscle ratio via DEXA Body Composition Scanning. After two to three weeks, follow-up scanning reveals how powerful Pritikin living is in shedding fat and increasing muscle. The end result is a leaner, fitter, better toned body.
What does it mean to be a TOFI? “It means,” warns Dr. Fruge, “that despite normal weight, you are still at increased risk for diabetes, heart disease, and other diseases related to obesity.”
Bottom line: Excess body fat, whether it’s around your belly or deep within, is dangerous.
“So get up and get moving!” encourages Dr. Fruge. “And enjoy the many benefits of the Pritikin Eating Plan, rich in healthful whole foods like whole grains, fruits, vegetables, and beans.
“I know of nothing else in medicine that comes close to what a healthy lifestyle like Pritikin can do.”