By Dr. Frank Sabatino

Cardiovascular disease is the number one killer of men and women in the US, accounting for 20-30% of all fatalities. Shockingly, autopsies on teenagers and young adults, that have died from other causes, revealed widespread damage and blockage of blood vessels to the heart (coronary artery disease) already existing in this population of young people.  However,  the shameful indictment of the multi-billion dollar cardiac healthcare industry is that this problem does not even exist in more than half of our planet,  especially in a wide variety of countries and indigenous  cultures that thrive on whole food plant nutrition with the minimal intake of animal products.(1)

The typical diet in the US is predominantly processed/ultra-processed food and animal products, and severely deficient in nutrient dense, anti-oxidant rich fresh fruit, leafy greens, vegetables, legumes, nuts, and seeds . This imbalance significantly increases chronic inflammation and exaggerated free radical damage referred to as oxidative stress. 

As a result, blood vessels to the heart are irritated and inflamed. The chronic inflammation damages endothelial cells that line the inner surface of coronary vessels that border the space through which blood flows. In response to this damage, the immune system sends white blood cells (macrophages ) to target and heal this damage. In the process, macrophages gobble up oxidized cholesterol (oxysterols and LDL-cholesterol) to produce fatty foam cells and plaque that block blood supply and oxygen to the heart. In addition, damaged endothelial cells can not effectively convert the amino acid L-arginine to nitric oxide that dilates coronary vessels to improve blood flow. This combination of vascular blockage and constriction promotes  heart damage, disease and death. 

The sad commentary, but good news, is that while heart disease is a devastating killer, we have learned  enough about nutrition over the past 30-40 years to never have this problem happen to anyone ever again. Landmark studies by Drs. Esselstyn and Ornish have clearly shown the power of low fat, whole plant food for both preventing and reversing heart disease. In Dr. Esselstyn’s initial study in 1985, a significant number of people with advanced coronary artery disease, on a very low fat plant-based diet without any meat, fish, dairy products and oils, showed a reversal of disease including a widening of coronary arteries, and a 70% regression of arterial plaques on five year follow up angiograms. (2) People that adhered to his program had no further cardiac events over a 12 year follow up period even though this same group had almost 50 major negative cardiac events in the year before entering this study. In addition cholesterol levels dropped significantly to an optimal level below 150mg/dl, and many patients reported that chest pain (angina) had significantly diminished or disappeared within weeks of starting the program. In an expanded study of 198 people in 2014, people that complied with the low fat whole plant diet had a rate of cardiac events less than 1%, compared to almost 70% for non-compliant patients, over a period of almost 4 years. 

In a five year study from 1986-1992, Dr. Ornish and his team subjected people with moderate to severe heart disease to a program of low fat whole plant food, aerobic exercise, group psychological support and stress management. The people that completed his 5 year follow up plant food/lifestyle program  showed a significant progressive reduction of coronary atherosclerosis, and increased diameter and blood flow in coronary blood vessels to the heart. The control group that did not follow this program had a progressive increase in vascular blockage over the 5 year period with more than twice as many negative cardiac events. (3) 

A real world story from Dr. Esselstyn further exemplifies the power of plant food to prevent and reverse heart disease. A 74 year old male who had a heart attack at age 42 and a stroke at age 45, had a 100% blockage in his right carotid artery, and 27% blockage of the left carotid artery a that resulted in bypass surgery. Despite medical treatment and modest diet changes reducing sugar, fat and meat in his diet, the blockage of his left carotid artery progressed to 80-90% occlusion. In a few short years, he had daily angina attacks and his physician had given up on him. He subsequently found and followed Dr Esselstyn’s  more rigorous whole food program. Within one month his angina and chest pain disappeared and he lost 41 pounds in four months. Within a few years he reduced the blockage in his left carotid artery to 50-69%, eliminated constant fatigue, remained very physically active and became so busy living he no longer thought about dying.

Make no mistake, whole plant food  can absolutely prevent and reverse heart disease. Eliminate all processed foods and focus on eating several pieces of fresh fruit, salad, and  a wide variety of steamed and sauted greens daily. Include the routine consumption of sweet and white potatoes and whole grains, exchange high protein lentil and bean dishes for meat dishes as many times a week as possible, and consume a small handful of heart healthy nuts and seeds daily.  

References

1. Esselstyn CB. A plant-based diet and coronary artery disease: a mandate for effective therapy. J Geriatr Cardiol  2017 May; 14(5):317-320.

2. Esselstyn CB et al. A strategy to arrest and reverse coronary artery disease: a 5-year longitudinal study of a single physician’s practice. J Fam Pract. 1995; 41:560-568.

3. Ornish D et al. Intensive lifestyle changes for reversal of coronary heart disease. JAMA 1998 Dec 16;280(23): 2001-7.