Thursday, February 19, 2009

Prevent and Reverse Heart Disease

    I have recently finished reading 'Prevent and Reverse Heart Disease' by Dr. Caldwell Esselstyn.  It is more than interesting.  His general message is very powerful.  Western diets based on animal protein lead to significant vascular inflammation and development of plaque (blockages).  Additionally the inflamed lining of these vessels also makes "vulnerable" plaques at higher risk of rupture.  People with a total cholesterol of less than 150 and LDL of less than 80 are at extremely low risk for coronary events.  His study spanning more than 15 years showed solid evidence of stabilization and even reversal of coronary artery disease.  This is remarkable.
    To achieve these results the study patients followed a strict change in diet.  A no fat vegan dietary plan.  "Nothing with a face or a mother" is allowed to be eaten.  This includes no fish, dairy, nuts (except a few walnuts in low risk people), no avocados, no oils, and no soy milk (except non fat).  This may sound spartan at first blush but he goes on to describe many food ideas and the last half of the book contains many recipes and meal plans.  I have been following this diet for the last 2 weeks and have been very pleasantly surprised.  No hunger, no cravings and many options.  It does take more work, both mental and physical, as most prepared foods are off limits.
     Now, as a cardiac surgeon, how is this new information to be integrated into my practice? First, I still believe that patients with tight lesions and unstable symptoms need urgent revascularization to relieve symptoms and ideally avoid muscle damage.  Next, I will be informing my patients about these findings, the potential impact on their long term health and encourage them to read this book and adopt the dietary changes. I am continuing my research in the exciting area.  
    Congratulations to Dr. Esselstyn for an amazing study over a long period, breaking with standard conventions and achieving stunning results.

""

4 comments:

Debbie SLP said...

"Eat to Live," "Eat for Health," and "Cholesterol Protection for Life" by Dr. Joel Fuhrman might be of interest to you and your patients, as well as "The China Study" by T. Colin Campbell, PhD. The messages are similar. Dr. Fuhrman does recommend fats from whole food, plant sources, such as seeds, avocados, and nuts, and achieves excellent outcomes with his very sick patients.

My difficulty with surgical interventions is that vascular disease is not limited to certain vessels, those we can visualize with current technology, but is present throughout the system. Surgery, it would seem, "fixes" only a tiny percentage of the problem. Clot-causing plaques can flake off anywhere, not just in the most visualizable vessels.

Dietary interventions are therapeutic to the entire system. Thanks for your article.

Deborah Bennett, M.S., CCC-SLP

27 years on Broadway said...

Dr. Katz- I am a big fan of the following three Doctors work
Dr. Caldwell Esselstyn, Dr. Colin T. Campbell's The China Study , and Dr. Fuhrmans Eat for Health, that has helped me lose 70 pounds in 5 months ..keep posting i will bookmark your blog

Marc R. Katz MD said...
This comment has been removed by the author.
Marc R. Katz MD said...

Thanks for your comments. I have read The China Study recently and also found it to be enlightening. In addition I am currently taking an online course from eCornell on plant based nutrition taught by Dr Campbell.
Yes, these are systemic diseases and I explain to my patients who need bypass surgery that this procedure is "fancy plumbing" and does not cure the underlying disease process. However, I absolutely do believe that in patients with critical blockages that bypass surgery has an important role.
What is new in my practice is that I can now help enlighten my patients, once they are out of the acute risk phase, that there is an opportunity to intervene in the systemic disease process that I was previously unaware of and that has shown remarkable results