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.

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