Is the calorie-free sweetener erythritol safe? The FDA did not evaluate long-term use, and new research suggests it may cause blood clots in people with high blood pressure and other risk factors.
Heart Attack Proof Diet: A Recipe for Heart Disease?
CNN keeps airing “The Last Heart Attack,” in which Dr. Sanjay Gupta tells the story of how and why President Bill Clinton was put on a vegan diet by Dr. Dean Ornish, and how Dr. Caldwell Esselstyn’s #1 selling book Prevent and Reverse Heart Disease echos the same dietary advice. As you know, reversing disease is something I care a lot about, but I’m not convinced Dr. Essylstyn’s heart attack proof diet is delivering what he promises.
Early in the show Dr. Gupta discusses Clinton’s strict vegan diet and defines its underlying philosophy: “No more meat. No more eggs. No more dairy. Almost no oil. The mantra is, eat nothing that has a mother or a face.”
(I have to agree with Dr. Gupta’s implication: If your olive oil has either a mother or a face, it’s probably best to leave it on the shelf.)
Dr. Esselstyn contends that, with his diet, heart disease is completely preventable.
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“Once they start eating this way, you [sic] will make yourself heart attack proof. We know that if people are eating this way, they are not going to have a heart attack.”
That’s a powerful and compelling claim. And there’s no denying that Dr. Esselstyn puts his money where his mouth is. Some of his seminar attendees have opted to forgo their doctor’s recommendation to undergo heart surgery and, instead, adopt Esselstyn’s diet. If, God forbid, one of them were to develop angina or have a heart attack, that would prove Dr. Essylstein’s heart-attack-proof claim (tragically) false.
What’s Wrong With this Picture?
To help demonstrate the benefits of veganism, Dr. Gupta and his CNN crew tells us President Clinton’s harrowing story. Concerned for her husband’s health, First Lady Hillary Clinton contacted vegan guru Dr. Dean Ornish, who was soon brought on as the President’s physician consultant on nutrition. Ornish completely reworked the President’s diet, steering him away from meat and dairy and directing the White House staff of chefs to, as just one example, replace beef burgers with the soy variety.
That was back in 1993. And what was the outcome of this dietary intervention? Though the TV show never addressed how well Clinton adhered to the diet over the years, according to the CNN program, “even with Dr. Ornish’s help,” by 1999 the President had put on 18 pounds. Then, soon after leaving office, Clinton began experiencing the symptoms of heart disease. In 2004, he had a quadruple heart bypass operation. By 2010, his doctors felt a followup operation was needed, this time to insert two stents.
By 2014, Clinton had been advised by another prominent doctor that vegan diets are too high in starches and sugars, and too low in protein. Thus, vegan diets put people at high risk of developing diabetes and pre-diabetes, along with complications of those conditions that include, unfortunately, heart attacks.
Now, before you think I’m trying to poke fun at Dr. Gupta, or Dr. Ornish or any of the practitioners of a vegan diet, let me say this: vegans helped to get consumers thinking about animal welfare. So props to them.
No, mostly I just wanted to offer Dr. Gupta a little friendly advice on the art of story telling.
Dr. Gupta: If you’re telling a story about, say, the importance of dedication in which a young girl practices shooting free throws four hours a day and doesn’t stop practicing all the way through high school, make sure to have that dedication ultimately benefit her somehow. Say, she earns a basketball scholarship to Stanford.
And if you’re telling a story about Bill Clinton benefiting from a decade of following a vegan diet, please don’t end the story with the protagonist (Clinton) clutching his chest on a hospital gurney, heading into the ER for yet another operation.
But enough literary theory.
Here’s how to tell a story:
Once upon a time an entire nation trying to feed a burgeoning population on the cheap came to depend on nutritionally bereft corporate foods. Then, one day, the best doctors and scientists and nutritionists and farmers and chefs—vegan and primal and everything in between—all got together and agreed on something: the way we’ve been doing business, particularly the way we’ve been caring for animals and the land, is insane, and that neglect is reflected in our food, and it’s killing us. Then they decided that working together would make things better.
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You are right about both of the diets. I followed Esselstyn’s diet for several months with no success. Then started to use statins for another 2 years. During this time no oil was reaching my cells. This deprevation of oils caused diabetes and insulin resistance that now I have to cure. Later, I found that among complaints to Dr Esselstyn were cases like mine and he responded there are exceptions to his diet. For example the calorie intake of food must be below a limit which I couldn’t achieve due to hunger from diabetes. But he never mentioned these exceptions in his books or lectures. I also followed Mediterranean diet for some time with no succes. later, I found out about Dr Sears and yourself who say regular oils like butter or fat in meat are not the problem but the seed oils are. However, since I 90% constriction in one of my veins I am not sure how to start using oils. Which fish oil and cow products can I start with?
Awsome Blog, Nice Work Keep it up!
I went on The Esselstyn diet after I had a massive heart attack with damage.
Six months on the diet and my heart was not improving. Did a 180 switch to a Paleo Diet. Three months later my heart was improving. Gained weight on the Esselstyn diet, lost weight on the Paleo. What do you think I believe in???
“my heart was not improving”
“my heart was improving”
More precisely? What do you mean by improving, not improving? Very vague comment here.
Bill Clinton got no benefit from his connection with Dr.. Ornsih because back then he DID NOT FOLLOW the Ornish protocols. The weight gain was evidence of this and if you ask him he will probably verify this. Not until he started eating the way Dr. Esselstyn diected did he gain the benefits. I did the same and eliminated my angina similarly. It’s about the food!!
Hi Dr. Cate,
After switching from a vegan diet a year ago to a higher fat diet with eggs, meat, and whole dairy, my lipid panel is a bit shocking: total cholesterol 353 (a couple years ago it was 202), triglycerides 43, HDL 150 (a couple years ago: 180), LDL 194 (a couple years ago: about 100). Of course they want to start me on a statin immediately and consult with an internal medicine specialist. To me the HDL/total ratio looks pretty good, but the LDL is high. I eat very little in the way of grains or sugars. Any suggestions would be highly appreciated!
The LDL number may not be meaningful. It has been shown to be a poor predictor of risk compared to insulin resistance markers for example elevated fasting glucose, high triglyceride, and low HDL. I discuss the real cause of heart attack and what do to reduce heart attacks in Deep Nutrition, chapters 8 and 9.
Hi Doc I tried your diet for 3 months my cholesterol ratio was 3.5, LDL 129, TRI 169, HDL 64, stop statin drug, now my ratio is 5, LDL 194, tri 109, and HDL 54 my ac1 came down to 5.6 from 5.8, my GFR came down to 52 from 66 BAD! Creatinine up to 1.36 from 1.13 . I have 1 kidney , why did this happen it looks bad?? Also I have 1 kidney I lose the other to cancer 10 years ago, I’m a personal trainer get plenty of exercise , I’m 70 years ols Vietnam VET want to stay around a little more. HELP!
The lipid ratio looks better, yay! And the creatinine bump might be simply because you’re eating more protein?? Lots of details missing though to really make a conclusion. Avoiding seed oils can only be good so do make sure you’ve got that nailed.
I’m curious why you “cling” to Denise Minger? What does this lady, with a training in English, no training in Medicine, Nutrition or Epidemiology has other than working for the Weston Price Foundation?
Two More Cents
– There’s a big difference between a healthy nutrition regimen for a healthy person and a regimen for someone with advanced atherosclerotic disease… primarily cardiovascular artery blockage and inflammation. All discussion is valuable, but recommend all be reasonable about debating food choices by focusing on the context of the individual and the intention.
– The mechanics of plaque buildup are pretty clear. So are the dangerous conditions of inflamed pockets of plaque. Myocardial infarction can be viewed as a plumbing problem… blocked pipes. Additionally, clots that cause infarctions are often an end-game result of nutritional issues. Such as, blood serum like sludge, and/or fat ratios that instigate or magnify inflammation of plaque sites.
– Reversal of heart disease… What does this mean? First you have to have it, let’s not forget that in a discussion. According to Esselstyn, it means creating a healthy blood environment that promotes healing the endolethial cells. This promotes reduction and eventually elimination of the fatty liquid pockets of cholesterol under the calcified layer.
So says Esselstyn. The total plaque doesn’t go away, it just gets healthier and therefore diameter of those vessels should increase.
Increased blood flow. Lessened risk of breakaway inflamed plaque. Lessened risk of blood clotting.
That’s about it. Not too complicated for a way to combat a potential myocardial infarction with your LAD is already 90% blocked. He also says the effects of his nutrition regimen begin quickly to change the body chemistry and the increase of plaque buildup, yet the full effects of “reversal” take 6 months or more
Seemed to work for his original study group with advanced disease and history of serious cardiac events, though the small number of participants is statistically meaningless. I suspect that the popularity of the book has brought about a number of other success stories that should be considered.
The contentious issues for serious study could be these on a short list:
Omega 6 and Omega 3 ratios are the crux of the issue on endolethial cells. There are many ways to adjust those nutritionally. Ornish champions Fish Oil supplements and that is backed with solid research in reducing cardiac events in at-risk patients. Esselstyn says any processed oil is bad for the Reversal Diet because it immediately changes the ratios. In his book, Omega 6 is bad, Omega 3 is good and your supply should come only from Flaxseed.
– Statin drugs. Esselstyn also recommends that patients with advanced coronary artery disease follow their cardiologists advice on statins. Especially if a patient is already taking statins. One of the little publicized facts about Clinton’s cardiac event the brought on a quadruple bypass surgery is that Bill Clinton stopped taking his Lipitor because he felt okay and didn’t think he needed it anymore! As we know, the statins have two benefits… lowering plaque buildup is one, and it also smooths out the existing calcified plaque layers. Same benefit some diets are after without pharmaceuticals.
It seems from the videos and other reports, that Bill Clinton did not take on the Ornish nutrition regimen until he had the the stents added to the replacement veins from the bypass. That was 2010.
His veins and existing coronary arteries had accumulated considerable additional plaque in the 4 years since his bypass. He says during those years he was following a “heart healthy” diet. Skim milk, lean meats, mostly poultry, mono-unsaturated oils, and all the rest.
I consider this significant due to all the many anecdotal reports of both bypass and stent patients who have a similar experience. Ask any cardiologists and the NIH keeps up with the same. The “heart healthy” diet didn’t work for those with advance disease to prevent more plaque buildup.
Which was my first point I believe. Context. If you’re facing death in a few years from a second cardiac event, then extreme takes on another light.
Whether Esselstyn is correct when he says even one drop of olive oil is off the diet, I can’t say. But the science behind the healthy endolethial cells seems clear now. And the recent studies show nitrous oxide is the key. Whether a nutrition regimen can provide that key element and promote healthy arteries and eliminate risk of a cardiac event is going to be different for each individual.
But a lot of people with advanced coronary disease are going that way. Following a plant-based diet isn’t that different than our ancestors did right up until the last 200 years of progress that gives us processed empty foods. Plants can provide all kinds of protein. Meat was a rarity on most tables thoughout human history and it was most often used like a condiment to flavor stews and dishes and provide that all important B12 component. Wild lean meat or pigs that weren’t fed corn The artic wolf… his main source of protein is small mice and other rodents.
What about that Mediterranean Diet loaded with olive oil. Oils are already a contentious issue amongst many healthy eaters Well, in Greece you’ll certainly find olive oil on a salad and used in frying foods… and yet there is also a lot of grains and veggies on the table, lots and lots. Little dairy eaten, cheese is from goat’s milk. Another component you don’t see in restaurants, but you do in every Greek household is a boatload of leafy greens. Cooked, raw, pickled, and all sorts of ways… it is a mainstay of the Greek diet. And Greek households tend to use fresh pressed olive oil locally made from locally grown orchards. Consider how the Bertolli extra virgin you buy at Trader Joe’s actually gets to the shelf… and ask yourself if its even close to the same food product the Greeks enjoy. Mediterranean is as much about truly fresh food as anything else we could debate
To put everything in a nutshell modern living is 100% responsible for most of our illness.
Over indulgence of any kind can and will shorten life expectancy as our very DNA is programmed to “self destruct”almost when over-fed.(look at the recent positive data on fasting for example).But I still maintain that sugars,flours,oils and all the chemicals that we absorb on a daily basis in modern life is the real culprit that causes disease.
A diet high in plant based nutrition with some fish and occasional red meat void of flour,grains, oils and chemicals will keep most healthy well into the golden years.
I believe you’re 100% correct
November 26, 2019 at 12:19 pm
If you are looking for evidence for Dr. Cate’s recommendations read her book “deep nutrition”. You should find the facts you are looking for there.
Are you implying that an elevated blood pressure after eating a high-fat meal is evidence that high-fat meals cause cardiovascular disease? Cardiac output increases after meals to deliver more blood to your digestive tract. The blood pressure increase reflects the increased demand for blood flow by your digestive tract. Blueberries are digested quickly (starting in the mouth with amylase) and readily absorbed compared to fats.
What type of physician are you Jon Tao?
I don’t understand why you would make such a statement about Dr. Esselstyn’s diet and not even explain why you aren’t convinced it is delivering what he promises. This is a very unprofessional statement to make about a colleague without any explanation. What is your basis for making such a statement? My guess is that you don’t know enough about what you are talking about. I really don’t know what point you were trying to make with any of what you said. It sounds like you have a bit of an axe to grind (issues). These guys you are picking on are out of your league. They have many, many years of research in their fields. You have a lot to learn before you go up against people like them.
I am familiar with Dr. Esselstyn’s work, I was a patient of his. By following his diet I was able to not only prevent heart disease, but reverse it as my before and months later heart cath pictures showed. You may nor be convinced, but before you talk about it on your website next time, you should at least be able to explain why you are making that kind of statement. And the Dean Ornish/Bill Clinton thing was kind of bizarre too. Are you basing the effectiveness of Dean Ornish’s diet on Bill Clinton’s experience? Isn’t that kind of ridiculous? And is this why you aren’t convinced about Dr. Esselstyn’s? Probably I rhink. Good luck.
Dr. William D. Mengers Sr.
For a thorough and entertaining taste of many of the books serious logical and scientific flaws, I like Denise Minger. Esselystyn and I do agree on one point: Vegetable oils are dangerous. Depending on your previous levels of consumption and other details of your diet, their elimination could explain some or perhaps all of the benefits you experienced. My way of thinking is detailed extensively in both of my books, if you are curious.
I find it interesting that the death rate from coronary heart disease in China is 79.7 per 100,000, whereas, in the United States it is 80.5 per 100,000 while the French (Who consume more fat than either the Americans or the Chinese) only have a death rate of 29.2 per 100,000.
@Marc. Hi,yes its strange to some but not to scientists.Actually there is not really that much connection between fat and heart disease at all.It was Ancel Benjamin Keys that came up with that dubious “Seven Countries” studies.My own view is that meat for people with established heart disease is probably not a good idea.The reason being is that people with established heart disease usually got there either by bad genetics,or by bad dietary and lifestyle choices over a number of years.Meat and fat is know to reduce blood flow and constrict the arteries which in healthy people may be of no immediate harm.However in someone with known heart disease any constriction and lack of blood flow to and from the heart is NOT a good idea obviously.
The problem is in the food we eat in general not many people realise that even so called healthy foods can contain large amounts of salt,sugar and fat.
Also Olive oils and actually all bottled and processed oils are also not good.
(Olive oil got a good rep because of the Mediterranean diet but it was actually the salads that help then NOT the oil.If your young and healthy with no signs of cardiac or inflammatory disease,your the right weight and the right body fat and you exercise!,if you keep to the diet of a hunter gatherer you should be fine.That means fruit,nuts,seeds,fish,meat,eggs etc but no flour,oils,sugars or anything from a tub or tin.
People are really scared of cholesterol thinking that its a fat,in fact cholesterol is a protein that your body needs for every cell to work and renew,without it or with low levels of it,you would simply die.People also get hung up on LDL and HDL with LDL being labelled as the bad guy in fact that’s not true.HDL and LDL work in unison,think of LDL as dustbin men collecting waste and bringing it back to the depot for recycling(LDL brings it back to your liver for recycling.)So if you eat a lot of cholesterol foods,your liver just makes less cholesterol.We are thinking now that the tables set for healthy cholesterol levels are maybe inaccurate,its been know for years for example that older folk with high cholesterol actually live longer and more healthy lives than those with low or medically corrected cholesterol.If we could stay away from junk food with its sugar,oils and even chemical pesticides,take in less calories than we burn and eat a very basic diet,like that of a hunter gatherer,we may be in the best shape of our lives.
Dr Cate. I’m sorry,I do no not really understand your question.In my post I clearly said that the only reason to “Blend”the Blueberries was for the BP test which would enable you to see beneficial results more rapidly,otherwise it may well take longer.People should avoid blending or juicing.
If meat is indeed blended or not the two are totally different food forms biologically.Obviously meat would not have the same health properties as bluberries.Meat even if it is blended will still constrict the arteries by 30-35% and in some people with established heart disease maybe more.However I’m not totally against meat,say for seasoning and I do think that fish especially salmon is great.(salmon)only effected the arteries by 2% by the way,which is negligible.But we must also talk here about sugars and bad carbohydrates, because they also cause inflammation and of course any unhealthy rise or spikes in insulin can never really be good.However fruit sugars are natural and although we see captive monkeys with diabetes,we rarely see monkeys in their natural habitat with diabetes or heart disease as the fibre in fruit probably slows down absorption. Remember we share 98% genes with chimpanzee
On my travels to china I did notice a strong contrast of meat only being used to flavour dishes,this was even more apparent with poorer peoples,rather than the more affluent.
(yes strangely there is still a great divide in China between the poor and rich)even though they are communist.The diet on the whole seems to be much more heart healthy with the constant use of leafy green and very bright vegetables.Fruit however was not eaten in abundance.Rice is there staple food of course and I did wonder if the pancreas of Asians in general is bigger and their insulin stronger than Caucasians/ Europoids)in that somehow over time their body has adapted to the huge carbohydrate spike that white rice gives.I must admit that my own waistline did start to bulge after a few weeks,while the Chinese around me actually ate more than me!.(I’m also very active as I’m a Martial Arts instructor and performer).”The Asian paradox”did stump me until I came across some people whom also suggested that due to the long term diet of white rice,somehow maybe their body’s had adapted and this is possibly the truth.
Thank-you Dr Cate for allowing me to post on this most interesting topic.
Dr Cate,please try this test for yourself at home.Take your resting heart rate and blood pressure.(write it down)then take some blueberries with some water and blend it up.
(you could of course eat them whole)but for this test we need them blended so that they enter your blood stream more rapidly(don’t worry about the sugar load either)ok drink the blueberries and wait,say 15- 20 mins.then measure your BP and heart rate again.
I guarantee you that they will both be lower,by quite a bit.The lower rates hence relaxation of the arteries occurs due to the increase in nitric oxide provided by the blueberries,does meat do that?No,No.
If the blueberries need to be blended to enter the bloodstream more rapidly, wouldn’t the meat?
A lot of my patients have also raised the question that native tribes eat meat and yet remain heart disease free.Well that nots really the full picture.First of all “native tribes”in their normal environment will eat meat if they can get it but most of the time,they are not successful at hunting,so most of their diet probably a good 80-90% is plant based.Also remember that they hardly ever eat sugar and most definitely not any oil.
don’t forget that we share 98% genetics with chimpanzees and although they do eat meat,its very very occasional and they are very healthy and stronger pound for pound than humans.The other question is nutrient density of food.Most people don’t know that plant based nutrition is actually a higher nutrition than a meat based diet.with leafy green vegetables coming in at a nutrient density of 100 while eggs(11)meat(8)and full fat dairy is(4)so you can hopefully see my point here.However sugar and its many clever disguises should also be avoided.But what about fructose I hear(the fruit is sugar).I never had the same bad effects from natural fruit sugar as I had from white table sugar.
I do believe that the body processes it much more easily and naturally.
I came across this website and decided to comment for all the confused souls out there.Confusion is a terrible thing and leads to stress and anxiety,which often leads to just giving up and results in bad health.I have been treating people with diet only for over twenty years.I am not a medical doctor but I can see the results that a good diet gives.
Although a follower of Buddhism myself, Buddhists contrary to what most people think are not all vegetarians,But I am.I used my own body and took many readings and tests to see the results of a meat based diet over a whole food vegetarian diet,other findings just confirmed tests like the brachial artery test by Dr Vogel.You can do this by yourself using a normal BP monitor.1.take a reading at rest before your meal.2.eat a typical western meal (ie) a big mac meal.watch your BP and most importantly heart rate raise!some heart rates will be close to 100 or more.This is the negative effect on your blood vessels.now on a separate day,eat a vegetarian meal with some dessert say of Blueberries(my favourite)and watch your heart rate and BP hardly move up or in some instances actually drop.This should be enough initial proof for the layman.
Sorry, I don’t want to fight the best diet…I want to adapt the best diet. LOL…I have been cleared to exercise, which should help in the effort to raise my HDL levels. I just hear that I need to go vegan in order to cleanse my arteries, but that seems extreme to me…I have no problem with vegetarianism, but I do enjoy fish.
Right now, most of us are trained to ignore the importance of raising that HDL because there’s no medication to do it. Diet, however, will. I outline how to do that in Food Rules, and Chapter 8 of Deep Nutrition is dedicated to helping you understand what really causes heart attacks!
Thanks for responding so quickly. I have just ordered Deep Nutrition from Amazon.com. Cannot wait to read it, but i am just so confused from all I hear from different physicians. They can’t all be correct, can they? How do I weed through all the preconceived notions and biases to get to the truth of which eating habits will work and which won’t?
Is there any other literature other than your books that you recommend for background knowledge? Thanks in advance.
Weston Price’s original book: Nutrition and Physical Degeneration. Hands down my favorite. To give you insights into the growing popularity of low-carb diets among doctors like myself who specialize in weight loss (and metabolic health) watch Dr Westman from Duke University.
I am currently in the worst shape of my life (45 yrs 5’10” 300 lb), but my doc says all my tests are good — stress/echo, heart holter, thyroid, glucose, cholesterol (152), low LDL. Only bad thing is slightly low HDL (39). She believes my occasional chest pains are anxiety and will not recommend any more tests.
Now, I want to take matters into my own hands and fight the best diet to fight and reverse the heart disease I am sure I have. It’s all so confusing though. What’s your advice?
Resolving the Coronary Artery Disease Epidemic through Plant-Based Nutrition
Caldwell B. Esselstyn, Jr., MD
From the Cleveland Clinic Foundation, Cleveland, Ohio
Caldwell B. Esselstyn, Jr., MD
The Cleveland Clinic Foundation
2001; 4: 171-177
Thanks for the link. This is great news for all of us who believe that the right diet can reverse arterial disease!
The article shows nice images of coronary arteries getting nice and wide opened looking. I am ssuming it’s not simply doctored images and that the arteries are actually clean and not invested with non-luminal disease only visible on intravenous ultrasound.
However, the key element of the diet is likely the avoidance of oxidized fats, not the strict limitation of all fats. The author seemingly ignores the fact that we know that only oxidized LDL promotes arterial damage and not healthy LDL. Because naturally occuring fats are not oxidized, there is no reason to avoid foods like butter, eggs, lobster and so on as long as they are cooked in ways that do not promote excessive heat damage, ie traditional cooking.
The Esselstyn diet is not a Vegan diet. Vegans eat oil. The Esselystn diet is oil free with the exception of a tablespoon of ground flax meal daily. If President Clinton would have tried and adhered to this diet first, rather than the Ornish diet, he likely would have had a better outcome sooner. Although a small study, everyone that has stuck with the Esselstyn diet has reversed their heart disease.
Adam, please post a link to or the title of the study you refer to. I would like to see how they assessed heart disease regression as well as learn other details of the diet for example carb and protein counts.
I would rather see a nation of vegans myself, just for the animal welfare. But the reality is we are omnivores.
As a Cornell-trained scientist myself, I found the research supporting China study highly flawed. For instance, the researcher went in with an agenda to prove something he saw in the lab. His claim that animal protein is unhealthy is supported primarily by an experiment on lab rats infected with hepatitis C virus and fed casein, a highly processed form of one of the protiens found in milk.
for anyone interested in learning some of the other flaws in the China Study, check out this podcast: http://www.thelivinlowcarbshow.com/shownotes/2887/denise-minger-debunks-the-china-study-episode-405/
There are societies who eat mostly or solely a plant based diet and there is virtually no heart disease or diabetes (and cancer) in these groups. I highly recommend “The China Study” by Cornell Univ. researcher Colin Campbell.. this is a large scale population study with incredible health data comparing rural (vegan) vs. urban Chinese, duplicated in rats, much more compelling than just analyzing Bill Clinton, who I have heard did not stick to a vegan diet until recently after his last scare. It’s not easy being vegan, if you love cheese etc (me) but we have a nation of diabetics and a nation where heart disease is the #1 cause of death, so I’d rather see a nation of vegans.
To the best of my knowledge, the Ornish Diet targeted at those suffering from heart disease has been correctly researched for over 25 years now, and I believe it is one of the few diets that has been proven to actually work for heart disease sufferers. Ornish’s very tight regimen is not aimed at those not in this position. But I find it difficult to argue with medically sound research. This blog has a lot of “opinion” in it. I don’t see many references in this particular blog entry that link back to any recognized medical research proving Ornish doesn’t work or is counter-productive. But if you have links to such research, I’m happy to read them.
Citations are good. I’ll start: I have hundreds of references in Deep Nutrition that explain my position. How about a citation for your assertion that the Ornish diet has been proven to work for heart disease sufferers?
If mom gets tired of cooking separate meals things may go back to where they were anyway, which sounds way ahead of the average SAD.
When it comes to oils, the cold pressed is good but what really matters is that it should be unrefined. The deodorization step generates lots of weird oxidized fats. Sesame oil is a little better than canola for frying, but not as heat stable as olive oil.
Thank you for your comments. We have done exactly what you suggest in your note. Going to the farm and meeting the farmer, the cows, the chickens, etc. has made my girls actually happier about eating meat. I talk about how wonderfully they’re cared for (sunshine, good grass, lots of room, etc.). Dr. Natasha Campbell-McBride in her book about the GAPS Diet explains that she has seen a correlation between vegan girls and a later incidence of eating disorders…this is sad and families should do their research before allowing children to choose their own diets.
I should have been more specific about this child’s diet up to this point. It is a wholefoods diet consisting of beans, grains, fresh vegetables, very little fruit, no potatoes, no pasta, no fried foods, no oils other than extra virgin coconut oil, ghee, olive oil, and cold pressed sesame. He can not have sugar of any kind or honey. He can have chicken and fish from pastured and wild sources.
A few weeks ago he spent a few days with his family at a buddhist monastary and now he wants to become a vegetarian. I think he was very moved by their way of life and attitude towards not killing animals for food. Your suggestion about visiting a farm is excellent as I know of several farmers who humanely raise their animals.
My concern was how would this affect the growth and development of a 7 year old if he refuses to eat any animal food. As a former vegan myself, who said to say was raised on a traditional diet of pastured animals but went astray, because I thought I was doing something more spiritual, I don’t know if the farm visit alone will do it.
The parents care about long term health consequences of dietary choices so if I could give them some basic information of why eliminating meat is harmful it would be most likely help.
I am giving them a copy of your very informative book Deep Nutrition.
One extra question regarding this family: they saute with cold pressed sesame oil. Is that ok because it has antioxidants or should it only be consumed unheated.
What is your opinion about a child who wants to go Vegan at the age of 7. This is a child who has had previous health problems, however, in general do you feel this is harmful for any developing body. Please specify why.
A vegan diet is very different from a traditional diet, and therefore not what we are genetically ‘designed’ to eat. It does not supply the right balance of nutrients, and it does not necessarily exclude powerful toxins, most notably vegetable oil and sugar. Animals that survive only on vegetable material have expanded foreguts or hindguts that act as enormous fermentation chambers where vast quantities of microbes ferment carbohydrate material into more complex nutrients. So even herbivores are, technically, not living only on vegetable matter. They’re living off of the byproducts of an intestinal microbiota that we human cannot replicate.
Most people who want to go vegan are concerned for animal welfare. There probably is no way you can change minds without addressing that fundamental concern. All the research in the world can’t make up for the image of a sick cow being beaten by slaughterhouse employees. In other words, if you really want to do something for this little girl, which I can sense that you do, you might want to take her to a farm where she can see the animals are loved during their lives. And then show her a movie of a cheetah chasing a gazelle or something so she can see that death is part of the cycle of life. And then of course, magically make sure that her parents don’t get torture meats. You’ve got your work cut out for you!
Our religious leaders, shamans mostly (and grandparents) used tell children stories to help them deal with this difficult issue of why we need to kill. When was the last time you went to a sermon and the pastor/minister/rabbi covered this topic?
The public is unlikely to hear about bad science, such as that which appears to support veganism, without assistance of lazy interviewers and publishers with low-standards, so thank you for highlighting the responsibility of journalists to avoid sloppy interviews (like failing to ask about Clinton’s compliance with Ornish’s diet), to provide alternative view points, and to disclose selective data culling. I’m happy to hear those of us who care about our health have someone like you on our side!
The lipid analysis Clinton had is not routinely done but is now much more widely available than it was when Clinton was in the White House. It’s called VAP. (More info here): http://cholesterol.about.com/lw/Health-Medicine/Drugs-and-treatments/The-VAP-Test-Beyond-Traditional-Cholesterol-Testing.htm
Did anyone else notice some “bad science” in the “Last Heart Attack” series by Sanjay Gupta, M.D? Some “information presented ” from the “Dean Ornish camp” I believe was “bad science” and should have been questioned by Dr. Gupta, or another viewpoint presented. A couple of quick examples: 1) A study is mentioned that supposedly shows the Ornish diet preventing heart attacks, but the study subjects were not only on the Ornish diet, but also on cholesterol lowering medications. This is a glaring confounding variable, and certainly misleading to the public if presented as acceptable data without challenge. 2)He discusses the use of blood tests to determine cholesterol particle size, but fails to mention these tests are not really available to the public—we couldn’t find any labs that even perform them. 3)As a journalist and medical writer, I always take care to present more than one viewpoint in my stories—especially in medical stories that could influence people to make important health decisions—and Dr. Gupta’s reporting should have pointed out that many studies do NOT show the Ornish diet to be beneficial to the heart. 4) Studies Dr. Gupta presented that appeared to make the case for the Ornish diet preventing heart disease were seriously flawed, and in order not to mislead the public, he certainly should have presented some challenge. (Especially alarming was a study of other cultures that follow his type of diet and have no heart disease—but the examples were few and included just a couple of very obscure cultures—while he glaringly left out more obvious cultures, e.g., Mediterranean, that have nearly non-existent rates of heart disease—and do not follow an Ornish-like diet, eating meat, lots of olive oil, etc.
Compliance! Maybe ask yourself why Pres. Clinton was unable to comply with the vegan diet? Perhaps to much sugar directly or via starch affecting hormones and hunger signals and a lack of satiety due to no fat or to little protein? Vegan diet or animal product diets may each provide benefits at least in the short term if: they lack Omega 6’s, sugar and fructose; in the long term i have heard from to many vegans who have run in to health problems; of course, they may do it wrong, but if it is so hard to do, that may say something in and of itself. Over the long run some inclusion of animal products is necessary for health; a review of basic biochemistry should lead anyone to this conclusion along with the fact that there is no society in the history of the planet that did not consume some animals.
Regarding Esselstyn: Read his book and see the number of his patients who were on statins. Also not the number who could not comply with his dietary restrictions.
Of course it’s great that you feel great. And I don’t feel a need personally to encourage you, or anyone who is not planning to have a child or breastfeed, to add animal products into your diet.
The fine point you bring up about processed foods bears emphasizing, however. I have yet to hear of anyone who went vegan who had any luck without also cutting processed foods. Why not just cut all processed foods, and eat an otherwise balanced diet that includes humanely raised or wild-caught animal products?
Wrong on preventing heart attacks. A pure vegan diet prevents all kinds of diseases, and can actually reverse arthritis and give asthma patients a huge breather. Diabetics also benefit from a vegetarian diet, and can actually get off insulin. My husband and I are 65 years old, and we have been vegetarians for 30 years. Neither of us has been to a doctor in 25 years, and that is the truth! We never get sick, and we don’t have checkups. Of course, we threw out sugar, salt, pepper, and all processed foods. We do check our blood pressure when we run upon those store machines. Perfection. The trick is, never, never cheat, and you will live longer and feel incredible. Exercise is also important. We have been doing yoga twice a day for 20 years. Unfortunately, doctors, medical companies, animal breeding laboratories (you don’t hear much about this), and drug companies want you to be sick, and the meat and dairy industry pay billions to lobbyists to brainwash you into thinking you have to eat that pesticide laden food to be healthy. Eating a vegetarian, or vegan diet, is not easy. We have to take our food on long trips, and when we eat out make sure waitstaff put no butter on our plain baked potato, and no dressing on our salad. Upscale restaurants can come up with great fruit salads and raw veggie salads, and many have whole grain breads. Being both brainwashed and lazy, people would rather get sick that make a life change, and I know people who are long gone because they would not try my diet for at least 6 weeks. Amazing.
I’m afraid you’re criticizing a blog post prior to reading it carefully. Just as a reminder, here’s the proper order: 1) Read blog post. 2) Criticize blog post.
I’m not being a smartypants. Apparently, lots of folks are doing this these days. Mr. John Staunton made the very same error. He, too, felt it entirely “unfair” that we failed to mention that perhaps President Clinton didn’t stick adhere to a vegan diet (although Dr. Gupta and his CNN team forgot to mention it). I should have done Dr. Gupta’s work for him by pointing out in clear language that “the TV show never addressed how well Clinton adhered to the diet over the years.”
But, see, the thing is, I did say that. Those very words, in fact. And I didn’t just add that language (in the post). It was there, from the beginning. I promise.
Which means, obviously, that you decided to make pot shots without reading the post, which is a little disappointing.
Still, believe it or not, I’m kind of glad you did, because it seems a bunch of people are doing that these days, especially when it comes to this ongoing nutrition debate that so many people seem so passionate about.
It gives me the opportunity to say this: Hey everyone, no matter what you believe about nutrition—whether you are a Deep Nutritionist or a primal person or a vegan or a fructarian or whatever—please do take the time to read a blog post, any post, prior to criticizing it. We all benefit from a sober, good-natured discussion about health and nutrition. Making thoughtless drive-by comments doesn’t really help.
Eric, I gather from your email that you’ve been feeling a lot better these days on Dr. Esselstyn’s diet. That’s fantastic! I’d recommend you stick with that diet.
Continued good health,
Luke, read a blog post first. mmmmm. What is this, 1954? Get with the times. Belief is science whether you agree or not.
I find that those who can’t be bothered to read a blog post, misquote what’s said in a blog post, make up their own facts, prove the article is correct and should be thanked.
Your blog post completely misses the fact that Clinton did not listen to Ornish, nor did he ever adhere to the Ornish diet during his time in the White House. Ornish was a complete failure at getting Clinton to change his diet, but that doesn’t mean the diet is a failure. For some reason you don’t mention Esselstyn’s 20 year study as reported in his book at peer reviewed articles where he reversed heart disease for patients who had been left without hope by the Cleveland Clinic’s cardiology department. Nor do you mention any alternative, possibly because no other diet or medical treatment has come close to verifiable reversals like this. The AHA diet doesn’t do it, nor has the South Beach diet, or Atkins for that matter. Bypasses and stents have now been shown in peer reviewed studies to have little to no effect on mortality, yet you so blithely dismiss something as simple as diet without so much as a reference to any countervailing research. Thank my lucky stars I never read your blog five years ago when I started the Esselstyn diet or I would have missed out on the chance to rid myself of the hundreds of dollars worth of medicine I was taking every month. Unless you have some 20 year studies to show reversal through some other method that is as simple as this, I’d recommend you take another look at Esselstyn’s work, and ignore the Internet yahoo’s such as Denise Minger.
I am glad you have recovered. I agree that a big unanswered question in the case of Bill Clinton was compliance. I don’t presume to know, and don’t think the media soundbites are a reliable measure of what he was doing. It seems an extraordinary omission on the part of the film makers to fail to bring up the issue of compliance. If you are interested, I do cite numerous references to support my dietary program in my books.
Correct, finally somebody who mentioned that!
Eric has stated most intelligent and believable information I have read here. I do not like the writing style or content of this piece. It almost seems like this is the work of the food and drug interests that do not want true health for their own reasons.
And by the way, The Last Heart Attack was postponed at least twice on CNN, I had to finally see it on You Tube. Coincidence? I think advertisers (purveyors of bad food) put the kabosh on CNN airing it as scheduled.
There are no cultures that are historically vegan. Even strict Indian vegetarians eat dairy products. Therefore, what makes people think a vegan diet is natural or healthy?
The work of Dr. Weston Price is the single most important set of studies ever done on human diets (IMO) and all of them included animal foods to some degree. But none of them included factory foods.
I think a diet consisting of a variety of fresh, minimally processed food, both plant and animal is the best approach. I wish the First Lady would promote real food, of all kinds.
Veganism!? As the late, great Julia Child once said: “The best way to execute French cooking is to get good and loaded and whack the hell out of a chicken. Bon appétit. ”
Take that Dean Ornish!! 🙂
Weston Price didn’t conduct any studies. His work was purely observational.
Observational surveys such as price did on human populations are indeed a valuable research tool and the now-famous Framingham studies are largely observational surveys. Price also did extensive laboratory research. Nutrition and Physical Degeneration gives plenty of details, for anyone who is interested.
Thank you kindly for liking the post. Cate and I endeavor to be fair in anything we write. Being a pescatarian/former vegan, you can hardly be blamed for giving this blog post a desultory reading. But, to be fair, please do read it once again, more carefully. You’ll run into the line, “Though the TV show never addressed how well Clinton adhered to the diet over the years,….”
If you’re right that Bill Clinton was unmoved by the recommendations of his trusted nutritional adviser, then I think you mean to say that Dr. Gupta and his CNN team was “unfair” by failing to mention this point in their report. I don’t know it you got to catch Dr. Gupta’s special. If not, check it out. I think you might conclude that (again, presuming your claim about Clinton’s diet is correct) Dr. Ornish was “unfair” by suggesting the President’s health went to pot not because he failed to heed his doctor’s dietary advise, but because of the stresses of the Presidency.
We didn’t infer Clinton’s vegan(ish) diet failed him; they did.
I was going to forward you the references for Deep Nutrition, as requested. But they are many. So might I suggest you secure your copies of Deep Nutrition and Food Rules, available right now on Amazon and at fine bookstores everywhere! You’ll find those references you wanted at the back pages (of DN).
If you happen to have references to articles upon which you rest your claim that Clinton chose to ignore Dr. Ornish, it would be much appreciated.
“No pans???” Sounds like Ornish has totally lost his marbles. Interesting link, thank’s Rodger!
Well I enjoyed the article but think its a little unfair as Clinton did not adhere to the vegan diet over those years so its unfair to infer the vegan diet didn’t help. The results of the trials on this kind of lifestyle seem to disagree with what you seem to be implying. I was wondering are there any trials done, preferably RCT’s, showing a similar result on the diet you are recommending…if there is I’d love to know of it/them. If you tell me you have referenced them in your books, let me know which ones and I will order it. Yours Sincerely, an open minded pescatarian/former vegan.
Given Jobs’ somewhat secretive nature, few details of his relationship with Ornish have come to light. This is interesting, though:
It also leads me to suspect that Dr. Ornish enjoys his role as vegan lifestyle guru to the rich and famous more than he values his responsibilities as a medical professional. He seems, I fear, to have fallen victim to TED Conference Syndrome, an affliction of the ego for which there is no known cure.
i think the above dr is very cynical regarding ornish and esselstynns reversal of heart disease, they both recommended a 10% fat vegan diet because that was the only one that REVERSED heart disease, people who have not got heart disease do not need to be so restricting although as it is now agreed it is a food borne illness mostly except congenital disease, so eating lots of olive oil may be one of the bearers of that illness as it is 14% saturated fat, the so called south beach diet and the mediteranean diet are MAYBE ok for those without disease.
I have seen that Steve Jobs address, as it turns out. Worth seeing. Cate and I try to be as kind as we can about our disagreements with—I’m going to channel Dr. Cornell West for just a second—our vegan brothers and sisters because we know a lot of them are coming at this thing with an eye toward the humane treatment of animals. They see a film or some photos depicting the terrible mistreatment of animals in a typical meat production facility, and they make an oath right there on the spot: “I refuse to subsidize this.” When none of us has such a reaction, I think we’re all in extra big, capital T trouble.
The truth is, folks hip to the latest nutrition research realize that in order to be healthy, really healthy, we need to eat what our genes have come to depend on, which includes some amount of animal products. On the other hand, given our society’s historic antagonism toward nature and for other species, that same small group of informed people (like you and me and the good folks who read this blog) are forced to walk through a very tight space between doing what’s healthy and avoiding giving money to the worst corporations—the worst people—imaginable, monstrous entities that view animals as exploitable commodities.
Overall ;), a great comment. Let’s all hope the best for Steve Jobs. Mostly, I wanted to thank you for using the word “funereal.” Isn’t that a nice word?
Oh my I didn’t realize Ornish had his hand in Steve Jobs’ care as well. All that sugar…as many low-carbers know, thanks to the excellent work of Dr. Seyfried at Boston College, cancer cells frequently cannot burn ketones because they have abnormal mitochondria and much of their ATP production comes from the fermentation of sugar into pyruvate.
And thanks for catching the typo!
President Clinton is an excellent example, though you might also have added Dr. Ornish’s equally dubious role in helping convince Steve Jobs to treat his pancreatic cancer by way of a vegan diet and postponing surgery until it became evident that his condition was continuing to deteriorate. Sadly, this strategy doesn’t seem to have worked out very well for Mr. Jobs in the long run. (Also, you may want to correct the misspelling of Stanford University, where the former Apple CEO gave an inspiring—if somewhat funereal—commencement address a few years ago.) Overall, a great piece, if a little too kind to Dr. Ornish and his followers for my taste.
Josh, thanks for the video link. Denise is funny!
Yes she is a lovely entertaining young lady but unfortunately she is wrong on her analysis.
If you look at how meat effects the blood pressure and the veins(do the blood pressure test)then clearly the over consumption of meat is not ideal.I do not personally believe that occasional small cuts of meat are that dangerous but remember in most healthy populations,the consumption of meat is lower than those that show high heart disease rates.I have found fish to be far less damaging to the blood vessels than red meat.
its appears from my own tests that meat actually causes a kind of”stiffening”to the arteries
and this can take some hours to resolve.However a diet of vegetables and or fruit actually improved blood flow.That is exactly why we now see many Martial artists and athletes turning to a vegan or vegetarian diet while in training camp for a big event,it also helps them cut weight easier.I personally think that people can eat red meat sparingly perhaps more of a seasoning on vegetables,Fish is probably ok mostly if its wild.But fruit and vegetables should always make up the bulk of the diet,while keeping other sugars and bad carbs very low indeed.
What ever makes you think that meat is bad. Where’s the science, where’s the thinking? Grains, legumes, starchy veg, fruits except for limes and lemons, sugar are all the same: empty calories that rob nutrients from the body to digest. Low fat and high carbs killed Eisenhower and Clinton’s next.
Did you read the article? If you did then I can only suggest you get your eyes checked.
I suggest mhikl that you re-read my comment and buy yourself some glasses.
may I also suggest that you invest in a good B.P monitor if you think that Meat is so wonderful.The fact remains that we were never designed to eat meat day in,day out.We were designed actually for a very low calorie diet of Plants,fruits,nuts and minimal meat(including fish).Once gain,can you see where I said”meat is bad?”in fact what part of”I do not personally believe that occasional small cuts of meat are that dangerous”don’t you understand.Now buy some glasses yourself,stop being insulting and go where you belong(at the back of the class)
I saw the show and thought it was a one sided presentation making a very strong case for the vegan low fat diet which I believes has value for some folks. However, I found it very interesting that with the prominent role that Dr. Agatston played on the piece, they never once asked him his opinion of the vegan diet. As everyone knows, he is the author of the South Beach Diet which he claims is beneficial for heart heath.
Denise Minger (an ex-vegetarian) did a really interesting (and funny) speech on this subject. She talked about how the (albeit questionable) success of veganism-promoting doctors like Dr. Ornish most likely comes from their recommendations to eliminate sugar, white flower, refined carbohydrates, hydrogenated vegetable oils and other processed foods. Here’s the link if you’re interested: http://vimeo.com/27792352
By the way, I love your writing style. Your blog and books are so much more enjoyable to read than their unnecessarily dense and dry counterparts.
Denise Minger works for the Price foundation, of course she’s going to promote meat. She also have no background in science, she has a degree in English, and hasn’t conducted, like Ornish and Esselstyn any experiments herself. No big deal. My biggest concern is all the video in which she appears with some of the Weston A. Price executives. Sorry, she’s not neutral.
Denise may not be neutral, but she is healthy, practices what she preaches, and her points are valid and her logic is sound.
Sorry, you answered my question by saying : “Denise may not be neutral”
“…but she is healthy” Yeah, and how old is she? Late twenties?
Dr Cate. I don’t know really what to make of you and your comments.
As a fellow physician of over 25 years experience and having a background in nutritional research,I find your comments quite absurd.How do you know that Miss Minger is indeed “healthy”?have you personally reviewed her blood reports or studied a recent CT Angiography of her heart or is it because she is young and maybe “female and outspoken”that you find some sort of comradeship with her.
I don’t deal in favoritism,I deal in facts. while i commend anyone(male or female)young or old coming forward to make statements as Minger does(if you can bare the (nonstop giggles),she is as far from a researcher as the moon is from Earth. But that is NOT to say that she does not have valid points as far as interpreting mis-infomation and manipulation of figures by the veg head community she does, but true research skills she has not.
The point are thus for me in my own research are clear.where heart disease already exists, a plant based diet is the best.where heart disease is minimal(and heart disease has been shown in young people 19 years old) a balanced diet is recommended,after all..no study has ever shown that scoffing endless meat,eggs and dairy has ever reversed heart disease or even slowed it.I wrote to you before and challenged you on your beliefs,you wrote back with some nonsense,therefore I challenged you again and if you cannot understand this,then I think you may need a lobotomy to dissect the part that gives health advice and thumbs up to the Mingers of this world.
A:Measure your B.P before you eat.B.eat a high fat meat meal(measure again)you will see Systolic and diastolic raise together with heart rate.
this is due to your heart having to work harder and your veins constricting(nothing extremely dangerous unless you have heart disease and in the long run,all regular hardcore meat eaters will).now get some Blueberries mix it with water then drink it.wait 30-45 minutes and observe that your heart rate,systolic and diastolic B.P will drop,is that too hard for you to understand or try for yourself,if it is,then please stop writing and close this blog of yours.
If you are looking for evidence for Dr. Cate’s recommendations read her book “deep nutrition”. You should find the facts you are looking for there.
Are you implying that an elevated blood pressure after eating a high-fat meal is evidence that high-fat meals cause cardiovascular disease? Cardiac output increases after meals to deliver more blood to your digestive tract. The blood pressure increase reflects the increased demand for blood flow by your digestive tract. Blueberries are digested quickly (starting in the mouth with amylase) and readily absorbed compared to fats.
What type of physician are you Philippe?
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