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Misleading Mediterraean Diets:
Dr. Esselstyn discusses a recent study on olive oil and nuts

Also Read:
Read Dr. Esselstyn's article from The American Journal of Cardiology, entitled:
Is the Present
Therapy for Coronary Artery Disease the Radical Mastectomy
of the Twenty-First Century?

(pdf file)

  Introduction: More Than Coronary Artery Disease (continued) Introduction: More Than Coronary Artery Disease (continued)
SHIFT TO ARREST-AND-REVERSAL TREATMENT
Shift to Arrest-and-Reversal Treatment | "Rectangularizing" Life's Journey
Making the Change | References

This sunmiit demonstrated to the medical commu nity and public that there are other options--that suc cessful arrest-and-reversal treatment (ART) therapy has been born, mandating a requiem for palliative cardiology.

At this conference, Dr. Colin Campbell reported the results of a major epidemiologic study demonstrat ing that plant-based nutrition avoids cardiovascular and other "Western" diseases. Drs. William Roberts, Erling Falk, and Greg Brown reviewed the latest dis coveries in the pathophysiology of atherosclerosis and how lowering lipids affects it. Drs. Frank Sacks, Donald Hunmnghake, Terje Pedersen, and James Shepherd--the leaders of 4 major lipid-reduction tri als with 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors, or "statins"--demonstrated that lipid lowering decreases deaths, cardiac events, and surgical interventions, even for people with "average" cholesterol levels. Dr. William Castelli explained the new understanding of heart disease mechanisms and risks.

Dr. Dennis Sprecher outlined the preventive strat egies being implemented at the Cleveland Clinic. Dr. Dean Omish showed how a plant-based diet can arrest and reverse coronary disease within 1 year. Dr. Hans Diehi demonstrated the measurable cardiac improve ment gained with a community-wide nutrition lifestyle approach. Dr. Sidney Smith outlined what we need to do to implement aggressive intervention and preven tion strategies.

Drs. Gerald Berenson and Henry McGill demon strated that atherosclerosis risk and disease begin in childhood. Dr. Charles Attwood outlined a safe, nu tritious plant-based diet for children and adolescents. Dr. Antonia Demas's success with her nutrition pro gram in schools in several diverse economic and cul tural settings destroyed the myth that children will not eat healthy plant-based food.

My own data with a similar diet have extended these findings over 10 years. I remain involved in a small study, begun in 1985, of 23 patients with triple- vessel coronary artery disease.6 We have 11-year fol low-up data for 21 patients and 9-year follow-up data for 2 patients. The goal of the study was to achieve, through plant-based nutrition and cholesterol-lower ing agents, a serum cholesterol <150 mg/dL as seen in cultures where coronary artery disease is virtually absent. Five nonadherent patients were released from the study after 12 and 15 months, and all have had further coronary events, Of 18 adherent patients with a history of 49 coronary events during the 8 years before the study, all but 1 have had no events since the study began. The exception was off-study for 2 years and experienced angina. He has since resumed adher ence, and his angina has disappeared. Those available for data analysis had a prestudy mean total cholesterol of 246 mg/dL. During the study, their mean total cholesterol has been 132 mg/dL, and their low~density lipoprotein (LDL) cholesterol level, 71.1 mg/dL. Sev enty percent experienced angiographically docu mented regression of stenotic lesions. Homocysteine levels are presently in the lowest category--8.5 j.~moIIL. We have not measured LDL oxidation, but we know that a plant-based diet generates few free radicals and has plenty of antioxidants with which to minimize the oxidation of the low LDL levels.

These patients' success resulted from adherence to a regimen that amply treated the critical factors of cholesterol, homocysteine, and oxidized LDL. Treat ment strategies consist of an initial in-depth physician interview with patient and spouse, bimonthly visits to review a diet diary and obtain serum cholesterol mea surements, and physician participation in quarterly group gatherings. The treatment strategy involves no relaxation, meditation, or structured exercise but fo cuses entirely on plant-based nutrition and cholesterol reduction. Despite skepticism about patients' willing ness to adhere to this diet, the patients in this study are

empowered by the knowledge that they are in control of the disease that formerly was destroying their lives.

We also have preliminary data from a more recent short-term experiment using the same diet and choles terol-lowering drugs in cardiac patients. These data show that one can achieve rapid reperfusion of isch emic myocardium via prompt cholesterol reduction with diet and drugs, without mechanical intervention, as early as 3 weeks after the start of treatment. We are able to decrease a total cholesterol of 240--290 mg/dL to <140 mg/dL within 10 days.

Precise mechanisms for this reperfusion remain speculative, but the results speak for themselves. This technique--with no mortality, no morbidity, and min imal expense--can achieve the benefits of reperfusion in patients who will continue to improve rather than erode.

Shift to Arrest-and-Reversal Treatment | "Rectangularizing" Life's Journey
Making the Change | References

 
   
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