British Heart Foundation
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Vegan lifestyle

In reading an article about whether a plant-based diet can reverse cardiovascular disease, it was said there have not been large enough studies on this and quoted one of less than 200 people. The China Study by Dr. Colin Campbell was a huge study and proved that arteries once clogged can be opened through the proper diet. There are photos in a book by Dr. Caldwell Esselstyn that show the opening of clogged arteries through photos, due to a completely plant-based lifestyle. Reversal of my condition is iffy because I have congestive heart failure, which may mean permanent damage. But I am following a plant-based diet anyway, because I don't want the other problems eating animals and their secretions cause. I have reduced my A1Cs to 5.3 and have no more diabetic meds and also reduced my blood pressure. I will take those as victories. I feel good and do almost everything I used to do before the heart failure, and will soon be 78 and still kicking. What you eat is what determines your health. I wholeheartedly believe that from my own experience.

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Well said! Keep with it, I have stuck to Esselstyn diet since Feb following my HA last October and I have been taken off ramipril and doc also wants me off beta blockers in a month and most likely statins in a few more months. My highest recorded cholesterol was around 4.6, now it's 1.6. My BP used to run very high at times now it's getting lower by the week, today it was 92/49! I have been getting intermittent breathlessness then at other times nothing even during exercise, but docs think it's more likely meds as my echo is apparently okay. I think it's because bisoprolol is dropping BP too low. I'm sticking to this lifestyle as I'm only 43 and want to avoid a bypass if possible or more stents. I've quit smoking, lost a few stone, don't drink anymore, fully plant based, recently got a dog and went from sedentary lifestyle most of time to walking/other exercise 45-60 mins a day. Still have a stressful job but I'm working on ways to cope with that, although it's not easy.

I love reading stories such as yours. You are doing a great job and you definately can prevent any worsening of your condition and have a good quality of life. Your body is trying to heal all the time and by eating plant based, it has no inflammation to struggle with therefore it can plough its energy into renewal and regeneration.

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Hi John. Totally agree with plant based diet. Like Andie I follow the Esselstyn diet. Lost 35 Kgs (5.5 stone). And although I have Familial Hypercholestraemia my cholesterol is as low as it has ever been on a low dose of statins. Feeling much better for it. I don’t crave anything and am on lowest possible medication so hopefully aim to lose some of those eventually. Brilliant news about your diabetic meds. Keep it going. Take care. Zena

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Hey John,

This one tends to split people doesn’t it? We bought Esselstyn’s book but I was a bit skeptical if I’m being honest. I checked out his research and found it’s really not based on any good evidence. I’ve copied from sites what I found about his research, I will paste it below;

24 patients were sent to him, “all suffering from advanced CAD” and began the horrifically strict dietary program he had developed based on his “logic and intuition.”

Interestingly, patients not only were put on Esselstyn’s incredibly low fat diet, but they were also given cholesterol lowering medications and were “switched to statin as soon as these became available in 1987.”

In addition, 9 of the 18 patients who stuck with the program had previously undergone coronary bypass surgery and two had undergone angioplasty of a coronary artery.

6 of the 24 original patients “could not comply with the program” and were sent back to their regular cardiologists. This gives you an idea of how difficult it was to follow this diet.

Esselsstyn’s “data” then consists of following 18 patients, 9 of whom had already undergone coronary bypass surgery, all of whom were taking statin drugs with his diet without any comparison group.

This group of 18 did well from a heart standpoint, of course. It is impossible to know if the diet had anything to with their outcome. Most of them had already undergone the “knife” or had had angioplasties that took care of their most worrisome coronary blockages. They were all taking statin drugs . They were all nonsmokers and they were all highly motivated to take good care of themselves in all lifestyle choices.

This “study” is merely a collection of 18 anecdotes, none of which would be worthy of publication in any current legitimate medical journal.

Three of the 18 patients have died, one from pulmonary fibrosis, one presumably from a GI bleed, and one from depression. Could these deaths be related to the diet in some way? We can’t know because there is no comparison group.

The lack of a comparison group is the biggest flaw, If he had followed his original intent, and randomized patients entering the study, he could claim that he had performed a legitimate, important scientific study. Twelve of the 24 would be allocated by lottery to the Esselstyn diet and 12 to whatever was the standard recommended CAD diet at the time. Unfortunately this approach, due to a “lack of funding, was not practical.”

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Also, if you’re interested, the “China study” has been completely discredited, check out this link if have the time.

paleozonenutrition.com/2011...

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Read your reply with a smile because it is typical of many views I've come across. Dr. Esselstyn is not the only study that convinced me to try the diet. Colin Campbell is the one that did the China Study, which involved thousands. Incidentally, the Esselstyn diet is not a hard one to follow if you are really interested in a program you can stick with forever instead of diets you go on, fall off and gain back more than you started with. I eat all I want of very good food without worrying about calories or anything except that it is whole food (not processed) and completely plant based. No animals or their secretions (dairy). Once you have been on the diet for about 3 weeks your tastes start changing. I am also salt and oil free, and if I eat somewhere that has added oil to food I can detect even a small amount and it tastes awful. If you are Paleo, we are at odds so I won't trouble you anymore about the benefits of being plant based. But the Paleo diet does not protect you from any of the chronic diseases, especially heart and vascular.

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I thought you were being rather harsh - you pasted text from someone else’s analysis and if you had continued from that article on could have included this too

“Scientific reviews of the effect of diet on CAD in the last 5 years have concluded that the evidence is best for the Mediterranean diet, which emphasizes fish consumption, olive oil and nuts. These reviews dismiss ultra-low fat diets because of a lack of evidence supporting them, and an inability to get people to follow them.”

I agree very much with johnthedog

In that I found and stated The Esselstyn diet 5 years ago when I found out I had to have a bypass- I was highly motivated and it wasn’t difficult to follow the very strict vegan diet and it has been very beneficial in that I was able to lose 10kg of weight and feel really good for it.

However, from my continued research I now adopt more of a mostly plant based diet, but have re-introduced fish and occasional lean chick, plus olive oil on my daily salad and nuts as occasional snacks - so essentially the Mediterranean diet.

My advice is to follow your own convictions and eat sensibly, keep checking your blood markers, weight, BMI etc and enjoy as stress free life as you can.

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Hi Bob,

I wasn’t being harsh, merely commenting on established facts. I had no need to paste any more as I was commenting on the failings of the research used by Esselstyn. If we were simply discussing the best diet then for sure thats far more subjective but it still wouldn’t change the failings in Esselstyn’s study group.

I think we’d agree on diet and I definitely agree with your advice but I care that what I believe is true and unfortunately Esselstyn misses the mark from the very beginning.

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I cincur that if you drastically drop the bad lipids in the blood stream that it can affect plaque, i know for a different reason. I had some small plaque when i had a scan at about 30, they said it was a warning. 15 years later i was obese and had weight loss surgery that permanently reduces the bodies ability to absorb fats. My blood chemistry is checked annually ever since and lipids are very low/healthy. A recent scan showed the little plaque that was there - has gone - but my case is extreme. I really dont think you can have my effect without surgery and lifelong large vitamin supplementation.

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It doesn't take long to find counter arguments to this, please dont stop taking your medication until advised to do so by your doctor:

deniseminger.com/2011/09/22...

theskepticalcardiologist.co...

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I got my info from the skeptical cardiologist, very helpful. I tried the diet out of fear and desperation and can now see that’s why most people buy Esselstyn’s book.

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Just what we all need another "sceptical cardiologist" lol. I haven't heard of anyone who has had a heart attack after complying with this diet. I've heard nothing but success stories. I understand some people are understandably threatened by the thought of giving up all the food they were brought up on, I know I was, but deep down in our hearts we know eating a whole food plant based diet is the right and natural way to eat. It's something you feel instinctively, I need no sceptical cardiologist to tell me this.

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I think you need to look up “sceptical” lol, you seem to be getting it confused with cynical. I’m glad you’re doing well with the program, most patients can’t follow this kind of diet for more than a few months. It is a shame that we still don’t have any data to back up the claims of Esselstyn just anecdotal tales. Good luck mate.

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That statement about there being no more research on Esselstyn's findings is not true and it's very misleading. There have been many larger studies, one of the largest being Dr. Colin Campbell's China Study. Esselstyn is not the only plant based doctor who is involved in WFPB, there are many. You seem to be hung up on him alone when he is only one of many who advocate a plant based lifestyle.

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Not true John, I added a link to criticisms of the China study also. When I say evidence I mean compelling evidence, scientific, peer reviewed papers. The time to believe something is when we have enough evidence and I’m sorry but we just don’t have any whatsoever that stands up to the scientific method. I hope the diet works for you I honestly do but I would say to anyone reading this, has anyone ever had a heart attack etc and got better with just the diet, no medication, no surgery, just the diet? I’m pretty sure all the advocates of this diet wouldn’t say no to meds or surgery over the diet, none.

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If you want scientific studies, look up Dr. Greger's nutritionfacts.org. Or better yet, get his book How Not to Die. All his statements are backed up by scientific studies which are listed in the back of the book. He doesn't advise anything unless he and his researchers have found scientific evidence that it is true. Incidentally, the title of his book does not mean you won't die, it means how not to die of chronic diseases caused by lifestyle: heart conditions, diabetes, cancer, etc. Most of the things that people are dying of can be prevented by lifestyle changes. They can even be reversed. I had diabetes 2 for 12 years with awful blood readings. After two months on this way of eating I was off diabetes meds. My blood pressure and cholesterol were lowered significantly. It works! I will never go back to wrecking my health by eating the standard diet in America.

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Not one scientific, peer reviewed paper on that site that backs up Esselstyn’s diet and claims, if I’ve missed it please feel free to share it. If there are any it should be easy to find them? Anyway, good luck mate, hope the diet works for you.

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Quick question Andie, did you have any kind of medical intervention and did/do you take medication?

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Having had Type I diabetes I heard about the benefits of a vegetarian diet over 25 years ago. This was mainly in context with Type II but seemed interesting. Anyway, I enrolled in a 5 day residential course. Although called vegetarian is was very strict with no fish and very limited cheese and eggs. Most of the Type I's struggled (many with BG control) whereas the most Type II's fared better. My conclusion was that for me a healthy low fat diet with plenty of veg was best.

BTW my need for a bypass was put down to hereditary factors as my father, his father and his brother all died of CVD. My cardiologist said the diabetes had added the issue of calcification. A double whammy in fact! :(

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I’m vegetarian . No fish or fish by product , very minimal cheese and eggs . I cannot stand the texture of eggs too meaty for me .it didn’t stop me suffering from Af and high BP having said that I do have other health issues -thyroid . I am very health conscious I really don’t think it matters if you eat veg or not it’s down to genetic make up .

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There are scientific studies which show that genetics play a part in disease, but a healthy lifestyle can change the outcome. It was worth a try for me and I am pleased with the result. I said goodbye to diabetes that had been plaguing me for years, and high blood pressure which is the root cause of many diseases. Of course my high cholesterol numbers are a thing of the past since it is not in my diet anymore. We need a little that our bodies manufacture, but not the amount eating animals and their products provides.

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I’m vegetarian and yes I do avoid meat fat but I can still eat crap if I wanna. There’s on issue being vegetarian but theees plenty of vegetarian junk food that will hurt ur heart. Trust me I’ve done it.

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I agree with you . I like a biscuit . Oat cakes and crisps . I’m not claiming to be a saint but I don’t go overboard

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Well done to those who are trying the wholefood plantbased (WFPB) approach. It works.

I especially applaud Johnthedog who is succeeding in stabilising and improving his condition even at 78 when others may think they cannot change the eating habits of a lifetime. Nothing tastes as good as healthy feels.

If you can put aside your scepticism (no one ever died from eating more fruit and veg), and you are motivated to come off meds under medical guidance, then what have you got to lose (other than losing some excess weight and losing the fear of needing more interventions).

As Drs Esselstyn and Ornish are quoted as saying, others may say this diet is extreme and yet how extreme is a cardiac bypass?

Both doctors' studies of reversal of plaque are published in peer-reviewed journals (Dr Ornish in JAMA).

As others have shared above, I too have come off BP meds and reduced cholesterol drastically with a WFPB diet and will continue for life because I have my life back.

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I fully agree, Esselstyn and Ornish have helped me change my lifestyle for the good, and yes my bypass was extreme and quite daunting to consider, but now having had the bypass I am determined not to have any other interventions, which includes all meds apart from daily aspirin.

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Good for you. Bypass surgery saves lives, but it does not cure the cause of the underlying disease. The only cure is to get rid of inflammation in the arteries that eventually causes trapped plaque that clogs things up, and your diet is what it's all about. The WFPB lifestyle treats the cause and not just the symptoms.

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Agree 100% and this has been my focus for the last 5 years, but I have made some modifications to my many WFBP diet based on my own research and assessments - and continue to monitor and refine.

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I keep reading posts about the Chinese study and being vegan etc. It is not a great study from a scientific point of view. As has been pointed out already, the Chinese study, which seems to take on mythical proportions on this site, uses statins liberally and it is impossible to say that diet alone is the reason for the drop in cholesterol levels.

As with most of the proponents of one diet regime or another, they have something to gain. Most people pushing being vegan are themselves, vegan, and why wouldn't they be, they think its the right answer. Most pushing non-dairy diets are similarly non-dairy, vegetable diet psuhers are vegetarians etc.. etc. But there are few if any really good scientific studies that indicate being vegan is in itself a panacea for all heart related ills. I know a few vegans who never look pictures of health and I know others who look great. But I know vegetarians and meat eaters who present exactly the same.

Humans are designed to be omnivorous (you only have to look at the teeth to know this). My own view is that any diet that requires you to take supplements (unless you have an underlying gastric/adsorption issue) is not a balanced diet. Most vegans need vitamin supplements (B12 from memory). And yes, I am a meat eater.

I eat meat, but not every day and not in huge amounts. I eat a lot of fruit and vegetables. Cheese is a rare treat, but I do have it. I enjoy a beer after golf and I may have a glass or two of red wine a week (although not so much in this heat). My cholesterol is well under 3 (thanks in large part to statins), my weight is steady at the top end of the BMI target weight, my BP is on the low end of target (thanks to meds). In short, I'm fitter than I have been in years but I have a life too and I don't worry about every thing I put in my mouth.

The bottom line has to be to eat well and eat sensibly. Be vegan by all means if that works for you, and you have the discipline to dbe so, but it is not the only answer out there.

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Sorry, but you are wrong about what we are designed to eat. Our teeth are not meant for tearing flesh off bones of wild animals like the carnivore's teeth. If you think our teeth that are called canines are meant for ripping through the hides of antelopes, you need to look at the teeth of the predators that do that. Maybe you're different, but my canines do not hang out of my mouth and aren't six inches long. Our teeth are meant for mashing and grinding, chewing food until it is very easy for our gullets to swallow. Our digestive system is meant for the slow process of digesting plants, not meat. Carnivores have short intestines so their food leaves the body in a short time. Ours goes through a slow, long process of being broken down. Look up the outer walls of plant cells vs. meat cells. Plant cells have tougher walls that require grinding and mashing. The walls of meat cells are softer and do not require carnivores to do any mashing. Watch a dog eat - they wolf their food down sometimes without even chewing it. You can get all the nutrients your body needs from plants. The romance with meat comes from taste alone. Meat eaters like the taste of flesh, because there is nothing meat can supply that plants can't. Protein comes from plants, it is not manufactured by any animal. When you eat meat, you are getting second-hand protein because most of the animals killed for meat are vegetarian.

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Humans are omnivores - end of

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How are you getting your vitamin B12 John? Plants don’t contain B12 and us humans need it. You mentioned protein, protein from plants produces a high excess of toxins that will be stored in your fat, you will have longer restitution periods after training and more. This is because even if our digestive system looks like a herbivores, its able to work like a carnivore and extract the pure protein from the meat. Plant protein does not have the right chain. So when separating the un-needed it produces a large amount of toxins, so you need to up your calcium intake when going vegetarian.

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Hogwash. You believe the standard arguments against vegetarianism that ignore scientific facts. Animals can't produce B12 any more than we can. Animals killed for meat used to get it from grazing and the plants they ate, but since they are raised on food that is not their natural diet they are given a B12 supplement. Predators eat animals that eat plants and get their B12 that way. Look it up. If vegans get so many toxins from plant protein, how do you explain the fact that vegans are living into old age without the usual chronic diseases? There are many elderly people who have been vegan most of their lives. It is thought to be a new thing because so many now are changing to this lifestyle and people hear about it more - but veganism has been around for a long, long time. Our digestive system tolerates the stuff most people cram into their bodies but they eventually get diseases because of it. The rate that people are having bypass surgery is astounding. And that surgery does not cure the problem, just the symptoms. Diabetes is commonplace now and used to be rare. Most on the Standard American Diet have high blood pressure. How would you explain the incidents of people reversing these diseases by clearing their bodies of artery clogging, cell destroying foods?

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Good luck with your diet John, I hope you stay well.

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At the risk of offending people, I am sorry but vegetarians aren't always healthy. Many still consume oil and cheese etc. No oil, no animal produce at all is what it takes. I have not heard anyone yet say they complied with the Esselstyn diet and had a repeat heart attack. I have however heard many ppl argue that it's down to genetics as their vegetarian lifestyle didn't save them from heart attack. No oil, cholesterol under 1.5 is what it takes to be virtually safe however this isn't an easy lifestyle at first so I would never knock someone for not sticking to it. Take gorillas, elephants etc, they are huge healthy solid animals and they live off plants, so can we and thrive on it. This said, everyone has their own priorities and that might not be to live until 100, mine isn't but after having a heart attack I want the time I have to be healthy and not reliant on medicines and machinery to keep me chugging along. Plus I choose to see this as a kind of experiment to see just how healthy I can possibly feel. I've still got a way to go.

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Hey Andie, do you know anyone who had a heart attack, tried the Esselstyn diet but didn’t have surgery or take meds? That would surely be a great test for the diet.

Regarding your Gorilla/ elephant analogy, It’s a matter of resources, and how to obtain them. There is a lot of plant matter, which is relatively easy to renew; if an animal is adapted to grazing, the resources are plentiful, and once they get past a certain size, there is basically no carnivore that will prey on them.

For carnivores, it’s a different story: being too large would be detrimental to agility and it may make it impossible to catch prey. There is also less to eat, according to the biological food pyramid, as carnivores are secondary or tertiary consumers. Herbivores are primary consumers. It’s not a fair comparison at all.

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For health humans need both Vitamins B12 and C. B12 comes mainly from meat and C, from fruit and veg. Therefore humans are omnivores and neither herbivores nor carnivores!

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B12 is not manufactured by any animal. Animals get B12 the same way we do, by eating plants or eating animals that eat plants. Do some research. It is impossible for animals to make B12. Because of the way animals used for meat are raised now, they do not graze and eat the way they are meant to, so they are given B12 supplements. Vegetarians take B12 supplements just like the animals do. There isn't any nutrient vegetarians can't get from plants, except it is hard to get enough vitamin D so that supplement is advised along with B12. (And milk, thought to be a source of vitamin D, is fortified with a D supplement.) There are vegetarians who have been eating that way for over 50 years and are healthier than those on the Standard American Diet (SAD) which now consists mostly of fat and salt. The technology creating fast food has been the downfall of America's health, and now it is spreading worldwide. Packaged convenience foods are the same. Things like Hamburger Helper may get the cook out of the kitchen faster, but do not provide good health - and there are kids being raised on things like that and McDonald's. The young generation is going to be suffering from what used to be adult diseases just like they are experiencing diabetes 2 at 10 years old now.

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Vitamin B12 is produced by bacteria in the gut of ruminants like cattle and sheep. Cattle have multiple stomachs to help them digest grass.

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B12 is produced by bacteria that live on the roots of grasses and plants and in surrounding soil. Animals that are killed for meat used to graze on this and got B12 from their diet. Years ago we used to not be so sterile with our vegetables and ate them right out of the garden, not as washed as today. We got B12 from our diet. Today those animals do not graze and are fed corn and soybean diets so they get supplements, just like we have to do to get B12. People think meat is where B12 comes from but if you do some research you will see what I say is true.

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