The Perfect Health Diet. Here’s our Perfect Health Diet food plate: NOTE: This is our new food plate, updated 2015. Foreign translations of the original food plate. Many doctors treating heart disease tend to prescribe drugs known as statins like Lipitor, but some physicians in Canada are trying a new method: a vegan diet.
Esselstyn, Jr., MDUpdating Synopsis. Modern cardiology has given up on curing heart disease. Its aggressive interventions- - coronary artery bypass graft, atherectomy, angioplasty, and stenting- -do not reduce the frequency of new heart attacks or prolong survival except in small subsets of patients.' For most patients these procedures do not treat life- threatening plaques. Thus, it is clear that the goal of cardiology has become the relief of pain and unpleasant symptoms in the face of progressive disability and often death from disease. It is time to call this approach by its true name: palliative cardiology. It is also time to acknowledge that this approach is not the only alternative for our patients. In this article, I will present converging lines of evidence (many of them well- known and universally accepted) reiterating that when serum cholesterol levels are maintained < 1. In a small group of my own patients, a 1. I will also show that this fact can- -and must- -be made on the basis of a truly curative cardiology that prevents, halts, and selectively reverses heart disease. Although coronary artery disease is the leading killer of men and women in the USA, it is rarely encountered in cultures that base their nutrition primarily on grains, legumes, lentils, vegetables, and fruit. In the Framingham study, people with cholesterol levels between 1. For over a decade it has been known that sufficient reduction of lipids may arrest and, in some cases, reverse coronary artery disease. An analysis of 3. This was dramatically confirmed when the Air Force/Texas Coronary Atherosclerosis Prevention Study of cholesterol reduction in > 6,5. During follow- up (mean 5. Modem cardiology identifies patients with coronary heart disease through history, physical examination, and stress studies. Coronary angiography is usually performed. Patients with > 7. Radiation may be added to decrease restenosis after angioplasty, and drugs are prescribed to decrease clotting. These are some of the reasons why the USA spends over a quarter of a trillion dollars a year on heart disease.'0 (In contrast, Canada, with fewer interventions, achieves equivalent survival rates in older patients with coronary artery disease.'1)Most patients who undergo these interventions do not have fewer new heart attacks or longer survival.' Life- threatening plaques are not directly treated. The procedures themselves carry risks of new heart attacks, strokes, infections, encephalopathy, and mortality.'2 In addition, benefits erode with time. A recent New England Journal of Medicine editorial pointed out that stents are overused and overpriced, and that some may be implanted without adequate anticoagulants, increasing thrombosis risk. By using the mortality figures calculated from an earlier study,1. These mechanical interventions treat only the symptoms, not the disease. It is therefore not surprising that patients who receive these interventions often experience progressive disease, graft shutdown, restenosis, more procedures, progressive disability, and death from disease. Thus, the leading killer of men and women in Western civilization is being left untreated. What is being practiced is . During this arrest and reversal therapy their lipid levels fell significantly, they experienced no new coronary events, and angiography showed that their disease had stabilized and in some cases selectively reversed. The goal at study onset in 1. Today, after 1. 2 years, I have followed the original patient cohort to determine adherence, safety, adverse effects, and long- term benefits. The original cohort contained 1 woman and 2. They agreed to follow a plant- based diet with < 1. They were asked to eliminate oil, dairy products (except skim milk and no- fat yogurt), fish, fowl, and meat. They were encouraged to eat grains, legumes, lentils, vegetables, and fruit. Cholesterol- lowering medication was individualized. The only goal was to achieve and maintain a total serum cholesterol of < 1. Six nonadherent patients were released within the first 1. By 1. 99. 8, these patients, who initially had levels of angiographic and clinical disease equivalent to those of the adherent patients, had sustained 1. The remaining 1. 8 patients adhered to the study diet and medication for 5 years. At 5 years, 1. 1 of these patients underwent angiographic analysis by the percent stenosis method, which demonstrated disease arrest in all 1. One patient admitted to the study with < 2. Autopsy revealed no myocardial infarction. Angina initially reported in 9 patients was eliminated in 2 and improved in the remaining 7. The patients' mean prestudy total cholesterol decreased from 2. During the 7 years since the conclusion of the 5- year study, all but 1 patient have continued to adhere to the prescribed diet and medication. Today, 1. 2 years after study inception, the mean total cholesterol of the patients is 1. Table I). Adherent patients have experienced no extension of clinical disease, no coronary events, and no interventions. This finding is all the more compelling when we consider that the original compliant 1. These results are particularly important because they show that arrest and reversal therapy stops, rather than slows, coronary atherosclerosis. I argue that we must redefine what we mean by the phrase . Four techniques were used to promote adherence and reinforce the plant- based diet: (1) At enrollment, treatment objectives were discussed in an in- depth, 6. Such immediate recognition in achieving lipid goals is critical reinforcement and provides the patient with real- time proof of success. Visits became monthly during the second 5- year period and have been quarterly for the past 2 years. Continued frequent patient encounters appear critical to teach dietary knowledge and reinforce new habits. Patients reported that their physician's commitment to the same diet was additional motivation. The study focused solely on lipid reduction through medication and diet, addressing, as Roberts has stated, . With such compelling long- term benefits, patients become empowered because they feel in control of the disease that was formerly destroying their lives. The successful results from arrest and reversal therapy in this group of patients suggests it should be offered to all patients with coronary heart disease. These significant lipid reductions were undoubtedly because of our unrelenting persistence in dietary compliance combined with a statin agent. Nevertheless, these reduced lipid levels are still in the range of normal for nations where the disease is absent. Despite the benefits of a low- fat diet and of low lipid levels, the American Heart Association, the Na tional Research Council, and the National Cholesterol Education Program recommend a 3. But coronary artery disease develops and progresses with these guidelines, condemning millions of Americans to this epidemic. By way of contrast, no one maintaining a total serum cholesterol < 1. Framingham study. Campbell et al,4 in the Cornell- China study, reports hundreds of thousands of rural Chinese going years without a single coronary event. Epidemiologic and evidence- based research has identified a lipid threshold for preventing the coronary artery disease epidemic. We have demonstrated that this threshold can be achieved and maintained with a plant- based diet and lipid- lowering medication when indicated, and that maintaining low lipid levels arrests and often reverses coronary artery disease. REFERENCESUpdating Synopsis. Fosresrer JS, Shah PK. Lipid lowering versus revascularization- -an idea whose time for testing has come. Circulation 1. 99. L1. 36. 2. 2. Ambrose IA, Fuater V. Can we predict future coronary events in patients with stable coronary artery disease? JAMA 1. 99. 7; 2. Kesteloot H, Huang DX, Yang XS, Claes I, Rosseneu M, Qeboers I, loossens JV. Serum lipids in the People's Republic of Clsina. Comparison of Western & Eastern populations. Arteriosclerosis 1. Campbell TC, Parpia B, Chen J. Diet, lifestyle and the etiology of coronary artery disease: The Corneli China Study. Am I Cardiol 1. 99. T- -2. 1T. 5. Take this letter to your doctor. Prevention 1. 96. Castelhi WP, Doyle IT, Gordon T, Hames CG, Hjortland MC, Hulley SB, Kagan A, Zukel WI. HDL cholesterol and other lipids in coronary heart disease: the Cooperative Lipoprotein Phenotyping Study. Circulation 1. 97. Blankenhom DH, Nessim HA. Johnson RL, Sanmarco ME, Azen SP, Cashan Hempill L. Beneficial effects of combined colestipol- niacin therapy on coronary atherosclerosis and coronary venous bypass grafts. JAMA 1. 98. 7; 2. Gould AL, Rossouw JE, Santanello NC, Heyse IF. Cholesterol reduction yields clinical benefit. A new look at old data. Circulation 1. 99. Clearfield M, Weis 5, Whitney E, Shapiro DR. Beere PA, Lsngendotfer A, Stein EA, Kruyer W. Gotto AM Jr. Primary prevention of acute coronary events with lovastatin in men and women with average cholesterol levels: results of AFCAPSITex. CAPS. The Air Force/Texas Coronary Atheroscle rosis Prevention Study. JAMA 1. 99. 8; 2. Braunwald E. Shattuck lecture: Cardiovascular medicine at the turn of the millennium: triumphs, concerns and opportunities. N Engl I Med 1. 99. Tu IV, Pashos CL, Naylor CD, Chen E, Normand SL, Newhouse IF, Mc. Neil BI. Use of cardiac procedures and outcomes in the elderly patients with myo cardial infarction in the United States and Canada. NEngi I Med 1. 99. The Bypass Angioplasty Revascularszation investigation (BARI) Investiga tors. Comparison of coronary bypass surgery with angioplasty in patients with multivessel disease. N Engl I Med 1. 99. Coronary artery stents- -gauging, gorging, and gouging. N Engl I Med 1. 99. Esselstyn CB Jr. Medendorp SV, Crowe TD. A strategy to arrest and reverse coronary artery disease: a 5- year longitudinal study of a single physician's practice. I Fain Proc 1. 99. Atherosclerotic risk factors- -are there ten or is there only One? Am I Cardiology 1. Ornish D, Brown SE, Scherwitz LW, Billings JH, Armstrong WT, Ports TA, Mc.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. Archives
November 2017
Categories |