Showing posts with label Ostfeld. Show all posts
Showing posts with label Ostfeld. Show all posts

Monday, February 2, 2015

Patient Googles His Way Out of Bypass Surgery*

By Robert Ostfeld, MD, MSc



One of the most common operations performed in the world today is coronary artery bypass graft surgery (CABG). I would like to share with you the remarkable story of a recent Cardiac Wellness Program patient here at Montefiore Medical Center (I’ll call him Mr. J), who changed his diet and averted the CABG knife.

Mr. J is a middle-aged man with high cholesterol and a family history of heart disease. Understandably, he desperately wanted to avoid the problems that many in his family had faced, so he ate a “healthy” diet of chicken, fish, and low-fat dairy, with a few fruits and vegetables mixed in. And he exercised. A lot. In fact, he loved exercising so much that he would do it for two to three hours a day — brisk walking, playing sports, etc.

Mr. J. first visited a cardiologist at age 55, after having experienced several weeks of tightness in his neck during physical activity. The condition had worsened to the point that only 30 to 45 seconds of exercise brought on significant discomfort. The doctor ordered a stress test, to see if heart disease could be contributing to this symptom. The test results were so wildly abnormal that he was sent immediately to the hospital for a cardiac catheterization, to look for cholesterol blockages in the vessels that supply his heart with blood. Such severe blockages were found that he was admitted directly to the hospital for coronary artery bypass graft surgery. In less than one day, his life had changed dramatically.

While lying nervously in his hospital bed, he began to think that maybe there was another way to approach this disease, so he went online. There, he read about the impact of a whole-food, plant-based diet on heart disease, and he decided that was the path for him. He called the nurse, gave back his hospital gown, and despite the pleas of his medical team, signed himself out of the hospital against medical advice. Mr. J’s nurse was so concerned that before he was able to leave, she called his wife to have her convince him to stay. He did not. Later, the nurse even called Mr. J at home to plead for his return. He politely declined.

Soon thereafter he found our Cardiac Wellness Program at Montefiore. He was already taking all the appropriate medications, and he chose to completely change his lifestyle as well. He fully embraced a whole-food, plant-based diet without oil and had perhaps the most remarkable turnaround I have ever seen. Within one week, he went from being able to walk only a block before feeling tightness in his neck to walking 25 blocks without incident! Fast-forward three months and he was back to exercising two to three hours each day without symptoms. That is what I call remarkable!

A few weeks later, Mr. J got another call from his nurse. She had just been diagnosed with cholesterol blockages in her heart, and her doctors were recommending cardiac procedures. With Mr. J in mind, she told her doctors no way and called him to learn how to do exactly what he did: embrace a whole-food, plant-based diet!

Mr. J never did get that bypass surgery, nor did he get a coronary stent. In fact, he did not need to have any procedures at all. He got healthier with appropriate medications and by wholeheartedly embracing a whole-food, plant-based diet.

The key to health, it seems, lies at the end of your fork.

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*Postscript: While many heart patients may reverse their disease with lifestyle change alone, Mr. J also continued his prescribed medications, given the severity of his condition, and their doses were lowered as his health improved. Please note that I am not recommending lifestyle change over medical intervention for any particular person, as every case is of course different. Some cases are fraught with more risk than others, so please consult with both your physician and a physician trained in lifestyle medicine before making significant lifestyle changes.

This post was originally published on the Forks Over Knives blog, here.

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Cardiologist Robert Ostfeld, MD, MSc is the founder and director of the Cardiac Wellness Program at Montefiore Medical Center in New York City, where he encourages patients to embrace a whole-foods, plant-based diet. He earned his MD at Yale and his MSc in epidemiology at Harvard, and he is an associate professor of clinical medicine at the Albert Einstein College of Medicine.



As always the information presented in this blog is for educational purposes only. It should not be considered as specific medical, nutritional, lifestyle, or other health-related advice.

Tuesday, July 1, 2014

TMAO: A Toxic Substance Formed When You Eat Meat Can Make You … Dead Meat

Guest Post by: Robert Ostfeld, M.D., M.Sc. 

We can add another reason to the list of why we should not eat meat. If the saturated fat and cholesterol in meat were not enough, there is a newly identified toxic kid on the block: trimethylamineoxide (TMAO).1,2

When we eat red meat, its carnitine interacts with our gut bacteria, forming trimethylamine, which is then metabolized by the liver into TMAO. And it appears that TMAO is not our friend.1,2

TMAO promotes the formation of cholesterol plaques in our blood vessels, which make them less healthy and may lead to heart attack, stroke, and death. TMAO reduces our body’s ability to excrete cholesterol.1,2 And, if that is not bad enough, TMAO may be linked to death from prostate cancer.3

The good news is that people who eat an exclusively plant-based diet appear to form little TMAO. In fact, when researchers fed steak to a vegan, virtually no TMAO was made.2  Why is that? Vegans, it seems, do not select for the specific gut bacteria that lead to the formation of TMAO, whereas meat eaters do. Hence, it’s as if plants create a coat of armor in our stomachs, protecting us when they are not even there.

So if we’re protected by plants, is it okay for us to eat steak for just a few days? Are we protected from TMAO? It appears that we may not be. The trillions of bacteria in our gut change very quickly. In fact, they may meaningfully shift even within one to two days!4 So aside from the many other deleterious effects of meat, even one day of steak could cut a chink in the natural armor afforded us by eating plants.

Notably, red meat is not the only source of TMAO. Choline, which is found in chicken, fish, dairy ― and even plants ― is another. Choline is structurally similar to the carnitine in red meat, and with the help of the same gut bacteria, also forms TMAO. Accordingly, when investigators fed omnivores an egg, they made TMAO.1

Although we have no dietary need for carnitine, we do require dietary choline. So how can we get the choline we require without the unwanted company of toxic TMAO? The answer appears to be in the armor. Eating a plant-based diet selects for gut bacteria that do not lead to the formation of TMAO.2 So even though we are eating choline in plants, our stomach’s plant-derived protection is in place, practically freeing us from concern about TMAO.

Science’s understanding of the interaction of our diet and gut bacteria and their influence on our health is at an early stage. However, evidence is mounting that a plant-based diet may be beneficial for this interaction in many ways. Yet another reason to go (or stay) plant based!

Robert Ostfeld, M.D., M.Sc.



As always the information presented in this blog is for educational purposes only. It should not be considered as specific medical, nutritional, lifestyle, or other health-related advice.

Thursday, May 1, 2014

Robert Ostfeld, M.D. and the Cardiac Wellness Program

I am really excited to share this guest post from Robert Ostfeld, M.D. I got to meet Dr. Ostfeld at the recent NYCvegfest. Dr. Ostfeld is a cardiologist and the founder and director of the Cardiac Wellness Program at Montefiore as well as an Associate Professor of Clinical Medicine at the Albert Einstein College of Medicine in the Bronx, New York. It's a great honor to have Dr. Ostfeld share about his program! I hope you enjoy. 

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As a cardiologist, outside of an emergency medical condition that requires an urgent intervention, I have never seen anything come close to providing the breadth and depth of benefits that a whole-food, plant-based lifestyle offers.

However, ten years ago I would not have been writing this post or otherwise extolling the benefits of a plant-based diet. During my training at Yale and Harvard with many outstanding physicians and scientists, I learned little about this approach. For years after my training, I applied evidence-based medicine, recommended a “healthier” lifestyle, which typically included a Mediterranean-style diet, and watched as my patients’ diseases often progressed. I became frustrated. There had to be something more.
Fortunately, I was introduced to the work of Drs. Campbell and Esselstyn. Based on their research, I started a Cardiac Wellness Program at Montefiore Medical Center in New York City, where we encourage patients to embrace a whole-foods, plant-based diet. The results have been amazing. My patients’ chest pain and shortness of breath have dramatically improved. Their cholesterol has plummeted, they have lost weight, and they are able to eliminate or reduce the need for multiple medications for problems such as hypertension, diabetes, high cholesterol, and chronic pain.
I’d like to share a real-life example: A patient in his late 50s began to develop chest discomfort. It progressed to the point where he would feel it even as he sat still. Cholesterol blockages in his heart were the cause. He did not want any cardiac procedures, and he was started on all of the appropriate medications. However, he continued to have discomfort even walking a block or two. He then changed his lifestyle, embracing a whole-foods, plant-based diet. His cholesterol fell dramatically, he lost weight, and after just a few months he could walk over a mile. Now, two years and no procedures later, he is jogging over two miles and says he feels 30 years younger!*
Patients also describe benefits they may not have originally expected, such as more energy, improved complexion, clearer thinking, better sleep, fewer colds, improved erectile function, increased stamina, and more! In fact, patients have cried tears of joy from the results they have achieved. Frankly, I have fallen in love with being a physician all over again.
I am grateful that you are reading this, as the need for this type of lifestyle change is only growing. Heart and blood vessel disease is the number one killer of adult men and women in the United States,1, 2 and approximately two out of every three twelve-year- olds in the US has early signs of cholesterol disease in the blood vessels that feed their hearts with blood.3 We are literally killing ourselves from diet-driven disease.

Each of you influences many people in your family and community. Please join me in helping to spread awareness about the benefits of the whole foods, plant-based lifestyle.
In my years of practice I have learned that it is never too early to make this change, and it is never too late. When we are born, our bodies are like turbo engines. A few decades of animal products and processed foods later, we turn those bodies into clunkers. Let’s turn back the clock … because we can! 
*Patient identifiers have been changed. 

1. American Heart Association. Heart disease and stroke statistics–2004 update. Dallas, Texas: American Heart Association, 2003.

2. Heart disease and stroke statistics–2010 update: a report from the American Heart Association. Circulation. 2010;121:e46-e215.

3. Stary HC. Evolution and progression of atherosclerotic lesions in coronary arteries of children and young adults. Arteriosclerosis. 1989 Jan-Feb;9(1 Suppl):I19-32.

4. S Castle and A Goodman. Rethink Food: 100+ Doctors Can’t Be Wrong. Two Skirts Productions, Houston, TX, 2014.


Note: this post was originally published Here

As always the information presented in this blog is for educational purposes only. It should not be considered as specific medical, nutritional, lifestyle, or other health-related advice.