The Broken Hearts Club

This is a more personal post than I normally like to share, but since February is national heart month, and I believe this post has an important and relevant message.

At the beginning of the month, I shared an amazing post from Dr. Ostfeld about how a heart disease patient changed his diet, and not only prolonged, but truly saved his life without any surgical interventions. Unfortunately, the story I’m about to share is it’s polar opposite, and happens far too often and to far too many families every single day in western countries.

While visiting Buenos Aires at the end of January, I received a message that a family friend had a second heart attack, and was in the hospital. I didn’t realize how serious it was at the time, however, I would arrive back in New York just in time for his wake and funeral. To say the least, it’s been a very sad and tiring time for my family.

Part of what makes this so incredibly sad, is because I believe his death was avoidable. Throughout my entire life, he ate an incredibly rich diet full of meats, dairy, and processed foods. He was always overweight and when I was young, he became the first person I knew to be diagnosed with Type 2 Diabetes. This didn’t change him in the least.

Than less than a year ago, he had his first heart attack, and an emergency triple bypass surgery. At the time, it seemed like he wasn’t going to make it. Yet, even to the astonishment of his doctors, he made what seemed like a full recovery. He was given a second chance; however, he didn’t seem to understand how serious his situation was. He refused to follow the doctor’s instructions to eat less saturated fat and cholesterol, and continued his sedentary way of life.

I even approached him and offered to talk with him and his wife about the impact that diet could have on his health. Unfortunately, he declined.

And now, he is gone. His wife, children, and grandchildren are now forced to cope with the results of his decisions.

While even Dr. Ostfeld writes that his story was one of the most remarkable transformations he’s ever heard of, there is a growing amount of evidence that shows that heart disease – America’s number one killer - is not only avoidable, but can also be reversed with a proper, plant-based diet.

Back in 1995, Dr. Caldwell B. Esselstyn, M.D. of the Cleveland Clinic published his bench mark long-term nutritional research on arresting and reversing coronary artery disease in severely ill patients. He then published a 12 year update in the Journal of American Cardiology, and then a 20 year update in his book, Prevent and Reverse Heart Disease. So what were these findings?

Starting in 1985, he took 24 severely ill heart disease patients and placed them on a very strict plant-based diet. He had a simple hypothesis; a low-fat plant-based diet could arrest heart disease (fat was kept to 10% of total calories). He came to this theory when he realized that coronary disease was essentially nonexistent in cultures whose nutrition assured a total cholesterol level of 150mg/dl or lower. Vegetables, berries and whole grains were able to be eaten without limit, fruits and juices were limited to a few severing’s per day. Fatty nuts and avocado were even more limited to a few times a week if at all. Oil, meat, and dairy of all kinds were completely off the menu. Two tablespoons of ground flax seeds daily was recommend for omega 3.

Between these 24 patients, they had 49 coronary events in the 8 years before the study. Out of those 24 patients who initially signed up for Dr. Esselstyn’s study, 6 were nonadherent and were returned to normal cardiac care. At a 10 year followup, those 6 patients who did not adhere to the diet had 13 new cardiac events.

The remaining 18 adhered to the diet. After 5 years, not a single patient had a repeat cardiac event and 11 of those 18 patients agreed to a second angiographic analysis which demonstrated that the heart disease was arrested in all 11 (100%). Further, in 8 of his 11 patients (or 73%), the disease had regressed. Angina initially reported in 9 patients was eliminated in 2 and improved in the remaining 7.

Evidence of reversing heart disease.

Similar results were reported in the 12 year follow up.

For comparison, in another study published in 2000, Richard M. Fleming, M.D. took 26 patients and placed them all on a healthy high carb vegetarian diet. Dr. Fleming planned on using a new technology known as a SPECT scan which enabled him to actually measure the blood flow within the coronary arteries.

His plan was to measure the before and after effects of diet. However after one year, Dr. Fleming discovered that ten of his patients decided against the vegetarian diet in favor for a high protein, low carb diet, which they believed would improve overall health. This gave Dr. Fleming the unique opportunity to compare the two diets on coronary health.

At the end of the year, those who stuck to the healthy vegetarian diet all showed a reversal of their partially clogged arteries – showing an average of 20% less atherosclerotic plaque in their arteries. Those who jumped ship to the low carb high protein diet significantly worsened, as the SPECT scans showed an increase of nearly 40% more artery clogging.

If you look at the provided scans, you can clearly see this. The yellow and red represent blood flow. On the top, you see the increased blood flow of a person following the vegetarian diet. On the bottom, you see the decreased blood flow of a person who switched to a high protein diet. While even Dr. Fleming admits more of this type of research is needed, it is suggestive, especially when taken in measure with Dr. Esselstyn.

If any drug had even come close to this type of result, it would be publicized everywhere. Instead, this life saving message has largely been ignored. One large criticism has resounded time and again, “Yes, these are excellent results, but the trial groups are far too small.”

So in 2014, Dr. Esselstyn responded with yet another new study. This time he followed 198 patients and 177 individuals were compliant with the diet (89%). Of this compliant group, only one individual suffered a cardiac event. That is a recurrence rate of .6% which represents the absolute lowest recurrence rate of any study on heart disease.

Out of the 21 individuals in the noncompliant group, 13 of them suffered adverse cardiac events. That is a rate of 62%. They were following standard cardiology care and medical interventions which included pills and various procedures. For those of you who like math that is a ratio of .6% to 62% meaning that Dr. Esselstyn’s work is 100 times more effective than that of the standard care given to most heart patients. 

These results are important because heart disease kills over 300,000 people annually and over 700,000 people suffer a heart attack every single year. Yet, as the results of these studies suggest, this needn’t be the case.

Please help me share this message. As Dr. Esselstyn says, “If the truth be known coronary artery disease is a toothless paper tiger that need never ever exist and if it does exist it need never ever progress.”

Dr. Esselstyne and Dr. Fleming aren't the only ones getting these results with diet and lifestyle changes. Dr. Ornish, Dr. McDougall and Dr. Ostfeld among others are all doctors who have created programs that have proven to arrest and reverse heart disease. In fact, just this week, Dr. Ostfeld and his colleagues at Montefiore Cardiac Wellness Program published a study that showed a patient completely reversed their angina simply by adopting a plant based diet.

For more on Dr. Esselstyn, watch the excellent documentary Forks Over Knives or get his book, Prevent and Reverse Heart Disease.

***

Esselstyn, Caldwell B. “Updating a 12 -Year Experience With Arrest and Reversal Therapy for Coronary Heart Disease (An Overdue Requiem for Palliative Cardiology)” The American Journal of Cardiology, August 1999, 334-39.

            “A Strategy to Arrest and Reverse Cornonary Artery Disease: A 5- Year Longitudinal Study of a Single Physician’s Practice.” The Journal of Family Practice Vol. 41 No. 6 December 1995 560-68.

            “A Way to Prevent CAD?,” The Journal of Family Practice. Vol. 63, No. 7 July 2014 257.

            “The Nutritional Reversal of Cardiovascular Disease – Fact or Fiction?” Experimental and Clinical Cardiology. Vol. 20, No. 7, July 2014 1901.

            Prevent and Reverse Heart Disease: The Revolutionary Scientifically Proven, Nutrition-Based Cure. Avery Publishers, New York, 2008.

Fleming, R. M. “The Effect of High-Protein Diets on Coronary Blood Flow.” Angiology Vol. 51 2000 1075-1083.

Ostfeld, Robert et. al. “A Whole-Food Plant-Based Diet Reversed Angina without Medications or Procedures,” Case Reports in Cardiology Vol. 2015, 2015.

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.

The Secret Power of Citrus!

UPDATE: 8/28/13

I have a few updates that I need to make to this post. When I wrote the post I understated two important points.

Eating oranges really is better than drinking the juice. Regardless of how fresh the orange juice is, in a study preformed on 18 non-insulin-dependent diabetes patients there was no difference in the sugar spike in the blood between drinking a glass of fresh squeezed, unsweetened orange juice and decaffeinated coke. There was a significantly lower spike in blood sugar levels when an entire orange was consumed instead. While this does not necessarily mean orange juice shouldn't be consumed, as the study puts it, it suggests that unsweetened juices should not be part of regular meal planning. 

I also mentioned, that when juice is consumed, you should also go for the least processed juice that is available. In this case, it would always be fresh squeezed. Even 100% juice isn't good enough. As one of my label reading rules goes: NEVER TRUST A PACKAGE! The reason why is because non-fresh squeezed juice is stored for over 1 year in giant tanks. During this period, the oxygen is removed, to keep the juice from spoiling. This also strips the juice of it's natural flavor. So: 

"Juice companies therefore hire flavor and fragrance companies, the same ones that formulate perfumes for Dior and Calvin Klein, to engineer flavor packs to add back to the juice to make it taste fresh. Flavor packs aren’t listed as an ingredient on the label because technically they are derived from orange essence and oil. Yet those in the industry will tell you that the flavor packs, whether made for reconstituted or pasteurized orange juice, resemble nothing found in nature."

As such, you should always choice 100% fresh squeezed juice. Who knows what is in anything else. 

ORIGINAL POST:

A little over one year ago, I wrote a post I called Vegan Doping, to be more specific, the post was about how nitrates in beets, beet greens, and arugula can help improve athletic performance when taken before exercise. It has since become one of my more popular posts, and several people have commented to me that they now “nitrate-load” religiously before races! Now, thanks to science and tons of research, I have another little tip to offer athletes… and it should come at no surprise that it has to do with healthy, plant-based nutrition!

When we think about the nutrients in oranges, we almost exclusively think about Vitamin C, however, all whole citrus fruits also come loaded with thousands of phytonutrients. One of these flavonoids, known as hesperetin, and found primarily in citrus fruits, has been found to increase blood flow! Not only is this a reason why citrus is an excellent food to help reduce one’s risk of stroke, but it also can help keep extremities warm and more importantly for athletes, it can help reduce muscle soreness!

When we exercise our muscles expand energy to contract. This process creates a natural byproduct known as lactic acid. While our bodies can become pretty efficient at removing the lactic acid, and in fact, training can result in the reduction of lactate formation, during very strenuous or long forms of exercise, no matter how fit one is, lactic acid will begin to build up in the muscles and will ultimately cause a burning sensation so great that the body will simply not be able to continue working at it’s current rate. Most often, this means the athlete has to stop, or significantly slow down to give the body a chance to clear this lactate out of it’s system.

Citrus fruits seem to have a remarkable ability to help expand the bodies ability to process lactate. This is most-likely because of the increased blood flow as a result of ingesting hesperetin. A study took over-weight women and started them on an aerobic exercise regimen of walking and running. After a few months the women’s lactate threshold increased by nearly 17%. A second group followed the same program but drank two cups of orange juice each day. They increased their levels by 27%. While both groups made large improvements over the three-month study, the citrus group had a lower level of lactate build up, signifying a significant improvement in performance while experiencing far less muscle fatigue from the control group.

While the study was conducted using juice, the whole orange or other citrus fruits were found to be even better at helping the body cope with lactate without causing as large of a sugar spike in blood levels. That said, it is far easier to fill a water bottle up with orange juice than it is to carry a bunch of oranges! Doing so may allow an athlete to work harder for a longer period of time. For those participating in serious endurance events, not only will the juice provide natural electrolytes and calories but it also helps to hydrate at the same time.

Hespertin also has advantages for non-athletes. As mentioned above, it helps increase blood flow. Drinking citrus juice or eating citrus fruits has been shown to help keep limbs warm when subjected to cold water. So if you are one of those people who always has cold hands in the winter, increasing your citrus consumption, may help. And finally, who doesn’t want to decrease their risk of stroke? Overall, there are tons of great benefits to eating oranges and other citrus fruits, and unlike drugs, the only side effects are increased health and vitality!

So either peel a grapefruit or drink a fresh squeezed glass of OJ each morning... it will make you
Better, Faster, Stronger! 

Note: Thank you to Dr. Greger for bring light to this subject and for making the research so readily available.

Further reading:

C. Morand, C. Dubray, D. Milenkovic, D. Lioger, J. F. Martin, A. Scalbert, A. Mazur. “Hesperidin contributes to the vascular protective effects of orange juice: A randomized crossover study in healthy volunteers.” American Journal of Clinical Nutrition. 2011 93(1):73 – 80.

A. Aguiló, P. Tauler, A. Sureda, N. Cases, J. Tur, A. Pons. “Antioxidant diet supplementation enhances aerobic performance in amateur sportsmen.” Journal of Sports Science. 2007 25(11):1203 – 1210. 

 N. P. Aptekmann, T. B. Cesar. “Orange juice improved lipid profile and blood lactate of overweight middle-aged women subjected to aerobic training.” Maturitas. 2010 67(4):343 – 347.

UPDATED SOURCES:

M. J. Sullivan, R. L. Scott. “Postprandial glycemic response to orange juice and nondiet cola: is there a difference?” Diabetes Educ. 1991 17(4) 274-278.

For more about the processing of OJ, see this Huffington Post article.