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.

Spicy Thai Cabbage Salad

Recently the word “superfood” has entered into the lexicons of Americans. (I have to give credit to my friend Julie for helping to popularize it.) However, the way we apply the term to foods has been ad-hoc and inconsistent, at best. Typically, we use the term for exotic and expensive sounding foods such as acai, goji berries, sea-buckthorn and the like. Depending who you talk to, you might also hear kale and quinoa described in such glowing terms. However, rarely will more generalize foods, such as iceberg lettuce be described as “super,” even if it is a health promoting food. Another food that is often ignored, but certainly deserves more attention, and is clearly entitled to the entry of the exclusive membership of "superfoods" is cabbage.

Considering how much attention kale has been getting recently, it is surprising that it’s superfood cousin, cabbage, has been left on the sidelines. Perhaps cabbage needs it's own Ryan Gosling meme. 

This is especially surprising considering there are over 400 articles on cabbage and the role it can play in cancer prevention and treatment. According to one study done on cancer cells in a petri dish, cabbage was one of the best vegetables for cancer prevention displaying the ability to kill multiple types of tumor cells (in part, thanks to the high amount of sinigrin an antioxidant found in cabbage); cabbage has also been shown to lower cholesterol in multiple studies, and red cabbage was awarded the “best bang for your buck” by Dr. Greger because of the high concentration of antioxidants, vitamins, and minerals as well as because of red cabbage's low price point. On top of all of this, cabbage is incredibly versatile, and can be added to just about any dish and prepared in nearly anyway!

This Spicy Thai Cabbage Salad is the perfect way to get more superfoods into your life!

Serves 3-4: 

For the salad:

1 ½ cups green or savoy cabbage, shredded

1 ½ cups purple cabbage, shredded

1 cup carrot, shredded

1 cup zucchini, shredded

3 stalks celery (optional)

1 large handful fresh basil, chopped

1 tablespoon fresh cilantro, chopped

½ cup peanuts or cashews (leave out if making a nut-free version)

Fresh or dried mint to taste

For the dressing:

2 tablespoons lemon juice

2 tablespoons apple cider vinegar

¼ cup Liquid Aminos or low sodium soy sauce

¼ cup vegetable broth mixed with ground flax seed (see: oil replacement guide)

2 tablespoons pure maple syrup

2 cloves garlic

1 inch piece of ginger, peeled

1 ½ tablespoons curry powder

1 teaspoon chili powder

1 teaspoon hemp seeds

The dressing will keep for about one week in the refrigerator. 

In a large bowl, combine all of the salad ingredients and toss to mix thoroughly.

In a high-speed blender, combine all of the dressing ingredients and blend until smooth. Pour over the tossed salad ingredients, mix well, and enjoy. 

D. Boivin, et. all “Antiproliferative and antioxidant activities of common vegetables: A comparative study,” Food Chem., 112(2): 374-380, 2009.

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.

Cooking without Oil

A while ago, I presented two research pieces on oils in general and one specifically on coconut oil. Not only are oils highly processed and bad for your arteries, but oil has around 4,000 calores per pound, making it the most calorie dense but nutrient-poor item in the American diet. Since my earlier postings, several people have asked, “well then, how do you cook?” Here are a few tips.

First, when buying pans, it’s best to buy heavier stainless steel or cast iron cookware. While any type of cookware will work, these higher grade metals are less likely to burn.

Dressings and Sauces:

·         My biggest suggestion is to become accustomed to using vinegars – particularly on salads. These are highly alkalizing and health promoting foods that taste great and can be found everywhere.

o   Try apple cider vinegar, balsamic, red and white wine but also look for flavored infused vinegars. I’ve had some delicious fig and berry infused vinegars. Even chocolate! I’ll be honest, pomegranate vinegar is gross.

·         To re-create creamier sauces or dressings replace the oil with blended silken tofu. I find 1 – 2 tablespoons does the trick.

·         You can also add ground flaxseed or chia seeds to hot water. Start using the same amount of water as you normally would use oil. Slowly add the ground seeds to the water and mix well until the water starts to almost gel and thicken. White chia seeds help make the most appetizing dressing color.

·         White beans or cashews are other great options for creating creamier sauces. Use the same amount of white beans as you normally use oil. If using cashews (always get the raw if you can,) I typically soak the cashews for at least 1 hours before – longer is better. I normally will do 1 part cashews and 1 part old fashioned oats. This creates a delicious creamy blend and helps cut the total fat from the cashews.

To sauté or Stir-fry:

·         Simply replace the oil you would normally use with either water or vegetable broth. First heat the pan and then add your food, add a small amount of water or broth as needed –note you will need less than you are expecting. Depending what you’re making, you can also try juices as well. Be sure to stir often.

·         Several vegetables such as mushrooms or onions contain enough liquid which will release while cooking. Heat the pan first and then cook at a slightly lower temperature for several minutes to caramelize onions or brown mushrooms. Stir constantly.

Baking:

·          To replace oil or margarine in baking, try using non-sweetened applesauce as a substitute for cookies, cakes, and other sweet baked goods (check out our Peanut Butter and Oat Cookies, the Quinoa and Chocolate Chip Cookies, or Engine 2’s Banana Oatmeal Peanut Butter Cookies.)

·         Mashed or pureed tofu can replace oil in other (non-sweet) baked goods.

·         Ground Flaxseed can also be an excellent sub for oil as well as for eggs (mix 1 tbsp ground flax with 3 tbsp water to create an egg replacer). For baking, use 3 parts flaxseed for every part oil or fat you are replacing. This can cause baked goods to brown more quickly so keep an eye on your dish.

·         Parchment paper is a game changer. It’s safe to cook on and makes clean up a breeze!

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.

How to Transition to Plant-Based Eating part 1

When I started keeping this blog, it was intended as a way to share some of the nutritional research I had been doing, but recently I realized that while you might now understand that the consumption of TMAO from animal products can increase your risk of heart disease, or why coconut oil really isn't healthy for us, I haven’t provided the tools to actually help make meaningful changes to your diet. If you don’t know how to wean yourself off animal products, then all the nutritional research that I present here, is essentially worthless.

One of the first things that need to be addressed is that changing one’s diet is very difficult. An estimated 45 million people go on some type of “diet” each year, and they spend roughly $33 billion on diet products. Yet, according to the CDC the United States is heavier than ever, with 35% of the total population categorized as being obese (a person with a Body Mass Index of 30 or higher). Obesity and the diseases associated with it, have an estimated annual medical cost of more than $147 billion dollars – to put some perspective to this number, that is 1/6^th of the annual US defense budget! There is clearly a disconnect between these diets, the huge amounts of money being spent and America’s ever growing waistlines. 

BMI For Adults Widget

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.

Mung Beans and Sprouting Guide

Sprouting is an ancient technique that has been used on all sorts of beans, legumes, and various seeds as a way to increase their nutrition profile, digestibility, and flavor. Over the winter I’ve become addicted to sprouted mung beans (sometimes called ming beans) but this process can be repeated with any other legumes including lentils and chickpeas (which are other favorites).

While you can buy sprouts from most grocers today, they are far cheaper when you sprout them yourself. Besides being relatively cheap, especially when compared to the huge amount of nutrients sprouted legumes offer, they can also be a nice way to add fresh, raw produce to your diet year around.  Adding sprouts is an easy way to make any meal look a little more exotic and fancy.  

One study published a few years ago examined food consumption in five different regions of the world and found that legumes intake was the most important factor associated with longer lifespan. The study found an 8% reduction in risk of overall mortality for every 20 grams of legumes consumed. 

As legumes, mung bean sprouts are an incredible source of nutrients. Besides being anti-inflammatory, they offer an excellent amino acid profile and are 20% calories from protein which is remarkably high (sigh, and yes, they are a complete protein, just like all whole foods!) They also are high in vitamin C and vitamin K, which is essential for the process of blood clotting. Vitamin K also helps regulates bone mineralization and helps maintain bone density. Mung beans are an excellent source of riboflavin, folate, iron, and manganese. They are also packed with Omega 3 and Omega 6 fatty acids as well as other micronutrients.

Besides being an all-around nutritional all-star, mung beans are incredibly easy to sprout taking an average of only 3 days before becoming edible. Once sprouted, mung beans have a tasty, fresh nutty flavor and offer a delicate crunch when added to a dish.

Once sprouted, you can keep mung beans in a sealed jar in the refrigerator for up to 5 weeks, although once you taste them, I'd be surprised if they last more than a few days!    

How to sprout legumes:

1. Take the desired amount (yield is approximately 2:1 so 1 cup of dry mung beans will be roughly 2 cups sprouted) and rinse them until the water runs clean.

     2. Then place the beans in either a bowl or jar and fill with cold filtered water. Add about 2-3 times the amount of water as there are beans. IE: 1 cup beans needs 2-3 cups water

     3.   Let soak overnight (8 – 12 hours)

     4. After soaking the beans, drain them and rinse them again with cold water.

    5. Place the beans in either an empty bowl or jar and set to the side. Store them in room temperature that isn’t directly hit by sunlight, but that does get some light.

   6. The next morning (day 2) the beans should be starting to open. Rinse once more in cold water and then return to the jar or bowl.

   

   7. By day three you should see little tails coming out of the body of the bean. You can either enjoy them this way, or let those little tails grow for another day for a softer sprout. Both are delicious. Rinse one final time, and then enjoy by adding to both raw and cooked meals.

   They’re great on salads, pastas, tossed in soups or pretty much any other dish! I just tossed some on top of my Green Mac N' Cheese. 

Darmadi-Blackberry, M. Wahlqvist et al. "Legumes: The Most Important Dietary Predictor of Survival in older people of Different Ethnicities," Asia Pacific Journal of Clinical Nutrition. 2004, 217-20.

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 Holistic Heart Book Review and Giveaway

Last month Dr. Joel Kahn offered a great guest post about where people can find reliable information about health and nutrition (I swear his very kind comment about my site was completely unsolicited!) However today I’m reviewing his new work and Dr. Kahn also agreed to send a copy of his book to a lucky winner so be sure to enter below!

Joel K. Kahn, M.D. The Holistic Heart Book: A Preventive Cardiologist’s Guide to Halt Heart Disease Now. A Reader’s Digest Book, 2013.

Since the early 90s when Dean Ornish, M.D. and Caldwell Esselstyn, M.D. first published their respective works proving that heart disease is not only caused by, but can also be reversed through lifestyle changes and diet, there has been a fury of research on the topic. Despite this, heart disease continues to be America’s number one killer, taking nearly 600,000 lives every single year. Dr. Joel Kahn, a preventative cardiologist and Clinical Professor of Medicine at Wayne State University School of Medicine has recently published his own heart health manifesto, which neatly ties the best research on heart disease into one easy to read and very informative book. It is no exaggeration to say, this book can literally change your life.

In clear and precise language Dr. Kahn explains how complex the heart really is, comparing it to the brain, as the heart has its own neurons, hormones, and electrical field. Dr. Kahn’s work is broken down into two sections. The first section reviews the most current research on heart disease.

Unlike Dr. Esselstyn’s Prevent and Reverse Heart Disease which focuses exclusively on diet and heart health, Dr. Kahn’s book takes a different approach and demonstrates that it takes a healthy body to have a healthy heart. For instance, the thyroid gland, which sits about a foot above the heart, can have a profound impact on heart health. Roughly 2% of Americans have an overactive thyroid, and another 5% have an underactive thyroid (hyperthyroidism and hypothyroidism). The disturbance caused by these hormonal imbalances can both greatly affect the heart in negative ways. In this section, Dr. Kahn also demonstrates the importance of healthy arteries and further complicates our understanding of HDL – basically it’s not as simply as calling it “good cholesterol.”

In the second part of the book, Dr. Kahn offers over 70 “prescriptions” that he often writes for his patients. However, these prescriptions are a far cry from the one your doctor would typically write you. Instead, this is where the book truly becomes “holistic,” although I mean that in best possible light. Backing everything up with citations to peer-reviewed articles, (and admitting when the evidence on certain topics is still weak - such as grounding). These prescriptions range all over the place, from eating your greens, to changing your cleaning supplies and deodorant, to practicing yoga (vitamin Y, as Dr. Kahn puts it).  

Surprisingly, (and perhaps slightly controversial) Dr. Kahn highly recommends several different vitamins and supplements. While he is very careful about which ones he actually recommends, he suggests discussing these with your primary doctor before adding any supplements to your regimen. Besides claiming that the research on the benefits of supplements is strong, he has also seen many of his patients thrive when they start including some supplements and vitamins. One in particular is CoQ10 – Coenzyme Q 10, which is a powerful antioxidant made by the body, helps assist cells to produce energy. Around the age of 40, our body’s production of this antioxidant begins to slow, and Dr. Kahn recommends it to many of his patients. (note: there was not a citation on this supplement)

While all of this could be overwhelming, Dr. Kahn recommends that people start slow, picking just a few of his prescriptions out to try for a few weeks before adding more to the routine. He writes that the goal is to incorporate as many as possible without adding additional stress to our lives. In fact, reducing stress is one of his main goals!

It needs to be added that Dr. Kahn considers himself an ethical vegan. That said, while he promotes and encourages a complete plant-based lifestyle, he is far less dogmatic than some of the other authors on this topic. In fact, in his book, he includes some pointers for those simply looking to make wiser choices when it comes to animal products.

This book stands out when compared to the other works on this topic, both for its easy-to-follow writing style as well as for its holistic approach. If you are looking for practical and easy-to-incorporate advice to help protect your heart look no further. The added benefit is all of the advice will help improve your overall health, not just your heart. As Dr. Kahn says, it takes a healthy body to have a healthy heart. 

I got to meet Dr. Kahn and his wife Karen at the NYC Veg Fest!

GIVEAWAY

Here are the rules. First, the winner needs to live in the United States (sorry international readers, no disrespect). The contest will end on March 15th at midnight. To enter, you must be a subscribed reader to BYOL. To increase your chances of winning leave a comment on this post. You will also gain a point if you "like" Bring Your Own Lentils facebook page. 

Also be sure to find Dr. Kahn on facebook. He is always post interesting articles on health and fitness

a Rafflecopter giveaway
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.

Sharping the Saw by Joel Kahn, M.D. Preventative Cardiologist

Today I have a really special post to share with you all. Joel Kahn, M.D. has written a special guest post for BYOL today on how and where a preventative cardiologist gets their information about health and nutrition. The advice he shares below is sound and can be a great resource to anyone regardless of their interest in nutrition. Dr. Kahn and I have been connected online for the past year, and being nearly done with his book, which I can’t recommend enough, I am greatly looking forward to meeting Dr. Kahn in person at the New York City Veg Fest.

Dr. Kahn is one of the nation’s most renowned interpreventional cardiologists. Having practiced invasive, interventional, and preventative cardiology since 1990, Dr. Kahn has years of clinical and research experience. He is a regular contributor for MindBodyGreen, Readers Digest magazine, and the recent author of The Holistic Heart Book.   

Sharpening the saw: How a teacher gets training:

I am excited to write a guest piece for BYOL and am looking forward to speaking at the NYC Vegetarian Food Festival March 1.  I am a cardiologist trained at the University of Michigan long ago (graduated summa cum laude due in part to my vegetarian diet!) and practicing in Detroit all these years. I do heart catheterizations, place stents, run to emergency rooms, see office patients, and answer a zillion calls and emails a day.

Long ago I chose a vegetarian lifestyle and then the big V over a decade ago. No burger, no cheese, no fish etc.  I have been on billboards across Detroit in my doctor coat announcing “Beat heart disease, diabetes and cancer, Go Vegan” and speak regularly on TV, radio and lectures on the health, environmental and ethical reasons that plant based lifestyles are the best and only choice for the future.

Increasingly I am looked upon to have the answers to tough question, tricky critics, anti-vegan blogsites, Paleo promoters and so on. So how does the teacher stay ahead of the rest and have as many answers as possible?  As Stephen Covey wrote in the Seven Habits of Highly Effective People, how do I sharpen my own saw to be able to cut more effectively?  Can these help you stay on top of trends in nutrition, animal rights and related topics?

One resource I used that may appeal to some readers was to formally go back to school. I chose a program in integrative cardiology offered at www.a4m.org in conjunction with the University of South Florida School of Medicine.  These year long curriculum of both online and classroom lectures is open to both physicians and others interested in an advanced training in many areas of health and wellness and offers the advantage of a university affiliation if so selected. Other resources for formal education can be found at www.functionalmedicine.org, www.abihm.org, and www.acam.org.   For those interested predominantly in nutrition, online programs offered at www.integrativenutrition.com, www.ecornell.com, and www.aryuvedicnutrition.com are available.

Not everyone has the time or interest to pursue these formal courses and still there are options, including ones I use, to stay current and engaged in the fast paced world of nutrition and health.  First on the list is to sign up for the daily emails from Dr. Michael Greger at www.nutritionfacts.org.   Dr. Greger is in Washington, D.C. and has been producing short and high quality videos on YouTube for several years.  There is no charge to receive his daily email and the number of videos exceeds 1,000.  Dr. Greger does very thorough research of the medical literature and all his videos are backed by multiple references drawn from the medical literature. He reviews about 14,000 articles on nutrition yearly and finds hidden gems. He presents the topics in vivid and clear formats and adds his special humor and slight sarcasm to provide a constant stream of enjoyable material. I watch his videos daily and often search his site for information. He produces one video a year that is an overview of a topic that lasts an hour and it has always been a highlight that I share liberally on social media. Sign up now if you have not.

Another site that will challenge and educate you is www.plantpositive.com. This site is shrouded in more mystery as the author is anonymous. I have emailed with him and he is a graduate student who chooses to keep his identity hidden.  He produces You Tubes which are free and last form about 8 to 30 minutes.  There are easily over 150 such videos so there are literally hours and hours of information.  Like Dr. Greger, this site relies heavily on medical references and not just opinion.  Plant Positive has taken the task of responding to Paleolithic blogger and authors, cholesterol confusionists, and all lovers of animal saturated fats.  There is a group of these people that are polished, practiced and vicious in their defense of eating animals for health. I listen and relisten regularly to these videos.  They provide a detailed analysis of the writings of Loren Cordain, Gary Taubes and others and identify false statements, distorted references, and logic fallacies on a regular basis.  This faction is not to be taken lightly and several physicians with best selling books promoting diets that are variations of Atkin’s ketogenic and pro-atherogenic venues are constantly confusing the public about the health risks of animal products.  I encourage you to jump into this site but be prepared for some of the topics to be very detailed and challenging.

My good friend Dr. Neal Barnard founded www.pcrm.org about 25 years ago. Trained as a psychiatrist, Dr. Barnard shifted to animal rights and plant based nutrition and set up this organization which does research, advocates for ethical treatment of animals, sues institutions fraudulently promoting unhealthy programs, and writes regular blogs that are shared on social media.  I learn so much from Dr. Barnard and am sure you will too.

A friend I have not yet met but hope to is Dr. John McDougall at www.drmcdougall.com.  Dr. McDougall worked in Hawaii decades ago and observed how the health of native Japanese started to deteriorate when they moved to Hawaii and starting to consume Western foods.  He established a clinic that promoted plant based diets rich in complex carbohydrates and whole grains and has treated tens of thousand of patients or more with these diets.  He regularly writes blogs, publishes book, and produces teaching videos and I have found these very helpful.

Another resource I bring to you is www.mindbodygreen.com. This site established in 2011 has grown at a meteoric speed and now 15 million or more visits occur monthly.  I began writing a weekly column for them a year ago and have contributed over 50 blogs on health and nutrition.  The authors are diverse and occasional blogs promoted non-vegan diets.  I respond to these vigorously for the often erroneous data they present.  Yoga, recipes, and life coaching are frequent other categories. 

And finally, www.bringyourownlentils.com.  This site is simply fun, diverse and of high quality. I am proud to be contributing and look forward to meeting you on March 1. Come say hello.  I will be talking about 10 Holistic Heart Tips and my new book The Holistic Heart Book www.holisticheart.com will be available.  

You can learn more at my website www.drjoelkahn.com or on Twitter at @drjkahn.  Ciao!

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.