For The Love of Your Heart

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Hundreds of books have been written on heart health with emphasis of very diverse goals but two basic scenarios stand out: Either you want to improve the health of your body and heart irrespectively of their health levels or you want to heal your diseased heart. Both of these strategies require the same basic lifestyle changes and medical treatments. However, healing a diseased heart requires some additional special efforts.

 


If you want to improve your heart health then get the basic scientific information.

A Book you have to Read:

Marc Gillinov, M.D. & Steven Nissen, M.D.

collected the essential basic fact on heart health and disease and summarized their pragmatic observations in this thick but easily readable and understandable book. Based on the guidelines of professional and government agencies and combined with their own medical experience they promote a widely accepted heart healthy lifestyle with

1. No smoking, 2. Five days per week challenging exercise (sweating), 3. Weight reduction to below obesity-level, 4. Blood sugar control, 5. Blood pressure control to <120/80, and 6. Total cholesterol level control to <200 mg/dL applying a low dosage (10mg) of a statin (Crestor) and a Mediterranean diet (20% fat). Under these conditions it is proven by numerous meta studies (average outcomes of tens of thousands of observed patients) that heart health is maintained or will improve. This is the “new” medical direction in our healthcare system, personally given health care advice based on the average behavior of all treated patients. The patient, who was traditionally being diagnosed through comprehensive individual observations documented in a written patient history, is now being treated as faceless average person. Well, of cause in average that works fine in 15 minutes long visits, and is risk-free for the physician but may not be so for some of the not-so-average patients.

 


If you have atherosclerosis or want to heal your diseased heart follow

Dr. Caldwell Esselstyn’s Advise:

In addition to the widely accepted heart healthy lifestyle with

1. No smoking, 2. Five days per week challenging exercise (sweating), 3. Weight reduction to below obesity-level, 4. Blood sugar control, 5. Blood pressure control to <120/80, Esselstyn prescribes in 6. a reduction of the cholesterol levels in the blood using a low dosage (10mg) of a statin (Crestor) and eating a“10% Fat Plant-based Diet” without any cholesterol intake from animal products,

low-salt content and no plant oils. Optimal Blood Data are Total Cholesterol below 150 mg/dL and LDL (bad cholesterol) below 85 mg/dL. At risk patients with heart disease should have a LDL (bad cholesterol) level below 70 mg/dL. Under these conditions it is proven in controlled individual patients observations that heart health will improve and it is shown that a diseased heart may heal.

 

The Interview you have to Hear:

Click picture to listen to interview.

 

Esselstyn and Ornish performed the first and up to now unrepeated studies on the influence of a low-fat plant diet on manifestation of atherosclerosis and the healing of heart disease.

Books you have to Read:

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Caldwell Esselstyn, MD

made clinical studies to show that a strict plant-based diet can reverse heart disease by lowering total cholesterol levels below 150 mg/dL as seen in cultures where heart disease is essentially nonexistent. Total cholesterol levels above 240 mg/dL can be considered as “high risk” for developing heart disease. His plant-based diet is directed at patients with heart disease and aims to reduce the risk of further complications and to heal the diseased heart. For this purpose, his diet does not allow any intake of cholesterol (present in all animal products, but not in plants) and requires a strict reduction of saturated fat intake and natural oil consumption (fish oil, olive oils, avocados, nuts etc.), which foster through triglycerides cholesterol production by the liver (as do excess of calories, alcohol and sugar). He accepts a lowest dose of drugs (statins like Crestor) for further reduction of liver-produced cholesterol and thus does not require any additional means of cholesterol reduction (as required by Ornish). This book has many great family recipes but has little practical guidance how to start with the new cooking.

http://www.heartattackproof.com

 

Dean Ornish, MD

made his clinical studies at  the same time as Esselstyn and stresses that the plant-base diet for the prevention and healing of heart disease requires further steps for the natural reduction of liver-produced cholesterol. He rejects use of cholesterol-reducing medication (like Crestor) but requests stress-reducing activities including 30 min daily physical exercise, social group therapy, meditation and Yoga for fostering inner harmony and happiness. On this account he can allow a fat-reduced diet that includes some cholesterol intake from animal products like fish, low-fat dairy products and other very-low fat ready-to-eat frozen meals – as well as fish oil. Most of his books are somewhat hard to read because of the abundant medical details discussed. The many recipes provided were refined by well-known chefs but are not geared towards the novice cook.

 

 

Is there a real scientifically based controversy?

 

 

All three books and their four authors agree on the basic fact of necessary life style improvement – like every other educated healthcare provider will do. Nissen and Gillinov even agree with Esselstyn on the essentiality of statin use. However,…(please watch)..

 

Go to Public Radio and listen to the interview:

Click picture to listen to the interview.

 

Excerpt from the interview:

Nissen: You know what really struck me is that I went to the Internet one day and you type in “heart disease” and you get all kinds of information, and the vast majority of it is dead wrong scientifically.

It’s terrible. We have people now out on the talk show circuit telling you that their diet is going to make you heart-attack-proof. That some ultra low-fat diet will melt away the plaques in your coronary arteries, and they’re convincing otherwise thoughtful people to not take the medications that they need and to have this magical faith that some wacky diet is going to make them all better.

We knew that it was the right time to write a book that’s based not on myth, but on fact. We acted like a jury – two of us would sit there and weigh the evidence, look at the science and then come to a conclusion. There are things in there where we tell you science doesn’t have the answer yet.

http://www.pbs.org/wnet/tavissmiley/interviews/steven-nissen-m-d-marc-gillinov-m-d/

 

So why retreating to verbal polemic? In their book “Heart 411” they do not have a chapter or even a discussion on or mentioning of HEALING a diseased heart. In writing (in their book p 52) they only mention Esselstyn’s and Ornish’s diets as being challenging to follow and producing unfavorable side-effect of lowering the HDL (good) level. Such an effect is not observed or reported by Esselstyn and Ornish neither in their books nor in their publications. One basic reason for their avoidance of HEALING might be that scientific patient studies of diet effects on any physiological phenomenon (including heart disease) are nearly impossible to control at a level required for analyzing a causality between study goals and outcomes since patients rarely adhere to the study rules, have a diverse and varying physiology as well as history regarding health, socioeconomically conditions, and self-control. Esselstyn and Ornish made their first and up to now unrepeated scientific studies with controlled patient groups (Private Practice or locked up into a rented hotel for weeks and not allowed to eat anything else than prepared in the hotel kitchen under detailed specifications); and then they used scientific and medical imaging tools to verify their observations and published them in peer-reviewed medical journals (Esselstyn, 1995, 1998; Ornish, 1998), publications the Heart 411 writers obviously do not find worthy to mention under their book’s sub-title motto: The ONLY (emphasis by authors) guide to heart health you’ll ever need. Their omission points to a characteristic conflict (Esselstyn, 2001) between devoted scientific observation done at the individual patient level and the averaging conclusion drawn from meta studies of thousands of patients. Whereas the later provides valid general behavior guidelines, the former provides valid individual solutions. The reconciling experiment is obvious: While staying on statins what will happen to the blood values after following a 10%-fat Esselstyn diet for over one year and then switching to a 20%-fat Mediterranean diet? My first experiences with breaking the Esselstyn rules a few times for a few days in 2011 might foreshadow the results (see chart on the Stories page of this website). Since summer 2013 this challenge is on.

 

All three books provide very important facts on cause and treatment of atherosclerosis and heart disease, which are unfortunately not taught to everyone in public schools or to future professionals in medical schools. However, as pointed out on Feb 29, 2012 in this episode of the Travis Smiley show, some first positive changes in our healthcare system (emphasizing cost savings through preventive care based on average behavior of all patients and closer guidance of the individual behavior of at risk patients through targets administrative follow up) are being now forthcoming and may have a general impact not only on the maintenance of heart health but also on the healing of heart disease.

 

 

Scientific References (click on PubMed link for article/abstract display):

 

·         Ornish D, Brown SE, Billings JH, Scherwitz LW, Armstrong WT, Ports TA, McLanahan SM, Kirkeeide RL, Gould KL, Brand RJ, Can lifestyle changes reverse coronary heart disease? The Lancet, 1990, 129 – 133. DOI: 10.1016/0140-6736(90)91656-U [PubMed]

·         Esselstyn CB, Presidential address: Beyond surgery. American Association of Endocrine Surgeons. Surgery. 1991 Dec;110(6):923-7 [PubMed]

·         Esselstyn CB, Ellis SG, Medendorp SV, Crowe TD, A strategy to arrest and reverse coronary artery disease: a 5-year longitudinal study of a single physician’s practice. J Fam Pract1995;41:560–568  [PubMed]

·         Esselstyn CB Jr. Foreword: changing the treatment paradigm for coronary artery diseaseAm J Cardiol. 1998;82(10B):2T4T.

·         Ornish D, Scherwitz LW, Billings JH, Gould KL, Merritt TA, Sparler S, Armstrong WT, Ports TA, Kirkeeide RL, Hogeboom C, Brand RJ. Intensive lifestyle changes for reversal of coronary heart disease. JAMA. 1998;280:2001–2007 (Context.—  The Lifestyle Heart Trial demonstrated that intensive lifestyle changes may lead to regression of coronary atherosclerosis after 1 year.) [PubMed]

·         Esselstyn CB. Updating a 12-year experience with arrest and reversal therapy for coronary heart disease (an overdue requiem for palliative cardiology), Am J Cardiol. 1999;84:339-341 [PubMed]

·         Esselstyn CB Jr. Resolving the coronary artery disease epidemic through plant-based nutrition, Preve Cardiol. 2001;4:171-177 [PubMed]

 

Books (many other different editions are published at various dates)

·         Esselstyn CB, Prevent and Reverse Heart Disease. Avery, NY, 2007. ISBN 978-1583332723 (hard cover)

·         Ornish D. Dr. The Spectrum: A Scientifically Proven Program to Feel Better, Live Longer, Lose Weight, and Gain Health.  Ballantine Books, New York NY, 2007. ISBN 978-0345496300 (hard cover)

·         Ornish D. Dr. Dean Ornish’s Program for Reversing Heart Disease. Random House, NY, 1990. ISBN 978-0394575650 (hard cover)

·         Gillinov M and Nissen S. Heart 411: the only guide to heart health you’ll ever need. Three Rivers Press, New York NY, 2012. ISBN 978-0-307-71990-4 (soft cover)

 

 

 

Other Materials

Leonard JN, Hofer JL and Pritikin, L. Live Longer Now. The First One Hundred Years of Your Life. Grosset & Dunlap, New York, NY, 1974. ISBN 0-448-12262-6 (paperback).

Kurzweil R. The 10% solution for a Healthy Life. Three Rivers Press, 1993. ISBN 0-517-88301-5 (paperback)

A Agatston. The South Beach diet Supercharged: Faster Weight Loss and Better Health for Life. St. Martin’s; Reprint edition, 2009. ISBN 978-0312372064 (paperback).

McCarty MF. Policosanol safely down-regulates HMG-CoA reductase - potential as a component of the Esselstyn regimen. Med Hypotheses. 59(3):268-79 2002 ; [PubMed]

Estruch R, Ros E, Salas-Salvadó J, Covas MI, D Pharm, Corella D, Arós F, Gómez-Gracia E, Ruiz-Gutiérrez V, Fiol M, Lapetra J, Lamuela-Raventos RM, Serra-Majem L, Pintó X, Basora J, Muñoz MA, Sorlí JV, Martínez JA, Martínez-González MA; the PREDIMED Study Investigators. Primary Prevention of Cardiovascular Disease with a Mediterranean Diet. N Engl J Med. 2013 Feb 25. [Epub ahead of print] [PubMed]

 

Web Materials

U.S.News Best Diets Rankings. 2013 [Web]

 

 

 

Offerings you should carefully Read or Subscribe to:

And yes, there are other physicians and cardiologist out there who advertise facts scaring uneducated consumers (deadly bananas) and then selling their knowledge in all kinds of dubious ways through political oriented media.

Hosted by newsmax.com (the organization claiming to be the #1 conservative news agency online with Bill O’Reilly, Dick Morris, Ed Koch, David Limbaugh) you get sold simple e-mail reports on freely available or common sense knowledge as well as their “proprietary” “revolutionary” remedy pills for approximately $50 per item.

 

 

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