Fat Free/Vegetarian Theory of Heart Disease

[123xyz]

As far as his studies go though, I'm totally unconvinced with the results, and he offers minimal detail to illuminate the ins and outs of his methods. The fact that he employs statins so routinely is a big no-no for me. I should also point out that of his original cohort (Before it became 11 patients), 23 were male and only 1 was female. Again this affects its relevance to general population.

If you want to base your diet around sketchy evidence its your call. I'm not saying the diet is all bad but to the best of my knowledge I can say that its far from optimum. Let us know how you get on with it anyway.

All the best,

Harry

Yup, the study has short falls and perhaps could have been done differently. To totally reject (or be "totally unconvinced", as you put it) the Esselstyn results, however, based on the objections you have raised, does not appear to be rational. But, to each his own. Ain't diversity wonderful?

[ofonorow]

Well, to quickly respond, I think DonHarry's analysis provides a counter-point to the claim of "no events in 12 years." So debate from both sides is very good and hopefully steers us closer to the truth.

Humans require fats in their diet (unlike carbs, which we can exist without.) The term "essential fatty acid" means we must obtain some fat from the die. Fats are broken down to the EFAs during digestion (as proteins are broken down into amino acids, and carbohydrates into the sugars e.g., glucose). So one can comfortably assume that those in the E. study consumed enough fat to survive that long. The good affect by avoiding fats and junk foods is that the ingestion of trans fatty acids was likely close to zero. The obvious problem with avoiding fats (oils) altogether is that every cell membrane in the body requires fats (lipids). Think of these membranes as balloons. There is a ongoing repair-like process to keep membranes intact so that our cells( there are trillions of them) do not collapse like a ballon with a pin stuck in it. (There is theory to which I subscribe that Type II Diabetes is entirely a cell membrane "disturbance" caused by trans fats substituting for the proper fats in cell membranes during this ongoing membrane maintenance and repair process - see: healingmatters.com.)

I have a cousin who subscribes to the Ornish "no fat" theory, and while he is still alive at age 60, he generally looks pale, has trouble sleeping, and just does not look well to me. (He also takes a pretty comprehensive set of vitamin supplements - just in case.)

And that leads me to the problem with statins for anyone on a low protein diet, .e.g vegetarians. These drugs not only interfere with endogenous cholesterol synthesis, the interfere with the body's production of coenzyme Q10 - the enzyme required to split the phosphorus atoms in ATP in the mitrochonria of every cell. Without coenzyme Q10, cells die from the lack of an energy source. Eventually organs die, without Coenzyme Q10 supplementation. On a normal diet, one would get about 5 mg of CoQ10, and that seems to be enough to keep, say the liver from failing, but on a vegetarian diet, it is very risky to take statins without CoQ10 supplementation. (As I have mentioned many times, attorneys for "health conscious female vegatarians" have called me because of our statin warnings. Their clients had lost their livers because these health conscious ladies had started taking the "safe" statins as prevention. Their doctors are not aware of the problem because the FDA does not require warnings on statin drugs. Such warnings are required in Canada. See: http://naturesperfectstatin.com/warn.htmfor scans from Canadian Medical Journals.

[123xyz]

Well, to quickly respond, I think DonHarry's analysis provides a counter-point to the claim of "no events in 12 years." So debate from both sides is very good and hopefully steers us closer to the truth.

Humans require fats in their diet. The term "essential fatty acid" means we must obtain some fat from the diet. Fats are broken down to the EFAs during digestion (as proteins are broken down into amino acids, and carbohydrates into the sugars e.g., glucose). So one can comfortably assume that those in the E. study consumed enough fat to survive that long.

I have a cousin who subscribes to the Ornish "no fat" theory, and while he is still alive at age 60, he generally looks pale, has trouble sleeping, and just does not look well to me. (He also takes a pretty comprehensive set of vitamin supplements - just in case.)

And that leads me to the problem with statins for anyone on a low protein diet, .e.g vegetarians.

I would not characterize DonHenry's recent post as "analysis". Nothing he posted invalidates the Esselstyn clinical results. Furthermore, DonHenry failed to provide a single example of a disease caused by an oil-free plant diet. DonHenry claims to not understand Esselstyn's methods. Geez, what's so hard to understand about an oil-free plant diet? So, what is the Truth here? Any assertion that Esselstyn was untruthful needs careful exposition.

The issue about fats is this: Do we need to eat saturated fats in the diet? If they are, in fact, nonessential, i.e., manufactured in needed amounts by the body, then there is no support for the assertion that they must be eaten in a diet. Is there any evidence that eating an oil-free plant diet leads to a saturated fat deficiency in the body?

The observation about your cousin does not add value. There are many possible explanations for your observations that have nothing to do with your cousin's diet. In addition, one can make subjective observations about particular individuals all day long and not prove anything.

The point with statins was conceded long ago in this thread. Why continue to harp on that point? The real question is this: How would the clinical results have been different if statins had not been used? I suggest that the results might have been even better because it's hard to imagine how they could have been worse after noting all the points you guys have made about the negative effects of using statins. So, what you guys are really saying is that Esselstyn's results would have gone from IMPRESSIVE to REALLY IMPRESSIVE if he had not used statins. Sorry, guys, but it's really funny to see y'all snared by your own trap.

[DonHarry]

DonHenry

Is there any point continuing this discussion if you're going to act like a 5 year old? Your opposition to do any actual reading on any of the subjects I have recommended goes hand in hand with your inability to think for yourself. Hence why you must be told what to eat without actually understanding why.

The point with statins was conceded long ago in this thread. Why continue to harp on that point?

It remains a valid point. You posted the links to E's studies which I objectively reviewed and found that your original analysis of his study was incorrect.

You're an obvious troll. Do some reading and learn to accept when you are wrong.

[Donjman]

Furthermore, DonHenry failed to provide a single example of a disease caused by an oil-free plant diet.

I couldn't think of a disease caused directly by it. But you'd be at far greater risk for a number of problems.

You fail to understand that although your diet won't kill you, it will leave you with sub optimum nutrition, therefore that way of eating (in your eyes) is valid.

The idea that an oil free diet is the "cure" or "fix" for heart disease is completely ludicrous, you need only look at native populations (such as the inuit) to see they eat essential a ZERO plant, high fat, high cholesterol medium protein diet and were (up to 50 years ago) completely free from heart disease.

It's interesting that you don't seem to understand the field of nutrition well at all, and seem to have placed a great deal of faith into this doctors diet plan.

The avoidance of sugar is a good idea, it should drop total insulin and glucose levels allowing for more ascorbate utilization and body fat storage. Also vegetables are good for health.

You'll develop an iron deficiency (as the iron is non heme and VERY poorly absorbed), you'll develop a B12 deficiency. retinol levels will be low, as will K2 levels. You'll also have a severe deficiency with EPA/DHA omega 3 fats. You'll essentially be on a high carb diet. Saturated fats being so essential (as cholesterol) that de novo lipogensis occurs when you don't eat them. All of this probably goes over your head a little at the moment, you seem pretty angry with your responses to DonHarry because he's poking holes in your argument.

The link between dietary fat intake and heart disease is weak at best. Understand that the lipid hypothesis has been proved wrong too many times to count, that it shouldn't be considered an accepted theory any more.

Also, check the Frammingham study.

What more do you want to know?

[Johnwen]

Am I missing something here? Last I heard all vegetables contain some amount of oils which have fats in them. Some have more some have less. So eating Vegetables only, provides the body with the fats it needs to survive. Unless GMO plants have messed this up too???
If a veggie were to eat only one type of vegetable they might become deficent in some areas but from what I understand most eat a wide assortment of various plants which should provide the body of it's needs for fats. Statins would block the livers absorbation of these fats and cause stress to the body.
In what I read in this post it's my beleif that that the people used in the study obviously were not adhereing to the plant only diet as reported. If they did after 12 years the mortality rate would be quite High!

But the question remains If Vegetable oil comes from Vegetables and Mineral Oil comes from Minerals! Where does Baby Oil Come from???

[123xyz]

This thread was started by the admn. The first post was made by me in response to the problems that jknosplr was having, to wit, nothing he seemed to try seemed to be working. He did admit to trying some dietary adjustments. So, I simply pointed out Esselstyn's study as a way of learning about an additional dietary adjustment to ponder because it was reported to have a good result and was something jknosplr apparently had not tried.

I am not promoting Esselstyn's protocol as the CAD panacea. I have nothing to gain whether it is embraced or renounced on this forum. It just does not matter to me. I did have some fun playing the Devil's Advocate. I was disappointed that nobody came forth to refute or explain his outstanding clinical results. His results stand unscathed by any post in this thread. I did see a lot of method criticism - I guess if one cannot kill the message one might as well try to kill the messenger & his methods. But the method criticism has not discredited the study outcome. The outcome is what it is. You can ignore it if you choose. You can identify potential risks and potential improvements but you cannot deny the results that were achieved. The results are the results and they are good.

Along the way, I asked a few questions that I thought the massive brainpower on this forum could easily answer, like, why do we need to eat saturated fats if our bodies synthesize all we need? And like, what evidence is there that an oil-free plant diet causes a saturated fat deficiency in the human body? And like, what specific diseases are clearly caused by an oil-free plant diet? But, alas, no answers yet.

Sorry if I offended any true believers of diet dogma that is substantially different from what Esselstyn advocates. I encourage all of you true believers to practice your dietary faith as you see fit. But, if you ever get to the point where you have run out of options in dealing with CAD, I humbly suggest that you remember Esselstyn.

The Happy Troll

[Donjman]

To attack the study directly;

The study included 22 patients with angiographically documented,

22 patients is a small sample size. Also no control group used.

These patients took cholesterol-lowering drugs and followed a diet that derived no more than 10% of its calories from fat

The study used statins, you cannot therefore make your own conclusions as to what would happen if they hadn't used statins.

Of the 22 participants, 5 dropped out within 2 years, and 17 maintained the diet, 11 of whom completed a mean of 5.5 years of follow-up

11 completed the study for 5.5 years. Very small sample.

All 11 of these participants reduced their cholesterol level from a mean baseline of 246 mg/dL (6.36 mmol/L) to below 150mg/dL (3.88 mmol/L).

So far we know that taking a statin drops cholesterol, no mention of the dosage used, the statin used etc. For all we know the 11 people could have been on high dose statins, which would achieve this cholesterol lowering effect without dietary intervention.

. Analysis by minimal lumen diameter of 25 lesions fotind that 6 regressed, 14 remained stable, and 5 progressed.

Lets remember here, 25 lesions, 11 participants. NOT 25 people. We are still dealing with 11 people.

25 lesions over 11 people is 2.27 lesions average per person. 6 lesion regressions is 2-3 people.

So 2-3 people got better, 2-3 people got worse, and 5-7 people stayed the same.

Is this supposed to be ground breaking?

ANY positive benefits from this study are down to;

- Avoidance of sugar (thus reducing glucose intake, insulin/glucose levels, adipose tissue, possibly impacting activity levels)

- Increase in dietary magnesium intake (thus increasing arterial relaxation, thus decreasing risk)

- Increase in vegetable intake (thus increasing C intake, antioxidant status, mineral status)

- Possible anti inflammatory effect of statin (aside from the other shocking drawbacks)

I was disappointed that nobody came forth to refute or explain his outstanding clinical results. His results stand unscathed by any post in this thread

This is the second time your precious study has been attacked. Read the thread, and make sure you read my post properly.

I thought the massive brainpower on this forum could easily answer, like, why do we need to eat saturated fats if our bodies synthesize all we need?

Again I have answered this, but because you don't read you may have missed it. De Novo Lipogenesis. The body will meet saturated fat minimum requirements from carb intake. Minimum isn't optimum.

The results are the results and they are good.

Reasons listed above. Again. Read.

Sorry if I offended any true believers of diet dogma that is substantially different from what Esselstyn advocates

Adopting a low fat diet with a statin is the currently accepted dogma. You seem confused.

But, if you ever get to the point where you have run out of options in dealing with CAD, I humbly suggest that you remember Esselstyn.

Appreciated. But remember that your diet will lead to malnurishment on very basic levels.

The Happy Troll

I'm glad your happy. Though it may be short lived, depression risk for low fat diets is high. The link between omega 3 and serotonin levels is well established. Still I'm sure you've already thought of that.

[bbtri]

Confirmation bias (also called confirmatory bias) is a tendency for people to favor information that confirms their preconceptions or hypotheses and reject conflicting information regardless of whether the information is true.

This thread has been a case study in confirmation bias.

[Donjman]

Oh also, it seems the study of very low fat diets (10% cals) was measured through dietary recall. In other words the participants would simply recall their food intakes and macro nutrient ratios would be obtained from this. Failing that it could be that the participants would be given advice at the beginning of the trial and left to their own devices throughout the study. Either way it's usually inaccurate as people usually underestimate fat intakes, portion sizes etc.

Its probable the statin did the bulk of the cholesterol lowering work, perhaps the fruit/veg increased antioxidant status and thus further lowered cholesterol levels.

Also the measured cholesterol was only total, no breakdown of HDL/LDL which would have been interesting to see.

I certainly wouldn't base my diet on a study with 11 participants in which a handful of people got a little better (and going in the face of evolution). At the expense of lowered Q10 problems (memory issues, fatigue, cardiomyopathy), a higher risk for depression, a higher risk of inflammatory conditions (due to low epa/dha intake) a probable iron deficiency, a likely b12 deficiency, a grain based diet (high in phytates and gluten), low retinol and overall limited food choices.

Read the Frammingham study, it uses thousands of people and shows that dietary fat doesn't really have much of an impact at all.

Before you reply with the ususal immature retort, read this; http://www.westonaprice.org/abcs-of-nutrition/1555.html

And this; http://www.westonaprice.org/abcs-of-nut ... rimer.html

And this; http://www.amazon.co.uk/Great-Cholester ... 441&sr=8-1

And this; http://www.amazon.co.uk/Great-Cholester ... 441&sr=8-3

And this one; http://www.amazon.co.uk/Practicing-Medi ... 526&sr=8-1

[123xyz]

Confirmation bias (also called confirmatory bias) is a tendency for people to favor information that confirms their preconceptions or hypotheses and reject conflicting information regardless of whether the information is true.

This thread has been a case study in confirmation bias.

You got that right.

Anyway, just so there is no confusion here, I'll summarize the Esselstyn study again before I take leave of this thread.

Esselstyn was a cancer surgeon at the Cleveland Clinic, which has a premier conventional cardiology facility. He proposed a study to the cardiologists. The clinic's internal review board approved the study. Esselstyn was given permission to conduct the study essentially in his spare time with no financial support that he acknowledges.

The cardiologists sent him 24 heart patients, all with severe 3 vessel disease, for whom conventional medicine could do more more. The patients were in despair & without hope. The death sentence had been rendered. Esselstyn was dealt a lousy hand but he played it anyway. There is no mention of what drugs the patients were using but a good guess is that they were all using drugs since they had been under conventional care by cardiologists.

The main part of the new protocol for the patients was a new diet: plant based (grains, legumes, fruits, vegetables) with no added oils. In addition they were to take a statin drug as needed to get their total cholesterol below 150. They also took a few vitamins. The protocol did not include EECP, EDTA chelation, massive vitamin doses, or other alternative therapies. Six patients would not comply with Esselstyn's protocol so they were released back to their cardiologists. The 18 remaining patients had had 49 serious cardiac events (heart attacks, bypasses, stents, etc.) in the previous 8 years. These 18 patients agreed to comply with the protocol.

The total study lasted 12 years. One patient did not make it to the end. His death sentence came due after 5 years and he died of a cardiac arrest, an electrical malfunction. Autopsy showed no CAD-caused heart attack. Of the other 17, one fell off the wagon for 18 months and reverted back to his prior diet. He ended up with a bypass but afterward returned to compliance. In all, 17 patients completed the 12 year study. In these 17 patients there were no cardiac events (other than the aforementioned bypass) during the 12 year study. Furthermore, the patients all recovered a large measure of their vigor, health & vitality. Now, 21 years after the study began, 14 are still following the protocol and are living active lives.

These are just the bare facts, obtained from reading the book. For more information, go here: http://www.heartattackproof.com/reversal01.htm

[Donjman]

I'll summarise my points again for you, since you can't understand.

It has nothing to do with the avoidance of dietary fat (save trans) end of story. There are some good points (avoiding sugar) and lots of bad points (listed before).

I'm glad your taking leave of the thread, I was getting sick of posting.

[DonHarry]

You got that right.

Are you completely deranged?

Before I take leave of this thread.

I think that's the best idea you've had yet! You clearly haven't read any of the information rich posts which have preceded your diluted non-directional posts.

Your precious study has been successfully disseminated on two occasions in this thread but for some reason you refuse to concede based on stubbornness. If the results really were fantastic and the catalogue of problems documented in the thread did not exist then I would have no problem with backing the study. Unfortunately this is not the case, something which you consistently either fail to see or simply ignore. Additionally, you STILL have your figures wrong. 17 patients did NOT complete the 12 year study. 11 patients did. Read the study for yourself, the figures donjman acquired were from the actual study, not Esselstyns misinterpretation in his book.

So 2-3 people got better, 2-3 people got worse, and 5-7 people stayed the same

Again, this is the meager reality of his study. If this is compelling enough for you to subscribe to a vegetarian oil free diet then more fool you.

I really can't fathom your ridiculous retorts in view of everything that has been brought up in this thread. You'd rather disregard the truth and risk sounding like a fool than just accept that perhaps you were wrong. These threads are started to identify the worth of theories/protocols/ideas, they are not presented with any malice - such as you seem to think they are. If you think that the only protocol that will be accepted on this forum is the Pauling Therapy then you're mistaken. Granted there is more than one way to skin a cat, unfortunately, after fairly explicit review, Esselstyns protocol is not one of them based on his single, very small, unremarkable study.

I'll let you have the last word however, since it means so much to you. Enjoy you're veg/oil free days.

[123xyz]

I'll let you have the last word

There does still appear to be some confusion. Esselstyn seems to be responsible for some of the confusion because two of his papers have conflicting info. The content of the article in The American Journal of Cardiology ( http://www.heartattackproof.com/reversal01.htm ) , however, agrees with his book, so I will base this reply on that material.

24 patients were referred to Esselstyn. 6 were rejected, leaving 18.
18 patients completed 5 years with no new cardiac events. 11 had angiograms at 5 years.
17 patients completed 12 years with no new cardiac events while compliant with the protocol.

The summary is simply this: 49 cardiac events in the 8 years preceding the study. No cardiac events for the 12 years of the clinical study. Given the condition of the patients at the beginning of the study, this is a marvelous outcome by any objective standard. There is no way that this outcome of the "precious study" can be "disseminated" or even decimated by anything written anywhere. The outcome is what it is. Period.

There have been some risks asserted for the Esselstyn protocol. Whenever risks are identified with an otherwise successful protocol, the common procedure is to identify & evaluate risk mitigation approaches before rejecting the protocol entirely. I would submit that risk-free dietary supplementation could at least partially mitigate some of these risks. For example: CoQ10 or CoQH supplementation for a known statin issue and large dose Vitamin C supplementation for any cancer issue. The vitamin protocol of Rath (referenced below) might be worth considering. It may be that some other risks, though real, may be minor or of low probability because, during and since the 12 year study, Esselstyn did not report any disease symptoms, physical problems or mental problems, manifesting in the patients, that could be attributed to his protocol. And, then, of course, one can always tinker with the protocol, e.g., eliminate the statins or add a little fish oil.

I would like to now make a small suggestion. If you know of a clinical study that started with a group of very sick heart patients, that got them to adopt a diet/drug/supplement protocol, that monitored the patient progress for many years and then published the results, please describe the study, the clinical results and provide a link to a website for more detail. I would personally be particularly interested in any clinical study featuring the diet that has "seen man through some million years" of evolution.

This is not exactly what I'm talking about but it's still interesting: A study was conducted by Rath et al: http://www4.dr-rath-foundation.org/THE_ ... /pub18.htm

In this study the emphasis was on nutritional supplements. The CAD patients were instructed to not change their diet or lifestyle. Patient symptoms were not specifically mentioned as important by the authors; they were more interested in the results of diagnostic tests. The patients generally were not in as bad a shape as Esselstyn's patients. Some definite successes were achieved by Rath with the nutritional supplement approach. Some prose from the study report:

"A total of 55 patients, 50 men and 5 women, with documented coronary artery disease (CAD) assessed by Ultrafast CT, were recruited for the study. The aim of this study was to determine the effect of a defined nutritional supplement program on the natural progression of coronary artery calcification particularly in its initial stages as measured by Ultrafast CT. The most important finding of this study is that coronary artery disease can be effectively prevented and treated by natural means. This nutritional supplement program was able to decrease the progression of coronary artery disease within the relatively short time of one year, irrespective of the stage of this disease. Most significantly, in patients with early coronary calcifications this nutritional supplement program was able to essentially stop its further progression. In individual cases with small calcified deposits, nutritional supplement intervention led to their complete disappearance."

[Donjman]

The summary is simply this: 49 cardiac events in the 8 years preceding the study. No cardiac events for the 12 years of the clinical study. Given the condition of the patients at the beginning of the study, this is a marvelous outcome by any objective standard. There is no way that this outcome of the "precious study" can be "disseminated" or even decimated by anything written anywhere. The outcome is what it is. Period.

It is nothing to do with the avoidance of dietary fat (save trans) or meat. It's to do with the avoidance of sugar and increasing vegetable intake. Read the Frammingham study.

The idea of avoiding fat and animal products is flawed and will lead to malnourishment.

I would like to now make a small suggestion. If you know of a clinical study that started with a group of very sick heart patients, that got them to adopt a diet/drug/supplement protocol, that monitored the patient progress for many years and then published the results, please describe the study, the clinical results and provide a link to a website for more detail. I would personally be particularly interested in any clinical study featuring the diet that has "seen man through some million years" of evolution.

I couldn't think of one.

Most now agree that man evolved for a few million years on a diet consisting of meat (and fat), fish and some plants. No bread, no rice, no pasta, no cereals.

Read the Frammingham study, it's massive and has been running for years and shows the correlations between dietary fat (including sat) are low with heart disease. This therefore shows that Esselstyn's idea of removing animal products and reducing fat intake to 10% is totally unnecessary. Given the risks of undernourishment it's not wise to do so. That is the bulk of his protocol and its wrong, his model of heart disease is flawed.

Here's another study. In this one women were asked to decrease total fat intake, increase fruit and veg intake, and increase grains.

The womens health initiative 2006 trial, involving 48 835 people.

Method was: Intensive behavior modification in group and individual sessions designed to reduce total fat intake to 20% of calories and increase intakes of vegetables/fruits to 5 servings/d and grains to at least 6 servings/d. The comparison group received diet-related education materials.

Conclusion: Over a mean of 8.1 years, a dietary intervention thatreduced total fat intake and increased intakes of vegetables, fruits, and grains did not significantly reduce the risk of CHD, stroke, or CVD in postmenopausal women and achieved only modest effects on CVD risk factors, suggesting that more focused diet and lifestyle interventions may be needed to improve risk factors and reduce CVD risk.

I'd love to hear what Esselstyn's theory is on why he gets the handful positive results. My theory is that his patients will have lowered BG levels, lower adipose tissue, lower insulin requirements leading the more C being available as well as other factors such as increase magnesium intake. They probably have lowered LP(A) and lower risk of clots.

What's his theory? That fat causes heart disease? How? By "clogging" the arteries?

The point is that his protocol does have some benefits. But there are far too many drawbacks. All because of Esselstyn's misguided idea that dietary fat is causing or is linked to heart disease due to some outdated 1950's schoolboy theory on cholesterol. The diet could be far better.

It seems to me you've just gone and bought the low fat T-shirt and don't want to have to buy some butter when you next go shopping.