Prevent & Reverse Heart Disease
By: Caldwell Esselstyn, Jr. M.D.
                          Kathy Freston Interviews The Author:


                                                 "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

So says: Dr. Caldwell Esselstyn, Jr. who received his B.A. from Yale University
and his M.D. from
Western Reserve University and was a researcher and
clinician at the
Cleveland Clinic for over 35 years, where he served as
president of the staff and as a member of the board of governors.  

In 1991,
Dr. Esselstyn served as the President of the American Association of
Endocrine Surgeons
, and organized the 1st National Conference on the
Elimination and Prevention of Heart Disease.  

In 2005, he became the 1st recipient of the
Benjamin Spock Award for
Compassion in Medicine.

Dr. Esselstyn is also an Olympic Gold Medallist in rowing, and he was awarded
Bronze Star as an army surgeon in Vietnam.  

In this series of interviews I've conducted with extraordinary nutritional
researchers and medical doctors, I've sought to understand the link between
diet and the most common and dreaded diseases that are prevalent in our

What I'm hearing over and over is that a plant based diet is both preventative
and healing, whereas a diet high in animal protein is destructive to our health -
this is the case with cancer, type 2 diabetes, and heart disease.  

The great news is that there is very real hope in shifting the course of our
health.  What is becoming very apparent through various peer reviewed
studies is that by changing our diet - eliminating that which causes havoc in
the body (animal protein) and adding in plant based proteins and eating lots of
vegetables, legumes, beans, and whole grains, we can not only prevent
disease, but also heal from it once it is already in motion.  

The following is a fascinating conversation I had with an extraordinary doctor
on diet and heart health.  

Kathy Freston: What exactly is coronary heart disease?  

Dr. Esselstyn: Coronary heart disease is the leading killer of women and men
in western civilization.  It is predicted to become the #1 global disease burden
by 2020.  

It consists of an inflammatory buildup of blockages in arteries to the heart
muscle.  These blockages are made of fat, cholesterol, calcium, and
inflammatory cells.  

Blockages can become severe enough to cause symptoms such as shortness
of breath or chest pain (angina).  When blockages suddenly become complete,
the portion of heart muscle fed by that blocked artery is now deprived of
oxygen and nutrients, thus it is injured or now dies.  This is a heart attack.  The
patient may survive or succumb if the event is accompanied by a fatal heart

Kathy Freston: Who develops heart disease?  

Dr. Esselstyn: Everyone eating the typical western diet.  In autopsy studies of
our GI's who died in the Vietnam and Korean wars almost 80% at an average
age of 20 years, had disease that could be seen without a microscope.  Forty
years later in 1999, a study of young persons between the ages of 16-34 years
who have died of accidents, homicides and suicides, finds the disease is now

Kathy Freston: What is the cause of the disease?  

Dr. Esselstyn: It is the typical western diet of processed oils, dairy, and meat
which destroys the lifejacket of our blood vessels known as our endothelial
cells.  This cell layer is a one cell thick lining of all of our blood vessels.  

Endothelial cells manufacture a magical protective molecule of gas called nitric
oxide, which protects our blood vessels.  It keeps our blood flowing smoothly,
it is the strongest dilator (widener), of our blood vessels, it inhibits the
formation of blockages (plaques), and it inhibits inflammation.  

Kathy Freston: With such natural protection, why do we ever develop heart

Dr. Esselstyn: Every western meal of processed vegetable oils, dairy products,
and meat (including chicken and fish) injures these endothelial cells.  As
individuals consume theses damaging products throughout their lives, they
have fewer functioning endothelial cells remaining and thus less of the
protective nitric oxide.  Without enough nitric oxide the plaque blockages build
up and grow creating eventually heart disease and strokes.  

Kathy Freston: Can it be stopped or even reversed?  

Dr. Esselstyn: Yes.  First we must look at the lessons learned from cultures
where there is a virtual absence of coronary artery heart disease such as rural
China, the Papua Highlands of New Guinea, Central Africa, and the
Tarahumara Indians of Northern Mexico.  Their nutrition is plant based without

Beginning in 1985 I initiated a study of seriously ill coronary artery disease
patients.  Their nutrition became plant based without oil.  Their cholesterol
levels plummeted.  Their angina disappeared.  Their weight dropped.  I have
reported this study at 5 years, 12 years, and 16 years, in the peer reviewed
scientific literature and again beyond 20 years in my book
Prevent and Reverse
Heart Disease.

In some of the patients we had follow up angiograms (x-rays) of previously
blocked arteries demonstrating striking disease reversal, which is a testament
to my often quoted statement:

"The truth be known coronary artery disease is a toothless paper tiger that
need never exist and if it does exist it need never progress."  

The greatest gift to these patients is the increasing recognition that they are the
locus of control for their disease - not some pill or procedure.  They have made
heart attack proof and lose the greatest fear of all heart patients
and their families - when will the next heart attack occur?  

Kathy Freston: What about drugs, stents, and heart bypass surgery?  

Dr. Esselstyn: Admittedly in the midst of a heart attack a stent or bypass may
be life saving, however, for the remaining 90% studies confirm that they do not
prevent future heart attacks or prolong life.  

They are associated with significant complications such as hemorrhage, heart
attack, stroke, cognitive decline, depression, and death.  The benefits erode
with the passage of time as the stents and bypasses may themselves develop

Some drugs may decrease blood pressure and the heart workload.  Others
interfere with clotting which helps a stent remain open.  Statin drugs lower
cholesterol.  None of these drugs or interventions addresses the basic
causation of disease and not surprisingly the disease progresses with the need
for more drugs, stents, and repeat bypasses.  

Kathy Freston: Why aren't physicians using nutrition therapy?  

Dr. Esselstyn: Most physicians have no training or understanding of the power
of nutrition.  In a busy practice they would not have the time for it.  It is my
belief that physicians must accord the plant based lifestyle transition its due.  

Every patient with cardiovascular disease should be referred to a physician or
nurse practitioner with the knowledge and expertise in these counseling skills.  

Kathy Freston: But I understand physicians don't believe patients will make
this transition.  How come?  

Dr. Esselstyn: Nutrition counseling is a skill, which physicians don't possess.  
Of all the encounters a patient with cardiovascular disease experiences,
perhaps the least time and lowest priority is nutritional counseling.  I see many
patients with heart disease who recount that nutrition was never even
mentioned.  It is therefore unlikely that the patient feels that nutrition is

Kathy Freston: What is that you do differently?  

Dr. Esselstyn: In an intensive 5 hour counseling session for a group of heart
patients, my first priority is to eliminate the mystery of what causes their
disease.  It has not been stress, or genes.  It is their western diet of processed
oil, dairy, and meat.  

Hypertension, diabetes, and smoking must be controlled but food trumps all.  I
spend at least an hour defining the protective role of endothelial cells and nitric
oxide functioning as the ultimate guardians of our blood vessels.  They quickly
understand that their lifetime of ingesting these harmful products has totally
overwhelmed and destroyed their endothelium to an extent where it is unable
to protect them.  

They fully grasp that they must forever eliminate ingesting foods that will
further destroy their already compromised endothelium.  They understand
heart disease is a food borne illness.  

Kathy Freston: Where is the good news?  

Dr. Esselstyn: The patients understand that they can halt their disease.  They
are presented with my scientific articles demonstrating reversal of disease.  
They learn that anginal chest pain may diminish or disappear within 10-14 days
in some patients while others may take longer.  

We share our data confirming reversal of carotid artery disease to the brain,
coronary artery disease of the heart, peripheral vascular disease in the
extremities, and the reversal of erectile dysfunction.

They are made to appreciate how rapidly and powerfully the endothelial
function may be restored.  The most significant message in our counseling is
patient awareness that they are empowered to be the locus of control of their

Kathy Freston: What is your take on the present management of heart disease
through drug stents and bypass surgery?  

Dr. Esselstyn: It is expensive, dangerous, and ineffective.  None of these
approaches addresses the factors that cause the disease.  A doctor would
never treat poison ivy without advising the patient to avoid exposure to poison
ivy plants.  

Sadly the usual treatment of cardiovascular disease almost never includes
hours of patient counseling so they may completely eliminate the foods, which
are injuring their endothelium.  

Stents may block, bypass veins shut down, drug doses increase, and blood
vessel disease worsens.  The present cost of this non-treatment of heart
disease is unsustainable even in our wealthy nation.  

Kathy Freston: Dr. Esselstyn, are you a threat to the stenting and bypass

Dr. Esselstyn: Not really.  Stents and bypass surgery in an emergency setting
are absolutely lifesaving.  

However, for non-emergency situations an intensive lifestyle trial of 3-6
months would eliminate the need for most interventions.  It is of interest that
when physicians and some interventional cardiologists themselves develop
the disease they come knocking at my door.  

Kathy Freston: Why do you think this information on diet and heart disease is
not more widely known? Is someone or something blocking your message?  

Dr. Esselstyn: The government, drug industry, and some of my own
profession.  The USDA every five years produces a food triangle, which
promotes the very foods which guarantee that millions of Americans will

The drug industry has a $21 billion dollar income from statin drugs alone.  The
stent manufacturers make billions more.  Neither of these industries would
want this epidemic resolved.

Physicians who perform stents and bypass surgery earn millions and are
hardly clamoring for fewer patients.

Kathy Freston: Any final thoughts?  

Dr. Esselstyn: When people learn to eat plant based to eliminate heart disease
it could inaugurate a seismic revolution in health.  Other diseases that resolve
include obesity, hypertension, stroke, heart attacks, gall stones, diverticulitis,
asthma, osteoporosis, allergies, rheumatoid arthritis, multiple sclerosis, lupus,
and a marked decrease in the common western cancers of breast, prostate,
colon, endometrial, ovarian, and pancreatic.  

Kathy Freston: Thank you, Dr. Esselstyn.  

Kathy Freston is the New York Times best-selling author of the Veganist and
The Lean.  

Heart Disease: A Toothless Paper Tiger That Need Never Exist

Kathy Freston
Caldwell Esselstyn