I am so honored to have an esteemed guest on my blog today, Dr. Caldwell B. Esselstyn. Dr. Esselstyn is one of the leading movers and shakers in the plant-based world. He studied at Yale and received his medical degree at Western Reserve University. Dr. Esselstyn was trained as a surgeon at the Cleveland Clinic and at St. George’s Hospital in London. He has been associated with the Cleveland Clinic since 1968. During that time, he served as President of the Staff and as a member of the Board of Governors. He chaired the Clinic’s Breast Cancer Task Force and headed its Section of Thyroid and Parathyroid Surgery.
In 1995 Dr. Esselstyn published his benchmark, long-term nutritional research documenting how he arrested and reversed coronary artery disease in severely ill patients with plant-based diet strategies. This information is provided in his book Prevent and Reverse Heart Disease.
Dr. Esselstyn and his wife, Ann Crile Esselstyn, have followed a plant-based diet for more than 26 years. Dr. Esselstyn presently directs the cardiovascular prevention and reversal program at The Cleveland Clinic Wellness Institute.
He has motivated thousands and thousands of people to take on a whole foods, plant-based diet to prevent and reverse disease. Who knows how many people he has saved over the years. He and his wife are absolutely passionate about the power of a plant-based diet. Ann, along with her daughter, Jane Esselstyn, co-wrote The Prevent and Reverse Heart Disease Cookbook.
It was so fun sitting down and talking with him about his take on what’s going on in the plant-based movement—now and in the future. He was so enthusiastic and generous with his time, and I’m happy to share some of his thoughts with you on my blog today!
Can you please tell us a bit about your own journey to a whole foods, plant-based diet?
I grew up on a dairy and Angus farm, and I took the usual route to medical school, studying at Yale and going through my internship. I was at Cleveland Clinic and served in the combat army. I went on to work with breast cancer, and realized that it was such a terrible force; you could do breast surgery but it did little to help the next victim.
So I started doing my own global research looking at places on the planet that had much lower rates of breast cancer. In Kenya it was very infrequent to get breast cancer, and in Japan it was very infrequent—but when they migrated to the US they soon had the same rates of breast cancer. The same thing with cancer of the prostate; incidence is extremely low in Japan. They had 137 prostate cancer deaths in 1978; today we have 20,000 per year in the U.S.
It became clear to me that disease risk was molded by the typical American diet, and I had to get the answers to this. Cardiovascular disease risk is very low in multiple cultures—even today. These diets are mostly based on whole plant foods without oil. It led me to the idea that you can eat to save your heart, and since then there have been many studies, such as the EPIC study and research from the World Cancer Fund, which clearly show that we need to decrease our reliance on meat.
So, I thought that maybe we could do this ourselves. My wife and I started eating a plant-based diet. In 1985, I had 24 patients in the Department of Cardiology who had triple vessel disease, and I showed that we could halt the disease and reverse it. On my website, you can see various articles published in peer-reviewed journals that show my work.
More and more people are interested in eating a more plant-based diet. Do you feel that programs, such as Meatless Monday, are helpful?
Programs like Meatless Monday are baby steps. You may be eating for your heart one day a week, but you are damaging it on the other days. When we imagine endothelial disease, from its inception, our great savior is nitric oxide. It is the strongest vessel dilator in the body, it prevents the walls of the artery from becoming inflamed or stiff, it prevents blockage or plaque to build up. It is our protector from cardiovascular disease. But eating meat, dairy and oils means fewer functioning endothelial cells and less nitric oxide.
Almost everyone on the planet has cardiovascular disease—we’re so trashed because of our diets. When they perform autopsies on 17-34 year-olds, they find that 100% of them have cardiovascular disease because of the way we eat. That’s why in our 40s, 50s and 60s we have clinical cardiac events. People shouldn’t eat foods that impair the endothelium—such as oils, and anything with a mother—meat, poultry, fish; and dairy products, such as milk, cream, butter.
All four of my children and their spouses, and my grandchildren eat a whole foods plant-based diet. Our family is not ravaged by the diseases of the typical American diet.
Do you feel that a plant-based diet is gaining traction with people?
I am excited to see that a plant-based diet is becoming more accepted. Look what happened with smoking, it went from 40 million smokers to 20 million. And look at seatbelts, and even HIV and AIDS. The public will change, but the millions of dollars in opposition from food companies and pharmaceuticals that profit from illness is a problem.
It’s so exciting to see the success of my classes. People can become empowered, once they realize they can do it—control and reverse heart disease. I have seminars with 10-12 people, and I call them each for about ½ hour before the seminar and ask them questions so that I can get my arms around their story. We have created a strong platform so that we can all move forward. How can I create compliance? Show them respect, give them some of my time. In the seminar everyone gets a notebook with recipes, articles, information about travel and restaurants, and a DVD of the seminar. Many people get started on this diet with my book alone. They might have seen the movie Forks Over Knives and looked me up on the Internet.
Of all the plant-based experts in the group, I’m probably considered the taskmaster. I’m very competitive and I don’t deviate from the program. I don’t want anything to impair one’s endothelial cells. I want to increase nitric oxide to halt disease. There are many ways that I see reversal in patients, including by angiogram, ultrasound, and PET scan.
Do you feel the health care community is starting to really embrace plant-based nutrition?
It’s so exciting to see what’s going on with mainstream healthcare, to see the transition. With all due respect, we need to acknowledge the fact that we have no training in nutrition or behavior modification in the specialty of heart disease. But things are beginning to change. Young cardiologists are more interested, I see a lot of physicians at my seminars. I am invited to speak at medical centers and colleges. What will really open the way is to show cardiology leadership the efficacy of the diet. But just 15 minutes in the office to talk to a patient is not going to do it.
One thing that we can’t forget is how much influence money has. Those creating the USDA Food Pyramid have often worked for the cattle and dairy industry, and let’s not forget the $35 million statin drug industry.
“People say that a whole foods plant-based diet is extreme, but what I think is extreme is the present American diet of processed foods and meat.”
There has to be more knowledge there among health care professionals—you can’t get people to do it if you think it’s extreme.
People argue that we should eat grass-fed meat, but in 1972 George Mann studied the Masai in Africa, who ate a lot of cattle, blood, and milk. He autopsied 50 of them and found that they had heart disease.
It is really quite striking to look at the epidemiological trials in Karelia, Finland in 1971-2. This was the heart attack capital of the world; people were eating so much dairy and meat. They changed the way people ate and cardiovascular disease went down 85%.
What are some of your own personal tips for being healthy and fit?
I exercise—it’s great for the bones. I like to bike ride and swim—it’s a bit kinder to the joints. But I have to stay in shape; I can’t get up and talk to people if I’m puffed up! (laughs) But I don’t complicate my recommendations to focus on exercise in detail. If there are too many behaviors to modify at the beginning, they won’t succeed so I spend it on food behavior.
Anne has many stir-fries that I love mixed with a whole grain. I like portabella mushrooms prepared in various ways. And just good old beans and rice with scallions, tomatoes, pepper, corn and salsa. Anne has made so many delicious salad dressings, which are in my book, and her book that she wrote with Jane.
What does the future hold for you?
Maybe in a few years I will write another book. I’m excited to be a member of the American College of Cardiology, which is something for a retired general surgeon. I’m excited to be on their nutrition committee. I’m committed to getting more information out to my profession. I’m passionate about summarizing my findings in patients that were told they needed a stent or bypass but made changes in their diet and their symptoms disappeared. Why should we operate, when we can reverse disease?
