In 1985, Esselstyn recruited patients with advanced but not immediately life-threatening heart disease for a clinical trial to explore whether heart disease might be reversed using diet. He confirmed the severity of the coronary artery disease with angiograms to be sure that their disease progression was advanced. The only other requirement for admission into the study was a willingness to attempt the dietary changes he proposed: effectively, a WFPB* diet.Zero cardiovascular events over 26 years for people who had advanced, symptomatic heart disease, many of whom underwent aggressive treatments including multiple bypass operations. Five were told by their cardiologists they had less than a year to live.
Dr. Esselstyn formally reported his findings at 5 and 12 years. In the 8 years prior to the study, his 18 subjects had had 49 coronary episodes (e.g., heart attacks angioplasty, bypass surgery), but during the 12 years after adopting a WFPB diet, there was only one event, involving a patient who strayed from his diet. He has casuallly followed his subjects since then and all but 5 are still alive today, 26 years later. The 5 who passed away did not die of cardiac fauilure, but from other causes. ... And the ones who are still alive are cardiac symptom free. The subjects had 49 cardiovascular events in the 96 months prior to the intervention, and zero cardiovascular events in the roughly 312 months since the intervention began. This life-and-death finding is about as profound as any health benefit I have even known. Nothing else in medicine comes close.
"After 5 years on Dr. Esselstyn’s plant-based diet, the average total cholesterol levels of his research group dropped from 246 mg/dl to 137 mg/dL (Above 240 mg/dL is considered “high risk,” below 150 mg/dL is the total cholesterol level seen in cultures where heart disease is essentially nonexistent.) This is the most profound drop in cholesterol ever documented in the medical literature in a study of this type."* WFPB is a Whole Foods Plant Based diet. I'm familiar with Dr. Esselstyn's WFPB diet. It restricts all animal foods (no meat, fish, eggs, cheese and other dairy) and all added fat. It even restricts nuts and avacado for those with established heart disease or those whose total cholesterol is not below 150 mg/dl. So, no oil-based salad dressing, no cooking or baking with oil or fat. These were some very motivated patients.
How about his take on salt? Do you have any thoughts on that yet?
I haven't come across anything in his new book, other than don't add it to food. And he hasn't given an argument for that, for why.
I did just read yesterday that the IOM, the Institute of Medicine, doesn't see the need to reduce sodium below 1500 mg:
The US Institute of Medicine (IOM), asked by the US Centers for Disease Control and Prevention (CDC) to review the evidence for limiting sodium intake, has reached a controversial conclusion: there is no consistent evidence to support lowering sodium intake in the general population to levels of 1500 mg/day [1,2].
Moreover, the report concludes, there is no scientific evidence to support treating certain population subgroups any differently from the rest of the US population.
The report, issued yesterday, was blasted by the American Heart Association (AHA), which claimed the report was "incomplete," failing to take into account the vast evidence linking high blood pressure to excess sodium consumption .
The AHA recommends that Americans consume no more than 1500 mg of sodium per day; federal guidance uses a cutoff of 2300 mg per day, except for certain subgroups that should aim for the 1500-mg target: people over 50, non-Hispanic blacks, and anyone with diagnosed hypertension, prehypertension, diabetes, congestive heart failure, or chronic kidney disease.
The IOM report does agree that there is a "positive relationship" between higher sodium intake and risk of CVD. But it says that the existing research does not conclusively establish that lowering sodium below 2300 mg/day increases or decreases the risk of heart disease, stroke, or all-cause mortality. Moreover, "the evidence on both benefit and harm is not strong enough" to indicate that so-called high-risk subgroups should lower their sodium intake to 1500 mg/day, the report concludes.
The lack of studies linking sodium intake to increased risk of hard events has long been a topic of hot debate. A number of modeling studies have estimated that excess salt intake shoulders the blame for millions of deaths worldwide, as well as soaring healthcare costs.
If you're not eating processed food, if you're cooking from scratch, using whole raw ingredients, you can get away with adding some salt. You're likely to be below that 2300 mg sodium amount which is the amount in about a teaspoon of table salt. That's my 2 cents.
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