Tuesday, April 12, 2011

Behind Enemy Lines

Dr. Caldwell B. Esselstyn
I had an interesting lunch last Thursday.  Half my plate was a green bean/pea shoot salad and the other half was a fruit salad with a touch of basil.  It actually wasn't too bad although it left me pretty hungry.  I think I ate 2 pounds of salmon/bacon cakes when I got home from work.  You see I went to a free luncheon program where the topic was a strict vegetarian diet.  The title of the "FREE Interactive Colloquium" was Prevent and Reverse Heart Disease presented by Dr. Caldwell B. Esselstyn, Jr., M.D.

This presentation was done at Cleveland State University just a few blocks west of The Cleveland Clinic.  For those not familiar, The Cleveland Clinic is renowned as the top heart hospital in the world.  Anyways, I got there kinda late due to work responsibilities and had to resort to a spot in the back if I wanted to view his slide presentation.  You see, I was actually interested in the presentation details.  The crowd of a couple hundred, I would guess, seemed to be mostly university faculty and students there by obligation or for the free food.  That may be condescending, they may have also been interested in the science.  I will say in general, there was a smaller population of overweight people in the audience than you would find in a population matched group of 200 people off the street.

I keep my mind open about nutrition and will change my ways if the science proves I should.  I went to this event to see the other side of the coin.  What I found out was this doctor had many of the same views as experts in the paleo nutrition world.  He shuns all seed oils although not for the exact reasons the paleo diet avoids them.  He recommends a diverse diet of vegetables which many in the paleo world also recommend.  His last view is where I give the doctor the most credit.  He feels most of the world's health problems can be greatly mitigated through nutrition.  This conviction is tough to stand by while practicing medicine at the world's most cutting edge cardiac treatment facility.  Food is not cutting edge.  He discussed the struggles he has in getting funding for his research.  Fact of the matter is medical device companies and pharmaceutical companies fund almost all of the health related research in this country.  This is why doctors and med students don't learn much about nutrition.  There just isn't nearly as much research for them to read about treatments or prevention that are nutrition based.

Those few points  are where I stopped agreeing with the doctor.  He recommends zero fat.  His patients cannot even eat avocados or nuts.  Can't eat "anything with a mother or face" or anything that came from something with a face like dairy or eggs.  He does recommend a lot of legumes and whole grains.

His presentation started by discussing how the Standard American Diet causes our cells to become "sticky".  I immediately recognized this as glycation which is caused by a high carbohydrate diet.  He failed to mention that detail.  Then he talked about how this stickiness causes LDL particles to adhere to our artery walls in the form of plaque.  He failed to mention that only the small LDL particles (which are also caused by a high carb diet) can get caught in the artery walls and accumulate there.  His presentation moved on from there to case studies where there appeared to be successful reductions in clogged arteries using his diet.

He did not present much on the overall health of his patients.  He is a heart doctor and he seemed laser focused on treating the artery walls.  He kinda touched on some other positive health outcomes but they were not well supported examples.  I wonder about autoimmune diseases, neurological issues, and cancers while on a diet full of so many carbohydrates, plant toxins, and void of fat and cholesterol our body needs for vitamin D syntheses and fat soluble vitamin absorption to name a few examples.

After the presentation was done, they opened up to the audience for what turned out to be 4 measly questions.   Although my arm was up and I was jumping, I didn't get to ask my many questions.  So much for "interactive".  One question asked was regarding whether skim milk was OK.  The doctor referenced the debunked China Study by his friend T. Colin Campbell.  He noted that a protein in milk called casein increased the risk of cancer but failed to mention another protein in milk called whey, reduced the risk of cancer.  Milk without either protein is no longer milk so he really didn't answer the question.

Since his talk last week, there has been an interesting report released.  I wonder if Dr. Esselstyn read this article from NPR regarding studies of ancient Egyptian mummies and their clogged arteries:
"Our hypothesis was that they wouldn't have [heart disease], because they were active, their diet was much different, they didn't have tobacco," he says.
But they were wrong.
One of the mummies the team scanned was a princess in her 40s, who presumably ate fresh food and wasn't sedentary. "That she would have atherosclerosis," Thomas says, "I think we're missing a risk factor. Right now we know that high blood pressure, smoking, cholesterol, inactivity and other things cause athersosclerosis, but I think that we're less complete than we think."
Ancient Egyptians did have access to meat, though Thomas says their diet consisted mostly of grains, fruits and vegetables.

Hmmmmm, a diet consisting of mostly grains, fruits and veggies.  You noticed the scientist says "we're missing a risk factor".  What do American and ancient mummy diets have in common?  Fruits and veggies?  C'mon, have you seen what the average American eats?  The most common factor is grains.  I am sure the ancient Egyptians ate "healthy" whole grains not the highly processed white stuff that is common today.  Grains none the less.  

Is it possible Dr. Esselstyn's diet reduces artery clogging while eating grains but NOT eating seed oils?  Possible but I cannot be sure based on his presentation. Here is what I can be sure of, saturated fat or fat from avocado will definitely stay in my diet until there is science to convince me otherwise.  Sorry Dr. Esselstyn, I am not convinced.



Kelly the Kitchen Kop said...

This is so sad, because how many sitting there bought into all he was saying? How many will remain sick, or become sick, because of his advice?!

This stuff drives me crazy!

Jo's Health Corner said...

Wow. Good post..I wonder the same thing, how many will get their lives destroyed by disease after listening to doctors pushing for vegetarian diets?

Chuck said...

@kelly & jo

his presentation was compelling for anyone with an untrained eye. what they didn't know is the low fat message to avoid heart disease has caused diabetes, cancers, neurologic issues, and obesity. the key is to find cultures of today or years past that don't suffer from all these diseases and imitate their diets.

Sophie said...

i think balance is key. I avoid any kind of diet that leaves out complete food groups.

Chuck said...

@Sophie...luv ur site and am experimenting with square foot gardening this spring. i do disagree with your philosphy re: eliminating foods. check this out

Sophie said...

Hi Chuck. Actually, I'm not against the idea of "everything in moderation" as long as the everything includes moderation as well! What I meant in my comment above is that I don't go for diets that say no carbs or no meat or no fat. I found for example, that if I eat about 2 oz of pasta and 3 oz of beef and do the rest of my meal in veggies I can maintain or lose weight (as needed) and I feel more energy. If I do no carbs or no beef, I can drop weight too but have no energy. I do believe every one's body is different and everyone should listen to their own body.

Anonymous said...

Caldwell Esselstyn took people with heart disease and *reversed* it. You can find his work in peer-reviewed journals via GoogleScholar. You ask "Is it possible Dr. Esselstyn's diet reduces artery clogging while eating grains but NOT eating seed oils?" It is not just possible, but actual. He has a book called "Prevent and Reverse Heart Disease" You say this "His presentation started by discussing how the Standard American Diet causes our cells to become "sticky". I immediately recognized this as glycation which is caused by a high carbohydrate diet." Sorry, but the diet of his patients which he says in his book as having between 9% and 11% fat, and no doubt less than 15% protein, comes as a massively high carbohydrate diet (none of it refined... in a section on fruit he writes "Fruit--and juice, especially--carries a high sugar content, and consuming too much of it rapidly raises the blood sugar. The body compensates to the sugar high with a surge of insulin from the pancreas--and the insulin, in turn, stimulates the liver to manufacture more cholesterol.") The book The China Study references MUCH, MUCH more than the Cornell-China Oxford project which Denise Minger tries to attack. Lastly, you simply can't realistically argue with the results of Dr. Esselstyn no matter why you think he achieved the results he did.