Caldwell Esselstyn, Jr, M.D.

What’s happening, food-eating people? I hope you’re having an awesome day.

On this blog, we try to focus on evidence-based nutrition. Plant-based nutrition is slowly making its way into the medical world as a form of treatment for diet-related diseases like heart disease, diabetes, and obesity. The efficacy of a plant-based diet is based on the latest and greatest of medical nutrition research. This series will focus on the prominent medical authorities who recognize the profound benefits of the diet. If you are new to the plant-based lifestyle, or you are still on the fence, there are more than a few names you should know.

While these doctors all share the same general message (eat whole, plant-based foods), there are some differences between what these doctors have to say. In this series, I will go into what these doctors advocate and the research that led them to these conclusions.

First up, Dr. Caldwell Esselstyn!

Dr. Esselstyn is featured alongside T. Colin Campbell, PhD in the groundbreaking documentary Forks Over Knives. His work has focused primarily on diet as a treatment for heart disease, the number one cause of death in the United States. Dr. Esselstyn is best known for a clinical trial he conducted with a group severe heart-disease patients at the Cleveland Clinic, which he outlines in his book Prevent & Reverse Heart Disease. His goal in the trial was to use nutrition as the main treatment in reducing his patients’ total cholesterol to less than 150. The trial was a resounding success. Dr. Esselstyn has used the power of food to help stop heart disease in people for whom it had progressed so badly, surgery was no longer an option. In his book, he outlines the diet he administered in the trial and the diet he still recommends to reduce the risk of heart disease. Here is what he says,

  • You may not eat anything with a mother or a face (no meat, poultry, or fish).
  • You cannot eat dairy products.
  • You must not consume oil of any kind – not a drop. (Yes, you devotees of the Mediterranean Diet, that includes olive oil, as I’ll explain in Chapter 10.)
  • Generally, you cannot eat nuts or avocados.
    You can eat a wonderful variety of delicious, nutrient-dense foods:
  • All vegetables, except avocado. Leafy green vegetables, root vegetables, veggies that are red, green, purple, orange, and yellow and everything in between.
  • All legumes – beans, peas, and lentils of all varieties.
  • All whole grains and products, such as bread and pasta, that are made from them – as long as they do not contain added fats.
  • All fruits

Now try saying that in one breath! That is quoted directly from the book by the way (found on pages 5 & 6). The things that generally stand out in these guidelines are his extreme low-fat recommendations, including no oil and even no nuts or avocados. Here is a short summary in an interview he did:

 

He does go on to address the oil point (in chapter 10 no less), citing the Lyon Diet Heart Study, by the American Heart Association, as the primary evidence advocating for “heart healthy” oil consumption. In the study, the researchers assembled a group of 605 1-time heart attack survivors. They split the subjects into a Mediterranean Diet group and a control group. It was noted that those following the Mediterranean Diet did much better than those who were given no diet instructions. Dr. Esselstyn notes that while this diet may do better than a typical western diet, it does not “arrest the disease and reverse its affects” (84), like a plant-based diet seems to do. He discusses this recommendations in many of his lectures. Dr. Michael Greger, another plant-based doc and creator of nutritionfacts.org, made a video on the very subject. Dr. Greger also made a more specific video on the subject of Olive Oil and arterial fuction.

As for nuts and avocados, Dr. Esselstyn’s advice of cutting them out completely is one of the more aggressive approaches I have found. He does say that walnuts can be consumed in moderation if you do not already have heart disease, but that is it. The idea behind this is that any excess dietary fat will lead to plaque build up in the arterial walls and increased risk of a heart attack. However, he does not address the health benefits of fatty plant-based foods, specifically nuts. Dr. Campbell mentions that this reductionist viewpoint is similar to how the dairy industry advocates for milk consumption to increase calcium intake and discusses the health benefits of these fatty plant foods. Dr. Greger advocates for nut consumption, but is more wary of avocado consumption. Both Dr. Campbell and Dr. Greger, however, do warn against eating high-fat foods, even whole, plant foods, in too high a quantity.

In general I try to follow Dr. Esselstyn’s guidelines as closely as I can, except for a small amount of nuts. As an athlete who has a hard time putting on added muscle mass, I do have to focus on eating enough food, since I don’t get the extra calories from added oils and sugars that come with processed foods. That being said, after reading Dr. Esselstyn’s book, I became much more aware of the less than “heart healthy” diet choices I was making, particularly involving added oil.

Nutrition is a family affair for the Esselstyns. Dr. Esselstyn and his wife, Ann Esselstyn, now tour the country giving lectures on plant-based nutrition. Their son Rip, a former triathlete and firefighter, also speaks on plant-based nutrition and has written multiple books on the subject. He also runs the website engine2diet.com. Rip’s sister Jane Esselstyn, a registered nurse, runs the website Health Care is Self Care.

If you are new to plant-based or you are still on the fence, I would highly recommend looking into Dr. Esselstyn’s work. He is at the forefront of the plant-based movement, and has saved many people’s lives through his dedication to nutrition-based preventative medicine.

Stay positive & eat plants,

-Henry

For more on Dr. Esselstyn, check out his lectures online:
The short version
The long version

 

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