This week we review Dr. Caldwell Esselstyn’s “Prevent and Reverse Heart Disease”

“If you follow a plant-based nutrition program to reduce your total cholesterol level to below 150 mg/dL and the LDL level to less than 80 mg/dL, you cannot deposit fat and cholesterol into your coronary arteries. Period.”


Want to know how to do this? Buy the book

Want to learn more? Read the review.

Prevent and Reverse Heart Disease by Caldwell B. Esselstyn, Jr., M.D. makes a compelling case that America’s number one killer, coronary artery disease, is entirely preventable and can even be reversed.

Health/diet books likely number in the tens of thousands with more being published every day. The authors range from M.D.s to new age gurus with no medical background whatsoever but who categorize themselves as experts because their auras align with the health vibrancy charka, or some such thing. As far as doctors writing books go, there are doctors and then there are DOCTORS, and when it comes to the subject of heart disease, Esselstyn is the latter. He was a surgeon, clinician, researcher, a member of the Board of Governors, and President of the Staff at the Cleveland Clinic, which is largely recognized as the premier heart clinic in the world. So yes, he’s got some major credibility points, and when he says that he has studied and come up with a way to prevent and even cure heart disease, his words are well worth considering.  As such, you might think that a prominent surgeon associated with such a prestigious hospital would endorse a medical solution, such as incredible new surgeries, but such is not the case.

Epiphanies can be be both amazing and frightening, especially when they run contrary to how your professional practice has operated since the beginning of time, and that’s basically what happened to Esselstyn.  After years as a surgeon he realized that there was only so much he could do, that there was only so much that surgery could offer, and it wasn’t enough. In the case of coronary artery disease modern medicine’s current practice is the treatment of symptoms and does nothing to prevent or even cure the underlying disease. In addition, treating the symptoms carries its own risks, some of which are worse than the disease. Now it’s not that Esselstyn became totally disillusioned with modern medicine, he acknowledges that it is wonderful and amazing, but he admits that surgery does have serious flaws. “It’s expensive, painful, frightening, often disabling and disfiguring, and too often merely a temporary stopgap against the disease it is intended to treat. It is a mechanical approach to a biological problem.”  Here’s how he describes modern medicine’s treatment of symptoms. “It’s as if we were simply standing by watching millions of people march over a cliff, and then intervening in a desperate, last minute attempt to save them once they had fallen over the edge. Instead we should be teaching them how to avoid the chasm entirely.”

Esselstyn believes that coronary artery disease need not exist. If it does exist it need not progress. But that’s not all. Like Nigel Tufnel’s custom Marshall amp, Esselstyn takes it to “11” by claiming that coronary artery disease can be reversed. That essentially one can make themselves “heart attack proof”. So if we want to avoid the chasm, how do we do it?

By changing the way we eat.   

Back in the 80s when Esselstyn began to realize that surgery was not the be-all and end-all, he took an interest in epidemiology. He noticed that high incidences of cardio vascular disease, cancers, diabetes, obesity, and more, occurred predominately in western countries. All the other countries especially in Asia & Africa, not so much. In fact, hardly at all. He also noticed that cultures with lower rates of disease than western countries had a common denominator: low intake of dietary fat and low cholesterol levels (blood levels of cholesterol were customarily below 150 mg/dL). And he saw that the connection between nutrition and disease (especially coronary artery disease) was critical. Nutrition as preventative medicine was a radical concept when he first considered it. And while today such thinking is more widely accepted, Esselstyn’s approach is a bit more extreme.

In 1985 he started a program at the Cleveland Clinic where he placed patients with advanced coronary artery disease on a truly low fat plant based diet to get their cholesterol below 150 mg/dL. Why that number?  Well, his studies showed that the populations of countries where cholesterol was below 150 had no heart attacks. Here’s the thing about cholesterol – “Our bodies need cholesterol and they manufacture it on their own. We do not need to eat it. But we do, when we consume meat, poultry, fish, and other animal-based foods, such as dairy products and eggs. In doing so, we take on excess amounts of the substance. What’s more, eating fat causes the body itself to manufacture excessive amounts of cholesterol, which explains why vegetarians who eat oil, butter, cheese, milk, ice cream, glazed doughnuts, and French pastry, develop coronary disease despite their avoidance of meat.”

Esselstyn is clear, “If you follow a plant-based nutrition program to reduce your total cholesterol level to below 150 mg/dL and the LDL level to less than 80 mg/dL, you cannot deposit fat and cholesterol into your coronary arteries. Period.”

With regard to his plant based diet, it’s a radical departure from the way most Americans eat. As a result it’s not what most would consider easy to adhere to. It’s made all the more difficult because Esselstyn is non-compromising. He clearly lays out what you can and cannot eat. There is never any doubt about what is and isn’t good for you. He’s strict. There is no working your way into it slowly. There are no free days. There is no moderation. Think of him as Yoda as far as dietary resolve is concerned. Try not. Do. Or do not. There is no try.

Is the diet able to be adhered to? Of course it is. And based on Esselstyn’s studies, which covered more than 25 years, his results demonstrate that his plant-based diet works. The effort is well worth it. Prevent and Reverse Heart Disease presents his plant based diet clearly and concisely. It explains in plain language what it is and how it works so it’s easy to follow. His stories of his studies and patients who benefited from them are inspiring. Plus the book also contains over 150 recipes which alone makes it worthwhile.