Wednesday, April 1, 2015

Top 5 Misconceptions About Food: A Doctor’s Daily Experience by Michelle McMacken, M.D.

As a primary care doctor, I spend my days taking care of patients with diabetes, high blood pressure, high cholesterol, heart disease, and obesity. I also see “healthy” patients whose eating habits are starting them on the road to a future filled with doctor’s appointments and hospital visits.

I enjoy reminding my patients that their fork can be more powerful than my prescription pad when it comes to preventing and reversing chronic diseases. This conversation usually uncovers some common misconceptions about food and nutrition. Here are five myths that I hear almost every day, among patients and colleagues alike:

1. “I need to eat more protein.”

Many people don’t realize that the average American consumes more than twice the Recommended Dietary Allowance (RDA) of protein, most of it from animal products. 1,2Unfortunately, animal-based proteins have been shown to promote faster growth, not only of normal cells but of cancer cells, and have been linked to a variety of cancers as well as heart disease, diabetes, Alzheimer’s disease, and kidney stones.3,4

Plant foods contain plenty of protein, and a whole-foods, plant-based diet actually provides exactly what’s recommended in terms of protein requirements – about 8-10% of total daily calories from protein.  This happens naturally when people eat a diet of diverse, whole plant foods – there is no need to count grams of protein!  And unlike animal proteins, plant proteins from whole foods are not associated with cancer or other chronic diseases.  In fact, these foods actually prevent many of the diseases we see today!

2. “I need to drink milk to have strong bones.”

Many people equate dairy with calcium, strong bones, and the prevention of osteoporosis (low bone density). Generations of advertising slogans have perpetuated this idea. However, dairy isn’t the answer here. Studies show that dairy products may actually increase the risk of fractures related to osteoporosis!5-7

The biological purpose of cow’s milk is to support the rapid growth of a calf. Humans have no nutritional or medical need to consume the milk of cows or any other nonhuman species. Cow’s milk has significant levels of female hormones, and usually contains antibiotics, pesticides, saturated fat, and cholesterol — substances that definitely do NOT do a body good! Dairy has been specifically linked with prostate, ovarian, and uterine cancer, as well as heart disease and early death.7-13

The best sources of calcium come from the earth, in foods such as kale, broccoli, bok choy, and Brussels sprouts. As a bonus, these vegetables are high in vitamin K, which is also important for strong bones. Beans may be an especially good source of calcium, because they are also high in phytates, antioxidant compounds that may enhance mineral absorption14 (despite common perception to the contrary) and thus protect bone density.15 Many brands of soy milk, almond milk, orange juice, and tofu are fortified with calcium and vitamin D, just as cow’s milk is artificially fortified with these nutrients. However, there is no need to specifically target calcium sources in the diet; a diverse, whole-foods, plant-based diet will provide all of the calcium you need.

3. “Chicken, turkey, fish, and eggs are healthy sources of protein.”

Chicken, turkey, fish, and eggs contain significant amounts of cholesterol and saturated fat, in many cases as much as beef,16 so they are not “heart healthy” foods. Plant-based sources of protein contain zero cholesterol and far less saturated fat. Chicken and turkey usually contain antibiotics, pesticides, and fecal contaminants, and have been associated with salmonella, staph, and other infectious disease outbreaks. Chicken, fish, and eggs have been associated with an increased risk of diabetes.17-25 Almost all fish contain mercury, which can cause neurologic and cognitive problems; many also contain polychlorinated biphenyls (PCBs), a toxin associated with cancer.16 And a recent study showed that eggs cause intestinal bacteria to make a substance called TMAO, which can trigger heart attacks and other cardiovascular events.26

Whole plant foods supply plenty of protein, and they don’t come packaged with cholesterol or high levels of saturated fat. Instead, their protein is bundled with fiber and many necessary nutrients! Great plant-based sources of protein include lentils, chickpeas, black beans, kidney beans, soybeans, and quinoa. Green vegetables such as spinach, collards, broccoli, and peas are also quite high in protein per calorie. But remember, it’s not necessary to seek out plant foods high in protein, since a varied whole-food, plant-based diet will naturally provide enough protein, without special effort.27

4. “I can’t eat carbs.”

Many people are mistakenly led to believe they should avoid carbohydrates, particularly for weight management and diabetes control. Instead, they focus on proteins — especially animal proteins — and fats. Sadly, this approach actually increases the risk of chronic disease and death,28-32 and it deprives people of the numerous nutrients found in carbohydrate-containing foods.
It is true, however, that not all carbohydrates are created equal. Refined, highly processed carbohydrates can raise triglycerides, promote weight gain, and drive up blood sugar. On the other hand, starches that come from whole grains bring fiber, essential fatty acids, B vitamins, zinc, and protein into our diets and provide an excellent source of energy. Beans, legumes, starchy vegetables, and fruits are other healthy carbohydrate sources. Balancing these foods with nonstarchy vegetables is an optimal way to eat for weight loss, diabetes control, and reversal of heart disease.

5. “Healthy food is too expensive.”

You don’t need to shop at a gourmet health food store to find nutritious foods. Actually, some of the healthiest foods are the least expensive, and they are readily available at most grocery stores and many local farmers’ markets. Beans, lentils, brown rice, and frozen vegetables are usually inexpensive, especially when bought dried and in bulk. (Organic fruits and vegetables can cost more, but eating nonorganic plant-based foods is still more nutritious than eating meat, chicken, fish, eggs, and dairy, organic or otherwise.)

Even when processed foods and animal products are sold cheaply, they are expensive in terms of the cost to your health. What you may save now, you could end up spending later in pharmacy co-payments and medical bills!


Michelle McMacken, M.D., is a board-certified internal medicine physician and an assistant professor of medicine at NYU School of Medicine.  She practices primary care at Bellevue Hospital Center in New York City, where she also directs a medical weight-loss program.  An enthusiastic supporter of plant-based nutrition, she is committed to educating patients, medical students, and doctors about the power of healthy eating and lifestyle modification. Be sure to connect and follow Dr. McMacken on Twitter.

This article was previously published on Forks Over Knives.


1 Institute of Medicine. Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids. Washington, DC: National Academies Press; 2002.
2 Rizzo NS, Jaceldo-Siegl K, Sabate J et al. Nutrient profiles of vegetarian and nonvegetarian dietary patterns. J Acad Nutr Diet 2013; 113(12):1610-9.
3Campbell TC, Campbell TM. The China Study: Startling Implications for Diet, Weight Loss, and Long-Term Health. Dallas: BenBella Books; 2006.
4 Barnard NB, Weissinger R, Jaster BJ, et al. Nutrition Guide for Clinicians, First Edition. Washington, DC: Physicians Committee for Responsible Medicine; 2007.
5 U.S. Department of Health and Human Services. Bone Health and Osteoporosis: A Report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services, Office of the Surgeon General; 2004.
6 Feskanich D, Willett WC, Colditz GA. Calcium, vitamin D, milk consumption, and hip fractures: a prospective study among postmenopausal women. Am J Clin Nutr 2003; 77:504-11.
7 Michaëlsson K, Wolk A, Langenskiöld S, et al. Milk intake and risk of mortality and fractures in women and men: cohort studies. British Medical Journal2014;349:g6015.
8 Qin LQ, Xu JY, Wang PY, et al. Milk consumption is a risk factor for prostate cancer: Meta-analysis of case-control studies. Nutr Cancer 2004; 48(1):22-7.
9 Qin LQ, Xu JY, Wang, PY, et al. Milk consumption is a risk factor for prostate cancer in Western countries: Evidence from cohort studies. Asia Pac J Clin Nutr 2007; 16(3):467-76.
10 Chan JM, Stampfer MJ, Ma J, et al. Dairy products, calcium, and prostate cancer risk in the Physicians’ Health Study. Presentation, American Association for Cancer Research, San Francisco, April 2000.
11 Chan JM, Stampfer MJ, Giovannucci E, et al. Plasma insulin-like growth factor-I and prostate cancer risk: a prospective study. Science 1998; 279:563-565.
12 Genkinger JM, Hunter DJ, Spiegelman D, et al. Dairy products and ovarian cancer: a pooled analysis of 12 cohort studies. Cancer Epidemiol Biomarkers Prev 2006; 15:364–72.
13 . Ganmaa D, Sato A. The possible role of female sex hormones in milk from pregnant cows in the development of breast, ovarian, and corpus uteri cancers. Med Hypotheses 2005; 65:1028–37.
15 López-González AA, Grases F, Monroy N, et al. Protective effect of myo-inositol hexaphosphate (phytate) on bone mass loss in postmenopausal women. Eur J Nutr 2013; 52(2):717-26.
16 Simon, D. Meatonomics. San Francisco, Conari Press, 2013.
17Li Y, Zhou C, Zhou X, et al. Egg consumption and risk of cardiovascular diseases and diabetes: a meta-analysis. Atherosclerosis 2013; 229(2):524-30.
18 Djoussé L, Gaziano JM, Buring JE, et al. Egg consumption and risk of type 2 diabetes in men and women. Diabetes Care 2009; 32(2):295-300.
19 Radzevičienė L1, Ostrauskas R. Egg consumption and the risk of type 2 diabetes mellitus: a case-control study. Public Health Nutr 2012; 15(8):1437-41.
20 Tonstad S, Butler T, Yan R, et al. Type of vegetarian diet, body weight, and prevalence of type 2 diabetes. Diabetes Care 2009; 32(5):791–6.
21 Chiu TH, Huang H, Chiu Y. Taiwanese vegetarians and omnivores: dietary composition, prevalence of diabetes and impaired fasting glucose. PLoS One 2014; 9(2):e88547.
22 van Nielen M, Feskens EJ, Mensink M. Dietary protein intake and incidence of type 2 diabetes in Europe: the EPIC-InterAct Case-Cohort Study. Diabetes Care 2014; 37(7):1854-62.
23 van Woudenbergh GJ, van Ballegooijen AJ, Kuijsten A, et al. Eating fish and risk of type 2 diabetes: a population-based, prospective follow-up study. Diabetes Care 2009; 32:2021–6.
24 Kaushik M, Mozaffarian D, Spiegelman D, et al. Long-chain omega-3 fatty acids, fish intake, and the risk of type 2 diabetes mellitus. Am J Clin Nutr 2009; 90:613–20.
25 Djoussé L, Gaziano JM, Buring JE, et al. Dietary omega-3 fatty acids and fish consumption and risk of type 2 diabetes. Am J Clin Nutr 2011; 93:143–50.
26 Tang WH, Wang Z, Levison BS. Intestinal microbial metabolism of phosphatidylcholine and cardiovascular risk. N Engl J Med 2013; 368(17):1575-84.
27 Young VR, Pellett PL. Plant proteins in relation to human protein and amino acid nutrition. Am J Clin Nutr 1994; 59 (suppl):1203S-1212S.
28 Larsson SC, Orsini N. Red meat and processed meat consumption and all-cause mortality: a meta-analysis. Am J Epidemiol 2014; 179(3):282-9.
29 Lagiou P, Sandin S, Lof M, et al. Low carbohydrate-high protein diet and incidence of cardiovascular diseases in Swedish women: prospective cohort study. British Medical Journal 2012; 344:e4026.
30 Fung TT, van Dam RM, Hankinson SE, et al. Low-carbohydrate diets and all-cause and cause-specific mortality: two cohort studies. Ann Intern Med 2010; 153(5):289-98.
31 Noto H, Goto A, Tsujimoto T, et al. Low-carbohydrate diets and all-cause mortality: a systematic review and meta-analysis of observational studies. PloS One 2013; 8(1):e55030.

32 de Koning L, Fung TT, Liao X, et al. Low-carbohydrate diet scores and risk of type 2 diabetes in men. Am J Clin Nutr 2011; 93(4):844-50.

As always the information presented in this blog is for educational purposes only. It should not be considered as specific medical, nutritional, lifestyle, or other health-related advice.

Sunday, March 15, 2015

Red lentil, Bulgur and Kale Patties

Later today I’m delivering a new talk called, The Facts and Fallacies of Fats at the New York Vegetarian Festival. 

So today’s post is short and sweet. 

This is a great new recipe I developed recently. Not only is it packed with nutrients and bursting with flavor, but it’s also great to pack and take along for a long day. I know I’ll have a few on me today at the Veg Fest!

This recipe calls for Bulgur wheat, but if you are following a gluten-free diet, it can easily be substituted with either quinoa or amaranth.

Red Lentil, Bulgur Wheat and Kale Patties
Makes 7-9 patties

1.5 cups of red lentils
1/2 cup of bulgur wheat (or quinoa or amaranth for gluten free)
1/3 cup of oats (either quick cooking or old fashioned)*
1 cup of kale, swiss chard or spinach - chopped
4 tbsps of canned diced tomato or tomato paste
1 clove garlic - minced
1 tbsp garlic powder
1 tbsp onion powder
Small handful of fresh or 1 tsp of dried basil
1 tsp of dried tarragon or oregano
Lemon juice, ginger powder and black pepper to taste
5 cups of water or veggie broth

* get gluten-free oats if needed.

Start by boiling the red lentils in the water or broth for about 10 to 15 minutes. As the lentils begin to soften and break down, add the bulgur wheat, garlic, and spices and cook for another 10 minutes (if you are using fresh basil, save it until the end). The water in the pan should be almost completely absorbed.

Turn the heat to low and add the oats, diced tomatoes, and chopped greens. Stir until well combined. Add the lemon juice and fresh basil if you’re using it.

Cook for another 1 to 2 minutes or until the greens have softened and turned bright green.

Now pre-heat the oven to 375. Let the mixture sit while the oven pre-heats. This is important because you want to give the oats a chance to absorb any remaining liquid in the mixture. This will make the mixture start to stick together.

I recommend letting the mixture sit for at least 10 minutes.

Now line a baking sheet with parchment paper. Using a tablespoon scoop out two tablespoons of the mixture and form into patties on the pan. If the mixture is too watery, they will not stick together, try adding more oats if this is an issue.

Once the patties are formed place in the oven and let cook for 15-18 minutes or until the patties start to brown on top. If you’d like you can flip the patties over at 12 minutes, but this isn’t necessary and increases the chance of the patties breaking apart.

I like to toss these on top of a large salad with lots of veggies, or just stick a few in a bag and take them with me for an easy on-the-go meal. They also make great burger replacements. Also try putting a tahini sauce on top.

As always the information presented in this blog is for educational purposes only. It should not be considered as specific medical, nutritional, lifestyle, or other health-related advice.

Sunday, March 1, 2015

A Year Without Kale (and the best tofu scramble you’ve ever tried).

Before I explain the title, I want to say that I’m very excited to be speaking at the 5th Annual New York City Vegetarian Food Festival. I’ve attended each year in the past and having watched the event through its evolution, I can honestly say it has constantly gotten better. This year the speaker line up includes some of the countries foremost experts on fitness and nutrition including Dr. Joel Kahn, Rich Roll, and Sid Garza Hillman, among many others.

I will be presenting a talk called the “Facts and Fallacies of Fats.” The talk will examine the research on which fats are truly healthy, and how much fat our bodies actually need in an attempt to clarify a topic which has become increasingly confusing. I’m very excited for the opportunity, and look forward to seeing many of you there! I talk on Sunday afternoon so be sure to stop by and say hi!

Now, back to the title… A year without kale.

Wait? What!? Why?

Yes, it’s true; you’ve read that correctly. As some of you may know, I announced the other day that I’m about to make a large, life-altering change. It’s easily the biggest and scariest decision I’ve ever made, which is also what makes it so exciting.

At the end of April, I will be saying goodbye to my home in New York City and getting on a plane bound for Buenos Aires, Argentina, with a one-way ticket in hand.

If you are curious as to why I would move to a city famous for it’s beef and it’s leather, it’s simple… my time in South America begins as many such adventures do… the pursuit of a beautiful woman.

Two Octobers ago, I met a woman at Jack Rabbit Sports Running Group. She is a doctor from Buenos Aires who was doing a month long observership at a New York hospital. We made an instant connection, and since then it’s been a wild ride of facetime phone chats and wonderful visits, which always seem far too short with far too much time in between. Anyway, we’ve now reach the point were it is time to take the next step.

But why a year without kale? Well, sadly, kale hasn’t caught on down in Argentina the way it has in the States, and it’s pretty hard to come by.  That said, I am being a little disingenuous, because we know of one market that has it on occasion, and I’ve also purchased over 1,000 seeds of different heirloom varieties, which I hope to grown on our balcony.

Now don’t worry, BYOL will continue and I’ll never be further than an email or skype message away from my readers in the States. During my time in Argentina, I plan on hosting some plant-based nutrition seminars and hope to work on some larger writing products. I will also continue the BYOL Nutrition & Wellness Counseling. And of course, I will be sharing many new recipes throughout the year!

Thank you to everyone for all of your continued support. It means more to me than I can adequately express.


Now for the reason you’re all really reading this post. The best tofu scramble you’ve ever tried!

I’ll do another post going through some of the questions and controversy about soy, but for now, know that whole sources of soy such as edamame, tempeh, and tofu can all be part of a balanced and health promoting diet.

That said, I always recommend purchasing organic soy products. I try not to be too much of a stickler about organics, because I don't want a plant-based diet to seem cost prohibitive. Soy, however, is a bit different, and to ensure you are getting a healthy, non-genetically modified product, organic is the way to go.

This tofu scramble is perfect for lazy weekend mornings or as a power dinner after a hard workout. But there are a few tricks to getting this just right.

Tofu Scramble:
Serves 2-3

½ block of organic tofu – drained and broken into small pieces
½ cup of quick cooking or old-fashioned oats (gluten free if desired)
4 – 5 stems of kale or spinach or any dark green
1 handful of fresh cilantro -chopped (optional)
½ avocado – cubed (optional)
½ tsp turmeric
½ tsp cumin
¼ tsp Indian black salt* (aka kala namak)
Pinch of cayenne pepper
Black pepper to taste

Roughly 2 cups of your favorite sautéed veggies: (try)
Bell pepper

* Black Salt is actually pink and is often found in Indian dishes. This is one of the secrets for the scramble, as the salt has a sulphur odor and taste that helps replicate the smell and taste of eggs. It will be found in almost any Indian market as well as online.

First, you need to make sure you drain the tofu well. You can easily do this with any number of tofu presses available for purchase. However, as a person who has been criticized for owning one too many kitchen gadgets, I’ve resisted making such a purchase. Instead I place the tofu on one plate and then place another plate (or two) on top of the tofu. I normally leave the tofu with the plates stacked on top of it for at least 30 minutes. This will help ensure you get all of the water out of the tofu. If you skip this step, your scramble will be watery.

While the tofu is being pressed, start chopping all of your chosen veggies. As I mentioned above you can make an endless amount of different combinations.

Once the tofu is done, use a fork to break it up into a mixing bowl. Add the spices and oats and mix well. Depending on the type of veggies I use, I normally add them to the bowl once the tofu and oats are well combined. If using the veggies above, consider keeping the greens as well as the onion and carrot to the side for now.

Now heat a pan and add the tofu and the veggies (consider adding the onion and carrot first to let them soften). Keep the greens, cilantro and avocado to the side for now. Stir the scramble frequently to prevent it from burning.

As the spice mix starts to cook into the tofu, the tofu will begin to turn a bright yellow color. Once this happens you can add the greens and cook until the greens begin to soften.

Serve and top with fresh cilantro and avocado and a piece of toasted Lentil Bread.  If you like, add hot sauce.

As always the information presented in this blog is for educational purposes only. It should not be considered as specific medical, nutritional, lifestyle, or other health-related advice.

Sunday, February 15, 2015

The Broken Hearts Club

This is a more personal post than I normally like to share, but since February is national heart month, and I believe this post has an important and relevant message.

At the beginning of the month, I shared an amazing post from Dr. Ostfeld about how a heart disease patient changed his diet, and not only prolonged, but truly saved his life without any surgical interventions. Unfortunately, the story I’m about to share is it’s polar opposite, and happens far too often and to far too many families every single day in western countries.

While visiting Buenos Aires at the end of January, I received a message that a family friend had a second heart attack, and was in the hospital. I didn’t realize how serious it was at the time, however, I would arrive back in New York just in time for his wake and funeral. To say the least, it’s been a very sad and tiring time for my family.

Part of what makes this so incredibly sad, is because I believe his death was avoidable. Throughout my entire life, he ate an incredibly rich diet full of meats, dairy, and processed foods. He was always overweight and when I was young, he became the first person I knew to be diagnosed with Type 2 Diabetes. This didn’t change him in the least.

Than less than a year ago, he had his first heart attack, and an emergency triple bypass surgery. At the time, it seemed like he wasn’t going to make it. Yet, even to the astonishment of his doctors, he made what seemed like a full recovery. He was given a second chance; however, he didn’t seem to understand how serious his situation was. He refused to follow the doctor’s instructions to eat less saturated fat and cholesterol, and continued his sedentary way of life.

I even approached him and offered to talk with him and his wife about the impact that diet could have on his health. Unfortunately, he declined.

And now, he is gone. His wife, children, and grandchildren are now forced to cope with the results of his decisions.

While even Dr. Ostfeld writes that his story was one of the most remarkable transformations he’s ever heard of, there is a growing amount of evidence that shows that heart disease – America’s number one killer - is not only avoidable, but can also be reversed with a proper, plant-based diet.

Back in 1995, Dr. Caldwell B. Esselstyn, M.D. of the Cleveland Clinic published his bench mark long-term nutritional research on arresting and reversing coronary artery disease in severely ill patients. He then published a 12 year update in the Journal of American Cardiology, and then a 20 year update in his book, Prevent and Reverse Heart Disease. So what were these findings?

Starting in 1985, he took 24 severely ill heart disease patients and placed them on a very strict plant-based diet. He had a simple hypothesis; a low-fat plant-based diet could arrest heart disease (fat was kept to 10% of total calories). He came to this theory when he realized that coronary disease was essentially nonexistent in cultures whose nutrition assured a total cholesterol level of 150mg/dl or lower. Vegetables, berries and whole grains were able to be eaten without limit, fruits and juices were limited to a few severing’s per day. Fatty nuts and avocado were even more limited to a few times a week if at all. Oil, meat, and dairy of all kinds were completely off the menu. Two tablespoons of ground flax seeds daily was recommend for omega 3.

Between these 24 patients, they had 49 coronary events in the 8 years before the study. Out of those 24 patients who initially signed up for Dr. Esselstyn’s study, 6 were nonadherent and were returned to normal cardiac care. At a 10 year followup, those 6 patients who did not adhere to the diet had 13 new cardiac events.

The remaining 18 adhered to the diet. After 5 years, not a single patient had a repeat cardiac event and 11 of those 18 patients agreed to a second angiographic analysis which demonstrated that the heart disease was arrested in all 11 (100%). Further, in 8 of his 11 patients (or 73%), the disease had regressed. Angina initially reported in 9 patients was eliminated in 2 and improved in the remaining 7.

Evidence of reversing heart disease.

Similar results were reported in the 12 year follow up.

For comparison, in another study published in 2000, Richard M. Fleming, M.D. took 26 patients and placed them all on a healthy high carb vegetarian diet. Dr. Fleming planned on using a new technology known as a SPECT scan which enabled him to actually measure the blood flow within the coronary arteries.

His plan was to measure the before and after effects of diet. However after one year, Dr. Fleming discovered that ten of his patients decided against the vegetarian diet in favor for a high protein, low carb diet, which they believed would improve overall health. This gave Dr. Fleming the unique opportunity to compare the two diets on coronary health.

At the end of the year, those who stuck to the healthy vegetarian diet all showed a reversal of their partially clogged arteries – showing an average of 20% less atherosclerotic plaque in their arteries. Those who jumped ship to the low carb high protein diet significantly worsened, as the SPECT scans showed an increase of nearly 40% more artery clogging.

If you look at the provided scans, you can clearly see this. The yellow and red represent blood flow. On the top, you see the increased blood flow of a person following the vegetarian diet. On the bottom, you see the decreased blood flow of a person who switched to a high protein diet. While even Dr. Fleming admits more of this type of research is needed, it is suggestive, especially when taken in measure with Dr. Esselstyn.

If any drug had even come close to this type of result, it would be publicized everywhere. Instead, this life saving message has largely been ignored. One large criticism has resounded time and again, “Yes, these are excellent results, but the trial groups are far too small.”

So in 2014, Dr. Esselstyn responded with yet another new study. This time he followed 198 patients and 177 individuals were compliant with the diet (89%). Of this compliant group, only one individual suffered a cardiac event. That is a recurrence rate of .6% which represents the absolute lowest recurrence rate of any study on heart disease.

Out of the 21 individuals in the noncompliant group, 13 of them suffered adverse cardiac events. That is a rate of 62%. They were following standard cardiology care and medical interventions which included pills and various procedures. For those of you who like math that is a ratio of .6% to 62% meaning that Dr. Esselstyn’s work is 100 times more effective than that of the standard care given to most heart patients. 

These results are important because heart disease kills over 300,000 people annually and over 700,000 people suffer a heart attack every single year. Yet, as the results of these studies suggest, this needn’t be the case.

Please help me share this message. As Dr. Esselstyn says, “If the truth be known coronary artery disease is a toothless paper tiger that need never ever exist and if it does exist it need never ever progress.

Dr. Esselstyne and Dr. Fleming aren't the only ones getting these results with diet and lifestyle changes. Dr. Ornish, Dr. McDougall and Dr. Ostfeld among others are all doctors who have created programs that have proven to arrest and reverse heart disease. In fact, just this week, Dr. Ostfeld and his colleagues at Montefiore Cardiac Wellness Program published a study that showed a patient completely reversed their angina simply by adopting a plant based diet.

For more on Dr. Esselstyn, watch the excellent documentary Forks Over Knives or get his book, Prevent and Reverse Heart Disease.

Esselstyn, Caldwell B. “Updating a 12 -Year Experience With Arrest and Reversal Therapy for Coronary Heart Disease (An Overdue Requiem for Palliative Cardiology)” The American Journal of Cardiology, August 1999, 334-39.

            “A Strategy to Arrest and Reverse Cornonary Artery Disease: A 5- Year Longitudinal Study of a Single Physician’s Practice.” The Journal of Family Practice Vol. 41 No. 6 December 1995 560-68.

            “A Way to Prevent CAD?,” The Journal of Family Practice. Vol. 63, No. 7 July 2014 257.

            “The Nutritional Reversal of Cardiovascular Disease – Fact or Fiction?” Experimental and Clinical Cardiology. Vol. 20, No. 7, July 2014 1901.

            Prevent and Reverse Heart Disease: The Revolutionary Scientifically Proven, Nutrition-Based Cure. Avery Publishers, New York, 2008.

Fleming, R. M. “The Effect of High-Protein Diets on Coronary Blood Flow.”
Angiology Vol. 51 2000 1075-1083.

Ostfeld, Robert et. al. “A Whole-Food Plant-Based Diet Reversed Angina without Medications or Procedures,” Case Reports in Cardiology Vol. 2015, 2015.

As always the information presented in this blog is for educational purposes only. It should not be considered as specific medical, nutritional, lifestyle, or other health-related advice.

Monday, February 2, 2015

Patient Googles His Way Out of Bypass Surgery*

By Robert Ostfeld, MD, MSc

One of the most common operations performed in the world today is coronary artery bypass graft surgery (CABG). I would like to share with you the remarkable story of a recent Cardiac Wellness Program patient here at Montefiore Medical Center (I’ll call him Mr. J), who changed his diet and averted the CABG knife.

Mr. J is a middle-aged man with high cholesterol and a family history of heart disease. Understandably, he desperately wanted to avoid the problems that many in his family had faced, so he ate a “healthy” diet of chicken, fish, and low-fat dairy, with a few fruits and vegetables mixed in. And he exercised. A lot. In fact, he loved exercising so much that he would do it for two to three hours a day — brisk walking, playing sports, etc.

Mr. J. first visited a cardiologist at age 55, after having experienced several weeks of tightness in his neck during physical activity. The condition had worsened to the point that only 30 to 45 seconds of exercise brought on significant discomfort. The doctor ordered a stress test, to see if heart disease could be contributing to this symptom. The test results were so wildly abnormal that he was sent immediately to the hospital for a cardiac catheterization, to look for cholesterol blockages in the vessels that supply his heart with blood. Such severe blockages were found that he was admitted directly to the hospital for coronary artery bypass graft surgery. In less than one day, his life had changed dramatically.

While lying nervously in his hospital bed, he began to think that maybe there was another way to approach this disease, so he went online. There, he read about the impact of a whole-food, plant-based diet on heart disease, and he decided that was the path for him. He called the nurse, gave back his hospital gown, and despite the pleas of his medical team, signed himself out of the hospital against medical advice. Mr. J’s nurse was so concerned that before he was able to leave, she called his wife to have her convince him to stay. He did not. Later, the nurse even called Mr. J at home to plead for his return. He politely declined.

Soon thereafter he found our Cardiac Wellness Program at Montefiore. He was already taking all the appropriate medications, and he chose to completely change his lifestyle as well. He fully embraced a whole-food, plant-based diet without oil and had perhaps the most remarkable turnaround I have ever seen. Within one week, he went from being able to walk only a block before feeling tightness in his neck to walking 25 blocks without incident! Fast-forward three months and he was back to exercising two to three hours each day without symptoms. That is what I call remarkable!

A few weeks later, Mr. J got another call from his nurse. She had just been diagnosed with cholesterol blockages in her heart, and her doctors were recommending cardiac procedures. With Mr. J in mind, she told her doctors no way and called him to learn how to do exactly what he did: embrace a whole-food, plant-based diet!

Mr. J never did get that bypass surgery, nor did he get a coronary stent. In fact, he did not need to have any procedures at all. He got healthier with appropriate medications and by wholeheartedly embracing a whole-food, plant-based diet.

The key to health, it seems, lies at the end of your fork.

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*Postscript: While many heart patients may reverse their disease with lifestyle change alone, Mr. J also continued his prescribed medications, given the severity of his condition, and their doses were lowered as his health improved. Please note that I am not recommending lifestyle change over medical intervention for any particular person, as every case is of course different. Some cases are fraught with more risk than others, so please consult with both your physician and a physician trained in lifestyle medicine before making significant lifestyle changes.

This post was originally published on the Forks Over Knives blog, here.

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Cardiologist Robert Ostfeld, MD, MSc is the founder and director of the Cardiac Wellness Program at Montefiore Medical Center in New York City, where he encourages patients to embrace a whole-foods, plant-based diet. He earned his MD at Yale and his MSc in epidemiology at Harvard, and he is an associate professor of clinical medicine at the Albert Einstein College of Medicine.

As always the information presented in this blog is for educational purposes only. It should not be considered as specific medical, nutritional, lifestyle, or other health-related advice.