Heart Attack Counterattack

From Dr. Fuhrman's book Eat to Live:

Two things are necessary to predictably reverse heart disease: one is to become thin and superbly nourished, and the other is to get your LDL below 100. Reversal of heart disease then occurs. If one expects to diminish atherosclerotic plaque over time and stabilize the plaque so the chance of having a heart attack significantly decreases, I insist that he or she must strive to achieve the following parameters of normalcy:

  • The patient must achieve a normal weight or become thin (less than one inch of abdominal fat in women, and less than three-quarters of an inch in men), or be in the process of steadily losing weight toward this goal.
  • The patient must achieve normal cholesterol. My definition of normal is an LDL cholesterol below 100 (most authorities are now using this benchmark). Drugs are rarely needed to attain this level when an aggressive nutritional approach is taken.
  • The patient's diet must be nutrient-dense. Animal products and detrimental fats must be avoided to prevent the after-meal fat surge.1 Refined carbohydrates should also be avoided to prevent the after-meal glucose surges and to control triglycerides. Homocysteine levels should be normalized, by supplementation with appropriate nutrients if necessary.
  • Blood pressure must return to within the normal range, below 130/85, or be slowly improving and moving toward this minimal goal. The normalization of blood pressure as medications are gradually discontinued represents reversal of atherosclerosis and is an important criterion to predict cardiac safety. The person who has removed his cardiac risk no longer requires blood pressure medication to maintain normal blood pressure readings. The vessels have become more elastic through nutritional intervention.

1. Ishikawa, T. 1999. Postprandial lipemia as an atherosclerotic risk factor and fat tolerance test. Nippon Rinsho 57 (12): 2668-72.

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Comments (4) Read through and enter the discussion with the form at the end
kitty - May 16, 2006 12:41 PM

The patient must achieve normal cholesterol. My definition of normal is an LDL cholesterol below 100 (most authorities are now using this benchmark). Drugs are rarely needed to attain this level when an aggressive nutritional approach is taken.
a) Would you care to show some studies that the women with high HDL, excellent ratio need to achieve this level? Most studies showed that for women HDL and the triglicerides are more important than LDL.
b) A lot of people with family history cannot achieve this level with just diet - a collegue of mine is a vegetarian, slim and is a leader of a hiking club. And she has high LDL.

Deirde - May 16, 2006 1:47 PM

Then why did my father who was underweight, low cholestoral, low blood pressure, walked a mile aday require a triple bypass at 50 and my mother who had all the medical issues never have heart problems!

Joel Fuhrman - May 17, 2006 9:25 AM


I agree that a women eating a nutrient-rich diet, with plenty of green vegetables and a high HDL and an excellent ratio would not need to achieve an LDL below 100 to be adequately protected against heart disease. However, when we consider women who are not overweight and have been eating a plant-based diet for many years, it is more typical that their HDL and triglycerides are low, but their low LDL is protective. You do not need a high HDL if your LDL is good enough.

I disagree with your next point that a lot of people with a family history cannot achieve this level with just diet. I have cared for thousands of patients with high cholesterol over the last 15 years with my Eat To Live (high micronutrient) diet and there is only a small minority who cannot achieve those beneficial levels. Occasionally it takes years to get there, but it eventually does in the vast majority of cases. Being a vegetarian is not the issue. Most vegetarians eat refined grains, oils and processed foods. Your friend may see a dramatic improvement in her numbers if she reads Eat to Live and then tweaks her diet to fit my recommendations. On the other hand, I too, have observed the occasional case that still has a high LDL, but that is rare.

Joel Fuhrman - May 17, 2006 9:26 AM


Heart disease has many risk factors besides weight and cholesterol. But the main reason your father developed heart disease is that his diet was Americanized. Most Americans eat piddling amounts of green vegetables, beans and nuts, which should be the major sources of calories in the diet. Processed foods and low phytochemical intake causes both cancer and heart disease, and allows those with less than optimal genetics to be at risk. If you read Eat To Live, you would be aware that you cannot guarantee good health from these numbers alone, you actually have to walk the walk with your knife and fork.

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