Disease Proof : Disease Proof : Health & Nutrition News & Commentary : Dr. Joel Fuhrman

David was your typical, athletic American who thought he was relatively “healthy” . . . until he had his first heart-related incident before the age of sixty. Thankfully he heard Dr. Fuhrman on the radio, and today his health and energy have been restored. Welcome to Disease Proof David! 

What was your life like before discovering Dr. Fuhrman’s nutritarian eating-style?

At age 59, I’ve lived a good life; happily married, manager for a Plastics Company, and a daily runner for the past 30 years. I’m also a golfer and very active as my wife and I have three grown sons who keep us pretty busy! I lost my father to a massive heart attack when I was young so I’ve always been aware that my health was important. However, I felt fairly invincible since I exercised so much, and I thought I was eating pretty healthy. 

However, as a runner I knew I was getting out-of-shape, because it was getting harder for me to run each day. I was slowly gaining weight despite running six mile runs everyday. Then in September 2010, I had chest pains that led to the installation of a stent in my right coronary artery that was 100% blocked. Fortunately, the other two arteries were 100% clear, and I didn’t have a heart attack. This experience was a wake-up call, and I struggled for answers as to how this could have happened. Plus, I did not like all of the drugs I was suddenly required to take. 

How did you find out about Eat to Live?

In late January 2011, I was in the middle of a long drive home from a business meeting, and by sheer chance I heard Dr. Fuhrman on Sirius radio having a discussion on the NYC Docs show about nutrition. His message on eating high-nutrient foods hit me hard. When the show was over I immediately called my son in California, who is a vegetarian and nutritionally committed, and asked him about what I had just heard. He said that what Dr. Fuhrman was talking about was the same thing that he’d been trying to get his mother and me to listen to for years. When I got home I ordered the book. 

How do you feel now?

Today I’m 44 lbs lighter and still losing – which is about a 30% weight reduction so far! I now weigh what I did in high school, and I can run like the wind, which is basically effortlessly! My cholesterol numbers have nose dived, my angina is gone, my energy level is up, and I‘ve cut back on many drugs and expect to eliminate all of them shortly. I’ve discovered Dr. Fuhrman's predictions in Eat to Live to be totally true; and it’s only been five months! 

Do you have any success tip(s) to share with others?

• Get the refined sugar out of your life, along with the Diet Coke.

• Eat all of the vegetables, beans and fresh fruits that you want – don't worry about calories or counting things, except for the limited amounts of nuts and seeds.

• Give this nutritional eating style a chance to take hold. The first few weeks are tough, but hang in there, because the results are worth it.  

In a nutshell, what has nutritarian eating done for you?

It’s given me a chance to help my body and has produced a lot of physical freedom. (The compliments on my weight reduction are pretty fun as well!) Plus, I now have new clothes to wear that were sitting around unused for a long time! More seriously, I don't worry about having a heart attack any longer. 

At 5’8” my weight has dropped from 190 to 145, and my goal was 165 lbs! 

Congratulations David ~ keep up the great work!

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Our society has been falsely led to believe that only highly technological interventions and drugs are effective at treating disease. In many cases, however, these interventions merely act as band-aids – temporarily relieving symptoms while the disease process continues to progress.

Percutaneous coronary intervention (PCI), a term that refers to angioplasty and stent placement procedures, is already known to have no advantage over optimal medical therapy (OMT); which refers to modest lifestyle changes plus anti-platelet, blood pressure-lowering, and cholesterol-lowering medications) for reducing heart attack incidence or cardiac mortality. This information made headlines in 2007; the COURAGE trial compared PCI plus OMT to OMT alone, and found no advantage associated with PCI procedures. [1] Since that time, literature reviews have confirmed that PCI did not decrease the rate of heart attack or cardiac death compared to OMT. [2]

Considering that PCI only treats a small portion of a blood vessel, but coronary artery disease affects the entire vasculature, this is not a surprising finding. Because of this finding, the indications for PCI evolved. Now, these interventions are indicated only for the purpose of relieving angina (chest pain caused by restricted blood flow to the heart) symptoms in coronary artery disease patients.

However, a recent review of several clinical trials in patients with stable coronary artery disease has revealed that PCI does not lessen angina any more than medical therapy either. [3] The researchers analyzed human trials that compared either angioplasty or stent placement to OMT with respect to angina symptoms. In 5 clinical trials conducted since 2000, 77% of patients were free of angina after PCI, and 75% of patients were free of angina after OMT, suggesting that PCI does not provide enhanced symptom relief compared to OMT. [4]

We must remember that aggressive interventions like angioplasty and stent placement have serious potential adverse outcomes, such as bleeding complications, heart attack, stroke, and death. [5]  Approximately 25% of angioplasties and 21% of stent placements clog up again (called restenosis) within 6 months, and about 60% of arteries treated by angioplasty will undergo restenosis eventually.[6, 7] These data tell us that PCI is not a long-term solution. Diet and lifestyle changes, however, are long-term solutions because they remove the cause of the heart disease. A low-fat, plant-based diet plus exercise and stress management has been shown to reverse atherosclerotic plaque progression. In addition, 74% of the coronary artery disease patients who had angina and made these lifestyle changes were free of angina after only 12 weeks. [8, 9] This is equivalent to the figures cited above for OMT – except of course, without drugs.

Despite the evidence, cardiologists continue to rationalize that angioplasty and stent placements are essential for their patients. The reality is that modern interventional cardiology should be stopped and medical and nutritional cardiology should be the standard of care. Everyone who has heart disease deserves to know that they have safer, noninvasive alternatives to stents and angioplasty.

In spite of the research we already have documenting the dramatic effectiveness of nutritional interventions [8, 10-12] and the futility of angioplasty and stent placement, this obviously still has not been sufficient to change the practices of conventional cardiologists. There are too many economic forces working against it. Nevertheless, for optimal atherosclerosis reversal and angina relief, my clinical experience with hundreds of patients with advanced heart disease, (confirmed by nutritional intervention studies) demonstrates that optimal nutritional therapy (ONT), with a vegetable-based, high-nutrient (nutritarian) diet – focused on vegetables, beans, fresh fruit, seeds and nuts - is dramatically more effective than PCI or OMT. This approach has already been demonstrated to be more effective than other nutritional interventions at lowering cholesterol; if we compare the published effects of dietary interventions on LDL cholesterol levels, a low-fat plant-based diet reduced LDL by 16%, but a nutritarian diet reduced LDL cholesterol by 33%.[13, 14] This data and my results offer more evidence to suggest that a nutritarian diet is ideal and by including more greens, beans, seeds and nuts leads to even more dramatic results and long-term benefits for heart disease patients.

Of course, larger more definitive studies are needed - exactly one of the initial goals of the Nutritional Research Project. Only with better controlled and documented research results can we foster increased awareness and acceptance of the therapeutic effects of a nutritarian diet for heart disease patients.

References:

1. Boden, W.E., et al., Optimal medical therapy with or without PCI for stable coronary disease. N Engl J Med, 2007. 356(15): p. 1503-16.
2. Trikalinos, T.A., et al., Percutaneous coronary interventions for non-acute coronary artery disease: a quantitative 20-year synopsis and a network meta-analysis. Lancet, 2009. 373(9667): p. 911-8.
3. Wijeysundera, H.C., et al., Meta-analysis: effects of percutaneous coronary intervention versus medical therapy on angina relief. Ann Intern Med, 2010. 152(6): p. 370-9.
4. Relief from Angina Symptoms: Percutaneous Coronary Intervention Not a Clear Winner. Journal Watch General Medicine, 2010.
5. Angioplasty and stent placement - heart. MedlinePlus.
6. Agostoni, P., et al., Clinical effectiveness of bare-metal stenting compared with balloon angioplasty in total coronary occlusions: insights from a systematic overview of randomized trials in light of the drug-eluting stent era. Am Heart J, 2006. 151(3): p. 682-9.
7. Hanekamp, C., et al., Randomized comparison of balloon angioplasty versus silicon carbon-coated stent implantation for de novo lesions in small coronary arteries. Am J Cardiol, 2004. 93(10): p. 1233-7.
8. Ornish, D., et al., Can lifestyle changes reverse coronary heart disease? The Lifestyle Heart Trial. Lancet, 1990. 336(8708): p. 129-33.
9. Frattaroli, J., et al., Angina pectoris and atherosclerotic risk factors in the multisite cardiac lifestyle intervention program. Am J Cardiol, 2008. 101(7): p. 911-8.
10. Esselstyn, C.B., Jr., et al., A strategy to arrest and reverse coronary artery disease: a 5-year longitudinal study of a single physician's practice. J Fam Pract, 1995. 41(6): p. 560-8.
11. Esselstyn, C.B., Jr., Updating a 12-year experience with arrest and reversal therapy for coronary heart disease (an overdue requiem for palliative cardiology). Am J Cardiol, 1999. 84(3): p. 339-41, A8.
12. Ornish, D., Avoiding revascularization with lifestyle changes: The Multicenter Lifestyle Demonstration Project. Am J Cardiol, 1998. 82(10B): p. 72T-76T.
13. Barnard, N.D., et al., Effectiveness of a low-fat vegetarian diet in altering serum lipids in healthy premenopausal women. Am J Cardiol, 2000. 85(8): p. 969-72.
14. Jenkins, D.J., et al., Effect of a very-high-fiber vegetable, fruit, and nut diet on serum lipids and colonic function. Metabolism, 2001. 50(4): p. 494-503.

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Coronary artery calcification is essentially the beginning of bone formation – except it’s happening in the arteries.^1-2 Sound scary? It is. Calcification is associated with a 3-4 fold increased risk of death from cardiovascular disease.³ And strangely enough, those who have vascular calcification usually have low bone density or even osteoporosis⁴ – hard arteries and weak bones??

Previous studies had tested the effects of cholesterol-lowering drugs (statins) on the progression of arterial calcification, and they were found to be ineffective. These scientists were looking for another solution. Vitamin D deficiency is known to produce a risk of cardiovascular disease, but had not been investigated for effects on arterial calcification. Because of the protective effect of Vitamin D on both bone and cardiovascular tissues, scientists thought that Vitamin D might be a player in this complex interplay between bone precursors and blood vessel walls.

Subjects with no previous heart disease symptoms but a high coronary calcium score (CCS) were included in the study. They supplemented with omega-3 fatty acids  and sufficient Vitamin D3 to achieve greater than 50ng/ml serum levels of 25(OH) Vitamin D. The response of these subjects to these therapies varied 18 months later. About half saw a decrease in CCS, and about half experienced no change or a small increase in CCS. Also about half of the subjects experienced slowed atherosclerotic plaque growth.⁵

What do these results tell us? It is difficult to interpret these results because of the lack of a control (no treatment) group, but it definitely opens the door to more studies on the role of Vitamin D in coronary artery calcification. 

We also don’t know anything about the diets of the subjects of the study. A phytochemical-rich diet plus Vitamin D and omega-3 supplementation could have achieved dramatic improvements in calcium score!

For now, we can now tentatively add coronary calcification to the long list of detrimental consequences of Vitamin D deficiency. Our best protection against these consequences, in addition of course to a high nutrient diet, is a good Vitamin D supplement.

References:

1. Fitzpatrick LA et al. Endochondral bone formation in the heart: a possible mechanism of coronary calcification. Endocrinology. 2003 Jun;144(6):2214-9.

2. Aigner T et al. Expression of cartilage-specific markers in calcified and non-calcified

atherosclerotic lesions. Atherosclerosis. 2008 Jan;196(1):37-41. Epub 2007 Feb 28.

3. Rennenberg RJ et al. Vascular calcifications as a marker of increased cardiovascular risk: a meta-analysis. Vasc Health Risk Manag. 2009;5(1):185-97. Epub 2009 Apr 8.

4. Hmamouchi I et al. Low bone mineral density is related to atherosclerosis in postmenopausal Moroccan women. BMC Public Health. 2009 Oct 14;9:388.

5. Davis W et al. Effect of a combined therapeutic approach of intensive lipid management, omega-3 fatty acid supplementation, and increased serum 25 (OH) vitamin D on coronary calcium scores in asymptomatic adults. Am J Ther. 2009 Jul-Aug;16(4):326-32.

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In 2007 researchers believed the diabetes drug Avandia might triple heart risks. And now they know for sure! A new study in the Archives of Internal Medicine reveals elderly diabetics taking rosiglitazone, the other name for Avandia, were more likely to suffer congestive heart failure and more likely to die; The New York Times reports.

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At the American Heart Association's annual meeting researchers revealed LDL cholesterol levels in U.S. adults have dropped since 1980, but triglyceride levels are 5 times higher. Scientists cite increased awareness of the dangers of high-fat diets and statins for the drop in LDL and the surge in obesity for the jump in triglycerides; Reuters reports.

Okay, it’s good to hear people are getting wise to high-fat diets. Diets rich in saturated fat are linked to heart disease, but statins are no saving grace. They have serious side effects and only offer a band aid solution. However, plant-based diets lower cholesterol, improve triglycerides, reverse cardiovascular disease and promote healthy bodyweight.

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