International Plant-Based Nutrition Heathcare Conference Round-up – Part 6

Can Nutrition Reverse Cardiovascular Disease: Fact or Fiction?

The biggest lie ever told about heart disease

Dr Caldwell Esselstyn – affectionately know as ‘Essie’ to his family, friends and patients – is a living legend in the field of nutritional medicine. The extraordinary results he has achieved with so-called ‘cardiac cripples’ (people whose heart disease was so advanced they were sent home to die by their cardiologists) have been published in major medical journals, and were featured in the documentary Forks Over Knives.

At nearly 81 years old, he still runs heart disease reversal programs, and maintains a speaking schedule that would exhaust most people half his age! A former rower who was part of the gold medal-winning team at the 1956 Olympics, he keeps himself in shape with running and cycling… and a wholefood, plant-based diet, which he has followed – along with his lovely wife Ann – for over 26 years.

Dr Esselstyn’s presentation was big on both detail and inspiration. You can view my summary of it in the International PBNHC Round-Up Webinar.

But in this post I wanted to focus on just one element of Dr Esselstyn’s presentation: the biggest lie that doctors tell heart patients.

The only problem was, there are so many lies told to heart patients, I found it hard to chose the biggest. So I’ll lay them all out, and you can pick your ‘favourite’. (By the way, Essie is far too much of a gentleman to call these ‘lies’ – that’s my word for it :).)

Lie # 1: Having high HDL cholesterol protects you against heart disease.

Truth # 1: While it’s true that a high capacity of HDL (the so-called ‘good’ cholesterol) to eject cholesterol from the body – known as cholesterol efflux capacity – protects against the build-up of atherosclerotic plaque on artery walls, and therefore against heart attack and stroke, the level of HDL in the blood does not correlate with your cholesterol efflux capacity.

In other words, you can have a high HDL and a low cholesterol efflux capacity, which will cause you to develop atherosclotic plaques in your arteries; or you can have a low HDL with a high cholesterol efflux capacity, which will stop those plaques from building up.

And by the way, statin drugs like Lipitor and Zocur do nothing to improve cholesterol efflux capacity (1).

Lie # 2: Cholesterol-lowering statins protect you against heart disease.

Truth # 2: Most people who are taking statin drugs are ‘primary prevention’ cases – that is, they haven’t yet have a heart attack, but they have some risk factors for it such as high cholesterol, high blood pressure and family history of heart disease. For this group, the benefit of taking statin drugs is very small – if it exists at all – and is outweighed by the risks.

Dr Esselstyn cited the JUPITER (Justification for the Use of Statins in Primary Prevention) trial, which was abandoned early after it was found that treatment was not lowering the death rate from heart attack and stroke… even though the drug company which sponsored the trial was blatantly manipulating the data:

“The results of the trial do not support the use of statin treatment for primary prevention of cardiovascular diseases and raise troubling questions concerning the role of commercial sponsors.” (2)

Lie # 3: We need oil in our diet, particularly olive oil which is ‘heart-healthy’.

Truth # 3: Dr Esselstyn’s major focus when working with heart disease patients, is to rehabilitate their endothelial function. The endothelium is comprised of the single layer of cells that line the inner wall of our blood vessels, forming what Essie describes as their ‘life jacket’. Healthy endothelial cells produce the gas nitric oxide, which dilates blood vessels (keeping blood pressure at a healthy level) and stops oxidised cholesterol, platelets and white blood cells from sticking to the blood vessel wall – the first step in the formation of an atherosclerotic plaque.

Anything that diminishes the capacity of endothelial cells to produce nitric oxide directly harms the cardiovascular system, pushing up blood pressure and increasing plaque formation. Aside from cigarette smoking, the major agent of endothelial damage is OIL – all oils, including olive oil! Even unheated oils cause this immediate impairment of function, even in healthy young people with no signs of heart disease (3). 

Why settle for the paltry 25-30% reductions in heart disease risk that have been trumpeted as huge successes in trials pitting the oil-heavy so-called ‘Mediterranean diet’ against the standard junk food diet, when you can achieve 100% protection against heart disease – even if you’ve already had a heart attack, bypass surgery or angiography, as most of Esselstyn’s patients have (4)?

Myth # 4: Bypass surgery and angioplasty save lives.

Truth # 4: Close to 90% of heart attacks are due to plaques which are so small, they don’t even show up on an angiogram (‘immature’ plaques). Yet it’s the large, stable plaques that do show up which prompt cardiologists to tell their patients that they need to have coronary artery bypass grafting or angioplasty with stent insertion (5)! Several large studies have found that except for a couple of small subgroups, there is no survival advantage for heart disease patients who have bypass surgery compared to those who don’t (6).


My own experience in working with clients with advanced heart disease confirms everything Dr Esselstyn said. I’ve had the great privilege of assisting numerous heart disease patients to lose weight, lower their pressure and cholesterol levels into the normal range, get off their medications and regain their quality of life.

If you’d like to know more about my program for reversing heart disease (including high blood pressure), fill in the form here.

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