#188: Dr. Caldwell B. Esselstyn, Jr. - Nine Ways a Plant-Based Diet Can Reverse Cardiovascular Disease
Dr. Caldwell B. Esselstyn, Jr.
New York Times bestselling author and PLANTSTRONG founder, Rip Esselstyn, is joined by a very special guest, his father, Dr. Caldwell B. Esselstyn, Jr., discussing the nine ways he has documented reversal of cardiovascular disease over the last 40 years.
When Dr. Esselstyn started his work at the Cleveland Clinic in the early 80s, he was the chairman of the breast cancer task force. In his work, he encountered multiple cultures where breast cancer was virtually non-existent and the same was true for cardiovascular disease.
Why was the incidence of cancer and cardiovascular disease so prevalent in the U.S. and other Western cultures, but not so in others?
Essy set out to prove that cardiovascular disease COULD be reversed with a whole food, plant-based diet, but first he had to find compliant patients and that’s where the conversation starts today. Once he had amassed compliant patients he did, in fact, prove reversal of heart disease in nine different measures, including:
Oh, and stick around to the end when he answers audience questions ranging from caffeine, salt, and alcohol, to diabetes, saturated fats, and gum disease.
Measures of Cardiovascular Disease Reversal. Watch the full YouTube Presentation HERE.
Episode Highlights
10:10 Where does cardiovascular disease begin?
11:00 Role of nitric oxide
13:00 Is it ever too late to bring endothelial cells back to life?
14:30 What are the foods you should and shouldn’t eat to protect endothelial cells
16:00 Benefits of chewing your greens six times daily
21:20 Top Greens to Consume (i.e. Essy’s Rap!)
39:45 Essy Answers Your Questions
40:30 Will this also help with type 2 Diabetes?
41:05 Why are my triglycerides so high when I’m compliant?
42:00 Is one drink of beer or wine ok with dinner?
42:35 Are you against statin drugs?
44:50 Can old plaque be reversed?
46:50 Are plant-based milks ok?
48:50 Why is the totality of sodium intake important?
49:50 What are your recommendations on B-12?
50:53 Is there a link between gum disease and heart disease?
51:11 What are your thoughts on red rice yeast extract in place of statins?
51:25 What’s more toxic - salt or sugar?
55:50 How can avocados damage endothelial cells
Episode Resources
Order Dr. Esselstyn's Book, Prevent and Reverse Heart Disease: The Revolutionary, Scientifically Proven, Nutrition-Based Cure
Dr. Esselstyn’s Prevent and Reverse Heart Disease Website
Slides from Dr. Esselstyn's Presentation
Join our PLANTSTRONG Sedona Retreat - October 9-14, 2023
To stock up on the best-tasting, most convenient, 100% PLANTSTRONG foods, including our cereals, granolas, pizza kits, broths and soups, check out all of our PLANTSTRONG products HERE.
Give us a like on the PLANTSTRONG Facebook Page and check out what being PLANSTRONG is all about. We always keep it stocked full of new content and updates, tips for healthy living, delicious recipes, and you can even catch me LIVE on there!
We’ve also got an Instagram! Check us out and share your favorite PLANTSTRONG products and why you love it! Don’t forget to tag us using #goplantstrong 🌱💪
Want to live your best PLANTSTRONG life? Join our exclusive PLANTSTRONG Community of friendly, plant-loving peeps! This is a goldmine of resources, recipes, and incredible support to feed your PLANTSTRONG life.
Full Audio Transcript
Dr. Caldwell B. Esselstyn, Jr:
With those 18 patients, I wanted to follow up how many coronary events of disease progression had they had in the eight years prior to coming into our study while they were in the hands of expert cardiologists. And they, interestingly enough, those 18 patients had 49 events of increasing or progressive disease. But once they came into our program, 17 of those 18 over the next 12 years had zero disease progression. And we often had striking examples of disease reversal. There was one patient who failed because after six years he got back into the french fries, lamp chops, glazed donuts, ended up having a bypass. But now I'm happy to say he is back with the flock, but proves the point that I'm trying to share today.
Rip Esselstyn:
I'm Rip Esselstyn and welcome to the PLANTSTRONG podcast. The mission at PLANTSTRONG is to further the advancement of all things within the plant-based movement. We advocate for the scientifically proven benefits of plant-based living and envision a world that universally understands, promotes and prescribes plants as a solution to empowering your health, enhancing your performance, restoring the environment, and becoming better guardians to the animals we share this planet with. We welcome you wherever you are on your PLANTSTRONG journey. And I hope that you enjoy the show.
It is always, always a pleasure to showcase and highlight the work of my father, Dr. Caldwell B. Esselstyn Jr. And a couple of weeks ago, we did a wildly informative Facebook Live session on the nine ways he has been able to document the reversal of cardiovascular disease utilizing a whole food, plant-based diet since he started his research at the Cleveland Clinic 39 years ago. And that's what we're going to be sharing here today. But first I want to give you a little context. When my father started his work at the Cleveland Clinic in 1984, he was the chairman of the Breast Cancer Task Force. And during his research, specifically his epidemiological research, he was able to encounter multiple cultures where breast cancer was virtually non-existent. And really not surprisingly, the same was true for cardiovascular disease. Now, you may be asking yourself, why was the incidence of cancer and cardiovascular disease so prevalent in the United States and other western cultures, but not so in others.
My father, who I'm going to refer to Essy during our conversation, set out to prove that that cardiovascular disease could be reversed with a whole food, plant-based diet. But first, it was imperative for him to find compliant patients. And that's where we're going to pick up our conversation today. I really, really, really hope that you enjoy this look back at the groundbreaking work of my father and appreciate the multiple ways in which he has proven cardiovascular disease reversal can happen simply by chewing those leafy greens and making sure that those endothelial cells play like a beautiful symphony. Oh, and be sure to stick around to the end when we're going to answer audience questions ranging from caffeine, salt and alcohol, diabetes, saturated fats, and gum disease. It's a wide-ranging conversation you do not want to miss. And during the presentation, he does have slides. So if you'd like to see that the proof is in fact in the plants, I highly recommend that you watch the YouTube version video. We'll put that link and his slides in the show notes. All right, with that, let's take it away, Essy.
Dr. Caldwell B. Esselstyn, Jr:
So as my research went on of more of this global pattern. It was quite apparent that I was encountering multiple cultures where cardiovascular disease was virtually non-existent. Okinawa, rural China, Central Africa, the Tarahumara Indians in northern Mexico, the Papua Highlands New Guinea, no heart disease. What's going on here? So suddenly it dawned on me, there would really would be more bang for the buck if we could really look at the leading killer of women and men in Western civilization, which was heart disease. Because if we could get people to eat to save their heart, it was clearly apparent that they would markedly diminish the common Western cancers of breast, prostate, colon, and pancreatic. So that was kind of the background that motivated me to say, it's time to see if we can't do some research in heart disease and see if we can get people who have heart disease to transition to whole food, plant-based nutrition and see if we can either stop or perhaps even reverse their disease.
Rip Esselstyn:
And so how confident were you when you set out with your first cohort of 22 patients that you could in fact show that you could reverse heart disease?
Dr. Caldwell B. Esselstyn, Jr:
Well, the epidemiological studies that I have just reviewed with you gave me a fair amount of confidence that this was something that was perhaps had a great chance of working. The real challenge was to see what we could do to get people to cling to this type of dietary nutrition change.
Rip Esselstyn:
So when you say cling, you mean kind of the bedrock of their success was on if you could make them compliant?
Dr. Caldwell B. Esselstyn, Jr:
Totally. That was, in other words, without compliance, you had nothing.
Rip Esselstyn:
And so why do you feel with your patients and your program, you had such compliance?
Dr. Caldwell B. Esselstyn, Jr:
Well, I think the most important thing of all is to show the patient respect. And if you're going to show a patient respect, I mean, you're going to give them your time. And my friend Bert Dunfee, who was a well-known West coast surgeon, used to say that the patients with cancer are not afraid to suffer, but patients with cancer are not afraid to die. So truly what is the key thing here is to show the patients that you believe in what you're doing. And I must confess that for the first five years I was so apprehensive, actually, the first, yes, the first five years, I was so apprehensive about not having compliance that I was seeing these patients every two weeks and we would check their cholesterol and their blood pressure and their weight.
And after doing this for five years, I then graduated and we did it for, I was seeing them then every month. And then after 10 years of the study. Now they were pretty well on autopilot, and I transitioned to seeing them on a quarterly basis. But that was really effective because it meant that they continued to stick with the program. And that's why we began to get these amazing results. Not only did we halt disease progression, but as we'll see later today on this program, we can show how there is striking examples of disease reversal.
Rip Esselstyn:
Now, you started your research in 1984, and here you are, you're a general surgeon, your specialty is the thyroid, the parathyroid and breast. How did that conversation go with whoever you had to get permission with to start doing this research with heart disease? And how many days a week did you start doing this research?
Dr. Caldwell B. Esselstyn, Jr:
Well, there wasn't, I was really still obligated with all my surgical responsibilities. So the initial group was really rather small. It was 24 patients. And I knew within the first month that there were six guys, nice guys who just quite didn't understand or get it. So we had these 18 patients that were the nucleus and they were the ones that stayed with us for over 12 years. And what was rather striking about it was those 18 patients, I wanted to follow up how many coronary events of disease progression had they had in the eight years prior to coming into our study while they were in the hands of expert cardiologists. And they, interestingly enough, those 18 patients had 49 events of increasing or progressive disease, however-
Rip Esselstyn:
Combined? That's combined?
Dr. Caldwell B. Esselstyn, Jr:
Yep. 49 was combined. But once they came into our program, 17 of those 18 over the next 12 years had zero disease progression. And we often had striking examples of disease reversal. There was one patient who failed because after six years he got back into the french fries, lamp chops, glazed donuts, ended up having a bypass. But now I'm happy to say he is back with the flock, but proves the point that I'm trying to share today.
Rip Esselstyn:
Yeah. And so how many days a week were you devoting to this research? Was this one day a week? Two days a week?
Dr. Caldwell B. Esselstyn, Jr:
Yeah, it was once a week.
Rip Esselstyn:
Once a week. Okay. Now I want everybody listening to know that I know, I'm sure that many of you have a lot of questions. And so we're going to reserve those for about another 20 minutes. First, though, I would love for Essy to actually go through to help highlight the points that we're trying to make here with reversal of cardiovascular disease. We have some slides that will help make that point. And so Essy I'd love for you to drive with Bess, our producer if you think this is a good time for you to start showing some of those slides and talking about the nine ways that you've shown reversal.
Dr. Caldwell B. Esselstyn, Jr:
Yeah, I think before we get into that, it would be important to perhaps mention, because probably people are wondering why is it that when you transition to whole food, plant-based nutrition, why is it that these changes occur? And I think to put some solid ground under that, I think all experts would agree that this disease has its initiating, that is its causation, inception, it's beginning is when we progressively injure the life jacket and the guardian of our blood vessels, which happens to be that delicate innermost lining of the artery called the endothelium.
And the endothelium manufactures a truly magic molecule of gas called nitric oxide. And nitric oxide is really quite remarkable because it is responsible for the salvation, preservation and protection of all of our blood vessels because of these remarkable functions that nitric oxide possesses. For example, nitric oxide will keep all the cellular elements within the bloodstream flowing smoothly like Teflon rather than Velcro. Number two, nitric oxide has the strongest, is the strongest blood vessel dilator in the body. When you climb stairs, the arteries to your heart, the arteries to your legs, they widen, they dilate. That's nitric oxide. Number three, nitric oxide will protect the wall of the artery from becoming thickened, stiff, or inflamed, protect us from getting high blood pressure or hypertension.
Number four is the absolute key. A safe and normal amount of nitric oxide will protect us all from ever developing any blockages and plaque. So really when you think about it, every single person on the planet who has cardiovascular disease, has their disease because by now, in the previous decades, they have so severely trashed, injured, compromised, and turned their endothelial system into a train wreck that they no longer have enough nitric oxide to protect themselves from making blockages and plaque. So this is, as we said, the key here is to understand that you want to restore the capacity of your endothelial cells to make nitric oxide. Because when that happens, when that happens, there is no disease progression. And we often will see significant elements of disease reversal. Now, I don't know if you want to do it now, Rip or not, but we should mention what are the foods that every time they pass your lips, you injure the endothelial cell.
Rip Esselstyn:
I would love that. Before we do that, I want to ask you this. So we have a range of people probably from 22 to 95 that are on this live call right now. Is it ever too late to start eating this way to bring those endothelial cells back to life?
Dr. Caldwell B. Esselstyn, Jr:
Absolutely not. Let me give you an example. The oldest patient I started with was 87. He came to see me because he had been told he had to have bypass surgery, but he was convinced that when they sawed him in half for this bypass surgery, he would die. He would not survive that. So he said, no, I'm not going to have the bypass. I'm going to go with your whole food, plant-based approach. And every six months or so, he would give us a call, let us know how he was doing. And then it was just about six months ago that my wife Ann got a call, and it was Stanley. And he was asking her, what kind of a recipe should I use because I'm going to have a party of 20 people. And he said, so he said, I really want you to know that the reason I'm having the party is I'm celebrating my 100th birthday.
Rip Esselstyn:
Really? So wait, can I repeat what I think I heard? So Stanley came to you 13 years ago.
Dr. Caldwell B. Esselstyn, Jr:
That's it.
Rip Esselstyn:
13 years ago, because he didn't want to have his chest sawed in half because he didn't think that that was a good idea. And he probably wouldn't live too much longer. And he went on your program and he's now 100 years old and he's, he's going to be cooking for a party of 20 guests. That's awesome. So what are the foods that you recommended Stanley eat that a allowed him to go another 13 years?
Dr. Caldwell B. Esselstyn, Jr:
Well, I think of what it really was, what are the foods that Stanley should not eat?
Rip Esselstyn:
Well, sure.
Ann Esselstyn:
I have to interrupt.
Rip Esselstyn:
Oh, everybody, just so you know, we also have Ann Crile Esselstyn is in the house. Ann, what's up?
Ann Esselstyn:
Well, I asked Jane what she would-
Rip Esselstyn:
We can't see you, Ann. Ann we can't-
Ann Esselstyn:
Stanley was having a party for about a hundred people, and we suggested Stanley have make sure that they used a hundred different plant-based product vegetables in the menu.
Rip Esselstyn:
Nice. Nice. Well, Dr. Will Bulsiewicz would be happy with that for sure. All right. So Essy, what foods, well, how do you want to direct this? What foods should we eat and what foods should we stay away from?
Dr. Caldwell B. Esselstyn, Jr:
Well, let's try take what we should stay away from first. We want to be sure that we categorize here, what are the foods that every time they pass your lips, you will injure the endothelial cell. All right. They are one, any drop of oil, olive oil, corn oil, soybean oil, safflower oil, sunflower oil, coconut oil, palm oil. Oil in a chip, oil in a cracker oil in the salad dressing, oil in a piece of bread. Oil injures endothelial cells. Now for those who have doubts about what I've just said, I did publish an article in the International Journal of Disease Reversal and Prevention. And the title of my editorial was, is Oil Healthy. And in that article, I review the animal studies and the human studies showing how oil injures the endothelial cells.
Rip Esselstyn:
Right.
Dr. Caldwell B. Esselstyn, Jr:
So in addition to oil, what's it going to be? It's you have to also eliminate animal protein. That is to say anything with a mother or a face, meat, fish, chicken, foul, turkey and eggs. Also, we want to eliminate dairy, milk, cream, butter, cheese, ice cream, and yogurt. Be careful of sugary drinks. Be careful of sugary foods. Cakes, pies, cookies, stevia, agave, excesses of maple syrup, molasses and honey. I don't like people that have severe heart disease not to have peanuts, peanut butter, nut butters, cashew sauce, or avocado. And lastly, eliminate coffee with caffeine. Decaff. Yes. Green tea. Yes. Black tea. Yes. So what are you going to eat-
Rip Esselstyn:
Before you go on, I have a feeling that you've, you've said that list once or twice before.
Dr. Caldwell B. Esselstyn, Jr:
Well, okay.
Rip Esselstyn:
What not eat. Okay, so what shall we eat?
Dr. Caldwell B. Esselstyn, Jr:
Yeah. So what are you going to eat? All those marvelous whole grains. W-H-O-L-E, whole grains for your cereal, bread, pasta, rolls and bagels. 101 different types of legumes, lentils and beans. All these marvelous red, yellow and green leafy vegetables and some white potatoes, sweet potatoes, and some fruit. Now, I must say that for patients who are seriously ill with heart disease, I made a modification about a decade ago, and the modification came about because of the awareness that the endothelial production of nitric oxide is age dependent. For example, you never have heard of an 8-year-old boy or a girl having a heart attack. No, they have nitric oxide coming out of their ears, but by the time they're aged 50, beautifully healthy, they now have 50% of the nitric oxide they had when they were aged 25. And by the time you're 80, you've lost 70%.
So the change I made in our program was a greater stimulation, a greater stimulation of the endothelial production of nitric oxide. And most importantly, we embraced the newer research that shows us that mankind has an alternate pathway for making nitric oxide. So what is that pathway? I need these patients seriously with heart disease to chew, not smoothies, not juicing, to chew six times a day, a green leafy vegetable, approximately the size of half of your fist or a quarter of your fist, which after it has first been steamed for five and a half to six minutes. So it's nice and tender. And then you must anointed it with several drops of a delightful balsamic or rice vinegar. Why? Because research has shown us that the acidic acid from those vinegars can help restore the nitric oxide synthase enzyme, which is contained within the endothelial cell and responsible for making nitric oxide.
So you're going to chew this alongside your breakfast cereal, again as a mid-morning snack, again with your luncheon sandwich. That's three. Mid-afternoon, four. Dinnertime, five. And of course, I adore it when you have that evening snack of arugula or kale. Now the second benefit from chewing the green leafy vegetable, it restores the capacity of your bone marrow to once again make the endothelial progenitor cells, which can replace our senescent injured, worn out endothelial cells. Now the third benefit from chewing the green leafy vegetable. Most important, when you're chewing a green leafy vegetable, you are chewing a green nitrate. As you chew this green nitrate, it is going to mix with the facultative anaerobic bacteria that reside in the crips and grooves of your tongue. Those bacteria are going to reduce that nitrate that you've been chewing to a nitrite. When you swallow the nitrite, it is now your own gastric acid, which is going to further reduce that nitrate to more nitric oxide, which can enter your nitric oxide pool.
So think about it, what you're doing for minimal expense with no hideous side effects all day long, dawn to dust morning tonight, you are absolutely restoring nitric oxide, the very molecule, the deficiency of which gave you this disease in the first place. Now, there is a caveat to this, toothpaste with fluoride or public drinking water with fluoride and mouthwash will injure the beneficial bacteria in your mouth. And I do not like antacids because they will decrease your gastric acidity and you will be unable to reduce the nitrite to more nitric oxide. Now the top six are, green leafy vegetables are kale, Swiss chard, spinach, arugula, B greens, and beets. And if you've got a half a second, I can go the rest of them Rip.
Rip Esselstyn:
Please do. And also, Barry Casey, Barry Casey really wants you to do the greens wrap as well.
Dr. Caldwell B. Esselstyn, Jr:
The whole list are bok choy, Swiss chard, kale, collard, collard green, beet greens, mustard green, turnip greens, Napa cabbage, Brussels sprouts, broccoli, cauliflower, cilantro, parsley, spinach, and arugula and asparagus. And the reason I'd like to go through that with you like this is so that you understand that whole food, plant-based nutrition can help maintain your memory.
Rip Esselstyn:
Love it. All right, will you, and again, everybody, we will do our best to get to your questions in just a little bit. So Essy, do you want to start hitting some of these slides?
Dr. Caldwell B. Esselstyn, Jr:
We'll start with number one.
Rip Esselstyn:
Yeah, Bess if you could hit that up. Thanks.
Dr. Caldwell B. Esselstyn, Jr:
I'm going to show you several slides here of disease reversal. Now this happens to be about as small as your naked eye can see, and I should share with you that these angiograms were all reviewed in the angiography core laboratory of the Cleveland Clinic Department of Cardiology. So when I give you a percentage of improvement, I know that it's accurate. This was a 67-year-old retired pediatrician. You're looking at the left anterior descending coronary artery, and when you measure from the arrow on the left to the arrow on the right, it was a 10% improvement.
Rip Esselstyn:
So before you go on, just so we're clear with everybody, in case you've never seen something like this before, the slide on the left is the one before they started treatment with whole food, plant-based nutrition. Correct. And the one on the right it, you can see it's opened up a little bit. And that's the, so you have the before on the left and the after on the right.
Dr. Caldwell B. Esselstyn, Jr:
Correct. Let's go to number two. Now, this is what we call the circumflex artery that goes to the back of the heart in a 58-year-old factory worker. And from the arrow on the left to the arrow on the right was defined as a 20% improvement. Let's go to the next one. This is a 54-year-old actually security guard, and you're looking at the right coronary artery. And from the arrow on the left to the arrow on the right was described as a 30% improvement. Can we go to the next, please? This happens to be a different patient. This is actually, his name is Dr. Joe Crow. He's in the first chapter of my book at age 44. He had had a heart attack and his cholesterol was 156. He was not hypertensive, he was not diabetic. He exercised regularly. He was not overweight.
But you can see in this view of his left, excuse me, left anterior descending coronary artery. This was the angiogram that was taken at the time of his heart attack. And you can see inside that yellow bracket that this lower third of the artery was all moth eaten and diseased. Well, he has an interesting story. It was, as you can see here, it was over too long a segment to not be a candidate for stents. You simply can't pound in stent after stent after stent, and it was too far down the artery for bypass. So Joe felt that they really couldn't do very much for him. So Ann and I had Joe and his wife out for supper two weeks after his heart attack. And I said, "Look, come on Joe. You have been eating this horrible Western diet. You've got the typical Western disease. Why don't you think about going plant-based?"
He said, "Okay, Ess, I'll give it a shot. They really couldn't offer me anything else, but I'm not going to take those statin drugs. I don't trust them. Too many side effects." "Fine. That's your call." Well, over the next two and a half years, he was the absolute personification of commitment to whole food, plant-based nutrition. In two and a half years after his heart attack, he had another angiogram. Now in the surgeon or in the surgeon's sort of office space at noontime on the day that I knew earlier that morning, Joe had had his follow-up angiogram. I walked over to his door, opened it up, and there he was sitting behind his desk and I said, "Joe, I understand you had the follow-up angiogram, could you share that with me?" He said, "Sure." I said, "How do you think we're doing? I said, "I think we're doing okay." And so if we go to the next slide, now you can see, look at the comparison between the left and the right.
Rip Esselstyn:
Yeah.
Dr. Caldwell B. Esselstyn, Jr:
That is stunning, because-
Rip Esselstyn:
Yeah. So the left one looks like it's kind of been eaten up by moths, and the right one is just the-
Dr. Caldwell B. Esselstyn, Jr:
Yeah, it's clear as a bell.
Dr. Caldwell B. Esselstyn, Jr:
Now, the point I want to make here is that when the, see, he was young. He was, what, 44 years old? So this plaque was young. When the plaque is young and it's made up of inflammation, fat and cholesterol, the body can do a stunning job with it. Here's another example. If we go to the next slide. This is now a 45-year-old gentleman from Florida, and you can see where the arrow is. This is obtuse marginal branch of the circumflex artery and where the arrow is, you can see there's an 80% narrowing there. Now, this gentleman had also other blockages, which prompted his cardiologist to tell him that what he needed was bypass surgery. But apparently he had bought a copy of the book, Prevent and Reverse Heart Disease, and said, no to his cardiologist. "I'm going to try to do this with diet." And the cardiologist said, "No, you're wasting your time." So a year went by and the cardiologist with the consent of the patient decided they'd look at it again. Remember, it was 80% blocked at this time. Let's have the next slide.
Now you can see it's 40% blocked. So he was really making some headway with this. So at this point, he changed cardiologists and his new cardiologist a year and a quarter later decided they ought to get another one. Next slide. Wow. It's all gone. So it's really a very compelling moment when you think that not one single physician was suggesting or advising it, that patient had to do this himself. And look at what you've got here, with minimal expense, you got to eat. And with minimal expense and no injury, no danger. Look what's happened. The patient has absolutely vanquished his disease, which really brings it to the fore. The question of why isn't it that every single patient with cardiovascular disease should at least be offered this perhaps as an option.
Now let's go to the next slide. We've talked a little bit about a heart. I want to mention a word or two here now about the leg. On the left, you see a measurement called the pulse volume. And the pulse volume is on the ankle of this 54-year-old gentleman who also had heart disease. And because of this block, partially blocked artery in his thigh, he had to stop while crossing the skyway to my office. He had to stop five times to let his calf muscle fill up with blood, so the cramp would go away. But I was so focused on his heart, I totally forgot about his leg until about 10 months into the program when he said, "Dr. Esselstyn, do you recall when I first started seeing you, I had to stop five times while crossing the skyway to your office?" "Yeah, I remember. Certainly I remember that." He said, "In the last month, it got to be 4, 3, 2 times, and now I don't stop at all. The pain is gone."
I said, "Well then, Don, let's do this. Back you go to the vascular lab and we will repeat the pulse volume." Now look what you see on the right. Bingo, it is now pulse volume was doubled. Double what we had before. We now have suddenly knew at the start of this program, we had absolutely irrefutable scientific, rock hard data that food and food alone could absolutely reverse this disease. And if somebody's going to say, well, wait a minute, what about the statin drugs? Well, wait a minute. Look at the date. 1986, we didn't have any statin drugs then. Matter of fact, if you go to my book, you will see some of our most profound examples of disease reversal occurred in patients who were unable or who didn't take statins. Next slide.
Rip Esselstyn:
Essy, how excited were you about that pulse volume, seeing the before and after?
Dr. Caldwell B. Esselstyn, Jr:
Oh, that was it. I mean-
Rip Esselstyn:
Yeah.
Dr. Caldwell B. Esselstyn, Jr:
... not only that, see that correlated with the disappearance of his symptoms.
Rip Esselstyn:
Yeah, yeah. But that was the first time-
Dr. Caldwell B. Esselstyn, Jr:
Yes. Yeah, that was 1986.
Rip Esselstyn:
But that was the first patient, Was that before you'd done any before and after angiograms? That was kind of the first-
Dr. Caldwell B. Esselstyn, Jr:
Oh yeah.
Rip Esselstyn:
... time you got a sniff that, wow, this is working, right?
Dr. Caldwell B. Esselstyn, Jr:
Yeah.
Rip Esselstyn:
Okay.
Dr. Caldwell B. Esselstyn, Jr:
What you're seeing now is the aorta and some of the iliac vessels in a 78-year-old retired high school chemistry teacher. And in his retirement, he and his wife liked to enter square dance contest. But during the fast square dance, he was getting bilateral calf pain because of a decrease in blood flow to that part of his leg. So he saw these vascular surgeons and they got these images you see here, and he was not too excited about the big operation that they proposed. And he said, after he came and had found us and came and for counseling, he said, "Dr. Esselstyn, if I choose your method, how long will it take me to get rid of my calf pain?" So I looked at him with great wisdom in my face, and I said, "Well, probably about eight or 10 months. Three months later, I got a phone call. "Dr. Esselstyn, you do not speak the truth. The pain is gone."
Rip Esselstyn:
So explain to me, what exactly are we looking at here on the screen right now?
Dr. Caldwell B. Esselstyn, Jr:
Well, you're looking at, on the left-
Rip Esselstyn:
Yeah.
Dr. Caldwell B. Esselstyn, Jr:
... you're looking at a visualization of the lower, at the top it's the lower abdominal aorta, and then it divides to the right and left leg through the iliac and then the femoral artery and so forth. But what you're seeing on the right is a sort of a concentrated view of the upper part of that, which is on the left, namely the lower part of the aorta and where it immediately divides to the right and left artery. And this, they're horribly filled with plaque and blockages as you can see.
Rip Esselstyn:
Okay, but are we looking at before and after here, or are we just looking at kind of-
Dr. Caldwell B. Esselstyn, Jr:
No, no, no, you're just looking at the before. The after is when he called me and said, the pain is gone.
Rip Esselstyn:
Got it, got it, got it, got it. And is the blockage basically the white? Is that the-
Dr. Caldwell B. Esselstyn, Jr:
That's right.
Rip Esselstyn:
Okay.
Dr. Caldwell B. Esselstyn, Jr:
That's right.
Rip Esselstyn:
Okay. Right. Thank you.
Dr. Caldwell B. Esselstyn, Jr:
Now, I have no idea where this audience is largely is fun. But in Cleveland, Ohio, when you're watching a mystery or a sporting event, just before the advertisement comes on, you will hear the melliflous tones of the announcer say, next slide. When the moment is right, will you be ready? Now we all know that the penile artery is much smaller than the coronary artery to the heart. So not infrequently, before somebody comes down with heart disease, they may find that they're having difficulty raising the flag. However, all is not lost. For instance, not infrequently I'll get a phone call 10 or 11 months after I've counseled somebody, which will go a little bit like this. Dr. Esselstyn? Yes. This is Mr. So-and-so, yeah, good to hear your voice. Yeah, doc, I really thought I ought to give you a call because recently something has come up and I'm wondering if I don't owe you another check. We have the next-
Rip Esselstyn:
That's very delicately put. Nice.
Dr. Caldwell B. Esselstyn, Jr:
Could we have the next, that's it. Now here is kind of, you have to sort of listen a little bit carefully because this is key. What you're looking at here on the left and on the right is what we call a PET scan. And the PET scan measures blood flow to the heart muscle. So for example, on the figure on the left where you see orange and yellow, that means there's pretty decent blood flow. But on the left, you'll see an area of green. And the green is what we call ischemia. That's a fancy medical word for poor blood supply. So at the time that he had that PET scan on the left, I counseled him. And then lo and behold, we brought them back three weeks later to repeat the PET scan. And now look on the right, it's almost all orange. And that's area that was green before is now being, being perfused. Pretty exciting to think that happens in three weeks.
Now the question I was raising about this to myself, I said, wait a minute. We haven't washed out the blockage or plaque in three weeks. What is going on here? So I consulted with Rodriguez, who is the chairman of cardiovascular pathology at the Cleveland Clinic, who perhaps dissects the hearts from 200 peers who are deceased every year. And the question I asked for him, if you can give me the next slide. The question I ask for him, I said, "Rod, how often do you ever see the blockage or blockages or plaque?" Because as you see on this slide for the audience, you can see those three main coronary arteries, the right coronary artery, the left anterior descending, and the circumflex. Where do they all go? They all go where they're supposed to go. They dive into the heart muscle to deliver oxygen and nutrients to the heart muscle.
Now it's those three arteries that get all the publicity for stents and bypasses. But I wanted to know from Rodriguez, how often did he ever see, once the artery had dived into the heart muscle, how often did he ever see any blockage or any plaque? His answer, never. So now I knew what was going on. How did we see that change within three weeks? Because when we first see these patients, their endothelial tissues are just so absolutely compromised and injured. They're barely making the great blood vessel dilator of nitric oxide. And now, believe it or not, they are making your two molecules, which are your enemy. They're called endothelin and thromboxane and endothelin and thromboxane are vasoconstrictors. By that I mean they tend to narrow the artery, not with a block inside it, but just by being pinched and narrowed by the action of these two molecules of endothelin and thromboxane.
So what happens then, as soon as these patients, suddenly they get it right, they're no longer injuring the endothelial cell. It's striking how rapid that recovery can become. Because what happens is as they start eating correctly, they make more and more nitric oxide, which is the vessel dilator, and they take away the endothelin and thromboxane, which were the vessel constrictors. When that happens, then this entire enormous cascade of intramuscular vessels that you see interconnecting with each other on this slide, they all open up. That means there's a huge increase in the volume of blood. So for example, if we look at Poiseuille's law of flow through the hollow viscus is related to the fourth power of the radius. Translation, a tiny increase in diameter in these thousands of vessels is an enormous increase in flow.
Now, at this point, I think it would be good to try the next slide. We promised we'd talked therefore, about these measures of disease reversal. I've shown you the angiogram. It also occurs, you can reverse a stress test. In other words, the patient is on a treadmill and they have angina, let's say. And then after they've had the treatment, suddenly, then that resolves and reverses. I've shown you the PET scan. We've also had situations where we've found that whole food, plant-based nutrition is capable of reversing disease in the carotid arteries that go to the brain. I've shown you the pulse volume reversal. And then of course, they're the common symptoms of reversal of chest pain, angina, claudication in the calf, and erectile dysfunction.
Rip Esselstyn:
Now, and there's one other that we don't have on there.
Dr. Caldwell B. Esselstyn, Jr:
The PET scan.
Rip Esselstyn:
Nope. There's one other that we don't have on there that should be a bullet point. And that is the ejection fraction.
Dr. Caldwell B. Esselstyn, Jr:
Correct. Yeah. Yeah. Ejection fraction is key. That's the ability of the left heart to propulse or to squeeze muscle, heart muscle. And is the force of forcing blood out of the ventricle into the aorta. That's your ejection fraction.
Rip Esselstyn:
Yeah. Wonderful. So this is what we're going to do now, Essy, if your game, let's throw some questions your way. You good with that?
Dr. Caldwell B. Esselstyn, Jr:
Let's do it.
Rip Esselstyn:
All right. Fantastic. Now, first I just want to say, because I know a lot of you are wondering where you can find a doctor who promotes this whole food, plant-based, salt, oil, sugar-free lifestyle in your area. And the answer is simple. Just go to, it's amazing what they're doing these days with telemedicine. Just go to plantbaseddocs.com. They have people that are registered in all 50 states, and you'll be set. All right. How about if we try and keep the answers pretty lean, because we got lots of questions. So Bess, I am just looking here. Go ahead. Essy, if you want to answer that question. Will this also help with type two diabetes?
Dr. Caldwell B. Esselstyn, Jr:
Oh, yes. It's been clearly, especially in the patients who have been increasingly gained weight and they've become diabetic as they beyond the age of 35 or 40. And if you can get to these folks and get them to lose the weight, it's just absolutely wonderful. Because look, diabetes is horrible. It's an absolute like pouring gasoline on the fire. It's a killer.
Rip Esselstyn:
Yeah.
Dr. Caldwell B. Esselstyn, Jr:
Get rid of it. Get rid of it.
Rip Esselstyn:
Yeah. All right. Why don't we do this one? This is from Joe Agganis. It starts with high Rip. I've been whole food, plant-based, no oil for three plus years. My triglycerides are over 200. I'm not doing smoothies or alcohol, but I do eat a lot of fruit. Could it be familial combined hyperlipidemia? Doctor is stumped. Thank you. What do you think Essy?
Dr. Caldwell B. Esselstyn, Jr:
Well, what was 200?
Rip Esselstyn:
Their triglycerides. They want to get that-
Dr. Caldwell B. Esselstyn, Jr:
Yeah. Oh, yeah. No. To really get to the bottom of this as quickly as we can. See if you can't go almost two and a half weeks or so without any fruit. Just without any fruit. See what that does for your triglycerides. Of course remember, it's the simple carbohydrates that tend to jack up your triglycerides. Things like alcohol, smoothies, lots of fruit, fruit juices, and so forth. Sounds like you're getting a lot of fruit.
Rip Esselstyn:
Okay. Essy, Jacqueline Fitzgerald wants to know, is one drink of beer or wine, four ounces, okay with dinner?
Dr. Caldwell B. Esselstyn, Jr:
Yeah. If it's one night a week.
Rip Esselstyn:
There you go. One night a week. Right, yeah. Just so everybody knows, we're not a fan of alcohol. It's basically empty calories and-
Dr. Caldwell B. Esselstyn, Jr:
Well, it's a toxin. It's a toxin to the brain. It's toxic to your heart is toxic to your liver.
Rip Esselstyn:
Yeah. Julie Steiner says, why do you not recommend statin drugs? I don't know if that's an accurate statement.
Dr. Caldwell B. Esselstyn, Jr:
No, I don't think I said that. You can't. I just said that if, let me put this in perspective. The statin drugs have made a contribution, but how many statin drugs do they supposedly take in Okinawa, rural China and Central Africa where they don't have any heart disease? None. They don't need it. Now, once you have heart disease, wouldn't it be sensible to really change the whole food, plant patient nutrition? But many patients can't or won't do that. So the easiest cop out for a physician is to write them a script for statin, which will help lower their cholesterol and improve their outlook. But let me just say that there are many patients who have come through our seminar that I conduct once a month. Many patients who have come through who simply learned long before they ever heard of me, that they simply couldn't take a statin.
Because they couldn't take a statin because of severe muscle cramps, or it was injuring their liver or was giving them diabetes, or it was giving them brain fog. And yet, as you'll see in the pictures in the book, some of the most profound examples that we've had of disease reversal have occurred in patients who were unable to take a statin, but fully were compliant with our program. So I think the statins certainly have at place, but I don't think that anybody should feel that they're being abandoned if they can't get their cholesterol down, even if they're, let's suppose they're following our program a hundred percent, and they still have a cholesterol, 180, 190, 200, 210. They're going to be fine if they're completely eating plant-based because then they're building what we call an endothelial fortress. An endothelial fortress. And so that's kind of the way I feel on the statins.
Rip Esselstyn:
Good. I've heard you say Essy too, that with the statins, you know, referred to as kind of whole food, plant-based as the belt, and then statins as kind of the suspenders, kind of help them. Maria Matthews has a question. This came in at 13:30 Bess. What about old plaque? Can that be reversed?
Dr. Caldwell B. Esselstyn, Jr:
Well, it's going to be more stubborn because old plaque, which has been there for decades, is going to be more made up of fibrosis, scar and calcification. But even those patients, interestingly enough, can often get back to full daily activity without restriction because of what I just went through earlier. When all those intra cardiac, that is the vessels that are intramuscular, once the blood vessels dived into the muscle, all those tiny vessels that don't have a plaque at them, but they're pinched, they're narrowed, they all open up. And that's why even these patients who may have a more stubborn plaque in the major vessels, they often get beautifully symptom free.
Rip Esselstyn:
Okay. I'm just going to read a little shout-out and testimonial here. This came in at 13:46 Bess from Laura Parrella. She says, se my cholesterol went from 282 to 147, triglycerides 205 to 72, LDL 189 to 94, my A1C from 6.5 to 4.2, all from whole food, plant-based, salt, oil, sugar-free lifestyle. And I also lost 80 pounds. I'm celebrating my second year anniversary on March 26th. You, Dr. Esselstyn are the reason why I am so successful. As I have learned from you, I absolutely adore you. Thank you. Do you ever get sick and tired hearing that?
Dr. Caldwell B. Esselstyn, Jr:
Thank you. No, I think that's what kind of keeps us going as long as we can get people to turn around.
Rip Esselstyn:
Yeah.
Dr. Caldwell B. Esselstyn, Jr:
The challenge remains because have you ever looked at what kind of food is advertised on TV?
Rip Esselstyn:
Yeah. So Bess, this came in at 13:46. It's Shujaat Khan. So Essy, there's a lot of talk about nuts, obviously, and we know that you're not a fan of nuts, but she wants to know, is almond milk for someone with heart disease-
Dr. Caldwell B. Esselstyn, Jr:
Oh, yeah.
Rip Esselstyn:
... detected on a calcium screening.
Dr. Caldwell B. Esselstyn, Jr:
Oh yes.
Rip Esselstyn:
Doc said non-obstructive heart disease. What are your thoughts on almond milk?
Dr. Caldwell B. Esselstyn, Jr:
I'm all for it.
Rip Esselstyn:
Okay.
Dr. Caldwell B. Esselstyn, Jr:
Especially low fat almond.
Rip Esselstyn:
Yeah, and let me explain that.
Dr. Caldwell B. Esselstyn, Jr:
Let me explain a word about nuts.
Rip Esselstyn:
Yeah, yeah. You do that and then I'll explain about almond milk.
Dr. Caldwell B. Esselstyn, Jr:
Oh, fair enough.
Rip Esselstyn:
Okay.
Dr. Caldwell B. Esselstyn, Jr:
The reason I'm a little bit slow on nuts. Nuts have a lot of saturated fat. And saturated fat is the last thing you want to do for your heart. The other thing is that I have yet to see a single study of patients who are seriously ill with heart disease, where, by giving them a diet of nuts that they're able to show absolute disease reversal. I just haven't seen it. There also is a study that often is overlooked because it's an old one. Back in the 1970s when Dr. Veselinovic and his team took rhesus monkeys, three groups, one group was getting corn oil, the other was getting butter fat, and the other was getting peanut oil. Now, then sadly, they sacrificed the animals after a year. The vessels in those having peanut oil were far and away much more destroyed and ravaged and the other groups.
Rip Esselstyn:
Okay. So what I was going to say about, so a small handful of almonds, one ounce is about 180 calories. Almond milk, you're lucky if 2% of that is coming from almonds and it's got about 35 calories, 40 calories per serving. So the amount of fat and the amount of calories is very minuscule compared to actual almonds themselves. Essy, I'm going to take a quick question. This came in at 13:48 from Cindy Dudak, and the question is about salt intake, because there's 210 milligrams per serving in our Indian lentil stew, and she wants to know if that's too high. Can I give feedback?
So the most important thing here, Cindy, is, and it's a great question, is the totality of your sodium intake over the course of the day. And if you're eating, as my father has suggested whole food, plant-based but you're also supplementing with some of, let's say, our PLANTSTRONG products, our cereals, our stews, our chilies, which are some of the lowest sodium products on the market, you'll be absolutely fine. And remember, the Institute of Medicine wants your total milligrams of sodium over the course of the day to be less than 1500 milligrams.
Dr. Caldwell B. Esselstyn, Jr:
Right.
Rip Esselstyn:
So if you were to eat that whole container that's 420 milligrams, you've got, you're eating fresh fruit and vegetables that's maybe got a total of 400 to 500, you should be absolutely fine. Would you agree with all that Essy?
Dr. Caldwell B. Esselstyn, Jr:
Oh yeah. You got to keep it low.
Rip Esselstyn:
What is the recommended amount of B12 to take while following whole food, plant-based? What are your thoughts on B12?
Dr. Caldwell B. Esselstyn, Jr:
Between the ages of 50, excuse me, the ages of 60 and 70, maybe 500 micrograms, over 70, 1000 micrograms. Why? Well, I had a favorite physician who was an expert in B12 who convinced me that the last thing you ever want to have happen to your patients to have B12 deficiency, you get anemia, and then you'll get some irreversible neurological damage, which is really something you don't want anybody to have. Because as we grow older, there are two most valuable things in the stomach that are so essential for the absorption of B12. One is gastric acid. Gastric acid tends to fall off as we get older. And the other thing we tend to lose is intrinsic factor, which is essential for the absorption of B12. So that's why he suggests a 1000 micrograms a day over the age of 70.
Rip Esselstyn:
Okay. This came in at 13:45 best, it's from Shavam Pandi. Dr. Esselstyn, do you think there's a link between oral hygiene and heart health?
Dr. Caldwell B. Esselstyn, Jr:
Yes. There's no question that if you have a disease, gums, if they're unhealthy, obviously this is going to somehow adversely impact the health of your endothelial cells.
Rip Esselstyn:
All right, love it. Thoughts on red rice yeast extract in place of statins?
Dr. Caldwell B. Esselstyn, Jr:
Yeah, I think this is probably something that's okay.
Rip Esselstyn:
Okay. All right. Essy, what do you think is more toxic salt or sugar?
Dr. Caldwell B. Esselstyn, Jr:
It's a question of whether you want to be shot or hung.
Rip Esselstyn:
Okay. All right. I don't think we want either you. This is came in at 13:43 from Lynn Huffman. My cardiologist is very supportive of plant-based. What are your thoughts on familial hypercholesterolemia? Can you still have high LDL in plant-based and be as healthy as possible?
Dr. Caldwell B. Esselstyn, Jr:
Yeah, it's going to be challenging, but it's interesting that you can, when often you take care of these patients with familial hypercholesterolemia, and there are other relatives in that family that have really, even with that impact of cholesterol have done very well. I like those patients who have a high cholesterol to do the best they can with whole food, plant-based nutrition. And it is interesting that the basis for developing heart disease, of course, is inflammation. So let's say that you can't keep your cholesterol below the 240 or 250, but if you are in no way creating an inflammatory, inflammation environment, let's say for instance, how do you know that you're being successful with that? You can get blood studies of inflammation, for instance. You can get a blood drawn and measure your oxidized LDL. You can look at asymmetric dimethylarginine, you can look at MPO, which is myelo peroxidase, and there's also TMAO, trimethylamine N-oxide. And lastly, HSCRP.
Those are all studies of inflammation. And if those are always nice and low and safe, even if your cholesterol is high, that means you've got sort of what I call an endothelial fortress. And you should be doing the very best you can to keep yourself from getting disease progression. And then there are also for these patients, some injectable compounds for lowering cholesterol.
Rip Esselstyn:
Okay. 13:23, Roger Gridvik, this is just another testimonial. I have lost a 100 pounds in one year and got rid of my type two diabetes by switching to a low fat plant-based food. Good for you. That's awesome. It seems to be that there's a fair amount of conversation about coffee, caffeine, green tea. Can you repeat your thoughts on that?
Dr. Caldwell B. Esselstyn, Jr:
Well, I'm a little bit cautious about, and again, I'm a bit of an outlier here. I don't like to have coffee with caffeine. And I'll tell you the reason for that. I mean, by the way, well, green tea and black tea and the decaffeinated are fine. But the reason I have reservations about coffee with caffeine is an Italian study. It's a good study there, a group of healthy young patients was, persons, participants was divided in half, half drank coffee with caffeine, the other was decaf. And then after they drank, they did a brachial artery tourniquet test, which a measurement of endothelial activity. Then they switched groups. And the group that previously was having coffee with caffeine was now decaf. And interestingly enough, it was always the group that was having coffee with caffeine that injured endothelial output of nitric oxide. And the other reason, see, the reason that my program succeeds where others may occasionally fail is because nobody else is as mean as I am.
Rip Esselstyn:
Well, I've never thought you were mean. I just thought you were very intense and you occasionally could be very stern. All right, you guys, I just love all these questions and I want to say that we so appreciate you guys being so interested in taking your health to the next level. Essy, what about avocado? Somebody here wants to know how is it that avocados damage the endothelial cells?
Dr. Caldwell B. Esselstyn, Jr:
Yeah. Again, it's interesting, where was it the other day? I was just reading again how avocado is contributing to some hypertension. And it has obviously a lot of fats, but the one that I want to get rid of is the saturated fat. So I just think it's in the corridor of foods that I would just assume people not have because of injury to the endothelium.
Rip Esselstyn:
Yeah. Well, it's interesting, and if you look at the breakdown nutritionally of an avocado, it is about 80% fat and 15% of that fat is coming from saturated fat. And you're a stickler about that. So there's been a few questions too about how we, as human beings, we need a certain amount of fat to absorb the fat soluble vitamins. What's your thought on that? And I know you recommend a pretty low fat, less than 10% of your calories coming from fat on your disease or heart disease reversal program, and you think that's ample, correct?
Dr. Caldwell B. Esselstyn, Jr:
Oh, yeah. I don't think we've ever heard of anybody who went into the emergency room and said, my God, help me out. I'm fat deficient. It's interesting that just within the last year or two in some leading medical journals, one is in the New England Journal of Medicine, the other was in American, the Journal of the American College of Cardiology. And the interesting thing was, these were a group of very responsible physicians, and the discussion was really sort of focusing around supplements. And pretty much it was uniformly agreed that presently is an industry that is totally out of control, and you really don't, when you get a supplement, you don't really know what it is that you're getting that's in that bottle or in that pill. And the consensus was that perhaps by, this is my introduction here about B12, with the exception of B12, you should be able to get all of your nutrients, vitamins, and minerals from a nice variety of healthful foods.
Rip Esselstyn:
Okay. You know what, we're at the top of the hour Essy, and so we're going to call it right now. I so appreciate everybody joining. I apologize if we haven't gotten to your question. I do want to just go a give a little plug to, we're doing our first retreat of 2023 in Black Mountain, April 16th to the 21st. And if anybody's interested in joining us in the gorgeous lush mountains of Black Mountain, that's about 25 miles from Asheville, North Carolina, check us out on plantstrong.com. Essy, would you like to say a word about your program that you offer to people with that are concerned about heart disease once a month?
Dr. Caldwell B. Esselstyn, Jr:
Well, sure. What it is that we try to reach out to patients who either, for instance, one, let's say that they've had a heart attack, they don't want to have another one, or they've got a lot of symptoms of heart disease and they've been told they have to have stents, or they've been told they have to have bypass, but they don't want to have it. In other words, the entire spectrum of people who have that kind of cardiovascular disease. We really love to see them. What the way the program works is it's a one single day, five hours, we limit it to people who are, let's say no more than 18 or 20 folks. They're going to learn all about how they have created their disease, and precisely how we are going to empower them as the locus of control to halt and to reverse their disease.
And since I'm a little bit old-fashioned, when my secretary gives me a list of who's coming, two weeks beforehand, I personally call every one of the patients to get my arms around their story and at the same time provide them with an opportunity to ask questions of me. So that coming to the seminar, we have a strong platform from which we can all move forward. So when you think about it, there's a total number of hours of close to six hours of information so that they're really going to get their arms around this disease and know how to handle it.
Rip Esselstyn:
And just to repeat everybody, because I see a lot of comments, will this be replayed? Yeah. You can go to our YouTube channel, go PLANTSTRONG, and we'll have this up within 30 minutes of shutting this off. All right, everybody, you guys keep it PLANTSTRONG. We're rooting and tooting for you all the way. You can do it. Essy, thank you for sharing with us the nine different ways that you have shown reversal of coronary artery disease over the course of the last 39 years. It's so absolutely impressive and empowering. Thank you.
Dr. Caldwell B. Esselstyn, Jr:
Thank you, Rip.
Rip Esselstyn:
Thanks so much for listening and watching. As you know, my father has been unwavering in his advice, and I am so proud to stand on the shoulders of this giant. And I'm sure that many of you have seen this, but if not, a new study has come out and it suggests that a keto like diet could trigger a spike in bad cholesterol. That's the LDL, which can lead to a buildup of plaque in the arteries and a significantly greater risk of heart attacks, strokes, and other cardiovascular events. These findings from the study were presented just two weeks ago in New Orleans, Louisiana at the American College of Cardiology's annual scientific session together with the World Congress of Cardiology. This, my PLANTSTRONG brethren, is huge, and it's precisely why we veto keto at every step. And I hope that you do too. We'll be sure to link to this article in the show notes as well. Have a great week. Make your endothelium sing and always, always keep it PLANTSTRONG.
Thank you for listening to the PLANTSTRONG podcast. You can support the show by taking a quick minute to follow us. Wherever you listen to your favorite podcast. Leaving us a positive review and sharing the show with your network is another great way to help us reach as many people as possible with the exciting news about plants. Thank you in advance for your support. It means everything. The PLANTSTRONG podcast team includes Carrie Barrett, Laurie Kortowich, Ami Mackey, Patrick Gavin, and Wade Clark. This season is dedicated to all of those courageous truth seekers who weren't afraid to look through the lens with clear vision and hold firm to a higher truth. Most notably my parents, Dr. Caldwell B. Esselstyn Jr, and Ann Crile Esselstyn. Thanks for listening.
