The following remarks by Caldwell B. Esselstyn, Jr.,
MD were delivered September 2, 2000 in Orlando, Florida at the Summit
Conference on Cholesterol and Coronary Risk presented by the Cleveland
Clinic Foundation in cooperation with the Walt Disney World Company.
These comments are a reflection of epidemiologic
survey information and Dr. Esselstyn's 12-year reversal study of patients
with severe coronary disease. In the longest study of its type, the author
has demonstrated elimination of disease progression in all compliant
patients who maintained a total serum cholesterol less than 150 mg/dl and
an LDL cholesterol less than 80 mg/dl through a plant-based diet and
cholesterol-reducing medications.
Plant-based nutrition provides us with a pathway to
escape the coronary artery disease epidemic. For persons in central
Africa, the Papua Highlanders of New Guinea, the Tarahumara Indians of
northern Mexico, and inhabitants of rural China as described in the
Cornell China Study, coronary disease is essentially non-existent while
hypertension, Western malignancies, obesity, and adult onset diabetes are
rarely encountered.
While I am proud to have been the founder of this
conference in 1997, it has become ever more apparent that these
conferences are not the ultimate answer. This stopgap risk factor and drug
oriented device-driven approach is not designed to conquer this epidemic.
This strategy is laden with expense, morbidity, mortality, and temporary
benefits which rapidly erode with time. We must focus on the toxic food
environment for otherwise our children and young adults will become the
next unsuspecting victims.
We have a crises of leadership in our public and private
institutions with an emphasis on prevention. Their advice to the public of
30% fat in the diet guarantees disease development and progression. This
level advocated by the National Research Council, the American Heart
Association, the National Cholesterol Education Program, and the National
Institutes of Health has been shown scientifically to worsen the disease.
For them to sanctify this diet as healthy for the American public, is
egregiously inaccurate. Like trying to fit Cinderella's slipper on one of
her sister's - it simply doesn't work. By way of contrast, the American
Cancer Society prefers 20% dietary fat, while the World Health
Organization advocates 15%.
In 1987 Dr. Scott Grundy proclaimed that with a blood
pressure of 110/70 and a total cholesterol of under 150 mg/dl, 90% of
heart attacks could be avoided. Sadly, no public or private institution
detailed for the public the plant-based diet that could achieve those
goals.
The United States Department of Agriculture has a
sorrowful record of caving to the special interests of industry as does
the U.S. Congress. The U.S. Dietary Guidelines committee has over half its
members with ties to industry, while the chairman of the health and human
services department wears a milk mustache. For those institutions to
decide America's nutritive needs is surely putting the fox in the hen
house.
A slogan has arisen from these groups stating there are
no strictly good foods or bad foods. This is sheer nonsense. Coronary
disease has no building blocks from the plant-based diet. Meat, cheese,
milk, butter, ice cream, eggs, fried foods, oils, and margarine are the
lethal atherosclerotic lynchpins. Vogel demonstrated endothelial damage in
young persons within hours of eating such foods. English children under 10
years of age have been found by ultrasound to be losing arterial
elasticity and distensibility The Bogalusa, PDAY, Korean, and Vietnam data
reveal coronary artery disease is ubiquitous in our young.
We require a new yardstick to measure cardiovascular
excellence in our institutions. No longer will the number or quality of
interventions and their temporary benefits suffice. There is ample
evidence-based research to support efforts geared to prevention. We must
ask how many patients have achieved successful arrest and reversal and
avoided new coronary and cardiovascular events through preventive
lifestyle changes? Some will argue that their patients might not follow a
plant-based diet. This, I increasingly find, is a totally negative and
self-serving speculation. Our experience is that patients rejoice that
they are now empowered to abolish their disease progression and are often
furious that they were not made aware of this option earlier. They clearly
recognize that the locus of control for this disease is vested with them.
While this conference will continue updating us with mechanisms of
disease, that information alone will never shut down atherosclerotic
development.
The truth be known, we don't need new information to end
this epidemic. The evidence is in! As practicing physicians, dietitians,
nutritionists, nurses, and researchers, you are an essential part of the
vanguard to disseminate the facts to patients, the public, and the
government.
As leaders, we must have the courage and a renewed moral
compass to provide the public with accurate information to abolish and
prevent atherosclerosis. We must seek leaders and institutions that are
not frayed or compromised by ties to industry or politics to deliver this
message. It must be science and not the messenger which dictates public
policy.
