studies show that people who drink moderately can derive some benefit. But these are people who like to hang out with their friends after work. They go to a bar or go to a restaurant for happy hour. It's a great place for people to get social support. So it's hard to separate how much of that benefit is due to the social support, and how much is due to moderate alcohol consumption. Rather than trying to sort out the relative parts, I would say they are probably both important. But I wouldn't tell somebody who is not drinking to start. I think that it is important that people feel like they have lots of ways of increasing their social support or managing stress. Some people may sit around drinking, and other people will do it in other ways.
JOHN ROBBINS: Medicine is a business and there are powerful commercial forces involved. There is a lot of money at stake, and the incentives haven't always been aligned with patient well-being.
DR. DEAN ORNISH: I think that is beginning to change with the Affordable Care Act. Now instead of reimbursement by procedure we're seeing reimbursement by diagnosis. When you say, “Here is X amount of dollars to take care of someone who has got heart disease,” then suddenly the doctor might be advising doing fewer procedures and helping people to change their lifestyles.
We all know that lifestyle is important in preventing disease. But now we're seeing lifestyle as a treatment. It can often work as well or even better, at a fraction of the cost, with only good side effects.
There is a convergence of forces that makes this the right idea at the right time. The limitations of high-tech medicine are becoming clear. Stents and angioplasties don't work for stable patients, and the surgery for prostate cancer isn't really necessary most of the time. Meanwhile, the power of these very simple, low-tech, low-cost interventions like lifestyle changes have become increasingly well-documented.
The opportunities are really ripe now for industries to realize that a new paradigm of medical care can be much more sustainable, and even profitable.
Health care costs are reaching a tipping point. They are not financially sustainable for the government nor for many families. Most large businesses are self-insured, and this is coming right off their bottom line. There is a debate between some people who say, “Let's just raise taxes and let the deficit go up,” and other people who say, “No, let's just dismantle or privatize Medicare.”
I say, “If 75% of the $2.8 trillion in health-care costs are for chronic diseases that can often be prevented and even reversed by making comprehensive lifestyle changes, this can be a third alternative. By teaching people how to change their lifestyles, we can make better care available to more people at significantly lower costs—and the only side-effects are good ones.”
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Caldwell Esselstyn, M.D.
You Can Prevent and Cure Heart Disease. Period.
Caldwell Esselstyn, M.D., is author of the bestselling book, Prevent and Reverse Heart Disease. Drawing on the insights from his decades of rigorous research and more than 150 scientific papers, Dr. Esselstyn explains, with irrefutable, scientific evidence, how we can literally end the heart disease epidemic forever by changing what we eat. His work is featured in the extraordinarily popular documentary, Forks Over Knives.
Do you or anyone you know suffer from heart disease? It's the leading killer in the world. Would you like to know Dr. Esselstyn's simple and life-saving prescription?
JOHN ROBBINS: You conducted a study that rocked the medical world. You have said that patients in your study who were compliant, and 95 percent of them were, became virtually heart-attack proof. That is strong language, and your research seems to support it. Yet the idea for your study was born decades earlier.
DR. CALDWELL ESSELSTYN: My work was kindled by reviewing the global literature on cardiovascular illness. It is quite striking that even today if you are a cardiac surgeon and you are going to set up your practice in rural China, Central Africa, or with the Tarahumara Indians in Northern Mexico, you might as well just forget it. You'll make more money selling pencils, because you are not going to have any cardiovascular disease to treat. There is none. These cultures, by heritage and tradition, are fully plant-based.
Yet by way of contrast, when we looked at the autopsies of our 20-year-old GIs in Korea and Vietnam, fully 80 percent already had gross evidence of coronary disease that you could see without a microscope. That study was repeated about forty years later in 1999. This time it was done in the United States, looking at young women and men between the ages of 17 and 34 who had died of accidents, homicides, and suicides. This time the disease was ubiquitous. Everybody at that young age already had the foundation of coronary disease. So it is very discouraging to think that when you graduate from high school in the United States today, not only do you get a diploma, but you also get a foundation of coronary disease.
This is further accentuated by a very interesting phenomenon that occurred during World War II when the Axis powers of Germany overran the low countries of Holland and Belgium and they occupied Denmark and Norway. It was characteristic that the Germans would take away the livestock from these cultures—specifically their cattle, sheep, goats, pigs, and turkeys. So now suddenly these Western-European nations were deprived of animal food and dairy during the war years. In 1951 it was quite striking to see the report in The Lancet, England's premier medical journal, by Doctors Strom and Jansen who reviewed the Norwegian experience with heart attacks and strokes during those war years. It was striking that from 1939 to 1945, deaths from stroke and heart attack in Norway plummeted. And yet, as soon as there was a cessation of hostilities, immediately back came the meat, back came the dairy, back came the heart attacks, and back came the strokes.
JOHN ROBBINS: What propelled you to conduct the study you did?
DR. CALDWELL ESSELSTYN: In the late 1970s and early 1980s, I was chairman of Cleveland Clinic's Breast Cancer Taskforce. I realized no matter how many women I helped with breast surgery, I was doing absolutely nothing for the next unsuspecting victim. That led me to a bit of global research. It was striking to find that breast cancer in Kenya was thirty to forty times less frequent than in the United States. In rural Japan after World War II, breast cancer was very infrequently identified and yet as soon as the Japanese women would migrate to the United States, by the second and third generation, they now had the same rate of breast cancer as their Caucasian counterparts. Perhaps even more striking was cancer of the prostate. In 1958 in the entire nation of Japan, how many autopsy-proven deaths were there from cancer of the prostate? Eighteen! By 1978, twenty years later, they were up to 137, but that still pales in comparison to the 28,000 who will die of prostate cancer this year in the United States.
At about that time I made a decision to focus on the leading killer of women and men in Western civilization, which is coronary heart disease. It was apparent that there were multiple cultures that were plant-based where this disease was virtually nonexistent. I thought how exciting it would be if we could help people to eat in a way that would save their heart. Because if they were eating to save their heart, then they would probably also be saving themselves from the common Western cancers of breast, prostate, colon, and pancreas.
In the summer of 1985, I went to our Department of Cardiology at Cleveland Clinic and asked for about twenty-four patients who were ill with coronary artery disease. Twenty-four patients was the maximum number I could manage and still carry out my surgical obligations.
JOHN ROBBINS: So you were given twenty-four patients, most of whom were not doing too well.
DR.
