February is American Heart Month – a time to raise awareness about heart health and urge those around you to prevent heart disease. Why? Because 48 percent of all adults in the US have some type of cardiovascular disease making it the leading cause of death in the U.S.
The term heart disease includes damage and disease of the blood vessels, the structure of the heart, and blood clotting. For this article, I’ll focus on preventing or treating atherosclerosis/arteriosclerosis aka – hardening of the arteries.
Regarding structure and function, the heart is a hollow organ made of smooth muscle that responds to both chemical and electrical messages to receive and move blood through the 60,000 miles of blood vessels that we call our circulatory system.
But, if you have ever felt the warmth in your chest having fallen in love or felt the heart-wrenching ache after losing someone, you know, the heart is so much more than just a fluid-filled bag attached to hoses. It doesn’t just move blood, it circulates the qi (energy) and Shen (spirit). It is known as the emperor of the human body – the ruler of all the other body functions (NeiJing).
In Chinese medicine, the heart must be empty to function properly. Not like the cowardly lion empty. But empty to receive love, to hear messages of compassion and to know truth when we hear it. It is no surprise that recent behavioral research has found that we live longer with less heart-related incidents if we have a healthy social connection to others.
Care of the heart on all levels is how we prevent heart disease. In The Heart Speaks, cardiologist, Mimi Guarneri, MD, a colleague of Dean Ornish, MD, shares how, as a girl, she lost her parents to heart attacks and went on to champion integrative cardiology after having an M.I. herself. She writes that part of preventing and reversing heart disease is to “Recognize and focus on your own need to restore and re-balance on all levels: body, mind, emotions, and spirit.”
Check her out at https://mimiguarnerimd.com/
Physical care of the heart
All heart health programs advise that we exercise regularly, get at least 7 hours of sleep a night, eat plenty of vegetables and avoid smoking, over drinking and consuming excessive amounts of refined carbohydrates and sugary drinks. Some emphasize emotional support and connection to others or a spiritual practice. But, for most, after our primary care doc recommends lifestyle changes once or twice and the patient hasn’t been able to follow through, as is human nature, the doc recommends keeping the blood fats and blood pressure low by using medications. This makes sense from a practical standpoint – lowering cholesterol can reduce the risk of heart disease and having normal blood pressure can reduce the risk further. Even using natural statins, can achieve this. However, according to Dr. McDougall’s analysis of the Cochrane review, using statins for primary prevention of heart disease only reduces the risk of heart attack by 1.6% and in those who had one already, statins were found to reduce a 2nd one 2.6%.
Will taking statins and anti-hypertensive drugs, do anything to reverse heart disease? Will it help us to have healthy linings to our blood vessels in the first place so we don’t develop the plaque that can chip off and obstruct flow? Will statins reverse damaged arterial linings (endothelium) once present? According to Dr. Daniel Chong, ND of the Vital Hearts Prevention Program, what increases the risk of having plaque in a hardened artery rupture leading to a thrombus and causing a heart attack is poor nutritional status/nutrient deficiencies that make the artery weakened.
Even a single high fat and sugar meal creates vascular adhesion molecules that damage the endothelium. Damaged endothelium makes arteries too stiff to maintain optimal blood flow eventually leading to blockage or plaque release in the form of a clot causing a heart attack or stroke. So, why isn’t anyone talking about endothelium? My guess, because it requires serious lifestyle changes to prevent or reverse pre-existing damage to it. I don’t know of any drugs that can reverse endothelial damage.
Healthy endothelial function doesn’t allow for plaque. So, how do you achieve healthy endothelium and keep it that way? Diet and lifestyle – period.
Only through diet and lifestyle can we increase our anti-oxidant status that promotes nitric oxide, an anti-plaquing agent that prevents stickiness, produces healthy artery dilation, reduces artery wall thickness and helps prevent blockage by reducing arterial. Even in the case of those with high risk for heart disease based on genetics, Dr. Chong says, “You can change susceptibility with nutrition, lifestyle and how you live that expresses your genetic expression, therefore, improve endothelial function and nitric oxide production.” You do that by avoiding the countless ways that cause harm to blood vessels and choosing things that promote healthy endothelium, reduce inflammation and promote healthy anti-oxidant status. He recommends a plant-based, whole foods, low oil diet for those who want to reverse existing heart disease.
Dr. Chong is a protégé of cardiologist and researcher Dr. Caldwell Esselstyn, MD who is featured in the movie Forks Over Knives (Netflix) who synthesized existing evidence, did his own prospective, lifestyle only research, created a program and proved that not only can you prevent but you can reverse heart disease all so he wouldn’t have to keep placing stents in the same people, on statins and anti-hypertensives, over and over again. While Dean Ornish, Pritikin, and many others have proven that lifestyle is key to changing our trajectory from medication dependence to health after heart disease. Dr. Chong’s Vital Hearts Program is a series of slides and his explanations of why Esselstyn’s approach is better than the others. You can find out more at:
I realize that we live in an era where Paleo diets and Ketogenic diets have a huge following and fat is all the rage. I’m simply saying, I’ve not seen human data to prove that they prevent and reverse heart disease. Chong cites several studies in support of plant-based diets in humans such as the Dietary Fiber and Reduced Ischemic Heart Disease study where they found that simple 6 gm incremental increase in fiber was equal to 25% reduction in ischemic heart disease mortality. These folks had around 60 grams of fiber daily.
In the 1980s Dean Ornish performed studies on those with heart disease using plant-based diets with 10% fat whole foods plant-based diet and 75% carbs and 15% protein. They demonstrated a reduction in LDL by 37% while medication lowered it only 6%, frequency of angina chest pain reduced 91% while those in the medication arm of the study had 165% increase in chest pains and arterial wall thickness reduced in the lifestyle group by 2.2% instead of increasing by 3.4% in the medication group.
In 1995, Esselstyn published in the Journal of Family Practice, his outcomes from treating patients who had severe heart disease, some not expected to live another year. After five years, on a strict low oil whole-food, plant-based diet, heart disease was clinically arrested in all patients and none had new infarcts. At 10 years, 6 continued on the diet had no further events but those who stopped, 10 had new coronary events. Of 25 original lesions, 11 regressed and 14 were stable.
While high-fat diets are trendy and have the support of theory and very intelligent promoters, I do not see any data that has proven heart disease reversal or human prospective data to support it compared to the low fat, vegan, plant-based, whole foods diet presented in Dr. Chong’s program. For now, I am trying it out myself and will keep you posted. I am fascinated by the data presented that it will also lower blood sugar and promote better brain health. Check out The Alzheimer’s Solution by neurologists, Sherzai & Sherzai.
The National Heart, Lung and Blood Institute have fantastic ideas for how we can keep it healthy by going to www.hearttruth.gov where you will find recommendations such as eating healthy food like vegetables, fruit and whole grains, limiting saturated fat and sodium, sugar and sweeteners; getting at least 2 ½ hours of physical activity each week and maintaining social connections with others. All of which, I totally agree, are important. So, if vegan isn’t your path, we can all eat more fruit, more veggies and try to get more fiber in our diets. Maybe replace 2-3 meals a week with lentils and beans? Food for thought….