Doctor's Note

For more on heart disease and plant-based dietary interventions, see:
Why Was Heart Disease Rare in the Mediterranean?
The Mediterranean Diet or a Whole Food Plant-Based Diet?
PREDIMED: Does Eating Nuts Prevent Strokes?
Optimal Cholesterol Level

This is a continuation of a theme I started in yesterday’s video about my personal journey into medicine. Be sure to check out my other videos on heart health and heart disease

For more context, also check out my associated blog posts: Watermelon for Erectile DysfunctionHeart Disease: there is a CureMagnesium-Rich Foods to Prevent Sudden DeathEating To Extend Our LifespanCancer-Proofing Your Body; and Is Coconut Oil Bad For You?

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  • Michael Greger M.D.

    This is a continuation of a theme I started in yesterday’s video about my personal journey into medicine. Please feel free to post any ask-the-doctor type questions here in the comments section and I’d be happy to try to answer them. Be sure to check out the other videos on heart health and heart disease. Also, there are 1,449 subjects covered in my other videos–please feel free to explore them!

  • Toxins

    I have been preaching this for months now! Cardiologists and doctors don’t seem to know about this, or believe me when i tell them heart disease is reversible.

    • Kent Lang

      Why not printing the Paper and show it to them? :)

  • LouiseF

    These pioneers deserve a Nobel prize in medicine. God only knows the countless people who are alive today because of them.

  • pincopallino

    That a plant-based diet is the best for our health is beyond any possible doubt. That is can even reverse heart disease has been demonstrated by the pioneer studies of Colin Campbell, Caldwell Essenstyn and David Ornish. However, there is point in their recommendations that I find very hard to understand (and thus to accept). They insist on a very low fat diet from which any type of added fat is eliminated, even olive oil (rich in monounsaturated fatty acids: MUFA) and flax oil (rich in omega-3). A diet very low in fats means very high in carbs (sure, unrefined complex carbs). Now, there is plenty of studies in peer-reviewed journals showing unambiguously that a high-carbs diet results in reduction of HDL-cholesterol without significant change in total cholesterol and increase of triglycerides; when you add that the main fate of the excess carbs is stored as palmitic acid, the most atherogenic saturated fatty acid, one must have some doubts about the recommended diet. It seems to me that the type of fats are much more important than the quantity (when the latter is reasonable, of course). A high proportion of MUFA, as provided by olive oil (which contains also squalene, a powerful antioxidant) or canola oil, with a good amount of omega-3 (flax oil, walnut oil; the latter has much less omega-3 however) sounds definitely more reasonable than a diet containing 75% carbs or more. I asked the Campbell foundation, no answer. I asked vegsource after reading an article about Essenstyn’s diet, I got unconvincing answers (no biochemical explanations, just “it works that as they say”).
    I’m vegan, I read the China Study and I’m reading Essenstyn’s book, as well as hundreds of studies and books. I can’t, so far, get any convincing support to the low fat theory.

    • Toxins

      Hello Pinco!

      These are doctors I have great respect for as well! They recommended low fat diets to their sick as can be patients who had already had previous heart attacks and damaged arteries. I don’t worry about low fat too much, because there really isn’t much healthy high fat whole plant foods except for nuts, which are the good kind of fats. (excluding coconuts)

      There are 2 reasons to avoid oil.

      1. Oil is empty calories, being all fat with no real nutritional value.

      2. Oil , even olive oil, was show to cause endotheleum cell wall damage in the brachial artery tourniquet test. That is the test where they cut off circulation to your arm for 5 min. and when they release, the blood should surge back into your arm through inflated blood vessels. If your endothelial cell walls have been damaged prior to a unhealthy meal, they will not inflate Olive Oil damaged the blood vessel walls in the test, as they did not inflate. Here is more on oil as well as Dr. Essyslten busting some current claims about olive oil by citing studies

      Fat though, is necessary for good health. We should just get fat from a healthy source outside of oil. Here is a link by Dr. Greger to why we need fat

  • pincopallino

    Thank you for your reply, Toxins, but I would like somebody to explain me how a 75% or more carbs diet can be healthier when it increases triglycerides and palmitic acid and lowers HDL cholesterol. Unless you want to trash hundreds of studies showing that these parameters are strongly correlated to CVD. I keep on getting the same arguments, but never an answer to these objections.

  • Michael Greger M.D.

    For some context, please also check out my associated blog post Watermelon for Erectile Dysfunction!

  • Paradigms

    Can be stopped, could be reversed, in yourself perhaps, but in some others their free will and lazy mental attitude got them to where they are. It is so much easier to buy gym equipment to stare at and collect dust while popping pills. Will the human nature of some ever be overcome? I came to this page linking from a page where you speak about the evils of coconut oil. Charging coconut oil advocates with using beef industry tactics by comparing coconut oil to butter, but this is the way some people live, they do eat butter. What would you suggest to get a somewhat demented poorly self managed diabetic under control?

  • Rebecca

    Please explain why caffeine (coffee, chocolate…) should be avoided. I am more interested in specifics rather than generalizations. Thank you.

  • Christopher Goeser

    Dr Greger, I am interested in your evaluation of the following study: Effects on coronary artery disease of lipid-lowering diet, or diet plus cholestyramine, in the St Thomas’ Atherosclerosis Regression Study (STARS) Lancet. 1992 Mar 7;339(8793):563-9. Does this study lend evidence that using diets other than Ornish or Esselstyn style low-fat vegan diets can halt or reverse coronary artery disease? This study was brought to light by Stephan J Guyenet, PhD, University of Washington. who spoke at McDougall’s Advanced Study Weekend this September.

  • lowell747

    What foods would you suggest for a diseased Gall Bladder. Hoping to avoid surgery? Thanks

    • Sheph

      My grandfather used to say that vinegar would cure gall bladder disease.

  • Fraudbuster

    What a fraud.

  • Rowena

    I’m vegan and I’m convinced of the overwhelming evidence presented here and so widely in fact I was lucky enough to see Dr Greger in London last week – he was brilliant! In regards to this paper (Can lifestyle changes reverse coronary heart disease?) I shared a link with a doctor friend of mind who asked to learn more and he mentioned that Ornish’s paper looks at a vegetarian diet, not vegan/plant-based. In addition there’s all the other interventions that take place so my doctor friend’s response was that it could’ve been due to the multitude of other lifestyle interventions. How should I respond to this? As a lay person I also don’t have access to all the medical journals – can anyone recommend any source papers (preferably published/peer-reviewed) that I could share with my doctor friend?

    • Thea

      Rowena: Esselstyn’s studies got similar results to Ornish and Esselstyn’s only intervention/change was the diet. You could look up the Esselstyn experiments if you wanted. His results were really amazing. He took extremely sick people with multiple heart incidents, who the main medical establishment had not been able to help, and for those people who stuck to the diet, they didn’t have a single heart attack again, and I believe they got better in many other measures as well (like lower cholesterol, etc.). Esselstyn has some free talks on YouTube I think. But he also has a great book that is probably available in your library, but is really worth buying anyway:
      I would also point out that Ornish’ diet is not 100% vegan, but I think it is largely plant based. It stresses the whole plant foods, not diary or eggs. And there are some other videos highlighting studies on this site which attempt to tease out what has the effect. For example, check out this video: Which isn’t to say that exercise is not important or that Ornish’s other interventions were also not important. But to say that diet was not part of Ornish’s success seems like denial to me.
      Hope that helps.

    • Thea

      Rowena: Also note that you can learn more about Esselstyn here on this website: Videos-of-the-day include links to “Sources Cited”. So, you may be able to find Esselstyn’s papers that way. Good luck!