What Is the Optimal Diet?

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

England has been keeping mortality statistics since 1665, when yes, one person fell down some stairs and died, but in that week, nearly 4,000 people died of the plague.

Today, the modern plague is heart disease, the #1 killer of men and women, but it wasn’t always this way. If you dig back into those old statistics, by the middle of last century, heart disease was already killing off 5 to 10% of the population. But it was practically unknown at the beginning of the 20^th century. Check out “The Natural History of Coronary [heart] Disease” just in the 1920s and 30s, skyrocketing 10-fold in men, and the same in women. What was going on? A clue could be found if you split people up by socioeconomic class. (You can tell this paper was written about 1950, because it’s split up into Males and…”Wives.”) It was the richest folks who had up to triple the heart disease as the poorest. Maybe it had something to do with their rich diets. You don’t know, until you put it to the test, and in doing so, discover the natural cure of coronary heart disease—discovered decades ago by Pritikin, a plant-based diet and lifestyle program; followed by Dr. Dean Ornish, and then Esselstyn at the Cleveland Clinic. But how many know of the name Hans Diehl?

Dr. Diehl was the first Director of Research at the Pritikin Center back in 1976. He was “inspired” by the amazing results they were getting at the Pritikin Center, amazing results like that of a certain Grandmother Greger. But he “recognized the limitations of [live-in] residential programs,” including their cost…and the ‘artificial’ living environment that made sustaining the behaviors more difficult [when patients] returned [back home].” So, Diehl developed the “CHIP” program “as an affordable 30-day lifestyle intervention” to be delivered in a community setting.

Ten years in, Esselstyn encouraged Hans to publish their results in the American Journal of Cardiology. And, here it is: “Coronary Risk Reduction Through [a] Community-Based Lifestyle Intervention,” famously starting out with a quote from the pioneer of coronary bypass surgery, describing it as “only a palliative treatment.” The only way we’re going to stop the epidemic is through prevention.

We know “[v]igorous cholesterol lowering [can] slow, arrest, or even reverse atherosclerosis.” But, it only works if you do it. Live-in programs work because you can control people’s diets, but they’re expensive, and people may go back home to toxic food environments. So, how about instead of them coming to you, you go to them in the community?

The original program was 16 evening sessions over four weeks, “[t]he major focus [being] to encourage participants to adopt the ‘Optimal Diet.'” They also encouraged people to walk a half-hour a day. But, most importantly, center their diet around whole plant foods. Now, that was the optimal: whole food plant-based. But, the program isn’t dogmatic, just encouraging people “to move along the spectrum” towards incorporating more whole healthy plant foods into their diets. They didn’t provide meals, just advice and encouragement, and…four weeks, later got an average weight loss of about six pounds, blood pressures went down about six points, and their LDL, bad cholesterol, down between 16 and 32 points, and fasting blood sugars dropped as well.

“Often, participants were able to decrease or discontinue antidiabetic, [cholesterol-lowering, and blood pressure-lowering] medication,” making their findings even more extraordinary. Better numbers on fewer drugs.

Live-in programs, like Pritikin and McDougall, are great in that you can optimize the “clinical benefits.” But, they can cost thousands of dollars—in addition to missing work—whereas CHIP is cheap, and they’re living at home. So, it’s not like they’ve been spoonfed some perfect diet for a few weeks at some spa, and then go back to their cupboards of cookies. CHIP is a free-living program, teaching people how to eat and stay healthy within their home environments.

Well, at least, that’s the theory. These remarkable results were after just four weeks in the program. “The true test…will be to what extent people adhere to their new lifestyle and sustain their health benefits” weeks, months, or even more than a year later, which we’ll explore, next.

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• Logan WPD. Mortality in England and Wales from 1848 to 1947: A survey of the changing causes of death during the past hundred years. Population Studies. 1950;4:132-178.
• Ryle JA, Russell WT. The natural history of coronary disease; a clinical and epidemiological study. Br Heart J. 1949;11(4):370-89.
• Morton D, Rankin P, Kent L, et al. The Complete Health Improvement Program (CHIP): History, Evaluation, and Outcomes. American Journal of Lifestyle Medicine. 2016;10:64-73.
• A timeline of CHIP.
• Diehl HA. Coronary risk reduction through intensive community-based lifestyle intervention: the Coronary Health Improvement Project (CHIP) experience. Am J Cardiol. 1998;82(10B):83T-87T.
• Merrill RM, Aldana SG, Greenlaw RL, et al. Can newly acquired healthy behaviors persist? An analysis of health behavior decay. Prev Chronic Dis. 2008;5(1):A13.
• Aldana SG, Greenlaw R, Diehl HA, Englert H, Jackson R. Impact of the coronary health improvement project (CHIP) on several employee populations. J Occup Environ Med. 2002;44(9):831-9.
• Graunt J. London's dreadful visitation. 1665.

Image credit: Monsruo Estudio via Unsplash. Image has been modified.

Motion graphics by Avocado Video.

• alternative medicine
• blood pressure
• blood sugar
• cardiovascular disease
• CHIP program
• cholesterol
• chronic diseases
• complementary medicine
• diabetes
• Dr. Caldwell Esselstyn
• Dr. John McDougall
• heart disease
• high blood pressure
• hypertension
• LDL cholesterol
• lifestyle medicine
• Plant-Based Diets
• prediabetes
• Pritikin
• vegans
• vegetarians
• weight loss
• workplace wellness