Famed cardiologist Dr. Caldwell Esselstyn once called heart disease a “toothless paper tiger that need never ever exist. And if it does exist, it need never, ever progress.” Yet heart disease kills more Americans every few years than ALL of our previous wars combined. Most alarming, people who die from a heart attack get no warning sign whatsoever. In fact, in his book “How Not To Die,” Dr. Michael Greger says of sudden cardiac deaths, “you may not even realize you’re at risk until it’s too late.” And for some, “their very first symptom may be their last.” Here one minute…and gone the next. It’s scary, and unnecessary. Yet a heart attack is also the number one reason that most of us, and those we love, will die. In fact, every 40 seconds an American will die of a heart attack, which equals 610,000 annual deaths from heart disease in the United States every year–that’s 1 in every 4 deaths. So what is coronary heart disease, or CHD? Is it preventable? And if so, how?
Heart disease is a catchall phrase for a variety of conditions that affect the heart’s structure and function. It falls under the umbrella of a disease referred to as Cardiovascular Disease, or CVD. According to the National Heart, Lung and Blood Institute, “CVD is the term for all types of diseases that affect the heart or blood vessels, including coronary heart disease (clogged arteries), which can cause heart attacks, stroke, congenital heart defects and peripheral artery disease.” Thanks to our Standard American Diet, or SAD (diet high in fat, low in fiber), fatty deposits build-up in the wall of our arteries and create what are called atherosclerotic plaques. According to Greger, “the majority of people with this cholesterol-rich gunk” develop atherosclerosis (athere-meaning “gruel”) and (sclerosis—meaning “hardening”). The build-up of these plaques, accumulate in the coronary arteries (arteries crowning the heart) and narrow the path for blood to flow to the heart. Greger cites William C. Roberts, the editor in chief of the American Journal of Cardiology, “there are only two ways to achieve low cholesterol, put 200 million Americans on a lifetime of medications or recommend they all eat a diet centered around whole plant foods.”
To illustrate this point, Greger describes how western doctors in 1930’s and 40’s, working in African missionary hospitals, found that most of the diseases of the western world were virtually non-existent there. Thinking they might be on to something, the doctors decided to compare the autopsies of Africans to those of Americans. Amazingly, out of 632 Ugandans autopsied in Africa, there was evidence of only one single heart attack. But out of 632 patients autopsied in Saint Louis, MO, doctors found evidence of 136 heart attacks…holy pork steaks! Baffled by the results they opted to study another 800 Ugandans. Out more than 1,400 bodies autopsied, there was still only that one person with a small “healed”lesion of the heart, meaning, that’s not even what caused their death.” So it’s got to be about their genetics, right? No. In fact, large-scale immigrant studies in China and Africa both showed how rates of certain diseases like heart disease, characteristically coincided with where one lives. In other words, if you move to an area where there are high rates of disease your risk goes up. But if you move to an area where there are low levels of disease your risk of disease goes down. These are what they called lifestyle diseases. So what can we do to prevent heart disease? Just focus on treating the cause and the symptoms will go away? No, not when there is money to be made. In 2017, Pfizer’s Lipitor generated 1.8 billion dollars in annual sales. Greger jokes (or is he?) that because Lipitor, a cholesterol reducing drug, and the best selling drug of all time, “garnered so much enthusiasm some US health authorities reportedly advocated they be added to the public water supply like fluoride is.” Statins like Lipitor are known to cause memory loss, increase the risk of diabetes, and may also double a woman’s risk of invasive breast cancer
Modern day Africans have extremely low cholesterol in their blood because their diets are comprised mainly of plant-derived foods, such as grains and vegetables. That means a lot of fiber and very little animal fat. Our western diet is mostly the opposite; comprised mainly of animal fat, and little or no plant fiber. Most of the fiber we do consume is processed (yeast breads and rolls, flour and corn tortillas, bagels, English muffins, etc.). And why is fiber so important, you ask? Found in plant foods, soluble fiber binds to the cholesterol particles in our digestive system and moves them out of the body before they’re absorbed. Insoluble fiber, aka, “roughage,” is also found in plant foods and essentially cleans out our intestines and keeps us feeling fuller longer. Yet the average American consumes about half of the recommended amount of fiber per day and more than double the recommended amount of fat.
So how come our doctors don’t give us nutritional prescription? Maybe because they don’t know any better. Or maybe they have no interest in knowing any better. Nutrition is not a requirement in most medical schools across the country. Physicians are taught to look for a set of existing symptoms (dis-ease) and write a prescription(s) for those symptoms… That’s it. Even if those pills do nothing to correct the underlying cause. And even if the drugs cause other health problems to occur. Medical practitioners have their required continuing education subsidized, if not entirely paid for, by the pharmaceutical industry. In a recent poll, Dr. Marcia Angell, a Senior Lecturer from Harvard Medical School, observed a “staggering 94% of physicians surveyed acknowledged receiving financial compensation of some form from pharmaceutical companies.” It has also become entirely standard practice for pharmaceutical companies to have a direct hand in both the design and analysis of medical research, as well as conducting clinical trials, and in the publication of those results. And finally, many doctors themselves are not healthy people. Overweight and out of shape, many doctors today parallel their cigarette smoking predecessors of 50 years ago. Dr. Neal Barnard of The Physicians Committee for Responsible Medicine, observed that doctors finally realized they were “more effective in counseling patients to quit smoking if they no longer had tobacco stains on their own fingers.” Barnard also likened a plant-based diet as the nutritional equivalent to quitting smoking.
Greger finishes the chapter on heart disease by further explaining why more doctors don’t counsel their high cholesterol patients about nutrition as an option for treatment. Aside from not having enough time to counsel their patients on diet (this was the case as explained by my own physician), most of them said they didn’t want their patients to feel “deprived” of eating the foods they loved.