Updated: Mar 11
It may be very likely that you or someone you know is affected by cardiovascular disease, like heart disease or stroke, which claims countless lives, unnecessarily. This article was written with the intent to shine a hopeful light on an otherwise, at first sight, dire looking situation. There may be more hope than you previously thought possible.
Is it really possible? Reversing heart disease?
What is heart disease?
The most common type of heart disease is coronary heart disease. Coronary heart disease occurs when plaque (a combination of fat, cholesterol, calcium, and other substances found in the blood) builds up in your arteries.
You may have heard this called, clogged arteries, the hardening of the arteries or atherosclerosis. The plaque reduces the amount of oxygen-rich blood getting to your heart, which can cause chest pain (also called angina).
Plaque can also lead to blood clots, which block blood flow and are the most common cause of a heart attack. (3) Atherosclerosis has long been regarded as an inevitable degenerative disorder associated with ageing.
But the vascular damage, that develops over decades begins silently in early childhood. (4)
Heart disease starts in childhood
The evidence that the atherosclerotic process begins in childhood, has been reported in multiple regions around the world. Fatty streaks already start being visible by age 10!
And by age 20 plaque starts to build up in the coronary arteries, from where it gets worse over time. Coronary arteries are the arteries that surround, and supply blood to, the heart.
And if things couldn’t be even more shocking, fatty streaks have even been observed in the aortas of small children less than 1 year old. (10)
Most people of 20-29 years of age have coronary fatty streaks of some degree, regardless of gender, race, or nationality. (11)
No wonder heart disease is the number 1 killer of our age!
The indisputable number 1 cause of death worldwide
If we just let the statistics speak, then there’s a good chance that you already have some form of heart disease, but you’re just not aware of it yet.
A heart attack occurs when an artery supplying your heart with blood and oxygen becomes blocked. In a similar way, a stroke can manifest itself when the blood supply to your brain gets interrupted or blocked.
Using another well respected source, such as the Global Burden of Disease Study 2017, (2) both heart disease and stroke top the list as well. Here they fall under the category "Cardiovascular diseases."
Cardiovascular disease (CVD) is a general term for conditions affecting the heart or blood vessels, usually associated with atherosclerosis. (14)
The cause of atherosclerosis
Atherosclerosis has long been regarded as an inevitable degenerative disorder associated with ageing. (15)
This has led many people to believe that they don’t have much choice in the matter. This is a slippery slope, because then it becomes easier to justify making harmful diet & lifestyle decisions that further speed up atherosclerosis' progression and diminish the quality of life.
Everybody can probably relate to this in some way. How many of us make choices, consciously, that are harmful in one way or another?
Everything in moderation, you’d say. Defining moderation, however, is a subjective matter. Moderation could still negatively affect your health or contribute to the further progression of heart disease.
If we manage to survive the onset of other diseases, are we all doomed then to die from heart disease in the end?
In short, No.
When it comes to heart disease there are things that are clearly linked to its progression:
High Blood Pressure;
High blood cholesterol levels;
Overweight or obesity;
Lack of physical activity;
Unhealthy diet and stress. (15)
As you can see, diet is mentioned last, but if we look closer at the list, we can see that a lot of those factors are, in most cases, the result of a POOR and INADEQUATE diet, since diet on its own can improve these things significantly: high blood pressure, high cholesterol, diabetes, overweight and obesity. (16), (17), (18), (19)
In other words, diet stands out the most by far.
Heart Failure Society of America (HFSA) presented a new nutritional guideline for heart failure last year due to the lack of detailed nutrition recommendations and existing heart failure guidelines.
Amanda Vest, head of the multi-disciplinary team that reached a consensus, states:
“Some of the popular diets that would be good for heart failure patients would be the DASH or Mediterranean diet, as well as plant-based diets.”(20)
That’s basically in line with current guidelines elsewhere, that recommend similar diets, namely diets high in fruits, vegetables, whole grains, nuts, and legumes; moderate in low-fat dairy and seafood; and low in processed meats, sugar-sweetened beverages, refined grains, and sodium. (21)
The American heart association calls it plant-forward: (22)
“Plant-forward emphasizes plant-based foods but is not strictly limited to them. Meat may be included but it’s usually not the main feature of the meal.”
Since all these guidelines show lots of similarities, what is the rate of success?
Guidelines fall short?
Although one could book significant improvements following aforementioned guidelines, they have nonetheless never proven to be able to reverse heart disease, like in an intervention discussed further below.
Considering it’s our number one cause of death, we may have massive improvements still ahead of us. In 2004 the World Health Organization (WHO) predicted that by 2020, coronary heart disease would be world’s most important cause of death and disability and, further, the most important cause of premature death. (25)
It looks like they were right.
Perhaps we’re missing something here.
Reversing heart disease is possible
Dr. J. Kahn, a cardiologist that is well aware of the possibility of reversing heart disease notes:
“The arrows always pointed towards the disease advancing and never reversing”
Dr. Kahn meant here that he had always learned to focus on the progression of heart disease. Reversal of heart disease was never a topic of discussion. And that it is still a current theme to this day.
Dr. Kahn and other physicians and doctors like him, who treat patients with heart disease, are well aware that reversal is not at all out of reach.
Let’s take a look at the following picture below, that deserves some elaboration in order to truly appreciate the beauty of what happened and what is possible with the right kind of intervention.
Here we see a part of the myocardium of a patient with coronary heart disease.
Myocardium is the heart wall’s muscular middle layer, which allows the heart to contract.
The yellow and gray parts indicate decreased blood flow.
You can perhaps imagine, judging from the lack of blood flow, the heart is not able to contract efficiently.
What happened after a dietary intervention of merely 3 weeks?
The red color indicates healthy blood flow. This means the heart is substantially more able to contract, leading to a healthier heart and body. This is quite a feat that shows just how powerful an intervention can be.
This data comes from an intervention set up by a renowned cardiologist named Dr. Caldwell B. Esselstyn. (26)
Dr. Esselstyn noted:
“CAD (coronary artery disease) remains the number one killer of women and men in western civilization despite 40 years of aggressive drug and surgical interventions. These approaches can be lifesaving in the midst of a heart attack. However, the elective use of percutaneous coronary intervention (PCI) shows little protection from future heart attacks or prolongation of life, perhaps because it does not treat the major cause of this disease. Such palliative treatments also carry significant risk of morbidity (death) and mortality and lead to unsustainable expense.”
Dr. Esselstyn is right.
Not only are there risks involved, if you don't actually treat the cause then you might as well be mopping the floor with the water running.
A more efficient way to handle things, would be to turn off the faucet and unclog that drain so water can flow through it. Just like you need to unclog your arteries for your blood to flow through.
Results of the most successful intervention treating heart disease
In Dr. Esselstyn's biggest intervention, he had an initial group of 198 people with Coronary heart disease, who followed his dietary plan. Of those 198, 177 stuck with the program and 21 were not adherent and dropped out.
What happened to those 177 people?
94% experienced symptom reduction and almost a quarter of the patients reversed their heart disease, whereas the progression of the disease in more than 60% of the patients in the non-adherent group got significantly worse.
The picture indicating improved blood flow within the myocardium is significant, but if this kind of intervention is being followed over a longer period of time it may lead to even more substantial changes.
To be more specific, let’s examine these 2 images below:
What we see here (on the left - A) is a clogged artery. Not just any artery though.
It is the left anterior descending coronary artery. This is the artery that supplies
blood to large areas of the heart.
This means that if this artery is clogged enough, it can lead to a massive heart attack, that most likely leads to death. It is therefore often called "THE WIDOW MAKER"
You see the remarkable difference (on the right - B) after persisting with ONLY a nutritional intervention for 32 months. The artery was able to return to its original healthy state.
Never before has there been any kind of intervention that came close in producing such extraordinary results as in Dr. Caldwell's intervention.
Other interventions have shown substantial results in halting the disease, but have not been able to show the kind of reversal as was prominent from Dr. Caldwell's interventional study. (27)
Nonetheless, one of those interventions lead by Dr. Dean Ornish, developed into a program that caught the increasingly growing attention of insurance companies. More and more insurance companies now offer reimbursements for patients who choose to participate in this program. It is even covered by the Federal Health Insurance program in the United States. (28)
What kind of interventions are we talking about here?
And perhaps more interesting:
What kind of intervention may put you in a position to not only stop the progression of this debilitating disease, but may actually offer you A WAY OUT and reverse it.
The dietary strategies proven most successful in reversing heart disease are discussed in the article: "How to Reverse Heart Disease with Diet."