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Craig G. Hurwitz, M.D.

Coronary Artery Disease and Plant Based Nutrition



     Coronary artery disease (cardiovascular disease) is still the number one killer of adult women and men in the Western world. The main culprit is plaque that builds up in the lining of the coronary artery. Plaque is an inflammatory process composed of cheese-like material that includes cholesterol, other lipids, immune cells, and inflammatory cells. Although plaque itself can block an artery, most heart attacks result from the rupture of the cap of the plaque. The first study to show major risk factors in coronary artery disease (CAD) including cholesterol, hypertension and smoking was the Framingham Heart Study begun following WWII. At the same time there was an early interest in the role of nutrition in the prevention and treatment of CAD. However, as technology progressed, the major focus of research shifted to coronary artery bypass surgery, angioplasty, and stents. Pharmacological advances led to the improvement in management of hypertension and elevated cholesterol with new drugs such as the ace inhibitors and the statins. But we still have a major health issue despite the advances in treatment.

It is only in the last 30 yrs that a small, courageous group of researchers have returned to scientifically explore the relationship between nutrition and coronary artery disease. Their interest extends the investigation to plant based nutrition. Dr. Caldwell Esselstyn was fascinated by his studies of cultures and their nutrition around the world. He learned that there are many cultures that have no coronary artery disease and eat a plant based diet. He used the plant based diet to treat a group of patients at the Cleveland Clinics that were referred to him because of severe, progressive coronary artery disease. He chose a plant based regimen that he felt would fight plaque and the rupture of plaque and help maintain the health of the blood vessels. The results were dramatic.

Dr. Esselstyn is about to publish a larger study of 200 patients.3 In comparing his larger study to other major studies covering a 4 year period, there is a 40 fold difference in the rate of recurrent cardiac events (0.5 percent compared to an average of 20 percent). These astonishing results have led him to conclude that coronary artery disease is a “food borne illness” that can be prevented, arrested, or in some cases reversed.3 
During this same period Dr. Dean Ornish directed research studies showing that even patients with severe coronary heart disease can often reverse their disease by making comprehensive lifestyle changes, including a very low fat diet that focuses on fruits, vegetables, whole grains, legumes and soy products in their natural, unrefined forms. On his website he states “they often have a hard time believing that the simple choices that we make in our lives each day-what we eat, how we respond to stress, whether or not we smoke, how much we exercise and the quality of our relationships-can make such a powerful difference in our health, our well-being, and our survival, but they often do.”4

You will find Dr. Esselstyn’s and Dr. Ornish’s specific food recommendations in the appendix. They both avoid the consumption of meat that has been linked to cardiovascular disease.5, 6  You may be asking            


“Where do I get my protein if I limit or don’t eat meat?”
Most people would be shocked to learn that we make our own protein. Like the beads on a necklace, the building units of protein are the amino acids. The human body can make most of the twenty amino acids that it needs to build a protein. However, there are eight essential amino acids that it has to get from breaking down the protein in the foods we eat. We need a variety of foods to get all the essential amino acids.
There are hundreds of thousands of different kinds of proteins. Every part of our body and every cell have proteins as major building blocks. In addition, our hormones and enzymes and metabolic transport systems are all proteins. These proteins wear out on a regular basis and are constantly being replaced.


We can get the required amino acid building blocks from the protein in plants alone. Note that some of the strongest animals, such as elephants, gorillas, and bison are all plant eaters.  Dr. Esselstyn states that the “protein available through plant-based nutrition is adequate to nourish professional champion athletes such as the iron man, professional football, mixed martial arts, track and field, etc.”7 However, we must vary the plants we eat to ensure an adequate supply of the essential amino acids. The wisdom of the body can do this over the course of a day and does not require an adequate supply of the essential amino acids at every meal.



Plant Based Nutrition (PBN):

  1. Introduction

  2. Coronary Artery Disease and PBN

  3. Cancer and PBN

  4. References & Websites