H, he is reporting on hemorrhagic strokes which are only 13 per cent of strokes. What about ischemic strokes? Since a great majority of strokes are ischemic and a great majority of people are NOT vegetarian then could you say that there is a higher stroke risk for non vegetarians? Why does he say that normal cholesterol levels are between 200 and 300?
Well, this is the first time I heard that 200 to 300 is average among HEALTHY people. Of what age? Are there more heart attacks and strokes among people with cholesterol under 150? Dr. Castelli of the Framingham study said in an interview I heard that of the thousands of patients he studied, only about half a dozen had heart attacks who had cholesterol under 150. Of course, my thought when I heard that is--how many of those in the study actually had numbers under 150? I imagine it is rare in our culture.
Although the number of Esselstyn's patients is small, his vegan no fat diet seems to have done the trick in improving their health. But as you know I have a vested interest in finding the right diet and wonder if you can point me to a peer reviewed study using a very high fat low plant food diet which used angiograms that showed halting and reversal of coronary artery disease? I know of course that in most cases (as in mine) the thrombus which causes a blockage and heart attack is not from older plaques so one wonders if it is the shrinking of older plaques that makes these patients incident free for 12 to 20 years. Or something else?
Re: Dr. Castelli of the Framingham study said in an interview I heard that of the thousands of patients he studied, only about half a dozen had heart attacks who had cholesterol under 150.
This is probably another spurious (coincidental) correlation. What age were those people? Cholesterol rises with age, thus young men would have generally lower cholesterol and at the same time negligible risk of heart attacks.
Re: Although the number of Esselstyn's patients is small, his vegan no fat diet seems to have done the trick in improving their health.
Yes, I have no reason to doubt his report. However, my interpretation of this fact is different from yours. I think the improvement with Esselstyn's diet was not due to low fat vegan but due to a reduced total intake of carbohydrate and prevented patients from consuming carbohydrates with fat. Both of those factors helped reducing insulin levels!
Esselstyn did prevent eating carbs with fat but I do not think his diet was low carb. As a matter of fact it seemed to be very high carb with recipes using pasta, rice, potatoes, whole wheat buns, couscous etc. I do not remember any restriction on starchy carbs.
Yes it was restricted in refined carbs. Buns, bread? I don't think so as far as I know Dr.E. approach. You may noticed, that there are people who don't loose weight and don't reduce the risk. If you read the published stats by or doctors (E and O) you will noticed that for almost half of the patients, it did NOT lead to an improvement. Why? Let me offer my guess - those patients were probably eating the most starch and the highest absolute amount of calories out of carbs! A diet of 80% carbs and total 1500kCal has a much lower glycemic load (GL=325g) and insulin impact than a diet with 60% carbs and 3000kCal total (GL=450g).
Diet based on green vegetables = less carbs = lower absolute glycemic load = lower insulin = arteriosclerosis reverses.
Diet based on cereals, bread and potatoes = high glycemic load = more insulin = faster disease progression.
Its possible but......how do you explain the fact that Dolores added a good bit of fat to her diet and kept her blood sugar low and still had a heart attack?(I don't think she ever had an insulin test but there is no reason to assume it would be elevated)
I have not heard of a successful culture that bases their diet on wheat.... but potatoes.....thats another story.
We can only guess, but IMHO, the most probable was that she was hyperinsulinemic (abeit with normal glucose) all those years. High insulin level promotes formation of arterial plaque, see for example this .
It may even be said that hyperinsulinemic people should probably not eat a high carbohydrate diet, even with potatoes etc, under any form because it maintains their metabolic syndrome or slows down their recovery. At the same time such diet may well be completely harmless and even healthy for the non-diabetic people!
Adding fat to a high carb diet in such circumstances (i.e. hyperinsulinemia) raises their insulin even worse.
This also explain why only some people (i.e. non-diabetic) may have improved on a high carb low fat vegan diet and why some people might worsen (i.e. those with metabolic syndrome, diabetes and hyperinsulinemia), as you found out in the published peer reviewed studies by Ornish and Esselstyn.
This probably explains that curious exclusion of the diabetic patients from that Esselstyn study that Dolores reported!
You will also notice on Esselstyn's website that although there were no cardiac events in compliant subjects, the reversal was selective in some arteries and what threw me for a loop was that in some arteries there was progression! This fact was not in his book. So if I were writing a book, I would not say that his diet (plus statins) makes you heart attack proof, but greatly decreases your chances of a cardiac event. Why the reversal in some arteries and the progression in others? (Did I report the exclusion of diabetic patients on this group?)
We need to consider the possibility that Dr Esselstyn is not above twisting facts and data manipulation/exclusion to promote his case.I'm not saying he is doing that but there are no sacred cows that we can let skate by without critical analysis and debate.
I know the Japanese have very high stroke rates because they have high blood pressure probably due to the enormous amount of salt they consume. This article points to lowering blood pressure rather than giving up a mostly plant based diet.
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