Healthy Heart, Healthy Life

Editor's Note: With our Food Revolution Series, we've shown how eating less or no meat can significantly reduce our impact on the planet, reverse the spread of hunger, and enable us to live more compassionately with the creatures in our charge. Today we continue by looking at how eating less meat, or no meat, can have a substantial direct benefit to you as an individual.

by John Robbins, an author widely recognized as one of the world's leading experts on the intimate link between diet and environmental and personal health. Amongst others, John is the author of the revolutionary book 'Diet for a New America', a book nominated for a pulitzer prize, as well as the updated 'Food Revolution' and 'Healthy at 100'.

Has anyone in your life ever had a heart attack or suffered from serious heart disease? If you answered Yes to that question, you’re not alone. In fact, most people in our society would be with you.

I would. I’m thinking at the moment about my uncle. Burton Baskin was my father’s brother-in-law, and also his business partner. Together, they founded, owned, and ran the Baskin-Robbins Ice Cream Company. A talented man with a great sense of style, my Uncle Butch, as we called him, touched countless lives with his expansive spirit. His fatal heart attack struck while he was still in his early fifties, with a loving wife, two incredible kids, a wildly successful business, and everything in the world to look forward to.

Tact was never my strong suit, and maybe I should never have mentioned it, but a few years later I asked my father whether he thought there could be any connection between the amount of ice cream my uncle had eaten and his fatal heart attack. Given that my uncle had weighed something like 220 pounds and that he had certainly enjoyed the family product, the question seemed a reasonable one. But my father was not particularly interested in such reflections. “No,” he said. “His ticker just got tired and stopped working.”

I can now understand why my father would not have wanted to consider the question. He had by that time manufactured and sold more ice cream than any other human being who had ever lived on this planet, and he most definitely did not want to think that ice cream might be harming anyone, much less that it might have contributed to my uncle’s death. Besides, not nearly as much was known, then, about the effects of saturated fat and cholesterol on the human cardiovascular system.

To this day there are a number of people in my family who are angry at me for mentioning any of this in public. They tell me that when I bring this up I am dishonoring my uncle’s memory. But I disagree. Burton Baskin loved life, and I believe that he would want his story told, if in the telling it might help others to be more aware of the choices they are making, and more able to live in a way that brings greater health and happiness into their lives.

Similarly, it’s poignant that Ben & Jerry’s ice cream cofounder Ben Cohen needed to undergo quadruple bypass surgery in 2001, at age 49, due to serious coronary artery disease.

Am I saying that an ice cream cone is going to kill you? Of course not. What I am saying, though, is that ice cream is very high in saturated fat and sugar; and the more saturated fat and sugar you eat, the more likely you are to have a heart attack. This is not a value judgment, and it’s not just my opinion. It is a statistical reality, arrived at by the most comprehensive and conscientious body of medical research in world history. What we eat does matter.

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The irony is that my father, who like many men of his generation did not believe there was much connection between diet and health, ended up suffering from severely high blood pressure and diabetes, two conditions which also are directly linked with the kind of high-saturated fat, high-sugar diet he ate for most of his life. Thankfully, however, when he was in his late seventies, he changed his diet in the direction I’ve long been advocating, and he experienced major improvements in his overall health. I cannot tell you how grateful I was the day he told me, “Thank God some of us have lived long enough to learn a few new things.”

Many of us, though, will go on eating bacon and eggs for breakfast, and hamburgers and milkshakes for lunch, until the day we wind up in a hospital, hurting badly. We won’t change until we get hit over the head.

Some of us, it seems, only know how to learn from pain. I can remember more times than I like to admit when I resisted learning new things with stunning tenacity, and held on to my opinions and behavior patterns despite insurmountable evidence that I was harming myself by doing so. I have been able, under a wide variety of circumstances, to remain loyally committed, despite everything, to my familiar ways of behaving, even when they no longer served any conceivable good purpose. Having acquired a great deal of experience that way, however, I now want to understand the messages life sends me and embrace the changes that are called for, without necessarily having to go through ungodly amounts of pain first.

The philosopher Nietzsche said it well: “He who will, the fates lead; he who won’t, they drag.”

What keeps us stuck? What keeps us from recognizing the power that we have to make choices that honor our spirits and enrich our lives? What keeps us passive and distant from our greatness? What keeps us closed down when we could be vibrant and creative? The same thing that keeps the animal in his cage, even when the door is opened and he has the chance to walk free. Habit.

When it comes to food choices, habit is stupendously powerful. Our familiar foods give us comfort, reassurance, and a sense of identity. They are there for us when the world may not be. They can be our best friends, loyal and true. It does not take effort or creativity to do the same thing over and over again. There is ease and relaxation in doing what we have always done. And if our habits are continually reinforced by the society around us, they can become even more powerful and alluring.

On the other hand, it does take effort to question whether our conventional ways of thinking and acting truly serve us. It takes effort to ask whether our lives are in alignment with the prayers and deeper purposes of our hearts. It takes effort to consciously make choices that deviate from the cultural norms, yet bring us closer to our wholeness and true health.

We all know people who eat with great care and still get sick, and we all know others who eat any old thing and seem to thrive. But does this change the fact that we have far better odds for healthy lives and vibrant bodies that express our living spirit when we eat more consciously and make healthier choices?

If I told you that you could join either group A, in which one out of every two men and one out of every three women would die of heart disease, or group B, in which heart disease deaths would be practically unknown and people would be healthier in every other way as well, which group would you join? Group B, of course. You’d be nuts to choose otherwise. And yet, tragically, the vast majority of people in our society are in fact members in good standing of group A. Eating the standard American diet that’s based on meat and dairy products, with plenty of white flour and white sugar, one-third of the women and one-half of the men in the U.S. population die of heart disease. Meanwhile, medical research is telling us that vegetarians and vegans (vegetarians who consume no dairy products or eggs) not only have far less heart disease, but also have lower rates of cancer, hypertension, diabetes, gallstones, kidney disease, obesity, and colon disease.(1) They live on average six to ten years longer than the rest of the population, and in fact seem to be healthier by every measurement we have of assessing health outcomes.

I know what some of you are thinking. Maybe vegetarians don’t actually live longer; maybe their lives are so boring it only seems that way. You’re thinking, Being a vegetarian is like being celibate; it might work for some people, but not for me. But I want to ask you a question: How much pleasure is there in illness? Who do you think enjoys life more, the person who is flourishing in vibrant health, eating a deliciously prepared yet simple meal of wholesome foods, or the person who is burdened by weight problems and high blood pressure, gorging on steak and ice cream?

I’ll tell you this: If you want to know what health is worth, ask the person who has lost it.

Scientific Data or Industry Propaganda?

The meat and dairy industries, naturally, disagree with everything I’m saying. They tell us repeatedly that their products are the cornerstones of a balanced and complete diet. They say we need the foods they produce to have adequate protein, calcium, iron, B-12, riboflavin, and zinc. They say that without the consumption of animal products, human health would decline dramatically.

What I think any sane person would want to know is this: Opinions aside, what does the hard data indicate? Does it support the contention of vegetarians and vegans that they have lower rates and less risk of heart disease, and indeed for almost all of the “diseases of affluence” that plague our culture? Is there sound science behind the claims that vegetarians are leaner and more fit people who outlive the rest of the population by six to 10 years? Or is this simply the fuzzy rhetoric of radical extremists?

The National Cattlemen’s Beef Association and the National Dairy Council tell us again and again that we jeopardize our health and well-being if we do not consume the products they provide. Impartial researchers and nonprofit public health organizations such as the World Health Organization, the American Institute for Cancer Research, the American Heart Association, the Physicians Committee for Responsible Medicine, the National Cancer Institute, and the Center for Science in the Public Interest, however, have a different perspective.

It can get contentious. . . .

Is That So?

“[It’s a] myth [that] people who eat vegetarian diets are healthier than people who eat meat.” — National Cattlemen’s Beef Association (2)

”Studies indicate that vegetarians often have lower morbidity and mortality rates. . . . Not only is mortality from coronary artery disease lower in vegetarians than in nonvegetarians, but vegetarian diets have also been successful in arresting coronary artery disease. Scientific data suggest positive relationships between a vegetarian diet and reduced risk for . . . obesity, coronary artery disease, hypertension, diabetes mellitus, and some types of cancer.” — American Dietetic Association Position Paper on Vegetarian Diets (3)

When we see industry statements juxtaposed nakedly against those from more objective sources, it is possible to see the contrast, get a sense of the differences, and appraise which is more likely to be true. But in everyday life, we are hardly ever given the opportunity to compare the messages we receive from industries promoting the sale of their food products with messages from more reliable sources.

The statements of the meat and dairy industries are important to evaluate because, even though they are no more true than any other form of advertising, they are broadcast so pervasively in our culture that they very likely have insinuated themselves into your mind. The meat and dairy industries in the United States spend literally billions of dollars annually, not only on advertising, but on thousands of other ways by which they influence what you think and how you spend your money. They provide free educational materials to schools. They issue a constant stream of public service announcements to radio and TV stations. They continually flood newspapers and magazines with press releases. They promote their products heavily to doctors, nurses, and dieticians. And they typically proceed with a veneer that implies they’re doing all this for your own good.

The amount of money spent on food in our culture is phenomenal, and these dollars are, of course, highly coveted. There are whole industries with massive budgets whose entire goal is to sell their products. From their point of view, if their products are healthy, great, and if not, they’ll find another marketing angle. They typically spend the most money promoting the very foods that are most harmful. They’ll want you to be more concerned with what’s cool or what other people are doing than what’s healthy. And they’ll tell you that their foods are healthy even when they’re not.

This is not just misinformation. It is really affecting people’s lives, and probably yours. There are industries profiting from keeping you ignorant, confused, and misinformed, buying and consuming products that lead to unnecessary suffering and death for you and your loved ones.

Today, heart disease is the number one killer of Americans.(4) More people die from heart and blood vessel diseases each year in the United States than from all other causes of death combined.

What is the single greatest risk factor for heart disease? A high blood cholesterol level.(5) And what is the single most important factor in raising blood cholesterol levels? The consumption of saturated fat. The correlations between cholesterol levels, saturated fat intake, and heart disease are among the strongest and most consistent in the history of world medical research. This is why every authoritative health body in the world, from the American Heart Association to the World Health Organization to the National Heart, Lung and Blood Institute, is calling for reductions in saturated fat consumption.

It is also, however, why the meat and dairy industries sometimes have not been happy with what has been learned. . . .

Is That So?

“Who says meat is high in saturated fat? This politically correct nutrition campaign is just another example of the diet dictocrats trying to run our lives.” — Sam Abramson, CEO, Springfield Meats (6)

“Meat contributes an extraordinarily significant percentage of the saturated fat in the American diet.” — Marion Nestle, Chair of the Nutrition Department, New York University (7)

Take hamburgers, for example. . . .

What We Know

  • Percentage of adult daily value for saturated fat in one Double Whopper with cheese: 130 percent
  • Percentage of eight-year-old child’s daily value for saturated fat in one Double Whopper with cheese: More than 200 percent
Scientists at the Center for Science in the Public Interest have studied the American diet for years, and have sought to give people sound information on which they can base healthy food choices. Recognizing the saturated fat in hamburgers, they have been outspoken about the health consequences of such food. “If you had to pick a single food that inflicts the most damage in the American diet,” they said in their newsletter in 1999, “ground beef would be a prime contender. Whether it’s tacos, meatloaf, lasagna, or the ubiquitous hamburger, Americans stuff themselves with ground beef without a second thought about its consequences. ‘Billions and billions served’ means ‘billions and billions spent’— on doctor’s visits and hospital bills.” (8)

How has the U.S. meat industry responded? Some of its representatives have called the Center for Science in the Public Interest “food fascists,” “culinary dictators,” and similar names.(9) This gives me pause. Name-calling has never impressed me as a valid form of argument. I suppose it shows the frustration of an industry with increasingly reduced scientific grounds on which to defend its products. Still, I would think these people could grasp that there is an enormous difference between dictating your food choices, which is a form of coercion, and providing education as to what science has learned about diet and health, so you can make informed choices about matters that affect your health.

Others, a little more thoughtfully, have pointed out that there are some kinds of saturated fat that don’t raise cholesterol levels. Red meat, for example, contains a type of saturated fat—stearic acid—that has little effect on cholesterol levels. But these comparatively rare types of saturated fat are almost always accompanied by the kinds of saturated fat that do raise cholesterol levels. Red meat is very high in another kind of saturated fat—palmitic acid—that is notorious for raising cholesterol levels.

With what we’ve learned about diet and heart disease, it is not easy to defend animal fat consumption today. Even the American Meat Institute and National Dairy Council acknowledge that the primary suppliers of saturated fat in the American diet are animal products—beef, cheese, butter, chicken, milk, pork, eggs, and ice cream. They like to point out, however, that their products are not the only culprits. There are a few other foods that are also high in saturated fat, such as palm and palm kernel oil, hydrogenated oils, margarine, and chocolate.

They are correct. But the producers of chocolate aren’t trying to convince you and me and the rest of the public that the foods they sell should be the mainstays of our diets. You won’t see famous actors and celebrities in expensive ad campaigns telling you that palm kernel oil is “real food for real people.” James Garner, speaking for the American beef industry, said that about beef. That was just before the actor, who was so fond of beef, was hospitalized for a quintuple bypass heart operation.

What We Know

  • Drop in heart disease risk for every 1 percent decrease in blood cholesterol: 3–4 percent (10)
  • Blood cholesterol levels of vegetarians compared to non-vegetarians: 14 percent lower (11)
  • Risk of death from heart disease for vegetarians compared to non- vegetarians: Half (12)
  • Blood cholesterol levels of vegans (vegetarians who eat no meat, eggs, or dairy products) compared to non-vegetarians: 35 percent lower (13)
Most of us grew up believing that animal protein is superior to plant protein, and that if we don’t eat animal protein we are risking our health. This is ironic given that animal proteins, in particular, have been found to raise cholesterol levels.14 Soy proteins, on the other hand, have consistently been found to lower cholesterol levels. (15)

Meanwhile, the meat, dairy, and egg industries in the United States continue to tell you that you should eat their products. And medical researchers continue to say something else.

Is That So?

“[It’s a] myth [that] the risk of death from heart disease can be greatly reduced if a person avoids eating a meat-centered diet.” — National Cattlemen’s Beef Association (16)

“Vegetarians have the best diet; they have the lowest rates of coronary heart disease of any group in the country.” — William Castelli, M.D., Director, Framingham Health Study, the longest-running study of diet and heart disease in world medical history (17)

It reminds me of the three stages any new truth always goes through. First, it is ignored. Second, it is violently opposed. And third, it is accepted as self-evident.

When it comes to the benefits of a plant-based diet for heart disease, we seem today to be in the middle of the violent opposition stage.

Is That So?

“The fallacy . . . is that animal foods are the critical elements in the diet that are causing coronary heart disease.” — National Cattlemen’s Association (18)

“In regions where . . . meat is scarce, cardiovascular disease is unknown.” — Time magazine (19)

“[Advocates of plant-based diets] lack a firm scientific basis. . . . No study . . . has demonstrated that changing diet prevents coronary artery disease.” — Dairy Bureau of Canada (20)

“A large and convincing body of evidence from studies in humans . . . shows that diets low in saturated fatty acids and cholesterol are associated with low risks and rates of atherosclerotic cardiovascular disease.” — U.S. National Research Council, in “Diet and Health, Implications for Reducing Chronic Disease Risk”

The meat, dairy, and egg industries are having a hard time. They can’t dispute that the primary dietary sources of cholesterol are eggs, shellfish, chicken, beef, fish, pork, cheese, butter, and milk. Nor can they dispute the fact that no plant food contains any cholesterol. Sometimes the chicken industry will imply that chicken is lower in cholesterol than beef. But that simply isn’t true. Chicken has about as much cholesterol as beef. There is simply no escaping the correlation between meat consumption and cholesterol levels.

What We Know

  • Intake of cholesterol for non-vegetarians: 300–500 milligrams/day (21)
  • Intake of cholesterol for lacto-ovo vegetarians: 150–300 milligrams/day (22)
  • Intake of cholesterol for vegans: Zero (23)
  • Average cholesterol level in the United States: 210 (24)
  • Average cholesterol level of U.S. vegetarians: 161 (25)
  • Average cholesterol level of U.S. vegans: 133 (26)
Blood cholesterol levels are of course not the only dietary factor affecting the risk of heart disease, but the advantages of having a lower level are enormous. William Castelli, M.D., Director of the Framingham Health Study, says that when people keep their cholesterol levels below 150, they are virtually assured of never suffering a heart attack. “We’ve never had a heart attack in Framingham in 35 years in anyone who had a cholesterol under 150.” (27)

It can be stunning how quickly people with heart disease improve when they adopt a low-fat vegan diet. Patients enrolled in the McDougall Program at St. Helena Hospital in Santa Rosa, California, consistently show dramatic improvement after only two weeks on a very low-fat vegan diet.

Faced with evidence like this, the meat, dairy, and egg industries persist nonetheless in trying to defend their products. Sometimes they attempt to shift responsibility onto your genes. It’s not what you eat that matters most, they say, it’s your DNA, so you may as well go ahead and have a steak. . .

Is That So?

“Your genetics are a prime determinant of whether you will get atherosclerosis and heart disease. If your parents and grandparents had it, then you are a candidate; if they didn’t have it, your risk is much lower.” — The Beef-Eaters Guide to Modern Meat (28)

“It’s true that a small percentage of patients have a hereditary form of arteriosclerosis in the sense that in their immediate family and their parents’ and grandparents’ families, there is a high incidence of atherosclerosis and coronary heart disease. . . . But that only constitutes about five percent of the cases. Most people (who develop heart disease) don’t really have a hereditary disease.” — Michael Debakey, M.D., Director, Cardiovascular Research Center, pioneer in heart transplants, bypasses, and the artificial heart (29)

The meat, dairy and egg industries have had a difficult time in recent years, as study after study has confirmed the link between their products and heart disease. In the effort to exonerate their products, they have often tried to make much of what is, in fact, very little.

In 1999, a study appeared in the Archives of Internal Medicine that has since been widely touted by the U.S. meat industry. This study, they say, “proves” that red meat should be part of a healthy diet. The reason for the industry’s enthusiasm is that participants in the study who ate lean red meat lowered their cholesterol levels by 1 percent. (30)

People who eat low-fat, near-vegan, plant-based diets, on the other hand, regularly lower their cholesterol levels by 10 to 35 percent. (31)

Another important risk factor in determining your risk of heart disease is the ratio of your total cholesterol to your HDL (high-density lipoprotein) level. The higher the ratio, the greater your danger of heart disease. The ideal ratio of total cholesterol to HDL is 3.0 to 1 or lower. (32)

The average American male’s ratio is 5.1 to 1.33 The average vegetarian’s ratio, on the other hand, is 2.9 to 1.34

When it comes to heart disease, the evidence against animal products has today become so convincing and so thorough that even many in the livestock industry can see the handwriting on the wall. Dr. Peter R. Cheeke is a professor of animal science at Oregon State University and serves on the editorial boards of the Journal of Animal Science and Animal Feed Science and Technology. In his widely used animal science textbook, he says,

“Many studies, involving hundreds of thousands of people, have shown . . . a positive relationship between coronary heart disease and serum (blood) cholesterol. The higher the serum cholesterol, the higher the risk for coronary heart disease. Populations in which the average serum cholesterol level is (low) . . . are those on the lower end of the per capita meat consumption scale, while those (with high cholesterol levels) are populations with high intakes of animal products. . . . It’s more useful to the livestock industries and animal scientists to come to grips with the demonstrated relationships among saturated fat and cholesterol intakes and coronary heart disease, than to claim that there is no relationship or that there’s some sort of conspiracy against animal products by the medical community.” (35)
Treating Heart Disease

For many heart attack victims, the first sign that anything is wrong is a searing pain, followed by a fatal heart attack. The more fortunate victims of heart disease have advance notice. They develop chest pain, called angina, and/or other symptoms that tell them something is seriously wrong. They are alerted by these signals to the reality that their arteries have become dangerously clogged, and that the flow of oxygen and nutrition carried by the blood throughout their cardiovascular system has become seriously impeded.

This year, more than 1 million Americans will undergo coronary bypass surgery or angioplasty to relieve pain by enlarging the opening in clogged arteries. The national cost for these two operations will be $15.6 billion.36 This, of course, is only the dollar cost, which takes no account of the agony and anxiety that will be experienced by these patients and their families. Nor does it say anything of the unwanted side effects and trauma they will endure.

What We Know

  • Risk of dying during bypass surgery: 4.6–11.9 percent (37)
  • Risk of permanent brain damage from bypass surgery: 15–44 percent (38)
  • Recipients of bypass surgery for whom it prolongs life: 2 percent (39)
  • Risk of death during angioplasty: 0.4–2.8 percent (40)
  • Risk of major complications developing during angioplasty: 10 percent (41)
  • Studies that have found that angioplasty prolongs life or prevents heart attacks: Zero (42)
Patients undergo bypass and angioplasty operations primarily to relieve angina and improve blood flow to the heart. Yet there is a 25 to 50 percent likelihood that within six months their blood vessels will again become blocked, and their chest pain will recur—assuming they continue to eat a meat-based diet. (43)

On the other hand, three-quarters of the patients who follow the renowned program for reversing heart disease developed by Dean Ornish, M.D., clinical professor of medicine and attending physician at the School of Medicine, University of California, San Francisco, experience marked and long-lasting reduction in angina—without surgery. (44)

The Ornish program is made up of five basic components:

  1. A very low-fat, whole foods, vegetarian (near-vegan) diet
  2. Half an hour a day of walking or other exercise
  3. Half an hour a day of stretching, meditation, relaxation, stress reduction, etc.
  4. Psychological and emotional support groups
  5. No smoking
Of course, there are people with heart disease who won’t follow these kinds of guidelines. They want it to be easier. They don’t want to change their lifestyles that much. Accordingly, the American Heart Association has come up with a program that includes some low-fat animal products and utilizes high doses of cholesterol-lowering drugs. I find it fascinating to compare the results patients obtain from these two programs.
  • How many patients on the American Heart Association program achieve discernible reversal of atherosclerosis? One out of every six. (45)
  • How many patients on Dr. Dean Ornish’s program achieve discernible reversal of atherosclerosis? Three out of every four. (46)
  • What kind of change do patients on average see in arterial blockage in five years on the American Heart Association program? A 28 percent increase. (47)
  • What kind of change do patients on average see in arterial blockage in five years on the Ornish program? An 8 percent reduction. (48)
There is a reason why more than forty insurance companies now cover all or part of the Ornish program. Nearly 80 percent of patients with severely clogged arteries who follow the Ornish program for a year or more are able to avoid bypass or angioplasty. (49)

Despite (or maybe because of) such outstanding results, the Ornish program has been the subject of massive controversy. Some say his approach is too drastic, and we should stick to more medically conservative methods. Ornish’s reply is simple and difficult to argue with: “I don’t understand why asking people to eat a well-balanced vegetarian diet is considered drastic, while it’s medically conservative to cut people open or put them on powerful cholesterol-lowering drugs for the rest of their lives.”

Some people in the meat and dairy industries, as you might imagine, have not been overly fond of Dr. Dean Ornish’s approach. They might have cringed when Newsweek, heralding his breakthrough approach, put his photo on the cover of an issue. They were not pleased when there were rumors he might be appointed Surgeon General. They have criticized his program from any angle they could find. Among other things, they have said that diet and lifestyle changes might be okay for younger people who aren’t all that sick, but they won’t work for older people and those who have severe heart disease. The reality, however, is that people who follow the Ornish program consistently show dramatic improvements, regardless of how old or ill they are. (50)

Critics of Ornish’s program have countered that it is not clear whether the improvements patients experience are due to the diet or to the other health-supporting components in the program. This is true. Ornish’s approach is essentially holistic, which means that all of the various pieces of the program work together to produce the intended effect. He has never had an intention to isolate the various components.

Interestingly, however, Cleveland Clinic general surgeon and researcher Caldwell B. Esselstyn, M.D., has demonstrated comparable results using a low-fat near-vegan diet, without employing the other factors in the Ornish program. Reporting in the American Journal of Cardiology, Esselstyn wrote, “In this study, patients become virtually heart-attack proof. We achieved these excellent results without structured exercise, meditation, stress management, and other added lifestyle changes.” (51)

Not ones to give up easily, meat and dairy industry advocates tried to refute Esselstyn’s work by saying that it’s not clear whether these kinds of results will continue over the long term, and besides, maybe his patients weren’t that sick to begin with.

Hardly. All of the patients in Esselstyn’s study had severe heart disease at the outset, yet after twelve years on his program, 95 percent of them were alive and well. How sick were they to begin with? The patients in Esselstyn’s study had experienced 48 serious cardiac events in the eight years before they joined the study. But in the 12 years after they joined the study, those patients who were compliant with the program experienced a grand total of zero cardiac events. (52)

Yes, said those holding court for the meat industry, but the diet is too restrictive for most people to comply with for any length of time. You just can’t ask people to be that restrictive in their diets and expect very many of them to comply.

This sounds reasonable. But what percentage of the patients in Esselstyn’s 12-year study do you think were compliant? Ninety-five. (53)

Does his program ask too much of people? Is an exclusively plant-based diet too radical? Esselstyn doesn’t think so. “Some criticize this exclusively plant-based diet as extreme or draconian,” he writes. “Webster’s dictionary defines draconian as ‘inhumanly cruel.’ A closer look reveals that ‘extreme’ or ‘inhumanly cruel’ describes not plant-based nutrition, but the consequences of our present Western diet. Having a sternum divided for bypass surgery or a stroke that renders one an aphasic invalid can be construed as extreme; and having a breast, prostate, colon, or rectum removed to treat cancer may seem inhumanly cruel. These diseases are rarely seen in populations consuming a plant-based diet.” (54)

From every direction, the evidence keeps piling up. Twenty-five years ago, the region of the world with the worst heart disease problem was North Karelia, in Eastern Finland. Today, the region of the world with the fastest dropping rates of heart disease is the very same North Karelia. What happened? The area adopted a “get fit” program, based on reducing cholesterol and smoking through government-sponsored media campaigns, labeling meats and other foods as to their saturated fat and cholesterol levels, and converting farms that had been producing animal products to growing vitamin-rich fruits and vegetables. How much difference did it make? In the past twenty-five years, heart disease deaths in North Karelia have been reduced by an astonishing 65 percent. (55)

How to Lower Blood Pressure

In Western societies, many of us would like to eat our bacon and eggs for breakfast, and then, if need be, take a cholesterol-lowering pill to lessen our risk of heart disease. We don’t want to change our lifestyles. We don’t want to question what we eat.

Even the most conscious of us may not realize what we are doing to ourselves, and may not see when we are harming ourselves.

I’m thinking, at the moment, of one of the great spiritual mentors of our time, Be Here Now author Ram Dass. After he read Diet for a New America, Ram Dass told me, “You’ve really made it hard for me to eat chicken now. I’ve always liked chicken. But you’ve left me no excuse. You’ve made it clear what I need to do.” He wrote an endorsement, stating, “John Robbins’ extraordinary book points out in an uncompromising fashion that our cultural dietary habits are killing us in spirit and body, and leaves little doubt as to the inevitable course of our actions.” Ram Dass was kind enough to serve for nearly ten years on the board of advisors for EarthSave, the nonprofit organization I founded to channel the public response to Diet for a New America into sustained, positive, and effective action.

But like many of us, Ram Dass has had food habits that might not be in keeping with his own best interest. He returned, in time, to eating chicken and ice cream and other such foods—and probably too much of them for his own good. He continued, even though his blood pressure was too high and his weight a challenge.

It does not dishonor this man, who has given so much of such value to so many, to acknowledge that he is human, and that he too has had struggles learning to care for himself and eat in accord with his optimal health and well-being. One of the things that has endeared Ram Dass to millions and made his message so meaningful over the years has been that he doesn’t pretend to be perfect or act as if he has it all together. I’ve always appreciated this about him, because it’s helped me, too, to be more fully human, and more fully honest with my own struggles.

Eventually, and tragically, he suffered a stroke. I love Ram Dass dearly, and am sad that he has had to suffer as a result of his stroke. I have only admiration for the courage with which he has sought to find meaning in his pain and to transform his suffering into growth. He is one of the people referred to in the saying, “Things tend to turn out the best for those people who make the best of things, however they turn out.”

After his stroke, Ram Dass finished writing his book Still Here, a moving guide to the final phases of life. In it, he talks about his stroke, which left him in a wheelchair and with limited speech. “One of the reasons for the stroke was that I had been ignoring my body. I had spent most of my life keeping my Awareness ‘free of my body,’ as I thought of it then; but I can see now that I was also ignoring my body, pushing it away. By forgetting to take my blood pressure medicine, I showed how I was disregarding my body.” (56)

We may never know why Ram Dass’ blood pressure was too high, nor what role his diet might have played in the stroke. We cannot know whether or not this dear man’s stroke would have happened if he had eaten more healthfully. But people with high blood pressure are seven times more likely to suffer a stroke, four times more likely to have a heart attack, and five times more likely to die of congestive heart failure than people with normal blood pressure.

It is certainly sad that so many people suffer from the consequences of high blood pressure without knowing how much of this is preventable through different food choices. Today, a greater portion of people are taking medication for high blood pressure than have ever taken medicine for any illness ever encountered in human history.

What We Know

  • Most common problem for which people go to doctors in the United States: High blood pressure
  • Ideal blood pressure: 110/70 or less (without medication) (57)
  • Average blood pressure of vegetarians: 112/69 (58)
  • Average blood pressure of non-vegetarians: 121/77 (59)
Definition of high blood pressure: The top number (systolic) is consistently over 140, or the bottom number (diastolic) is consistently over 90, while the person is at rest.
  • Incidence of high blood pressure in meat eaters compared to vegetarians: Nearly triple (60)
  • Incidence of very high blood pressure in meat eaters compared to vegetarians: 13 times higher (61)
  • Patients with high blood pressure who achieve substantial improvement by switching to a vegetarian diet: 30–75 percent (62)
  • What patients are typically told when prescribed medications for high blood pressure: “You’ll probably need to take these for the rest of your life.”
  • Patients with high blood pressure who are able to completely discontinue use of medications after adopting a low-sodium, low-fat, high-fiber vegetarian diet: 58 percent (63)
  • Incidence of high blood pressure among senior citizens in United States: More than 50 percent (64)
  • Incidence of high blood pressure among senior citizens in countries eating traditional low-fat plant based diets: Virtually none (65)
Breaking Free

We know today that the same diets that help to prevent most heart attacks also help to prevent most cases of high blood pressure. And we know that these same diets also do wonders for those who, unfortunately, have already developed these problems. This is marvelous news, for it places in our hands the means to prevent massive amounts of unnecessary suffering.

Not everyone, however, is pleased that this knowledge has been attained. There are those who, perhaps a little biased by their own self-interest, say and do some remarkable things. . . .

Is That So?

“We must be eternally vigilant to guard against those who would undermine confidence in the health benefits of eating meat. If meat-eaters have higher blood pressure, it’s from the stress of having to defend the perfectly reasonable desire to chow down on a thick sirloin against the misguided and intrusive efforts of the food police.” — Sam Abramson, CEO, Springfield Meats (66)

“Blood pressure fell within hours of starting the (very low-fat vegan diet) McDougall Program. Twenty percent of the people were on blood pressure medications the day they began the program. In almost every case the medications were stopped that day. Yet the blood pressure dropped (significantly) by the second day. This data is from over 1,000 participants at the McDougall Program at St. Helena Hospital in the Napa Valley of California.” — John McDougall, M.D.

The irony is that many of us still think we must eat animal products in order to have balanced diets and be healthy. We still think heart attacks and high blood pressure are regrettable but more or less inevitable byproducts that come with living well and growing old. We think that the best we can do for heart attacks is to take cholesterol-lowering drugs, and that the best we can do for high blood pressure is take medication to bring it under control. These illnesses have become so much a part of the American scene as to virtually be institutions. We don’t realize to what extent our destinies lie in our own hands, and on our own plates. We don’t realize how powerfully and inexorably our food choices lead us toward or away from these afflictions.

Many of us feel confused. There is so much information about diet and health all around us. How do we sort it out? Our task is not made easier when those who sell the foods that contribute to heart disease, high blood pressure, and many other diseases are doing everything they can, and spending billions of dollars in the effort, to influence how we think and what we eat.

Confused and disempowered, we too often end up not making the food choices that could dramatically improve the health of our cardiovascular systems, greatly reduce our risk of heart disease and high blood pressure, and vastly improve the quality of our lives. We complain, we feel bad, we get sick, but we don’t do the one thing that could in fact go far to restore our inner vitality and the unimpeded circulation of our bloodstreams.

It’s a shame that we allow people and industries to keep us bewildered and alienated from our personal power. It’s a shame that we allow them to keep us ignorant of the enormous health advantages that would be ours with a shift toward a more healthy plant-based diet.

Fortunately, more and more of us are every day realizing we can choose a way of life, and a way of eating, that free us to our highest health potential and lead us to a far more fulfilling experience of our bodies and our lives. We can experience the joy of healthy cardiovascular systems and healthy hearts, and naturally healthy blood pressure levels. We don’t need any longer to clog our arteries with saturated fat and cholesterol, but can feed our bodies with wholesome natural food so we can truly live to the heights of our potential. We can break out of the habits that tell us to conform and stay put, and say No to the lies of industries that profit from our pain.

We can do what gives us power, energy, and aliveness. We can say Yes to our vitality and passion. Leaving behind the standard American meat-based diet in favor of a healthy plant-based diet can be like breaking free from chains, to become, perhaps for the first time, truly free.

Dick Gregory, the human rights activist and devoted vegetarian, has said that when you eat consciously and cleanse your body of toxins and fears, something truly wonderful happens. “You are really at home with Mother Nature and happily at peace with life in Mother Nature’s World. You can shout the words of the familiar freedom phrase and they will have a meaning only you will truly realize: ‘Free at last!’” (67)

Editor's Note: Stay tuned for Part II - Preventing Cancer


1. Messina, Virginia, and Messina, Mark, The Dietitian’s Guide to Vegetarian Diets: Issues and Applications (Gaithersburg, MD: Aspen Publishers, 1996), p. 58. 2. “Myths and Facts about Beef Production,” National Cattlemen’s Beef Association, displayed on the Web site of the National Cattlemen’s Beef Association in 2001. 3. “Position of American Dietetic Association on Vegetarian Diets,” Journal of the American Dietetic Association 97 (1997):1317–21. 4. American Heart Association, Heart Attack and Angina Statistics, 1999. 5. Roberts, William, “Atherosclerotic Risk Factors: Are There Ten or Is There Only One?”, American Journal of Cardiology 64 (1989):552. 6. Personal communication with author. 7. Liebman, B., “Where’s the Ground Beef Labeling?”, Nutrition Action, June 1997. 8. “Here’s the Beef,” Nutrition Action, September 1999. 9. Murphy, Dan, “Food Fascists on the Attack Again,” October 27, 2000; 10. Law, M. R., Wald, N. J., Wu, T., et al., “Systematic Underestimation of Asso-ciation between Serum Cholesterol Concentration and Ischaemic Heart Disease . . . ,” British Medical Journal 308 (1994):363–6. 11. Resnicow, K., Barone, J., Engle, A., et al., “Diet and Serum Lipids in Vegan Vegetarians: A Model for Risk Reduction,” Journal of the American Dietetic Association 91 (1991):447–53. See also West, R. O., et al., “Diet and Serum Cholesterol Levels: A Comparison between Vegetarians and Nonvege- tarians . . . ,” American Journal of Clinical Nutrition 21 (1968):853–62; Sacks, F. M., Ornish, D., et al., “Plasma Lipoprotein Levels in Vegetarians: The Effect of Ingestion of Fats from Dairy Products,” Journal of the American Medical Association 254 (1985):1337–41; Messina and Messina, The Dietitian’s Guide to Vegetarian Diets. 12. Phillips, R., et al., “Coronary Heart Disease Mortality among Seventh-Day Adventists with Differing Dietary Habits,” American Journal of Clinical Nutrition 31 (1978):S191–8; Burr, M., et al., “Vegetarianism, Dietary Fiber, and Mortality,” American Journal of Clinical Nutrition 36 (1982):873–7; Burr, M., et al., “Heart Disease in British Vegetarians,” American Journal of Clinical Nutrition 48 (1988):830–2; Thorogood, M., et al., “Risk of Death from Cancer and Ischaemic Heart Disease in Meat and Non-meat Eaters,” British Medical Journal 308 (1994):1666–71; Berkel, J., et al., “Mortality Pattern and Life Expectancy of Seventh-Day Adventists in the Netherlands,” International Journal of Epidemiology 12 (1983):455–9; Chang-Claude, J., et al., “Mortality Pattern of German Vegetarians after 11 Years of Followup,” Epidemiology 3 (1992):395–401. 13. Resnicow, et al., “Diet and Serum Lipids in Vegan Vegetarians.” See also Messina and Messina, The Dietitian’s Guide to Vegetarian Diets. 14. Anderson, J. W., et al., “Meta-Analysis of the Effects of Soy Protein Intake on Serum Lipids,” New England Journal of Medicine 333 (1995):276–82. See also Carroll, K. K., “Dietary Protein in Relation to Plasma Cholesterol Levels and Atherosclerosis,” Nutrition Review 36 (1978):1–5. 15. Ibid. 16. “Myths and Facts about Beef Production.” 17. Barnard, Neal, The Power of Your Plate (Summertown, TN: Book Publishing Company, 1990), pp. 25–6. 18. National Cattlemen’s Association, “Fact Sheet” Retort to the PBS Documentary, Diet for a New America, 1991. 19. Walles, C., “Hold the Eggs and Butter: Cholesterol Is Proved Deadly and Our Diets May Never Be the Same,” Time, March 26, 1984, p. 62. 20. “Dairy Farmers of Canada Response to Becoming Vegetarian,” Dairy Bureau of Canada, 1996. 21. Messina and Messina, The Dietitian’s Guide Vegetarian Diets, p. 18. 22. Ibid. 23. Ibid. 24. McDougall, John, The McDougall Program for a Healthy Heart (New York: Dutton, 1996), p. 134. 25. McDougall, The McDougall Program, pp. 66–7; see also Fisher, M., et al., “The Effect of Vegetarian Diets on Plasma Lipid and Platelet Levels,” Archives of Internal Medicine 146 (1986):1193–7; Sacks, et al., “Plasma Lipoprotein Levels in Vegetarians”:1337–41. 26. Ibid. 27. Barnard, The Power of Your Plate, p. 15. 28. Holerton, Gene, The Beef-Eater’s Guide to Modern Meat (Los Angeles: Holerton Publishing, 1998), p. 6. 29. Barnard, The Power of Your Plate, pp. 33–4. 30. Davidson, M., et al., “Comparison of the Effects of Lean Red Meat vs. Lean White Meat on Serum Lipid Levels . . . , “ Archives of Internal Medicine 159 (1999):1331–8. See also Barnard, Neal, Letter to the Editor, Archives of Internal Medicine, February 14, 2000. 31. Ornish, Dean, “Can Lifestyle Changes Reverse Coronary Heart Disease?” Lancet 336 (1990):129–33; Ornish, Dean, et al., “Intensive Lifestyle Changes for Reversal of Coronary Heart Disease,” Journal of the American Medical Association 280 (1998):2001–7; Thorogood, M., et al., “Plasma Lipids and Lipoprotein Cholesterol Concentrations in People with Different Diets in Britain,” British Medical Journal 295 (1987):351–3. 32. Barnard, Neal, Food for Life (New York: Harmony/Crown Publishers, 1993), p. 30. 33. Ibid. 34. Castelli, W., “Epidemiology of Coronary Heart Disease,” American Journal of Medicine 76(2A) (1984):4–12. 35. Cheeke, Peter, Contemporary Issues in Animal Agriculture, 2nd ed. (Danville, IL: Interstate Publishers, 1999), p. 47. 36. Nutrition Action, June 1999. 37. O’Connor, G. A., “A Regional Prospective Study of In-Hospital Mortality Associated with Coronary Artery Bypass Grafting,” Journal of the American Medical Association 266 (1991):803; Hannan, E., “The Decline in Coronary Artery Bypass Graft Mortality . . . ,” Journal of the American Medical Association 273 (1995):209; Williams, S., “Differences in Mortality from Coronary Artery Bypass Surgery at Five Teaching Hospitals,” Journal of the American Medical Association 266 (1991):810; McDonald, C., “CABG Surgical Mortality in Different Centers,” Journal of the American Medical Association 267 (1992):932; Steinbrook, R., “Hospital Death Rates for Five Surgeries Vary,” Los Angeles Times, March 27, 1988; Shortell, S., “The Effects of Regulation, Competition, and Ownership on Mortality Rates among Hospital Inpatients,” New England Journal of Medicine 318 (1988):1100; Kirklin, J., “Summary of a Consensus Concerning Death and Ischemic Events after Coronary Bypass Grafting,” Circulation 79 Sup 1) (1989):81. 38. Hill, J., “Neuropathological Manifestations of Cardiac Surgery,” Annals of Thoracic Surgery 7 (1969):409; Editorial, “Brain Damage after Open-Heart Surgery,” Lancet 1 (1982):1161; Henriksen, L., “Evidence Suggestive of Diffuse Brain Damage Following Cardiac Operations,” Lancet 1 (1984):816; Editorial, “Brain Damage and Open Heart Surgery,” Lancet 2 (1989):364; Murkin, J., “Anesthesia, the Brain, and Cardiopulmonary Bypass,” Annals of Thoracic Surgery 56 (1993):1461; McDougall, The McDougall Program, pp. 206–7. 39. Nutrition Action, June 1999. 40. McDougall, The McDougall Program, p. 211. 41. Ibid. 42. Parisi, A., “A Comparison of Angioplasty with Medical Treatment of Single Vessel Coronary Artery Disease,” New England Journal of Medicine 326 (1992):10; Graboys, T., “Results of a Second-Opinion Trial among Patients Recommended for Coronary Angioplasty,” Journal of the American Medical Association 268 (1992):2537; Graboys, T., “Second-Opinion Trial in Patients Recommended for Coronary Angiography,” Journal of the American Medical Association 269 (1993):1504; McGivney, S., “Angioplasty vs. Medical Therapy for Single-Vessel Coronary Artery Disease,” New England Journal of Medicine 326 (1992):1632. 43. McDougall, The McDougall Program, p. 210. 44. Ornish, et al., “Intensive Lifestyle Changes.” 45. Ornish, Dean, “Can Lifestyle Changes Reverse Coronary Heart Disease?” 46. Ibid. 47. Ornish, et al., “Intensive Lifestyle Changes.” 48. Ibid. 49. Ornish, Dean, comments in Millennium Lecture Series Symposium on the Great Nutrition Debate, Jefferson Auditorium, U.S. Department of Agriculture, February 24, 2000. 50. Nutrition Action, June 1999. 51. Esselstyn, C. B., Jr., “Updating a 12–Year Experience with Arrest and Reversal Therapy for Coronary Heart Disease,” American Journal of Cardiology 84 (1999):339–41. 52. Ibid. 53. Ibid. 54. Esselstyn, Caldwell, “Making the Change,” 55. “Heart Disease Programme Wins Plaudits,” BBC News, February 14, 2000; see also Worldwatch Institute, State of the World 2000 (New York: W. W. Norton, 2000), p. 77. 56. Dass, Ram, Still Here (New York: Riverhead Books, 2000), p. 186. 57. McDougall, The McDougall Program, p. 216. 58. Sacks, F. M., et al., “Low Blood Pressure in Vegetarians: Effects of Specific Foods and Nutrients,” American Journal of Clinical Nutrition 48 (1988):795–800. 59. Ibid. 60. Ophir O., et al., “Low Blood Pressure in Vegetarians . . . ,” American Journal of Clinical Nutrition 37 (1983):755–62; see also Melby, C. L., et al., “Blood Pressure in Vegetarians and Non-Vegetarians: A Cross-Sectional Analysis,” Nutrition Research 5 (1985):1077–82; Melby, C. L., et al., “Relation between Vegetarian/Non-Vegetarian Diets and Blood Pressure . . . ,” American Journal of Public Health, 79 (1989):1283–8. 61. Ophir, et al., “Low Blood Pressure in Vegetarians.” 62. Lindahl, O., et al., “A Vegan Regimen with Reduced Medication in the Treatment of Hypertension,” British Journal of Nutrition 52 (1984):11–20; Margetts, B. M., et al., “Vegetarian Diet in Mild Hypertension: A Randomised Controlled Trial,” British Medical Journal 293 (1986):1468–71; Rouse, I. L., et al., “Blood Pressure Lowering Effect of a Vegetarian Diet: Controlled Trial . . . ,” Lancet 1 (1983):5–10. 63. McDougall, The McDougall Program, pp. 222–3. 64. Ibid, p. 213. 66. Personal communication with author. 67. Gregory, Dick, Callus on My Soul (Marietta, GA: Longstreet Press, 2000), p. 301.

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dylan (anonymous)

this is crap

Written in April 2011

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