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Ask Dr. Gourmet

What do you think of Dr. Esselstyn's 'Heart Attack Proof' Diet?

I just read CNN's latest article highlighting Dr. Caldwell Esselstyn Jr.'s plant-based diet to prevent heart attacks and reverse heart disease.

His diet recommendations counter many items in the Mediterranean Diet. See this excerpt below from his website and please clarify! Now I'm really unsure what to eat. Fish? No fish? Nuts, no nuts? Olive oil, or no oils whatsoever? No avocados?

Excerpted from Prevent and Reverse Heart Disease:

Here are the rules of my program in their simplest form:

  • You may not eat anything with a mother or a face (no meat, poultry, or fish).
  • You cannot eat dairy products.
  • You must not consume oil of any kind—not a drop. (Yes, you devotees of the Mediterranean Diet, that includes olive oil, as I’ll explain in Chapter 10.)
  • Generally, you cannot eat nuts or avocados.

You can eat a wonderful variety of delicious, nutrient-dense foods:

  • All vegetables except avocado. Leafy green vegetables, root vegetables, veggies that are red, green, purple, orange, and yellow and everything in between
  • All legumes—beans, peas, and lentils of all varieties.
  • All whole grains and products, such as bread and pasta, that are made from them—as long as they do not contain added fats.
  • All fruits.

Dr. Gourmet Says...

butternut squash stuffed with quinoa, cranberries, and greens

It has long since been proven that the type of diet that Dr. Esselstyn advocates is not substantially more beneficial for you than the Mediterranean Diet. The science is based partly on research that looks at vegetarian diets and partly on Dean Ornish's work. In fact, due to the extreme nature of the low fat regime, it may actually be more harmful.

Is this healthier than Mediterranean diet? Probably not. The research is clear that extremely low fat diets do not prevent heart disease.

That said, this is a catchy title for a book but a TOUGH diet to follow and likely impossible for most.

In the 1990s I would have patients come into my clinic after having a heart attack and they would bring with them Dr. Ornish's book, saying that they had found the cure for their heart disease. While the research that this was based on was somewhat flawed, in many ways that is irrelevant. Diets like this are simply not sustainable for most people.

It's just silly to think that with all the wonderful choices of food - fish, avocados, whole wheat pasta, brown rice, fruit, veggies, olive oil, walnuts, chicken, yogurt - that one can sustain a diet that contains only vegetables, fruits, beans and cereal grains. But that's why we call them fad diets. They come along, people follow them for a little while, discover how silly it is to try to live that way for the long term, and move on. The unfortunate thing is that by taking such draconian approach, people come to believe that you can only be healthy by following a rigorous, strict diet that takes good, delicious food away from you - and that is just not true.

It is a silly approach.

Eating well and eating healthy are about balance - eating great, healthy food that's great for you and enjoying your life - not being an extremist.

Thanks for writing,

Timothy S. Harlan, MD, FACP, CCMS
Dr. Gourmet