The Real Heart Healthy Diet

Dr. Dean Ornish and Dr. Caldwell Esselstyn Jr. have clearly demonstrated that low-fat Whole Food Plant Based (WFPB) diets can prevent and treat coronary artery disease (CAD). Their diets are truly low in fat as approximately 10% of  total calories are derived from fat.  The American Heart Association’s guidelines for fat are ridiculously liberal as they advise Americans to limit total fat intake to less than 25 – 35% of total calories. The United States Department of Agriculture (USDA) recommends adults older than 19 years old to consume 20-35% of calories from fat. Contrary to popular belief, neither the AHA or the USDA has ever recommended dietary fat levels anywhere close to what’s been shown to prevent and even reverse CAD.

From 1990 to 2005-2006, Americans consumed an average of 34% of their total calories as fat. This amount of fat consumption exceeds even the AHA’s liberal standards.

The AHA and the USDA guidelines for dietary fat intake haven’t changed all that much in the last three decades. And although both the AHA and the USDA recommend diets high in fruits, vegetables, legumes and whole grains, they never clearly encourage folks to severely limit meat, fish, poultry, eggs, dairy and added oils.  In fact, the USDA encourages certain oils (ie. Olive and canola, safflower, soybean, corn and cottonseed).

Following these guidelines will ensure that CAD will continue to cause the premature deaths of thousands of Americans.

According to the Centers for Disease Control (CDC), 385,000 people die from coronary heart disease annually.  We won’t make much of a dent in these numbers unless dietary professionals start promoting low-fat WFPB diets.

Heart attack survivors are often put on statin drugs and are asked to make small and mostly insignificant changes in their diet. These changes include, but are not limited to:

•    Replace eggs with egg whites
•    Replace butter or margarine with olive, coconut or canola oil
•    Replace vegetable oils with olive, coconut or canola oil
•    Replace butter with light butter
•    Replace bacon with turkey bacon
•    Replace cheese with reduced fat cheese
•    Replace red meat with poultry and fish
•    Replace whole milk with 1% or skim milk

Dietitians have been making these recommendations for decades, and unless they start helping people transition to low-fat WFPB diets with no added fat, salt and sugar, Americans will continue to be plagued by CAD.

I was recently made aware of  the “Healthy Hearts on the Hill”Coalition”. The “Hill” represents the West Hill, Arbor Hill and South End communities of Albany, NY.  The Coalition’s mission is to facilitate community neighbors’ engagement in health-promoting behaviors known to reduce risks for heart disease and disability, thereby creating healthier communities.  It is certainly a noble mission.  However, this list of 14 so called heart-healthy recipes contains recipes, that any preparation of which would be considered disease-promoting behavior. The list includes:

•  6 recipes that exceed 25% of total calories as fat (Exceeds the AHA’s liberal guidelines)
•  7 recipes exceed 7% of total calories as saturated fat (Exceeds the AHA’s liberal guidelines)
•  Only 3 recipes provide less than 20% of total calories as fat.
• The recipes include the following disease-promoting foods
  • Salmon
  • Turkey
  • Ham Hocks
  • Butter
  • Cheddar Cheese
  • Skim milk
  • Eggs
  • Chicken
  • Beef
  • Oils

 Four of the recipes can only be described as artery damaging by any reasonable person. They include:

• A recipe that provides 47% of calories as fat and 22% calories as saturated fat
• A recipe that provides 50% of calories as fat and 11.5% calories as saturated fat
•  A recipe that provides 61% of calories as fat and 14.7% calories as saturated fat
•  A recipe that provides 33% of calories as fat 19% calories as saturated fat and 1096 mg sodium!

These recipes represent guidelines that result in a slightly altered version of the chronic disease-promoting Standard American Diet (SAD). Because compliant CAD patients feel they are following a heart-healthy lifestyle, they are often surprised when they have future coronary events.  CAD patients that follow the Ornish or Esselstyn programs are much less likely to have future coronary events. 

If you are a CAD patient and your dietitian is recommending the same insignificant changes that have been around for decades, find yourself another dietitian. Find one that wants to help you stop the progression of, and maybe even reverse your CAD!