November 25

How to Reverse Heart Failure with Diet


Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

It is a hopeful sign of the times when entire issues of cardiology journals are not just dedicated to nutrition, but to plant-based diets in particular. Dr. Williams, past president of the American College of Cardiology, starts out with a quote attributed to Schopenhauer. “All truth passes through three stages. First, it is ridiculed. Second, it is violently opposed. Third, it is accepted as [like, well, duh.]” And, “the truth…for the benefits of plant-based nutrition continues to mount.” The evidence, we got; the problem is the “inertia, culture, habit, and widespread marketing of unhealthy foods. Our goal must be to get the data out to the medical community and the public where it can actually change lives….” That’s like my personal life’s mission in four words: Get the data out. Based on what we already know in the existing medical literature, plant-based nutrition “clearly represents the single most important yet underutilized opportunity to reverse the pending obesity and diabetes-induced epidemic of morbidity and mortality,” meaning disease and death.

The issue included your typical heart disease reversal cases: a 77-year old woman with heart disease so bad she couldn’t walk more than a half-block or go up a single flight of stairs, severe blockages in all three of her main arteries, and referred to open heart surgery for a bypass. She chose, however, instead “to adopt a whole-food plant-based diet, which included all vegetables, fruits, whole grains, potatoes, beans, legumes, and nuts.” Even though she said she was trying to eat pretty healthy before, within a single month of going plant-based, her symptoms had nearly resolved, and forget about a block, “she was able to walk on a treadmill for up to 50 minutes without chest discomfort or [becoming out of breath].” Her cholesterol dropped about a hundred points, from around 220 down to 120, with an LDL under 60. But then, a few months later, she must have started missing her chicken, fish, and low-fat dairy, and went back to her prior eating habits. Within a few weeks, with no change in her meds or anything, her chest pain was back, and she went on to have her chest sawed in half after all. Then, she continued to eat the same diet that contributed to cause her disease in the first place, and went on to have further disease progression.

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This one, though, has a happier ending. It started out the same: a 60-year-old man with severe chest pain after as little as a half-block. Decided to take control of his health destiny, and switched to a whole food plant-based diet from his quote-unquote “healthy” diet of skinless chicken, fish, low-fat dairy that had been choking off his heart. Within a few weeks, the same amazing transformation. From not being able to exercise at all to walking a mile, to then being able to jog more than four miles, completely asymptomatic, off all drugs, no surgery, off to live happily ever after.

Now, of course, case reports are really just glorified anecdotes. What we need is a randomized controlled trial to prove heart disease can be reversed with lifestyle changes alone. And, guess what? There was one, published literally 30 years ago, proving angiographic reversal of heart disease in 82 percent of the patients––opening up arteries without drugs and without surgery. So, these case reports are just to remind us that hundreds of thousands of Americans continue to needlessly die every year from what was proven to be a reversible condition decades ago.

The conventional use of case reports, though, is to present some novel results in hopes of inspiring trials to put it to the test. For example, a case report on a plant-based diet for congestive heart failure. So, not just coronary artery disease, but the heart muscle itself was so weakened it couldn’t efficiently pump blood––only able to eject about 35 percent of the blood in the main heart chamber with every beat, whereas normally the heart can pump out at least half; which is exactly what his heart was able to do just six weeks after switching to a whole food plant-based diet, instead of choosing to get his chest cracked open. The first report of an improvement in heart failure following adoption of a plant-based diet, but not the last.

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A 54-year-old woman, obese, type 2 diabetic, presenting with swelling ankles due to her heart failure. She switched from her chicken and fish to whole plant foods. She started out eating healthier and lost 50 pounds, reversed her diabetes—meaning normal blood sugars on a normal diet without the use of diabetes medications—and her heart function normalized, from an abysmal ejection fraction of just 25 percent up to normal. Since it’s not a randomized controlled trial, all we can say is that her improvements coincided with her adoption of a whole food plant-based diet. But given the burden of heart failure as a leading cause of death, how it usually just gets progressively worse, and the overall evidence to date, a plant-based diet should be considered as part of heart failure care. And look, we already know it can reverse her coronary artery disease, and so, any heart failure benefits would just be a bonus.

Now, we just need good strategies for healthcare “practitioners to support patients in plant-based eating.” Here are some excellent suggestions to pause and reflect on. For example, doctors can use the Plantrician Project’s prescription pads and prescribe a good website or two.

“While it is certainly true that many people would be resistant to fundamental dietary changes, it is equally true that millions of intelligent people motivated to preserve their health are now taking half-way measures that may provide only modest benefit—choosing leaner cuts of meat, using reduced-fat dairy products.” “Most of these people have neither the time nor the training” to actually see what the science shows themselves. Don’t they deserve honest, forthright advice when their lives are at stake? Those who wish to ignore this advice, or implement it only partially, are certainly at liberty to do so. You want to go smoke cigarettes, go bungee jumping? It’s your body, your choice. It’s up to each of us to make our own decisions as to what to eat, how to live. But we should make these choices consciously, educating ourselves about the predictable consequences of our actions.

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