Ep.104: Healing Hearts and Changing Lives through Plant-based Living with Dr. Caldwell Esselstyn

Robyn:

Hey everyone. It’s Robyn Openshaw and Welcome back to Vibe. We are continuing our series on learn from our elders. These are folks who are well past retirement age and still doing amazing things in the world. And this one is exciting because I have wanted to get him on the show for a very long time. He is world renowned. He’s one of the very first medical doctors who was out there not just preaching the benefits of the whole foods, plant based diet, but also doing research in it, which he continues to this day. His name is Caldwell Esselstyn, and if you know his name or if it sounds familiar to you, it’s probably because Bill Clinton often refers to following Esselstyn’s protocol, after, uh, I believe triple bypass surgery.

And what’s funny is that last year I also read Bob Harper’s book called The Super Food Diet, and it’s the book he wrote a year after he almost died of a widow maker heart attack. Bob Harper is one of the personal trainers now, a celebrity in his own right, um, along with Jillian Michaels, I think is her name, uh, and Bob Harper is that sunshiny fun, you can do this personal trainer on “The Biggest Loser.” And so how strange that this super rocked up really super fit guy who’s had an a lifelong career in fitness, has a huge heart attack. And he talks in the book very humbly about how he was wrong about pushing so much protein. And he believes that excessive protein played a role in his, you know, also partly hereditary widow maker heart attack, which is a very specific type of heart attack that does have a hereditary component to it. And he, in the introduction, mentions that he followed Caldwell Esselstyn’s protocol.

And what’s really funny is that as I interviewed Dr. Esselstyn, he didn’t know who Bob Harper was. So that’s how famous he is, is that really famous people are out there doing his protocol and writing about him in their books and he doesn’t even know. But he got his medical doctor degree from Western Reserve University. And in the 1950’s he was the number six or on the victorious United States rowing team. So he actually got a Gold Medal at the Olympic Games. He was trained as a surgeon at the Cleveland Clinic and also in St George’s hospital in London.

And then he went to Vietnam and in 1968 he was awarded The Bronze Star. He’s been associated with the Cleveland Clinic since 1968. He mostly retired from medical practice in the year 2000. But he does talk to us in the interview about the fact that he still helps patients. I think he’s like the best doctors out there who just can’t say no to people who need their help and they know that they have very specific and very big experience that can help.

He was featured in the very famous documentary called: “Forks Over Knives” and it’s about the careers of Esselstyn and his colleague Dr. Colin Campbell, who was coauthor of the China study, which is a best-selling book about the biggest nutrition study in history, which came to the conclusion with over 800 statistically significant findings, that the diet to prevent cancer, heart disease and autoimmune diseases was a mostly or all plant-based diet.

So we are talking to Dr. Esselstyn, well into his eighties. I asked him how old he was and he just gave me a reference point of going to medical school in the 1950’s. But then of course I looked him up on Wikipedia to find out how old he is, and I know that he’s older than 80.

I do want to mention that we have some sound issues. As we got started with the interview, Dr Esselstyn said there were some really loud clicking sounds going on. And so we told him to ditch the headset and we’re always usually sticklers for having a headset because we want really good sound on the show. But we kept the interview anyway, even though the sound isn’t perfect through his laptop, because this man is really a legend. There’s like three paragraphs in his bio about awards that he’s been given and his scientific publications number over 150.

And so I was really excited to be able to interview Dr. Esselstyn. He has four children. He has 10 grandchildren. His wife and his son are best-selling authors and so they’re an amazing family and I’m really excited to bring you this interview.

So Dr. Caldwell Esselstyn, Welcome to the Vibe show.

Dr. Esselstyn:

What a pleasure Robyn to be with you today.

Robyn:

I’ve been trying to reach you for a long time because I really was excited to learn more from you about your very long career. You are really sort of known as probably the leader out there in the plant based nutrition movement. And I bet it was super unusual for you as a young medical doctor to start talking about eating plants. What was that like for you?

Dr. Esselstyn:

Oh, well I was halfway through my career as a general surgeon when I guess in all honesty, what happened was I became increasingly disillusioned with the fact that for no matter how many women I was doing breast surgery, I was doing absolutely nothing for the next unsuspecting victim. And that led me to do a bit of global research. And it was quite striking to see that breast cancer rates in places like Kenya, for example, were 30 and 40 times less frequent than the United States. And if we looked at rural Japan in the 1950’s, breast cancer was very infrequently identified. Yet as soon as the Japanese women would migrate to the United States by the second and third generation, still Japanese American, they now had the same rate of breast cancer as their Caucasian counterpart.

And perhaps even more compelling was cancer of the prostate. Which in the entire nation of Japan in 1958, how many autopsy proven deaths were there in the entire nation? 18. That’s probably the most mind boggling public health figure that I’ve ever seen. By 1978. Twenty years later, they were now up to 137, which still pales in comparison with the 28,000 who will die this year in this country. But nevertheless, uh, it just seemed to me that along with this global research, it was increasingly apparent that there would be more bang for the buck if we could look at heart disease because here we had the leading killer of women and men in Western civilization, which was virtually nonexistent in these cultures which were plant based without oil.

And so the dream became simply this, if we could persuade people to eat differently to save their heart, they would at the same time give themselves the greatest opportunity to protect themselves from the common western cancers of breast, prostate, colon, and pancreatic, perhaps. So that was how this had its onset. And so I spoke with my wife, Ann in 1984. And, uh, well it’s kind of an interesting story how Ann came on board. We were both at a surgical meeting in New Haven, Connecticut. And it was 1984 in April and the weather was pretty bad and uh, unfortunately the talks and presentations were a little bit boring, but nevertheless, always at these surgical meetings, they have these banquets afterwards.

And uh, I had known that I was going to do this study, but I just didn’t know when I was going to get it started because I was a cholesterolholic. I had grown up on an Aberdeen Angus cattle farm and a dairy farm. And uh, I was really into eating a lot of beef. So I knew I was going to do this. And there’s a wonderful doctor up in Rhode Island, who said, in lifestyle changes, you go through a number of phases including pre-contemplation, contemplation, action, and then maintenance.

And I was somewhere probably in pre-contemplation. When at that banquet a waitress put a plate of roast beef, in front of me. And the roast beef was so enormous. It was draped over the sides of the plate. And I just looked at it and shook my head. And Ann looked at me. And she said, “Are you not going to eat your roast beef?” And I said, “No”. She said, “Well then I’ll have it”. But Ann’s mother had died at age 52 from cancer of the breast. And two weeks after that meeting in New Haven, her sister came down with breast cancer. And then she looked at me and said, “I’m with you”. So we started a whole food plant based nutrition ourselves in April of 1984.

And after a year, and we were familiar with this, I went to our department of Cardiology and asked if I could have a small number of maybe 24 patients who were ill with cardiovascular disease. That is to say coronary artery disease. And uh, I was going to try to see if I couldn’t get them to eat plant-based. So that was the outset of the initial study. And the patients who came, were as my late brother in law, said, “These were Esses’ Walking Dead”.

They had failed their first or second bypass. They had failed their first or second angioplasty. They were too sick for these procedures or they had refused. Five were told by their expert cardiologists that they would not live out the year. And all five of those made it beyond 20 years. So we really began to see some exciting things happen and we published this on several occasions. And then when I retired from surgery in 2000, it was just too exciting with the results that we were getting for me to stop. And so I have continued on since then seeing patients and writing up our results.

Robyn:

It’s funny you said that people were saying that your group was called “Esses’ Walking Dead” because I’ve interviewed two experts on the Vibe podcast who refer to you as Esse and so I had to stop myself from laughing. Where’d you get the name Esse? Who started calling you that?

Dr. Esselstyn:

So it’s the short version of my last name, which is Esselstyn. Nobody really likes to call you, Caldwell. My first name and Esselstyn is a little bit cumbersome. So always the males had been called Esse. Yeah.

Robyn:

Yeah. I think it was David Katz and John Robbins who call you Esse. So you are very well known. And one of the things that people know most about you is that you treated Bill Clinton, I believe he had triple bypass surgery or something like that. And he went plant based or all but plant based. What can you tell us about that?

Dr. Esselstyn:

You know, I think that would be a little bit inaccurate. President Clinton had his cardiac episode which led him to have surgery, and that was, I gather a triple bypass surgery. And after he’d had the surgery, I thought, you know, he probably could use a little bit more information. So I tried through a friend of ours who was an acquaintance of the Clintons and I, uh, signed over and they got him a copy of my book. And so I had never met the man. But then he had his second go around where he had to have some more stents as his disease continued to progress after his heart surgery because he obviously was never eating really correctly after the heart surgery.

And it was on a CNN broadcast with Wolf Blitzer where President Clinton was being interviewed by him and he, President Clinton, said that he didn’t want to have any more of these stents and he accredited, Dr Dean Ornish and Dr Caldwell Esselstyn, yours truly, and Dr Colin Campbell and his son, and he gave us a nice support for our book, over the television. But no, I have never personally shaken hands with him, nor have I met him. But he has read our book. I hope that it makes that clear. And clears up any questions.

Robyn:

Yeah. That’s actually kind of funny because what our audience doesn’t know is that now I know that you aren’t his personal physician, which you get credited for. I’ve read it in several different media outlets.

Dr. Esselstyn:

That’s right. No. No, I was never his personal physician. No, that is correct. I was not. But that isn’t to say we wouldn’t like to help.

Robyn:

Yes. Well, your work certainly served him well because he uses your name. And what my audience doesn’t know is that before we started this interview, I said that Bob Harper, in his book, after his widow maker heart attack, he’s the personal trainer celebrity in the series on TV, “The Biggest Loser” gives you credit.

But tell us a little bit about the movie “Forks Over Knives”. It’s about the career of both you and Colin Campbell and you both grew up on a dairy ranches and had to completely change your diet from what you were raised with once you saw the evidence. Yes?

Dr. Esselstyn:

Colin Campbell, has been a great friend of mine for years. In 1991 when I was trying to put together the first national conference on the elimination and prevention of heart disease, one of the first people that I called were uh, Colin Campbell and Dr. Dean Ornish as part of the faculty. And Collin, I had heard about his study, but I had not met him, but I made a bold phone call to him and said that I was setting up this conference, and would he be happy to share his China study experience with us? And he did. And uh, so that began a friendship which has continued to this day over the last, uh, 18 years now. No, actually more than that, close to 20.

Now the movie “Forks Over Knives”, was I guess the brainchild of Dr Brian Wendel. And they reached out to Collin and myself and I guess because of his research and because of my research, they asked if we would be willing to be part of this film. And we both said yes. And it was really very professionally done I thought. And they made a great effort to authenticate their film and have in it not a lot of hype and snake oil, but really have the viewer understand that this was an exposure to science that they were getting. And I think that’s what it made it fairly powerful. I don’t know, have you had an opportunity to see it yourself?

Robyn:

I have. And I loved it. And I really appreciate learning when people who are in a career that has a lot of status like PhD’s and Medical Doctors like yourself and Dr. Campbell are willing to say, there’s something I’ve learned here and I’m going to completely change my own diet. As both of you did. Are you still totally plant based whole foods? Or you know, John Robbins eats a little bit of fish when we interviewed him. I was curious about that because some experts think that people over 65 need a bit more protein. So where are you and Ann at with your diet now?

Dr. Esselstyn:

No, no, no fish. Absolutely no. Look, the oceans are already being overfished. Matter of fact that they’re not being fished. Presently, the oceans are being bulldozed would be a more accurate way of putting it. And what are you getting when you’re getting fish? You’re getting Pcbs, mercury and dioxins. And what is there unique about a fish? Um, well, if you need Omega 3, there are plenty of other ways to get Omega 3, through chia seeds and flax seed meal and you have plenty of green leafy vegetables. And now they have preparations for Omega 3, that are made from algae and not fish oil. Uh, so I guess I’d have to say that, No. I am totally plant based. No, we do not eat fish. And I hope that answers your question.

Robyn:

It does. Thank you. How has the medical establishment reacted to your work from 1984 till now? Are you seeing a shift in the way they see nutrition?

Dr. Esselstyn:

Totally, totally, totally different now. I mean, I was always sort of a hard nose macho surgeon before I got interested in doing research in nutrition. And after that at the Cleveland Clinic, my Alma Mater, behind my back, I was called Dr. Sprouts, which actually I’m kind of proud of that, because what happened was, we really began getting some absolutely incredible results. And we found that with these patients who are seriously ill and really often left for dead, that not only you could you stop the progression of the disease, but we’d often see significant examples of reversal.

Now you have to remember that along the way there are roadblocks to getting this sort of thing accomplished. Now, the one that really affects people’s strongly often is monetary reward. For instance, you can get paid a fair amount of money for doing a bypass operation or a stent. But if you’re talking to a patient about Brussels sprouts and Broccoli, uh, the compensation is more modest. So really our work is an enormous threat to medicine’s biggest cash cow. And, and one thing that was, and actually still is so apparent is that with all due respect for their care and compassion and fund of knowledge of my cardiovascular colleagues, uh, they’d be the first to admit that never in medical school and never in their postgraduate cardiology training have they really had any in depth education about the causation of the illness that they had been designated to treat.

Uh, and really it’s so challenging. A matter of fact, I should share with you that three years ago, I was invited by the American College of Cardiology to join their nutrition committee, which I have proudly done. And the nutrition committee has excellent leadership, under Andrew Freeman and very aggressively is trying to educate the cardiovascular community as to the causation of their illness. Because today, as in the past, really there’s been a covenant of trust ever since the days of Hippocrates that whenever possible, the caregiver is going to share with the patient what is the causation of the illness. And sadly, today in cardiovascular medicine that simply is not being done.

Uh, the patients get a stent and then they come back two or three years later or sooner for another stent. And then a few more stents. I have seen one patient who had 51 stents and, uh, that almost borders on the, well, it’s inappropriate. Because the patient was never taught about what are the foods that every time they pass your lips will you absolutely injure the delicate innermost lining of the artery, the endothelium. Because that’s where all experts in this disease would agree that where heart disease has its inception, it’s onset is beginning, is when we progressively injure that delicate innermost lining called the endothelium, which makes an absolutely magic molecule of gas, nitric oxide, and which is responsible for the salvation and the protection of all of our vasculature because of its remarkable functions.

For example, nitric oxide keeps all the cellular elements within our blood stream flowing smoothly, like Teflon rather than Velcro. It keeps things from getting sticky. Number two, nitric oxide is the strongest blood vessel dilator in the body. When you climb stairs, the arteries to your heart, the arteries to your legs, they widen, they dilate, that’s nitric oxide. Number three, nitric oxide protects, the wall of the artery from becoming thickened, stiff, or inflamed protects us from getting high blood pressure or hypertension. Number four, now here is the absolute key. A safe and normal amount of nitric oxide will protect you from ever developing blockages or plaque and therefore literally if everybody on the planet, whether they’re from London, Berlin, Chicago, New York, or Springfield, Missouri, if they have cardiovascular disease, it is because by now in the preceding decades, they have so sufficiently trashed, injured and compromise the capacity of their endothelial cells to make nitric oxide. They don’t have enough nitric oxide to protect themselves from making blockages and plaque.

However, the good news here is this, this is not a malignancy, and once you can get patients to understand, never again are they to have pass their lips any of these foods that are going to injure that delicate, innermost endothelial lining, then the endothelium will recover, make enough nitric oxide so you not only can halt the disease, but often we see significant elements of disease reversal.

Now what are the foods that every time they pass your lips, you injure the endothelial cells? They are, any drop of oil, olive oil, corn oil, soybean oil, safflower oil, sunflower oil, coconut oil, palm oil, oil in a cracker, oil in a piece of bread, oil in a salad dressing. Oil injures the endothelial cells, as does anything with a mother or a face. Meat, fish, chicken, fowl, Turkey, eggs. And anything that has dairy, milk, cream, butter, cheese, ice cream and yogurt. And sugary drinks, Pepsi, Coke, Diet Colas. And sugary foods, cakes, pies, cookies, Stevia, Agave or any excess of maple syrup, molasses and honey. And I don’t like coffee with caffeine. Decaf? Yes. Tea with caffeine? Yes. But coffee with caffeine? No.

Robyn:

Okay. Dr Esselstyn, you may know that last year, 2017, the number one searched term on the internet on Google was the Ketogenic diet. And your program bands oils and you’ve just explained why. So that’s a good segue to this question. At GreenSmoothieGirl, we’re about to publish a blog post that is sure to get us lots of hate mail because it’s called 21 health experts debunk the Ketogenic diet. And your quote that I want to ask you for officially your opinion on the current diet fad, which is to eat, um, around 70 percent of your calories from fats, will be the last one that we add to this blog post.

So will you tell us in your words what you think about the Ketogenic diet?

Dr. Esselstyn:

Well, I think that if you look over the scientific literature, to my knowledge, there’s only been one diet that has ever halted, arrested and reversed patients who are seriously ill with cardiovascular disease, and that is whole food, plant based nutrition. I am totally unaware that there is a single study by the Ketogenic diet that you’ve mentioned, of 70 percent, that has been reviewed in a peer reviewed process where they have taken patients who are seriously ill, with their demonstrable cardiovascular disease and had been able to show the halting and the reversal of that disease.

Robyn:

Wonderful. Excellent quote. Thank you. We will let you know when that publishes. You’ll be our 21st and I had a feeling that you would say something like that. Tell us a little bit about how people live in their eighties, still doing their very best work. What are some of the things that you and Ann do, and not just the food thing but other things you’ve learned in more than 80 years on the planet that would serve people who are younger and don’t have as much life experience as you, that keep you young?

Dr. Esselstyn:

That question sort of reminds me of the one that everybody seems to get when they are a 101 or 106 and they are always asked what have they done to have such a healthy life, and you always get somebody who says, well, I have six Martinis every day, or I like to smoke two packs of cigarettes every day, it makes it a little bit challenging. But I think more realistically with what is known today about the human organism, the chronic illnesses that we have here in the United States in abundance, it’s interesting that about 80 percent of them are related to whole food, plant based nutrition. By that I mean things like cardiovascular disease, high blood pressure, diabetes, strokes, vascular dementia, Crohn’s disease, ulcerative colitis, rheumatoid arthritis, Lupus, and multiple sclerosis, allergies and asthma. And the list goes on and on.

And whole food, plant based nutrition is the greatest gift that medicine has really received in the last century. Really challenging almost everything else we’ve learned in medicine because it appears that the human body, when you give it the correct fuel, is so capable of really eliminating and ending and preventing and reversing of these diseases. Uh, it’s just that we’ve absolutely sort of fallen into this pitfall, perhaps since the beginning of the 20th century of, uh, getting all this processed food and the heavy emphasis on meat.

For instance, right now, the thing that is destroying the planet faster than anything else appears to be the eating of animals. And, uh, I think it’s $70 billion a year that are slaughtered. And when you think of the waste products that are created, plus the methane they produce, it’s really a tremendous challenge for the planet.

But I think, uh, the personal rules that to really give vibrant health are, to do several things. One and on the top of the list, unquestionably, is to eat whole food, plant based nutrition. And the other is, get adequate amounts of uninterrupted sleep and exercise. And there should be some sort of cerebral stimulation with friends and family and co-workers, so that you’re still using your head in a challenging way on a regular basis. And I think those are going to be important.

Now, the American Heart Association has something like seven things that they sort of swear by which are like, have a body mass index of under 25, no smoking, eat a sensible diet, keep your cholesterol without any medication under 200 , keep your blood sugar without any medication, fasting under 100. And the challenge with all of that, as much as I respect the American Heart Association, uh, I’m unaware that with was those seven items that I’ve talked about that you’ve ever eliminated or reverse heart disease. And that only comes about when you get rid of the foods that I mentioned earlier in this discussion, which are the ones that injure the endothelium. Because once you stop the injury to the endothelium, the body has this remarkable capacity to right the ship, correct it and heal. And then vascular disease should not have to be in your future.

Robyn:

So, I know you’re really excited about some work that you’re doing right now. And you mentioned that when you got started in 1984 doing these publishable research studies on the effects of a whole foods plant based diet and you saw all kinds of really advanced disease turning around, especially cardiovascular disease. You said, it was too exciting to quit. And I wonder if that has anything to do with why now 15 to 20 years after most people are retired, you’ve had a very, very successful career at one of the most lucrative things there is to do. What keeps you going and really pushing the envelope further and still helping people and continuing your profession? What are you working on now that you’re so excited about?

Dr. Esselstyn:

Well, I think that right now my plate is full with treating patients. And uh, the excitement for me comes when suddenly somebody who, uh, is crippled, with cardiovascular disease and they are able to, how do I say this, often I get a phone call from somebody who says, “Dr. Esselstyn, I was told after I had my angiogram that I had to be a candidate for open heart bypass surgery.” Now we can help those people. But it’s going to take a good half hour to 45 minutes of conversation. Because there’s no question that if somebody is in the middle of having a heart attack, that a stent or a bypass can be absolutely lifesaving. However, when those procedures are offered electively, there does not appear to be any prolongation of life and nor any protection from a heart attack, and that’s the science.

So people have to know that if they are willing to commit at the time we call and really especially make themselves totally plant-based and do it correctly, often they will begin to get rid of their angina or chest pain within days. Often within six or seven days, they’ll find themselves with their angina diminishing. And now you know, you’ve got them hooked. And they are elated to think that you have empowered them as the locus of control to halt and reverse their disease. And that’s the kind of thing that really, quite honestly keeps me going. When I get another email back from these patients, seven to ten days later saying, my God, I don’t know, why I would ever have that bypass when I’ve been able to, by changing my diet, I’ve been able to get rid of my chest pain.

So, it’s so terribly exciting and rewarding for me to think that, uh, not only we have saved society a lot of money, but most importantly, we saved that patient from, uh, the problems with the open heart surgery because, well, as I said in an emergency, it can be lifesaving. Remember, there are some tough challenges to the operation. The worst thing that can happen is you can die. Then there’s always hemorrhage. There can be by infection, there can be a stroke, there can be a heart attack. The incision doesn’t heal. And, uh, and the sad thing is that those procedures have, whether it’s a stent or a bypass or any of the drugs that cardiologists using today, none of them have one single thing to do with the causation of the illness. And sadly, the bypass uses veins, often from the leg, which don’t last. They all will eventually fail, some within one or two years, some at four or five years. And, uh, it’s very interesting when you do a very large prospective study to see how well the veins last, it’s just not very good at all. It’s a stop gap cash job, which does not really address the fundamental question.

And the reason that cardiologist resort to it, is that the cardiologists don’t know how to get the patients to change their lifestyle and eat plant based. Matter of fact, one of the common criticisms of our program is that I don’t know how Dr. Esselstyn, how he gets away with doing this when, uh, none of my patients will do it. Well, if you’re a cardiologist and you believe in our work and you give a patient 12 or 15 minutes in an office visit and expect them to change to whole food, plant based nutrition, you’re dreaming. You’ve got to show the patient respect. And the only way to show the patient respect is to give them your time. Which is why our counseling seminar is six hours. And I have an opportunity to call all of them before they ever come to the seminar. So they really know that they’re going to get all the information, all the science that they can understand and precisely how we empower them to be the locus of control, to halt and reverse their disease. So, that keeps me going. Yes.

Robyn:

I love it. When are you going to retire? Do you think? Not any time soon, you’re not going to retire?

Dr. Esselstyn:

It’s not on the horizon. Maybe when people stop wanting to see me, that’ll be the clue. But right now, we’re going gangbusters. And it’s really exciting to help these people. All these patients that come, come on their own. They aren’t sent by physicians and when they do go back home, and they do see their physician, their physician has to start dropping their cholesterol medication as their cholesterol improves, they drop their diabetic medications, as diabetes disappears, they’ll drop their hypertensive medications as their blood pressure problems disappear. And I have yet, over 30 some years, to receive a single phone call or email from a physician saying, Dr Esselstyn, how dare you teach my patient the healthiest diet on the planet?

Robyn:

Well, I love your work. You’re an amazing inspiration to me on how to be vibrant in your eighties. And so I really appreciate you giving us this time. Will you tell us the book that you think that my mostly 35 to 65 year old female audience should, should buy of yours, which, which one book or two?

Dr. Esselstyn:

Well, my wife is here, so I can’t just say my book. But my book is, “Prevent and Reverse Heart Disease” and her book and my daughter’s is “The Prevent and Reverse Heart Disease Cookbook”. And my son has one called “The Seven Day Rescue”. So I guess that really is plugging the family pretty hard. But also there are wonderful books by John McDougall, wonderful books by Neal Barnard and of course Collin Campbell and many others. It’s really quite an exciting community of plant based physicians who are really shouldering this message and many of whom I don’t have time to mention or have neglected to mention, but the atmosphere and the enthusiasm is so totally different now than it was 34 years ago.

Robyn:

Oh, I’m so very grateful for you giving us a little bit of your time because our audience will learn a lot from this interview. Thank you so much.

Dr. Esselstyn:

You too, Robyn, all the best.