New Cardio-Vascular Disease Study Results

Jeff Novick posted this over on the McDougall forums. He has the thread locked so nobody can reply, so here it is in its entirety.

(Edited to add:)
Looks like Dr. Fuhrman was right all along. Maybe his program deserves another look.

Trending Cardiovascular Nutrition Controversies- Nuts, Oil..

Just published in the Journal of the American College of Cardiology.

The authors include Dr Barnard, Dr Esselstyn, Dr Ornish & Dr Williams

Trending Cardiovascular Nutrition Controversies
(J Am Coll Cardiol 2017;69:1172–87)

Andrew M. Freeman, MD,a Pamela B. Morris, MD,b Neal Barnard, MD,c Caldwell B. Esselstyn, MD,d, Emilio Ros, MD, PHD,e Arthur Agatston, MD,f Stephen Devries, MD,g,h James O’Keefe, MD,i Michael Miller, MD,j Dean Ornish, MD,k Kim Williams, MD,l Penny Kris-Etherton, PHDm

Full text

http://www.onlinejacc.org/content/69/9/1172

Abstract

The potential cardiovascular benefits of several trending foods and dietary patterns are still incompletely understood, and nutritional science continues to evolve. However, in the meantime, a number of controversial dietary patterns, foods, and nutrients have received significant media exposure and are mired by hype. This review addresses some of the more popular foods and dietary patterns that are promoted for cardiovascular health to provide clinicians with accurate information for patient discussions in the clinical setting. 

A Look to the Future

In summary, the future health of the global population largely depends on a shift to healthier dietary patterns (Central Illustration). However, in the search for the perfect dietary pattern and foods that provide miraculous benefits, consumers are vulnerable to unsubstantiated health benefit claims. As clinicians, it is important to stay abreast of the current scientific evidence to provide meaningful and effective nutrition guidance to patients for ASCVD risk reduction. In this brief review, just a few of the current trends in nutrition have been highlighted to serve as a starting point for the patient-clinician discussion. Available evidence supports CV benefits of nuts, olive oil and other liquid vegetable oils, plant-based diets and plant-based proteins, green leafy vegetables, and antioxidant-rich foods (Central Illustration). Although juicing may be of benefit for individuals who would otherwise not consume adequate amounts of fresh fruits and vegetables, caution must be exercised to avoid excessive calorie intake. There is currently no evidence to supplement regular intake of antioxidant dietary supplements. Gluten is an issue for those with GRDs, and it is important to be mindful of this in routine clinical practice; however, there is no evidence for CV or weight loss benefits, apart from the potential caloric restriction associated with a gluten-free diet.

Summary Chart

Looks like Dr Esselstyn just put his name on a published paper endorsing nuts & oils

In Health
Jeff

Takotsubo Syndrome in BHF Magazine

Back in 2009 I suffered a heart condition known as Takotsubo Syndrome. I was my cardiologist's first patient with it, and as of 3 years ago when my husband became a patient of his thanks to his CVD and subsequent CABG surgery, I was still the only one he treated. Very few doctors and no nurse, including cardiac care unit nurses, I've ever spoken with had heard of this rare disease, either.

I know Takotsubo Syndrome has been in a lot of new reports recently with the death of Debbie Reynolds so soon after her daughter. I'm glad the word is getting out, and I hope this recent tragedy has prompted doctors here in the USA to do more reading and research on it, for their patients' sake.

It was so good when I recently found a Takotsubo Facebook community and had contact with others who have also suffered this cardiac problem. For so many of us, we're the only only people who ever heard of it, much less had it and have been treated. It seems doctors in Great Britain are more up to date on this than docs here in the USA, and they treat it more seriously than my cardiologist did. They actually keep people in the hospital for more than a day and encourage rest for the first few weeks, not push you out the door and force you into an exercise program ASAP.

And they also make the public aware of the disorder outside of tabloid news. The British Heart Foundation appears to be the UK's version of the American Heart Association, and has a monthly magazine. In this current issue they have some articles on Takotsubo Syndrome, explaining what it is, how it's treated, one woman's story, and what the future may bring. For instance, this was the first time I ever saw the warning that TSS recurrence rate is as high as 15%, and that some people never fully recover, continuing to suffer from extreme fatigue for years afterwards, even if all tests show the heart structure has returned to normal. That, along with my diagnosis of MCTD, can explain a lot of my on-going problems. 

There's just one big medical surprise after another lately.

Do Not Cath - I Will Sue, from the September 2016 ASW

Why A Plant Based Diet is Best for Heart Disease

A great demonstration on how the heart works, how it's harmed by a SAD diet, and how a plant-rich diet can lower the risk of heart disease. Yes, it's an ad for his new book, The End of Heart Disease, but everything he says goes for the McDougall and Esselstyn food plans, too.

New Episodes of Healthy Living On-Line

The newest episodes of Foody TV's Healthy Living Series are on-line. For some reason there is no #7, not on Foody itself or their YouTube channel. Maybe it'll appear in the future?

The recipes for the original 6 episodes can be found at the Foody web site, and hopefully the recipes for these 4 new ones will join them soon.


Lesson 8 with Wendy - Look and Feel Your Best
Butternut Squash and Quinoa Chili, Oven Ratatouille



Lesson 9 with Hans Diehl and Shayda - Medical Institute
Millet Pudding, Fennel Salad




Lesson 10 with Lindsey (Happy Herbivore) - Bar Food Twist
Cauliflower Buffalo Wings, Peanutless Peanut Sauce




Lesson 11 with  Dr. Joel Kahn - Heart Health
Broccoli Bisque, Zucchini Pasta with Quick Sun-Dried Marinara Sauce

For Those With Irregular Heartbeats

Doctors demonstrate irregular heartbeats, set to music.

very funny ^^
heart rhythm disorders
Posted by Medical MCQ on Monday, January 12, 2015

VeganMoFo Day 15 - Pea Soup

Hot soup for a cool day. The storms that blew through here finally brought lower temps with it, so I got a chance to make this family favorite for lunch.

I have so many good recipes for this soup, but in keeping with my theme, I'm using Ann Esselstyn's this time:

Split Pea Soup
This is one of my favorites. I love its thickness but make it as thin as you wish by adding extra water. - Ann Esselstyn

3 cups dry split peas
7 cups of water or more as needed (8 in the book)
1 bay leaf
1 teaspoon dry mustard
2 cups minced onions (about 2)  (one in book)
4 to 5 medium garlic cloves, crushed
3 stalks celery, minced
3 medium carrots, sliced or diced
3 small potatoes  (5 in the book)
Lots of freshly ground black pepper
3 to 4 tablespoons red wine or balsamic vinegar  (4 to 5 in the book)
l ripe tomato diced
Lots chopped cilantro or parsley

1. Place split peas, water, bay leaf and mustard in a heavy pot. Bring to a boil, lower heat as much as possible, and simmer, partially covered for about 20 minutes.

2. Add onions, garlic, celery, carrots, and potatoes. Partially cover, and leave it to simmer gently for about 40 minutes more with occasional stirring. Add more water if it looks too thick.

3. Add black pepper and vinegar to taste and serve topped with diced tomatoes and minced cilantro/ parsley or just mix the tomatoes and cilantro into the soup.

Tip: To make this soup quickly, use a pressure cooker. Brown onions in the cooker, add other ingredients, then turn to high and cook for 8 minutes. 

For an amazingly delicious variation, combine everything through carrots. Do not add potatoes. Cook until dry peas have completely softened and lost their shape. Transfer some of the soup to a blender and slowly add 16 ounces frozen peas (or use an immersible blender, adding the frozen peas to the pot). Return to pot and heat. Add pepper and more water, if desired.


Prevent and Reverse Heart Disease
Caldwell Esselstyn, MD and Ann Crile Esselstyn
page 198
AND
http://www.meetup.com/Dr-Es-Vegan-No-Oil-Diet-Cleveland-Akron-Ohio/pages/Recipes_by_Ann_Crile_Esselstyn/

Thick is right! Notice this uses a pound and a half of peas instead of the usual 1 pound (2 cups). Also notice the recipe says in a few places ". . . in the book." This is because I copied the recipe from that web page of recipes in the MeetUp site, then compared it to what the book says. I'm using the book's amounts for the water and potatoes, the book's amount for vinegar.

Other changes:
I skipped the bay leaf.

Instead of fresh onions I used frozen.

Instead of fresh celery I used dried from Spices, Etc. I've been using dried vegetables from here for years and decided after last week's fiasco I'll use them in these recipes again, just as I would if making this when it wasn't for VeganMoFo.

Yukon Gold potatoes are what I bought this week so that's what I'm using here.

I always break up my pea soups with an immersion blender, and this one is no different. Neither of us likes the chunkiness of unblended pea soup. 

And my final changes, instead of a fresh diced tomato, I'm using a can of no-salt added petite diced. It's mostly being used as a garnish and not as part of the soup itself. Same with the parsley. I sprinkled some dried on the top, and added some frozen peas as garnish.

This potful will serve us well for the entire weekend for lunches. If hubby needs something more, I have plenty of whole wheat bread he can dunk in it.

Invisible Illness Awareness Week

I never knew anything like this existed!

http://invisibleillnessweek.com/

Aside from his fading scar, my husband's coronary artery disease is invisible. My CFS is invisible, as is my hypothyroid, hypoglycemia, partial deafness, asthma, and degenerative disc disease and other arthritis and neuritis problems. And now that my labwork is showing I have an autoimmune disease, add that to the list.

I think I'll be spending a lot of time on that web site the next few days. 

My Mind's A-Twirling

First I chose to do strict Essy food plan when hubby started getting chest pains. Then I added McDougall and Engine 2/FOK meals into the mix. Then came Dr. E's magazine interview and Jeff's talk with Dr. E to clarify certain issues that were brought up in both the interview and his Plantstock speech regarding fruit, flour products and potatoes.

And I'm as confused as ever.

He says to eliminate flour products if trying to lose weight, even though they're allowed in his heart disease food plan. Many of Dr. McDougall's heart healthy recipes that I chose to cover next month contain flour products. In fact, next week alone I have 4 recipes that include them.

And the greens! Dr. E says for his heart patients he recommends 6 servings of greens a day, to include them in every meal. I understand how important they are, and I do as Jeff does and try toss a handful in a pot when it's appropriate, but many of these meals I can't see having greens with, and I've tried them in oatmeal and it rendered the oats inedible.

It's hard to pick meals to make when one person has to stop losing weight, one has to stop gaining, and both have to eat heart healthy. And now to choose meals that include loads of greens? And to get 6 servings in my husband daily when he eats only 2 meals a day and can't tolerate salads right now? Along with all the other recommendations & guidelines? While hubby still has a poor appetite? ARGH!

I wish VeganMoFo didn't come right in the middle of hubby's recuperation period, when he's still trying to get his appetite back and I was still trying to get this family attuned to eating 100% the Dr. Esselstyn way.

So, right now I reserve the right to change my VeganMoFo theme around once again, and even though I had made out a list of 30 McDougall meals from the McDougall Program for A Healthy Heart book, I will probably go back to my original plan and pick and choose between those two books, Dr. Fuhrman's Cholesterol Protection for Life, and Neal Pinckney's Healthy Heart Handbook, with maybe a few others tossed in here and there.

When I come up with a new menu for next week and pass it by my husband, then I can finally go shopping for the ingredients. Hopefully it'll be a menu we stick with. Last week I planned on making all his old favorites, but it didn't turn out that way. Only twice did I make what was planned, with him changing his mind hours before dinner, one day the minute I was about to start cooking. Yesterday I wound up just roasting up a casserole dish full of scrubbed red and Yukon Gold potatoes and ate them with beans and fresh salsa. Looking back on it, I should have tossed some greens in there, too. He said it was the best meal he had all week. I hope I'll be able to stick with the planned menus for this coming week, but after yesterday, when he gave up his beloved weekly pizza for potatoes, I'm not so sure.

So, I'll be posting a heart-healthy recipe daily. Whether or not I actually get to make it will be another story. If I do, I'll be sure to post photos and comments on it. I know this isn't exactly what VeganMoFo is about, but it's the best I can promise at this time. It's better than posting about aprons, like I had to do during one of the earlier VeganMoFo's I participated in. Last year I did a few about Jeff and Rip's handstand rivalry. Now that was scraping the bottom of the barrel! LOL

Dr. Neal Pinckney - Healing Heart Foundation

Since he's home, my husband's appetite has been poor. Granted, before all this he would rarely eat breakfast - maybe once a month, lunch at work consisted of a white flour potato roll and a slice of yellow American cheese (usually) or a slice of seitan (once in a blue moon) or leftovers on weekends. Dinner was always our big meal for the day and aside from his weekly cheese & pepperoni pizza, would be WFPB, no SOS (Whole Foods Plant Based, no sugar, oil or salt). I think I already mentioned his evening potato chip habit.

None of the old tried and true meals appealed to him this past week, and he's just been picking at everything. He would eat most of his breakfast, but some days skipped lunch and just had some applesauce. At dinner, if he ate about a cup of the meal offered that was it. As a result, the weight is dropping off of him. He's also weak and fatigued probably more than other post-op CABG patients because this is on top of his expected post-op fatigue and anemia. Add to this the effect of being on both a beta blocker and ACE inhibitor so his blood pressure is hovering around 86/50. Unfortunately, I suspect his cardiologist will be happy with the weight loss, even if it does mean he's too weak to even walk around the apartment without feeling like he's about to pass out. My husband's BMI was officially in the overweight category, but he's been at the exact same height and weight since he graduated high school back in the 1960's. The only time he lost was when he had the "Martian Death Flu" back in the early 1970's, before we started dating, when he and his mom were both so sick neither had the energy to get dressed to buy food so they went hungry and slept all day until it was over. As soon as they were both well, the weight came back on within days.

So I went looking through my cardfile for different recipes to make. I looked through Susan V's recipes, Jan Tz's, all the Esselstyn's and McDougall's, the nutritarian ones, Marla's and Sandy's and Jeff's, the EDTV ones, HH and the people she first ripped off, the PPK.

Then I came across a row of recipes that had been neglected for a while, those from Dr. Neal Pinckney's Healing Heart Foundation web site and his book, The Healthy Heart Handbook (available in its entirety at the web site). As I looked over the recipes I realized I hadn't made some of these in ages, that maybe that's what hubby needs to whet his appetite. I went back to the web site's recipe page to see what else is there, and was pleasantly surprised at how many I had passed up in the past that now look appealing! I spent over an hour just copy/pasting recipes, and will most likely spend even more time there later gathering more.

So now I have a list of meals I'm going to be trying as the weeks go on. For this week, hubby already warned me not to make anything fancy, in fact, not to plan on making anything at all, that he has no idea what he'll feel like until the time comes to eat. Really makes it hard to shop and prepare, you know! I do have a container of Jeff's Longevity Soup in the fridge we've been working on, and my freezer is full of veggies and the pantry filled with a variety of grains and pastas, as well as several forms of tomatoes, so most meals I can make up with no notice. For instance, today I hope to make Ann Esselstyn's Potato, Pea and Couscous Hash for dinner, but I won't know until it's time to start cooking if that's what I wind up making. But by next week his appetite should be back and I plan on making a menu to stick to, and I know a number of Dr. Pinckney's recipes will be included on it, like Lima Linguini Diablo and maybe even Okonomiyaki if I feel adventurous. Well, if the doctor eases up some of the sodium restrictions, that is. I'm sure that sauce is pretty high in it, even if I do use only the lower-sodium version. If I do wind up making some new dishes, I'll be sure to pop fresh batteries in the camera and take photos and notes on them.

Hubby Update

Yesterday (7/22/2013) morning he had his by-pass surgery, with 4 arteries grafted. The surgeon said they were positioned in a great place, that they didn't need to put him on the heart-lung machine, avoiding the "post bypass surgery cognitive dysfunction" that Dr. McDougall spoke of about Bill Clinton. No pump, no heart stoppage, no problems. Also, because of this, his surgery was completed in 2 1/2 hours instead of the 4-6 hours we were originally quoted.

He was awake and looking around within a half hour of the completion of the surgery while in the CTICU. The nurses didn't want him ripping anything out so sedated him again.

When I called this morning I was told he was off the respirator since last evening and the breathing tube was removed this morning. Later today not only will they get him out of bed but will make him walk a few steps at the bedside. He can't go far because he's still connected to chest tubes, IV's and other assorted tubes and wires.

The doc said he'll be home in 5 to 7 days.

In the meantime, while all of this has been going on, one car developed transmission trouble, the other had a dead battery while parked on the roof deck of the hospital parking garage on the day it hit 102 (Heat index 110), and my son wound up in the emergency room with an asthma and anxiety attack 2 days later. Oh, and today we have flood warnings out, and 2 of the roads between here and the hospital always flood, so my husband already directed me the other day NOT to come visit him if thunderstorms were even predicted. It's already been raining all night, so those roads are probably flooded already. My son and I will use today to do the laundry, some shopping and cooking, have three meals for the first time since last Tuesday (Heck, ONE hot meal that wasn't leftovers!), and generally decompress. If it's not too hot later (Ha!) I may even make some muffins with the very brown bananas in the refrigerator. I have the phone number to a direct line to the nurse caring for him (ratio is one on one in the Cardiothoracic ICU) and can call any time, day or night and speak directly to her, and when hubby is strong enough, to him, too. The nurse at 5am said he may be strong enough to talk to me later, that his throat was too sore from the trache tube to talk when I called, but he did give a thumbs-up when he heard we may not be coming because of the storms. That did help relieve some of the guilt I was feeling about my decision. :)

So, off to do the first Richard Simmons video for a few days, a nice hot breakfast, a long hot shower, then off to the laundromat with 2 weeks of laundry. 

Thanks again for all those good vibrations and prayers.

Thanks, everyone. 

As it turns out, he has 9 blockages in 3 of the major arteries, one 100%, and a few smaller blockages in other ones. He was immediately admitted after the cath and the doc made arrangements to have him transferred to a larger area hospital this morning for further tests during the weekend while the Plavix gets out of his system, and is scheduled for his surgery Monday morning. The doc told me this is the worst case he's ever seen, the extensive blockages, which is why he wants this taken care of ASAP by the best guy around. One of my husband's uncles had similar blockages in his carotid arteries back in the 1970's, long before all these miracle meds and treatments were developed. Another uncle, with no prior history of cardiovascular  disease, dropped dead while riding the snowblower, and each of these guys had completely different lifestyles than we do, so there must be some genetic component to this. 

The surgeon doing the procedure is the Chairman of Cardiothoracic Surgery for Barnabas Health and a former head of a similar unit in Cleveland Clinic, so hopefully he believe in the Esselstyn way of eating, or at least heard of it, as opposed to every doctor here.

His first meal after the cardiac cath, while still having to lie flat on his back, was a turkey sandwich with chicken noodle soup. At dinner, his tray contained a chicken cutlet coated in congealed globs of some yellow sauce, 6 (I counted) green beans, mashed potatoes with the butter already congealing on top of the mound, tomato soup (again, with congealing grease goblets on the surface), and chocolate pudding. Both meals were served with a can of ginger ale soda and contained salt and extra butter with the silverware and condiments pack. (sigh) I'm glad I had my container of rice and veggies on me!

So, today I'll arrive at the hospital around 8am to catch the doctors and await the ambulance that's transporting him. My husband said he doesn't want us to go to the new hospital today because  1) the heat (It hit 102º yesterday, heat index 112, and the same is forecast for today), 2) traffic is a bitch in that area of Newark, NJ, 3) He doesn't want MY heart over-stressed (My BP is up this week, no surprise), and 4) they'll probably keep him busy with those other tests as soon as he gets settled in. Whether we honor that request or not is still up in the air. Ditto tomorrow, when thunderstorms so severe have been warned of since Tuesday of such intensity that The Weather Channel has had a red warning box around the day in its 10 day forecast. We do know the roads between us and the hospital flood severely in any rain, so as much as it pains me I may have to listen to him and not visit. At least we'll have all day Sunday together, and you can bet your bippy that I'll go with a bag full of already-cooked potatoes, some already cooked veggies, and a few pieces of fruit to munch on, because I certainly don't trust any hospital cafeteria and know the only places to eat around there are fast food joints.

Scribbles, I was so surprised yesterday just going to the stores to get him some PJ's and slippers at how many people we ran into, that either they or their spouses had bypass surgery, one guy as young as age 42! I don't know how all of you (spouses) survived the stress! I know this is just the beginning of a long road ahead, and it's beginning to feel over-whelming already. And this heat!! Not even 5am and it's already 85! I'm stressed enough over just that because it affects my asthma and BP, causing me and my son (also asthmatic) chest discomfort! Now add my husband's situation on top of that?!?! 

The Dangers of Moderation - My Husband's Stress Test Results

For those who bothered to read my post regarding my husband's chest pains the other day, here's a follow-up.

He failed his stress test.

He got extremely short of breath within seconds, his blood pressure spiked and the nurses said he showed EKG changes which indicated cardiac damage and he needs a cardiac cath done ASAP, so it's scheduled for tomorrow. He has the same cardiologist as I had back in 2009 and he and one of the same nurses who assisted in my cardiac cath back then explained that there most likely is some blockage, that the cath will will show how badly and where. If it's in a not-too-bad place and less than 75% blocked the doc said he can first try lifestyle changes, meaning 100% adherence to the food plan of Drs. Esselstyn and McDougall and a strict, strenuous exercise program; but if the blockage is in another area or too solid, he may need an angioplasty, with or without a stent, or even bypass surgery as worst case scenario. The doc & nurse both said that the whole foods, plant-based, no SOS food plan for dinner, his biggest meal of the day, certainly helped and may have prevented this from happening sooner, but those cheese and pepperoni pizzas and cheese sandwiches and potato chips did their own share of the damage.

In either case, my husband is now committed to 100% (Dr., not Rip) Esselstyn/McDougall, and as soon as he's allowed to, a steady exercise program.

We plan next week on packing a box of all the cheat foods that are still in the house and finding a food pantry to donate them to. I'm sure those folks in need would love to have jars of natural peanut and cashew butter, boxes of macaroni and cheese, maybe even bags of potato chips (Unless our son refuses to give them up himself and hides them in his room). We may have a jar or 2 of marinara sauce that have a tiny bit of oil in them, so those will have to go, as will the semolina pastas we have left (only 2 boxes right now because I already stocked up on Tinkayada brown rice pasta when the store had a sale a few weeks ago). Of course, his "emergency" cans of SPAM will have to go. I've been tossing them out as they got outdated (and when they started to swell on the pantry shelf. No kidding!) so there are only 2 of those left, too. Those cans have been here since long before Hurricane Sandy so that tells you how long they've been around.

Of course, if they feed him after the cath tomorrow they'll give him a typical hospital tray of SAD food. After mine they gave me greasy breaded veal parmesan coated with at least a half inch thick layer of mozzarella cheese, as well as very salty broth and ice cream for dessert. I have a cooker of rice going right now and plan on bringing a container of it with veggies to eat for my own breakfast at the hospital tomorrow while he's having the test done. I brought brown rice krispies today but never had a chance to eat them. I'll bring another container for my husband to eat instead of the crap food they give him after the test. Our hospital dietary department has no idea what even "vegetarian" means, much less "whole foods plant based no sugar, oil or salt!"

I hear him stirring about in the kitchen so I guess his nap is over and it's time for lunch. I'll reheat that Awesome Almost All Orange soup for us. It was delicious, BTW. 

Keep your fingers crossed, candles lit and rosary beads humming tomorrow around 7:30am, okay? Thanks.