Prevent and Reverse Heart Disease with Caldwell B. Esselstyn, Jr., M.D.

we have the honor of listening to dr. Caldwell Esselstyn trained as a surgeon at the Cleveland Clinic and is a fellow of the American College of Cardiology. Any of you who have seen the movie Forks Over Knives will learn about his prestigious medical career from the excellent publications he has produced and produced books for medical professionals and non-professionals alike; He served in Vietnam and received the Bronze Star and in 1986 won a gold medal with the US Olympic rowing team. Team Estes, join us. Thank you very much for coming, sir. I really want to thank Naomi and her team for organizing this amazing conference and it is a great pleasure for us as speakers who have felt the passion. this kind of investigation to see that there is interest across the committee now we have a lot of ground to cover and I'm told I have to get you out of here before midnight so I thought we should really start solving the problem.

The key here is that we in this country have to hang our heads in recognition of the fact that we have built a multi-billion dollar healthcare industry around a

disease

that doesn't even exist and half the planet is your

heart

surgeon. and you decide what it is you're going to hang your shingle in Okinawa maybe rural China Central Africa the Tarahumaras the Papal Highlands Trigg on that you better plan on selling pencils why they don't have cardiovascular

disease

why everyone strives for holistic nutrition plant based oil free now this The slide is the oldest in my presentation, taken in 1968 when I was leaving Vietnam as a combat surgeon and it reminds me to share with the audience that if we do autopsies in our young GIS, the average age is 20 years, 80% of those who had autopsies in Korea had obvious evidence of coronary artery disease that could be seen without a microscope, still not enough for their cardiac event, but here the disease was already entrenched.

That study was repeated 45 years later. Now I'm looking at those young women and then. between the ages of 17 and 34 who have died from homicides and direct suicides, now the disease is omnipresent, it is not enough for your cardiac events, but here in this country, if you graduate from high school, you will get a diploma and also you will get the basis for cardiovascular diseases. illness now, is there anyone here in the audience who is over 17 years old? It's always much more exciting when you talk to patients. Well now we had the opportunity as a medical community to get it right in World War II, that was when the Axis powers of Germany over the Netherlands of Holland and Belgium and occupied Denmark and Norway and in 1951 the doctors Strom and Janssen and the England's leading medical journal, The Lancet, examined death rates from strokes and

heart

attacks in Norway during this period and it was interesting overall if we look here at deaths from heart attacks and strokes in Norway in 1927, going up to 1938, going up to 35, going up to 39 and we get to the 14141 Germans who knew that these Germans were these great public health educators, but look what happened in 1945 with the death of Adolf Hitler the cessation of hostilities in the European theater immediately returns the meat returns dairy returns strokes and heart attacks return but unfortunately we didn't get it right now here the plot thickens in the next four One or five slides would be the most important in my presentation if you look at the right, obviously, it's a terribly diseased artery and it's taken many decades to get it and you're probably saying when that's finally going to close that little opening there.

In that right artery there will be a heart attack, but I really only know that about ten percent of heart attacks come from something that is that chronic or that serious, but I want you to know that here on the left we have a normal artery and even those of you. in the back of the room we can see that delicate inner lining of a normal artery that little dark line the endothelium that all the experts would agree that the endothelium is absolutely the lifesaver and the guardian of our blood vessels because it makes a real magic molecule of nitric oxide gas which has some really remarkable functions now on the left when you start eating the cheeseburger the hamburger the malted pizza everything suddenly starts to get sticky sticky your platelets your white blood cells your LDL cholesterol everything gets sticky this is the interface Blood flows here in this blue area and you can notice the small endothelial cells that separate the artery wall from the blood flow.

Now up here on the top left, these little orange LDL cholesterol molecules get so gooey on the pizza. I've been eating and the endothelium is sticky and has some cracks and fissures, so, look, your LDL cholesterol migrates and finds its way into the subendothelial space where it quickly gets oxidized by these free radicals as this type of food you're eating like this. that now the submental across the space of those companions does not like these hard, dense little particles of LDL and calls the SWAT team on our white blood cells, which Peter, who is from Harvard, has painted blue in honor of Yale and us I would like that now.

You see this macrophage gobbling up all these hard, dense little particles of LDL until we get here, when we do what we do so often in medicine, we change the name, now it's called the foam cell and the foam cell is really the Darth Vader of this sequence because it produces these nasty metalloproteinases proteinases and these nasty metalloproteinase enzymes tend to thin the layer over the plaque here on the left, you can see how thin the top of this layer is and what happens is it gets so thin that the pure force of the blood running over it tears it and now, suddenly, we have the rupture, this is a fundamental moment, you have a rupture of a plate that is no larger than 10 20 30 40 or 50 percent and now there is relief outside or extravasation into the flowing blood which activates our platelets our clotting factor and before you know it we are here to be in a matter of minutes now we are forming a clot and this clot itself self-propagates So in a matter of minutes more, not only are we over the sea and the clot is completely blocking this artery, so all the descending blood flow here stops this heart or cardiac muscle here, totally deprived of oxygen and nutrients, and it starts to die. and that's 90 percent of your heart attacks now, if I do my job correctly for you today, every one of you and your friends and family should be able to be a heart attack test, we're not going to do this, you're not going to make yourself heart attack proof with another medication or a pill or a procedure or an operation you are going to do it by changing your biochemistry how you are going to change your biochemistry by completely changing whole food plant-based nutrition when you do stop completely stop this nasty cascade of events I just described things don't get sticky no LDL migration to the subendothelial space no SWAT team no foam cell actually won't erode or thin the layer covering your plaque will strengthen the layer covering your plaque if it strengthens the layer that covers your plaque it can't break if it can't break it has been made heart attack proof we think it will take about three weeks For that to happen now, you can forget about the x-ray, but I want you to notice that half of the opening is a plaque and the other half is still opening and these are the endothelial cells.

We used to think until 1980. We used to think. of the endothelial cell like one of those nice red bricks that just lined one of our tubes that everything changed in 1980 in 1980 the doctor started working in Brooklyn he was taking the largest blood vessel in the rodent, the aorta, and he would do this type of an elliptical spiral staircase that crossed the endothelium he immersed it in the saline bath and one day it would contract without cutting, he immersed the aorta that dilated he did it again it dilated now suddenly the race began globally what was the e d RF The first doctor God had discovered the relaxation factor derived from the endothelium.

Thank God, that term was with us for only eight years when Dr. Lube Ignarro first obtained it and Dr. Murad discovered that EDR F was a nitric oxide gas for which they won the Nobel Prize in 1998. What is it about nitric oxide what makes it so special? Nitric oxide keeps all the cellular elements in our bloodstream flowing smoothly like Teflon instead of a filter. Nitric oxide is the strongest blood vessel in the body when you climb stairs the arteries to your legs to your heart widen it dilated nitric number three nitric oxide

prevent

s the wall of your artery from becoming diseased, stiff or inflamed protects you from having high blood pressure or hypertension number four nitric oxide nitric oxide in a normal, healthy amount will protect you from developing blockages or plaque, so literally everyone on the planet, whether they are from Chicago, New York, London, Berlin or work Of narf, if they have cardiovascular disease, it's because by now Over the previous decades, they have caused such serious injuries and turned their endothelial system into a mess that they don't have enough nitric oxide to protect themselves from plaque blockages, but the The good news is that this is not a malignant disease once you get patients to understand that they should never again pass any morsel of food that could further jeopardize the danger and compromise the ability of their endothelial cells to produce nitric oxide, then the endothelial cells recover.

The progression of your disease stops. We often see significant elements of the disease.

reverse

now, how do you measure nitric oxide? An ultrasound probe is taken, placed over the brachial artery at the elbow and there on the screen it is read, then, for five minutes, it is inserted from the inflated upper arm above the bust, the systolic blood pressure so that , for In five minutes there is no blood flow in the forearm and hand. I've done it, it's not exactly addictive, but still, when you immediately release the cuff, we measure the diameter of the brachial artery and in a normal individual it will be 30%. older now the next thing that happened was interesting when dr.

Robert Fogel, chair of cardiology at the University of Maryland, took a group of healthy young people to a certain fast food restaurant characterized by arches that are: half of him received the cornflakes of the brachial artery, the cat tourniquet in breast, those who ate French fries and sausages in a 120-minute break. your heart and your tourniquet test were unable to donate the artery that one meal of French fries and sausages had so damaged the ability of your endothelial cells to produce nitric oxide that they did not have enough to dilate your artery but being young they followed them until the end late Early in the evening they started to recover but you and I know that the next morning for breakfast it will be scrambled eggs with bacon.

For lunch we will have white bread with sausages and mayonnaise. for dinner baked potatoes with sour cream lamb chops vegetables soaked in butter. ranch dressing on the salad ice cream for dessert here in the good old United States we started in our childhood hammering and beating and damaging our endothelial cell system all day long while I was emphasizing right now the endothelial cells, these are three other very defense mechanisms important that our bodies have reached midnight, we could discuss the others, but let me say this, each of these members of the optimal defense vaccines are completely increased when you eat plant-based nutrition, when you eat plant-based nutrition, you are doing let all of these work as best as possible, let's get some results, this is the first study I did, it was small because I was still actively involved in surgery, nothing against women, it's just the way patients were sent to me.

They all had severe triple vessel coronary artery disease and I wanted them to avoid foods that damage endothelial cells every time they pass the lips any drop of oil olive oil corn oil soybean oil safflower oil sunflower oil oil coconut palm oil oil and a cookie or just a piece of bread oil in salad dressing and with a mother or a face fish poultry chicken turkey eggs and dairy-free milk cream butter cheese ice cream sugar-free yogurt and I don't like coffee with caffeine now here is a peer reviewed scientific article for those of you who are nervous about what I just said about oil Allah, I love the intake of soybean and palm oil have a similar acute detrimental effect on endothelial function in healthy young subjects, this is the hallmark of the Cleveland Clinic workers and this is how those who are paleo argue, all these foods contain lecithin and carnitine molecules and Stan Hazendiscovered that when these molecules are ingested through these foods, people who are omnivores have in their microbiome, the bacteria in their gut will metabolize lecithin and Connaughton into trimethylamine TMA, which is rapidly oxidized. by your liver to trimethylamine oxide and trimethylamine oxide damages your blood vessels here is the scheme of lecithin in carnitine has bacteria trimethylamine oxide vascular disease however, Stan discovered that if those people were completely plant-based FINA by Lambchop check your non TM AO blood pretty exciting However, if you decide to cut that lab for 4 or 5 days in a row, you will now turn your bacteria into nasty bacteria.

I'm going to change the subject for a moment because in October 2015, the World Health Organization did what no one thought could be achieved. All of these different nations got together and agreed that red meat had the same level of carcinogenicity as smoking cigarettes. So what are you going to eat? You're going to eat all these wonderful whole grains for your cereal bread and pasta. 101 different. types of legumes and lentils, all these wonderful red, yellow and green leafy vegetables and some fruits, now a comment here about something we've started in the last six and a half years, it's not in my book, but I do convince a patient with heart disease so imagine shrinking your head to get into your coronary artery, you can see that the plaque is an absolute clone. of oxidative inflammation now that's why we eat antioxidants but no, don't go to the health food store buy a bottle of pills that says antioxidant because it doesn't work, they're going to be harmful antioxidants that we want you to get from your food, what food foods high in what we call the AK value or the oxygen radical absorbance of air conditioning, blueberries, strawberries and blackberries in your morning oatmeal cereal, is a great start, but nothing can beat the antioxidant value of leafy vegetables greens, so I asked these patients not to chew smoothies, not juices, chew a green leafy vegetable about six times a day, but about the size of a fist after having boiled it in water for five and a half to six minutes to Make it tender and nice, and then you should anoint it with several drops of a delicious balsamic vinegar because it has been shown that the acidic acid in balsamic vinegar restores the enzyme nitric oxide synthase that is contained within the endothelial cell responsible for producing nitric oxide, so that you're going to chew this along with your breakfast cereal again there's a mid-morning snack again with your lunch and sandwich that's three in the afternoon for dinner five God, I love it.

Could you have that kale snack at night? What do you do all day? You're bathing and enjoying that horrible oxidative cauldron of inflammation with nature's most powerful antioxidant now you're going to say what greens she's talking about: bok choy chard, kale, collard greens, beet greens, mustard greens , turnip greens, napa cabbage, Brussels sprouts, broccoli, cauliflower, cilantro, parsley, spinach and arugula and asparagus and the top five are kale, chard, spinach, arugula and beet greens. Look, it also helps your memory now in this first group. I want to share with you several disease reversal angiograms after you have seen the next three slides.

More than 90% of doctors in this country know that this disease is reversible. This is the left anterior descending coronary artery of a 67-year-old retired pediatrician. This is as small and improvement as the eye can see. Look here from left to left. right in this next up to the leaves here to see this is the circumplex and a 58 year old factory worker and this was described as a 20% improvement from here to the right to here, it's even easier to see in this next the right coronary artery where this was described as a 30% improvement from here to here now next is my colleague this is Joe Crow and Joe replaced me as chair of the breast cancer task force in 1996, at age 44 he started to have chest pain, no a non-diabetic non-hypertensive smoker with no family history exercises regularly but cardiology examined him in October 1996 and could not find anything a month later he finished his surgical program he sat down to do the guards' post-op when of suddenly the sitting elephant appeared they painted his chest his jaw shoulder arm having a heart attack they tore him to the catheterization laboratory they started the catheterization cardiac arrest they resuscitated the catheterization he finished another cardiac arrest then he stabilized three days later they discharged him but very depressed because at the time of At his angiogram, what they had found was that the entire lower third of his left anterior that descended through the Widowmaker, the entire lower third was moth-eaten and diseased into two much longer segments to hit immediately after the stent and it was too much I was very depressed, so I took Joe Aaron's wife out to dinner two weeks after his heart attack.

Joe, come on, you've been eating this horrible, horrible Western diet. I have the typical illness, why don't you think about turning to plants? We have ten years of data. Okay, yeah, I'll try. They couldn't offer me anything else, but I'm not going to accept any. of those statins I don't trust them, well, that's your decision, it's not a problem, he became the absolute embodiment of the commitment to whole plant-based nutrition for the next two and a half years, his total cholesterol plummeted, his LDL cholesterol went from 98 to 38 then they did another angiogram and the day at noon I found out he had his follow up angiogram earlier in the morning, I walked into his office and there he was sitting behind the desk, I said, Joe, listen, How was the follow-up angiogram come on, you came, putting your arms around me, you said, I think we're doing good, so I said, well, that's great, but how about is there any chance I can see the angiogram? and he said, sure, now this isn't going to happen.

It happens to everyone, but when the plant is young and soft and composed of inflammation, cholesterol and fat, the body has a remarkable ability to get rid of this. However, my job today, before the subtalk is over, will be to show you how even those patients who have old plaque formed by fibrosis and calcification scars and are unlikely to be changed or modified now, even those patients return to their activities. daily without restrictions, despite my bright personality, we had six of the original 24 patients I met in the first 24 months, well, excuse me. I knew it was in the first two or three months that they just didn't get it.

I didn't have the money for this study, so with my blessing and their opinion, we turned over full time to their expert cardiologists and followed them as a kind of quasi-control group for the next 12 years and four of the six had to undergo surgery. another operation and die, on the other hand, what happens to the 18 of the state with the program that we wanted to know in the eight years? before entering the program while they were in the hands of expert cardiologists, how many disease progression events were there in those eight years before entering our study and were there these 49 events categorized as seen here on this slide, however, a time? those 18 patients entered our study over the next 12 years 17 those 18 had no further events, we had one little sheep that strayed from the flock after six years, got into lamb chops, chips and glazed or nuts, had more pain and had a bypass, but Now he's back with the flock, but it proves the point that I'm trying to share with you today, so it's exciting since for us we took a pretty good hit, people said, wait a minute, This is a small study, dr.

Esselstyn, this diet of yours is really quite extreme, strict, severe and draconian, and how do you know that you can do this again and with a larger group and you will get similar results? By the way, let me say it when someone calls our diet harsh, strict, extreme. draconian, that is the diet that half of the planet Earth eats and that never has this disease, but the diet that is really extremely strict and with serious corneal lesions is the one that ninety-seven percent of Americans eat every year. days and that guarantees that before they die they want to perish along with some horrible chronic disease, okay, so this is the second study, it's 200 patients and the Journal of Family Practice from July 2014 were lost to follow-up, but of course What we are particularly proud of is that you can see how many were here at 89.3 almost 90% adhered to our program, how do you make that happen?

Because most doctors who want to use this approach say that dr. Esselstyn I just couldn't get my patients to do this and it's not that the message is wrong, it's how the message is articulated. The only way I think people will make a change in their lifestyle is by showing them respect, the only way. What I know is that showing respect to a patient is giving them my time, so several things right now once a month, usually for no more than 12 or 16 patients, always with your partner or spouse, you must have the spouse or partner there , we have a One day they will receive a six-hour program because they come from the route from Canada through the United States.

A six hour program you will learn all about how they have created this disease and precisely how we are going to empower them as the place. of control to stop and

reverse

their disease and you have to have a little fun with them, for example, when we have the group there and I will say now remind me again how often you use someone how often you eat out Oh dr. Esselstyn not very often, let me try again, how often do you eat out? Maybe it's three or three times a week, okay, so yeah, that's a hundred and fifty-six days out of the 365 that you're taking and you're already training the destroyed endothelium and you're trying to train ruining it more that doesn't make sense look there's four there are four reasons to go out to eat one you don't cook two you don't wash the dishes three you don't wash are not three is the environment four is the company to go out to eat to further destroy more endothelial cells and I must also say that two weeks before we have our seminar, my secretary will send me a list of the names and phone numbers of the patients and then I personally insist on calling each one of them because I want to know their story and I want them to have the opportunity to ask me questions so that when they come to the seminar Let's have a solid platform from which we can all move forward now.

I'm very proud of the fact that look, how do you know they were sick? 119 and I 177 had already had a stent or a bypass and this is what is becoming colossal. Now we're at the point where pretty much anyone who was asked to have it done. any elective stent or bypass, but are willing to follow raw plant-based nutrition, they will rarely, rarely, rarely have to undergo that intervention, so here are the results of those who are adherent. We had a patient who had a small stroke on the 21st who does not meet the 62% in disease progression now.

I decided to compare our results to some of the more well-known standard studies out there and this one on the left is the primary cardiac event, heart attack, stroke and death, so let's look at it. on the far right, that's the Mediterranean, being on a diet, heart study at the end of four years, 25 percent will have had a heart attack, stroke or death, next to it is the natural history of coronary heart disease from the Hospital Columbia in New York City, 20 percent of the heart. attack stroke and death at four years and then next to 19.4% of karate bones, but look here, we are six tenths of a percent away, which is a difference of more than 30 times.

What's going on here? Why is there such a difference between our results and theirs? because since the days of Hippocrates there has been a basic pact of trust that, whenever possible, the caregiver will share with the patient what the cause of the disease is and, unfortunately, today in cardiovascular medicine that is not done, along with other current speakers. I am proud to join them. We were asked to become members of the Committee on Nutrition and the American College of Cardiology and we are trying very aggressively to see if we can educate cardiologists about the importance of the cause of disease. have been appointed to treat now, precisely the same month that I wrote another article about three patients, what right do I have to write about three patients, well, all three were an absolute history of President Carter's disaster and, by the way, let me be sure that you understand that he hugs his friends, his friends.

I have great respect for the caring, compassion and knowledge of my cardiovascular colleagues, but you know that openness can be the best, even better, so here is an interesting I studied three patients, thefirst he is actually from Newfoundland, Canada, and I met my I didn't know Bob Mercer, but I corresponded with him by phone and by mail when he was 44 he had a stroke he had a partial occlusion of his right carotid it was actually a collusion total and a small stroke, but he had such severe angina that they discovered that a daring surgeon in Toronto would operate on him.

I was the one who was totally blocked. Gerardo Torrado overcame that operation and had a wonderful result. Until he was 69 years old, he had problems, diabetes, severe angina, erectile dysfunction and out of control diabetes and the only carotid artery he had left was 90% of all the things that had happened to him at that time. His 37-year-old daughter had a heart attack during her convalescence and found a book called Preventing and Reversing Heart Disease and said Dad, we should do this together. They did it one year. I received a letter from Bob Mercy Dr. Esselstyn, thank you, my angina is gone, I lost 40 pounds, my diabetes is gone, my shattered tile dysfunction is gone and my only remaining carotid artery, which was in the 90 block, is now in the block 67%, here's Bob Mercy, now these other two sets of artistic arrows are in 32 years old in Cleveland he became diabetic 42 years old in Cleveland he had angina and at the Cleveland Clinic, my alma mater, he had the first of 14 since then They told him these don't work, they should be avoided, that was great for another year and a half. in China and they said there was nothing more they could do from an intervention standpoint, you have to deal with medications and he found his way through our program he lost 40 pounds he got rid of his diabetes he got rid of all the tonsils and I think I also have an art picture here, yes, and he appears every month at our seminar.

Now the other one is Jim McNamara, who had a small stroke because he was prediabetic in his right carotid artery and then he started getting horrible sonication and they failed him. The first operation failed his protruding leg. The first second operation on his leg failed. The third surgery on his leg failed and he was miserable when he tried to lift his leg to go to sleep due to severe tingling and he jumped on board and lost 40 pounds. He lost everything. of his prediabetic state and now he can walk without stopping without problems with his circulation he arrived late so there is no mortality from the Diana there is no morbidity with the diet the benefits improve over time there are no additional expenses because you have to eat and you think about a patient who has had a heart attack, they are walking around with the sword of Damocles hanging over their head, when will I have my next heart attack?

Dan says you'll never have to have your next heart attack, you eat in a way you make yourself, you're intact, proof what the hell it's good to have a big part of if your brain isn't there. We gained a lot of information about this through work. from Megan Leary and her team on the West Coast, who in 2001 at the Miami Stroke Meetings looked at more than 5.5 billion eyes of Americans' brains and found that at age 50 you started noticing these little white dots tiny ones that started at appear on the American brand these are small strokes, but come on, you're 50 years old, a big brain, a small stroke, it's not a problem.

Suddenly I thought that now you are 65 years old, you are no longer 50 and more often also before you say honey, huh, where was I? leave the car keys you get to that bingo downstairs you're 75 years old you look at her and she says honey where did I leave the car well guess what for that suddenly you're 85 and you look at her and say are you my love? I can't take it back from suddenly having dementia on your 85th birthday. You look hard at all those previous decades to lay the groundwork so that dementia doesn't have to happen.

You know, here's a normal MRI. I counted. 90 in these, can you imagine a message trying to get through that scar now look carefully here on the left the brain reaches the skull look carefully here on the right there is a large gap between the brain and the skull that is cerebral? atrophy you don't want that as you get older you want your brain to grow roar you know how you do that exercise well you're going to do it walking four or five times a week fast enough to almost break a sweat o You can ride a bike in your pants, but the Exercise is the key just as it is for the following situation.

You can see on the left the normal thigh muscle of a 40 year old triathlete. At the top right you can see the thigh muscle of a 70-year-old couch potato. right lower thigh muscle of a 70 year old triathlete keeps moving now here on the left you are looking at the pulse volume and a patient who came to my office and crossed the Skyway had to stop five times due to pain in his right claudication in the calf and if so, I was so focused on his heart that I completely forgot about his leg 11 months later, said dr.

Esselstyn, do you remember the first time I thought about seeing you or stopped five times across the Skyway to your office? Yeah, you said you know this last month turned into four times, three times, two times, once I don't stop anymore when you go to the vascular. now the lab work on the right the pause file is double what we had now within fifteen months of starting the study we had absolutely irrefutable scientific data that food and food alone could absolutely reverse cardiovascular disease and you will say, wait a minute, what about the statin, well this is the second patient I'm sharing with you today, dr.

Crowe, who refused, and this patient, Don, in 1986, we didn't have any statins back then, so even the many patients who come to see us who are just paralyzed by statins and can't take them are not deterred. to enjoy these benefits. Here's another one. This is a 78-year-old retired high school chemistry teacher, in his retirement, he and his wife love Sandra in this square dance competition, but during the quick square dance, he was feeling bilateral calf pain, so who saw these vascular surgeons and they got the images that you See here that show how seriously ill he was, but he didn't like the big operation they had planned for him.

He came to see us during counseling, Dr. Esselstyn said, if I choose his method, how long will it take me to get rid of this pain in my calves? So I looked him very wisely in the face and told him that this would probably take about 10 or 11 months and three months after that. I received a phone call dr. Esselstyn, you are not telling the truth, the pain is gone, it's okay, I don't know. I'm assuming you're all from this general area of ​​Virginia, but I have to share with you that in Ohio when you watch a mystery or a sport. event just before the ad appears, you will hear the announcers' honeyed tones say something like when the time is right, will you be ready?

Now we all know that the penile artery is actually quite small compared to the size of the coronary artery, so no. Infrequently, before someone suffers from heart disease, they may no longer be able to raise the flag. However, all is not lost. It's not uncommon for 10 or 11 months after you've told someone to receive a phone call. Esselstyn yes, they said mr. so-and-so sure couldn't hear from you, yeah, I said I really thought I should call you because something came up recently and I'm wondering if I don't owe you another check now. I promise you today before.

In conclusion, I wanted to share with you how those patients who have a plaque composed of fibrosis, scar and calcification can still return to activities of daily living without restrictions. it's rubidium pet diaper animal heart scan and translation if it's orange or yellow that's good you're on the left but right down here where it's green that's bad that's poor blood supply. We call that ischemia now at the time he had that first PET scan I advised him and 20 no and 10 days later his cholesterol from 248 to 137 and then three weeks after his first PET scan we repeated it now look to the right, everything It's back, wait a minute, we didn't eliminate anyone I got rid of a plaque in three weeks what's happening here now this is what here is what the story is if you look closely you will see that this is a heart with no name, without any muscle , you're looking at the heart and you see those three big epicardial arteries in the right corner are the left anterior descending and the circumflex that get all the publicity, all the Stan and bypass interventions, but look where each of those arteries goes, It will get smaller and smaller as it sinks into the heart muscle.

That's where all the oxygen and nutrients transported by this argument go to the muscle, there are thousands of them there, so I asked Rodriguez, who at the Cleveland Clinic is the director of the cardiovascular pathology laboratory and dies sexes 200 hearts a year by deceased and I said how often do you see a good standard garden variety after this chronic plaque in the artery once it has entered the muscle never never once in a while very very good in a severe diabetic otherwise never , so this is what happens when At this point we first see these patients, you already know that their endothelial system is garbage, in fact, it is now your enemy, it is doing almost no nitric oxide, your friend and now It is producing two molecules that are against you, endothelium and thromboxane, which are basal. blood vessel constrictors, so this whole bundle of arteries, when you first see them, all those thousands, our babies are constricted and as soon as you get those patients to stop re-damaging their endothelial system, as they become recovers, it stops producing the basal constrictor that begins. doing the nitric oxide vasodilator and it opens up that whole huge cascade of intramuscular vessels and that's why you hear patients say that those with angina in a matter of days their disease is improving is quite exciting, but that seems to be what's happening here are the eight measures of disease reversal you can see it in an angiogram you can see it in the stress test I just talked to you about the PET scan we talked about the carotid we talked about the volume of the pulse with the leg and the three symptoms of angina, Claudication and Erectile Dysfunction concluding for those of you who don't come to Cleveland very often.

This is the building where I worked on the eighth floor for many years as a surgeon when I bring it to you because I want you to know what the trees look like. like in Cleveland in February, however, now that I have retired from surgery, I have moved to the Wellness Institute at the Cleveland Clinic and, although the budget is more modest, I can assure you that morale is quite high. and I always like to end with my favorite. This is a woman in Life magazine trying to learn how to do the splits and even though it's been 50 57 years since I left medical school, I'm just saying that while the brain is important, nothing is as important as persistence persistence persistence best exemplified. by this young damsel Life Magazine from 1939 trying to learn how to do the splits but it's hard she stood her ground and all the things that happened the other day in downtown Norfolk Nayomi saw her and now she had I got it right.

I just want to summarize with some comments. One if. I remember we started late. The questions still. I guess the reason I found myself when I was thinking about my career as a surgeon. Why did I think that when I retire from surgery I will leave? to learn two things, I'm going to learn to play the piano and I'm going to learn to win a good serve, neither of those things could have been beaten, but why? Because I really see before us in medicine what I really think could be an absolute seismic revolution and this seismic revolution in health that we have before us is never going to happen with another pill or another medication, the seismic revolution is never going to happen. through another procedure or an operation, but the seismic revolution will come about when we in the profession have the will, the courage and the determination to share with the poet what is the lifestyle and, more specifically, what is the nutritional literacy that the It will empower as the locus of control to completely annihilate chronic diseases.

Thank you. I won't let you ask another question, well, we will open the space for questions now that you are looking for difficult ways about tap water and alkaline water and the benefits of tap water and alkaline water. Do you have any ideas about them and their potentials? benefits not whatever you want I mean what kind of water did the Okinawans eat what kind of water did they drink Central Africa I think so. I don't have any problem with either of them. I have a question for you. You talked earlier about how effective eating on campus is based on young soft plaque and I know you mentioned at the end that you were talking about some of the more advanced disease states that I hadn't heard of and I was just curious how that affects someone with a score high calcium and how thatit works to reverse calcium or stop progression and I have a quick second question about something I haven't heard of addressed: the effects of this on elevated lipoproteins.

You know, the calcium score is something interesting and important when you get a calcium score. That tells the doctor two things, it tells us that you have coronary artery disease but it also tells us that you have a number of black inflamed non-calcified arteries. It is the inflamed non-calcified ones that are the most dangerous because those are the ones that can rupture but and this is something that I think most doctors don't know, but it was something that Dr. Bill Castelli taught me years ago. Casselli was for many years the director of the world famous Framingham study and he said that if you find someone who scored high in counseling and does it absolutely well and for the next year eats whole foods, plant-based, then they have another score. of calcium and if it was a hundred at the beginning, now it may be 175 or 200, but he said the patient is much better because what happened is during the time that they are eating whole plant-based foods, which are very powerful. as an anti-inflammatory, since the previously non-calcified inflamed plaques are losing their inflammation, it is as if the body wanted to take action and accelerate the suffocation of this inflammation by pouring some calcium into those plaques that were not previously causal. pipeline, so if your doctor tells you, Mike, I know that the plant-based diet you're on is making you worse, that's absolutely wrong.

Well, now the other one was about developing a small LP. Yes, sir, what is 20 percent of approximately the The population will have small LP. What do you think they do with the small LP area in central Africa in Okinawa? How many of you have ever checked your little one's health? I think that's the pretty good consensus. I have shared with you today that everyone in this audience and all friends and family should eat in a way that builds absolute endothelial strength. Your endothelium is strong and resilient and therefore you do have a strong LP and even if you have a small LP.

It's going to be harmless. Do you know something you have to think about when we get too carried away with cholesterol? Do you think that when the human body formed hundreds of thousands of years ago we came this far with an understanding of our The body has this understanding that every cell membrane in our body is made of cholesterol. Now we're just going to say that when we were somehow reformed we were blessed with an organ that produced cholesterol that would make us all. Vascular Rex I don't believe that for a minute. I mean, if you had, say, a thousand people who absolutely follow the program that I adopt for tea, there will be some who will have a cholesterol of 110 or 140, 160, 180, 200, 220, but as long as they eat so that they have an endothelial strength, I don't think that should be a cause for concern.

The question is, the last slide you showed was where all Americans will have some type of atherosclerosis and, in some ways, most of the patients that we see in the clinic, for example, middle-aged patients. Norris factors get good exercise and Restorick cardiovascular disease risk factors score maybe less than 7.5%, but in India it is difficult for some of these patients.get it, you know, 105 in most of cases stays in that 95 to 105 range or do this to need a statin if you even follow a star, yeah, I think that's an excellent point, but remember this, what are you going to do with your patient, who such maybe you know?

He will make you feel better because their number will be smaller, but I'm not sure they have to have that because, as I mentioned, we have a lot of patients who have come to us who just can't take a set. There are four. The side effects evaluated are mental confusion about severe muscle pain, the other is of course a liver problem and therefore if the patient has an LDL of eleven five and eats in a way that maintains absolute endothelial strength, he should work absolutely well because it is the injury to the endothelium where this disease originates.

That's for all the experts that I'm familiar with who agree that this disease had MS onset and, but yeah, but do this and do it right. You know, it really makes you think twice every time you want to go out to eat and, for example, I had a patient last week. No one I've seen, but some of the guys who got a phone call said they had been following our program and although four years earlier he had a pair of stents put in, after finishing a 5K last Sunday he was hospitalized with a heart attack and had told his wife that he told her to follow our program 100% but 100% does not include In every lunch at his workplace, he ate the Beyond Beyond Beyond Me burger, etc., which are loaded with coconut and all oils that are transported in pieces.

Thank you very much for being here and I would like to ask you specifically the importance. of leafy greens kale Swiss chard spinach beet greens What if you are taking a medication like whorfin due to a genetic disorder and can't take these leafy greens? How can you get the benefit without eating them? The problem is often. comes up with patients who have atrial fibrillation and are taking coumadin and their question about everyone buying them Cavey, you are eating with these four vegetables makes it difficult and what is more or less the consensus of those who understand this and do it well is If it speaks with the doctor doing the anticoagulation, have you taken coumadin and are you excelling on them?

Look, I'm going to constantly eat this amount of green leafy vegetables and then they will appropriately adjust the coumadin level so that it has achieved the level of anticoagulation that is appropriate and on the other hand what you have presented is a little more challenging do you have some congenital condition no? I know what that condition is that you probably have a clotting disorder that requires you to be taking blood thinners that may increase the risk of blood clots in the legs or lungs. Yes, then I would do it again. If you come, you would talk to your doctor and say, "Listen.

I really don't think I should be excluded." enjoying the healthiest foods on the planet and perhaps they would agree to allow you to increase your vegetables and will appropriately adjust your coumadin dosage so that you can still achieve your target level of anticoagulation. Thank you so much. I feel very grateful and grateful. being here and you being here today my question is about homocysteine ​​levels, how do you feel about that and why a homocysteine? Yes, I think most people will realize that when they eat a whole plant-based food, the esteem of the homeless will not increase, you know, we should request a test and be proactive, or the doctor, even if You don't have heart disease, do you think you need to have your hours checked?

Do you know one of the things that is leading us? to debtor's prison as a country faster than anything you can imagine is healthcare and one of the things we do with healthcare is we have all these tests and it's amazing how much testing costs just to get a CT scan, it's thousands of dollars and even when you go and get a metabolic panel done for blood work, all of this costs, so I'm leaning more and more toward the next partnership to try to keep the testing to an absolute minimum that's consistent with safety. for the patient, but I think if someone is eating totally, without exception, both foods, plant-based nutrition, they will hit all their numbers, they will be somewhere where they should be right now, and we should mention about a word about omega-3 se It's going to talk a lot because right now the American Heart Association is having its annual meeting and there's a paper that for the first time contradicts what we've learned before that fish oil is supposed to be beneficial. tablets now that paper was sponsored by the fish oil tablet manufacturer and that always raises a flag, however look at what they are looking at if you want to get omega-3.

I don't want you to have to get it with oil that may have PCBs, dioxins, etc., and mercury, if you want to get omega-3 in ice you should be able to get it in flaxseed meal, chia seeds, and lots of leafy greens; however, if you control your omega-3 and get Omega Control, you will get it should be optimal at a minimal or moderate level or too low and if it is too low then I would say take omega-3 tablets, not an oil, but They are made with algae, that's the idea and this way and also be a little conservative. about these these tests just ended, it's gotten to the point where insurance companies are still paying for them, but god they are so expensive and all the money we have as a country should go towards education, restoring the grid and infrastructure . get into health, which is crazy because of people who eat well, this wouldn't be a problem, it's just interesting that there are two authors from the University of Chicago, 1999, until Pell and Murphy, who wrote in Chicago University Press , they estimated that this country could eliminate heart disease we would save 40 billion dollars I will probably be reprimanded for what I am going to say but this was my personal decision I am 66 years old Almost two years ago I had a stent placed in 90 percent of the block 30 doctor Prescription medications are four or five medications that I only talked about for two weeks because how they are made and because I was extremely concerned about the long term side effects that I have been in general.

I will say that in making that decision not to take the medications it was extremely stressful because it allows us to make a big decision or not and now that I have been to a doctor in two years I feel like I need to go to one and I'm not sure what tests I should take ". We are asking because my doctor said that if I want to recover, I will go off my prescription medications, but I feel great. I'm strong. I just started using p90x. Good job.