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A Way to Reverse CAD

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  • A Way to Reverse CAD

    THE JOURNAL OF FAMILY PRACTICE | JULY 2014 | VOL 63, NO 7Caldwell B. Esselstyn Jr, MD; Gina Gendy, MD; Jonathan Doyle, MCS; Mladen Golubic, MD, PhD; Michael F. Roizen, MD The Wellness Institute

    Though current medical and surgical treatments manage coronary artery disease, they do little to prevent or stop it. Nutritional intervention, as shown in our study and others, has halted and even reversed CAD


    Purpose: Plant-based nutrition achieved coronary artery disease (CAD) arrest and re-versal in a small study. However, there was skepticism that this approach could succeed in a larger group of patients.The purpose of our follow-up study was to define the degree of adherence and outcomes of 198 consecutive patient volunteers who received counseling to convert from a usual diet to plant-based nutrition.


    We followed 198 consecutive patients counseled in plant-based nutrition. These patients with established cardiovascular disease (CVD) were interested in transitioning to plant-based nutrition as an adjunct to usual cardiovascular care. We considered partici-pants adherent if they eliminated dairy, fish, and meat, and added oil.


    Of the 198 patients with CVD, 177 (89%) were adherent. Major cardiac events judged to be recurrent disease totaled one stroke in the adherent cardiovascular participants—a recurrent event rate of .6%, significantly less than reported by other studies of plant-based nutrition therapy. Thirteen of 21 (62%) nonadherent participants experienced adverse events.

  • #2
    fatmax - My cardiologist is telling me either stents or bypass surgery, so I am trying to find the best and quickest solution. I have about 4 more months to show some improvement. Are there equivalent studies that show that a high fat diet can reverse existing heart disease?

    I eat a vegetarian diet because I had too. I have several snps that indicate a likely problem digesting and metabolizing saturated fat. The longer I stayed on a high fat diet, the worse I got. I have to keep saturated fat under 10 g a day to stay out of the ER.

    The study I linked is of people diagnosed with cardiovascular disease and how 99.4% of people who adhered to the diet did not have another recurrent event. Is there another study that is anywhere close to this success rate?

    I was hoping to have a discussion about why it worked. My guess is it is an extremely low inflammation diet. Dr Esselstyn also advocates the use of low dose statins when necessary. He targets LDL below 50 and total cholesterol below 150.

    This video does a good job of explaining why the numbers work.


    • #3
      Which SNPs are you looking at?


      • #4
        Originally posted by Robin View Post
        Which SNPs are you looking at?
        FTO rs9939609 possible 60% increased risk for obesity and type-2 diabetes
        PPAR gamma rs1801282 abnormal fat metabolism
        FTO rs17817449 saturated fat may have a negative effect on blood glucose and insulin levels, This particular genotype, rs17817449(G;G), is associated with a 1.7-fold increased obesity risk.
        FTO rs1121980 2.76-fold increased risk for obesity particularly with saturated fat

        There may be more. I ran this in 2017 and there is a newer version of the analysis tool available, but I can't find my new report right now.

        Last edited by rich; 02-02-2019, 11:17 AM.


        • #5
          Thank you very much for providing this.


          • #6
            Thanks Rich.


            • #7
              Originally posted by fatmax
              If you can't tolerate consuming saturated fat then you are in a dire predicament indeed. Do you have the same problems with all types of saturated fats: dairy versus monounsaturated versus other animal fats such as from red meat?
              I have a similar reaction to saturated fat from different sources. I tried researching it over a year ago and there is little to no information on the subject. I believe the source is not important because any time I go over 10 g/day, especially if I do it on multiple days, my blood pressure rises dramatically. This is usually from too many nuts. I stopped eating avocado and coconut oil for the same reason.

              Mono and poly unsaturated fats don't seem to be a problem.

              Here's what I believe is happening when I eat saturated fat.
              Indications are I also have a leaky gut. I don't have the typical symptoms, but lab tests indicate I do have a leaky gut.

              When I eat saturated fat, I have trouble (genetic) both digesting and metabolizing it. So what happens to fat when it isn't digested or metabolized?

              Some of the undigested saturated fat leaks into the blood stream. According to Dr. Rhonda Patrick, the immune system attacks bacteria in the gut creating lps's (lipopolysaccarides). These go through the gut wall and bind to pieces of ldl currently in circulation on the same docking port that the ldl uses to bind to the liver. Then they are attacked by the immune system, creating inflammatory cytokines, and finally beginning the formation of plaque (foam cells).

              This 13 minute video by Rhonda Patrick and Joe Rogan is packed with good information.


              This helps explain why sdLDL particle # may be high.

              Some undigested fat leaked through the gut wall into the blood system, some attached to lps's to get into the blood system, and some of the metabolized fat could not be metabolized by the cells to produce energy, and remained in the blood system.

              This would explain why I never had the burst of energy most people on LCHF have. Only some of the saturated fat I ate was ever digested and metabolized, and since I was eating low carb, I didn't create a lot of glucose, so I was energy starved. My body was constantly in an inflamed state from all the cytokines being created and the liver couldn't get the lps's out of my blood system fast enough. (I think this is why my blood pressure would spike and then start coming down around 1 am. I think the liver must start a major cleansing process about that time.)

              The other bad thing that happened was the saturated fat and leaky gut were creating foam cells in my blood which created plaque in my arteries and aortic valve.

              Here is information on lps's and saturated fat. I first learned about saturated fat and lps's in Dr. Gundry's book, Plant Paradox.

              High–Saturated Fat Diet Increases Endotoxemia (
              Lipopolysaccharide is the major component of the outer membranes of gram-negative bacteria. It induces a strong immune response in animals and so is often used by researchers to create animal models of asthma, rheumatoid arthritis, and other immune diseases. Lipopolysaccharide, a heat-stable poison made by bacteria, was the first described endotoxin and is responsible for the consequences of certain infectious diseases.1 It binds to receptors in many cell types, but has a particular affinity for monocytes, dendritic cells, macrophages, and B-cells. Lipopolysaccharide triggers secretion of pro-inflammatory cytokines, generates superoxides, and acts as a pyrogen, causing fever.2

              This is abstract from study (reformatted for readability). I don't have access to full article:

              Metabolic syndrome (MetS) results in postprandial metabolic alterations that predisposes to a state of chronic low-grade inflammation and increased oxidative stress. We aimed to assess the effect of the consumption of the quantity and quality of dietary fat on fasting and postprandial plasma lipopolysaccharides (LPS).

              A subgroup of 75 subjects with metabolic syndrome was randomized to receive 1 of 4 diets:
              • HSFA, rich in saturated fat;
              • HMUFA, rich in monounsaturated fat;
              • LFHCC n-3, low-fat, rich in complex carbohydrate diet supplemented with n-3 polyunsaturated fatty acids;
              • LFHCC low-fat, rich in complex carbohydrate diet supplemented with placebo, for 12 week each.

              We administered a fat challenge reflecting the fatty acid composition of the diets at post-intervention. We determined the plasma lipoproteins and glucose, and gene expression in peripheral blood mononuclear cells (PBMC) and adipose tissue.

              LPS and LPS binding protein (LBP) plasma levels were determined by ELISA, at fasting and postprandial (4 hours after a fat challenge) states. We observed a postprandial increase in LPS levels after the intake of the HSFA meal, whereas we did not find any postprandial changes after the intake of the other three diets.

              Moreover, we found a positive relationship between the LPS plasma levels and the gene expression of IkBa and MIF1 in PBMC. No statistically significant differences in the LBP plasma levels at fasting or postprandial states were observed. Our results suggest that the consumption of HSFA diet increases the intestinal absorption of LPS, which, in turn, increases postprandial endotoxemia levels and the postprandial inflammatory response.


              • #8
                So you think this trouble with saturated fats is entirely genectic? Are you APOE 4?


                • #9
                  Originally posted by Robin View Post
                  So you think this trouble with saturated fats is entirely genectic? Are you APOE 4?

                  Indirectly, I think the underlying cause has to do with redox potential. I believe if redox potential is high, your epigenetics can override genetics, but when low you default to genes. I think with all the steps we take to try to beat heart disease, we are actually trying to raise our redox potential.

                  I don't understand redox potential real well, but my simplified understanding is you need a lot of extra negative charge potential to offset things like cell oxidation and LDL oxidation.

                  Last edited by rich; 02-03-2019, 04:29 PM.


                  • #10
                    This is the quote from Plant Paradox by Dr. Gundry I mentioned above: The context is within discussion of leaky gut.

                    Because they have eliminated fats, low-fat diets do not allow LPSs, which have to travel on long chain saturated fatty acids to attack through the gut wall which would cause inflammation. pp154-155
                    Last edited by rich; 02-04-2019, 04:10 AM.


                    • #11
                      For folks with redox problems, you can get MTHFR testing. You can often do a trial of a methylated supplement, such as Thorne MethylGuard. Be careful, though, people can get sleep loss & even anxiety with these.