Coronary artery disease is the leading killer

of women and men in Western civilization.

Yet the truth be known, it is nothing more

than a toothless paper tiger that need never exist.

And if it does exist, it need never ever progress.

This is a food borne illness.

My story begins, actually, in the late 1970s, early 80s,

when I was chairman of the breast cancer task force at the Cleveland Clinic.

My frustration was that no matter for how many women

I was doing breast surgery, I was doing nothing for the next unsuspecting victim.

This led to a bit of global research.

It was quite striking to find that breast cancer rates in Kenya

were something like 30 or 40 times less frequent than in the United States.

And if you looked at breast cancer rates in rural Japan in the 1950s,

it was very infrequently identified.

And yet as soon as the Japanese women would migrate to the United States,

by the second and third generation.

they now had the same rate of breast cancer

as their Caucasian counterparts.

But even more powerful perhaps was data on cancer of the prostate.

In 1958, in the entire nation of Japan,

how many autopsy proven deaths were there from cancer of the prostate?

18.

That's the most mind-boggling public health figure I think I've ever heard.

But I made a decision then,

that I was concerned that my bones would long be dust

before I could really get answers between nutrition and cancer.

And so I chose to deal with cardiovascular disease,

which is the leading killer of women and men in Western civilization.

And it was quite striking that in this global review

there were a number of cultures, by heritage and tradition,

that simply lack any cardiovascular disease.

They were plant-based.

And so with that information I came back to Cleveland.

And my wife and I decided to go on this plant-based diet for a year.

And then I asked cardiology if I could have

about 24 patients, which is the number

that I can handle and still carry out my surgical obligations.

And the 24 patients that I received,

were, as my late brother-in-law used to say, the walking dead.

But they were most cooperative

and it was within about, say, 15 months of starting this program

that we had something striking develop.

I was treating a 52-year-old gentleman who, in addition to his heart disease,

had a partially blocked artery in his right thigh.

And he told me about the fact

that when he was crossing the skyway to my office, he had to stop five times

because of pain in this calf, because of this blocked artery.

So I had him go to the vascular lab and we got his pulse volume.

And then I forgot all about his leg, so focused on his heart.

Eight months later, he said, "Dr. Esselstyn do you recall

when I first started seeing you,

I had to stop five times crossing the skyway here to your office?

This last month, it got to be four times, then it was three, two, one,".

He said, "I don't stop anymore, the pain is gone".

"Don, back you go to the vascular lab."

I think if you look here, you can see the difference in pulse volume

when I first saw him, and here we were eight months later,

it was now almost two times greater.

So the thing that was so exciting about this was,

in science we had demonstrated what we call "proof of concept."

Not only that, but this occurred one year before the invention of the statin drugs.

So this was so powerful, because it showed us that indeed with nutrition,

we can actually not only halt this disease, but we could reverse it.

And not shortly thereafter, what occurred, we saw this now in the heart.

This is a 54-year-oold security guard where our angiography core laboratory

described this as a 30% improvement.

But what really got our attention was a fellow surgeon at the clinic

who, at age 44 in 1996, began to get chest pain.

He did not have hypertension, he did not have diabetes,

he did not have a strong family history, he was not overweight

and cardiology worked him up in October of 1996, could find nothing.

Three weeks later, he was finishing his surgical schedule.

Sat down to write post-operative orders.

Splitting headache, immediately followed by this crushing elephant in his chest,

pain in his shoulder down his arm.

Joe was having a heart attack.

Whipped down to the cath lab, start the catheterization, cardiac arrest,

resuscitate, and finish the catheterization.

And then he was sent up to the floors

and discharged three days later, but very depressed.

Why?

Because what they identified was that

his left anterior descending coronary artery, in the front of the heart,

the entire lower third was moth-eaten and diseased,

over too long a segment to have stents, too far down the artery to have a bypass.

So he was very depressed about this,

so my wife Anne and I had him out to the house with his wife for supper,

two weeks after his heart attack.

"Joe you've been eating this typical Western diet.

You've got the typical Western disease.

We've got 10 years of data, how about going plant-based?"

"Okay Ess, I'll give it a shot, they couldn't offer me anything else."

He became the absolute personification of commitment to plant-based nutrition.

And over the next thirty months he then had another angiogram.

You know, up in the surgical suites, our offices are three doors apart.

And at noontime of the day that I knew earlier that morning

he had his follow-up angiogram,

I found myself letting myself into his office.

There he was sitting behind his desk,

"Joe, I understand you had the follow-up angiogram this morning,

Mind sharing with me, how did it go?"

Got up from around his desk, put his arms around me, "I think we're doing okay."

"Well, any chance I could see the follow-up angiogram?"

"Yeah!"

It was really quite striking and exciting to see what actually can happen;

when you give the body every opportunity it can.

The healing capacity is incredible.

So now let's talk a little bit about how do you injure the artery

in the first place, what seems to be going wrong.

Now on the right, there is a seriously diseased artery.

You're probably saying, "That's going to have a heart attack."

No, that only causes about 10% of heart attacks,

but it certainly will cause chest pain and shortness of breath.

What I really want you to notice is on the left,

and here, on the inside of this artery,

there's a very, very, tiny, little dark single layer of cell "magic carpet",

that all experts would agree is where the inception of this disease occurs.

This magic carpet is called the endothelium.

And the endothelium has an absolutely magic molecule that it produces.

It's a gas, nitric oxide.

Nitric oxide has a number of wonderful functions.

Nitric oxide keeps our blood flowing smoothly

like Teflon, rather than velcro.

Two, nitric oxide is the strongest vasodilator in the body.

When you climb stairs, the arteries to your heart dilate,

the arteries to your legs dilate.

Nitric oxide inhibits inflammation from the wall of the artery,

protect you from getting hypertension, and most importantly

nitric oxide, in plentiful amounts,

will protect you from ever developing blockages or plaque.

Alright, how do those 90% of heart attacks occur?

You will see here the artery is divided.

And what you're looking at in the first serial on the left,

is that when you start eating that cheeseburger,

the pizza, the milkshake, your blood flow gets sticky.

And certain elements like your endothelial cells get sticky,

your LDL cholesterol gets sticky, and then the LDL bad cholesterol

migrates into the sub endothelial space,

where it sets up this absolute cauldron of inflammation.

And that cauldron of inflammation begins making inflammatory enzymes

that gradually begin to thin out this delicate cap over the plaque.

It gets thinner and thinner until it's as thin as a cobweb,

and then the sheer force of blood going over that thinned out plaque ruptures,

and now we have spillage of plaque content into the flowing blood,

which activates our platelets, our clotting factor.

Now we are at the beginning of a clot, a thrombosis,

which is in and of itself, self-propagating.

So in a matter of minutes, now we have an artery that is totally blocked,

and all the downstream heart muscle has been deprived of oxygen and nutrients

and starts to die.

That's the heart attack.

But there is something absolutely magically exciting about this series,

because if I can convince you that all you have to do

is change your nutrition,

so your internal biochemistry is such

that you will not injure or thin out the cap over your plaque,

you will actually diminish your plaque,

and you will strengthen the cap over the plaque.

Alright, how do we do this?

It's very easy, we avoid the foods that injure the endothelium.

What are they?

Even pure virgin olive oil, corn oil, soybean oil,

safflower oil, sunflower oil, coconut oil, palm oil, dairy.

Anything with a mother or a face, meat, fish.

(Laughter)

Meat, fish, chicken, and turkey, and also caffeine in coffee, and fructose.

Alright what are you going to eat?

(Laughter)

All those marvellous whole grains for your cereal, bread and pasta.

101 different types of legumes, vegetables,

which are red, yellow, and green leafy, and fruit.

But especially the green leafy vegetables are like water on the fire.

What green leafy vegetables?

Bok choy, swiss chard, kale, collards, collard greens, pink greens,

mustard greens, brussels sprouts, broccoli, cauliflower, cilantro,

parsley, spinach, and arugula and I'm out of breath.

(Applause)

But remember, no oil!

(Laughter)

Now conventional cardiology,

with all those procedures and all that expense,

is high mortality, high morbidity, and sadly it does not cure the disease,

and the expense is unsustainable.

However, when you're treating causality with plant-based nutrition,

no mortality with the diet, no morbidity with the diet.

And what happens with the passage of time, the benefits just continue to improve.

And lastly nobody has greater fear of another heart attack

than somebody who's already had a heart attack.

And how empowering it can be for them and their family to know

that they themselves can now become

the locust of control for this disease, destroying it.

Whereas in the past, it had been trying to destroy them.

And that, lastly, I want to just share with you,

this isn't just that original earlier study.

But what we're about to publish another 200 patients.

And the reason we have 91% compliance

is because we have a very strong intense single five hour counselling seminar.

That's the same amount of time the cardiac surgeon has,

but I have the patient when they're awake.

(Laughter)

So how do we do?

If we look at the vertical axis,

what you're seeing here is the average of about three independent

cohorts cardiology studies that are quite well known.

And the recurrent cardiac events, after four years,

run about 20% on average.

Our own, which is called "Treating The Cause,"

is a half of one %, that means roughly a 40 fold difference.

So in summary, it is so exciting what happens

when you treat the causation of disease.

Because it is not only prompt,

it is powerful, and it is persistent.

And for those who, in the future,

are coming down with cardiovascular disease,

I hope it is going to be unconscionable not to inform them

of the power of this option from which they can thrive.

Thank you.

(Applause)