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Have you seen the documentary, "Forks over Knives" and if so, what did you think? ;o)

I just saw it (streamed via Netflix) having stumbled on the "plant-strong" approach when doing some quick research on current thinking about diet and heart disease. The first story I found was about Bill Clinton, who I noticed while watching his convention speech was looking healthier than I ever remember seeing him, and that led to my learning about Caldwell Esselstyn, "Forks over Knives", etc. Your thoughts?

AntoniaJames is a trusted source on Bread/Baking.

asked almost 2 years ago
57 answers 17975 views
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drbabs

Barbara is a trusted source on General Cooking.

added almost 2 years ago

Hi AJ. I saw it a while ago, and I follow a blog: happyhealthylonglife.com in which the author writes about "evidence-based living," and she has adopted this diet whole hog (sorry). I would say that it has caused me to eat more plant-based than I used to, and to limit fat more than I used to (My father is a heart patient who had his first bypass operation at 57, and there's Alzheimer's disease on both sides of my family.) I struggle with absolute restrictions mostly because I'm not overweight or sick, my numbers are good, and hell, I just like food and love to cook. However, I do find myself making oatmeal for breakfast and salads for lunch more often than I used to. And I tried but I can't stand coffee without real milk. So I try to strike a balance. I think there's probably scientific validity to the eating plan, and if I were a heart patient I might be more vigilant about it. But since we're talking about prevention and not active disease, i have decided that being an omnivore who skews towards plants is the right choice for me. Besides, my husband would divorce me if we ate beans and salads every night. (kidding.)

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AntoniaJames

AntoniaJames is a trusted source on Bread/Baking.

added almost 2 years ago

Thanks, drbabs. The site for which you provided the link is quite interesting and informative! And your answer is helpful and thoughtful, as always. ;o)

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drbabs

Barbara is a trusted source on General Cooking.

added almost 2 years ago

I think that Deb who writes the blog I mentioned is really inspiring. Here is the blog entry when she was about a year into changing the way she eats: http://www.happyhealthylonglife...

Waffle3
added almost 2 years ago


For anyone interested, Forks Over Knives "examines the profound claim that most, if not all, of the degenerative diseases that afflict us can be controlled, or even reversed, by rejecting our present menu of animal-based and processed foods".

I seriously doubt that. Reminds me of "The Road to Wellville". Dr. Kellogg meet Dr. Esselstyn; I think you two might have a lot in common.

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drbabs

Barbara is a trusted source on General Cooking.

added almost 2 years ago

Dr. Kellogg was a bit of a weirdo. http://www.nndb.com/people...

Dr. Esselstyn at least has some science behind him. http://www.ncbi.nlm.nih...

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AntoniaJames

AntoniaJames is a trusted source on Bread/Baking.

added almost 2 years ago

Thank you for the quote summarizing the film! ;o)

Waffle3
added almost 2 years ago


As did Kellogg:

http://www.ncbi.nlm.nih...

Some of his ideas even make sense:

http://www.ncbi.nlm.nih...


Junechamp
ChefJune

June is a trusted source on General Cooking.

added almost 2 years ago

I think that is probably true --- to a point. I think processed foods, while convenient, are probably bad for us, and I also think Americans in general eat far too much meat.

The Mediterranean and Asian diets have both been proven over the years to be far more healthful, and while neither eschew animal protein, those diets are "plant based with animal embellishment," if you will.

Buddhacat
SKK
added almost 2 years ago

I saw Forks over Knives and it was illuminating. Consistent with The China Study by Dr. T. Colin Campbell. Before I saw it I had seriously upped my vegetables and fruits and whole grains and greatly lowered meat and dairy. Processed foods aren't even in my house.

I have seen profound positive changes in friends with diabetes, high blood pressure and allergies who have followed this kind of eating.

The research is good. Marion Nestle supports this way of eating. A lot to be learned.

Buddhacat
SKK
added almost 2 years ago

By the way, AJ, my understanding is Bill Clinton is a vegan at the urging of his daughter Chelsea, who is also a vegan.

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AntoniaJames

AntoniaJames is a trusted source on Bread/Baking.

added almost 2 years ago

Thanks, SKK! I was quite impressed, while watching Clinton (on TV) speak at the Demo's convention, how incredibly healthy, and genuinely so, he looked. So when I saw in the Google search results for "Esselstyn" the connection, I became much more interested. Clinton actually adopted Esselstyn's program for the purpose of improving his health, when he needed stents after his bypass surgery. I am dealing with some really scary lab results + compelling family history right now, but have no interest in dealing with symptoms only via drugs and not addressing the cause, if such a course of action is possible. ;o)

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added almost 2 years ago

Have you seen "Hungry for Change"?

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added almost 2 years ago

Have you seen "Hungry for Change"?

Buddhacat
SKK
added almost 2 years ago

AJ, another doc to check out is Dr. MacDougall http://www.drmcdougall.... He is in California, and his work is consistent with Dr. Esselstyn. Love the question and the inquiry.

Sit2
Sam1148

Sam is a trusted home cook.

added almost 2 years ago

The thing to ask..and I''ve seen it here...is where are the Farmers? Not the food they grow. The USA is a big country, moving from A to B is expensive..moving small farmed food is expensive. Finding a market for premium local food in an economy that's a just a touch off from depression is harder still especially for the small farmers that sell the food and try to make a living off the land.

While we can feel good about ourselves 'eating local' from our gardens, or truck farmers, markets etc. It's rather expensive compared to wal-marts. And even if walmart was magically removed, you'd still have people looking for food that didn't cost as much.
Sure, you'll find bargains on veggies, fruits, truck farmers, farmer markets..etc..etc. But again you have to be able to travel to those places, and the food has to travel as well.
Small farmers are coming back..at premium prices to sell to upscale resturants and markets. But in reality of mid-America, that product is expensive in Whole Foods..or other upscale places. Yes, we can point to a few projects for urban farmers that make a miniscule harvest, or someone growing some back yard gardens. Still where are the small farmers, and their replacements as they get older and retire? They make news, and pointed out as 'man bites dog' stories in media...instead of being common place.


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added almost 2 years ago

I agree with Sam. Humans are omnivores and have developed different eating strategies for different habitats. Most of the strategies were successful and people were able to reproduce and carry on. Perhaps we should look at the fast and processed food diet as an attempt to create a new strategy for our 'new', modern environment. i will argue that the strategy has failed given the high degrees of dietary diseases and allergies.

You hear similar claims of great benefits from proponents of veganism, the Paleo diet, etc. etc. It all seems to have a religious fervor about it--do this and find salvation or be prepared for hellfire and damnation, And they all claim to have scientific proof of the diets' benefits. All of this leaves a person wondering just what on earth he should do.

I am convinced that the strategy that works best for me is simply to eat real food. I eat tons of fruit, vegetables, legumes. I buy as much of these foods locally as I can, but since I live half the year in Germany, I have to rely on fruits and vegetables from Italy and France as well. I don't shy away from whole fat dairy products or meats--but I am careful about my sourcing of these products, and almost all of the meat and dairy products I consume are local. I cut back on bread and pasta but will not entirely eliminate those foods. I walk a lot and get a fair amount of exercise. All in all, I believe I am living and eating much like my ancestors did and the strategy was successful for them.

I would love to see more real scientific evidence of benefits of various diets. but when money for scientific research is coming from vested interests, how can you trust the results?

Sit2
Sam1148

Sam is a trusted home cook.

added almost 2 years ago

I agree and disagree...because in research there's a heck of lot of variables in the outcome matrix. I think your lifestyle is more important than a item in your diet.

So research focuses on one or two things as the 'diet' for Chinese, Greek, French, etc..etc.
Now, we can objectively prove that a high starch, 'fast food', fats, and processed food diet is bad..but then again you get into 'what people' are in the study...people that are inactive? and don't walk or work out, or sit at a desk all day? Bascially, in the past through out recent history...nutritionists and 'dietitians' have gotten almost everything wrong. No ,fats..replace it transfats--wrong...no eggs, wrong, even no leafy green veggies for fear of kidney and gout.
Now, it's no wheat, no soy products, no animal product (even honey??). Geeze do what that want, but dang it...look at the cultures that are healthy, No magic bullet..they eat happy..and eat lots of flavor in smaller portions and sweat a lot in manual labor...and rarely give a second thought to a 'diet'.


The_cook
added almost 2 years ago

I actually have not seen the documentary and I should check it out. But the conversation and controversies are all worth reading. As one of those "dietitians" Sam refers to, I will come clean. I eat a high fat diet, moderate portions of all proteins, and have always since my California childhood loved lots of fresh vegetables, fresh fruits, and whole grains. My weight is so good Weight Watchers refused to hire me. And I too like butter and real milk in coffee, a habit I picked up living in France for a couple of years. The level of nutrition confusion is mind boggling. And the conclusion I have finally reached is that people who cook most days are the ones who have the best chance of keeping healthy. Cooking may in fact be more important that what gets cooked.

Dsc_0048b
added almost 2 years ago

AJ I am with you on the scary family history though so far my own lab results have been in the OK range they could be better - one cardiologist wanted me to get my LDL down to 70!). From what you share on this site, it appears that you have a a healthy lifestyle with exercise and wonderful whole foods. I guess I skew towards drbabs' approach and try to find a balance. I have made the choice for now to stick with extra vegetables, mostly whole gains (almost no white flour or rice), and meats and other highter sat fat animal protein in limited moderation, treating foods outside those parameters the way we do dessert: not everyday and in smaller portions. I also walk or do some other exercise almost every day - at least 5 days a week, usually more, and have just gone back to yoga after a couple of year hiatus. I doubt I could completely give up wonderful cheeses, meatballs and spaghetti, eggs, etc. I have, however, learned to love kale and farro and rye. As i get older if my numbers get worse, I figure I will reconsider the food choice/medication dilemma. The very complicated thing is that as persuasive as Esselstyn is, so are those who advocate for the evils of sugar and white foods, etc. There is so much one can read on this and I've read so much of what's out there, Gary Taubes, Marion Nestle, and so little consensus that it is challenging to really know what the right path is. I think that if one is happy as a vegan and doesn't feel deprived all the time, then why not. If one is miserable doing it, then why? I suspect this is an issue that will become more and more timely, even here, as people age and find themselves with cholesterol, sugar, bp issues.

Dsc_0048b
added almost 2 years ago

And, I think that Gourmet Metrics is right in that cooking at home, which you also do, AJ, is one of the most beneficial things one can do. That said, it is not the only piece, as Laurie Colwin (and my older sister) died tragically young from a heart attack. Sometimes genetics is very strong.

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added almost 2 years ago

Thanks for posting this, Antonia James. I sent my dear mother a link to some of the info that has been posted in the responses. Our family history unfortunately isn't great either, and while her health isn't poor, I always worry about what may lurk around the corner. I would love to hear a dr, scientist, or nutritionist weigh in on the other side, because it seems the results are undeniable.

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AntoniaJames

AntoniaJames is a trusted source on Bread/Baking.

added over 1 year ago

Hi again ATG117. Just thought you'd be interested to know that I went 18/21 vegan in early October -- 18 meals a week are totally plant based (though I do use fish sauce occasionally for those meals). The other two meals include fish (2 of them) and the third non-vegan meal usually consists of fried eggs and bacon or sausage. After 10 weeks, my low density lipids fell by 33%, though I still have quite a way to go. What's interesting is that I wasn't eating any junk, at all (and never have) before I made this change. I plan to continue eating this way even after I get down to the desired levels, as it's been quite enjoyable and interesting. It's worked well because I still enjoy, though on a much more limited basis, the foods that I really like. In fact, I enjoy them more by eating them so much less frequently. And I'm fortunate that Mr. T, my partner, has been a great sport about all this. (He eats meat many days when he goes out for lunch. His LDLs are down, too, but not by as much.) ;o)

Dsc_0048b
added over 1 year ago

AJ _ that's great news!! did you also have an increase in HDL?

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AntoniaJames

AntoniaJames is a trusted source on Bread/Baking.

added over 1 year ago

Thanks, HK! HDLs are actually a bit lower but were very high to begin with, so no worries there. Triglycerides still extremely low, too. ;o)

Buddhacat
SKK
added over 1 year ago

AJ, thank you so much for updating us on how you have altered your eating and the great results you have produced health wise. I love the idea of 18/21!

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AntoniaJames

AntoniaJames is a trusted source on Bread/Baking.

added over 1 year ago

And thank you, SKK! 18/21 just kind of happened. I knew it would be easier for all concerned if we had certain fish twice a week -- easier for my partner to accept, easier to make the transition in my meal planning, etc. And having a wildcard once a week makes the entire venture so much less austere, for those of us who love charcuterie, etc. If I had the time or inclination, I'd be blogging about this. The entire planet (except the meat/poultry/dairy businesses and their related supply systems, I suppose) would be much better off, I suspect, if everyone went 18/21. ;o)

Birthday_2012
luvcookbooks

Meg is a trusted home cook.

added almost 2 years ago

Full disclosure, I am a physician and saw this movie as part for Social Medicine Rounds. The science in the movie is sound, and the diet can make big differences in health. Promoted by one of the cardiologists in our hospital who follows a vegan diet and takes the stairs throughout the hospital (quite a shock for the students and residents rotating through cardiology).
For me, I love all kinds of foods, but like Dr. Babs, am trying to trope more towards plants and whole grains, along with more exercise.
My family also has a strong fam hx heart disease, so I do pay attention, but I think being happy with what you eat contributes to heart health as well.

Waffle3
added almost 2 years ago


Even if the premise were true and you could prove it, I wouldn't change a single thing about my diet. I cook for maximum taste and pleasure. Compromising out of fear is simply not an option. To quote me quoting Graham Kerr, "Madame, you could go outside and get run over by a bus and just think what you would have missed!" My last meal, whenever it comes, will not be tofu.

That is not to say I don't eat my vegetables or eschew exercise nor eat so much that I'm even a single pound overweight. There are reasonable, rational guidelines to follow. But a life lived in fear is a life half lived. Enjoy.

Buddhacat
SKK
added almost 2 years ago

Quoting Graham Kerr? That is interesting.

Waffle3
added almost 2 years ago

How so? Tell me more.

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added almost 2 years ago

In my opinion, then only thing that the "documentary" really demonstrated was that extreme dietary changes in people who have extremely bad health, who were eating an extremely poor diet, can have an extremely profound effect. You notice I used "extreme" a lot: I don't think this "documentary" is necessarily applicable to the general public, or can be generalized, for the same reason I put documentary in quotations: this is not a particularly honest or un-biased examination of the entire scientific data set. If you do some digging, you will actually find that the data the movie does discuss is not portrayed in an entirely honest way. Much of the research done by the two main subjects is either ignored, because it does not support or refutes their claims, or is mis-characterized and portrayed to imply something it doesn't actually demonstrate, such as the China Study. It was an interesting movie, but once I started looking at the criticisms of the stories and characters in it, it was revealing and disappointing.

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AntoniaJames

AntoniaJames is a trusted source on Bread/Baking.

added almost 2 years ago

Thanks again, everyone. What I'd really like to know, having read these answers, is whether there is any good research out there one way or the other about whether a change in diet can reverse heart disease -- where the starting point is a fairly balanced, totally junk-food-free, virtually-processed-food-free diet that does include regular consumption of fat derived from animals (especially pork, bacon, sausage, etc., cheese, butter, cream, etc.). "Forks over Knives" includes some fairly dramatic graphics of such reversal, specifically with respect to the reduction in plaque within the arteries. I am primarily motivated in all this to avoid taking drugs to prevent the worsening of my condition and to reduce my LDL levels, which are currently off the charts. Yes, I know that half the people who have heart attacks do not have high cholesterol and that half of the people with high cholesterol do not suffer from heart attacks, but I have also been told that those numbers are fairly meaningless in the case of a strong family history, which is my situation. Any sources of good, reliable research to shed light on this would be most appreciated. I have a family that depends on me and a lot of things I want to do, but also have the skill and the motivation when it comes to cooking and eating to make the best choices for the long term. ;o)

Dsc_0048b
added almost 2 years ago

Good luck with this journey. I think you have identified the key question here which is that unlike President Clinton, you're not starting from a baseline diet of big macs and fried food. I am also curious about whether (or how much) you can make more changes without medication, considering what your baseline is. I would bet that there is no specific study of what you're asking. I think that for me, a month or two experiment would be worth it. I suspect if your numbers were going to change you would see a change within that amount of time. That said, I do wonder whether fat free yogurt and wild salmon, for example, would really change results of the Esselstyn program. I also wonder whether, as Michael Pollan has written, the meat of grass fed animals is chemically different and not as unhealthy as that of feedlot animals (which then brings up your other concerns of whether this is sustainable for the planet).

Buddhacat
SKK
added almost 2 years ago

The China Study by T. Colin Campbell, PhD
The Most Comprehensive Study of Nutrition Ever Conducted (on front of book)
"Everyone in the field of nutrition sciences stands on the shoulders of Dr. Cam[bell, who is one of the giants in the field. This is one of the most important books about nutrition ever written..." Dean Ornish, MD

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AntoniaJames

AntoniaJames is a trusted source on Bread/Baking.

added almost 2 years ago

Incidentally, is there anything in dispute in Forks over Knives about the environmental impact of factory-farming animals? I'm really confused about the whole sustainable meat thing, too. Is there enough pasture land on the planet, and do the economics work, or can they be made to work somehow, to allow everyone who's now eating meat from factory-farmed animals to eat meat solely from animals who've been pastured instead? Resources/research on that topic would be appreciated, too! ;o)

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drbabs

Barbara is a trusted source on General Cooking.

added almost 2 years ago

The researchers in "Forks Over Knives" and their disciples have solved this by prohibiting ALL animal product. No meat, chicken, fish, dairy, etc. A plant based diet entirely.

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AntoniaJames

AntoniaJames is a trusted source on Bread/Baking.

added almost 2 years ago

Thanks, drbabs! I'm totally prepared to go that route if it works and improves my chances of living a long, healthy life without the usual prescription drugs for a chronic and dangerous coronary condition. Whether it would be a hardship or not depends entirely on one's attitude, of course. And I'm fortunate to have the skill and imagination to meet the challenge. Just looking at the recipes on this site designated as vegan convinces me that eating that way is a perfectly viable option. ;o)

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drbabs

Barbara is a trusted source on General Cooking.

added almost 2 years ago

It's definitely viable if somewhat limiting. I have no doubt that you could do it with grace and style. The only uncomfortable part for me is the sheer amount of processed foods (soy yogurt, textured vegetable protein, etc.) that people seem to use--can that really be better for you than a piece of salmon? I struggle with the balance--food as creative outlet and pleasure vs. health. I sent you a private message--did you get it?

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AntoniaJames

AntoniaJames is a trusted source on Bread/Baking.

added almost 2 years ago

drbabs, I would never buy or consume the processed foods marketed to people eating only a plant-based diet. Bleehh! I do eat tofu, and have since it first was commercially available. That's about as processed as I get, apart from a few condiments. (I'm fortunate that there is a Korean grocery store about two blocks from my gym; they sell really fresh tofu, quite inexpensively, too.) Everything else I make myself. I picked up a couple of quite promising looking vegan cookbooks at the library only to find that they were full of recipes that relied heavily on non-dairy cheese (really bleeehh) and flavored tofu/seitan, etc. And TVP is just not an option. I'd stick with traditional foods from places where people rarely eat meat and are not trying to eat meat-like substitutes. Thanks again. ;o)

Buddhacat
SKK
added almost 2 years ago

AJ, Cooking with less meat or not meat is easy and fun. My favorite recipes are from Raw Recipe Books, although I do not eat 100% raw. These recipes are vegan so you don't have the nonsense like TVP and all that. I often include these recipes when making food for our meat eaters. Just don't use the terms vegan or vegetarian. Two books that may excite you are RAW by Charlie Trotter (yes, the Charlie Trotter from Chicago) and Roxanne Klein. Gorgeous, tasty, and great to riff off of. And THE RAW GOURMET by Nomi Shannon.

Waffle3
added almost 2 years ago


If the answers were known, nobody would be making movies and selling books touting they know a secret. Researchers have been arguing over the lipid hypothesis for 150 years yet still can't even agree on what is cause and what is effect. We know there is a connection between cholesterol and heart disease but does cholesterol indicate that a problem exists, that it's a repair mechanism, or does it by itself cause heart disease? Simply put, we don't know and anyone who claims they do is either pushing their political views or attempting to separate you from your money with offers of false hope.

I maintain the best strategy is to live the best, fullest, happiest life you can in the short amount of time we're here. Concentrate on the joy, not the worry, if for no other reason than stress itself can cause disease.


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added almost 2 years ago

Are you saying there’s no link with diet and health? That living, breathing proofs like Bill Clinton don’t exist?

Waffle3
added almost 2 years ago


Puzzling response. No, not at all. What I'm saying is that it is no longer accepted as fact that the consumption of saturated fat causes heart disease. … We do know, however, there is a direct relationship between excess weight and all manner of illness. Clinton, after quadruple bypass surgery *and* stent surgery, finally got the message and lost weight. He credits veganism but that's nonsense. He simply reduced the number of calories he was used to stuffing into his face. If a vegan diet worked for him, fine, but that's not proof it's some miracle cure. … Fewer calories + exercise = weight loss + fitness + health. Too simple to sell books, can't make a movie about it.

Sit2
Sam1148

Sam is a trusted home cook.

added almost 2 years ago

It didn't work out so well for Steve Jobs.

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added almost 2 years ago

Omg! Steve jobs lived far longer than his original prognosis suggested thanks to his stellar healthcare nutrition! And cancer is not what we’re talking about here.

Waffle3
added almost 2 years ago


Whoa… what? You can't be serious. Jobs refused standard medical care for nine months in lieu of alternative treatments and doomed himself in the process. By the time he relented and had the tumor removed, it had metastasized and took out his liver. And while we may not have been talking cancer in particular, Esselstyn makes the same claims about cancer as he does heart disease and strokes.

http://money.cnn.com/2008...

Waffle3
added almost 2 years ago


Here's a Harvard cancer specialist on the subject:

http://gawker.com/5849543...

Dsc_0048b
added almost 2 years ago

AJ - here's a link to something that came across my blog feed. I don't know too much about the science they use, but it might be interesting. http://civileats.com/2012...

The_cook
added almost 2 years ago

Hello AJ. Strong evidence does exist according to my professional association that keeping total fat intake between 20% to 35% calories, reducing calories from saturated fat and trans-fatty acids to

I am thankful I do not have to follow this regime because like you I love cheese, butter, cream, pork, bacon, sausage. With no family history and good cholesterol numbers, I can eat as I choose. Julia Child referred to my fellow dieticians as nutrition terrorists and food nazis and I would not disagree. But you know, there is a time and place for all things and you might want to consider a consultation with a dietitian who is sensible, realistic, and willing to help you individualize general guidelines for the specifics of your situation. On the other hand, many smart well education people have both time and skills to work the numbers out for themselves and it sounds to me as if you absolutely up to the job.

Birthday_2012
luvcookbooks

Meg is a trusted home cook.

added almost 2 years ago

Ms. James, just noticed that Forks over Knives has a Facebook page you can Like. I didn't sift through all the comments so you may already know this. I have to say that, knowing you only through Food52, there is NO WAY you could go completely vegan with pleasure, but I could be wrong.

The_cook
added almost 2 years ago

Hello AJ. Reposting missing data. Strong evidence does exist according to my professional association that keeping total fat intake between 20% to 35% calories, reducing calories from saturated fat and trans-fatty acids to less than 7% of calories, and keeping cholesterol consumption below 200mg per day does decrease the risk of heart disease. Saturated fat should be replaced with complex carbohydrates from fruits, vegetables, whole grains or with protein or with unsaturated fats from oils, nuts, fatty fish (omega-3), avocado. And I will add, not an easy way to eat for those of us who are used to a more traditional approach.

Waffle3
added almost 2 years ago


Michael Pollan on animal protein-based diets, the lipid hypothesis and food as guilt vs. pleasure:

http://michaelpollan.com...

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added over 1 year ago

I think it's great. I also think that any steps one can take it tha direction would be use ful, even without being as strict as they would have us all ideally be. Bill Clinton worked with Esselytn after hhe needed stents following his bypass, etc.

Birthday_2012
luvcookbooks

Meg is a trusted home cook.

added over 1 year ago

AJ, you have inspired me to try your 18.21 diet, not yet, but maybe for Lent. Thanks!!