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← Making heart attacks history: Caldwell Esselstyn at TEDxCambridge

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Showing Revision 5 created 11/29/2016 by TED Translators admin.

  1. Coronary artery disease
    is the leading killer
  2. of women and men in Western civilization.
  3. Yet the truth be known, it is nothing more
  4. than a toothless paper tiger
    that need never exist.
  5. And if it does exist,
    it need never ever progress.
  6. This is a food borne illness.
  7. My story begins, actually,
    in the late 1970s, early 80s,
  8. when I was chairman of the breast cancer
    task force at the Cleveland Clinic.
  9. My frustration was that no matter
    for how many women
  10. I was doing breast surgery, I was doing
    nothing for the next unsuspecting victim.
  11. This led to a bit of global research.
  12. It was quite striking to find
    that breast cancer rates in Kenya
  13. were something like 30 or 40 times
    less frequent than in the United States.
  14. And if you looked at breast cancer rates
    in rural Japan in the 1950s,
  15. it was very infrequently identified.
  16. And yet as soon as the Japanese women
    would migrate to the United States,
  17. by the second and third generation.
  18. they now had the same rate
    of breast cancer
  19. as their Caucasian counterparts.
  20. But even more powerful perhaps
    was data on cancer of the prostate.
  21. In 1958, in the entire nation of Japan,
  22. how many autopsy proven deaths
    were there from cancer of the prostate?
  23. 18.
  24. That's the most mind-boggling public
    health figure I think I've ever heard.
  25. But I made a decision then,
  26. that I was concerned
    that my bones would long be dust
  27. before I could really get answers
    between nutrition and cancer.
  28. And so I chose to deal
    with cardiovascular disease,
  29. which is the leading killer of women
    and men in Western civilization.
  30. And it was quite striking
    that in this global review
  31. there were a number of cultures,
    by heritage and tradition,
  32. that simply lack
    any cardiovascular disease.
  33. They were plant-based.
  34. And so with that information
    I came back to Cleveland.
  35. And my wife and I decided to go
    on this plant-based diet for a year.
  36. And then I asked cardiology
    if I could have
  37. about 24 patients, which is the number
  38. that I can handle and still carry out
    my surgical obligations.
  39. And the 24 patients that I received,
  40. were, as my late brother-in-law
    used to say, the walking dead.
  41. But they were most cooperative
  42. and it was within about, say,
    15 months of starting this program
  43. that we had something striking develop.
  44. I was treating a 52-year-old gentleman
    who, in addition to his heart disease,
  45. had a partially blocked artery
    in his right thigh.
  46. And he told me about the fact
  47. that when he was crossing the skyway
    to my office, he had to stop five times
  48. because of pain in this calf,
    because of this blocked artery.
  49. So I had him go to the vascular lab
    and we got his pulse volume.
  50. And then I forgot all about his leg,
    so focused on his heart.
  51. Eight months later, he said,
    "Dr. Esselstyn do you recall
  52. when I first started seeing you,
  53. I had to stop five times crossing
    the skyway here to your office?
  54. This last month, it got to be four times,
    then it was three, two, one,".
  55. He said, "I don't stop anymore,
    the pain is gone".
  56. "Don, back you go to the vascular lab."
  57. I think if you look here, you can see
    the difference in pulse volume
  58. when I first saw him,
    and here we were eight months later,
  59. it was now almost two times greater.
  60. So the thing that was
    so exciting about this was,
  61. in science we had demonstrated
    what we call "proof of concept."
  62. Not only that, but this occurred one year
    before the invention of the statin drugs.
  63. So this was so powerful, because
    it showed us that indeed with nutrition,
  64. we can actually not only halt
    this disease, but we could reverse it.
  65. And not shortly thereafter, what occurred,
    we saw this now in the heart.
  66. This is a 54-year-oold security guard
    where our angiography core laboratory
  67. described this as a 30% improvement.
  68. But what really got our attention
    was a fellow surgeon at the clinic
  69. who, at age 44 in 1996,
    began to get chest pain.
  70. He did not have hypertension,
    he did not have diabetes,
  71. he did not have a strong family history,
    he was not overweight
  72. and cardiology worked him up
    in October of 1996, could find nothing.
  73. Three weeks later, he was finishing
    his surgical schedule.
  74. Sat down to write
    post-operative orders.
  75. Splitting headache, immediately followed
    by this crushing elephant in his chest,
  76. pain in his shoulder down his arm.
  77. Joe was having a heart attack.
  78. Whipped down to the cath lab,
    start the catheterization, cardiac arrest,
  79. resuscitate, and finish
    the catheterization.
  80. And then he was sent up to the floors
  81. and discharged three days later,
    but very depressed.
  82. Why?
  83. Because what they identified was that
  84. his left anterior descending coronary
    artery, in the front of the heart,
  85. the entire lower third
    was moth-eaten and diseased,
  86. over too long a segment to have stents,
    too far down the artery to have a bypass.
  87. So he was very depressed about this,
  88. so my wife Anne and I had him out
    to the house with his wife for supper,
  89. two weeks after his heart attack.
  90. "Joe you've been eating
    this typical Western diet.
  91. You've got the typical Western disease.
  92. We've got 10 years of data,
    how about going plant-based?"
  93. "Okay Ess, I'll give it a shot,
    they couldn't offer me anything else."
  94. He became the absolute personification
    of commitment to plant-based nutrition.
  95. And over the next thirty months
    he then had another angiogram.
  96. You know, up in the surgical suites,
    our offices are three doors apart.
  97. And at noontime of the day
    that I knew earlier that morning
  98. he had his follow-up angiogram,
  99. I found myself letting myself
    into his office.
  100. There he was sitting behind his desk,
  101. "Joe, I understand you had the follow-up
    angiogram this morning,
  102. Mind sharing with me, how did it go?"
  103. Got up from around his desk, put his arms
    around me, "I think we're doing okay."
  104. "Well, any chance I could see
    the follow-up angiogram?"
  105. "Yeah!"
  106. It was really quite striking and exciting
    to see what actually can happen;
  107. when you give the body
    every opportunity it can.
  108. The healing capacity is incredible.
  109. So now let's talk a little bit
    about how do you injure the artery
  110. in the first place,
    what seems to be going wrong.
  111. Now on the right, there is
    a seriously diseased artery.
  112. You're probably saying,
    "That's going to have a heart attack."
  113. No, that only causes
    about 10% of heart attacks,
  114. but it certainly will cause chest pain
    and shortness of breath.
  115. What I really want you
    to notice is on the left,
  116. and here, on the inside of this artery,
  117. there's a very, very, tiny, little dark
    single layer of cell "magic carpet",
  118. that all experts would agree is where
    the inception of this disease occurs.
  119. This magic carpet is called
    the endothelium.
  120. And the endothelium has an absolutely
    magic molecule that it produces.
  121. It's a gas, nitric oxide.
  122. Nitric oxide has a number
    of wonderful functions.
  123. Nitric oxide keeps
    our blood flowing smoothly
  124. like Teflon, rather than velcro.
  125. Two, nitric oxide is the strongest
    vasodilator in the body.
  126. When you climb stairs,
    the arteries to your heart dilate,
  127. the arteries to your legs dilate.
  128. Nitric oxide inhibits inflammation
    from the wall of the artery,
  129. protect you from getting hypertension,
    and most importantly
  130. nitric oxide, in plentiful amounts,
  131. will protect you from ever
    developing blockages or plaque.
  132. Alright, how do those
    90% of heart attacks occur?
  133. You will see here the artery is divided.
  134. And what you're looking at
    in the first serial on the left,
  135. is that when you start
    eating that cheeseburger,
  136. the pizza, the milkshake,
    your blood flow gets sticky.
  137. And certain elements
    like your endothelial cells get sticky,
  138. your LDL cholesterol gets sticky,
    and then the LDL bad cholesterol
  139. migrates into the sub endothelial space,
  140. where it sets up this absolute
    cauldron of inflammation.
  141. And that cauldron of inflammation
    begins making inflammatory enzymes
  142. that gradually begin to thin out
    this delicate cap over the plaque.
  143. It gets thinner and thinner
    until it's as thin as a cobweb,
  144. and then the sheer force of blood going
    over that thinned out plaque ruptures,
  145. and now we have spillage
    of plaque content into the flowing blood,
  146. which activates our platelets,
    our clotting factor.
  147. Now we are at the beginning
    of a clot, a thrombosis,
  148. which is in and of itself,
  149. So in a matter of minutes, now we have
    an artery that is totally blocked,
  150. and all the downstream heart muscle
    has been deprived of oxygen and nutrients
  151. and starts to die.
  152. That's the heart attack.
  153. But there is something absolutely
    magically exciting about this series,
  154. because if I can convince you
    that all you have to do
  155. is change your nutrition,
  156. so your internal biochemistry is such
  157. that you will not injure or thin out
    the cap over your plaque,
  158. you will actually diminish your plaque,
  159. and you will strengthen
    the cap over the plaque.
  160. Alright, how do we do this?
  161. It's very easy, we avoid the foods
    that injure the endothelium.
  162. What are they?
  163. Even pure virgin olive oil,
    corn oil, soybean oil,
  164. safflower oil, sunflower oil,
    coconut oil, palm oil, dairy.
  165. Anything with a mother
    or a face, meat, fish.
  166. (Laughter)
  167. Meat, fish, chicken, and turkey,
    and also caffeine in coffee, and fructose.
  168. Alright what are you going to eat?
  169. (Laughter)
  170. All those marvellous whole grains
    for your cereal, bread and pasta.
  171. 101 different types
    of legumes, vegetables,
  172. which are red, yellow,
    and green leafy, and fruit.
  173. But especially the green leafy vegetables
    are like water on the fire.
  174. What green leafy vegetables?
  175. Bok choy, swiss chard, kale, collards,
    collard greens, pink greens,
  176. mustard greens, brussels sprouts,
    broccoli, cauliflower, cilantro,
  177. parsley, spinach, and arugula
    and I'm out of breath.
  178. (Applause)
  179. But remember, no oil!
  180. (Laughter)
  181. Now conventional cardiology,
  182. with all those procedures
    and all that expense,
  183. is high mortality, high morbidity,
    and sadly it does not cure the disease,
  184. and the expense is unsustainable.
  185. However, when you're treating causality
    with plant-based nutrition,
  186. no mortality with the diet,
    no morbidity with the diet.
  187. And what happens with the passage of time,
    the benefits just continue to improve.
  188. And lastly nobody has greater fear
    of another heart attack
  189. than somebody who's already
    had a heart attack.
  190. And how empowering it can be
    for them and their family to know
  191. that they themselves can now become
  192. the locust of control
    for this disease, destroying it.
  193. Whereas in the past,
    it had been trying to destroy them.
  194. And that, lastly,
    I want to just share with you,
  195. this isn't just
    that original earlier study.
  196. But what we're about to publish
    another 200 patients.
  197. And the reason we have
    91% compliance
  198. is because we have a very strong intense
    single five hour counselling seminar.
  199. That's the same amount of time
    the cardiac surgeon has,
  200. but I have the patient when they're awake.
  201. (Laughter)
  202. So how do we do?
  203. If we look at the vertical axis,
  204. what you're seeing here is the average
    of about three independent
  205. cohorts cardiology studies
    that are quite well known.
  206. And the recurrent cardiac events,
    after four years,
  207. run about 20% on average.
  208. Our own, which is called
    "Treating The Cause,"
  209. is a half of one %, that means
    roughly a 40 fold difference.
  210. So in summary,
    it is so exciting what happens
  211. when you treat the causation of disease.
  212. Because it is not only prompt,
  213. it is powerful, and it is persistent.
  214. And for those who, in the future,
  215. are coming down
    with cardiovascular disease,
  216. I hope it is going to be unconscionable
    not to inform them
  217. of the power of this option
    from which they can thrive.
  218. Thank you.
  219. (Applause)