Authors: T. Colin Campbell,Thomas M. Campbell
BROKEN HEARTS 131
of health professionals at eight diverse sites have been trained to treat
heart disease patients with Dr. Omish's lifestyle intervention program.
Patients eligible to participate are those who have documented heart
disease severe enough to warrant surgery. Instead of surgery, they may
enroll in a one-year lifestyle program. This program was started in 1993,
and by 1998 there were forty insurance programs that covered the costs
for selected patients. 32
As of 1998, almost 200 people had taken part in the Lifestyle Project,
and the results are phenomenal. After one year of treatment, 65% of
patients had eliminated their chest pain. The effect was long lasting, as
well. After three years, over 60% of the patients continued reporting no
chest pain. 32
The health benefits are equaled by the economic benefits. Over one
million heart disease surgeries are undertaken every year.32 In 2002,
physician services and hospital care for heart disease patients cost $78.1
billion (that does not include drug costs, home health care or nursing
home care) .2 The angioplasty procedure alone costs $31 ,000, and by-
pass surgery costs $46,000.32 In marked contrast, the year-long lifestyle
intervention program only costs $7,000. By comparing the patients who
underwent the lifestyle program with those patients who underwent
the traditional route of surgery, Dr. Omish and his colleagues demon-
s t r a t e d that the lifestyle intervention program cut costs by an average of
$30,000 per patient. 32
Much work remains to be done. The health care establishment is
structured to profit from chemical and surgical intervention. Diet still
takes the back seat to drugs and surgery. One criticism that is constantly
leveled at the dietary argument is that patients will not make such funda-
m e n t a l changes. One doctor charges that Dr. Esselstyn's patients change
their eating habits simply because of Esselstyn's "zealous belief. "47 This
criticism is not only wrong and insulting to patients; it is also self-fulfill-
ing. If doctors do not believe that patients will change their diets, they
will neglect to talk about diet, or will do it in an off-handed, disparaging
way. There is no greater disrespect a doctor can show patients than that
of withholding potentially lifesaving information based on the assump-
t i o n that patients do not want to change their lifestyle.
Well-meaning institutions are not exempt from such closed-mind-
edness. The American Heart Association recommends a diet for heart
disease that favors moderation, rather than scientific truth. The National
Cholesterol Education Program does the same thing. These organizations
THE CHINA STUDY
132
pitch moderate diets with trivial changes as being healthy lifestyle "goals."
If you are at high risk for heart disease, or if you already have the disease,
they recommend that you adopt a diet containing 30% of total calories
as fat (7% of total calories as saturated fat) and less than 200 mg/day of
dietary cholesterol. 48,49 According to them, we should also keep our total
blood cholesterol level under the "desirable" level of 200 mg/dL,49
These venerable organizations are not giving the American public the
most up-to-date scientific information. While we are told that a total
blood cholesterol level of 200 mg/dL is "desirable," we know that 35%
of heart attacks strike Americans who have cholesterol levels between 150
and 200 mg/dPo (a truly safe cholesterol level is under 150 mg/dL). We
also know that the most aggressive reversal of heart disease ever dem-
o n s t r a t e d occurred when fat was about lO% of total calorie intake. Stud-
ies have clearly demonstrated that many patients who follow the more
moderate government recommended diets see a progression of heart
disease. 51 The innocent victims are health-conscious Americans who
follow these recommendations, keeping their total cholesterol around
180 or 190 mg/dL, only to be rewarded with a heart attack leading to a
premature death.
To top it off, the National Cholesterol Education Program danger-
ously writes, "Lifestyle changes are the most cost-effective means to re-
duce risk for CHD[coronary heart disease]. Even so, to achieve maximal
benefit, many persons will require LDL [cholesteroll-Iowering drugs."49
No wonder America's health is failing. The dietary recommendations
for the most diseased hearts among us, given by supposedly reputable
institutions, are severely watered down and followed by the caveat that
we'll probably need a lifetime of drugs anyway.
Our leading organizations fear that if they advocate more than mod-
est changes, no one will listen to them. But the establishment-recom-
m e n d e d diets are not nearly as healthy as the diets espoused by Drs.
Esselstyn and Omish. The fact is that a blood cholesterol level of 200
mg/dL is not safe, a 30% fat diet is not "low-fat," and eating foods con-
taining any cholesterol above 0 mg is unhealthy. Our health institutions
are intentionally misleading the public about heart disease, all in the
name of "moderation."
Whether scientists, doctors and policy makers think the public will
change or not, the layperson must be aware that a whole foods, plant-
based diet is far and away the healthiest diet. In the seminal paper re-
garding the landmark Lifestyle Heart Trial, the authors, Dr. Omish and
BROKEN HEARTS 133
his scientific colleagues, write, "The point of our study was to determine
what is true, not what is practicable [myemphasisl."46
We now know what is true: a whole foods, plant-based diet can pre-
vent and treat heart disease, saving hundreds of thousands of Americans
every year.
Dr. William Castelli, the long-time director of the Framingham Heart
Study, a cornerstone of heart disease research, espouses a whole foods,
plant-based diet.
Dr. Esselstyn, who has demonstrated the most significant reversal of
heart disease in all of medical history, espouses a whole foods , plant-
based diet.
Dr. Ornish, who has pioneered reversal of heart disease without
drugs or surgery and proved widespread economic benefit for patients
and insurance providers, espouses a whole foods, plant-based diet.
Now is a time of great hope and challenge, a time when people can
control their health. One of the best and most caring doctors I have ever
met puts it best:
The collective conscience and will of our profession
is being tested as never before. Now is the time
for us to have the courage for legendary work.
Dr. Caldwell B. Esselstyn,Jr.8
-
...._.___..........________....__...______. 6_ ..___..._.._.._ __........
__ . __. .._.___ ._
____ ............
Obesity
PERHAPS YOU'VE HEARD THE NEWS.
Perhaps you've caught a glimpse of the staggering statistics on obe-
sity among Americans.
Perhaps you've simply noticed that, compared to a few years ago,
more people at the grocery store are overweight.
Perhaps you've been in classrooms, on playgrounds or at day care
centers and noticed how many kids are already Crippled with a weight
problem and can't run twenty feet without getting winded.
Our struggle with weight is hard to miss these days. Open a newspa-
p e r or a magazine, or turn on the radio or TV-you know that America
has a weight problem. In fact, two out of three adult Americans are
overweight, and one-third of the adult population is obese. Not only
are these numbers high, but the rate at which they have been rising is
ominous (Chart l.2, page 13).1
But what do the terms "overweight" and "obese" mean? The standard
expression of body size is the body mass index (BMI). It represents body
weight (in kilograms, kg) relative to body height (in meters squared,
m 2 ) . By most official standards, being overweight is having a BMI above
twenty-five, and being obese is having a BMI over thirty. The same scale
is used for both men and women. You can determine your own BMI
using Chart 6.1, which lists the necessary information in pounds and
inches for your convenience.
135
THE (HINA STUDY
136
CHART 6.1: BODY MASS INDEX TABLE
Normal Overweight Obese
8MI
19 21 23 24 27 29 30 35 40
20 25 26 28
22
(kg/m)
Height
Weight (lb.)
(in .)
143 167 191
91 96 100 105 110 115 119 124 129 134 138
58
198
143 148 173
59 94 99 104 109 114 119 124 128 133 138
153 179 204
102 107 112 118 123 128 133 138 143 148
97
60
111 116 122 127 137 143 148 153 158 185 211
61 100 106 132
191 218
62 104 109 115 120 126 131 136 142 147 153 158 164
141 158 163 169 197 225
63 107 113 118 124 130 135 146 152
122 128 134 140 145 151 157 163 169 174 204 232
110 116
64
132 138 144 150 156 162 174 180 210 240
65 114 120 126 168
130 136 142 148 161 167 173 179 186 216 247
124 155
66 118
121 127 134 140 146 153 159 166 172 178 185 191 223 255
67
144 158 171 177 184 190 197 230 262
68 125 131 138 151 164
69 128 135 142 149 155 162 169 176 182 189 196 203 236 270
278
132 139 146 153 160 167 174 181 188 195 202 209 243
70
71 136 143 150 157 165 172 179 186 193 200 208 215 250 286
191 199 213 221 258 294
169
72 140 147 154 162 177 184 206
197 204 219 227 265 302
189 212
73 144 151 159 166 174 182
179 194 210 225 233 272 311
186 202 218
74 148 155 163 171
224 240 279 319
75 152 160 168 176 184 192 200 208 216 232
246 287 328
156 164 172 180 189 197 205 213 221 230 238
76
THE CHILDREN
Perhaps the most depressing element of our supersize mess is the grow-
ing number of overweight and obese children. About 15% of America's
youth Cages six to nineteen) are overweight. Another 15% are at risk of
becoming overweight. 2
Overweight children face a wide range of psychological and social
challenges. As you know, children have a knack for being open and
OBESITY 137
blunt; sometimes the playground can be a merciless place. Overweight
children find it more difficult to make friends and are often thought of
as lazy and sloppy. They are more likely to have behavioral and learning
difficulties, and the low self-esteem likely to be formed during adoles-
cence can last forever.3
Young people who are overweight also are highly likely to face a host
of medical problems. They often have elevated cholesterol levels, which
can be a predictor for any number of deadly diseases. They are more
likely to have problems with glucose intolerance, and, consequently,
diabetes. Type 2 diabetes, formerly seen only in adults, is skyrocketing
among adolescents. (See chapters seven and nine for a more thorough
discussion of childhood diabetes.) Elevated blood pressure is nine times
more likely to occur among obese kids. Sleep apnea, which can cause
neuro-cognitive problems, is found in one in ten obese children. A wide
variety of bone problems is more common in obese kids. Most impor-
t a n t l y, an obese young person is much more likely to be an obese adult,3
greatly increasing the likelihood of lifelong health problems.
CONSEQUENCES FOR THE ADULT
If you 'are obese, you may not be able to do many things that could make
your life more enjoyable. You may find that you cannot play vigorously
with your grandchildren (or your children), walk long distances, par-
ticipate in sports, find a comfortable seat in a movie theatre or airplane
or have an active sex life. In fact, even sitting still in a chair may be im-
possible without experienCing back or jOint pain. For many, standing is
hard on the knees. Carrying around too much weight can dramatically
affect physical mobility, work, mental health, self-perception and social
life. So you see, this isn't about death; it really is about missing many of
the more enjoyable things in life. 4
Clearly no one desires to be overweight. So why is it that two out of
three adult Americans are overweight? Why is one-third of the popula-
t i o n obese?
The problem is not a lack of money. In 1999, medical care costs relat-
i n g to obesity alone were estimated to be $70 billion.5 In 2002, a mere
three years later, the American Obesity Association listed these costs at
$100 billion. 6 This is not all. Add another $30-40 billion out-of-pocket
money that we spend trying to keep off the weight in the first place. 5
Going on special weight-loss diet plans and popping pills to cut our ap-
p e t i t e s or rearrange our metabolism have become a national pastime.
THE CHINA STUDY
138
This is an economic black hole that sucks our money away without
offering anything in return. Imagine paying $40 to a service man to
fix your leaky kitchen sink, and then two weeks later, the sink pipes
explode and flood the kitchen and it costs $500 to repair. I bet you
wouldn't ask that guy to fix your sink again! So then why do we end-
lessly try those weight-loss plans, books, drinks, energy bars and as-
s o r t e d gimmicks when they don't deliver as promised?
I applaud people for trying to achieve a healthy weight. I don't ques-
t i o n the worthiness or dignity of overweight people any more than I
question cancer victims. My criticism is of a societal system that allows
and even encourages this problem. I believe, for example, that we are
drowning in an ocean of very bad information, too much of it intended
to put money into someone else's pockets. What we really need, then, is
a new solution comprised of good information for individual people to
use at a price that they can afford.
THE SOLUTION
The solution to losing Weight is a whole foods, plant-based diet, cou-
p l e d with a reasonable amount of exercise. It is a long-term lifestyle
change, rather than a quick-fix fad, and it can provide sustained Weight
loss while minimizing risk of chronic disease.
Have you ever known anyone who regularly consumes fresh fruits,
vegetables and whole grain foods-and rarely, if ever, consumes meats
or junk foods like chips, French fries and candy bars? What is his or her
weight like? If you know many people like this, you have probably no-
ticed that they tend to have a healthy weight. Now think of traditional
cultures around the world. Think of traditional Asian cultures (Chinese,
Japanese, Indian), where a couple of billion people have been eating a
mostly plant-based diet for thousands of years. It's hard to imagine these
people-at least until recently-as anything other than slender.
Now imagine a guy buying two hot dogs and ordering his second beer
at a baseball game, or a woman ordering a cheeseburger and fries at your
local fast food joint. The people in these images look different, don't they?
Unfortunately, the guy munching his hot dogs and sipping his beer is rap-
idly becoming the "all-American" image. I have had visitors from other
countries tell me that one of the first things they notice when they arrive
in our good land is the exceptional number of fat people.
Solving this problem does not require magic tricks or complex
equations involving blood types or carbohydrate counting or soul