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Eating to Reverse Heart Failure  … from WebMD Michael Greger M.D. FACLM

An entire issue of a cardiology journal dedicated to plant-based nutrition explores the role an evidence-based diet can play in the reversal of congestive heart failure.

It is a hopeful sign of the times when an entire issue of a cardiology journal is not just dedicated to nutrition, but to a plant-based diet in particular. Dr. Kim Williams, past president of the American College of Cardiology, starts his editorial with a quote attributed to the philosopher Arthur Schopenhauer: “All truth passes through three stages. First, it is ridiculed. Second, it is violently opposed. Third, it is accepted as being self-evident.” He goes on to write that “the truth (i.e., evidence) for the benefits of plant-based nutrition continues to mount.” We’ve got the evidence. The problem is the “inertia, culture, habit, and widespread marketing of unhealthy foods. Our goal must be to get the data out to the medical community and the public where it can actually change lives—creating healthier and longer ones.” That’s essentially my life’s mission in four words: Get the data out. Based on what we already know in the existing medical literature, “plant-based nutrition…clearly represents the single most important yet underutilized opportunity to reverse the pending obesity and diabetes-induced epidemic of morbidity and mortality,” meaning disease and death.

As I discuss in my video How to Reverse Heart Failure with Diet, the issue featured your typical heart disease reversal cases, including a 77-year-old woman with such bad heart disease that she couldn’t walk more than half a block or go up a single flight of stairs. She had severe blockages in all three of her main arteries and was referred to open-heart surgery for a bypass. However, instead of surgery, “she chose to adopt a whole-food plant-based diet, which included all vegetables, fruits, whole grains, potatoes, beans, legumes and nuts.” Even though “she described her previous diet as a ‘healthy’ Western one,” within a single month of going plant-based, “her symptoms had nearly resolved”—and forgot about walking a block. “She was able to walk on a treadmill for up to 50 min without chest discomfort or dyspnea,” becoming out of breath. Her cholesterol dropped about a hundred points from around 220 mg/dL (5.7 mmol/L) down to 120 mg/dL (3.2 mmol/L), with an LDL under 60 mg/dL (1.5 mmol/L). Then, four to five months later, she must have started missing her “chicken, fish, low-fat dairy and other animal products” and “returned to her prior eating habits.” Within a few weeks, with no change in her medications or anything else, her chest pain returned and she went on to have her chest sawed in half after all. After the surgery, she continued to eat the same diet that had contributed to causing her disease in the first place, then went on to have further disease progression.

Another case featured in the journal has a happier ending. It started out similarly: A 60-year-old man with severe chest pain after walking just half a block decided to take control of his health destiny and switched to a whole food, plant-based diet. “He described his prior diet as a ‘healthy’ diet of skinless chicken, fish, and low-fat dairy with some vegetables, fruits, and nuts”—a diet that had been choking off his heart. Within a few weeks, he experienced the same amazing transformation—from not being able to exercise at all to walking a mile, then being able to jog more than four miles (6.4 km), completely asymptomatic, off all drugs, without any surgery, and off to live happily ever after.

Now, of course, case reports are just glorified anecdotes. What we need is a randomized controlled trial to prove that heart disease can be reversed with lifestyle changes alone. Guess what? There was one published three decades ago, proving angiographic reversal of heart disease in 82 percent of the patients. Their arteries opened up without drugs and without surgery. So, these case reports are just to remind us that hundreds of thousands of individuals continue to needlessly die every year from what was proven to be a reversible condition decades ago.

The conventional use of case reports, though, is to present novel results in the hopes of inspiring trials to put them to the test. For example, consider this case report on a plant-based diet for congestive heart failure—not simply coronary artery disease. In this case, the heart muscle itself was so weakened that it couldn’t efficiently pump blood. It was only able to eject about 35 percent of the blood in the main heart chamber with every beat, whereas, normally, the heart can pump out at least 50 percent. And that’s exactly what the patient’s heart was able to do just six weeks after switching to a whole food, plant-based diet, which he chose to do instead of getting his chest cracked open. The researchers wrote: “To our knowledge, this is the first report of an improvement in heart failure symptoms and left ventricular ejection fraction following adoption of a plant-based diet.” It may be the first, but it isn’t the last.

Another case: A 54-year-old woman, obese and diagnosed with type 2 diabetes, presented with swelling ankles due to her heart failure. She switched from her regular diet of chicken and fish to whole plant foods. She started eating more healthfully, lost 50 pounds, and reversed her diabetes—meaning she had normal blood sugars on a normal diet without the use of diabetes medications. Her heart function normalized, too, going from an abysmal ejection fraction of just 25 percent up to normal, as you can see below and at 5:00 in my video. Since it wasn’t a randomized controlled trial, all we can say is that her improvements coincided with her adoption of a whole food, plant-based diet. But, “given the burden of heart failure [as a leading cause of death], its adverse prognosis,” meaning it usually worsens progressively, “and the overall evidence to date, a plant-based diet should be considered as part of a multifaceted approach to heart failure care.” We already know it can reverse coronary artery disease, so any heart failure benefits would just be a bonus.

Now, we just need good strategies for healthcare “practitioners to support patients in plant-based eating.” Shown below and at 5:42 in my video are some excellent suggestions to pause and reflect on. 

Doctors, for example, can “use the Plant Rx pads produced by the Plantrician Project” and prescribe a good website or two, like NutritionFacts.org, as seen below and at 5:50 in my video

“While it is certainly true that many people would be resistant to fundamental dietary changes, it is equally true that millions of intelligent people motivated to preserve their health are now taking half-way measures that may provide only modest benefit—choosing leaner cuts of meat, using reduced-fat dairy products….Most of these people have neither the time nor the training to evaluate the biomedical literature themselves. Don’t they deserve honest, forthright advice when their lives are at stake? Those who wish to ignore this advice, or implement it only partially, are at liberty to do so.”

Do you want to go smoke cigarettes? Bungee jump? It’s your body, your choice. It’s up to each of us to make our own decisions as to what to eat and how to live, but we should make these choices consciously, educating ourselves about the predictable consequences of our actions.

Did I say reverse coronary heart disease? As in reverse the number one killer of men and women? I’ve got a lot of videos on the topic, and How Not to Die from Heart Disease is a good place to start.

Check out the Plantrician Project at plantricianproject.org. I am a proud supporter. 

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