Caldwell B. Esselstyn, Jr., M.D.: Response to The New England Journal of Medicine article “Primary Prevention of Cardiovascular Disease with a Mediterranean Diet”

Misleading Research

The New England Journal of Medicine article entitled Primary Prevention of Cardiovascular Disease with a Mediterranean Diet is misleading and inappropriately titled. It should read Promotion of Cardiovascular Disease with a /Mediterranean and Control Diet.

All three dietary groups had almost equal facility promoting the growth and clinical appearance of cardiovascular disease in those who at study onset did not have this illness. The single exception was the control group which had a significantly higher stroke rate; however at baseline, they also appeared to have a greater BMI, waist circumference, hypertension, anti hypertensive agents and diuretics suggesting a cohort at greater risk for strokes.

Earlier this month the British Medical Journal updated the randomized Sydney Heart Study, which confirms the findings of this present Spanish study that the addition of oils worsened the outlook for cardiovascular disease.

By way of contrast, our small plant based nutrition study (devoid of 10 food items contained in the Spanish Study Control diet group known to injure endothelial cells) took patients with established advanced cardiovascular disease and not only halted disease progression but was able to demonstrate disease reversal. We will shortly publish an expanded version confirming our original findings.

The epidemiological ultimate confirmation of the power of plant based nutrition to prevent cardiovascular disease is best demonstrated in T. Colin Campbell’s China Study. In a rural province in China over a three year period examination of over 250,000 death certificates, not one death was attributable to cardiovascular disease.

Caldwell B. Esselstyn, Jr., M.D.

Caldwell B. Esselstyn, Jr., received his B.A. from Yale University and his M.D. from Western Reserve University. In 1956, pulling the No. 6 oar as a member of the victorious United States rowing team, he was awarded a gold medal at the Olympic Games. He was trained as a surgeon at the Cleveland Clinic and at St. George’s Hospital in London. In 1968, as an Army surgeon in Vietnam, he was awarded the Bronze Star. Dr. Esselstyn has been associated with the Cleveland Clinic since 1968. During that time, he has served as President of the Staff and as a member of the Board of Governors. He chaired the Clinic’s Breast Cancer Task Force and headed its Section of Thyroid and Parathyroid Surgery. In 1991, Dr. Esselstyn served as President of the American Association of Endocrine Surgeons, That same year he organized the first National Conference on the Elimination of Coronary Artery Disease, which was held in Tucson, Arizona. In 1997, he chaired a follow-up conference, the Summit on Cholesterol and Coronary Disease, which brought together more than 500 physicians and health-care workers in Lake Buena Vista, Florida. In April, 2005, Dr. Esselstyn became the first recipient of the Benjamin Spock Award for Compassion in Medicine. He received the Distinguished Alumnus Award from the Cleveland Clinic Alumni Association in 2009. In September 2010, he received the Greater Cleveland Sports Hall of Fame Award. His scientific publications number over 150, “The Best Doctors in America” 1994-1995 published by Woodward and White cites Dr. Esselstyn’s surgical expertise in the categories of endocrine and breast disease. In 1995 he published his bench mark long-term nutritional research arresting and reversing coronary artery disease in severely ill patients. That same study was updated at 12 years and reviewed beyond twenty years in his book, Prevent and Reverse Heart Disease, making it one of the longest longitudinal studies of its type. It is most compelling, as no compliant patients have sustained disease progression. Today, beyond 20 years compliant patients continue to thrive. Dr. Esselstyn and his wife, Ann Crile Esselstyn, have followed a plant-based diet for more than 26 years. Dr. Esselstyn presently directs the cardiovascular prevention and reversal program at The Cleveland Clinic Wellness Institute. The Esselstyns have four children and eight grandchildren.

JenO

Thanks for commenting on this. I saw the report on the news last night and wondered why they didn’t say “…and if you follow a plant-based diet your odds for decreasing cardio vascular disease decrease even further”. The media has a long way to go…
http://www.facebook.com/davidstillson David Stillson

I’ve given up on letting the news media tell me anything. I think I’ll stick to common sense instead.
Rissa

I’m sorry but…wait circumference? Come on I can’t share if someone can’t make sure everything is correct. I get so much flack already I don’t need people going off on that they can’t even get the spelling correct.
Pingback: Caldwell B. Esselstyn, Jr., M.D.: Response to The New England Journal of Medicine article “Primary Prevention of Cardiovascular Disease with a Mediterranean Diet” | The Engine 2 Diet | plantcentric
Tina

I really wanted to share this article, as I deeply respect Dr. Esselstyn. However, the basic editing errors render this article elementary and undermine the information presented. So disappointed.
Pingback: Spanish Mediterranean Diet Study Shows Promise | Plant-Based Odyssey
Mark

I couldn’t believe it when I saw a doctor on a TV News show yesterday showing the audience how much olive oil “we should be consuming” each day–it totaled out to something on the order of 1.5 litres per month! Unbelievable.
Maria

Could you list the ten foods specifically in the Spanish Study Control that you eliminated in your program? Thank you.
- http://www.facebook.com/peter.rowe.104 Peter Rowe
  
  Maria, I don’t know the specifics of the Spanish study, but Dr. Esselstyn’s diet is pretty simple to describe. Strictly Vegan. No food, including no ingredient, can come from any animal source, with the possible exception (in moderation) of honey, as it contains neither fats nor animal proteins. That’s the primary directive. Secondly, no added oils. Not in cooking, nor as any ingredient. Not a drop. If an ingredients list describes any oils at all, you don’t eat it. You don’t add oils, nor cook with them. Between this, and the vegan directive, you’ve covered most of Dr. Esselstyn’s plan. Add to this a directive of whole grain/whole food, instead of processed. Whole wheat instead of white bread, for example, is much more nutritious, and much lower in glycemic index, which works to lower triglycerides and has other benefits. You also would perhaps use things like soy products, which are also often highly processed, with caution (a good idea anyway, given some of the other aspects to soy in terms of GMO foods, and possible effects on endocrine systems, but this is not specifically part of Dr. Esselstyn’s diet plan). Finally, among the few plant based foods high in fats, if you have existing heart disease, you’d avoid nuts and avocado. If you don’t have existing heart disease, you’d use these foods only in moderation, simply so that your overall intake of fats accounts to only around 10 percent of total calories. I’ll bet that if you examine the diet described in that Spanish study, and compare to what I’ve described of Esselstyn’s diet, you can work out for yourself what is eliminated… Hope this helps.
Disappointed

It is difficult to know what to believe, there are always so many contrasting ‘beliefs’. We have been on the the engine 2 Diet for 28 days. While my husband has lost 11 pounds and we are looking forward to getting his blood work re-done, I have had no change in weight, no relief from GERD and have hit walls trying to get any help. We’ve bought the book, been following on f/b and online but it appears the only way to get specific questions answered or get any assistance requires ‘buying’ more. Pay for a membership where there is more information and questions answered. Spend close to $600 for an immersion weekend. I have to say that sadly, while the Esselstyn community has ‘credentials’, so do other fad diet experts. I see nothing here that seems much different than another ‘doctor’ on the television ‘news’ reporting some other ‘research’.
- mskatonic
  
  I had the same issue when I tried the Engine 2 diet. No weight loss, no change in my blood work, lots of crankiness, overall disappointed. I’ve since gone back to eating whole foods, cut back on sugar, eliminated most grains, and I feel great.
  
  And this article really doesn’t explain what problems Dr. Esselstyn has with the study. “All three dietary groups had almost equal facility promoting the growth and clinical appearance of cardiovascular disease in those who at study onset did not have this illness.” Well, can you explain what those are? Can you cite something, anything? What are your benchmarks? What do you consider to be “bad”? It sounds off the cuff and reactionary, which is surprising coming from a medical man who must know in this day and age that to make a point, you need to be ready to come in with facts, not vague references to a “small plant based nutrition study”.
  
  I don’t disagree that industrial oils are largely responsible for inflammation and atherosclerosis in many people eating modern diets, but it seems wrong to conflate them with natural oils like coconut, nut, macadamia, and so on. Cottonseed and soybean oils are almost certainly bad for you. “Good” fats, on the other hand, are almost certainly not, and a lack of it in the diet could even be considered a detriment.
  - Alyssa
    
    I am also disappointed and feel like the Engine 2 team has let me down. They seem to always talk about how they are there for you as a support system, etc. But, when I asked for help and even offered to pay someone for advice I reached a dead end. I did everything that Natalia told me to, and even sent her a detailed food journal for a week just to get no response or help in the end. Even with repeated follow up emails.
- Jill Honer
  
  It can be very frustrating, especially when many of us don’t have medical or nutrition degrees. One month feels like a long time, but you will see improvements. I like what Dr. Doug Graham says, “you’re as strong as your weekest link.” exercise, sleep, and positive thinking are as important as diet. My son tried being vegan years ago, and didn’t do well at all. He wasn’t plant based vegan. Eating real food instead of packaged vegan food is also important. You may have been completely plant based, but I know that’s where some people make mistakes. Plant based vegan should help gerd, too. The diet is naturally alkalining. It takes time, and it’s hard to be patient when we’re waiting to feel good. There are lots of free video blogs on YouTube. I watch how studies are financed and I research the researchers before I make health decisions. ‘fully raw’ and ‘rawfully organic’ are both good sites with videos, recipes, and diet tips. Good luck! It is a journey, but it can be interesting and fun.
  - Jill Honer
    
    sorry – weakest link!
- Franco45
  
  I had a heart attack and stent placement in September . The unadjusted bill from the hospital was $98,000. So $600. For an immersion weekend Doesn’t sound so bad.
- shelley stanfield
  
  Disappointed, we found by reading both Dr esselstyns book and the engine 2 offered up some differences and we found Dr He’s approach is geared more towards reversing disease, its more strick than Rips, he recommends little to no oil even plant sources, no processed soy products, and even tofu only occasionally, because its 40% fat. I suggest that approach. My Midwest mom of 75, who started the diet about 3 months after my husband and I did ( plant strong 14 no now) and she came off of her simvastatin for cholesterol and her metformin for diabetes , the cholesterol med was something shed been using since she was in her 50s. Or some form of the med. She also lost 25 pounds with diet alone! Shes never been athletic and now she feels good enough to work out at the gym!She was a huge cheese lover, lots of cold pressed olive oil, meats and also processed sweet snacks. Not any more! If she can do it, you can, just hang in there and remember it took years to damage our bodies, give it time to heal! If you have Facebook check out Engine 2s for networking with people in the same boat, sharing tips and recipes, and success stories! All free! And if you haven’t watched forks over knives, its free on Netflix as is Rips Engine 2 kitchen rescue! Don’t give up, you can do it. And once you start feeling and seeing the results , you’ll never want to go back!
- http://www.facebook.com/peter.rowe.104 Peter Rowe
  
  Dear Disappointed, First, you should understand that both Rip Essestyn’s engine 2 diet, and his father, Dr. Calwell Esselstyn’s diet, upon which Engine 2 is based, are designed for health, especially the prevention of cardiovascular disease. Weight loss is not the primary goal of these diets, and while common, is not guaranteed. Among other things, it’s quite possible to follow these plant based diets and still consume more than enough calories to retain your current weight. If you concentrate your diet on the green leafy veggies, with less in grains, starches, beans, rice, etc, you’ll cut calories. And, the high nutritional value of these foods will give you an equal sense of having eaten enough. With that, you can start to loose weight. But again, these are not fad, weight loss diets. These diets are designed literally, to save your life. You will find interesting information if you look at other diets that espouse essentially the same ideas, ie Dr. John McDougall, Dr. Joel Furhman, Dr. Dean Ornish, Dr. Neal Barnard, Dr. T. Colin Campbell, and a number of others. All these people start with a diet that is strictly vegan. Not vegetarian, but vegan. Then they reduce fats and oils, and highly refined grains/processed foods. While these authors may discuss different aspects, and stress different points, in essence all these people are describing what is for all intents and purposes, the exact same way of eating. If you compare diet plans and fads in general, it’s like a herd of cats going in all directions, with in common that they start with weight loss, and generally a book or product with which the authors intend to make money (sometimes, lots of it.). They start from that point, and diverge in all directions. Incomprehensible. Then look at the people I mention above. All highly trained scientists and doctors, they started from a wide range of places and interests, generally looking not at weight loss, but health, cardiovascular disease, cancers, and the like. Instead of the herd of cats, when they looked, they all seem to have come to the exact same conclusions about diet, with only minor differences in emphasis or interest or style. This is a powerful insight, and should give you confidence in following Engine 2, or any of the suggestions from these others. What you’re fixing is your health first. When you do that, with good nutrition, all sorts of things start to happen. But you should understand that 28 days to make a judgment is an impatient unrealistic expectation. It takes, for one thing, at least six weeks or more just to start to reset your brain chemistry to no longer crave the fats, the dairy, and more. Till then, your body is still trying it’s best to remain as it was. Give this time. Understand that these diets are not temporary quick weight loss, then back to your old ways, ideas. You may benefit from reading Dr. Caldwell Esselstyn’s “Prevent and Reverse Heart Disease”. It gives much more of the medical information about what and why these diets work. Joel Furhman’s books give more detailed information on the various nutritional values of these foods, and how to maximize the benefits. Dr. T. Colin Campbell’s “China Study” has been called the gold standard in Epidemiological studies on diet and health. Reading it will give you a much greater understanding of what you’re trying to do, and why it’s worth doing. And as I said, please give yourself a little time for you, and your body, to adjust to a whole new way of eating. Instant gratification is not what any of these diets are about, though you may find you start to feel better quickly. Actual weight loss, like actual reversal of heart disease, is more gradual. But it does indeed happen. Since I switched to Esselstyn’s diet a bit over 2 years ago, I’ve lost over 50 lbs, and now weigh what I did in high school (168). This did not happen immediately, or quickly, but was gradual, almost unnoticed, even though I actually was often eating more calories than before when I was gaining weight no matter what I did. I didn’t do this for weight, but it’s a welcome bonus. My cardiovascular health is noticeably improved, and my diabetes control is much better. Those, for me, were the real aims, and so far, I’ve not been disappointed.
- jeremy
  
  granny smith apples will do amazin work for gerd give it a try trust me
http://www.facebook.com/bill.gere Bill Gere

Since we constantly get bombarded by sales pitches for the “diet of the week”, It would be quite helpful if Engine2 or Dr. Esselstyn would devote an area of the website with a few paragraphs on each of the top diet fads, and explain why these highly advertised diets and books both help and fail our health. – Thanks for all your good information!
http://www.facebook.com/cindiequilts Cindie White-Weiss

I told my husband last night, “Let’s wait and see what Dr. Esselstyn says.” I knew you would debunk this. Thanks.
Ekonokat

To disappointed and mskatonic, I respectfully disagree and think you must be doing something wrong. I have been plant strong and following Dr. E’s advice since I saw the Clinton/Gupta program. I was able to get off of steroids, non-steroidals and daily pain pills almost immediately and had a complete remission of my severe PMR/arthritis. I feel better than ever. I try my best to avoid sweets and breads, both my downfalls, but do avoid as completely as possible sugar, oils and white flour or anything that is not whole grain. Try to re-evaluate what you are eating and see if you are really compliant. It does work!
- Franco45
  
  I agree. We have been on the Dr’s diet since my HA in September. At the same time i kicked up my exercising. After 6 weeks my total cholestrol went from 177 to 152 and i was not taking any statins. I lost 16 pounds. Looking back, my biggest fault was cheese and olive oil. I had thought that olive oil was the “perfect” oil. Two salids a day. At least a liter a month. The question remains: is it the diet or the exercise???
- mskatonic
  
  It does work. For you. The assertion that it works for EVERYONE? Not the case with me.
  
  I tried to be vegan for a year. And not a junk food vegan: a whole foods, whole grain, low-fat vegan who ate her beans and her veggies and her salads and was constantly starving and sick and gaining weight. Physical recovery from exercise? Forget about it. When I went back to meat and healthy fats, I saw my cholesterol levels improve, my overall energy (and muscle recovery) go up, and my life get back in line.
  
  I don’t deny that “plant strong” works for some people. I think, however, that many people come in many different configurations, and it’s reckless to propose that everyone will thrive on a 100% plant-based diet.
  
  Implying that I “just didn’t try hard enough” is also reckless. If something isn’t working, you stop doing that thing. Then you find something that does work. Which, thankfully, I did.
  
  Again, though: the main reason for my initial critique was that I would really like for the doctor to cite reasons for why he doesn’t agree with this study. Holding up the China Study doesn’t help; there’re numerous rebuttals to it. Vegans need to move away from it: it’s a flawed study and it isn’t helping their case.
  
  In short, he has debunked nothing. He has simply waved his hands at the issue and hoped it’ll go away. That’s not doing the hard work of citing WHY the study is wrong — that’s comforting the choir. And your movement deserves better.
  - Tim Korat (Science Teacher)
    
    Nice post, The only problems I see (after over 20 years of personal study on nutrition) with this/these diets is the utter lack of fat soluble vitamins (A,D,K). The diets work for most people because your liver has an amazing capacity for storing and reusing these vitamins to prevent deficiencies but you’ll never have an abundance of them without dietary consumption. You need these in your diet because in your small intestine they are needed to bond with the alkaline minerals so the minerals are assimilated properly in high amounts. This is necessary to conteract and neutralize the daily acidic waste created and the excess acidic waste stored in between your fat cells and fatty tissues. Without neutralizing and eliminating these acids your body will refuse to let go of the fat cells as doing so would cause acidosis and damge the body. These acids are the underlying cause of all problems in the human body. (See Dr. Paovo Airola, Dr. William A. Lane, Dr. George Crile (also from Cleveland) and Dr. William Howard Hay (whos book was written on the shores of Lake Erie 3 hours east of Cleveland). Dr. Weston A. Price discovered activater X which was later Identified as Fat Soluble Vitamin K and his book “Nutrition and Physical Degeneration” gives much info on fat soluble vitamins
    and their role in preventing cavities as well as helping in the uptake of A,D and K.
jinx watson

What no one is talking about is who funded the “Mediterranean Diet Study?” [olive oil association, nut association, the Mediterranean diet association. . . look and see!] I don’t pay any attention to medical research unless it’s funded by NIH or medical schools. I have followed Esselstyn’s eating plan for two years since my heart attack (after a lifetime of eating “Mediterranean style”) and my cholesterol is way down, weight way down and I have never felt deprived of any kind of food. As someone who loves to cook and invent dishes, I’m having fun!
- SenatorCletusSoffpossum
  
  Ahh yes, who funded the study. The often overlooked aspect of research. From what it looks like the Mediterranean diet study was funded mostly by the Spanish government. Spain produces 45% of the worlds olive oil and doesn’t exactly have a thriving economy right now. Doesn’t necessarily make it invalid but does raise an eyebrow. Very interesting.
http://www.facebook.com/profile.php?id=1675060873 Shabih Alqamar

Thank You !
Optimist

Too all disappointed, disgruntled and in dismay. Plant based is the way too go. Its the only diet that truly boots your cardiovascular system. Remarkable how something so simple can be so powerful. I spent endless hours in the gym trying to strengthen my cario but never dreamed I could be this much improvement. I struggled for years to get the vegan thing right. Only when I went low fat did it relly work. I believe the key is whole foods and portion size. You can’t eat the same portions you did when your not plant based. For example 2 slices of toast and an apple doesn’t cut it for breakfast. Now I eat 1 cup of oats with a table spoon of flax seed and 3 or 4 fruits. People still believe in the low calorie nonsense while eating plant based and that’s a recipe for failure. You have to double or triple the volume of food you eat especially with fruits nd vegetables. The plant based diet is nutrient dense not calorie dense so you need eat a lot more. Most likely your not eating enough. The food you eat may be healthy but your still starving. Your body will never let go of fat if its starving. Another tip that may be helpful is cut out caffeine. I found huge results from eliminating caffeine especially in my waistline. The other thing is I went from doing intense exercise to moderate and got better results. It’s like doctor Caldwell says “Diet trumps everything”. Also check out the hr + lectures from Dr. Allan Goldhammer. Very informative and motivational.
- Guest
  
  Micronutrient dense, yes. But severely lacking in B12, choline, and other important nutrients that you can’t get no matter how high you pile your plate.
  
  And I know Engine 2 dismisses the need for protein, but I find those claims dubious.
  
  Again, great if it works for you, but it doesn’t work for everyone, and people should recognize that.
http://www.facebook.com/teresa.berger.5 Teresa Berger

Can we please get this article published?
Shelley Stangler

The New York Times had an article in today’s (march 3, 2013) paper slathering praise on the Meditteranean diet while dismissing Drs. Esselstyn, Barnard and McDougal’s work as a “book” which indicates that a vegan diet prevents heart disease, although that remains “unproven,” and to drive home that point, has a picture of a man who is a vegan with a tag line that the diet “has never been rigorously tested.” I hope the writer does not consider herself an unbiased journalist. My husband not only lost tremendous weight (which admittedly one could do with weight watchers or eating grapefruits all day as well), but his diabetic retinopathy went into remission, his cholesteral is way below “normal” levels without medication, and his diabetes is so well-controlled that his glucose readings are normal. The only thing I do agree with is that Esselstyn is too strict for most people to follow. I also note that it is not “marriage friendly.” However, there is no question that the plant based diet is the way to go. It is a disservice to the public to suggest that it is OK to pour 1000s of calories of oil and nuts all over your food.
- Penny
  
  Well said! It amazes me that 18 years of data collected Dr E’s patients, 20 years from the China Study are “flawed”. Lets ask how unbiased the USDA was when they invented four major food groups, the Food Pyramid, the recommendation of meat and dairy in a “healthy diet. Oh wait, that was done in an effort to promote the cattle and dairy industry wants it? Yes, it was. If we’re going to debunk, let’s look at all the players.
- http://www.facebook.com/peter.rowe.104 Peter Rowe
  
  Agreed that the NYT’s article is junk journalism. Calling the lifes work of these three scientists, and a bunch of others, just a “book” which is unproven suggests that journalist hasn’t bothered to read the book(s). Nor does he/she understand science. In science, there is seldom any total proof of anything. But there are ideas, theories, conjectures, which are then tested and demonstrated The amount of data amassed by Esselstyn, Ornish, and others, on diet and heart disease is far more than just a little, or open to much doubt. Esselstyn took a relatively small sample of people, true, but all had been expected to live between six months and two years, max. All but one were just fine, and healthy, many many years after starting Esselstyn’s program. Ornish finds the same. Over 20 or more years, these two and others have found what amounts to virtually 100% success. Not just some improvement in some percentage of cases. It’s literally, all of the people who do this, which indeed can be rigorous, get those positive results. How much evidence do you need? It’s likely that people who don’t get the results they expect, may be looking for the wrong results or expectations, rather than what these diets can actually do. Even more likely is that they neither fully understand what they are trying to do or how to follow these plans, nor are they actually following the plans correctly. These are precise diet plans, and for the best results, they must be understood and followed. Not “almost” followed…
  
  And to the commenter who suggests that the China Study is flawed, you can find almost anything you look for on the internet, including lots of people who’ll manage to cook up some opinion on just about anything. It is true that one can criticize the book itself. Campbell is a scientist, not a professional writer. And the book attempts to distill a massive amount of study data into a consumer friendly book. The critics make the mistake of confusing the published consumer book with the science itself, or the published scientific papers, that go into far more detail. If critics talk about some aspect of the China Study not fully demonstrating something, they should go back to the actual, real data, not call the book wrong. People who actually understand the amount of quality of the data collected by the study, don’t come up trying to refute it. This wasn’t just Dr. Campbell and a couple people cooking up some study. This was hundreds, maybe more, researchers working on a massive study, collecting massive amounts of data. And the correlations it shows are so numerous, and so strong, that for those who claim it’s correlation not causation, well, they’re technically right, but it’s a pretty weak point given the strength and quantities of those corrolations, to then discount the links found.
Kneyda Sommer

The E2 diet worked for me. I went on it along with my family 1 1/2 years ago. We all are doing great and feel great.
Penny

Sadly, the plant based path is not something that the five or so major food production corporations, the evil GMO companies, lobbyists, etc want us to know about. They will promote their bottom line and people will follow and eat. Our food system is in peril and so is our nations health. Thank you Dr Esselstyn for taking the path less traveled and continuing to heal, inform and educate.
TheUltimatePessimist

Last night I had a beautiful piece of cod, with a bit of cajun spices and broiled with moderate olive oil, and then some pan seared escarole (using about 1 tbls of olive oil) with chic peas, some lemon juice and cracked pepper and a touch of romano cheese, and a glass of red wine and a glass of water, after having ran 3 miles at moderate pace after stretching earlier in the day. If you maintain that kind of diet and lifestyle you’ll be fine, notwithstanding the well-intentioned claims of the Vegan/No Oil arguments and, if you truly enjoy food, it will be enhance your quality of life and reduce your stress. Don’t worry about the village in China; I don’t aspire to eat like them and would rather eat the way my ancestors ate, not the way an American with corporate-food eats. I think the problem with the discussion is that it is absolutist. That said, if you are happy to eat the Vegan/No Oil diet, I have no problem with that, but be careful not to turn your nose at my choices which I think are fine.
Thank you.

The Engine 2 Diet

Caldwell B. Esselstyn, Jr., M.D.: Response to The New England Journal of Medicine article “Primary Prevention of Cardiovascular Disease with a Mediterranean Diet”

About the author

About Engine

Categories

Contributors

Recommended read

The Big Oil Post! Plus A Giveaway

Caldwell B. Esselstyn, Jr., M.D.: Response to The New England Journal of Medicine article “Primary Prevention of Cardiovascular Disease with a Mediterranean Diet”

How Karl got plant-strong!

Being Fat in America: John Robbins

Fast Food: Thanksgiving Recipes – PLUS! A Giveaway!

How Joel Got Healthier, Leaner, Stronger And Faster.

A Product That Never Changes.

The College Greens: Plant-Strong Marathoning!

Tuesdays With Jeff: Insights Into Your Health: A Common Sense Approach To Sound Nutrition

Adventures With Ami: How Big Is Your Salad?

How Joel Got Healthier, Leaner, Stronger And Faster.

A Product That Never Changes.

The College Greens: Plant-Strong Marathoning!

Tuesdays With Jeff: Insights Into Your Health: A Common Sense Approach To Sound Nutrition

Adventures With Ami: How Big Is Your Salad?

Twitter