Facts of Nathan Pritikin's heart disease diagnosis

[Tobias Brown]

I became fascinated in the work and life of Nathan Pritikin by watching John McDougall's interview with him in the 80s (available on YouTube).

I've yet to find details on Pritikin's diagnosis of heart disease. He says that he had "cardiac insufficiency"... His autopsy showed extremely clean coronary arteries. But do we know as an objective fact that Pritikin had gross heart artery blockage? Did they do a angiography back then? What tests did they use? It seems that there's no objective data or I've missed it so this might cast into doubt his reversal claims.

Sorry if I am skeptical here. Hopefully, I can be set straight on the issue.

[pickles]

"cardiac insufficiency" - aka heart failure - isn't caused exclusively by blockages. can be high blood pressure, alcohol/tobbaco abuse or even unknown causes.

[Dougalling]

Hello

This will answer your questions. It is a sad story indeed. May he rest in peace.

http://articles.latimes.com/1985-07-04/ ... n-pritikin

[RebusCannebus]

Hello

This will answer your questions. It is a sad story indeed. May he rest in peace.

http://articles.latimes.com/1985-07-04/ ... n-pritikin

Rather than answering the O.P.'s questions, I think the article echoes his skepticism, as evidenced by this excerpt:

But because Pritikin was not subjected to definitive diagnostic techniques in the 1950s, there was no confirmation of fatty deposits in his arteries. His doctors agreed it will never be known to what extent--if at all--they existed in his body. The diagnostic failure will mean it cannot be said with certainty that the Pritikin diet had the effect in its inventor that he claimed for it.

OTOH, I vaguely recall an interview with Pritikin in which he claimed he was symptomatic in his forties (angina, maybe? Can't recall.) Regardless, I operate on the assumption that he did indeed reverse his CAD with diet. Many here can attest to the same outcomes. Some no doubt even have radiographic evidence to prove it.

[LowCarbIsDeadly]

I believe his good looking arteries was the result of his diet for sure. I'd like to see somoene on a paleo diet show a reversal of heart disease. Any studies out there that show that a paleo diet can halt or reverse heart disease? I mean real angiographic proof that filling heart patients full of grass fed beef and free range eggs is good for them.

[geo]

Whether you believe he had CVD or not you cant argue with his autopsy which showed a 69 yo man with a clean cardiovascular system, a strong heart and musculature and NO CVD. Show me another 69 yo that can say that. Its a testament to his diet and lifestyle if nothing else.

BTW, if you want to know the details of his program and the science, studies and rational for it his book: The Pritikin Program for Diet nd Exercise is a great book even if it is 30+ yrs old.

TRIVIA NOTE: Dr McDougall wasn't the first to have a Maximum Weight Loss Program. Pritikin had one too much earlier and its detailed in the above book.

Also, his son also put out a very decent book in the late 90's called The Pritikin Principle, which is all about calorie density...a favorite topic in these forums...

If you don't believe he cured his CVD, you can prove to yourself whether the program works or not by simply trying it, or better yet try Dr McDougalls program, both are similar and should provide similar results. Many of us can show you what results we've been able to achieve with nothing more than cheap food and a little walking (see my testamonial link below).

[wade4veg]

I've yet to find details on Pritikin's diagnosis of heart disease. He says that he had "cardiac insufficiency"... His autopsy showed extremely clean coronary arteries. But do we know as an objective fact that Pritikin had gross heart artery blockage? Did they do a angiography back then? What tests did they use? It seems that there's no objective data or I've missed it so this might cast into doubt his reversal claims.

Sorry if I am skeptical here. Hopefully, I can be set straight on the issue.

It is good to be skeptical.
Some will point to his autopsy, but when you find out who did the published article in the New England Journal of Medicine, you still have to remain skeptical of the findings.
From the 1985 LA Times article---
"The account of the autopsy results being published today was written jointly by Hubbard, Dr. Stephen Inkeles, an internal medicine specialist at Pritikin's Longevity Center in Santa Monica, and R. James Barnard, a cardiovascular disease researcher at the Pritikin program who also holds an appointment at UCLA."

More than a bit of self interest in two of the three writing that article.

But I wonder what you are really looking for when you speak about "reversal". What does that actually mean to you?
You need to have a set of criteria of what constitutes "reversal"

Does that mean a person with a 80% blockage goes to a 70% blockage, or a 40% blockage?
Does it mean that a person who was suffering from 3 bouts of angina a day now has only 1 bout every other day, or even zero episodes?
Does it mean that a individual gradually removed 90% of all blockages?

In the mean time, we really have no idea where Pritikin started and we might even question the analysis of his end point regarding cleaner arteries.

It would appear you will improve your odds following Pritikin's or Dr. McDougall's ideas, but to what extent you attain "reversal" is open to question.
For many, merely halting or slowing the cardiovascular disease would be beneficial, even if you can't "reverse" it.

First, the definition... you need to have that in mind before you can compare it to outcomes of programs.

[SeekKnowledge]

The description of the process Pritikan went through is part of
of his lecture series posted on this site.

The Lost Lectures from Nathan Pritikin

Here is the link to the page where you can download approximately
8 hours in Pritikin's own voice.

https://www.drmcdougall.com/health/education/podcast/nathan-pritikin/

One of the things I most respect about Dr. McDougall is his willingness, indeed
his insistence, on giving credit to his mentors. I am very grateful that he shares
so much of their work here.

Also, Jeff was the nutritional director of the Pritikin Center for several years
and he may have more information he would be willing to share.

.

[Skip]

Pritikin's health over the years is discussed in this book https://www.amazon.com/Pritikin-Man-Hea ... who+healed

HIs cholesterol level was 280 (in 1955) and two years later it was 210. In 1958, Pritikin went to the Sansum Medical Clinic in Santa Barbara for a thorough health exam and stress test. His EKG revealed that Pritikin had heart disease. The Sansum record stated: "Posterior wall coronary insufficiency"

[Tobias Brown]

To reply to wade4veg, by "reversal" I guess I mean to move toward or achieve a "heart attack proof" state of health. So, a person would go from being at clear risk reversing the problem so significantly that the risk plummets -- to the ultimate point after a few years of effort to near total recovery, so to extremely low risk.

A doctor recently explained to me that blockage isn't the main problem with heart disease. A person can be 90% blocked and the heart could function just as well as if it were clear. The problem is with plaques erupting or dislodging. So, maybe measuring reversal by blockage amounts isn't logical. (A person with minimal blockage yet more prone to plaque "eruptions" might be more at risk. So, the factors that influence plaque eruptions seems to be key.

(I write this as a recent survivor of a heart attack and bypass surgery, at 52, after 3.5 years as a highly dedicated and conforming all plant diet eater (with no oils).) I will detail my case in a future post, as I'm on the road to recovery.

[wade4veg]

To reply to wade4veg, by "reversal" I guess I mean to move toward or achieve a "heart attack proof" state of health. So, a person would go from being at clear risk reversing the problem so significantly that the risk plummets -- to the ultimate point after a few years of effort to near total recovery, so to extremely low risk.

A doctor recently explained to me that blockage isn't the main problem with heart disease. A person can be 90% blocked and the heart could function just as well as if it were clear. The problem is with plaques erupting or dislodging. So, maybe measuring reversal by blockage amounts isn't logical. (A person with minimal blockage yet more prone to plaque "eruptions" might be more at risk. So, the factors that influence plaque eruptions seems to be key.

(I write this as a recent survivor of a heart attack and bypass surgery, at 52, after 3.5 years as a highly dedicated and conforming all plant diet eater (with no oils).) I will detail my case in a future post, as I'm on the road to recovery.

I hope you are doing well during your recovery. Before I comment on our original topic, I must say, your "future post" will be one of the most interesting to read. Your details as well as the comments sure to follow.

Regarding "reversal". I think you have a good handle on what the priority is and aren't stuck on the idea that a person will go from a 90% blockage to a 60% or less blockage. Just isn't the reality, which is why I don't put mush credence in the before and after suggested in the Pritikin autopsy results. With Pritikin we have zero idea of the "before".

I'm not sure that a 90% blocked heart could function "just as well as if it were clear", unless you mean during times when it was not under load or stress. At 90% I think most, though not all, would feel angina during significant exercise. Still, under most circumstances you would still need a clot to create most heart attacks.
However I know a person with whom I was communicating who suffered a heart attack near the end of a half marathon.
But there was no actual clot, leading to total blockage. Instead he over stressed the heart which had a 90% narrowing, and went into ventricular fribrillation...heart just stopped working properly. Long story... by miracle a med team 300 yards down the road got his heart beating again and rushed him to the hospital.
Very few such cases survive total heart stoppage. Also spectators were giving him compressions within 1 minute.
He did have a eventual keyhole bypass of one location in his LAD... due to the fact that the position of the 90% narrowing could not be stented. However, he never did have a actual clot or blockage during his heart attack.
BTW, he is back running with minimal damage to his heart. One of only a very few who survive such a episode.

Now you are in recovery. We are instructed that months and years on a plant based diet will "reverse" the condition which worries you.
That a dangerous area, even though not unusually narrowed, will burst forth and release the toxic stuff that sets up a near instant clot, leading to a full heart attack even in arteries that aren't that narrowed by buildup.
Apparently it doesn't work all the time in every individual.
Personally I add in a significant statin for that very reason. There are many studies showing that aside from lowering one's cholesterol, TC, LDL, etc, that statins also change the nature of the walls and especially the dangerous pools/ collections of the toxic brew lipid pool that hides just under the artery walls. The stuff that leaks and sets up the clots.

Some examples
"Conclusions Independent of their plaque-regressive effects, statins promote coronary atheroma calcification. These findings provide insight as to how statins may stabilize plaque beyond their effects on plaque regression."
http://content.onlinejacc.org/article.a ... id=2211958

Look at this... Click on image 2 showing the changes after just 5 weeks on atorvastatin (Lipitor)
http://www.journalofcardiologycases.com ... %2900025-9
You may need to blow up those images to see them better.

So, pertaining to your interests... changing the composition of the danger spots that may exist even where blockage is minimal.

Anyway, I think you are aiming in the right direction. As to what mix of diet and medicine will lead you there is what we need to discuss.

I look forward to your detailed post about your recent experience. Expect a few here to doubt it is possible, that you must have failed the plan in some manner. I think your post will be instructive for everyone with a open mind.

[pundit999]

A doctor recently explained to me that blockage isn't the main problem with heart disease. A person can be 90% blocked and the heart could function just as well as if it were clear. The problem is with plaques erupting or dislodging. So, maybe measuring reversal by blockage amounts isn't logical. (A person with minimal blockage yet more prone to plaque "eruptions" might be more at risk. So, the factors that influence plaque eruptions seems to be key.

It is possible to have 90% blockage and not suffer any problems because there may be significant collaterals that have formed it take the place of the original artery.

Even some people with 100% blockage in some arteries do not have any issues!

[Skip]

It's been proven without a shadow of a doubt that the adoption of a whole food plant based diet (with some mild exercise) can stop and even reverse the onset of cardiovascular disease. The work of Pritikin, Esselstyn, and Ornish (and many others) have proven this. So what is the point in discovering how bad Pritikin's cardiovascular disease was? Trying to go back 60 years and get accurate information on his disease is very hard to do and pointless in my opinion.

[Tobias Brown]

...what is the point in discovering how bad Pritikin's cardiovascular disease was? Trying to go back 60 years and get accurate information on his disease is very hard to do and pointless

It's a matter of knowing which cases a layperson can turn to first to convince oneself/others. Pritikin's case, though interesting, isn't the first stop, apparently. So, what are first cases to turn to? in Esselstyn, Ornish, & others.

I expect that the key issue isn't reversal but risk reduction, control, or elimination. How much reversal is necessary to reduce risk? Can reversal occur yet only marginally reduce risk?

[Skip]

It's a matter of knowing which cases a layperson can turn to first to convince oneself/others. Pritikin's case, though interesting, isn't the first stop, apparently. So, what are first cases to turn to? in Esselstyn, Ornish, & others.

There is a body of evidence or a preponderance of evidence which a layperson can turn to. Here is an example of one such piece of evidence: http://dresselstyn.com/JFP_06307_Article1.pdf and Esselstyn offers other evidence. This might be a good place to start: http://www.dresselstyn.com/site/articles-studies/

Sounds like you are the one who needs the convincing........