How did Esselstyn, Barnard, Ornish & Williams get caught up?

[healthyvegan]

http://www.onlinejacc.org/content/69/9/1172

Journal of the American College of Cardiology
Volume 69, Issue 9, March 2017>
DOI: 10.1016/j.jacc.2016.10.086
PDF Article
Trending Cardiovascular Nutrition Controversies
Andrew M. Freeman, Pamela B. Morris, Neal Barnard, Caldwell B. Esselstyn, Emilio Ros, Arthur Agatston, Stephen Devries, James O’Keefe, Michael Miller, Dean Ornish, Kim Williams, Penny Kris-Etherton



Funded by the Barcelona Olive Oil University. Seems like a nice PR move to design a published paper to associate olive oil with heart health by suckering in our best...

The footnotes are ripe;
Dr. Freeman has done nonpromotional speaking with Boehringer Ingelheim. Dr. Morris has served on advisory boards for Amgen, AstraZeneca, and Sanofi Regeneron. Dr. Ros has received grants for research through his institution from the California Walnut Commission and is a nonpaid member of its Scientific Advisory Committee. Dr. Miller is a Scientific Advisor for Pressed Juicery. Dr. Ornish consults with Healthways and TerraVia, and receives royalties as an author and honoraria as a speaker. Dr. O’Keefe has a financial interest in Cardiotabs, a nutritional supplement company; and has done promotional speaking for Boehringer Ingelheim, Amgen, and Sanofi Regeneron. Dr. Kris-Etherton serves on the California Walnut Commission Scientific Advisory Committee, Avocado Nutrition Sciences Advisors, Seafood Nutrition Partnership Scientific and Nutrition Advisory Council, McDonald’s Global Advisory Council, and the TerraVia Scientific Advisory Board, and has research funding from the California Walnut Commission, Canola Oil Council, McCormick Spice Institute, and National Cattlemen’s Beef Association.

Not that I don't agree this isn't a step forward on many fronts, but its also a game of 3D chess for these special interests. I wonder if there is more to the story? Would like to hear from the Dr's.

[Kaye]

Jeff has posted/discussed it here

viewtopic.php?f=22&t=54739

I must admit I am shocked to see Dr Esselstyn put his name to a study suggesting oils and nuts are beneficial/recommended and that olive oil reduces some CVD outcomes when consumed in moderate quantities as that seems to go against everything he has always taught, I love hearing him say "NO OIL" . I wonder if he will release a statement either explaining why he has supported the results of this study or distancing himself from it.

[StarchHEFP]

http://www.onlinejacc.org/content/69/9/1172

Journal of the American College of Cardiology
Volume 69, Issue 9, March 2017>
DOI: 10.1016/j.jacc.2016.10.086
PDF Article
Trending Cardiovascular Nutrition Controversies
Andrew M. Freeman, Pamela B. Morris, Neal Barnard, Caldwell B. Esselstyn, Emilio Ros, Arthur Agatston, Stephen Devries, James O’Keefe, Michael Miller, Dean Ornish, Kim Williams, Penny Kris-Etherton



Funded by the Barcelona Olive Oil University. Seems like a nice PR move to design a published paper to associate olive oil with heart health by suckering in our best...

The footnotes are ripe;
Dr. Freeman has done nonpromotional speaking with Boehringer Ingelheim. Dr. Morris has served on advisory boards for Amgen, AstraZeneca, and Sanofi Regeneron. Dr. Ros has received grants for research through his institution from the California Walnut Commission and is a nonpaid member of its Scientific Advisory Committee. Dr. Miller is a Scientific Advisor for Pressed Juicery. Dr. Ornish consults with Healthways and TerraVia, and receives royalties as an author and honoraria as a speaker. Dr. O’Keefe has a financial interest in Cardiotabs, a nutritional supplement company; and has done promotional speaking for Boehringer Ingelheim, Amgen, and Sanofi Regeneron. Dr. Kris-Etherton serves on the California Walnut Commission Scientific Advisory Committee, Avocado Nutrition Sciences Advisors, Seafood Nutrition Partnership Scientific and Nutrition Advisory Council, McDonald’s Global Advisory Council, and the TerraVia Scientific Advisory Board, and has research funding from the California Walnut Commission, Canola Oil Council, McCormick Spice Institute, and National Cattlemen’s Beef Association.

Not that I don't agree this isn't a step forward on many fronts, but its also a game of 3D chess for these special interests. I wonder if there is more to the story? Would like to hear from the Dr's.

I agree there is a heavy influence on the olive oil. However, it's important to know that even in the authors that are not funded by "big olive" such as Steven Devries (I know him), that he is on the side of EVOO for health. I know he is concerned about the fake oils also, and only recommends olive oils with a stamp of purity of the documentation of the origin and an expiration date. And let's say that it could have been worse. At least they are not telling people to eat "lean beef"! For a leading medical journal to get this kind of consensus, is a very big deal. Let's celebrate the paper for what it is, not for what it's not. At least we are coming to more of a reasonable consensus than ever before.

all sources of animal protein (eggs, fish, poultry, red meat, and processed red meat) were noted to increase all-cause mortality relative to vegetable protein, with processed red meat being associated with more CV deaths and egg consumption being associated with more cancer deaths

[bbq]

Question to myself - why does it smell like these examples?

Dr. Fuhrman: Not a credible martyr
https://www.drmcdougall.com/forums/viewtopic.php?f=1&t=31586&start=30#p317505

I accepted Dr. Fuhrman’s request to help him publish a peer-reviewed paper by lending my name as a secondary author. I did so because I believed his claim that he had something important to say. In effect, he wanted to use my reputation because of my half-century of publishing about 350 papers, my serving on the editorial review boards of five journals and my serving on several grant review panels of NIH, the American Society and other organizations.

Fuhrman’s manuscript really was not a study. It was a summary of case histories from his practice. As project director his name was listed last, as is customary. Dr. Sarter was the person who tabulated the data. Her name was listed first, as is customary. They are the authors who assembled the data, wrote the manuscript and submitted the paper. My name was in the middle, as is customary for people who have a secondary part in the project.

Those WFPB doctors weren't listed as the main authors, though. And then we can't really tell if they're actually reading the finalized version as well as participating in writing that paper, or maybe they're just happy about a consensus (more like a compromise for me personally?) that's good for the sake of unity?

It's just kinda strange to see those names to be associated with someone funded by the seafood (fish oil?) industry, McDonald's, and cattlemen etc. while reminding me an incident like this:

British Broadcasting Corporation (BBC), Your Credibility Is Tarnished
http://nutritionstudies.org/british-broadcasting-corporation-bbc-your-credibility-is-tarnished/

Cornell Nutrition Scientist Responds to BBC’s “Clean Eating” Documentary
http://www.prweb.com/releases/2017/02/prweb14051812.htm

BBC Respond To Cornell Nutrition Scientist Over "Clean Eating" Documentary
https://www.plantbasednews.org/post/just-how-credible-are-the-bbc-after-their-clean-eating-doc

[StarchHEFP]

You may have a point there BBQ although this is a review article. Think of it like a textbook with an editor, with chapters that each author does not agree with. However I can tell which of the authors must have written this section. Writing the section below does not constitute endorsement of all the other stuff in the article. But at least they got their little "spiel" in there. I wish they had said something explicit about the oil in this section.

The plant-based diet
Whole food plant-based dietary patterns are becoming increasingly popular because of a variety of reported health benefits. A vegan dietary pattern is devoid of all animal products, whereas a vegetarian diet is typically a nonmeat diet, but can include milk products and eggs. All plants contain protein, but in variable amounts. Pound for pound (dry weight), vegetable protein-rich foods, such as legumes, contain as much or more protein than most animal foods, without the sodium or fat. One cup of cooked lentils contains 18 g of protein (and no fat or sodium). For comparison, an average 6-oz steak may have up to 40 g protein, but also has 12 g of SFAs, which is nearly two-thirds of the recommended daily allotment (114). It is not necessary to intentionally combine or “complement” plant foods to obtain adequate protein (115). Although the quantities of essential amino acids vary from 1 food to another, nearly all plant-derived foods contain most of the essential amino acids. Including foods from a variety of plant sources can provide adequate quantities with careful diet planning.

Epidemiological studies and RCTs indicate that plant-based diets are associated with improvement in ASCVD risk factors and a decreased risk of ASCVD. Studies have been conducted both for the prevention and treatment of CVD with plant-based diets, often in conjunction with other heart-healthy lifestyle behaviors.

In the European Prospective Investigation into Cancer and Nutrition, 44,561 men and women were followed for 11.6 years. Of the participants, 15,151 (34%) were vegetarians (consuming no meat or fish) (116). Vegetarians had a lower mean BMI, lower non-HDL-C, lower systolic blood pressure, and a 32% lower risk of developing CHD. In the United States, vegetarian dietary patterns are associated with lower prevalence of T2DM and metabolic syndrome (117,118). Meta-analyses have also shown that, compared with omnivorous dietary patterns, vegetarian dietary patterns are associated with healthier body weight and blood pressure (119,120).

In a systematic review and meta-analysis of 8 studies with a Seventh Day Adventist population (n = 183,321), there was a reduced risk of CHD events (RR: 0.60; 95% CI: 0.43 to 0.80 vs. RR: 0.84; 95% CI: 0.74 to 0.96) and cerebral vascular disease events (RR: 0.71; 95% CI: 0.41 to 1.20 vs. RR: 1.05; 95% CI: 0.89 to 1.24) in vegetarians compared with nonvegetarians (121). Furthermore, populations consuming a predominantly plant-based diet are reported to rarely develop CVD. These include the Okinawans, the Papua Highlanders of New Guinea, the rural Chinese, central Africans, and the Tarahumara of northern Mexico (122–126).

Clinical trials have also demonstrated benefits of plant-based dietary patterns in patients with CHD. In 1983 and 1990, RCTs using a lifestyle medicine intervention of a whole foods, low-fat, vegetarian diet, moderate exercise, social support, and stress-management training documented significant reversal in CHD, as measured by improvements in ventricular function using radionuclide ventriculography, a 400% increase in myocardial perfusion by cardiac positron emission tomography, regression in coronary atherosclerosis using quantitative coronary arteriography, and 2.5 times fewer cardiac events when compared with a randomized control group (127–130). There was a dose-response correlation between adherence to this lifestyle intervention and changes in percent diameter stenosis. Two demonstration projects showed significant improvements in all risk factors, a >90% reduction in angina within weeks, decreased need for medications, and a 77% reduction in the need for revascularization (131,132). Additionally, in 1995 and 2014, a whole food plant-based diet intervention was shown to result in prevention of coronary artery disease progression and angiographic disease reversal (133–135). On this basis, it appears that a whole food, plant-based diet may halt progression of coronary atherosclerosis and achieve evidence of angiographic disease regression.

Most recently, a large prospective cohort study of U.S. health care professionals described the association between animal versus plant protein intake and mortality outcomes (136). This study showed increased all-cause and CV mortality with high animal protein intake (including processed red meat, unprocessed red meat, and eggs). High plant protein intake was inversely associated with mortality rates. These findings are consistent with recommendations to increase plant protein intake and substitute plant protein for animal protein.

Plant-based diets and ASCVD: the bottom line
Evidence indicates that a diet that is predominantly plant based is associated with improved ASCVD risk factors, reduced CHD progression, and beneficial effects on ASCVD. A whole food, plant-based dietary pattern plays an important role in ASCVD risk reduction.

[bbq]

'Avoid fads and stick to diet guidelines,' say US heart experts
http://www.nhs.uk/news/2017/02February/Pages/Avoid-fads-and-stick-to-diet-guidelines-say-US-heart-experts.aspx
https://www.ncbi.nlm.nih.gov/pubmedhealth/behindtheheadlines/news/2017-02-28-avoid-fads-and-stick-to-diet-guidelines-say-us-heart-experts/

Butter or olive oil? Eggs or no? New nutritional review cuts through the myths.
https://www.washingtonpost.com/lifestyle/wellness/butter-or-olive-oil-eggs-or-no-new-nutritional-review-cuts-through-the-myths/2017/02/24/7af5ee2c-fa0f-11e6-be05-1a3817ac21a5_story.html

Step away from the blender: How a juice diet can make you FAT by concentrating the calories and making it easier to overconsume
http://www.dailymail.co.uk/health/article-4266028/How-juice-diet-fad-make-fat-cals.html

Avoid celebrity fad diets and just eat your greens to stay healthy, say experts
http://www.mirror.co.uk/lifestyle/dieting/avoid-celebrity-fad-diets-just-9929199

Both NHS and PubMed Health mentioned the study, then we've got the usual coverage by the mainstream media as well.

Finally we've got some articles in Chinese, Japanese, and French already:

http://bbs.wenxuecity.com/health/694934.html
http://gigazine.net/news/20170228-dietary-fads/
https://www.santelog.com/news/cardiologie/alimentation-et-risque-cardiaque-demeler-le-vrai-du-faux_16979_lirelasuite.htm
http://www.paperblog.fr/8328373/alimentation-et-risque-cardiaque-demeler-le-vrai-du-faux-journal-of-the-american-college-of-cardiology/

[patty]

When caught in asking "Why?", it is to ask "Why Not?" Truth always follows. Someone recorded a indigenous person and upon playing back the recording, the indigenous person became very upset, because he felt it only recorded a feather of the whole bird. Our language is Newtonian and Darwin. In Chinese the character of crisis is also opportunity.

I like this from Elisabet Sahtouris "EarthDance":

Because our perception has been so focused on separate organisms in their physical or social environments, we tend to see insect, animal, and human societies, as well as whole ecosystems, as collections of individuals that have come to live and function together. It is actually more appropriate to see that such collections have always functioned as wholes, never separated into completely individual and independent beings. Some are relatively more or less independent than others, but all their complex forms and ways have evolved within a single system, just as our cells evolved their separate functions within an inseparable whole. Their connections with their species fellows and with their ecosystems are always as holons within holarchies, up to the whole Gaian planet. These interconnections were never broken and cannot be, just as our cells cannot break their connections with their organs or their/ our whole bodies.

Sahtouris, Elisabet (2012-02-02). EarthDance: Living Systems in Evolution (Kindle Locations 1144-1150). . Kindle Edition.

Aloha, patty

[pundit999]

It makes total sense to me to see that we must consume only whole plants. Oil is concentrated, processed food and we did not evolve on it. So it is better to avoid it.

I am ambivalent on nuts and other high fat plant foods since they are whole, just higher calorie density. We should limit their intake.

[colonyofcells]

Based on the whole philosophy of T Colin Campbell, probably cannot condemn nuts and seeds altho in practice, some people who have overeating problems find it easier to just ban nuts and seeds. I can also do just fine without soy, beans, peas and lentils, and fruits.

[Helpinghands]

Instead of doing all this guessing and conjecture why doesn't somebody ask them for an explanation? It's possible he changed his mind after reviewing the evidence.

[colonyofcells]

It is harmless for unrefined plant based diet evangelists to work together with more mainstream authorities. There is no need for unrefined plant based diet evangelists to be fundamentalists and there is no need to avoid working with more mainstream authorities. The olive oil industry pays for lots of studies so sometimes these mainstream studies cannot be easily avoided without appearing like an anti olive oil zealot. Some study might say olive oil in a standard american diet looks helpful but there are really no studies being funded to say that unrefined plant based diet without oil is even healthier.

[StarchHEFP]

Instead of doing all this guessing and conjecture why doesn't somebody ask them for an explanation? It's possible he changed his mind after reviewing the evidence.

Guess what? In about 1-1/2 weeks I'm going to see Dr. Ess himself at the heart conference at Cleveland Clinic. I will ask him about this article and if I am able to talk to him I will report my findings

My guess is that his stance is still no oil, no oil, no oil.

As far as nuts, he acknowledged the reason he didn't include nuts is that the people in the study were feeble, weak, and didn't have much time, so he wanted to test a truly low fat diet which would work, and it did, and that's why his recommendation is there for no nuts. He did add a suggestion for a little but of flax a day.

His main suggestion is flood your heart with leafy greens and crucifers, all day every day.

[Risto]

You may have a point there BBQ although this is a review article. Think of it like a textbook with an editor, with chapters that each author does not agree with. However I can tell which of the authors must have written this section. Writing the section below does not constitute endorsement of all the other stuff in the article. But at least they got their little "spiel" in there. I wish they had said something explicit about the oil in this section.

Well, it is one article, not a compilation of articles with different authors. Usually the journals have some kind of a requirement for the corresponding author to get the permission of each of the listed authors before submitting the manuscript. The idea is that everyone stands behind the manuscript.

I happened to get a message like that myself before this past Christmas, when someone I used to collaborate with was submitting a paper that used some of my data from years ago. I'd thought the whole project had been long dead. The email was of the form "please read this and if I don't hear from you by Friday, I assume you agree and I'll submit the manuscript". I was happy enough to see my work, which I'd thought had gone nowhere, to be put into some use, so it was all good. But it does happen that messages like that go unseen or unanswered, and the paper gets published anyway.

Also, at least in the case of primary research papers (as opposed to reviews), withdrawing your name from something that you've actually worked on is a pretty drastic thing to do, since your supervisor is likely to be among the authors and you generally want to add to your list of publications. I know of a lot of cases where not all of the authors agree with some of the more speculative conclusions in a paper, but didn't want to rock the boat over something that's out of their own narrow field (say, being a biochemist whose name ends up in a clinical nutrition paper).

[bbq]

As usual I'm more like "the devil is in the detail" kinda dude, here's my take and not everyone would like that:

Heart Disease Starts in Childhood
http://nutritionfacts.org/video/heart-disease-starts-in-childhood/

Stopping Heart Disease in Childhood
http://nutritionfacts.org/2014/07/15/stopping-heart-disease-in-childhood/

So far there's only one diet that's scientifically proven to reverse ASCVD and for that particular purpose ALONE, we've gotta focus on the references and pay attention to items 127 to 135:

Effects of Stress Management Training and Dietary Changes in Treating Ischemic Heart Disease
http://sci-hub.cc/10.1001/jama.1983.03330250034024
http://jamanetwork.com/journals/jama/article-abstract/381576

Changes in Myocardial Perfusion Abnormalities by Positron Emission Tomography After Long-term, Intense Risk Factor Modification
http://sci-hub.cc/10.1001/jama.1995.03530110056036
http://jamanetwork.com/journals/jama/article-abstract/389631

Can lifestyle changes reverse coronary heart disease? The Lifestyle Heart Trial
http://sci-hub.cc/10.1016/0140-6736(90)91656-U
http://thelancet.com/journals/lancet/article/PII0140-6736(90)91656-U/abstract

Intensive Lifestyle Changes for Reversal of Coronary Heart Disease
http://jamanetwork.com/journals/jama/fullarticle/188274

Avoiding revascularization with lifestyle changes: the multicenter lifestyle demonstration project
http://sci-hub.cc/10.1016/S0002-9149(98)00744-9
http://www.ajconline.org/article/S0002-9149(98)00744-9/abstract

The Effectiveness and Efficacy of an Intensive Cardiac Rehabilitation Program in 24 Sites
http://sci-hub.cc/10.4278/ajhp.24.4.arb

A strategy to arrest and reverse coronary artery disease: A 5-year longitudinal study of a single physician's practice
http://www.dresselstyn.com/site/study01/

Updating a 12-year experience with arrest and reversal therapy for coronary heart disease (an overdue requiem for palliative cardiology).
http://www.dresselstyn.com/site/study02/

A Way to Prevent CAD?
http://dresselstyn.com/JFP_06307_Article1.pdf

Yes, we're talking about the reversal of ASCVD here and let's not beat around the bush too much. Since heart disease starts in childhood as mentioned above, for the vast majority of our population (including vegans and vegetarians eating junk) the only things worth reading should be items 127 to 135 in the references.

In other words, we could feel free to wait for that prognosis from one of those beloved cardiologists before we switch to the only scientifically proven diet. Or we could also know better and do the right thing before we're getting hit by the leading cause of death. Sometimes the very first sign of heart disease might look just like this:



There's still that fine line between "Plant Perfect" and "Plant Strong" as Ann Crile Esselstyn explained in this video:

http://youtu.be/q6OGmcRSsm0

Basically the former for reversal and the latter for prevention, therefore almost everything they included in the study should be ONLY good for prevention while we've gotta understand what the deal is when we're going for reversal.

[gracezw]

In Table 2 of this paper, it says,

"Green leafy vegetables (3 servings daily) reduce the risk of incident T2DM and CVD."

Is it true that 1 serving of raw green leafy vegetables(think raw kale, raw cabbage or raw lettuce) is 1 cup?

What about 1 serving of cooked green leafy vegetables? Is it a cup or else?