1/26/2017

Heart disease reversal

diets
Susan Buckley, RDN, CDE
South Denver Cardiology

Heart disease

 Despite all the progress medical science has made in

recent decades to combat heart disease, cardiovascular
problems remain the nation's No. 1 killer.
 Every 40 seconds someone somewhere in the U.S. dies
from heart disease.

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Heart disease

 Heart disease (which includes Heart Disease, Stroke and

other Cardiovascular Diseases) is the No. 1 cause of
death in the United States, killing nearly 787,000 people
alone in 2011- about 1 of every 3 deaths in America
 Heart disease is the leading cause of death for people
of most racial/ethnic groups in the United States,
including African Americans, Hispanics and Whites.
 For Asian Americans or Pacific Islanders and American
Indians or Alaska Natives, heart disease is second only to
cancer

Heart disease

 Cardiovascular diseases claim more lives than all forms

of cancer combined.
 Coronary heart disease is the most common type of
heart disease, killing nearly 380,000 people annually.
 In the United States, someone has a heart attack every
34 seconds.
 Direct and indirect costs of heart disease total more
than $320.1 billion. That includes health expenditures
and lost productivity.

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Heart disease

 Heart disease is the No. 1 killer of women, and is

more deadly than all forms of cancer combined.
 For every woman who dies of breast cancer, 6
women die from heart disease
 Only 1 in 5 American women believe that heart
disease is her greatest health threat.
 Since 1984, more women than men have died each
year from heart disease.

Heart disease
 An increasing number of doctors are aware that diet plays a
crucial role in health, and that nutritional changes can have
dramatic effects on the development and progression of disease.
 But for a number of reasons, current medical practice places little
emphasis on primary and secondary prevention.
 For most physicians, nutrition is not of significant interest.
 It is not an essential component of medical education; each
generation of medical students learns about a different set of pills
and procedures, but receives almost no training in disease
prevention.
 Doctors have limited time with patients and are not rewarded for
educating patients about the merits of truly healthy lifestyles.

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Heart disease
 Less than 1% of U.S. adults meet the American Heart
Association’s definition for “Ideal Healthy Diet.”
 Over 159 million U.S. adults –
or about 69% – are overweight or obese.

Heart disease

 The role of diet is crucial in the development and

prevention of cardiovascular disease.
 Diet is one of the key things you can change that will
impact all other cardiovascular risk factors.
 Comparisons between a diet low in saturated fats, with
plenty of fresh fruit and vegetables, and the typical diet
of someone living in the developed world show that in
the former there is a 73% reduction in the risk of new
major cardiac events.

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Heart disease
 Research makes it clear that abnormal blood lipid (fat) levels
have a strong correlation with the risk of coronary artery
disease, heart attack and coronary death.
 In turn, abnormal blood lipids are related to what you eat for
most people
 A diet high in saturated fats (e.g. fatty meats and cheese) and
trans fats (often used in cakes, cookies and fast food) leads to
high levels of cholesterol.

Heart disease
 Without inflammation being present in the body,
cholesterol would not accumulate in the wall of the blood
vessel and cause heart disease and strokes.
 Without inflammation, cholesterol would move freely
throughout the body as nature intended.
 It is inflammation that causes cholesterol to become
trapped.
 If we chronically expose the body to injury by toxins or
foods the human body was never designed to process, a
condition occurs called chronic inflammation.
 Chronic inflammation is just as harmful as acute
inflammation is beneficial.

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Heart disease
 What are the biggest culprits of chronic inflammation?
 The overload of simple, highly processed carbohydrates
(sugar, flour and all the products made from them) and
the excess consumption of omega-6 vegetable oils like
soybean, corn and sunflower that are found in many
processed foods, as well as excess saturated fats
 Extra sugar molecules attach to a variety of proteins that
in turn injure the blood vessel wall.
 This repeated injury to the blood vessel wall sets off
inflammation. When you spike your blood sugar level
several times a day, every day, it is exactly like taking
sandpaper to the inside of your delicate blood vessels.

Heart disease

 We eat too much damaged food and not enough heart

protecting foods
 Low fruit and vegetable intake accounts for about 20% of
cardiovascular disease worldwide.
 Fruit and vegetables contain components that protect
against heart disease and stroke.

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Heart reversal diets:

The Dean Ornish Plan

Prevent and Reverse Heart Disease: Caldwell B.
Esselstyn, Jr., MD of the Cleveland Clinic
The McDougall Program
30-day Heart Tune-up by Steven Masley, MD

The Ornish plan

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The Ornish Plan

 The first program scientifically proven to “undo” (reverse)

heart disease by optimizing four areas:
 1. Diet
 2. Exercise/Fitness
 3. Stress Reduction
 4. Emotional Support

The research
 Dr. Ornish’s 37 years of research has scientifically proven that
the integrative lifestyle changes he recommends can:
improve chronic conditions – such as heart disease,
diabetes and prostate cancer
change gene expression, turning on health-promoting
genes & turning off disease-promoting genes.
lengthen telomeres — the ends of chromosomes — which
begins to reverse aging on a cellular level.
Medicare is covering "Dr. Dean Ornish's Program for
Reversing Heart Disease" in sites that have been trained in
the program.

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The Ornish plan

 Diet recommend for preventing and reversing heart
disease:
 Rich in fruits, vegetables, whole grains, legumes, and soy
products in their natural, unrefined forms.
 Low in total fat (<10% fat), saturated fats, and trans fats.
For a 1500 calorie/day diet – 17 grams total fat/day (2
Tbsp peanut butter has 16 grams of fat)
 High in omega-3 fatty acids from supplements (fish oil, flax
oil, salmon).
 Low in refined carbohydrates such as sugar, white flour
(bread, pasta), white rice, and sugar-sweetened
beverages.
 Low in processed and refined foods.

Nutrition Guidelines For Reversing Heart

Disease:
 Fat — No more than 10% of calories are from fat. This is achieved
by not adding any fats, oils, avocados, coconut, etc. to a mostly
plant-based diet. The 10% of calories from fat comes from fat
that occurs naturally in grains, vegetables, fruit, beans, legumes,
small amount of nuts/seeds, and soy foods.
 Cholesterol — No more than 10 mg of cholesterol per day. To
meet this goal, non-fat dairy products are limited to 2 servings
per day. Non-fat dairy products are optional. Soy products can
be used instead of dairy products because they are cholesterol
free.
 Animal Products — Meat, poultry, fish and any products made
from these foods are eliminated. Non-fat dairy foods (no more
than 2 servings/day) and egg whites are included.

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 Calories — Unrestricted unless weight loss is desired.

Small frequent meals spread throughout the day
help avoid hunger and keep energy levels
constant. Portion control is stressed
 Sugar — Permitted in moderation. No more than 2
servings/day including non-fat sweets. A serving is
equivalent to 1 tablespoon or 12 grams of sugar.
 Caffeine — Small amounts of caffeine including
regular and decaffeinated coffees and teas, and
cocoa. Individuals with arrhythmia and elevated
stress should still avoid any caffeinated beverage.

 Sodium — Moderate salt use, unless medically indicated

otherwise.
 Alcohol — Allowed in small amounts but not encouraged. If
consumed, enjoy one serving a day: 1.5 ounces liquor, 4
ounces wine or 12 ounces beer.
 Soy — One serving per day of a “full-fat” soy food. A full-fat soy
food is one that contains greater than 3 grams of fat per
serving, with none of the fat coming from added fats or oils.
 Supplements— A low dose multivitamin and mineral
supplement with B-12 (without iron, if not of childbearing age),
fish oil and, possibly upon the advice of a physician, calcium
supplements. Antioxidant vitamins and folic acid are optional
and are based on health history and nutritional intake of these
nutrients.
 Patients take 4 grams/day of fish oil or flax oil to provide the
omega-3 fatty acids

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Typical day on Ornish plan

 Breakfast  Lunch
 Oatmeal with dried cranberries  Stir-fried veggies with low-sodium
teriyaki sauce and brown rice
 4oz. of natural vegetable or
fruit juice  Green salad with edamame,
chickpeas, beans and fat-free
 Morning Snack raspberry dressing, and one whole
wheat roll
 Non-fat granola bar
 Dinner
 Banana  Tacos: black beans, brown rice, fat-free
 One cup of tea; green tea, sour cream, fat-free cheese and salsa;
without milk or sugar, is ideal corn tortillas
 These tacos are low in fat and high in
protein.
 Night Snack
 Hummus with assorted dipping
vegetables

The Ornish plan

 The clinical results obtained by the Ornish Program were

based on the entire package, which involves not only a
plant-based diet but also:
 physical exercise
 stress management techniques including meditation
and yoga, and
 psychological support group sessions.

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Cons to the Ornish plan

 Because the diet is extremely low in fat of all types, it can
be challenging to follow long-term
 The Ornish Diet restricts the amount of unsalted nuts and
seeds you eat. Nuts and seeds have been shown in
research to be good for heart health. Also, unsalted nuts
and nut butters in moderation can improve the taste of
meals and help you feel fuller, if used judiciously.
 If menus are not carefully planned, the diet can be very
low in calories, vitamin B12, and iron.

Dr. Esselstyn

 Many of you have probably heard Dr. Esselstyn's name

connected with former President Bill Clinton
 President Clinton, as a result of his love of fast food and
a rich diet, had heart problems and elected to have a
quadruple heart by-pass in 2004.
 Six months after the by-pass he had an additional
procedure to eliminate scar tissue and fluid build up.

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Esselstyn

 In 2010, when the by-pass failed to work properly, two

stents were added to help relieve the situation.
 At this point President Clinton looked for another way to
return to reasonable health and his search led him to Dr.
Esselstyn's book, "Prevent and Reverse Heart Disease" and
Dr. Campbell's book, "The China Study".
 President Clinton has lost 24 pounds by pursuing Dr.
Esselstyn's plant based diet and he plans to reverse heart
disease by following this new heart healthy diet and
lifestyle.

Dr. Esselstyn

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Dr. Esselstyn
 He was trained as a surgeon at the Cleveland Clinic
 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 20 years in his book, Prevent and
Reverse Heart Disease, making it one of the longest
longitudinal studies of its type.
 Dr. Esselstyn presently directs the cardiovascular
prevention and reversal program at The Cleveland
Clinic Wellness Institute.

Dr. Esselstyn

 The program is a nutrition-based therapy that has been

scientifically-proven to reverse heart disease.
 Coronary angiograms (X-Rays) of the patients show an
actual reversal of heart disease.
 Strick plant-based diet - no foods of animal origin
whatsoever

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Dr. Esselstyn

 You may not eat anything with a mother or a face (no

meat, poultry, or fish).
 You cannot eat dairy products.
 You must not consume oil of any kind—not a drop. (Yes,
you devotees of the Mediterranean Diet, that includes
olive oil)
 Generally, you cannot eat nuts or avocados.

Dr. Esselstyn

 You can eat a variety of delicious, nutrient-dense foods :

 All vegetables except avocado. Leafy green
vegetables, root vegetables, veggies that are red,
green, purple, orange, and yellow and everything in
between
 All legumes—beans, peas, and lentils of all varieties.
 All whole grains and products, such as bread and pasta,
that are made from them—as long as they do not
contain added fats.
 All fruits

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 Vegetables - Just about all vegetables are permitted on this

plan with the exception of avocados. If you are a cardiac
patient avocados have a very high fat content. Those that do
not have heart disease may eat avocados as long as blood
lipids are not elevated.
 Legumes - Beans, peas, and lentils of all kinds.
 Whole Grains - Just about any grain as long as it is "whole"
grain. "Whole" means that it has not been polished or
processed to eliminate much of the nutritional value. You
should eat breakfast cereals that do not contain added oil and
sugar. Breads should be whole grain without added oil. Whole
grain pastas are allowed. You should be careful of restaurant
pastas that almost always contain eggs, white flour and some
oil.
 Fruit - Fruit of all kinds are permitted. It's best to limit fruit
consumption to three servings a day. Also, avoid consuming
pure fruit juices since you get excessive amounts of sugar that
will elevate your triglycerides. Be careful of all desserts for the
same reason.
 Beverages - The heart healthy diet allows the following
beverages. Water, seltzer water, oat milk, no-fat soy milk,
coffee, and tea. Alcohol is okay in moderation.

 For those who have heart disease, a heart healthy diet

includes supplements and Dr. Esselstyn recommends
the following:
 Multivitamin - One a day that covers all the basic
requirements.
 Vitamin B12 - 1000 mcg (micrograms) daily.
 Calcium - People over 50 should take 1000 milligrams
daily...over 60 take 1200 mg daily.
 Vitamin D - Those over 50 should take 1000 IU daily.
 Omega Fatty Acids - Consume one tablespoon of
flaxseed meal each day. Perhaps sprinkling on your
cereal.
 Cholesterol - lowering drugs (if necessary). These must
be taken under supervision of a physician. Drugs may
be needed if you cannot get your total cholesterol
below 150mg/dL.

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Dr. Esselstyn

 In the first continuous 12 year study of the

effects of nutrition in severely ill patients, those
who complied with this program achieved total
arrest of clinical progression and significant
selective reversal of coronary artery disease.
In fully compliant patients, angina can
disappear in a few weeks and abnormal stress
test results can return to normal.

Typical day

Breakfast: Cereal, plant milk (your choice), and

banana and berries
Lunch: Hummus and Sundried Tomato
Wrap and cup of Curried Tomato Lentil Soup
Snack/Dessert: Ginger Banana Smoothie
Dinner: Moroccan Bean Stew with Sweet
Potatoes with side of Couscous

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The Mcdougall plan

 Dr. McDougall is the founder and director of the nationally

renowned McDougall Program: a ten-day residential
program that he and wife Mary McDougall host at a luxury
resort in Santa Rosa, CA
 John A. McDougall, MD has been studying, writing, and
speaking out about the effects of nutrition on disease for
over 30 years
 His program has been shown to reverse serious illnesses
including high blood pressure, heart disease, diabetes and
others, all without the use of drugs.

The Mcdougall program

 A diet of plant foods, including whole grains and
whole-grain products (such as pasta, tortillas, and
whole-grain bread), and a wide assortment
of vegetables and fruit.
 Plenty of spices and usually small amounts of sugar
and salt to enhance the flavor of food.
 Exercise as simple as a daily walk.
 The exclusion of animal foods, including red meat,
poultry, dairy products, eggs, and fish –
 The exclusion of all oils including olive oil, safflower oil,
and corn oil.

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Typical day on mcdougall plan

 Breakfast: Swiss Chard and Mushroom Tofu

Scramble
 Lunch: Vegan Chickpea Quinoa Burgers with
Lemon and Thyme
 Snack: Sweet Potato Hummus with veggies
 Dinner: Mexican Black Bean Corn Tacos &
Cabbage
 Dessert: Oil-Free Vegan Fudgey Blackberry
Brownies

The 30-day heart tune up Steven

Masley
 Steven Masley, M.D. is a physician, nutritionist, author,
speaker, award-winning patient educator, and a fellow
with the American Heart Association.
 Dr. Masley is a Clinical Assistant Professor at the University
of South Florida, and he teaches programs at Eckerd
College and the University of Tampa.
 Dr. Masley has published several health books, including
The 30-Day Heart Tune-Up, Ten Years Younger, and
numerous scientific articles.

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The 30-day heart tune up

 Steven Masley, M.D., has a five-point plan for preventing

and reversing the progression of heart disease, based on
his own clinical studies.
 In his book, "The 30-Day Heart Tune-Up," he details how
to effectively boost your heart health in as little as a few
weeks.

The 30-day heart tune up

 He believes you have to look beyond cholesterol and do more
than simply take statin drugs to keep your arteries clear to lower
your risk for heart attack.
 More important to adopt healthy lifestyle habits. ”Without lifestyle,
I don't believe statins work," he says.
 "There is quite a bit more to it than cholesterol and there's a lot of
controversy as well," he says. "In our research we've shown that
cholesterol was not a very good predictor if you're growing
plaque in your arteries or not.“
 Although statins can be helpful for some, especially men, Dr.
Masley notes, studies have not shown them to be helpful for
women in studies.

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 “Half the people who die of heart disease have normal

cholesterol. How helpful is that?” says Steven Masley, MD,
author of The 30-Day Heart Tune-Up: A Breakthrough
Medical Plan to Prevent and Reverse Heart Disease.
 More importantly, he says, “Plaque is what causes heart
disease.” Plaque constricts arteries, reducing the flow of
oxygen and nutrients, and can trigger clots that lead to
heart attacks and strokes.
 Plaque levels can be tested with a non-invasive Carotid
Intima Media Thickness (CIMT) ultrasound scan, but few
doctors use it and insurance plans don’t cover the cost.
But even without the test, plaque can be controlled and
even reversed.
 Masley’s heart tune-up plan is based on his research, in
which more than 100 patients were able to reduce and
reverse plaque with a strategy that includes eating the
right foods and taking heart-healthy supplements.

The 30-day heart tune up

 “Dean Ornish was one of my mentors,” states Dr. Masley.
“We were the first two people publishing data to show that
you can shrink atrial growth through diet and lifestyle
changes.”
 Masley’s program follows the same basic principles of diet,
exercise, and stress management, but also incorporates
advances in diagnostic testing, measured fitness programs,
heart nutrients and a broader nutritional plan.
 “I believe that you can add more healthy protein and fats
(for greater patient compliance) and still achieve success.”

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The 30-day heart tune up

Dr. Masley has come up with a five-point
plan — what he calls the "Five Fs" — for
lowering the risk of heart disease:
Fiber
Fitness
Body Fat
Fish and fish oil
Food nutrients

Fiber

 Making sure you're getting enough natural fiber in your

diet — from vegetables, fruit, beans, and nuts — is the
single best thing you can do to boost your heart health.
 "They're awesome, they do so many things," he says.
"They help us lose weight, they suppress appetite, they're
good for our blood sugar, blood pressure, they slow
aging."

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Fitness

 The standard minimum guideline — 30 minutes of

moderate exercise most days of the week — is a good
rule of thumb to follow.
 But what's most important is determining your fitness
level.
 You can do this by measuring metabolic equivalents —
METs — that gauge the intensity of physical activity and
the amount of oxygen consumed in your workouts.
 "It's not about how many minutes you work out; it's
about how fit you are," he says

What is a met?

 One metabolic equivalent (MET) is defined as the

amount of oxygen consumed while sitting at rest
 The more your physical exertion, the more METs.
 Most healthy people should be able to achieve 10 to 12
METs on a treadmill fitness test lasting 12 to 18 minutes.
 For every single MET increase in fitness, your risk of heart
attack and stroke decrease by 12.5%.

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Body fat

High body fat is a primary predictor of heart

health, which is why most Americans need to
adopt sensible diets and exercise regularly to burn
it off.
Body fat really does make a difference in heart risk
he says. "And the two best predictors of losing
weight are to eat your fiber and get fit. So if you
do those, the body fat is less important and usually
goes away on its own,“ says Masley

Fish and fish oils

Dr. Masley recommends 1,000 milligrams per day

of healthy fish oils, from food or supplements.
They found actual fish [salmon, trout, sole] to be
better than the supplement … but they were
both clearly beneficial

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food Nutrients
 Most Americans don't consume enough healthy
nutrients, putting them at risk for heart disease, Dr.
Masley says.
 Among the nutrients he recommends: 2,000 IUs a day
of vitamin D, 400 milligrams of magnesium, and vitamin
K from green leafy vegetables.
 If you’re deficient in vitamin K—and most Americans
are, says Masley—calcium will shift from your bones to
your arteries, where it’s harmful.
 Eating a daily cup of cooked green vegetables, such
as broccoli, kale, or spinach, will give you between 250
and 1,000 mcg of vitamin K, but most people don’t get
enough.
 In a supplement, take 250 mcg daily of vitamin
K2."They are powerful and 70 to 80% of Americans are
grossly deficient" in these vitamins and nutrients, he
notes.


30-day heart tune up

 Healthy Fats: Olive oil, fish and other types of
seafood, almonds, pecans, pistachios, walnuts, and
hazelnuts, including nut butters and oils.
 Clean, Lean Protein: Organic, grass-fed lean poultry
and beef, and organic, grass-fed, low-fat dairy.
 Whole Grains: Oats, barley, quinoa, wheat, millet
 Beneficial Beverages: Green tea, cocoa, and dark
chocolate, and if you drink alcoholic beverages, red
wine in moderation (no more than 1–2 glasses daily).
 Flavor: Use chili; curry powder (a blend including
turmeric, coriander, and cumin); Italian herbs and
spices such as oregano, rosemary, and thyme; and
other seasonings to make food taste great.

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30-day heart tune up

 On the flip side, foods such as sugar and flour increase

the odds of prediabetes, inflammation, and plaque
production. Most people should avoid them.
 But healthy, fit people may benefit from nutrients found
in whole-grain flour, says Masley.

 CoQ10 CoQ10 is another important nutrient for heart health.

 The body’s levels of CoQ10 decline naturally with age, so
supplements are essential, especially if you are taking a statin
medication for high cholesterol.
 Even modest dosages of various statins have been shown to lower
blood levels of CoQ10 considerably.
 Researchers have concluded that inhibition of CoQ10 synthesis by
statin drugs could explain the most commonly reported side effects,
especially fatigue and muscle pain, as well as the more serious side
effects such as severe muscle damage (rhabdomyolysis).
 CoQ10 supplementation in subjects on statin drugs has been shown
to reduce markers of oxidative damage and improve tolerance to
these drugs. The recommended dosage is 100 mg twice daily if
taking a statin.

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The 30-day heart tune up

 In addition to incorporating the "Five Fs", Dr. Masley advises

steering clear of trans fats — which he refers to as "embalming
fluid" — and processed foods high in refined carbohydrates,
sugar, and flour.
 "Those are the two biggest risk factors for getting cardiovascular
disease today…I would put [those] right up there with tobacco
use," he argues. "The difference is a lot more people use sugar
and flour and embalming fluid trans fats than use tobacco."

The 30-day heart tune up

 Eat 4-5 cups of fruits and vegetables per day to

decrease your risk of heart attacks and stroke by 35%
 Each cup of leafy greens per day cuts risk of heart
attack or stroke by 25%
 Bean/legumes: ½-1cup per day
 Whole grains – 2 cups per day
 Nuts – 1 oz per day
 Avocados – part of healthy fats

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The 30-day heart tune up

 While he doesn’t demonize saturated fat, he notes that excess

intakes of saturated meat and dairy fats can be bad.
 Why? He says that excess consumption of saturated animal-
source fats raise total cholesterol levels and (perhaps more
importantly) speed formation of plaque … especially if you
have diabetes or the cluster of symptoms known as metabolic
syndrome, linked to cardiovascular disease and diabetes.
 However, he points out that the dominant saturated fat in
chocolate and coconut (stearic acid) is not unhealthful, and
praises dark chocolate (in moderation) for its artery benefits.

Stephen Sinatra reverse heart disease now

 Cardiologist Stephen Sinatra has more than 35 years of
clinical practice, research, and study beginning as an
attending physician at Manchester Memorial Hospital
(Eastern Connecticut Health Network).
 His career there included nine years as Chief of
Cardiology, 18 years as director of medical education,
seven years as director of echocardiography, three years
as director of cardiac rehabilitation, and one year as
director of the weight reducing program.
 In 1987, Dr. Sinatra founded the New England Heart
Center. Through it, he became a well-known advocate of
combining conventional medical treatments for heart
disease with complementary nutritional, anti-aging, and
psychological therapies.

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Stephen Sinatra reverse heart disease

now
 45% of calories come from low-glycemic carbohydrates.
 Protein makes up about another 25%: High quality,
organic, lean meat and poultry, organic tofu, and free-
range eggs are highly recommended, as is nonfarm-
raised fish at the low end of the mercury level scale.
 Remaining 30% of calories come from healthy fats such
as organic avocado, extra virgin olive oil, and organic
nuts-particularly almonds and walnuts.

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Stephen Sinatra reverse heart disease

now
 He recommends the Pan-Asian Modified
Mediterranean (PAMM) diet—a combination of the
heart-healthy diet plan followed by the people on the
Greek island of Crete (also known as the
Mediterranean diet) and a diet common among
people living on the Asian side of the Pacific Rim
 It includes fresh fruits and vegetables in season, fish and
nuts.
 Meat is used sparingly, often just enough for flavoring.
 Meals are based on numerous small portions for lots of
variety, and the lightest meal is at the end of the day,
when the body is quieter and the metabolism slower.

 Sources of essential fatty

Foods to include acids (EFAs) and protein,
 Steel cut oatmeal such as wild cold-water fish
and organic eggs
 Vegetables, such as asparagus,  Fermented soy products,
broccoli, kale, Brussels sprouts, and such as tempeh
spinach  Fish, especially fatty ones like
 Legumes, such as lentils, soybeans, wild salmon
and chickpeas  Healthy fats, such as olive,
sesame, walnut, avocado,
 Onions and garlic (these contain and flax oils
sulfur derivatives and allicin, which
 Nuts and seeds, including
help lower lipids and blood walnuts, almonds, chestnuts,
pressure) and flaxseed
 Fresh herbs, such as rosemary,  Cottage cheese, feta
thyme, and basil cheese, and grated
Parmesan
 Fruits, such as berries, apples, etc.

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Limit/Eliminate
 Foods containing refined white  Canned vegetables,
flour or sugar, such as breads, because they’re usually very
pastas, and bagels high in sodium
 Partially hydrogenated oils,  Processed fruit juices, which
found in commercially are often loaded with sugars
prepared crackers, cookies,  Omega-6 oils, such as corn,
chips, and other snacks safflower, soy, and canola
 Saturated Fats
 Starchy vegetables such as
corn, peas, and carrots

Focus on Omega 3 fats on Sinatra Plan

 Dr Sinatra focuses on omega 3 fats due to research

showing that in the Lyon France trial, 605 heart attack
survivors were assigned to eat either a Mediterranean-style
diet or a diet then recommended by the American Heart
Association (AHA).
 Four years later, participants following the Mediterranean-
style heart-healthy diet plan were 50 percent to 70 percent
less likely to have had repeat heart attacks.
 Best of all, there had been no sudden deaths in this group.

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Sinatra Plan

 A separate analysis of the Lyon study found that deaths

from all causes were also significantly lower among
those following the Mediterranean diet (there were 14
deaths in the Mediterranean group compared with 24
among those following the AHA diet).
 When researchers looked at cancer development in the
third and fourth years of the study, they found similar
advantages to the Mediterranean-style heart-healthy
diet plan: Only two people on the Mediterranean diet
had developed cancer, compared with 12 in the AHA
diet group.

Sinatra Plan

 The key appeared to be essential fatty acids (EFAs).

 A separate study of EFAs published in 1995 supported
this assumption.
 People who ate two meals of fatty fish per month—such
as salmon, anchovy and mackerel—experienced a 30%
reduction in cardiac arrest; four fatty-fish meals a month
were associated with a 50% reduction in cardiac arrest!

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 EFAs, which cannot be manufactured by the body

(hence the name “essential”), penetrate layers of
cholesterol-laden plaque, soothing inflammation in
blood vessels and preventing blood-clotting
deposits from lining coronary arteries.
 EFAs can also prevent spasms of the coronary blood
vessels
 The Med. Diet along with the diet favored along the
Pacific Rim, is rich in the omega-3 fatty acids that
include two particularly important EFAs,
docosahexaenoic acid (DHA) and eicospentaenoic
acid (EPA).
 The typical Western diet, by contrast, is rife with
refined carbohydrates and animal proteins, and
includes few, if any, inflammation-reducing omega-
3s

Supplements recommended
 A good, daily  5 g of D-Ribose twice daily
multivitamin/multimineral  1 gram garlic (preferably the
nutritional supplement high allicin form)
 75–150 mg of CoQ10  1 gram of vitamin C
 400–800 mg of magnesium  B-complex vitamins
 1–2 g of fish or squid oil for  200–400 units of vitamin E in
omega-3 fatty acids a mixed tocopherol that
includes gamma tocopherol
 2–3 ounces of pomegranate (don't buy vitamin E if it says
juice daily "DL" on the label)
 1 cup of organic green tea a  150 mcg of vitamin K2
day menaquinone-7 (MK-7)
twice daily
 500–1,000 mg of L-carnitine

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Summary

 Different diets have been shown to reverse heart disease

 May be some genetic factors
 Some are vegan and very low fat
 Some include animal protein and have more good fats
 All are high in plants and fiber: vegetables, fruits, whole grains
 All severely restrict processed foods: white flour, sugar, pasta,
omega 6 fats like corn, sunflower, safflower oils
 Some include supplements
 Exercise, stress management and social support are also very
important for reversing heart disease according to the studies

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