By Steven Clark
Eating to live, rather than living to eat.
That’s my new philosophy.
Actually I really had no choice after a visit to my primary care physician.
So, in terms of my diet, bean burgers have replaced cheeseburgers. Faro has elbowed pasta off the dinner plate. And, the kind of pizza you buy on Arthur Avenue has been supplanted by homemade pizza with low-fat cheese and sun dried tomatoes on whole grain pocket bread.
The #11 on the Jersey Mike’s sandwich board (provolone, ham and salami with all the trimmings)? Fuhgeddaboudit. The go-to sandwich contains falafel, tomato and hummus.
It’s like going from the food version of Mt. Everest to the bunny hill at the old Nevele Hotel.
It all started with my PCP expressing annoyance that I tended to treat a visit to his office as a chore commensurate with taking the garbage out or cleaning up after the dog. When I visit him after a nearly four-year hiatus, he lets me know, in no uncertain terms, that just because I’m not overweight and I exercise regularly, that doesn’t necessarily equate to being in good health. Referring to my previous lab results, he points out that they are hardly of Hall of Fame caliber. In fact, he insinuates that I’m barely hitting at baseball’s Mendoza Line (named for a player with a lifetime batting average of .215).
And so he orders tests that show, much to my surprise and chagrin, that my cholesterol is high (215). Most disturbing is my LDL score which, if it were a college grade point average, would probably put me on probation. A subsequent test further reveals that I have plaque in the arteries leading to my heart, causing blockages that while not requiring any invasive procedures, clearly demands attention. “A blockage like this is a widow maker and he doesn’t take it seriously,” the aforementioned PCP screams at my wife, who makes the mistake of running into him at the suburban New Jersey hospital they both work at.
Not terribly professional, but he does get through loud and clear.
I schedule an appointment with a cardiologist, who puts me on a daily regimen of 20 grams of Crestor to lower my bad cholesterol. At the urging of my brother, I start a plant-based diet based on the book, Prevent and Reverse Heart Disease, written in 2007 by Dr. Caldwell Esselstyn, a one-time surgeon at the Cleveland Clinic. At around the same time, Esselstyn’s son, Rip, wrote the book The Engine 2 Diet (named for the firehouse in Austin, Texas where he worked as a firefighter). Both books became New York Times’ best sellers and Esselstyne father and son, joined by T. Colin Campbell, author of The China Study, are featured in the popular documentary Forks Over Knives.
The books and documentary all advocate a no fat, whole-food vegan diet as a way to cut inflammation and so avoid or reverse heart disease and several other chronic diseases. Recommended is the avoidance of refined and processed foods including sugars, bleached flours and oils, replacing them with whole grains, legumes, vegetables and fruits. Eat no food, the authors write, with a face or a mother (yay to quinoa and broccoli, nay to chicken and shrimp).
In other words, pretty much everything I used to eat is literally and figuratively off the table.
Plant-based diets are not the same as vegetarianism or veganism. People following some plant-based diets choose their foods primarily from plant sources (nuts, seeds, oils, whole grains, legumes and beans), but also occasionally consume some animal products (like non-fried poultry or fish, eggs and lowfat dairy).
My brother gives me his favorite recipes, like the one for bean burgers that proves the point that you can eat pretty much anything if you put enough ketchup or salsa on it. Vegetables become the cornerstone of the diet. This includes veggies like kale, for example, which has been hailed as America’s healthiest food. In a blender, it seems to mix well with everything, even fruit – sort of the food version of the poodle.
My brother, who has no heart disease, started following the senior Esselstyne’s diet nearly 10 years ago for the simple reason that people climb mountains: because he can. He swears by the diet, even though he looked like a zombie after the first few months on it, having dropped a good amount of weight. A close friend of mine, a dentist who believed strongly in science, suffered a less sanguine outcome. Arnie had years earlier required stents for a heart condition and, swearing by the diet, chose to ignore his doctor’s advice for more medical intervention. He would die, at age 59, from an apparent heart attack. The research shows that eating a highquality, plant-centered diet supports heart health, lowering the risk of cardiovascular disease by 52 percent, according to research published in the Journal of the American Heart Association. The study followed nearly 5,000 adults, ages 18 to 30 for over 30 years, finding that those whose diets regularly included the most nutritionally rich-plant foods and the fewest unhealthy animal products, such as high fat meats, were least likely to develop heart disease. Even people who shifted to such a diet as they aged benefited, regardless of the quality of their original diet. A separate study also published in the AHA Journal found similar benefits for postmenopausal women who ate more plant-based foods. Women who most closely followed a specific diet of plant-based foods known to lower cholesterol were 11 percent less likely to develop any type of cardiovascular disease. They lowered their risk for heart failure by 17 percent and coronary heart disease by 14 percent.
A new report published in Cardiovascular Research cuts to the chase: The best way to avoid heart disease is to eat whole and plant-based foods. According to the 2017 Global Burden of Disease study, poor food choices account for about half of all cardiovascular disease fatalities.
Andrew Freeman, a cardiologist and the co-founder of the Nutrition and Lifestyle Work Group at the American College of Cardiology, writes, “I’ve seen people whose diabetes, angina or blood pressure go into remission. I’ve seen autoimmune diseases go away when you cut inflammation. The best way to do that is with a plant-based diet, and people get better.”
Pretty compelling stuff. Yet, consuming a plant-based diet does not come without controversy. The consuming of “nightshades” – vegetables including tomatoes, peppers, eggplants, and potatoes (not sweet potatoes) – are verboten to celebrities like Tom Brady, football’s greatest quarterback, who shuns them by claiming, without evidence, that they contain an alkaloid called solanine that causes inflammation. Similarly, dietitians point to the importance of a diet containing omega-3 – found in flax seeds, walnuts, cauliflower, chia seed pudding, edamame, hemp seeds – to counteract those foods containing omega-6 – which are in chicken, dairy, fried and processed foods and eggs – that cause inflammation.
My sister, who is a vegan, and my daughter, who is a doctor, both strongly encouraged me to modify my plant based, no fat diet by including certain oils (e.g. from avocado, which I now do on a daily basis) and adding more protein (smoothies, nuts, eggs). My daughter, who spent more years in training than most murderers get in prison, uses her most doctorly manner by saying “you look like a homeless guy who hasn’t eaten in days” (as I’ve lost nearly 20 pounds and weigh less than I did in high school). My wife, who prepares most of the food for my diet, has no problem piling on.
Yet, somewhat sadly, I find I can’t help myself from feeling good when I climb on the scale, an acolyte of the adage “You can never be too rich or too thin.” I admit this to my daughter, who counters that it only goes to prove my anorexic tendencies and distorted sense of body image.
Of course, it’s not hard to lose weight when cutting down on virtually all guilty pleasures – nightly pasta dinners, ice cream desserts, baked goods for breakfast, weekend pizza splurges – while continuing to work out vigorously five days a week. That’s why I asked Sharon Savary, the Clinical Nutrition Manager at SBH and a Registered Dietitian for more than 30 years, to offer her thoughts on what she would recommend to stop the weight loss.
She suggests adding some foods with monounsaturated fat to my diet. For example:
Walnut butter. One ounce is about 185 calories and four grams of protein. Add it to toast or a celery stalk once or twice daily.
Quinoa. One cup of this grain contains 222 calories. It has eight grams of protein and five grams of fiber. It’s good as part of a soup or salad.
Tahini. One tablespoon contains 80 calories and 2.5 grams of protein. It’s good to add to a sandwich, salad or soup.
Sweet potato. One sweet potato contains about 180 calories and plenty of fiber, and is a good replacement for rice or pasta. Legumes. She suggests chickpeas, lentils or black beans. Of the three, I prefer the taste of the black beans, which include 227 calories and 15 grams of protein.
Two lab tests more than a month apart – the latest nearly five months after starting the diet and the medication – show my cholesterol is now well under control. Is it the diet? The medication? A combination of the two? Who knows? The cardiologist has cut the medication in half. My PCP doesn’t scream at my wife anymore. And my daughter, now that I’ve regained a couple of pounds, is no longer afraid she’ll find me living on the street. As for the diet, as much as I long for a return to my old eating habits, I’m a little afraid to rock the boat.
Pass the celery and the hummus.