Read an Excerpt
The New Ethics of Eating
By Erik Marcus
McBooks Press, Inc. Copyright © 2001 Erik Marcus
All rights reserved.
Heart disease — America's number one killer — has met its match. A landmark program established by Dr. Dean Ornish has shown that changes in diet and lifestyle can stop and, in some cases, reverse the damage done by heart disease. The diet that Ornish recommends is largely vegan.
The beat goes on
Think of all the people you know — from world leaders to a beloved relative — whose lives have been diminished by heart disease, or who have died of a heart attack or stroke. Think of the complex surgeries they undergo, the shelves of drugs they consume, the bills we all share in paying, the lost time and talents, the ruined lives, the grieving. Think about the irony of our acceptance of this set of tragedies as commonplace and "normal," when "normal" really should mean long life and many years of good health.
We have been prey to a disease of our own making. In our pursuit of the good life, we've piled our plates high with meats and creamy sauces. We've believed in the virtue of drinking big glasses of milk, even as grown-ups. In fast-food restaurants, we choose our meat, cheese, egg, and high-fat foods from appealing, full-color pictures.
"It's no surprise that half of all Americans develop heart disease," says researcher and clinician Dr. Dean Ornish, "because the typical U.S. diet puts everyone at risk."
The diet of prosperity has turned out to be a killer. A high-fat, animal-based diet is the single most significant cause of death from heart disease.
The good news is that, for many people, America's leading cause of death is no longer inevitable. Living healthy lives in general — reducing stress, exercising, not smoking — can help, but the most effective way to stop the progress of heart disease is to switch to an all-plant or nearly all-plant diet.
Let's look at the story of a man who, after suffering two heart attacks and a severe degree of disability, enrolled in Dr. Ornish's Opening Your Heart program. His health rapidly regained, this man — now 82 — hikes mountain trails as a pastime.
Midway on a transcontinental flight, an older man kept checking his watch. Nobody noticed. The passengers around him were caught up in the banalities of the flight — watching a forgettable movie, reading, and choosing between steak or chicken when the flight attendants wheeled the meal cart down the aisle. Pale, his forehead clammy with perspiration, and with his watch reminding him that the flight wouldn't touch down for another four hours, Werner Hebenstreit wondered if he would reach the San Francisco airport alive.
Worried that a second heart attack was striking, Werner felt confused by this invisible enemy.
Five years earlier, his first heart attack had nearly killed him. In the aftermath of this frightening experience, Werner, always a man to follow instructions to the letter, did exactly what the cardiologists told him to do. He stopped eating red meat and cut back on eggs. He swallowed a fistful of pills every day, enduring their numerous side effects. He tried to exercise moderately. Despite all this, his condition worsened. When out walking, he would sometimes be unable to finish crossing the street before the light changed. As honking cars sped by, Werner would stand exhausted in the middle of the intersection while his oxygen-starved heart struggled to keep beating. Neither medical advice nor his own determination was enough to stave off Werner's heart disease. Sick and weak, the 71-year-old Werner had boarded this flight in a wheelchair.
For most of his life, Werner had felt himself to be very healthy. He had excelled in boyhood sports, and as an adult, he was strong and vigorous. A courageous man whose life was forever changed by events in Nazi Germany, Werner had overcome a series of ordeals unthinkable to most Americans. Now, worried that a second heart attack was striking, Werner felt confused by this invisible enemy. He looked around the airplane and felt cheated, and very alone.
In fact, Werner need not have felt singled out — he merely topped the list of those on board whom heart disease would eventually kill. Sooner or later, nearly half his 400 fellow passengers would share his fate.
After decades of eating meat, dairy products, and eggs, Werner had unwittingly clogged his arteries to such an extent that the blood flow to his heart was seriously impeded. The buildup of cholesterol, fat, and cellular debris had so narrowed these major pipelines, that Werner's heart wasn't getting enough blood. Short episodes of this deprivation of blood, and hence oxygen, could bring on chest pains, or angina. If a blood clot were to get caught in one of the narrow places in Werner's arteries, cutting off the flow, it could result in the actual death of heart tissue; in other words, a heart attack.
Werner's fears were confirmed. He had his second heart attack on the airplane. He was met by an ambulance when the flight landed, and the other passengers saw him whisked away across the tarmac, not knowing if he would live or die.
Facing the ultimate enemy
In 1935, the Nazis began rounding up Jews in Werner Hebenstreit's native Germany. Werner was barely 20 years old when, on a moonless night, he kayaked down the Danube river into the safety of Austria. From there, it took him until the end of 1937 to reach India by hitchhiking east from country to country. He made his living playing a concertina in third-rate nightclubs. He decided to make India his home, though without a university education or even a trade or craft, opportunity was scarce. Nevertheless, he raised enough money to get his parents and sister out of Germany shortly before the outbreak of war in Europe. Once war was declared, the British sent Werner to an internment camp for two years, in the erroneous belief that he was a German spy.
Werner survived the internment and managed to keep his family alive. In 1946, they emigrated to San Francisco. Werner had a photographic memory and a business aptitude that he had honed during years of desperate wartime conditions. Shortly after arriving in San Francisco, he obtained a broker's license and began insuring German immigrants. Werner made the most of his skills of salesmanship and deal-making. In the 1950s he wrote thousands of insurance contracts. By the 1960s he was negotiating for a partnership in one of San Francisco's most prestigious brokerage firms.
Life was rewarding and full for Werner until his first heart attack in 1981. He slowed down and followed his doctors' orders, but became progressively more debilitated until his second attack in January, 1986. "After that, I felt nearly dead," says Werner. Four months later, tired and discouraged, Werner joined the first group of patients to enter Dr. Dean Ornish's program for reversing heart disease.
In Werner's career as an insurance broker, he had mastered the art of negotiation. And once he made a deal, he would move heaven and earth to hold up his end of the bargain. Werner survived the in-flight heart attack, but he knew now that it was time to make the deal of his life. A cardiogram had revealed the worst possible news: one coronary artery was completely closed up, and two others showed severe blockages.
"What can I do to get better?" he asked his cardiologist. "What kind of deal can I make to stay alive?" is what he was thinking.
The doctor wrote several new prescriptions for more powerful medication and sent Werner home. He was now armed with propanolol and nifedipine, whose effects helped to combat the angina pain, Isordil to reduce the load on his heart, and Persantine to prevent blood clots. The medications, while potentially saving his life, made him feel worse. Headaches, dizziness, nausea, depression, and fatigue were among the side effects.
Werner's life settled into a routine of sitting in a chair in his living room, swallowing fourteen pills throughout the day, and feeling constant pain, weakness, and fear. Any physical exertion, even shaving or combing his hair, shot fierce pains through his chest. As the weeks went by, Werner shrank further into his brown easy chair, awaiting the end. His only uncertainty was whether the heart attack that would finish him would strike in months or in hours. He was angry and bitter, and his tongue grew so sharp that only his wife Eva would spend time with him.
Then one day the Hebenstreits got an unexpected phone call. Eva answered it, listened for awhile, and then said to her husband, "A Dr. Dean Ornish wants to speak to you about a heart study." Another doctor wanting to make deals. Werner didn't hesitate: "Tell him I'm sick and tired of doctors."
But Dr. Ornish kept Eva on the line, telling her about his program. "Your husband fits exactly the profile we think we can help the most," he explained. Werner gestured angrily for Eva to hang up, but instead she carried the phone across the room to the brown easy chair. "At least listen to what he has to say." Werner scowled, then took the receiver and said icily, "Okay, Doctor, whatever you have to sell — I'm not buying."
Ornish laughed. "That's good, because I'm not trying to sell anything. Mr. Hebenstreit, I'm putting together a study of Bay Area residents who have had recent heart attacks and angiograms. We've developed a program that we think offers an effective treatment and a real possibility for improvement. I was hoping to get together with you to see if this is a program you would like to pursue."
"No offense, Dr. Ornish, but I don't see any reason to. I've already done everything my doctors advise. I'm so sick from the drugs I'm taking, I'm just not interested in experimental treatments."
"I understand, Mr. Hebenstreit. But a main point of this study is to replace drugs with dietary changes, moderate exercise, stress management, and group support. In my past studies, most of my patients soon became able to stop taking much of their medication."
Love and medicine
A medical doctor and researcher whose patients include celebrities and public figures, Dean Ornish is something of a celebrity in his own right. (A People magazine photograph published in June 1995 captured him clutching a guitar and leaping like a rock star across his living room floor.) Ornish was the first clinician to present findings that showed that changes in diet and lifestyle can reverse even severe heart disease without surgery or drugs. The results of his groundbreaking study appeared in the Journal of the American Medical Association (JAMA) in 1983 and in the British journal, The Lancet, in 1990. That same year, Ornish shared his revolutionary findings with the general public in a book titled Dr. Dean Ornish's Program for Reversing Heart Disease. The book quickly hopped onto The New York Times bestseller list, and each of Ornish's other books has enjoyed similar success. Eat More, Weigh Less, published in 1994, was reviewed in publications ranging from JAMA to Glamour.
Ornish grew up in Dallas, Texas. His father was a dentist and his mother a historian. A National Merit Scholar, Ornish entered Rice University only to drop out in his sophomore year. Feelings of depression led him to discover the healing qualities of meditation and a vegetarian diet. A year later, he resumed his studies, this time at the University of Texas. In 1975 he graduated first in his class. He enrolled in Baylor College of Medicine, where he became interested in cardiology and first began to research the potentially beneficial effects of diet and meditation in treating heart patients. Ornish received his M.D. in 1980, became a clinical fellow at Harvard Medical School, and fulfilled his internship and residency in internal medicine at Massachusetts General Hospital in Boston.
In 1984, Ornish founded the nonprofit Preventive Medicine Research Institute in Sausalito, California, where he and his colleagues focus on alternatives to surgery and drugs for the care and prevention of heart disease. A firm believer in such stress-relievers as meditation, yoga, moderate exercise, and group sessions to relieve feelings of isolation, Ornish combines many techniques in his Opening Your Heart program. In his book on reversing heart disease, he explains:
"Physically, this program can help you begin to open your heart's arteries and to feel stronger and more energetic, freer of pain. Emotionally, it can help you open your heart to others and to experience greater happiness, intimacy, and love in your relationships. Spiritually, it can help you open your heart to a higher force (however you experience it) and to rediscover your inner sources of peace and joy."
"That sounds very nice, Doctor, but I'm tired. And I really don't want to pay for another program that probably won't work. Good day."
But before Werner could hang up, Ornish responded, "Don't worry about cost — this study is funded. It won't cost you a dime to participate. Now if you and your wife can come to my office, I'd love to explain the program to you. What have you got to lose?"
After a long pause Werner sighed. "All right, Dr. Ornish," he said. "We will meet with you."
With that phone conversation, Werner had started on the road back to health and a full and active life. He didn't know it yet, but he was about to share in the success of a study that would redefine cardiac treatment. Werner was about to become one of the first Americans to experience a reversal of advanced heart disease.
THE EXPECTED WAY TO DIE
Heart disease is the leading killer of men and women in the United States. Almost one of every two Americans will die from heart disease. The numbers associated with it are staggering: 40 million diagnosed with heart disease, and 1.5 million a year having heart attacks. Cardiovascular disease kills over 700,000 U.S. citizens each year; one-fourth of the victims are under age 65. Much effort has gone into developing surgeries and drugs to help victims survive, but in the end, heart attacks are seen by many as a natural and expected way to die.
But heart disease is much less common in countries where people consistently eat low-fat diets containing minimal amounts of animal products. Low-fat, plant-based diets keep blood cholesterol levels low.
The risk of heart disease in China is only about 5 percent of the risk Western populations face.
According to Antonio Gotto, past president of the American Heart Association, societies whose average blood cholesterol is very low have virtually no coronary heart disease or atherosclerosis — hardening of the arteries which leads to cardiovascular disease. The risk of heart disease in China is only about 5 percent of the risk Western populations face. In Japan, life expectancies exceed those in the U.S. at every age, but when Japanese people move to this country and start to eat as we do, their mortality rates become indistinguishable from ours.
In fact, over 200 studies involving people who move from one country to settle in another have shown that atherosclerosis is largely a disease of dietary lifestyle. New arrivals in this country who adopt the American diet, or supplement their largely plant-based meals with American fast-food or meat-centered dishes, often give up their freedom from heart disease.
Over the past several years, the evidence implicating elevated serum, or "blood," cholesterol as a major risk and causal factor in cardiovascular disease has grown conclusive. A 1984 National Institutes of Health panel of experts agreed that an "elevated blood cholesterol level is a major cause of coronary heart disease," and in 1990, the American Heart Association issued a report stating: "The evidence linking elevated serum cholesterol to coronary heart disease is overwhelming." By 1995, medical textbooks covered the issue with phrases like, "Evidence incriminating cholesterol in coronary heart disease is extensive and unequivocal."
High blood cholesterol is one of three major risk factors for cardiovascular disease, along with smoking and high blood pressure.
Lack of exercise, obesity, stress, diabetes, or a family history of heart disease are also contributing factors. Esteemed cardiology expert, William Roberts, however, has concluded that the most significant risk factor for heart disease is the lifetime presence of a blood cholesterol level above 150. (Cholesterol is measured in milligrams per deciliter of blood. People at high risk for heart disease may have cholesterol levels of over 300. The average cholesterol level of vegans in the U.S. is 128.) Roberts pointed out that even in the presence of other common risk factors, arteries just will not harden when cholesterol levels are low.
Excerpted from Vegan by Erik Marcus. Copyright © 2001 Erik Marcus. Excerpted by permission of McBooks Press, Inc..
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